A systematic review of the impact of corruption in Latin America during the spread of the first wave of COVID-19

Introduction

The Covid-19 pandemic has caused economic, political and social impacts. The first wave of contagion made America the new epicentre in mid-2020, after devastating in Europe and Asia and resulted from the demographic, political and economic gaps that have existed for decades. Limited access to education and hygiene that restricted the success of health strategies against Covid-19.^1–3

Peru's early health actions against Covid-19 were prompt. However, while these measures prevented many deaths, they did not achieve the pre-established indicators and, on the contrary, put at risk promising rates of recovered patients and reduced infections.^3,4

Informality, cultural factors and the need for a daily income are considered ⁵ the main reasons for a reluctance to comply with Covid-19 strategies based on quarantine, targeting, and mass screening for SARS-CoV-2. However, lurking endemic corruption must be added, which is overlooked by the media and internet bias towards Covid-19 news. ⁶

In this context, corruption, minimal citizen accountability, and socio-economic factors challenge proposals to contain Covid-19 and the success of government strategies, resulting in limited success and the perpetuation of the state of emergency that threatens future economic and community health.^7,8

In this study, we conducted a systematic review to analyse the relationship between corruption and Covid-19 in Latin American countries during the first wave of contagion in 2020. We highlight its main components and the institutions involved, as it is likely that similar situations exist elsewhere.

Methods

Search strategy

We systematically searched scientific search engines (MEDLINE/PubMed, ScientiDirect, SciELO, LILACS, and Latindex), public pre-publication servers (bioRxiv, SocArXiv, medRxiv, and Preprints), and Google Scholar (meta-search) to identify studies on corruption during the Covid-19 pandemic. For PubMed, the terms ((SARS-CoV-2) OR (Covid-19)) AND ((Corruption [Mesh]) AND (Latin America)) were used, and for the other search engines, the terms ((SARS-CoV-2) OR (Covid-19)) AND ((Corruption) AND (Latin America)) were used in English, Spanish and Portuguese. The manual search was conducted between 15 July and 25 June 2020, and the review was conducted independently by two authors to verify the inclusion criteria of the studies following PRISMA recommendations (Figure 1).

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Figure 1.

PRISMA flowchart of studies selected on corruption and COVID-19.

Results

In the study selection, the initial search yielded 1073 studies, 36 in MEDLINE/PubMed, 20 in SciELO, 6 in ScienceDirect, 1000 in Preprints, 8 in bioRxiv, 2 in SocArXiv, and one in medRxiv. From the 25 eligible studies, all were eliminated for not meeting the study inclusion criteria. Nine studies were eliminated for being narrative studies that explore social issues related to Covid-19 but do not involve a central analysis of corruption processes.^7,10–16

In addition, other studies on corruption did not have a nexus to the current pandemic,^17–22 while two studies presented models for estimating corruption in different settings without being unique to Covid-19.^23,24

During the study period, no studies were identified that met the standard required to analyse the analogy between corruption and Covid-19 in Latin American countries. Therefore, there is insufficient evidence to support a firm explanation.

Discussion

This systematic review showed that there is no evidence available on corruption of processes and Covid-19 in Latin American countries, the corruption’s components, and the extent to which it affects public and private institutions in the context of the current pandemic; it was an “empty review” as no studies were eligible for inclusion and analysis. ²⁵ The empty review is a tool to improve the synthesis of evidence. ²⁶ This study shows the lack of studies on the impact of corruption during Covid-19, even though corruption is a known and widely evident phenomenon in Latin America that worsens inequity. ²²

Corruption has been destroying the fragile economic structures of almost all Latin American countries,^21,27 and Peru in particular, and it is important to assess its impact. Poverty and corruption make perfect allies for the progress of the disease in Latin America.^3,8,10 The lack of a study assessing the impact of corruption during the first wave of contagion in 2020 leads us to propose a negative synergy between corruption and the pandemic (Figure 2) and to extend an exploratory discussion on the main events.

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Figure 2.

Correlation between corruption and Covid-19. The back-and-forths of these two components generate a vicious circle that hampers the promising impact of health strategies against the pandemic by exacerbating the disease in Latin America, particularly in Peru.

