Sophie Peresson Director, Pharmaceuticals & Healthcare Programme - Transparency International UK Sophie Peresson is the Director of Transparency International’s Pharmaceuticals and Healthcare Programme (PHP). http://www.transparency.org.uk/our-work/pharmaceuticals-healthcare-programme/ The Programme has been set up, with a purpose to achieve genuine change in the pharmaceutical & healthcare sector through reducing corruption and promoting transparency, integrity and accountability. Sophie holds a Masters in Law from the Sorbonne University, a post-graduate degree from the School of Advanced International Studies (SAIS) Johns Hopkins University. She is currently completing an MSc in Global Health at the London School of Hygiene and Tropical Medicine. She has over fifteen years’ experience of working in public health, working for influential international NGOs such as the Red Cross and Marie Stopes International. Her experience spans both communicable and non-communicable diseases. She is an expert adviser to the European Institute for Women’s Health (EIWH) and has held several board positions. She is also a contributor to the Global Burden of Disease Study. She has a well-established track record in collaborating in international projects, research initiatives and has been on the steering committee of several influential publications, e.g. The Diabetes Policy Puzzle.

1. MANCHESTER UNIVERSITY – 24 FEBRUARY 2016
Sophie Peresson
Director, Pharmaceuticals & Healthcare Programme - Transparency International UK

2. CORRUPTION IN THE HC SECTOR
Source: Savedoff, W.D. and Hussmann, K. (2006): Why are health systems prone to corruption? In:
Transparency International (ed.) Global Corruption Report 2006.
transparency.org.uk

3. transparency.org.uk

4. CORRUPTION ABUSES
transparency.org.uk
Political and
regulatory
Healthcare legislation
and controls being
compromised by
corruption.
Research and
development
Incomplete disclosure
of scientific evidence
and unethical clinical
trial practices.
Patents and
registration
Patent ever-greening
and bribing/withholding
of information to obtain
licences.
Product quality
Counterfeit, falsified
and substandard
products.
Promotion
Mis-marketing and
unethical promotion
driven by incentivised
sales targets.
Health service
delivery
Demand side
corruption leading to
reduced access to
healthcare.
Procurement
Conflicts of interest,
including the selection
of essential medicines.
Expenditure fraud
risk
The risk of diversion of
public resources and
abuse in the
expenditure of large
healthcare delivery
budgets.

5. TI’s new Pharmaceuticals& Healthcare Programme
• Why are we doing it?
• What change are we seeking?
• What is the problem?
• How will we bring about change?
• Corruption and the development agenda

6. transparency.org.uk
A GLOBAL PROBLEM
• $7 trillion annual global spend
• 17% of people worldwide stated they had paid a bribe
when dealing with the medical sector Global Corruption
Barometer, 2013
• Estimate 10-25% public procurement funds lost to
corruption
• Pharmaceutical & healthcare sector supply chains are
global, long and complex

7. IMPROVING GLOBAL HEALTH AND
HEALTHCARE OUTCOMES
FOR THE BENEFIT OF
ALL PEOPLE OF ALL AGES
OUR GOAL

8. Why are we doing it?
• Economic impact – when large amounts of public funds are wasted;
• Health impact – the waste of public resources reduces the
government’s capacity to provide good quality services and
products; patients may turn to unsafe medical products available on
the market instead of seeking health services, leading to poor health
outcomes for the population;
• Government trust impact – inefficiency and lack of transparency
reduces public institutions’ credibility. This not only erodes the trust of
citizens but can also decreases foreign investment in the health
sector and levels of health aid.

9. What change are we seeking?
• Purpose: to achieve genuine change in the pharmaceutical
& healthcare sector through reducing corruption and
promoting transparency, integrity and accountability
• Which means…
 Greater understanding of corruption in the sector
 Acknowledgment of the problems
 Development and acceptance of solutions
 Greater transparency and accountability
 Reduced levels of corruption
 Better outcomes for patients

12. What is the problem?
Five key areas identified
 Research & Development
 Manufacturing, including counterfeits
 Marketing practices
 Registration processes
 Procurement and distribution

13. transparency.org.uk
PRIORITISING IN THE
PHARMACEUTICAL & HEALTHCARE
VALUE CHAIN
Research &
Development
Manufacturing Registration Marketing
ProcurementDistribution
Prescription,
Dispensing &
Health Services
Patients
Selection

14. How will we bring about change?
 Advocacy and policy analysis
 Research
 Standard-setting
 Multi-stakeholder dialogue
 Advocacy to companies, governments, regulators,
global health community
 In practical terms
 Publishing typologies and trends
 Illustrative research into key areas
 Developing and publishing indices
 Producing good practice guidance

15. EXAMPLES OF CORRUPTION IN THE
HEALTH SECTOR

16. NHS - FUNDING AND STRUCTURE
• Funding for the NHS comes directly from taxation and is granted to the
Department of Health by Parliament.
• For 2013/14, the total NHS budget was around £109.721billion.
• NHS is an independent body, at arm’s length to the government.
• Collection of hundreds of organisations, the majorities of these are the
responsibility of clinical commissioning groups (CCGs).

17. FUNDING AND STRUCTURE

18. FRAUD CONSPIRACY AGAINST NHS
“Operating theatre experts jailed for fraud conspiracy against NHS”
(NHS Protect)
A team of perfusionists conspired to defraud Basildon and Thurrock
University Hospitals NHS Foundation Trust for 9 years ending in 2014.
The four directors of London Perfusion Science Ltd (LPS) all held full time
jobs at Basildon Hospital while working privately at numerous other NHS
hospitals.
Between 2007 and 2011 salaries were paid for 14,000 hours that were not
actually worked.
The total loss to the NHS was £430,000.

19. HONDURAS - PATIENTS PAY THE COST OF
CORRUPTION
•In 2015 Honduran investigators discovered that a national pharmaceutical
company, in part owned by the congressional vice president, was involved
in a scandal allegedly cost the Honduran public health system as much as
$120 million.
•The scheme involved selling overpriced and in some cases defective
medicines to government. 11 cases have been identified in which it
appears women died after taking the defective drugs.

20. BANGLADESH - CORRUPTION RIFE IN
DRUG ADMINISTRATION
•A report by Transparency International Bangladesh (Jan 2015) found
extensive evidence of corruption within a national drug administration.
• Money was received for issuing new licenses for pharmaceutical
companies, registering new drugs, approving packaging and gaining export
approval.
•Money changing hands ranged from US$5 to US$20,000, with evidence
suggesting that small pharmaceutical companies were more prone to such
behaviour.

21. CORRUPTION AND DEVELOPMENT

23. UK Aid Strategy
• Corruption holds back development. It is bad
for the poorest, and bad for business.
• It corrodes the fabric of society and public
institutions.
• In its Aid strategy, the UK restates its
commitment to stamping out corruption and
vows to continue expanding it. The UK will
hold a global anti-corruption summit in
London in 2016 to drive this agenda forward.
transparency.org.uk

24. Sophie Peresson
Pharmaceuticals and Healthcare Programme
Transparency International UK
Sophie.Peresson@transparency.org.uk
www.transparency.org.uk - www.transparency.org
transparency.org.uk