The COVID-19 pandemic tested global supply chains in ways never seen before. In particular, medical procurement functions were placed under unprecedented pressure to acquire critical supplies, from equipment like PPA and RNA tests to pharmaceuticals, including COVID-19 vaccines and booster shots.
There are many success stories from the pandemic, with industries small and large pivoting at unprecedented speeds to meet new and unprecedented demand. The fact the world has largely recovered from the worst of the pandemic’s effects is partly due in a very real way to the procurement and logistical efforts of major health organisations and their ability to coordinate their supplier ecosystems.
However, there are also more than enough stories of inefficiency, price gouging, and corruption. In the UK alone, Conservative peer Michelle Mone and her children had secretly received £29 million of profits from government PPE contracts which she had lobbied for during the COVID-19 pandemic.
Corruption and lack of transparency
In many cases, citizen groups argue, corruption within medical supply chains is a direct result of a lack of transparency that benefits public procurement organisations, drug companies, and those committing fraud, at the expense of citizens in need of effective and affordable healthcare.
In early 2024, a group of more than 50 civil society organisations—including the People’s Vaccine Alliance, Public Citizen, and Health GAP—penned an open letter to the heads of the world’s largest pharmaceutical procurement functions.
Addressed to top executives at UNICEF, the Pan American Health Organization (PAHO), vaccine alliance Gavi, The Global Fund to Fights AIDS, Tuberculosis and Malaria and the US President’s Emergency Plan for AIDS Relief (PEPFAR), the letter urges greater transparency—namely, the phasing out of “secrecy clauses”—in purchasing agreements with major pharmaceutical manufacturers.
“Shielded by their non-disclosure agreements, private companies are impeding the public’s interest in transparency, oversight, and accountability, fostering an environment conducive to corruption,” reads the letter. The scale at which these major buyers acquire medical products reflects the scope of the problem. The United Nations’ procurement system alone spent $10.6 billion on medical products in 2021 (this has admittedly fallen for the first time in the last year, as the effects of the pandemic abate).
A proposed end to secrecy clauses
The letter’s authors go on to urge that major health procurement agencies use their buying power to reject secrecy clauses that are hindering “equitable access to essential medicines by making it harder to establish fair terms, reasonable prices, and timely supply”.
“We believe it is time for the largest procurers of medical products, including UNICEF, PAHO, Global Fund, PEPFAR and Gavi to act individually to adopt new transparency policies and collectively to support the adoption and enforcement of a new common standard that rejects secrecy, and that supports more robust, accessible reporting of procurement contract terms and agreements. Similarly, governments should reject coercive non-disclosure agreements, and simultaneously they should clarify or modify their freedom of information and drug procurement laws to ensure that supply, price, and distribution terms are publicly available,” the letter concludes.
The last three years have demonstrated beyond a shadow of a doubt the potential for medical procurement to rise to immense challenges in times of crisis, as well as emphasising its absolute criticality in a world where access to medical care remains unequal and, in many places, scarce.
Procurement, then, has a responsibility to drive transparency and cooperation throughout the medical supplier ecosystem and ensure that corruption, greed, and fraud have no place in the process of manufacturing, procuring, and administering life-saving materiel.
