The current study of the Cyprus Integrity Forum (CIF) highlights the pitfalls that must be avoided to preserve the sustainability of our country, social equality and environmental integrity, and above all to protect the prestige of our country as a state of law and morality and not as a centre of opportunistic corruption as some have accused us of in the past and are waiting for the opportunity to do the same in the future.
The COVID-19 pandemic is not exclusively a major health challenge for the whole world, but at the same time, an opportunity for all governments and partners to try their effective will to manage the various parallel losses created primarily by the economy. It is precisely this global challenge that will highlight the true honesty and transparency of what is often said by all governments around the world.
The will and policy pursued to date by the Government of Cyprus to manage this virus has proved to be quite successful, ranking our Cyprus as one of the safest countries in the world, leaving behind countries such as the United Kingdom, Germany, Italy, France, or Spain.
What we are expected to show now is our effective will for rationalisation and full transparency in management of the damages caused by this pandemic, especially in the economic sector. Easy solutions are many, but very few are really transparent and timeless fixed solutions, which are not prone to various forms of corruption and will not perpetuate the stigma of social inequality and lack of real integrity. These few solutions also need the appropriate political courage and morality to implement them.
This is an excellent opportunity to highlight our new Cyprus. We expect that the government's moves and various partners will be commensurate with the effective steps taken since the first day to manage the virus.
As CIF, we will support such effective measures. However, at the same time, we will remain strict judges in case of promotion of opportunistic or ineffective measures that will jeopardise the prestige and reputation of our country and perpetuate the accusations of previous years, based on a lack of transparency, sustainability, timeless stability and ethics.
The COVID-19 pandemic requires rapid global action. Currently, 212 countries and regions around the world have been affected, with over 6.2 million confirmed cases and nearly 380,000 deaths reported. Many countries have imposed restrictions on public life to reduce the pandemic, setting limits on unnecessary activities such as travel and social gatherings, and closing schools, offices, universities and leisure facilities.
According to Transparency International, “During crises like the outbreak of a deadly virus, the risk of corruption in healthcare is exacerbated by dramatically increased pressure on the system. Disruption, uncertainty and distraction contribute to an environment, in which corrupt actors can take advantage of the crisis for their own benefit”
It is essential to maintain and expand transparency, openness and integrity throughout the health sector. Several critical measures can be taken against corruption, including the open publication of research on vaccines and treatments, the protection of whistleblowers in health systems, and the provision of equal access to life-saving therapy.
However, the need for transparency and accountability goes beyond health systems themselves.
Meaning of Corruption and Its Relation to Health Sector
Corruption is the abuse of power for private gain. The World Health Organization (WHO) refers to corruption in relation to global health as “misappropriation of authority, resources, trust or power for private or institutional gain that has adverse effects on regional, local or international health systems and/or that negatively impacts individual patient and/or population health outcomes” (Mackey and Liang 2012).
The exact economic cost of corruption affecting the health sector is unknown. WHO estimates that of the $5.7 trillion spent on health worldwide in 2008, $415 billion (7.3%) was lost to fraud and healthcare abuse. Using the data collected from 33 organisations in 7 countries, one study (Gee and Button 2015), estimates that global average losses from fraud and healthcare abuse in 2013 were 6.19% ($455 billion of $7.35 trillion in global healthcare spending). It is noted that these occur in periods outside the pandemic.
The GRECO Guidelines
The Council of Europe's Anti-Corruption Group (GRECO) has published guidelines aimed at 50 member states to prevent corruption in the context of the health emergency caused by the COVID-19 pandemic.
Guidelines issued by GRECO President Marin Mrčela emphasise that the pandemic increases the risks of corruption. The healthcare sector is especially exposed, particularly due to the growing need for emergency medical supplies and the simplification of procurement rules, the need to find facilities, and overloaded medical staff.
The president of GRECO stated that, "decisions related to measures by central, regional and local authorities to face the pandemic must be transparent and subject to oversight and accountability. Whistleblowers in the health sector must be protected.”
Transparency in the public sector is one of the most important means of preventing corruption, regardless of the form. “The need for regular and reliable information from public institutions is crucial in times of emergency. This concerns the spread and risks of the pandemic as such, but also emergency measures taken in response to them. We should not allow COVID-19 to compromise our values and our standards, including transparency and accountability. Digital information platforms, such as dedicated transparency portals, are valuable corruption-prevention tools and instrumental in protecting the rule of law.”
Corruption practices can affect the public or private sector and be linked to the procurement system, bribery in medical services and corruption in research and development of new products, including conflicts of interest and the role of interest groups. There is also the risk of fraud involving the marketing of counterfeit medical products, which in turn poses serious risks to public health.
Lessons Learned and CIF Contribution
As CIF, we would like to point out that corruption develops even more in times of crisis, especially when institutions and control systems are weak and public confidence is low. Before they occur, identifying corruption risks can help strengthen the global response and provide health care to those who need it most.
Given the guidelines, reports and announcements of the global bodies involved, it is important to pay close attention to the following:
- Supply of medicines and medical equipment.
- Price control. Due to shortages of medicines and other goods and services, there is increased pressure and demand, and the risk increases of suppliers charging higher prices.
- Exchange of information on deficiencies. Without transparent information on medicines that may be deficient, health systems have no way of preparing other solutions, such as finding alternative manufacturers.
- Funding for the treatment and development of vaccines. With substantial outflows of money, governments should work to monitor funds to ensure that it is not used to manage personal interests.
- Transparency of clinical trial data. The development of antiviral medicines and vaccines must be a transparent effort, rather than a secret competition between private companies or even national governments.
- Prevention of general misinformation and complaints protection. There are serious concerns about the spread of misinformation and the threats that some may face in order to not talk about irregularities that may occur. The establishment and strengthening of the system for the protection of public interest witnesses play a key role in the transparent process followed in the management during the period of pandemic and crises in general.
- Risks of bribery. In some countries, medical providers face very difficult decisions about which patients should be treated based on who needs care the most. This creates fertile ground for bribery.
- Various charity organisations created amid the pandemic for raising funds that are ultimately made available to terrorist organisations.
- Various techniques of social engineering created with the widespread use of technology to collect personal or corporate information that will eventually be used by fraudsters.
The existence of open and transparent contracting procedures and the implementation of effective controls help to reduce risks. Helping and implementing more effective procedures to help citizens, and especially the most vulnerable groups during a pandemic, should in no way be confused with and misinterpreted as the withdrawal of control measures and substantial due diligence. Governments must act in an open and transparent manner in order to build and maintain public confidence. As the COVID-19 pandemic continues to spread, we need to have open and honest discussions about the vulnerabilities of health systems that make them more vulnerable to corruption.
We at CIF remain at the forefront of making sure that transparency continues to be the most important front and foundation for the rational approach to any challenge, even this serious pandemic. We are ready to provide any assistance and guidance to both citizens and the business world of Cyprus in this direction.
The Cyprus Integrity Forum (CIF) was established in 2011 and is today the leading institution in Cyprus for the fight against corruption and promotion of transparency. It is an independent, non-governmental, non-politically partisan and non-profit organisation. CIF collaborates with various organisations in Cyprus, Europe and the USA to effectively raise public awareness in all layers of society for combating corruption in our everyday lives, enhance the content and quality of public and corporate governance in all forms of business and ensure that the State and all Governmental Bodies act and behave in a manner that promotes transparency and ethics in all respects.