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Corruption burns universal access
Zimbabwe Lawyers for Human Rights (ZLHR)
October 01, 2010

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http://www.zlhr.org.zw/index.php?option=com_content&task=view&id=55&Itemid=124

Foreword

It has unfortunately become routine to say that corruption is a curse for developing countries on their way out of poverty. Corruption diverts highly needed public monies from their initial use into private hands, leads to inefficient public investment, and causes a lack of private investment. Corruption in the health sector is probably one of the most detrimental faces of the problem because life is directly at stake. If treatment is made conditional to corrupt practices, it could well be that the lives of those who cannot afford paying bribes will be endangered. In the case of HIV/AIDS, the danger is even higher, as there is no cure for the disease, despite the mitigation effect of antiretroviral treatments. This issue is even more pressing in a country like Zimbabwe - one of the countries affected the most by the pandemic.

This is why a study like this is extremely important, both from a health perspective, and a governance perspective. Various corruption practices have been found in the interaction between people living with HIV/ AIDS and hospital personnel. Results are shocking: the majority of respondents of the survey acknowledge being forced to pay bribes, either to be enrolled in the treatment scheme, or to receive ARVs. The mere fact that 10% of the patients who refuse to pay bribes are being taken care of is an encouraging sign in this dark picture.

The figures shown in this study definitely call for action. One can argue that informal payments are being solicited as a livelihood strategy by poorly paid health personnel. This certainly holds true to a large extent. However this assumption does not prevent a government from taking action within a health sector reform process.

Systemic change is needed in order to allocate existing resources more efficiently, to possibly increase the share of the health budget in the total state budget, and eventually to pay better salaries.

Accountability mechanisms must be put in place and monitored; ethics training must become part of the health curriculum and jobs terms of references.

At the other end of the spectrum, civic action and human rights advocacy groups can hold the authorities and the health staff accountable for their results and practices. By repeating the urgency of the situation, civil society organisations can certainly help in moving the anticorruption agenda within the health sector forward and make people more aware of the serious consequences on health of governance deficiencies. To that end, well-researched and grounded work, such as what has been produced here by the Zimbabwe Lawyers for Human Rights, is needed. Hard facts, as those presented here, widely distributed among the health community, will hopefully create momentum for changing mindsets and practices.

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