An interdisciplinary review of digital technologies to facilitate anti-corruption, transparency and accountability in medicines procurement

Abstract

Background: Pharmaceutical corruption is a serious challenge in global health. Digital technologies that can detect and prevent fraud and corruption are particularly important to address barriers to access to medicines, such as medicines availability and affordability, stockouts, shortages, diversion, and infiltration of substandard and falsified medicines. Objectives: To better understand how digital technologies are used to combat corruption, increase transparency, and detect fraud in pharmaceutical procurement systems to improve population health outcomes. Methods: We conducted a multidisciplinary review of the health/medicine, engineering, and computer science literature. Our search queries included keywords associated with medicines procurement and digital technology in combination with terms associated with transparency and anti-corruption initiatives. Our definition of 'digital technology' focused on Internetbased communications, including online portals and management systems, supply chain tools, and electronic databases. Results: We extracted 37 articles for in-depth review based on our inclusion criteria focused on the utilization of digital technology to improve medicines procurement. The vast majority of articles focused on electronic data transfer and/or e-procurement systems with fewer articles discussing emerging technologies such as machine learning and blockchain distributed ledger solutions. In the context of e-procurement, slow adoption, justifying cost-savings, and need for technical standards setting were identified as key challenges for current and future utilization. Conclusions: Though there is a significant promise for digital technologies, particularly e-procurement, overall adoption of solutions that can enhance transparency, accountability and concomitantly combat corruption, is still underdeveloped. Future efforts should focus on tying cost-saving measurements with anti-corruption indicators, prioritizing centralization of e-procurement systems, establishing regulatory harmonization with standards setting, and incorporating additional anti-corruption technologies into procurement processes for improving access to medicines and to reach the overall goal of Universal Health Coverage. ARTICLE HISTORY

Cryptocurrencies and Corruption

“…De Souza, Luciano and Wiedenhöft (2018), however, emphasize that blockchain is publicly accessible and that the parties to the contract can have equal access to information, which reduces the information asymmetry, thus making the scope for corruption smaller. Other authors (e.g., Deshwal, Singh Kaurav and Thakur, 2019; Mackey and Cuomo, 2020;Berg, Markey-Towler and Novak, 2020;Sladič et al, 2021) describe different ways how blockchain technology can be used as a tool for transparency and a mean to fight corruption in developing countries -namely, 1. the impossibility of encrypting servers at the same time, which reduces the risk of illegal attack; 2. the ability to detect and prevent fraud in the procurement process; 3. the fact that smart contracts based on blockchain are self-enforcing -in their pure form (that is, where all triggers and conditions of the contract are managed on-chain) they do not need any external authority to enforce or otherwise manage disputes; and 4. blockchain allows for transactions to be recorded in an immutable and tamper-proof manner.…”

Lessons post-COVID from national and international approaches to safety and quality in healthcare

“…Greater transparency can also help to counter potential corruption. 16 In the quality learning system, research on safety and quality should be prioritised to build a firm evidence base of what works, using both the traditional research methodology as well as alternative ways of learning in real time. 15,17 Case study 3 demonstrates how one can learn in times of crisis.…”

Promoting anti-corruption, transparency and accountability to achieve universal health coverage

“…It examines in deeper detail the overarching role of good governance in pharmaceuticals, and specific anti-corruption tools such as integrity pacts, price transparency, open contracting, and e-procurement. Tim Mackey and Raphael Cuomo analyze evidence from the medical, engineering, and computer science literature to determine what we know about digital solutions to improve transparency and accountability in medicines procurement and supply [6]. They focus in particular on e-procurement systems, machine learning approaches, and other digital solutions allowing the detection of fraud and abuse.…”