Tariffs Corruption And Other Impediments To Medicinal Access In Developing Countries: Field Evidence

Africa Fighting Malaria | 06 Aug 2006
Medical News Today
Lengthy customs procedures, onerous bureaucratic hurdles and tariff related corruption at borders are highlighted as barriers to accessing medicines in a new report published by the American Enterprise Institute. The report "Tariffs, Corruption and Other Impediments to Medicinal Access in Developing Countries: Field Evidence" presents evidence from interviews conducted with various organizations involved in supplying medicines and medical devices to developing countries.

As lead author, Dr Roger Bate of the American Enterprise Institute notes "we know that tariffs and taxes increase the cost of medical treatment in poor countries, but our study exposes the degree to which the delays and corruption associated with tariffs undermine healthcare and public health programs." Bate and the co-authors go on to call for countries urgently to remove import tariffs and to simplify customs procedures so that urgently needed medical supplies can be delivered promptly.

The study finds that 85% of reported cases of importing medicines and medical devices experienced unanticipated delays, ranging from a few days to several months. Some of the cases resulted in legal expenses to free goods from customs, but in 90% of the cases, a non-official payment, such as an administrative fee, was charged and in one third of the cases a bribe was demanded from customs officials. Non-official payments and bribes increase the cost of delivering much needed medicines and medical technologies and discourage trade and healthcare aid to some poor countries. According to the study, bribes are demanded most routinely in Vietnam and least in China and Uganda. The worst performing country with regard to unnecessary delays was Nigeria, followed by Kenya.

The study finds that most official aid from donor governments is exempted from tariffs and political pressure from donor country missions can ease the flow of medical aid through customs. However, charities, faith based organizations, private companies and NGOs do not have the political clout or influence to avoid these highly damaging trade barriers.

Roger Bate argues that any customs delays can be disastrous not only because patients are forced to wait for their medicines or could be denied treatment altogether, but in some cases medicines that require cold storage are stored incorrectly, effectively destroying the shipment.

According to Richard Tren, co-author of the study and director of Africa Fighting Malaria, "the delays can often be disastrous for malaria control programs. In those countries with seasonal malaria, it is essential that malaria control activities begin on time, before transmission begins. The delays caused by corrupt, venal government officials hamper public health programs and may well lead to unnecessary deaths."

Tren goes on to argue that "the discretionary power given to customs officials must be removed. They have no right to deny people access to healthcare and essential medicines. It is incumbent on poor country governments to remove the tariffs and any other regulations that allow this corruption to take place. The politicians that maintain these tariffs and give power to corrupt border officials are as guilty as the customs officials that receive the bribes."

The removal of all tariffs on medicines and medical devices has been the focus of a World Trade Organization sectoral initiative, led by the United States, Singapore and Switzerland. The authors argue that despite the recent collapse of the Doha Development Round, WTO members should still pursue the worthy goal of freeing medicines from import tariffs and the corruption that often accompanies these charges.