Corruption in healthcare service delivery directly affects human life and impedes happiness and well-being. 

Corruption does not only deprive people from easily accessing health care through qualified hospitals, but also extends to fraudulent medicines, and trafficking in human organs, medical devices and equipment that may lead to the death of innocent people.

The world annually spends more than $ 3 trillion on health services, which are funded by humanitarian aid and local taxes. Such large financial inflows constitute a tempting target for abuse, fraud and manipulation.

The diversity of global health systems and the complex combination of the different actors involved, the scarcity of good records maintained in many countries, the complexities of distinguishing corrupt practices, the inefficiency and minor mistakes make it difficult to determine the total costs of corruption in this sector.

The United States, for example, which spend 15.3 percent of its national income on health care, have two health care programs - Medicare and Medicaid. The two programs estimate that 5-10 percent of their budget is lost in the "increased cash payments burden" process. 

A comprehensive healthcare program known as "Obamacare" was developed under President Barack Obama to prevent opportunities for corruption in the American health system.

In Cambodia, health practitioners interviewed for the World Corruption Report 2014 estimated that more than 5% of the health budget is lost to corruption even before it leaves the central government.

In Nigeria, cases were detected where forgers used to substitute life-saving adrenalin and other active ingredients with water, which would cause some kind of poor health condition and adversely affect resistance to malaria, tuberculosis and HIV (AIDS).  According to the German website Deutsche Welle (DW), quoting the German website "Frankfurter Rundschau", by 2018, there were 37.9 million registered cases of HIV positive worldwide. In 2018 alone, 1.7 million people were infected with the virus, and 770,000 persons infected with AIDS died worldwide in 2018.

In the UK, the Anti-Fraud Unit of the National Health Services reported that, since 1999, corruption cases worth more than £ 170 million were stopped. Accordingly, the total financial benefits of the National Health Services Unit quadrupled to an amount enough to build 10 new hospitals.

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Corruption in health services involves the provision of bribes to operators of health services and medical professionals. It also affects areas of manipulation of information about drug testing, drug conversion, medical supplies, purchases and insurance companies' bills.

Many factors make all health systems in rich and poor countries vulnerable to corruption, whether funded by the public or private sector, including:

• Lack of accurate information on diseases, medicines and medical equipment in health systems and with health sector professionals. • Lack of studies of health forecasts that reveal who will be sick at a given moment, when the disease will occur, what types of diseases people will face and what appropriate and effective treatments are. • The complexity of health systems and the large number of parties involved therein multiply the difficulties and problems with regard to the generation and analysis of information and corruption detection and prevention. The relationships between medical suppliers, health care providers and policy makers are ambiguous and non-transparent and can lead to distorted public health policies.

Types of corruption in healthcare:

• Embezzlement and thefts from budget funds or from user fees return. • Corruption in procurement by engaging in bribes; failure to promote and encourage quality contractual standards; financial expenditure in hospitals, construction and purchase of expensive technologies. • Corruption in payment systems that include corrupt practices; waiver of fees; falsification of insurance documents for specific patients; use of hospital budgets for the benefit of certain favored individuals; illegal invoicing of insurance companies, falsification of invoice records and creation of imaginary patients. • Corruption in the medical supply chain where medical products are prone to diversion or theft at certain points in the distribution system. • Corruption at the health service delivery point where it can take many forms such as blackmail, accepting payments secretly for services that are supposed to be provided free of charge, demanding payment for special privileges or treatment or accepting bribes to influence decision-making.

- In the United Arab Emirates, we get more reassured when we hear the nation's voice. His Highness Sheikh Mohammed bin Rashid Al Maktoum says: “here in the UAE, we promise you all, me and my brother His Highness Sheikh Mohammed bin Zayed Al Nahyan, that we will never allow corruption”. With this, the homeland's voice continues to ring in our hearts, and we feel more reassured. We are so much grateful to Allah for the presence of these wise leaders around us. They deserve all our love, sincerity, dedication and cooperation in order to combat all types and forms of corruption.

Emirati writer and researcher

Member of the UAE Authors and Writers Union

Adel Abdullah Humaid