World Health Organization Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector, 144 College Street, Toronto, ON, M5S 3M2, Canada.
Leslie Dan Faculty of Pharmacy, Canada University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada.
Global Health. 2023 Nov 24;19(1):91. doi: 10.1186/s12992-023-00994-x.
Health systems are often susceptible to corruption risks. Corruption within health systems has been found to negatively affect the efficacy, safety, and, significantly, equitable distribution of health products. Enforcing effective anti-corruption mechanisms is important to reduce the risks of corruption but requires first an understanding of the ways in which corruption manifests. When there are public health crises, such as the COVID-19 pandemic, corruption risks can increase due to the need for accelerated rates of resource deployment that may result in the bypassing of standard operating procedures.
A rapid review was conducted to examine factors that increased corruption risks during the COVID-19 pandemic as well as potential anti-corruption, transparency and accountability (ACTA) mechanisms to reduce these risks. A search was conducted including terms related to corruption, COVID-19, and health systems from January 2020 until January 2022. In addition, relevant grey literature websites were hand searched for items. A single reviewer screened the search results removing those that did not meet the inclusion criteria. This reviewer then extracted data relevant to the research objectives from the included articles. 20 academic articles and 17 grey literature pieces were included in this review. Majority of the included articles described cases of substandard and falsified products. Several papers attributed shortages of these products as a major factor for the emergence of falsified versions. Majority of described corruption instances occurred in low- and middle-income countries. The main affected products identified were chloroquine tablets, personal protective equipment, COVID-19 vaccine, and diagnostic tests. Half of the articles were able to offer potential anti-corruption strategies.
Shortages of health products during the COVID-19 pandemic seemed to be associated with increased corruption risks. We found that low- and middle-income countries are particularly vulnerable to corruption during global emergencies. Lastly, there is a need for additional research on effective anti-corruption mechanisms.
卫生系统往往容易受到腐败风险的影响。卫生系统内部的腐败已被发现会对卫生产品的效果、安全性，以及显著的公平分配产生负面影响。实施有效的反腐败机制对于降低腐败风险很重要，但首先需要了解腐败表现的方式。当发生公共卫生危机时，如 COVID-19 大流行，由于需要加速资源部署速度，可能会绕过标准操作程序，腐败风险可能会增加。
进行了快速审查，以研究 COVID-19 大流行期间增加腐败风险的因素，以及潜在的反腐败、透明度和问责制 (ACTA) 机制来降低这些风险。从 2020 年 1 月至 2022 年 1 月，搜索了与腐败、COVID-19 和卫生系统相关的术语。此外，还对相关灰色文献网站进行了手工搜索。一名审查员筛选搜索结果，剔除不符合纳入标准的结果。然后，该审查员从纳入的文章中提取与研究目标相关的数据。本综述纳入了 20 篇学术文章和 17 篇灰色文献。纳入的文章大多描述了不合格和伪造产品的案例。一些论文将这些产品的短缺归因于伪造版本出现的主要因素。描述的腐败事件大多发生在中低收入国家。确定的主要受影响产品是氯喹片、个人防护设备、COVID-19 疫苗和诊断检测。一半的文章能够提供潜在的反腐败策略。
COVID-19 大流行期间卫生产品短缺似乎与腐败风险增加有关。我们发现，中低收入国家在全球紧急情况下特别容易受到腐败的影响。最后，需要进一步研究有效的反腐败机制。
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