Governance and Corruption in the
Pharmaceutical Sector:
Causes and Consequences

Definining and Measuring Corruption and its Impact - Manuel Balan

In this module we will introduce corruption as one of the key development issues affecting both high and low income countries. Corruption is a term that is usually misemployed to characterize a wide range of activities seen as pernicious. We will therefore clarify and discuss what is and is not corruption and what are the different types of corruption. Then, we will move on to addressing the many issues surrounding measurements of corruption, a particularly complicated task, given the inherent secrecy surrounding corrupt acts (at least of those that are “successful” in remaining in the dark). We will look at different tools and methodologies used to measure levels of corruption and review their merits and shortcomings. Finally, we will also discuss the economic, political, and social consequences of corruption. The objective of the module is to lay the foundation for the following discussions throughout the workshop, which will focus more in depth in the pharmaceutical sector. 


Vulnerabilities of the Pharmaceutical Sector to Corruption - Jillian Kohler

This session will:

 

Canada's Regulatory System and Governance Failures - Joel Lexchin

This presentation will look at how the mission of Health Canada to protect the health of the public has been compromised by its relationship with the pharmaceutical industry. Specifically, it will briefly examine the effects of user fees on how premarket trials are reviewed, how closely Health Canada monitors drug safety, how much information about efficacy and safety Health Canada makes public and finally will compare risk management versus the precautionary principle as the basis for regulation.

The learning objectives are as follows:

Tackling Corruption in Healthcare Procurement: How 'Open Contracting' Improved Healthcare in Nigeria, Ukraine and Honduras - Lucas Amin

This session will introduce participants to:

The Role and Limits of Ethical Codes for the Pharmaceutical Industry - Carl Coleman

In recent years, there has been a proliferation of codes of ethics for the pharmaceutical industry.  Some of these codes are created by individual companies, while others are developed collaboratively by industry associations or nongovernmental organizations.  While these codes are not legally binding, they may nonetheless have a significant impact on industry practices, particularly when they are backed up by extra-judicial enforcement mechanisms.  This session will outline the types of ethics codes that have been developed in the global pharmaceutical industry, explore some of their key provisions, and assess their role and limitations as a means to combat the problem of corruption.

 

Incentivizing Company Performance in Fighting Corruption: The Access to Medicine Index - Danny Edwards

Companies should have robust systems of self-regulation in place to curb corruption. These systems should complement and reinforce international standards and national legal structures. Where legal and enforcement systems are weaker or absent, usually in lower-income contexts, such systems may play an important role in mitigating the risk of corruption. 

The pharmaceutical industry provides a good case study of just how important these systems are. Major pharmaceutical companies are expanding their presence in low and middle-income countries to respond to unmet medical needs and to gain share of new and emerging markets. Given the generally weaker legal controls in such markets, companies must be able to ensure the highest standards of behaviour across their operations. To achieve this, they need to implement compliance systems that minimise the risk of misconduct occurring.

In this seminar, Danny Edwards, Research Programme Manager for the Access to Medicine Foundation, will share the findings of the 2016 Access to Medicine Index, which analysed the access-to-medicine strategies of the world’s largest pharmaceutical companies alongside their compliance systems to pursue the highest ethical standards in all of the countries where they do business. He will also describe developments in the updated methodology for the Access to Medicine Index, in anticipation of the next iteration, due at the end of 2018.

 

Leveraging the Sustainable Development Goals to Tackle Pharamceutical Corruption - Tim Mackey

Corruption in the health and particularly pharmaceutical sector is endemic, found across the entire spectrum of the health commodity supply chain.  Corruption in the pharmaceutical sector comes in many forms, including manifesting itself as unethical drug marketing, rigged drug bidding and procurement, illegal payments and kickbacks to health professionals, and the international trade in fake medicines.  Despite these clear risks to the delivery and utilization of life-saving medicines, data measuring the impact of these different forms of pharmaceutical-based corruption remain elusive.  However, the 2015 adoption of the UN Sustainable Development Goals (SDGs) represents an opportunity to change this equation.  Specifically, the SDGs now include goals and targets specifically related to “health” and “corruption” in their respective domains.  This discussion will highlight the opportunity to leverage SDG goals 3 and 16 to map and build out a set of shared sub-indicators that could measure progress towards the fight against corruption in health.  It will also highlight emerging technologies that could be leveraged to monitor, analyze, and report on pharmaceutical corruption.