Transparency International2019-09-252019-09-252011-04-062006http://hdl.handle.net/20.500.12424/177564"Every year, the world spends more than US $3.1 trillion on health services, most of which is financed by governments. European members of the OECD collectively spend more than US $1 trillion per year and the United States alone spends US $1.6 trillion. In Latin America, around 7 per cent of GDP, or about US $136 billion, is consumed by health care annually, of which half is publicly financed. In lower-income countries, private health spending is often greater than public health spending, although the latter is still a significant amount. The share of total government revenues spent on health care ranges from under 5 per cent in Ethiopia, Egypt, Indonesia and Pakistan to more than 15 per cent in Ireland, Germany, the United States and Costa Rica. These large flows of funds are an attractive target for abuse. The stakes are high and the resources precious: money lost to corruption could be used to buy medicines, equip hospitals or hire badly needed medical staff. The diversity of health systems worldwide, the multiplicity of parties involved, the paucity of good record keeping in many countries, and the complexity in distinguishing among corruption, inefficiency and honest mistakes make it difficult to determine the overall costs of corruption in this sector around the globe. But growing evidence from around the world indicates that corruption, fraud, and abuse are resulting in significant losses of public money and denial of good quality health services to millions of people. Transparency International defines corruption as ‘the abuse of entrusted power for private gain’. In the health sphere the abuse includes examples of corruption such as bribery of regulators and medical professionals, manipulation of information on drug trials, the diversion of medicines and supplies and corruption in procurement; but also examples of fraud, such as the overbilling of insurance companies. The perpetrators of corruption in the health sector include many private actors, notably medical professionals, who are considered to be bound by professional ethics that require them to serve the common good."engWith permission of the license/copyright holderhealth carefinance ethicsPolitical ethicsCultural ethicsBioethicsMedical ethicsHealth ethicsPreprint