Legislating for Good Governance in the Pharmaceutical Sector through UN Convention Against Corruption (UNCAC) Compliance

ABSTRACT

Pharmaceutical sector corruption undermines patient access to medicines by diverting public funds for private gain and exacerbating health inequities. This paper presents an analysis of UN Convention Against Corruption (UNCAC) compliance in seven countries and examines how full UNCAC adoption may reduce corruption risks within four key pharmaceutical decision-making points: product approval, formulary selection, procurement, and dispensing. Countries were selected based on their participation in the Medicines Transparency Alliance and the WHO Good Governance for Medicines Programme. Each country’s domestic anti-corruption laws and policies were catalogued and analysed to evaluate their implementation of select UNCAC Articles relevant to the pharmaceutical sector. Countries displayed high compliance with UNCAC provisions on procurement and the recognition of most public sector corruption offences. However, several countries do not penalise private sector bribery or provide statutory protection to whistleblowers or witnesses in corruption proceedings, suggesting that private sector pharmaceutical dispensing may be a decision-making point particularly vulnerable to corruption. Fully implementing the UNCAC is a meaningful first step that countries can take reduce pharmaceutical sector corruption. However, without broader commitment to cultures of transparency and institutional integrity, corruption legislation alone is likely insufficient to ensure long-term, sustainable pharmaceutical sector good governance.

KEYWORDS:

• Corruption
• access to medicines
• transparency
• accountability
• pharmaceutical policy

Introduction

Frequently defined as ‘the abuse of entrusted power for private gain,’ corruption has been identified as a barrier to economic growth, the achievement of the right to health, the attainment of the United Nations (UN) Sustainable Development Goals (SDGs), and the equitable distribution of public resources to those most in need (Kohler et al., 2014; Mackey et al., 2016; Transparency International, n.d.). Corruption in the public sector has been described as a key element of economic underperformance and a major obstacle to poverty alleviation and development, with UN Secretary-General António Guterres declaring it to be ‘criminal, immoral, and the ultimate betrayal of public trust’ (Guterres, 2020; United Nations, 2003). Globally, its impact is borne unequally, with the effects of corruption often amplified within low- and middle-income countries (LMICs) (Guterres, 2020). In turn, this compounds the challenges to providing basic health services already faced within many of these countries (Brunelle-Quraishi, 2011; United Nations, 2003).

Corruption exacerbates inequities in access to healthcare services and has been linked to poor health outcomes through the diversion of government health systems spending and the distortion of incentives held by healthcare decision-makers and providers (Botero-Rodríguez et al., 2022; Lessig, 2013). The pharmaceutical sector is characterised by unique risk factors that make it particularly vulnerable to corruption (Rodwin, 2013). These risk factors largely arise due to the sector’s governance complexities and high number of public-private decision-making points concentrated within a highly regulated environment. These risks are also associated with the sector’s substantial information asymmetries between stakeholders, technical complexities, and the large flows of money and high-value goods that are available for corrupt actors to exploit (Mackey et al., 2016). Key decision-making points along the pharmaceutical value chain are especially exposed to corruption risks, due in large part to their importance in determining the availability and price of pharmaceutical products. These include product approval, formulary selection procurement, and dispensing (Kohler et al., 2014; Kohler & Ovtcharenko, 2013; Mackey et al., 2016; Publications Office of the European Union, 2013). This in turn threatens to undermine the attainment of Universal Health Coverage (UHC), a UN SDG target, since timely patient access to affordable, quality, and effective essential medicines is directly harmed by pharmaceutical sector corruption (Bruckner, 2019). By contrast, increased pharmaceutical sector accountability and integrity have been shown to have a robust positive correlation with patient health outcomes (Kohler & Ovtcharenko, 2013; Mackey et al., 2016; MacKey & Liang, 2012).

This paper presents an analysis of Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia’s compliance with select provisions of the UN Convention Against Corruption (UNCAC), an internationally binding anti-corruption treaty to which all countries are parties. In particular, it examines how UNCAC compliance may reduce pharmaceutical sector corruption risks within the four identified pharmaceutical decision points: product approval, formulary selection, procurement, and dispensing. We find that while these countries display high compliance with UNCAC provisions on procurement and the enactment of certain public sector corruption offences, several countries do not penalise private sector corruption or provide statutory protection to whistleblowers and/or witnesses in corruption proceedings. This outcome suggests that pharmaceutical sector actors may face the fewest legal consequences for engaging in corruption when dispensing pharmaceuticals to patients as compared to the other examined decision points, since this is where non-procurement-related private sector corruption is most likely to occur within the pharmaceutical value chain.

The UNCAC and the international anti-corruption legal framework

In 2003, the UN General Assembly adopted the UN Convention Against Corruption (UNCAC), the world’s first and only comprehensive global anti-corruption instrument, which subsequently entered into force on 14 December 2005 (Rose, 2015; Weilert, 2016). The adoption of the UNCAC marked the culmination of nearly three decades of anti-corruption activity pursued by countries domestically and on the international stage, as well as a concerted post-Cold War push by international organisations to include corruption within their development agendas (Rose, 2015; The World Bank, 2022; U4 Brief, 2007; Vlassis, n.d.; Webb, 2005; Weilert, 2016). Negotiations of the UNCAC, which were completed between January 2002 and October 2003 in Vienna by the UN Ad Hoc Committee for the Negotiation of a Convention Against Corruption, progressed at a speed unusual for an international anti-corruption instrument of its size (Rose, 2015). International participation in the UNCAC was also notably high (Rose, 2015). Throughout negotiations, an average of over 100 states attended each session, with the final draft commanding broad support from all regional groups (Weilert, 2016). 140 countries signed the UNCAC at the time of its adoption, with very few reservations to its substantive provisions on corruption prevention, criminalisation, international enforcement cooperation, asset recovery, and technical assistance (Rose, 2015). Today, all but nine UN members have ratified the UNCAC, resulting in its characterisation as a truly global anti-corruption instrument (United Nations Office on Drugs and Crime, 2021).

