DiscoverKickBack - The Global Anticorruption Podcast28. Taryn Vian on corruption risks in the health sector & distrust in science in times of COVID-19
28. Taryn Vian on corruption risks in the health sector & distrust in science in times of COVID-19

28. Taryn Vian on corruption risks in the health sector & distrust in science in times of COVID-19

Update: 2020-04-06


Taryn Vian (@TarynVian), Prof. at the Department of Population Health Sciences, School of Nursing and Health Professions, University of San Francisco (USF).

For people who think about the relationship between corruption & public health, what are some of the main lines of research & what are some of the important findings?
Taryn outlines that one main problem lies in the fact that people have to pay doctors for public health services that are supposed to be free of charge. Quantitative & qualitative studies have investigated why people pay doctors & how they know why they have to pay or give “gifts” while intervention has tested how corrupt practices like informal payments & absenteeism can be reduced.

What does health care corruption- look like during times of emergencies in comparison to “normal times”?
Taryn points out that one of the risk factors for corruption during emergencies stems from the pressure to finish things quickly. Such pressures can create incentives to ignore controls. As a result, higher tolerance of saying “we’ll figure out the paperwork later” often emerges.

In an emergency situation is it even more important that we stick to corruption guidelines or not? How do you implement the right measures in emergency situations?
Taryn describes audits conducted by the catholic relief service after a natural disaster revealing 100 findings. Yet, closer examination often revealed that minimal mistakes were committed such as a single missing signature out of four. This suggests that we need to find a different procedure for times of emergency. There are streamlined processes e.g. for the procurement of emergency medicine.
How many countries in the world have implemented emergency measures/procedures? Are there examples?
There were gaps in procurements of test kits in the US because the US proceeded as business as usual. Many countries have emergency procurement procedures. The question is how to launch such special procedures at the right time for the right products & also still holding people accountable.

What observations do you have on a relation between the coronavirus pandemic & corruption?
One place where Taryn sees a link between corruption & the Coronavirus play out is in the US. Here, one of the big problems is that the government has not appointed actors, which undermines the trust between decision-makers & scientific leaders. There is a lack of trust in science in our government right now. The personalization of power is a big problem. Such distrust can have very adverse effects.

In a public health crisis, the government needs to give directives to people. Directives that are not popular. If there is no trust in the government, people will not want to follow their directives.
Yes, e.g. Ebola crisis in Sierra Leone & Liberia. People were actively avoiding government directives because there was no trust. Corruption during “normal” times eroded the trust towards the government bodies which undermines emergency response efforts as people might to not comply with the recommendations or orders of the government.

Informal payments & bribes during normal times do have an adversarial effect on trust in the payment system. Can you elaborate on the evidence for this claim?
Dagmar Radin looked at the connection between corruption & trust. She argued that there is a connection. Other work showing similar links stems from Nicaragua, where a comparison of social audits over a 4 year period has been conducted, showing that trust increased when the government tried to work against informal payments.

Which measures have been effective in reducing corruption in the health sector under control?
There is a famous study on community monitoring in Uganda by the World Bank showing promising effects of involving communities to increase accountability. However, studies by the Harvard Kennedy School in Tanzania did not exactly replicate the findings above. There have been many interventions against corruption.
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28. Taryn Vian on corruption risks in the health sector & distrust in science in times of COVID-19

28. Taryn Vian on corruption risks in the health sector & distrust in science in times of COVID-19