Abstracts

78 challenge for assessing their institutions’ effectiveness. While criminal justice agencies, such as the Public Protector, the Hawks, and the Special Investigating Unit, have specific roles regarding anticorruption, no single institution that is solely responsible for fighting corruption exists. Compared to these organizations that have a reactive approach to corruption, auditing institutions, such as the AGSA, have a proactive strategy in dealing with corruption; they are charged with detecting potential irregular expenditures and making them publicly visible through published reports. These audits provide the opportunity for other agencies to pursue investigation if there is a flagrant indication that corruption could be happening. With limited budgets, personnel, and powers, it is difficult for these agencies to focus solely on corruption in the health sector. In addition, while all of these organizations work toward the common goal of fighting corruption, ambiguity as to which institution is responsible for dealing with which particular instances results in duplication that may produce varying or conflicting results (Pereira et al., 2012). This diffused and potentially overlapping responsibility thereby weakens the effectiveness of anticorruption efforts. Civil Societies and Nongovernmental Organizations NGOs and independent agencies also partake in the fight against corruption. They empower communities to come together for collective action by giving them platforms to voice their concerns at all levels of government. CorruptionWatch, a nonprofit organization and an accredited chapter of the global civil society organization Transparency International, provides an online platform for the public to report corrupt activities via a hotline, starts investigations on the reports of alleged acts, analyzes information to identify patterns, and mobilizes people through campaigns against corruption (Corruption Watch, n.d.). Another nonprofit organization fighting against health care corruption, Section 27, is a human rights organization that focuses on access to health care services and other socioeconomic rights. Their name is based on Section 27 of the South African Constitution, which guarantees the rights to health care, food, water, and social security. They collaborate with other social justice, law enforcement, and professional health organizations to research, advocate, and improve South Africans’ socioeconomic conditions. Just like Corruption Watch, they publish reports to informSouth Africans of how their rights are being violated by corruption. As of 2018, Section 27 had received 657 cases, and of those cases 123 were health related, ranking second behind education (Section 27, 2018, p. 14). The organization’s 2018 annual report also highlighted efforts in exposing corruption in private ambulance and medical equipment procurement, the Life Esidimeni tragedy, and illegal stem cell treatment trials. In 2017, a private general practitioner signed a multimillion rand contract with the Free State Department of Health to conduct illegal and unproven stem cell therapy trials on patients, and Section 27 reported these activities to the Health Professions Council, South African Health Products Regulatory Authority, and the NDoH, with the intention to suspend the experimentations (Section 27, 2018, p. 27). While these civil societies perform diligent work to shed light on corrupt activities that risk the health of South Africans, their resources and capacity are limited as they are but small NGOs. As a result, they investigate only a select number of reports and move forward only with cases that have the greatest positive impact. In addition, their primary functions are educating, advocating, and lobbying; therefore, they do not have authority to execute full investigations. Although their efforts against corruption are impactful, because they influence both the public and state authorities, they are not enough to fully address the problem. Health Sector Regulators Health sector regulators play an important role in protecting the health and safety of the public as they ensure strict compliance, regulate standards and policies aligning with the government’s priorities, and prevent corruption in the health sector. According to the Medical Schemes Act developed by the South