Before the pandemic, more than a dozen former governors and presidents of the region's countries had arrest warrants. Some are in preventive detention. Others are judicial fugitives on warrants or imprisonment, seeking extradition or asylum, but are about to return to their countries to deal with the anti-corruption criminal justice system. With the emergence of new acts of corruption during this pandemic, public or state officials (and servants) continue to violate nationals' fundamental rights, affecting their economic income by failing to build hospitals equipped with highly specialised health care personnel to combat Covid-19; thousands of people have died.^8,16,17,28 In addition to the harm from the contagion's effects, the fundamental rights to life, health, social welfare, and a better quality of life with dignity,^8,13,24,29 have been adversely impacted by the corrupt and corrupters who divert and facilitate huge sums of money to transnational and national companies, and individuals. Fresh acts of corruption^6,27,30 have been recorded in all of the region's nations during this epidemic, with some authorities intending to let them go unpunished. As a consequence, the serious health crisis, social isolation, and deprivation of constitutional rights go unchecked. Instead, it has encouraged corrupt and corrupting authorities (as well as certain public workers) to design extremely subtle types of actions or crimes against the public administration, emphasising crimes such as passive bribery, extortion, embezzlement, fraud, and so on.

Corruption scandals during the pandemic have alarmed governments, international authorities, and quarantined citizens, so SARS-CoV-2 has not prevented a persistent “virus” from continuing to spread throughout Latin America. Corruption has become the norm in Latin America due to erratic allocation of funds, exorbitant purchase prices and a lack of transparency in government access to resources to respond to the pandemic.^19,31,32

The year 2020 has brought the most damage to the region and, at the same time, has been the year where acts of corruption have been registered.^{2,3,8,19,28–34} During this period, the biggest cases of corruption have been the overpricing by US $2 million spent to purchase mechanical respirators for critical Covid-19 patients in Bolivia, and the salary increases of governors and mayors (>US$5,000) in Paraguay and the overpriced purchase of 15,000 expired N95 masks. ³⁵ Brazil had the world's second-highest number of cases in 2020, about 49,000 Covid-19 deaths, and reported embezzlement of more than $200 million in public funds in seven states. In Colombia, embezzlement of funds, illegal awarding of contracts without public tender, even altering market prices for poor families and money transfers between public officials have been reported.^30,31 This is why corruption has mainly affected the education (16%) and health (13%) sectors. ³⁶

On the other hand, when Ecuador became one of the countries most devastated by Covid-19, the overpriced purchase of plastic body bags (from US$12 to US$144 per unit) was reported.^15,37 El Salvador has also reported acts of corruption; during the first wave of contagion, with more than 63 reports of corruption, involving the Ministry of Health (16%), the Ministry of Economy (24%), and local municipalities (22%).^37,38

Before the pandemic, both Peru and Brazil were understood to have latent corruption problems. ³⁹ Although the International Corruption Perception Index does not list Peru as one of the main countries with this problem, ⁴⁰ we argue that the political evidence of the last three decades indicates that corruption affects everything from the country's top leaders to civil society, i.e. there is endemic corruption that has surfaced during the pandemic.^{6,21,30–33,41}

In this bicentennial of the Peruvian Republic, corruption cases have increased since the fortnight of March of this year, when the purchase of diluted disinfectant and labile face masks by the Peruvian National Police (which caused 11,000 contagions and 200 deaths) stands out. ³⁵ Later, during the political and social crisis, cases of corruption by public officials in the purchase of vaccines emerged, even involving the Presidency of the Republic. ⁶

Although the acts of corruption are now public and there are comments and reflections on them, they are not being analysed as a whole, through the lens of science. ^{6,21,24,28,41–43} Therefore, there is no real evaluation of the impact of corruption, even though it is well defined what occurred and when it occurred. ⁴⁴ There is an urgent need to establish and deploy a methodological dialogue between science and corruption to assess its consequences, understand the phenomenon (which is very common in Latin America) and propose prevention, control and monitoring strategies. ⁴⁵

Proper governance can improve not only public health activities in prevention and health promotion, but reduce the scope of corrupt practices. E-government in the framework of digital government and sectional government compliance could contribute to reducing corruption during the Covid-19 pandemic,^19,24 provided that they are contextualised according to national priorities and data is applied in an organised manner according to the sectors assessed. ²³ In the context of a population with little education in hygiene and sanitation, how can we build the will, is undermined by corrupt practices at territorial, national, and regional governmental levels?

Conclusion

No studies were found that met the criteria for inclusion in this review of corruption and Covid-19 during the first wave of contagion in Latin American countries. The gathering and scrutiny of evidence of the impact of corruption during pandemic is now a necessity for this region.