The UNCAC contains 71 Articles, addressing substantive anti-corruption provisions as well as provisions on the administration and enforcement of the UNCAC itself. Key anti-corruption components of the UNCAC include provisions on public employee codes of conduct, transparency and accountability measures, and punishable corruption offences. Compliance with the UNCAC primarily requires country parties to implement the Convention’s substantive provisions into their national legal systems. While there is no general provision in the UNCAC requiring state parties to adopt all UNCAC standards into their domestic law, five Articles describing various corruption offences contain unambiguously mandatory implementation language: Articles 15 (bribery of domestic public officials), 16 (bribery of foreign public officials), 17 (embezzlement by a domestic public official), 23 (laundering of the proceeds of crime), and 25 (obstruction of justice). All other UNCAC provisions contain language allowing party implementation with varying degrees of flexibility. For example, compliance with Article 8 requires states to ‘endeavour to apply, within [their] own institutional and legal systems’ codes of conduct for public officials, while Article 21 merely requires states to ‘consider adopting’ measures to criminalise private sector bribery.

Country compliance with the UNCAC is formally evaluated through the UN Office on Drugs and Crime Implementation Review Mechanism, which employs a country self-assessment coupled with a peer-review process. To date, two rounds of formal peer-review cycles have been implemented and/or scheduled for all country parties to evaluate country compliance with different UNCAC Chapters (UNODC, n.d.). While the self-assessment and peer-review system enables countries to proactively self-monitor for compliance against defined standards in a non-adversarial implementation environment, it has also been criticised for its lack of civil society involvement and inability to levy enforceable penalties against non-compliant parties (Conzelmann, 2011; Hechler et al., 2011; Trivunovic et al., 2013; UNODC, 2011).

Anti-corruption initiatives for global health

Following the adoption of the UNCAC by the UN General Assembly, access to medicines campaigns in LMICs increasingly sought to incorporate anti-corruption strategies – framed as transparency and accountability efforts – into broader global health initiatives (Paschke et al., 2018). Over the next decade, these notably included the WHO Good Governance for Medicines (GGM) programme and the Medicines Transparency Alliance (MeTA), two international initiatives focussed on strengthening pharmaceutical sector governance to improve health outcomes in LMICs.

The WHO GGM was launched in 2004 as a programme designed to address the need for transparency and corruption prevention in domestic health sectors. Over 38 countries participated in the three-phase programme, which involved national pharmaceutical sector transparency and corruption vulnerability assessments, the development of action plans based on the WHO Model GGM Framework, and the implementation of country-tailored programmes within participating Ministries of Health (Baghdadi-Sabeti & Serhan, 2010; Kohler & Baghdadi-Sabeti, 2011; John Martin & Ollier, 2012). The GGM programme development and implementation phases focussed on institutionalising and enforcing codes of conduct, sanctioning corrupt behaviour by enforcing domestic anti-corruption legislation, providing adequate avenues for whistleblowing, and strengthening the transparency and accountability of pharmaceutical sector administrative procedures (Baghdadi-Sabeti & Serhan, 2010; Kohler & Baghdadi-Sabeti, 2011).

MeTA was established in 2008 with the goal of improving transparency and accountability in the pharmaceutical system through multi-stakeholder evidence review and collaboration, based on the underlying hypothesis that patient access to medicines could be improved by enhancing evidence-based pharmaceutical sector decision-making (Vian & Kohler, 2016). The programme has been credited with facilitating enhanced data collection, disclosure and drug pricing policy changes in the seven LMICs in which it operated (J Martin & Schurmann, 2016; Vian & Kohler, 2016). Unlike the GGM programme, whose broad range of anti-corruption efforts included a focus on enforcing offence-based corruption legislation and levying penalties for non-compliance, MeTA was uniquely focussed on reducing information asymmetries between pharmaceutical sector stakeholders to curtail opportunities for embedded actors to engage in corrupt behaviour (Anello, 2008; J Martin & Schurmann, 2016; Vian & Kohler, 2016).

The GGM programme and MeTA both implicitly recognised that the adoption and enforcement of anti-corruption laws, while necessary, would be insufficient to improve good governance and reduce corruption within country pharmaceutical systems. Domestic leadership promoting ethical and transparent behaviour among pharmaceutical sector decision-makers was considered vital (Anello, 2008; Baghdadi-Sabeti & Serhan, 2010) but much more challenging to achieve. The anti-corruption approaches adopted by both the GGM programme and MeTA align strongly with the UNCAC, which in addition to its requirement that parties prohibit and penalise certain types of corrupt behaviour within their domestic legal systems, provides a baseline set of anti-corruption policies for the broader prevention, detection, punishment, and deterrence of a wide range of corrupt activities (United Nations Convention Against Corruption, 2004). All seven MeTA countries (Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia) are parties to the UNCAC. Jordan, the Philippines, and Zambia also participated in the GGM programme.

This paper evaluates these seven countries’ adoption of and compliance with a subset of UNCAC provisions that complement their GGM and MeTA participation by reducing the risk of corruption in domestic pharmaceutical product approval, formulary selection, procurement, and dispensing processes. It contributes to ongoing discussions examining the effectiveness of the UNCAC at enabling country parties to strengthen their domestic anti-corruption measures and explores the limitations of international instruments at curbing pharmaceutical sector corruption. The results also highlight the role of comprehensive anti-corruption laws and policies at strengthening baseline governance across the pharmaceutical value chain to promote access to medicines and UHC, in line with the WHO Global Action Plan for Healthy Lives and Wellbeing for All (SDG 3) and the UHC2030 initiative (The Global Action Plan for Healthy Lives and Well-Being for All, n.d.; UHC2030: Our Mission, n.d.).

