Afghanistan: Vulnerability to Corruption Assessment (VCA) in the Afghan Ministry of Public Health; MEC, 2016

This Special Report on Vulnerability to Corruption in the Afghan Ministry of Public Health was undertaken by the Independent Joint Anti-Corruption Monitoring and Evaluation Committee (MEC) at the request of the Minister of Public Health, Dr. Ferozudin Feroz. The purpose of this Report is to assess the extent of corruption risks in the Afghan health system; to identify where these vulnerabilities exist; and to draw important lessons and make recommendations on how to counter corruption risks. An assessment team comprising dedicated Afghans and international experts knowledgeable about both the Afghan health sector and anti-corruption work undertook this study. To conduct this assessment, 269 former MOPH officials from all ranks, non- management employees and frontline MOPH staff, health sector implementers, civil society organizations, community leaders, patients and their families throughout the country participated in face-to-face interviews and focus group discussions. Their personal knowledge and experiences vis-à- vis the health system, as well as direct observations of the assessment team formed the basis of this study. This Special Report illustrates the magnitude of the problem in the Afghan health sector. Patients and their family members experienced corruption in the context of fear, suffering, uncertainty, pain, and death. Corruption in the Afghan health sector covers a range of illegal, unethical and disturbing acts that happen within an environment of systemic failure. Most often, it is entrenched, widespread and a dominant pattern. It affects all stakeholders in the health sector. Officials and employees have often been powerless in the face of corruption, frustrated and with a strong feeling being let down by colleagues and political leadership. Patients have to pay bribes in many wards. Doctors often use the public service to find clients and refer them to their private clinics. Finally, patients and their families feel their voices can‟t be heard. The report provides a powerful justification to undertake measures to restore confidence in, and credibility to, the health ministry‟s systems and practices, and to significantly improve health delivery to the Afghan people. It is hoped that the Afghan people‟s outpouring of anguish as revealed through the interviews will serve as a powerful motive for the health ministry officials to pursue genuine reform that will lift the health standards of the Afghan society.