Fighting corruption in healthcare systems is everyone’s responsibility. The health of our continent depends on it. (Delwyn Verasamy/M&G)
Commemorated on 11 July each year, African Anti-Corruption Day marks the adoption of the African Union Convention on Preventing and Combating Corruption (AUCPCC) in 2003. Envisioned as a bold collective step by African states to tackle corruption and reaffirm their commitment to accountable governance, the convention came into force in 2006.
More than two decades later, this annual observance should ideally serve as a moment for reflection, evaluation and renewed commitment. But against the backdrop of deepening scandals and persistent impunity, one is compelled to ask: what exactly are we commemorating?
Sub-Saharan Africa remains the lowest performing region globally in the 2024 Transparency International Corruption Perceptions Index, with an average score of just 33 out of 100, and a staggering 90% of countries in the region scoring below 50.
These statistics speak to the abuse, misappropriation and misallocation of resources — and in the context of healthcare, the unnecessary loss of human life. The Covid-19 pandemic exposed the devastating consequences of unchecked corruption in health systems across the continent during such crises.
In this context, commemorating African Anti-Corruption Day risks becoming a hollow ritual, a well-branded event with speeches and slogans but little evidence of tangible reform or meaningful accountability. If this day is to remain relevant, it must be linked to concrete action — and the urgent need to confront the continued failure of many anti-corruption strategies.
In our recent paper, we discussed the persistent corruption plaguing the healthcare sectors in Zimbabwe and South Africa. We also evaluated the effectiveness of existing anti-corruption strategies in both countries. One thing is clear: despite the enactment of laws, the establishment of oversight bodies, the initiation of audits and several health sector reforms, corruption remains deeply entrenched.
Nepotism
Several forms of corruption plague the two countries’ healthcare systems. One of the most entrenched issues is nepotism and political patronage in hiring and promotions. Rather than being based on merit or professional qualifications, appointments — especially to senior positions — are often influenced by personal or political connections. In South Africa, this problem is exacerbated by the concentration of appointment powers in the hands of members of the executive council, who wield significant discretion over senior healthcare appointments. This opens the door to favouritism.
Another major concern is procurement corruption, where contracts for medical goods and services are frequently awarded not based on merit or value for money, but on nepotism and personal relationships. Such practices compromise the quality and reliability of health service delivery, often inflating costs and delaying access to essential resources.
Equally alarming is the theft and embezzlement of medical supplies and equipment, which robs the public of vital healthcare services. In both countries, there are widespread reports of public-sector healthcare workers diverting state-funded medication and equipment to support their private practices. The siphoning of public resources results in chronic shortages of critical medicines and equipment in hospitals and clinics, leaving ordinary citizens to bear the brunt of a weakened healthcare system.
Despite the introduction of various anti-corruption strategies, corruption in Zimbabwe and South Africa continues largely unchecked.
A central issue is the lack of effective whistleblower protection. In South Africa, the Protected Disclosures Act was designed to protect individuals who report wrongdoing, but poor implementation means many whistleblowers remain vulnerable. Equally, Zimbabwe has a poor whistleblower protection framework. In both countries, those who speak out risk losing their jobs, being harassed or killed. Without proper protection and incentives, few individuals are willing to come forward, allowing corruption to flourish in silence.
Another major problem is politically captured institutions. In South Africa, many high-profile figures linked to the ANC have been implicated in serious corruption scandals yet continue to operate with impunity. In Zimbabwe, the ruling Zanu-PF party exerts significant control over institutions that are supposed to operate independently, such as the National Prosecuting Authority (NPA). As long as those implicated in corruption enjoy political protection, the rule of law becomes selectively applied.
In South Africa, there is also ineffective coordination among anti-corruption bodies. Agencies such as the South African Police Service, the NPA, the Directorate for Priority Crime Investigation, and the Special Investigating Unit often work in silos, each focusing on its narrow mandate. This fragmented approach hinders information sharing and slows down investigations, making it easier for corruption networks to evade justice.
A further weakness is the lack of political will. Leaders in both countries routinely make strong statements about fighting corruption, yet decisive action rarely follows. Investigations are delayed, prosecutions dropped, and politically connected individuals shielded from accountability. Without genuine commitment from the highest levels of government, anti-corruption institutions are left to function with limited authority and impact.
Insufficient funding is another obstacle. In Zimbabwe, anti-corruption agencies operate on extremely tight budgets, often lacking the resources, staff, and tools to carry out thorough investigations or follow through on cases. The situation is so dire that some institutions are barely able to cover operational costs, let alone tackle complex corruption networks.
The media landscape in Zimbabwe further complicates the fight against corruption. A deeply polarised media means that corruption cases are either underreported or reported with heavy bias, depending on political allegiances. This often turns corruption into a tool for political point-scoring rather than an issue of national concern.
Finally, public participation in anti-corruption efforts remains weak in both countries. Citizens often feel powerless or cynical, believing that reporting corruption is futile. In some cases, communities are unaware of reporting channels or distrust them. Without a strong civic voice and meaningful public involvement, anti-corruption strategies risk becoming top-down processes with little grassroots impact.
Promising opportunities
Despite many problems, Zimbabwe and South Africa have promising opportunities to fight corruption more effectively in healthcare.
One such opportunity lies in the use of technology. As digital tools continue to advance, they offer ways to reduce the role of human discretion in areas such as procurement, drug distribution, and patient data management. For example, blockchain technology can help create transparent, tamper-proof records of financial transactions, making it easier to trace how public funds are used and harder for dishonest officials to cover their tracks. Similarly, e-health systems, including electronic medical records and automated supply chains can help prevent theft and mismanagement by improving oversight and accountability.
Additionally, artificial intelligence can be used to detect unusual patterns in procurement data, monitor medicine stock levels, or flag suspicious transactions that might indicate fraud. These tools are already being used in other parts of the world to fight corruption in public health, and there is no reason they cannot be adapted to the African context with the right investment and political support.
Stronger action
If Zimbabwe and South Africa are serious about fighting corruption in the healthcare sector, stronger action is urgently needed. First, both governments must focus on strengthening their anti-corruption institutions. These institutions need proper funding to hire and retain skilled staff, offer regular training, and have access to the tools and technology needed to carry out effective investigations.
Moreover, there must be a safe and supportive environment for whistleblowers. Both countries should strengthen legislation to protect those who report corruption. Creating a dedicated anti-corruption agency, supported by specialised anti-corruption courts, and fostering a more diverse and independent media can also help to strengthen the fight against corruption.
As we commemorate African Anti-Corruption Day, we must move beyond speeches and slogans. We must act — from policymakers and health professionals to civil society, the private sector, the media, and ordinary citizens.
Fighting corruption in healthcare systems is everyone’s responsibility. The health of our continent depends on it.
Dr Luckmore Chivandire is a lecturer at the University of Westminster Business School. Dr Munyaradzi Saruchera is the director and senior lecturer at the Africa Centre for Inclusive Health Management at Stellenbosch University, as well as a professional associate at the Anti-Corruption Centre for Education and Research of Stellenbosch University (ACCERUS). Pregala Pillay is a professor at the School of Public Leadership at SU and director of ACCERUS.