Methods

This study engaged in a multi-country investigation of national anti-corruption laws and policies applicable in the pharmaceutical sectors of all seven MeTA countries (Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia). The research classifies and critically analyses these legal texts against selected UNCAC provisions that are directly applicable to actors who manage the flow of pharmaceuticals within the four pharmaceutical sector decision-making points of interest: (1) regulatory approval, (2) formulary inclusion, (3) procurement, and (4) dispensing (see Table 1 and Annex A). UNCAC provisions that were excluded for the purpose of this study included the Convention’s general preambular and organising provisions (Preamble and Chapter I) and provisions on money laundering and asset recovery (Chapter V), international cooperation (Chapter IV), and the administrative management of the Convention (Chapters VII and VIII).

Table 1. UNCAC anti-corruption provisions included for analysis.

Key anti-corruption element	Relevant UNCAC Article(s)
Codes of conduct and conflict of interest declarations for public officials	Articles 8(2), 8(3), 8(5)
Procurement standards	Article 9(1)
Transparency (public access to information and civil society participation in anti-corruption efforts)	Articles 9(2), 10, 13(1), 13(2)
Public sector corruption offences (bribery, embezzlement, trading in influence, abuse of function, illicit enrichment)	Articles 15, 17, 18, 19, 20
Private sector corruption offences (bribery)	Article 21
Accountability (penalties for engaging in corruption)	Articles 8(6), 26(1), 30(1), 30(6), 30(7), 34
Witness and whistleblower protection	Articles 25, 32(1), 33
Corruption prevention (public official training)	Article 60(1)

A country-by-country and UNCAC Article-by-Article analysis was employed to evaluate country compliance with the selected UNCAC Articles, with specific consideration of whether countries have adopted the selected UNCAC Articles into their domestic law or policy. UNCAC Articles were grouped topically by anti-corruption objective (see Table 1), with country adoption also analysed contextually based on whether each examined UNCAC Article contained mandatory or non-mandatory adoption language. The selected UNCAC Articles were chosen based on their applicability to the four pharmaceutical sector decision-making points of interest, and country anti-corruption laws and policies were included for analysis if they were of general applicability or of specific applicability to the pharmaceutical sector.

Domestic adoption of the selected UNCAC Articles was evaluated by cross-referencing the selected UNCAC Articles with country laws identified in official UNCAC Implementation Review Mechanism country reports and the UN Office of Drugs and Crime (UNODC) Tools and Research for Anti-Corruption Knowledge (TRACK) Legal Library database (Country Profiles, n.d.; Legal Library, n.d.). Manual searches within domestic legal databases using keywords from each selected UNCAC Article were also conducted to ensure that amended versions of the recorded legislation, newly enacted statutes, or other subsidiary policy documents were not omitted. An additional search through Ministry of Health and national pharmaceutical regulatory body databases was conducted to identify the existence of codes of conduct applicable to government employees working in pharmaceutical regulatory approval bodies, formulary selection committees, and pharmaceutical procurement bodies, as well as pharmacists and healthcare workers involved in directly dispensing pharmaceuticals to patients. All searches were conducted in April 2023. The majority of documents were available in English, either in their original form or as official institutional translations. A small subset of documents was not available in English, and these documents were either read in their original language or read with the assistance of unofficial web-based translation tools. Identified laws and policies that were clearly no longer in force were not included for analysis. Once each country’s laws and policies were identified, their inclusion in this study was determined based on their substantive incorporation of each selected UNCAC Article (ex. use of verbatim or near-verbatim UNCAC Article language or clear use of non-UNCAC language which either fully or partially incorporated the substance of each selected UNCAC Article).

Results

116 laws and policies were included in the analysis of all seven MeTA countries’ UNCAC compliance. The number of identified laws and policies per country ranged from 11 in Uganda to 22 in the Philippines (see Annex B).

Peru adopted all examined UNCAC Articles through legally binding instruments (see Table 2). All other countries did not adopt at least one of the examined UNCAC provisions, with Zambia adopting the fewest examined provisions overall. While all countries primarily used domestic law to adopt the examined UNCAC Articles, Ghana, Jordan, the Philippines, and Uganda also employed non-binding domestic policies to substantively address one or two additional UNCAC Articles (most commonly Article 60(1), for the provision of anti-corruption training to public officials). In all countries but Peru, laws or policies adopting all four of the examined non-mandatory UNCAC corruption offences could not be identified (Articles 18-21). Most commonly, laws and policies adopting UNCAC Article 18 trading in influence, Article 20 illicit enrichment, and Article 21 private sector bribery could not be identified, as well as laws and policies adopting UNCAC Articles 32(1) and 33 for witness and whistleblower protection. By contrast, all countries uniformly adopted domestic legislation incorporating the three examined UNCAC Articles with unambiguously mandatory implementation language (Article 15 public official bribery, Article 17 public official embezzlement, and Article 25 obstruction of justice). All countries also uniformly adopted domestic laws incorporating the non-mandatory UNCAC Articles on transparent and accountable procurement procedures (Article 9(1)), the removal and disqualification of persons engaged in corruption from public office (Articles 30(6) and (7)), and the implementation of codes of conduct and conflict of interest disclosures for public officials (Articles 8(2), (3) and (5)).

Table 2. Country compliance with UNCAC provisions relevant to pharmaceutical sector corruption.

