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Transparency as a game changer in the health sector?

Insights from ACTUE Colombia

Corruption prevention is not an end in itself, but a means to improve sector performance and build public trust. Using pharmaceutical policy as an entry point, ACTUE Colombia tested innovative transparency and integrity initiatives in the health sector. The results showed that ‘radical’ transparency is necessary but not sufficient, and that a set of corruption prevention measures applied together is key to transformative change. Flexible responses to new opportunities are essential, and project timelines should extend beyond a single government term.

25 October 2022
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Transparency as a game changer in the health sector?

Main points

  • The Colombian health sector has long been plagued by allegations of corruption, with a crisis in 2011 that shattered trust in the system.
  • The ACTUE Colombia project, funded by the European Union, supported a set of transparency and integrity measures intended to improve sector performance and rebuild public trust.
  • Focused initially on the pharmaceutical subsector, the project broadened to include an ‘island of integrity’ in Invima, the food and drug oversight agency; subnational health sector transparency initiatives; and a diagnosis of corruption risks and levels of tolerance towards corruption in the health sector.
  • A change of national government coincided with closure of the project, creating challenges for sustainability of the initiatives.
  • The experience showed that ‘radical’ transparency is necessary but not sufficient. Transparency must be complemented by a set of mutually reinforcing integrity and accountability measures to achieve transformative change.
  • Coordination is crucial. The Ministry of Health should install a durable, high-level coordination mechanism at sector and institutional levels to ensure synergies between multiple integrity initiatives and to break down ‘silos’ so that these measures have real impact.
  • The time horizon of development projects matters. Donors should ensure that the lifespan of an anti-corruption project transcends the term of a single government. 

Cite this publication

Hussmann, K.; (2022) Transparency as a game changer in the health sector?. Bergen: U4 Anti-Corruption Resource Centre, Chr. Michelsen Institute (U4 Practice Insight 2022:2)

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About the author

Karen Hussmann

Karen Hussmann is a public policy expert with extensive experience in governance, anti-corruption issues, health-sector integrity, and fragile states. Her experience includes having been the director of an EU financed anti-corruption programme in Colombia, senior consultant for the U4 Anti-Corruption Resource Centre and the EUROsociAL II Programme in Latin America, and accountability expert with UNDP in Afghanistan. She has also worked many years with Transparency International. She is currently an independent consultant conducting applied policy research and working with partners on policy development and implementation of anti-corruption standards. She teaches the U4 online courses Essentials of anti-corruption and Corruption risk management.


All views in this text are the author(s)’, and may differ from the U4 partner agencies’ policies.

This work is licenced under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND 4.0)