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India joins WB to fight health sector corruption

In an effort to fight fraud, corruption and systemic deficiencies in India’s health sector, the Government of India and the World Bank Group have joined forces and announced immediate steps to investigate indicators of wrongdoing.

New Delhi: In an effort to fight fraud, corruption and systemic deficiencies in India's health sector, the Government of India and the World Bank Group have joined forces and announced immediate steps to investigate indicators of wrongdoing and to implement further safeguards.

The government has announced its intention to re-examine all ongoing and future projects to ensure that they incorporate the lessons from a Detailed Implementation Review (DIR), which is an instrument used by the World Bank to help assess the risk of fraud and corruption.

The five projects covered by the DIR include the US $114 million Malaria Control Project, the US $82.1 million Orissa Health Systems Development Project, the ongoing US $54 million Food and Drug Capacity Building Project, the US $193.7 million Second National HIV/AIDS Control Project and the US $124.8 million Tuberculosis Control Project.

The DIR launched by the World Bank in 2006 and supported by the Government of India has found serious incidents of fraud and corruption in five health projects, which began implementation between 1997 and 2003, financed by the government and the World Bank and other donors.

The detailed review was prompted by a World Bank investigation in 2005 into a Reproductive and Child Health (RCH1) project, where it found corrupt practices by two pharmaceutical companies which were subsequently disbarred by the bank and the government.

Both of them have introduced detailed anti-corruption plans into all new health projects in view of the findings of the RCH1 investigation.

Mentioning that the probe has revealed unacceptable indicators of fraud and corruption, World Bank Group President Robert B Zoellick said that the government and the World Bank are committed to getting to the bottom of how these problems occurred.

He further added that, on the bank's side, there were weaknesses in project design, supervision and evaluation and there are also systemic flaws.

Zoellick expressed his determination in fixing these problems with the help of Volcker Report which points the way towards what has to be done.

Both the government and the bank have committed themselves to tighten oversight of the entire bank-supported health portfolio, currently nine projects.

They would also ensure that all new health sector projects include measures to counter the risks identified in the DIR such as comprehensive audits and performance reviews by independent third-party agents.

Zoellick said the Bank's governance and anti-corruption work from now on would be placed before the scrutiny of independent and external reviewers to ensure that the institution was making tangible progress in its fight against corruption.

The bank and the government have already sought to address a number of the risks identified now in the DIR through new project design over the past two years, taking guidance from the RCH1 investigation.

Some of these remedial measures already being built into new projects in health and other sectors include enhanced transparency, building on India's recent Right to Information Act, to include Web publication of all procurement processes, bidding and contract awards.

Besides implementing oversight by project beneficiaries, citizens and civil society, using community score cards and social audits, tightening oversight and recruitment of NGOs (for example the National AIDS Control Organization has terminated 163 NGO contracts out of 952) are also suggested.

Other measures includes tightening quality control to ensure the quality of pharmaceuticals procured, including independent validation of World Health Organisation (WHO) good manufacturing practice certificates and disclosing full results on government websites.

It also suggested procurement audits for 100 per cent of projects annually and aggressive tightening of procurement controls to catch collusive bidding, including designing new software detectors, besides aggressive acceleration of complaints processing and action.

In lieu of the mission to curb fraud and corruption, the Ministry of Finance said that necessary action under the relevant laws, rules and regulations would be taken against those suspected of wrongdoing and, if found guilty, they will be visited with exemplary punishment.

The World Bank will also be continuing its probe, which may lead to further sanctions such as debarment of companies and appropriate action under the rules against any bank staff if found negligent.
—iGovernment Bureau

Dear Colleagues

The problem described is decades old, and it is interesting that over this time neither the Government of India nor the World Bank Group has made very much progress against corruption and poor performance in socio-economic development projects.

The root cause of corruption is that the system makes corruption relatively easy. There are systemic weaknesses in government systems and in the World Bank approaches that result in very poor accounting and virtually no timely accountability. While a good corporate accounting system will highlight financial control issues every month, if not more frequently, a government / World Bank system might perhaps do the same some years later when there is a monitoring and evaluation review, or something like the Detailed Implementation Review (DIR).

M&E and the DIR are too little and too late. What is needed is good timely responsibility accounting ... and why not in 2008 use some of the techniques now available for real time management like biometric controls and web accessible relational database accounting. There needs to be accessible information about project activities at both the community level and about the project or organization. Costs need to be compared to activities, to results and to benefits arising. Ultimately it is the public that should get the accounting!

Government and the World Bank has never wanted this to be done ... for years and years and years ... either because they do not know how to do it, or they fear the results will not be satisfactory. Neither is a good reason.

As an interested observer and analyst of the relief and development sector and advocate for excellence in transparency and accountability I am appalled. The good news is that the modern public is learning, and will not tolerate the status quo much longer.

Sincerely

Peter Burgess
The Tr-Ac-Net Organization
www.tr-ac-net.org

FIRST OF ALL LET ME THANK YOU FOR HAVING SUCH A GREAT PLATFORM TO THE COMMON MAN LIKE ME. Thank god. Some body is looking into the issues of such large scale corruption in this sector, which largely used to be sweeped under the carpet after the procurement process. BUT THE ACTUAL AND UNFORTUNATE PART IS THAT WHEN SENIOR PROFESSIONALS AT THE LEVEL OF DIRECTOR'S AND SR.SCIENTISTS PUT UP A SCIENTIFIC JUSTIFICATION TO THE WHOLE EXERCISE OF PROCURING COSTLY EQUIPMENTS INTO VARIOUS NATIONAL AND STATE LEVEL LABORATORIES. HEALTH ADMINISTRATORS AND AT TIMES EVEN THE BEST OF POLITICIANS GET CONFUSED AND GET CAUGHT IN THE MIDST OF JARGON OF SCIENCE AND TECHNOLOGY. in some committees set up internally and within the political set up, unfortunately there are vested interests in supporting such activities despite having a fair idea that such equipments are not necessary for the organisation at a given point of time.

UNFORTUNATELY MY ORGANISATION HAPPENS TO BE ONE OF THE SUFFERERS.[/quote]

This is indeed a very good initiative to start with. In my opinion what is to be called as corrupt practice actually need some brainstroming. In my view it is not always linked with direct money. As on today the entire health sector is defunced because of petty corrupt practices. Mere saying about health sector reform or doing some work on it is unable to do anything.
One should adopt a scissors approach (work from both end-top-down and bottom-up) for corrective measures. Now who will take the initative? At current situation nobody! Bureauocrats are not given appropriate power for a assured (certain) period to work on and take any initiative. Health administrators are also sometimes overpowered by political decisions. Decisions on Systemic change sometimes lead to bottlesnecks for implementation.
There are many issues to work on.............

I appriciate that review of these projects have started & I will request that can't we look into the matter in advance, as I am anticipating same is going to be the fate of National Rural Health Mission.

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