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A review of corruption and accountability issues in Nigeria’s COVID-19 response: Implications for health systems governance

By: Prince Agwu, Nma Ekenna, Uche Obi, Tochukwu Orjiakor, Aloysius Odii, Enyi Etiaba, Benjamin Uzochukwu, Obinna Onwujekwe

Flexible and urgent health spending during public health emergencies distorts procurement processes and potentially encourages corrupt practices in health systems. This can erode public confidence, resulting to poor compliance to health safety measures during public health crisis. Thus, anticorruption in health, and in pandemic responses is key. COVID-19 related articles (reports from various government bodies and CSOs) on resource mobilization, appropriation, public perceptions towards accountability and anticorruption, were reviewed. Findings were organised under three themes: i) mobilized resources for COVID-19, ii) evidence of corruption or anticorruption in spending them and iii) implications for health systems governance.

About N36.3b ($US93.5m) was raised through 295 donations to federal and state governments, to combat the virus. Additionally, Nigeria appropriated N10b ($27m) to epi-centres and the disease control agency in the country. Whilst information on available resources are freely available, that on expenditure has been opaque, which has generated heated concerns. Lack of evidence of optimal utilization of resources under the frames of accountability and anticorruption has aroused public concerns and trust in the actual existence of a pandemic. Diminished health worker motivation connects with industrial actions.

CSOs need to be actively engaged in driving government to show accountability, through partnering with multilateral organisations and donors to increase pressure on government to be accountable with resources mapped out for pandemic responses. Health workforce groups and Associations also need to actively engage government and demand accountability. Finally, conversations on corruption and accountability issues that affect health systems should be encouraged.

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