Advertisement

Hague Journal on the Rule of Law

, Volume 7, Issue 1, pp 141–151 | Cite as

Challenges in Multi-Level Health Governance: Corruption in the Global Fund’s Operations in Uganda and Zambia

  • Sharifah Rahma SekalalaEmail author
  • Monica Twesiime Kirya
Note

Abstract

There has been a marked rise in new organisations such as public private partnerships (PPPs) within the global health sector, of which The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is perhaps one the most well-known. From its conception, it was hailed as a new breed of international institution which would be less bureaucratic, more transparent and more accountable to its stakeholders. However, the GFATM has unfortunately been plagued by corruption in its operations in several developing countries. In this note, we draw on case studies of GFATM experiences of corruption in Uganda and Zambia to argue that we should be cautious in welcoming this new form of global governance in regard to its ability to ensure transparency and accountability. This is because one of the key strengths of the PPP structure, is that it creates autonomy at the national level, which constitutes a weakness when there is corruption. Indeed, despite evidence of widespread corruption in the GFATM in both of our case study countries, the GFATM has been unable to effect successful prosecution of the culprits and recover money that has been siphoned off, as both the Ugandan and the Zambian governments have exhibited a lack of political will.

Keywords

Corruption Global governance HIV/AIDS Public private partnerships (PPPs) The Global Fund 

References

  1. Amundsen I (2006) Paper presented at the U4/OECD-DAC expert meeting on political corruption and the role of donors, Paris, 22–23 March 2006Google Scholar
  2. Bayart JF et al (1999) The criminalisation of the state in Africa. Indiana University Press, IndianaGoogle Scholar
  3. Beishem M et al (2011) Global governance through public private partnerships. In: Enderlein H et al (eds) Handbook on multi-level governance. Edward Elgar Press, Cheltenham, pp 115–143Google Scholar
  4. Brown GW (2010) Safeguarding deliberative global governance: the case of the Global Fund to fight AIDS, tuberculosis and malaria. Rev Int Stud 36(2):511–519CrossRefGoogle Scholar
  5. Brugha R, Walt G (2001) A global health fund: a leap of faith? BMJ Br Med J 323(7305):152CrossRefGoogle Scholar
  6. Brugha R et al (2004) The Global Fund: managing great expectations. Lancet 364(9428):95–100CrossRefGoogle Scholar
  7. Cammack D (2007) The logic of African neopatrimonialism: what role for donors? Dev Policy Rev 25(5):599–614CrossRefGoogle Scholar
  8. Chabal P, Daloz J-P (1999) Africa works: disorder as a political instrument. The International African Institute and Indiana University Press Google Scholar
  9. Enderlein H et al (eds) (2010) Handbook on multi-level governance. Edward Elgar Press, CheltenhamGoogle Scholar
  10. Fritz V, Menocal AR (2007) Developmental states in the new millennium: concepts and challenges for a new aid agenda. Dev Policy Rev 25(5):531–552CrossRefGoogle Scholar
  11. Fritzen S (2006) Beyond ‘political will’: how institutional context shapes the implementation of anticorruption policies. Policy Soc 24(3):79–96CrossRefGoogle Scholar
  12. Kapilashrami A, McPake B (2013) Transforming governance or reinforcing hierarchies and competition: examining the public and hidden transcripts of the Global Fund and HIV in India. Health Policy Plan 28:626–635CrossRefGoogle Scholar
  13. Mwenda A (2007) Personalising power in Uganda. J Democr 18(3):2337CrossRefGoogle Scholar
  14. Mwenda AM, Tangri R (2005) Patronage politics, donor reforms and regime consolidation in Uganda. Afr Affairs 104(416):449–467CrossRefGoogle Scholar
  15. Persson A et al (2010) The failure of anti-corruption policies: a theoretical mischaracterization of the problem. In: QoG working paper series 19.10Google Scholar
  16. Rowden R (2009) The deadly ideas of neo-liberalism: how the IMF has undermined public health and the fight against AIDS. Zed Books, LondonGoogle Scholar
  17. Sekalala S (2015) Solving global health problems through soft law, a case study of HIV/AIDS, tuberculosis and malaria. Cambridge University Press, Cambridge (forthcoming)Google Scholar
  18. Szeftel M (2000) ‘Eat with us’: managing corruption and patronage under Zambia’s three republics, 1964–99. J Contemp Afr Stud 18(2):207–224CrossRefGoogle Scholar
  19. Taylor SD (2006) Divergent politico-legal responses to past presidential corruption in Zambia and Kenya: catching the ‘big fish’, or letting him off the hook? Third World Q 27(2):281–301CrossRefGoogle Scholar
  20. Taylor EM, Harper I (2014) The politics and anti-politics of the Global Fund experiment: understanding partnership and bureaucratic expansion in Uganda. Med Anthropol Cross-Cult Stud Health Illn 33(3):206–222. doi: 10.1080/01459740.2013.796941 Google Scholar
  21. Von Soest C (2013) Persistent systemic corruption: why democratisation and economic liberalisation have failed to undo an old evil. Z Vgl Polit 7(1):57–87CrossRefGoogle Scholar
  22. Wild L, Domingo P (2012) Why politics matter: aid effectiveness and domestic accountability in the health sector. A comparative study of Uganda and Zambia. International Institute for Democracy and Electoral Assistance (International IDEA), StockholmGoogle Scholar
  23. Young Nicola Man W et al (2014) Is endemic political corruption hampering provision of ART and PMTCT in developing countries? J Int AIDS Soc 17:1CrossRefGoogle Scholar
  24. Zürn M (2011) Global governance as multi-level governance. In: Enderlein H et al (eds) Handbook on multi-level governance. Edward Elgar, Cheltenham, pp 183–221Google Scholar

Copyright information

© T.M.C. Asser Press 2015

Authors and Affiliations

  • Sharifah Rahma Sekalala
    • 1
    Email author
  • Monica Twesiime Kirya
    • 2
  1. 1.University of WarwickCoventryUK
  2. 2.International Programs Director, International Governance AllianceKampalaUganda

Personalised recommendations