"Quantifying corruption losses in health" Transparency-Morocco contribution. TAOUJNI SAAD;Avril 2023

Dear moderator and speakers of the panel  organized by Transparency International and the USAID on April 18, 2023.

In the link sent with the email of April 16, 2023, two sentences caught my attention. The first statement suggests that corruption in the health sector has an economic impact of $500 billion annually, which is sufficient to achieve Sustainable Development Goal 3, which aims to ensure good health and well-being for all. The second statement indicates that corruption costs the developing world $1.26 trillion each year, which is nine times more than all Official Development Assistance (ODA), provided annually.

I do not agree with the statement by Samantha Power, USAID Administrator. Last week (April 12, 2023), the Organization for Economic Cooperation and Development (OECD) announced that ODA totals $204 billion. The increase in ODA was driven by aid to Ukraine as well as support for refugees. If we estimate corruption at $1.26 trillion (a figure which is already difficult to accept), then it is only six times the ODA. How was Mrs. Samantha Power able to quantify the global cost of corruption?

I strongly condemn, of course, any form of corruption, but I wonder about some other effects resulting from the unbridled liberalism coming from the North. All of us are looking for a little more transparency in this field.

I have two questions. First, why is TI interested only in corruption in the public sector, all combined areas, rather than condemning corruption in the private sector? Many Poor People suffer from the effects of Corruption in health care, social protection and medicine and the laws of certain countries prohibit such practices.

I would like to know your thoughts about corruption in these private sectors, where many bad practices occur. These sectors are capable of securing profitable laws and agreements from governments and international organizations that provide them with certain advantages at the expense of the population's lives.

Secondly, how can we quantify some other effects on the health systems of developing countries, such as the impact of the pharmaceutical industry's monopoly (The Big Pharma), lobbying, the absence of drug price controls, and TRIPS agreement effects? The Agreement on Trade-Related Intellectual Property Rights (TRIPS), created by the World Trade Organization (WTO) in 1995, treats medicine like any other goods. Joseph Stiglitz argues that TRIPS represents the triumph of the particular interests of the great European and American multinationals over the general interests of billions of people in developing countries, condemning millions to death

How can we quantify other effects on 100 million indebted American citizens suffering from the lack of price controls on medication and healthcare? This system lets monopolies decide prices alone in the absence of any invisible hand. For me, lobbying and monopolies likely must cost more than corruption.

The health system American model is the most expensive and the least efficient in Wealthy countries, and it should not be exported.

 SAAD TAOUJNI

Consultant, researcher in health systems and in social protection, more especially in universal health coverage (UHC), and in health economy. Expert in hospital management and in health insurance organizations.

Jurist and an activist fighting for universal social security and healthcare coverage for all. Also, militant for gender equality and against corruption. Member of Transparency Morocco and the Moroccan Institute of International Relations (MIIR). Member of the Moroccan Social Protection Observatory.