All countries adopted a combination of specific codes of conduct and conflict of interest policies governed at the Ministry of Health, drug regulatory authority, medicines selection committee and/or procurement body levels, with a residual general code of conduct and conflict of interest policy applicable to all civil servants when no decision-level code of conduct or conflict of interest policy was available (see Table 3). These codes were generally consistent with one another, differing primarily in their applicability to particular groups of civil servants and the specificity of their prescribed behavioural standards. For example, in Kyrgyzstan all civil servants are required to declare information about their or their immediately family members’ property and income (Law No. 114 on Civil Service, 2004, Art. 33), but state and municipal employees are specifically required to notify immediate supervisors of conflicts of interest upon becoming aware of them (Law No. 153 on Combatting Corruption, 2012, Art. 9).

Table 3. Country implementation of pharmaceutical sector codes of conduct and/or conflict of interest policies.

Furthermore, all countries but Ghana maintained a separate publicly available code of conduct for pharmacists – professionals responsible for dispensing publicly reimbursed medicines to patients but who frequently work as private sector employees rather than as civil servants subject to public codes of conduct (see Table 3). Since the penalties for a pharmacist’s failure to comply with their professional code of conduct often include their suspension or removal from the profession, the enforcement of pharmacist codes of conduct may serve as a remedial corruption deterrence measure in Jordan, the Philippines, and Zambia, where domestic legislation does not explicitly penalise private sector bribery. By contrast, in Ghana, where domestic legislation also does not penalise private sector bribery, the absence of a pharmacist code of conduct suggests that medicines dispensing may be particularly vulnerable to corruption since pharmacists face comparatively fewer legal and regulatory consequences for soliciting bribes from patients or engaging in embezzlement, fraud, or other corruption offences.

Discussion

While all seven MeTA countries display high compliance with most examined UNCAC provisions – particularly Articles on transparent and accountable procurement standards and adopting the UNCAC’s mandatory public official corruption offences – several countries do not penalise private sector corruption or provide statutory protection to whistleblowers and/or witnesses in corruption proceedings. These results suggest that pharmaceutical sector actors may face the fewest legal consequences to engaging in corruption when dispensing pharmaceuticals to patients (ex. by soliciting informal payments from patients) compared to pharmaceutical regulatory approval, formulary inclusion, or procurement processes, since this is where private sector, non-procurement related corruption is most likely to occur within the pharmaceutical value chain.

Though a core element of the WHO GGM programme explicitly included a focus on enforcing anti-corruption laws, the three evaluated MeTA countries that also participated in the WHO GGM (Jordan, the Philippines, Zambia) did not demonstrate greater adoption of the examined UNCAC provisions. Notably, all three of these countries did not recognise the offence of private sector bribery (UNCAC Article 21). This is particularly relevant as the direct burden of corruption borne by an individual patient is generally greater when they are personally solicited for a bribe (ex. by their dispensing pharmacist) rather than when they sustain the costs of upstream corruption (ex. price fixing within a pharmaceutical procurement body) that are subsequently spread across the entire pharmaceutical value chain. Since a pharmacist’s likelihood of engaging in corruption decreases when they face greater legal consequences to being caught (Karpoff et al., 2017), this suggests that patients in Kyrgyzstan, Peru, and Uganda – where private sector bribery is considered an offence – may benefit from greater legal protection against direct exposure to pharmaceutical sector corruption than those patients in Jordan, the Philippines, Zambia, Ghana. Here, the assumption that active enforcement of these corruption provisions is pivotal. If certain corruption offences are in fact rarely enforced, the deterrent effect of corruption legislation will be significantly attenuated (Forzley et al., 2013; Hussmann & Peñailillo, 2007). Similarly, when countries do not enact legislation that provides individuals with adequate whistleblower or witness protection (UNCAC Articles 33 and 32(1)), the deterrent effect of corruption offence legislation may be undermined when actors know that the actual likelihood of being caught and successfully prosecuted is low. This raises further corruption risks in the Philippines and Zambia, since in addition to not recognising the offence of private sector bribery, the Philippines does not maintain codified whistleblower protection laws while Zambia does not maintain witness protection legislation.

The varying degrees of substantive UNCAC compliance observed in this study reflect the limitations of an international agreement frequently criticised for achieving wide country participation at the cost of reduced enforcement capacity (Rose, 2015). The limited number of provisions that impose firm obligations on state parties, coupled with a self-assessment review mechanism that carries few penalties for non-compliance, create opportunities for countries to eschew implementation of the broad range of provisions originally envisioned in the UNCAC as essential for the creation of a robust and harmonised legal system capable of preventing corruption at both the domestic and international levels (Brunelle-Quraishi, 2011; Rose, 2015). When the degree of substantive compliance rests largely at the discretion of each state party, it becomes difficult to pinpoint the precise factors driving compliance within each country. While some posit that the likelihood of self-governing compliance driven by domestic policy is greater in democratic nations responsive to the pressures of their electorate and subject to the rule of law, UNCAC compliance among the seven MeTA countries does not correspond to their relative rankings on popularly cited democracy indices (Brunelle-Quraishi, 2011; Economist Intelligence Unit, 2023). Peru’s full adoption of all examined UNCAC provisions instead suggest that compliance may be driven by pre-existing country alignment with the UNCAC’s substantive provisions, as evidenced by the country’s prior participation in the Inter-American Convention Against Corruption, the first binding multilateral agreement on corruption and a precursor of the UNCAC (Webb, 2005). It also suggests that the adoption of non-mandatory provisions may be more comprehensive when countries are given a greater period of time to effect any prerequisite legislative changes. This is particularly true when a particular legislative change requires harnessing the political will of legislators subject to status quo party alignments or competing policy priorities.

