Full text PDF - International Policy Network

Corruption in public health 117The absence of basic information, regular audits and monitoringevidence define an environment that invites misconduct. AsColombia implemented Law 100 reforming its health care systemit unearthed extensive corruption and mismanagement in reportingand record keeping in public programs. In response theMinistry of Health set up a nationwide database for data matchingand payment controls to identify and correct abuses that wereresulting in paying “ghost” workers, among other problems. Thatcombined with a multimedia campaign informing citizens of theirrights and obligations under the newly reformed system provideda segue-way into better oversight and involvement of citizens(Soto, 2002).Drug procurement poses multiple challenges and Chile’s experienceis instructive in how to institute reforms that serve multipleobjectives. Chile’s drug and medical supply system run by the government,CENEBAST, was plagued with poor management, frequentstock outs and overstocks of other medicines. The reform was builtaround a shift from a rules-based system to one grounded in transparencyand good incentive structures. Its main components were:(1) introducing electronic bidding for pharmaceuticals; (2) reform ofCENEBAST to change its mandate to procurement agent for hospitalsand other providers who define drug priorities; and (3) informationdissemination that let it be known that pharmaceuticalprocurement would be under scrutiny. An important element of theinstitutional reform was allowing other agencies and the privatesector to purchase, store and transport drugs, removing CENEBAST’smonopoly position.The reform reduced information asymmetries between providersand the procurers of pharmaceuticals. and produced clear and fairrules resulting in bids from a broader spectrum of companies andlower prices for government hospitals and clinics. Overall in 1997,US$ 4 million was saved just in pharmaceutical purchases (Cohenand Montoya, 2001).Nigeria has taken an aggressive stance on the issue and has rootedout considerable illegal manufacturing, identified substandard