Prescription for Failure: The Need for Addressing Corruption in India

| October 19, 2011 | 0 Comments

One of the many ways India is trying to innovate in the health sector: biometric scanning programs to track patients’ progress on treatment.  Photo courtesy of Operation ASHA.

By Vishal Arora
Health Policy Columnist

This past September, the New York Times ran a story about three Indian health officials being shot to death within a span of one year.  All three of them were involved in transactions dealing with the healthcare budget of Uttar Pradesh, a state within India.[1] Speculations about the killings center around kickbacks these men might have received, even though Uttar Pradesh is noted to have some of the worst quality of care within India.  Stories concerning corruption like these are deeply problematic, especially considering India’s advancing global presence.

This is not the first time Uttar Pradesh has received this type of media attention.  Another egregious healthcare failure occurred this past August for government-run clinics within the state.  Roughly 8,500 crores ($1,729,756,140 USD) were mismanaged and only a small fraction of that money actually reached clinics.[2] The exact destination of this money is unknown, but many patients believe that it was distributed in kickbacks or personal purchases of health administrators.  The goal of these funds was to support free healthcare in villages throughout Uttar Pradesh, especially for women and children.  But instead, there are now women delivering babies in understaffed clinics, children with infectious diseases going untreated and surgical needs not being met.

Studies show that this level of corruption is not limited to certain areas of India.  In a Center for Global Development survey of Indian public officials, business executives, and the general public, health was ranked as the second most corrupt sector in the whole country.  Corruption was defined broadly in the study, from officials accepting kickbacks to incentive-based salaried health workers shaving hours and treating “shadow patients.”[3] As with many industries within India, corruption and mismanagement impede the full potential of healthcare providers delivering quality, universal care to Indian citizens.

That said, we must realize that the root of these health delivery problems stems from a multitude of contributing factors.  By no means are these stories and studies supposed to discredit the efforts of particular health administrators or providers within the Indian national health system.  Over the past decade, India has surged to prominence in the field of global health, from the use of telemedicine, biometric scanning programs to track patients’ treatment, doctors developing cheap surgical techniques, and the scale-up of tuberculosis guidelines.[4],[5],[6],[7] Even when India receives outside funding, impressive numbers are released to the public.  For instance, the Global Fund to Fight Aids, Tuberculosis and Malaria has provided enough funding for putting 310,000 people on antiretroviral therapy in India as well as treating 790,000 cases for tuberculosis.[8]

Essentially, some of the most extraordinary health-related solutions have sprouted from India and are being championed as examples around the world.  However, as India advances on the global stage, its citizens and public officials should embrace cautious optimism, realizing the grave threat of corruption to growth of their industries.  Only when this problem has been fully addressed can India achieve an environment that is relatively politically, socially and economically stable for its citizens.

 


[1] Polgreen, Lydia. “Health Officials at Risk as India’s Graft Thrives.” New York Times 17 Sept. 2011. Web. 13 Oct. 2011. <http://www.nytimes.com/2011/09/18/world/asia/graft-poisons-uttar-pradeshs-health-system-in-india.html?_r=2&hpw=&pagewanted=all>.

[2] Khetan, Ashish. “Where did Rs 8,500 cr of UP’s health funds go?” Tehelka Magazine 20 Aug. 2011. Web. 10 Oct. 2011. <http://www.tehelka.com/story_main50.asp?filename=Ne200811COVERSTORY.asp>.

[3] Lewis, Maureen. “Governance and Corruption in Public Health Care System.” Center for Global Development Jan. (2006). Web. 9 Oct. 2011. <http://www.u4.no/pdf/?file=/document/literature/file_WP_78.pdf>.

[4] Blake, Linda. “Telemedicine Transforming Rural India.” Voice of America News 25 May 2010. Web. 12 Oct. 2011. <http://www.voanews.com/english/news/asia/Telemedicine-Transforming-Rural-India-94837509.html>.

[5] Thies, William, Shelly Bhatra, Nupur Bhatnagar, Julie Weber, and Aakar Gupta. “A Biometric Attendance Terminal and its Application to Health Programs in India.” 15 June (2010). Web. 10 Oct. 2011. <http://research.microsoft.com/pubs/137976/thies-nsdr10.pdf>.

[6] “Lessons from a frugal innovator.” The Economist 16 Apr. 2009. Web. 10 Oct. 2011. <http://www.economist.com/node/13496367>.

[7] Agrawal, S.P., and L.S. Chauhan. “Tuberculosis Control in India.” (2005). Web. 11 Oct. 2011. <http://www.tbcindia.org/pdfs/tuberculosis%20control%20in%20india-final.pdf>.

[8] India: Grant Portfolio. The Global Fund, 7 Sept. 2011. Web. 14 Oct. 2011. <http://portfolio.theglobalfund.org/en/Country/Index/IDA>.

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