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Harry Cassin
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Is graft really a gateway for Ebola? Sure it is

Ebola outbreak in Sierra Leone (Image courtesy of the World Health Organization)We’re not here to knock those who don’t agree with what we say. Everything in every post is fair game for comment and criticism. But we wanted to be clearer about what we meant when we talked in our usual shorthand way about the link between corruption and Ebola.

Some readers weren’t happy about that post. Most of the objections, all published as comments under the post, said there’s no proven link between corruption and Ebola, so looking at the CPI rank of the countries hardest hit by the virus doesn’t mean anything.

The readers raised an important question: How can anyone know whether there’s a causal link between graft and the incidence and treatment Ebola?

Proving with a scientific certainty a correlation between corruption and Ebola isn’t possible. First, you can’t scientifically measure the amount of graft in any county. TI measures the perception of corruption, and that’s probably the best you can do.

Second, there are too many variables to ever have a true control group to study. Only if you could isolate corruption could it be possible to then measure how the spread and treatment of Ebola in a country or region are directly linked to the amount of graft there. Some variables include sanitation practices, water quality, nutrition, access to medical care, and so on.

But is corruption just another variable? Not really. It’s more helpful to think about in a different way. In chronically corrupt countries, public funds meant for infrastructure and human services are siphoned away. That causes a lack of clean drinking water, proper sanitation, a safe food supply, and effective health care, and leaves the local population more vulnerable to an infectious disease like Ebola.

That’s why graft is best understood as a gateway to public health crises, in the same way it’s now understood to be a gateway to terrorism, crime, and poverty.

This isn’t a new idea.

A 2007 paper published by Health Policy and Planning, one of the Oxford Journals, started this way:

Corruption is a pervasive problem affecting the health sector. At the level of individuals and households, there is mounting evidence of the negative effects of corruption on the health and welfare of citizens (McPake et al. 1999; Gupta et al. 2002; Azfar 2005; Lewis 2006; Rose 2006). In the last 10 years, efforts to combat corruption have gained the attention of national governments, development partners and civil society organizations (World Bank 2000; Transparency International 2006). While comprehensive government reforms to address endemic corruption may be needed, sector-specific solutions can be pursued at the same time or even in the absence of political will for more systemic reforms (Spector 2005).

The author of the paper is Taryn Vian, an associate professor of global health at Boston University. She has a PhD from BU and an MSc from Harvard. Her bio says she “has over 30 years’ experience in the health sector as a health economist, policy analyst, and project leader” and has worked in more than 30 countries, including many in Africa and Asia.

Another peer reviewed research paper from 2011 on childhood deaths also talked about the gateway aspect of corruption on public health.

It said:

Health impacts of corruption can not be only summarized as those acting directly on health access and services. For example, nearly 1.2 billion people in the world do not have guaranteed access to water and more than 2.6 billion are without adequate sanitation, with devastating consequences for development and poverty reduction. In developing countries, about 80 per cent of health problems can be linked back to inadequate water and sanitation [7]. The human consequences of this water crisis are devastating and affect the poor and women most of all. Experts concur that the water crisis is a crisis of water governance where, as suggested elsewhere, corruption could be one of the main cause and catalyst for this crisis and that it could affect all aspects of the water and sanitation sector, from resources management to services [8]. More globally corruption was shown to affect all domains of life from education to economic performances [4] and thought these ways could also impact health outcomes.

The paper — Corruption Kills: Estimating the Global Impact of Corruption on Children Deaths — was jointly published by two teams. One team was from the department of parasitology and mycology at the Université des Antilles et de la Guyane in French Guiana, and the other was from the Centre d’Investigation Clinique Epidémiologie at the Cayenne General Hospital in French Guiana.

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Incidentally, our earlier post about Ebola is available in Mandarin on the FCPA Blog’s site that’s part of Fortune China. The posts that appear there are all selected by Fortune and not by us.


Richard L. Cassin is the publisher and editor of the FCPA Blog. He can be contacted here.

Richard L. Cassin is the publisher and editor of the FCPA Blog. He can be contacted here.

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Richard L. Cassin is the publisher and editor of the FCPA Blog. He can be contacted here.

– See more at:

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1 Comment

  1. I criticized the previous article not because I don't believe that graft is a gateway to Ebola (I do) but because its heading gave me an unmet expectation that the article would give evidence that some graft led to some water / sanitation etc. problem which in turn helped Ebola. This second article's body matches its heading.

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