All It Takes for Corruption in Health Systems to Triumph, Is Good People Who Do Nothing; Comment on “We Need to Talk About Corruption in Health Systems”

Document Type : Commentary


1 Department of Pediatrics, Amsterdam UMC, Amsterdam, The Netherlands

2 Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands


Numerous investigations demonstrate that the problem of corruption in the health sector is enormous and has grave negative consequences for patients. Nevertheless, the problem of corruption in health systems is far from eminent in the international health policy debate. Hutchinson, Balabanova, and McKee have identifed in their Editorial five reasons why the health policy community has been reluctant to talk about it: (1) Problem of defining corruption; (2) Some corrupt practices are actually ways of making dysfunctional systems work; (3) The serious challenges to researching corruption; (4) Concerns that focus on corruption is a form of victim blaming that ignores larger issues; and (5) Lack of evidence about what works to tackle it. In this commentary, we pay a closer and critical look at these five excuses for doing nothing. We conclude that the vast majority of the world population, being the poor in low and middle-income countries (LMICs) who disproportionately suffer from the problem of corruption in health systems, need good people with high moral and ethical principles who have the courage to disregard these five reasons. The poor need good people who understand that it is crucial to first acknowledge this problem, despite the obvious uncertainties involved, before you can change it. The poor therefore need good editors, good policy-makers, good managers, and good clinicians. We agree with the authors that we first need to talk about corruption. But above all, we need good people who are subsequently willing to walk the talk.


Main Subjects

  1. Hutchinson E, Balabanova D, McKee M. We need to talk about corruption in health systems. Int J Health Policy Manag. 2018;8(4):191-194. doi:10.15171/ijhpm.2018.123
  2. Mostert S, Njuguna F, Olbara G, et al. Corruption in health-care systems and its effect on cancer care in Africa. Lancet Oncol. 2015;16(8):e394-404. doi:10.1016/s1470-2045(15)00163-1
  3. Transparency International. Global Corruption Report 2006.   
  4. Alatas SH. The Problem of Corruption. Singapore: Fong & Sons Printers; 1986.
  5. Mostert S, Sitaresmi MN, Njuguna F, van Beers EJ, Kaspers GJ. Effect of corruption on medical care in low-income countries. Pediatr Blood Cancer. 2012;58(3):325-326. doi:10.1002/pbc.23408
  6. Einterz EM. International aid and medical practice in the less-developed world: doing it right. Lancet. 2001;357(9267):1524-1525. doi:10.1016/s0140-6736(00)04640-7
  7. Lewis M. Governance and corruption in public health care systems. Center for Global Development website.  Published January 26, 2006.
  8. Adusei LA. Hiding Africa's looted funds: The silence of Western media. WikiLeaks website.  Published June 18, 2009. 
  9. Conde A. At Davos, the west must help us root out corruption in Africa. The Guardian; January 22, 2014.
  10. Gumede W. FPC Briefing: Corruption Fighting Efforts in Africa Fail Because Root Causes Are Poorly Understood. Published 2012.
  11. Mostert S, Arora RS, Arreola M, et al. Abandonment of treatment for childhood cancer: position statement of a SIOP PODC Working Group. Lancet Oncol. 2011;12(8):719-720. doi:10.1016/s1470-2045(11)70128-0
  12. Mostert S, Njuguna F, Langat SC, et al. Two overlooked contributors to abandonment of childhood cancer treatment in Kenya: parents' social network and experiences with hospital retention policies. Psychooncology. 2014;23(6):700-707. doi:10.1002/pon.3571
  13. Mostert S, Njuguna F, van de Ven PM, et al. Influence of health-insurance access and hospital retention policies on childhood cancer treatment in Kenya. Pediatr Blood Cancer. 2014;61(5):913-918. doi:10.1002/pbc.24896
  14. Mostert S, Lam CG, Njuguna F, Patenaude AF, Kulkarni K, Salaverria C. Hospital detention practices: statement of a global taskforce. Lancet. 2015;386(9994):649. doi:10.1016/s0140-6736(15)61495-7
  15. Mostert S, Njuguna F, van der Burgt RHM, et al. Health-care providers' perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya. Pediatr Blood Cancer. 2018;65(8):e27221. doi:10.1002/pbc.27221
Volume 8, Issue 10
October 2019
Pages 610-612
  • Receive Date: 30 April 2019
  • Revise Date: 22 June 2019
  • Accept Date: 22 June 2019
  • First Publish Date: 01 October 2019