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62 Diagnosing Corruption in Ethiopia
and are frequently pressured by legislative representatives, executive
branch officials, and sometimes even the courts, in ways that begin to
undermine them. One of the simplest and most effective ways that
Ethiopia can address corruption in its health sector is for the president,
ministers, legislators, and media to courageously stand behind and support
effective and responsible control agencies and investigators.
Notes
1. Data presented in the text refer to 2008 unless otherwise specified.
2. The Marginal Budgeting for Bottlenecks planning software is used for health
policy planning, costing, and budgeting. It was developed by teams from the
United Nations Children’s Fund, the World Bank, and the ministries of health
in several countries and can be found at http://www.devinfolive.info/mbb/
mbbsupport.
3. These estimates are highly uncertain. Precisely because of the extent of
coordination, it was difficult to know whether published reports adequately
distinguished sources of funds. So, for example, portions of foreign
aid that go through Channel 1 and Channel 2 may be double-counted. In
addition, reports frequently fail to distinguish commitments from disbursements.
4. Ethiopia was engaged in such an assessment, but the results were not available
for this study.
5. According to a response from the FMOH, many of the “risks entailed” in issuing
licenses and regulating drug sales would be limited through ongoing
interventions aimed at “institutionalizing and enforcing standards and codes
of ethical conduct among all health sectors” (FMOH 2010).
6. According to a response from the FMOH, guidelines and procedures for
addressing service users’ complaints have been drafted as part of a larger
regulatory framework on food products, drugs, health professionals, and
health facilities (FMOH 2010).
7. WHO’s National Health Accounts data show that Ethiopia received about
US$50 million in foreign aid to health in 1998, rising to about US$100 million
in 2001 (WHO 2004). The 2005 National Health Accounts study estimated
foreign aid to the sector at US$193 million (HCFT 2006). Our calculations
suggest that foreign aid to Ethiopia’s health sector has more than doubled in
the past few years, probably exceeding US$500 million in 2008.
8. According to a response from the FMOH, efforts were under way at the time
of the assessment to address issues with the internal and external audit system,
and this study could not assess progress that may have been made in this
area (FMOH 2010).