Studies demonstrate that country success at reducing corruption likely operates independently from the mere adoption of anti-corruption legislation (Forzley et al., 2013; Hussmann & Peñailillo, 2007; Mungui-Pippidi & Kossow, 2016). Instead, anti-corruption efforts are frequently dependent on an underlying domestic commitment to principles and practices of institutional transparency and accountability among both public and private sector actors, monitored by an engaged civil society and enforced by an independent judiciary (David-Barrett et al., 2017; Kohler & Ovtcharenko, 2013). Viewed in this light, country enactment of corruption legislation may be seen as the by-product of a pre-existing government interest in tackling corruption, while the enforcement of enacted legislation may signal government willingness to expend real resources on reducing corruption – with the benefit of both holding existing corrupt actors accountable and prospectively deterring future corrupt behaviour. Country compliance with the UNCAC, as measured through country enactment of domestic law or policy that implements the UNCAC’s substantive provisions, thus provides an important but incomplete picture of a country’s total anti-corruption efforts. Importantly, the mere adoption of UNCAC Articles cannot capture a country’s long-term success at implementing the administrative, technical, and institutional machinery required to operate and enforce these laws and policies, including earmarking dedicated financial resources, developing standardised transparency and accountability procedures, and providing updated training across all levels of decision making. Within the pharmaceutical sector, UNCAC implementation can contribute to the deterrence and reduction of opportunities for corruption within the regulatory approval, formulary inclusion, procurement, and dispensing processes. However, in the same way that country compliance with the UNCAC may falter without a strict enforcement mechanism, domestic anti-corruption legislation alone, without adequate institutional support and enforcement, is insufficient for the elimination of pharmaceutical sector corruption.

The results of this study indicate that private sector corruption remains a key area that stands to benefit from concerted anti-corruption legislative activity as it is an area that is among the least regulated yet the most likely to directly affect patients. Despite criticism of the UNCAC’s enforceability, this study also underscores the UNCAC’s value at providing countries with a strong legal framework for identifying, penalising, and deterring corruption. By establishing clear behavioural standards that carry penalties for non-compliance, anti-corruption law is an important tool that policymakers can leverage to strengthen public health systems. As such, UNCAC compliance can serve as a useful benchmark when evaluating broader domestic legal approaches to reducing pharmaceutical sector corruption and promoting access to medicines. Additional research exploring country UNCAC implementation beyond mere Article adoption, including research that develops evidence-based methods for measuring country adherence to and enforcement of adopted anti-corruption laws and policies, would provide further insight into how legal tools can be practically applied to reduce pharmaceutical sector corruption.

Conclusion

A review of MeTA country compliance with UNCAC provisions relevant to pharmaceutical sector governance demonstrates that countries have successfully adopted the UNCAC’s mandatory provisions recognising bribery, embezzlement, and the obstruction of justice as penalisable offences, as well as its non-mandatory provisions on codes of conduct for public officials and procurement transparency and accountability. However, countries have inconsistently adopted the UNCAC’s non-mandatory provisions recognising trading in influence, illicit enrichment, and private sector bribery as penalisable offences, as well as its provisions on whistleblower and witness protection. Correspondingly, this study identifies medicines dispensing as a pharmaceutical value chain decision-making point particularly vulnerable to corruption, as the heightened presence of private sector decision-makers allows this transaction to escape the purview of the UNCAC’s mandatory corruption offences – which are only applicable to the behaviour of public officials. While private sector codes of conduct enforced through professional regulatory bodies may serve to mitigate this effect, these results suggest that patients in countries that both do not recognise private sector corruption as an offence and do not maintain adequate codes of conduct for pharmacists are protected by fewer legal safeguards against corruptionwhen seeking to obtain medicines. Strengthening countries’ anti-corruption legal regimes by fully adopting the UNCAC’s non-mandatory provisions is a meaningful first step that countries can take to increase the costs of engaging in corruption, and thus, reduce the likelihood that actors in fact choose to engage in corruption. However, without broader commitment to cultures of transparency and institutional integrity, corruption legislation alone is insufficient to ensure long-term, sustainable pharmaceutical sector good governance.

Acknowledgements

The authors thank Veronika Wirtz and Lisa Forman for their review and editorial contributions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Leslie Dan Faculty of Pharmacy, University of Toronto [grant number New Initiative and Innovation Award]; Netherlands Organisation of Scientific Research and the Amsterdam University Funds [grant number Veni Talent Grant].

