Consider the equation:

B_p > C_psy + pp (C_crim + C_soc) + C_fav

“In this equation, B_p represents the perceived benefit of an act of corruption, C_psy the psychological costs, pp the perceived probability, C_crim the criminal costs, C_soc the social costs to the individual, and C_fav the costs of doing the corrupt act.” [1]

An interesting and very well written article in the Lancet by Patricia Garcia tackles the problem of corruption in global health.[1] She outlines the enormous extent of the problem and describes the huge costs to society of rampant, endemic corruption. She also outlines the many and various forms that corruption can take, from absenteeism to diversion of funds.

The earlier equation suggests that the problem must be tackled at many levels. Importantly, care providers and managers need to resist temptation and behave with high rectitude. The personal psychological cost of engaging in corruption is high for high rectitude people. However, corruption can become institutionalised and part of the culture. In that case, it is not possible to rely on individuals and the culture has to be changed and dis-incentives must be introduced.

People sometimes excuse corruption on the basis of poverty and poor pay. Yet News Blog readers might remember a study in which higher pay for the police did not reduce the amount of money collected illegally.[2] The Author calls on more research into the prevention of corruption.

Richard Lilford, ARC WM Director

References:

1. Garcia PJ. Corruption in Global Health: the Open Secret. Lancet 2019; 394: 2119-24.
2. Foltz JD, Opoku-Agyemang KA. Do higher salaries lower petty corruption? A policy experiment on West Africa’s highways. London, UK: International Growth Centre (IGC); 2015.