Appendices

Annex A: Full text of UNCAC Articles included for analysis

Table

UNCAC Article	Provision Text
Chapter II, Art 8(2)	Each State Party shall endeavour to apply, within its own institutional and legal systems, codes or standards of conduct for the correct, honourable and proper performance of public functions.
Chapter II, Art 8(3)	Each State Party shall, where appropriate and in accordance with the fundamental principles of its legal system, take note of the relevant initiatives of regional, interregional and multilateral organisations, such as the International Code of Conduct for Public Officials contained in the annex to General Assembly resolution 51/59 of 12 December 1996.
Chapter II, Art 8(5)	Each State Party shall endeavour, where appropriate and in accordance with the fundamental principles of its domestic law, to establish measures and systems requiring public officials to make declarations to appropriate authorities regarding, inter alia, their outside activities, employment, investments, assets and substantial gifts or benefits from which a conflict of interest may result with respect to their functions as public officials.
Chapter II, Art 8(6)	Each State Party shall consider taking, in accordance with the fundamental principles of its domestic law, disciplinary or other measures against public officials who violate the codes or standards established in accordance with this article.
Chapter II, Art 9(1)	Each State Party shall, in accordance with the fundamental principles of its legal system, take the necessary steps to establish appropriate systems of procurement, based on transparency, competition and objective criteria in decision-making, that are effective, inter alia, in preventing corruption. Such systems, which may take into account appropriate threshold values in their application, shall address, inter alia: The public distribution of information relating to procurement procedures and contracts, including information on invitations to tender and relevant or pertinent information on the award of contracts, allowing potential tenderers sufficient time to prepare and submit their tenders; The establishment, in advance, of conditions for participation, including selection and award criteria and tendering rules, and their publication; The use of objective and predetermined criteria for public procurement decisions, in order to facilitate the subsequent verification of the correct application of the rules or procedures; An effective system of domestic review, including an effective system of appeal, to ensure legal recourse and remedies in the event that the rules or procedures established pursuant to this paragraph are not followed; Where appropriate, measures to regulate matters regarding personnel responsible for procurement, such as declaration of interest in particular public procurements, screening procedures and training requirements.
Chapter II, Art 9(2)	Each State Party shall, in accordance with the fundamental principles of its legal system, take appropriate measures to promote transparency and accountability in the management of public finances. Such measures shall encompass, inter alia: Procedures for the adoption of the national budget; Timely reporting on revenue and expenditure; A system of accounting and auditing standards and related oversight; Effective and efficient systems of risk management and internal control; and Where appropriate, corrective action in the case of failure to comply with the requirements established in this paragraph.
Chapter II, Art 10	Taking into account the need to combat corruption, each State Party shall, in accordance with the fundamental principles of its domestic law, take such measures as may be necessary to enhance transparency in its public administration, including with regard to its organisation, functioning and decision-making processes, where appropriate. Such measures may include, inter alia: Adopting procedures or regulations allowing members of the general public to obtain, where appropriate, information on the organisation, functioning and decision-making processes of its public administration and, with due regard for the protection of privacy and personal data, on decisions and legal acts that concern members of the public; Simplifying administrative procedures, where appropriate, in order to facilitate public access to the competent decision-making authorities; and Publishing information, which may include periodic reports on the risks of corruption in its public administration.
Chapter II, Art 13(1)	Each State Party shall take appropriate measures, within its means and in accordance with fundamental principles of its domestic law, to promote the active participation of individuals and groups outside the public sector, such as civil society, non-governmental organisations and community-based organisations, in the prevention of and the fight against corruption and to raise public awareness regarding the existence, causes and gravity of and the threat posed by corruption. This participation should be strengthened by such measures as:(a) Enhancing the transparency of and promoting the contribution of the public to decision-making processes;(b) Ensuring that the public has effective access to information;(c) Undertaking public information activities that contribute to nontolerance of corruption, as well as public education programmes, including school and university curricula;(d) Respecting, promoting and protecting the freedom to seek, receive, publish and disseminate information concerning corruption
Chapter II, Art 13(2)	Each State Party shall take appropriate measures to ensure that the relevant anti-corruption bodies referred to in this Convention are known to the public and shall provide access to such bodies, where appropriate, for the reporting, including anonymously, of any incidents that may be considered to constitute an offence established in accordance with this Convention.
Chapter III, Art 15	Each State Party shall adopt such legislative and other measures as may be necessary to establish as criminal offences, when committed intentionally: The promise, offering or giving, to a public official, directly or indirectly, of an undue advantage, for the official himself or herself or another person or entity, in order that the official act or refrain from acting in the exercise of his or her official duties; The solicitation or acceptance by a public official, directly or indirectly, of an undue advantage, for the official himself or herself or another person or entity, in order that the official act or refrain from acting in the exercise of his or her official duties.
Chapter III, Art 17	Each State Party shall adopt such legislative and other measures as may be necessary to establish as criminal offences, when committed intentionally, the embezzlement, misappropriation or other diversion by a public official for his or her benefit or for the benefit of another person or entity, of any property, public or private funds or securities or any other thing of value entrusted to the public official by virtue of his or her position.
Chapter III, Art 18	Each State Party shall consider adopting such legislative and other measures as may be necessary to establish as criminal offences, when committed intentionally: The promise, offering or giving to a public official or any other person, directly or indirectly, of an undue advantage in order that the public official or the person abuse his or her real or supposed influence with a view to obtaining from an administration or public authority of the State Party an undue advantage for the original instigator of the act or for any other person; The solicitation or acceptance by a public official or any other person, directly or indirectly, of an undue advantage for himself or herself or for another person in order that the public official or the person abuse his or her real or supposed influence with a view to obtaining from an administration or public authority of the State Party an undue advantage.
Chapter III, Art 19	Each State Party shall consider adopting such legislative and other measures as may be necessary to establish as a criminal offence, when committed intentionally, the abuse of functions or position, that is, the performance of or failure to perform an act, in violation of laws, by a public official in the discharge of his or her functions, for the purpose of obtaining an undue advantage for himself or herself or for another person or entity
Chapter III, Art 20	Subject to its constitution and the fundamental principles of its legal system, each State Party shall consider adopting such legislative and other measures as may be necessary to establish as a criminal offence, when committed intentionally, illicit enrichment, that is, a significant increase in the assets of a public official that he or she cannot reasonably explain in relation to his or her lawful income
Chapter III, Art 21	Each State Party shall consider adopting such legislative and other measures as may be necessary to establish as criminal offences, when committed intentionally in the course of economic, financial or commercial activities: The promise, offering or giving, directly or indirectly, of an undue advantage to any person who directs or works, in any capacity, for a private sector entity, for the person himself or herself or for another person, in order that he or she, in breach of his or her duties, act or refrain from acting; The solicitation or acceptance, directly or indirectly, of an undue advantage by any person who directs or works, in any capacity, for a private sector entity, for the person himself or herself or for another person, in order that he or she, in breach of his or her duties, act or refrain from acting
Chapter III, Art 25	Each State Party shall adopt such legislative and other measures as may be necessary to establish as criminal offences, when committed intentionally: The use of physical force, threats or intimidation or the promise, offering or giving of an undue advantage to induce false testimony or to interfere in the giving of testimony or the production of evidence in a proceeding in relation to the commission of offences established in accordance with this Convention; The use of physical force, threats or intimidation to interfere with the exercise of official duties by a justice or law enforcement official in relation to the commission of offences established in accordance with this Convention. Nothing in this subparagraph shall prejudice the right of States Parties to have legislation that protects other categories of public official.
Chapter III, Art 26(1)	Each State Party shall adopt such measures as may be necessary, consistent with its legal principles, to establish the liability of legal persons for participation in the offences established in accordance with this Convention.
Chapter III, Art 30(1)	Each State Party shall make the commission of an offence established in accordance with this Convention liable to sanctions that take into account the gravity of that offence.
Chapter III, Art 30(6)	Each State Party, to the extent consistent with the fundamental principles of its legal system, shall consider establishing procedures through which a public official accused of an offence established in accordance with this Convention may, where appropriate, be removed, suspended or reassigned by the appropriate authority, bearing in mind respect for the principle of the presumption of innocence.
Chapter III, Art 30(7)	Where warranted by the gravity of the offence, each State Party, to the extent consistent with the fundamental principles of its legal system, shall consider establishing procedures for the disqualification, by court order or any other appropriate means, for a period of time determined by its domestic law, of persons convicted of offences established in accordance with this Convention from: Holding public office; and Holding office in an enterprise owned in whole or in part by the State.
Chapter III, Art 32(1)	Each State Party shall take appropriate measures in accordance with its domestic legal system and within its means to provide effective protection from potential retaliation or intimidation for witnesses and experts who give testimony concerning offences established in accordance with this Convention and, as appropriate, for their relatives and other persons close to them
Chapter III, Art 33	Each State Party shall consider incorporating into its domestic legal system appropriate measures to provide protection against any unjustified treatment for any person who reports in good faith and on reasonable grounds to the competent authorities any facts concerning offences established in accordance with this Convention.
Chapter III, Art 34	With due regard to the rights of third parties acquired in good faith, each State Party shall take measures, in accordance with the fundamental principles of its domestic law, to address consequences of corruption. In this context, States Parties may consider corruption a relevant factor in legal proceedings to annul or rescind a contract, withdraw a concession or other similar instrument or take any other remedial action.
Chapter VI, Art 60(1)	Each State Party shall, to the extent necessary, initiate, develop or improve specific training programmes for its personnel responsible for preventing and combating corruption.

Annex B: Instruments used to adopt the selected UNCAC Articles

Table

UNCAC Article	Adopting Instrument
Ghana
8(2)	Ghana Constitution, 1992 (Chapter 24: Code of Conduct for Public Officers), Arts 285-285 Code of Conduct for the Ghana Civil Service, s. 23(1)
8(3)
8(5)	Ghana Constitution, 1992, Art 286 Public Office Holders (Declaration of Assets and Disqualification) Act, 1998 (Act 550), s. 4 Public Health Act, 2012 (Act 851), s. 86 National Health Insurance Act, 2012 (Act 852), s. 7(1)
8(6)	Public Health Act, 2012 (Act 851), s. 86(2) National Health Insurance Act, 2012 (Act 852), s. 7(2)
9(1)	Ghana Public Procurement Act, 2003 (Act 663), ss. 47-48, 50(3), 59, 78-80, 86, 89, 93(1)
9(2)	Financial Administration Act, 2003 (Act 654), ss. 40-41 Public Health Act, 2012 (Act 851), s. 95 National Health Insurance Act, 2012 (Act 852), s. 24
10	Ghana Constitution, 992 (Chapter 5: Fundamental Human Rights and Freedoms), s. 21 Public Health Act, 2012 (Act 851), s. 96 National Health Insurance Act, 2012 (Act 852), s. 25
13(1)	Ghana Constitution, 1992, s. 35(8)
13(2)	Ghana Constitution, 1992, s. 216
15	Ghana Public Procurement Act, 2003 (Act 663), s. 32 Financial Administration Act, 2003 (Act 654), s. 62 Criminal Code, 1960 (Act 29), ss. 240, 241, 247
17	Financial Administration Act, 2003 (Act 654), s. 62 Criminal Code, 1960 (Act 29), ss. 124, 128, 260, 179 Public Property Protection Act, 1977 (SMCD 140), s. 4
18	Criminal Code, 1960 (Act 29), s. 252
19	Criminal Code, 1960 (Act 29), s. 179
20
21
25	Criminal Code, 1960 (Act 29), ss. 222, 234 Economic and Organised Crime Act, 2010, s. 21
26(1)	Interpretation Act, 1960 (CA 4), s. 32
30(1)	Criminal Code, 1960 (Act 29) Civil Service Act, 1993 (PNDCL 327), s. 77 Public Health Act, 2012 (Act 851)
30(6)	Public Office Holders (Declaration of Assets and Disqualification) Act, 1998 (Act 550), s. 10
30(7)	Ghana Constitution, 1992, s. 94(2)
32(1)	Evidence Act, 1975 (NRCD 323), s. 69
33	Whistleblower Act, 2006 (Act 720), s. 12 Evidence Act, 1975 (NRCD 323), s. 107(1)
34	Ghana Public Procurement Act, 2003 (Act 663), s. 3
60(1)	National Anti-Corruption Action Plan
Jordan
8(2)	Code of Conduct in Public Services, Art 4 Code of Conduct and the Ethics of the Public Service, 2013 (issued under Art 67 of the Civil Service Law No 82, 2013) Quality Manual of Drug Control and Inspection Department, Art 5.1
8(3)
8(5)	Code of Conduct and the Ethics of the Public Service, 2013 (issued under Art 67 of the Civil Service Law No 82, 2013), Art 9 National Medicine Policy, 2014, ss. 1, 5.2
8(6)	Code of Conduct and the Ethics of the Public Service, 2013, Art 11 Civil Service Code, Art 146
9(1)	Government Works Law and its Amendments No 71 of 1986, Arts 6, 16 Government Procurement Bylaw No 28, 2019 High Court of Justice Law No 12, 1992 Tenders Procedures and Participation Conditions Instructions No 1, 1994, s. 62
9(2)	Financial Rules No 3, 1994 and Amendments, Art 47 Industry and Trade Law No 18, 1998, Art 6 Jordan Constitution, 1984, Arts 112, 119 Jordan Audit Department Law, 1952, Art 22 Jordan Central Bank Law, 1971, Art 62
10	Jordan Law Guaranteeing the Right of Access to Information, 2007, Art 7 Integrity and Anti-Corruption Law No 13, 2016, Art 8(9)
13(1)	Jordan Law Guaranteeing the Right of Access to Information, 2007, Art 4 Integrity and Anti-Corruption Law No 13, 2016, Art 4
13(2)	Integrity and Anti-Corruption Law No 13, 2016, Art 4
15	Criminal Code, Arts 169-171, 173
17	Criminal Code, Arts 174–175
18
19	Criminal Code, Arts 176, 182
20	Financial Disclosure Law, Art 6
21
25	Integrity and Anti-Corruption Law No 13, 2016, Art 26 Criminal Code, Arts 185, 208
26(1)	Criminal Code, Art 36
30(1)	Criminal Code Economic Crimes Law, Art 4
30(6)	Economic Crimes Law, Art 4
30(7)	Criminal Procedure Code, Art 365 (5)
32(1)	Integrity and Anti-Corruption Law No 13, 2016, Art 24
33	Integrity and Anti-Corruption Law No 13, 2016, Art 24
34	Government Works Law and its Amendments No 71, 1986, Art 11 Criminal Code, Arts 44, 37
60(1)	National Integrity and Anti-Corruption Strategy, 2020–2025
Kyrgyzstan
8(2)	Law No 114 on Civil Service, 2004, Arts 10-11 Law No 51 on Combatting Corruption, 2003, Arts 12, 18
8(3)
8(5)	Law No 114 on Civil Service, 2003, Art 33 Law No 153 on Combatting Corruption, 2003, Art 9(5)
8(6)	Law No 51 on Combatting Corruption, 2003, A12(3)
9(1)	Public Procurement Law, 2004, Arts 17(2), 46, 19, 8, 27, 8(5), 14(3), 5, 63, 67
9(2)	Law No 76 on Accounting, 2002, Art 12(3) Law No 1553-XII on Basic Principles of Treasury, 1994, Art 14 Constitution of the Kyrgyz Republic, 2010, Art 88(6)
10	Law No 213 on Access to Information held by State Bodies and Local Self-Government, 2006, Arts 4, 16, 34
13(1)	Law No 213 on Access to Information held by State Bodies and Local Self-Government, 2006, Art 3 Law No 89 on Guarantees and Freedom of Access to Information, 1997, Art 3 Law No 51 on Combatting Corruption, 2003, Art 8 Presidential Decree on Improvement of Interaction between State Authorities and Civil Society, Art 2(2)
13(2)	Law No 19 on the Protection of Persons who Reported Corruption Offences, Arts 9, 11
15	Criminal Code of the Kyrgyz Republic, Arts 310, 313 Public Procurement Law, 2004, Art 6
17	Code on Administrative Offences, Art 413 Criminal Code of the Kyrgyz Republic, Arts 189, 307
18
19	Criminal Code of the Kyrgyz Republic, Arts 304-306
20	Criminal Code of the Kyrgyz Republic, Art 308
21	Criminal Code of the Kyrgyz Republic, Art 224
25	Criminal Code of the Kyrgyz Republic, Arts 317, 332, 325
26(1)	Civil Code, Art 96 Code on Administrative Liability, Arts 505–522
30(1)	Criminal Code of the Kyrgyz Republic
30(6)	Law No 99 on Local Self-Government and Local State Administration, 2008, Art 68(3) Constitutional Law No 155 on the Government, 2005, Art 16(3)
30(7)	Criminal Code of the Kyrgyz Republic
32(1)	Law No 51 on Combatting Corruption, 2003, Art 2 Code of Criminal Procedures, 1999, Arts 188, 170, 12 Law No 170 on Protection of Witnesses, Victims and Other Participants in Criminal Proceedings, Art 2
33	Law No 51 on Combatting Corruption, 2003, Art 9 Law No 19 on the Protection of Persons who Reported Corruption Offences, Art 12
34	Public Procurement Law, 2004, Art 6 Civil Code of the Kyrgyz Republic, Art 185
60(1)	Law No 153 on Combatting Corruption, 2012, Arts 16–17
Peru
8(2)	Decreto Supremo No 042-2018-PCM que crea la Secretaria de Integridad Publica en la Presidencia del Consejo de Ministros, Art 4 Ley No 27815, Ley del Codigo de Etica de la Funcion Publica, Arts 1, 8(2) Ley No 30225, Ley de Contrataciones desl Estado, Arts 253-255
8(3)
8(5)	Decreto Supremo No 042-2018-PCM que crea la Secretaria de Integridad Publica en la Presidencia del Consejo de Ministros, Art 4 Ley No 27815, Ley del Codigo de Etica de la Funcion Publica, Art 8 Constitucion Politica del Peru, Art 40
8(6)	Ley No 27815, Ley del Codigo de Etica de la Funcion Publica, Art 10 Ley No 30225, Ley de Contrataciones del Estado, Art 255.1
9(1)	Ley No 30225, Ley de Contrataciones del Estado, Art 2, 12, 16, 52, 138 Decreto Supremo No 334-2018 EF, Art 117.1
9(2)	Ley No 27806, Ley de Transparencia y Acceso a la Informacion Publica, Art 5 Ley No 29976 que crea la Comision de Alto Nivel Anticorrupcion, Art 3 Decreto Legislativo No 1438, Arts 7.2, 33
10	Ley No 27806, Ley de Transparencia y Acceso a la Informacion Publica, Arts, 3, 5, 10 Decreto Supremo No 042-2018-PCM que crea la Secretaria de Integridad Publica en la Presidencia del Consejo de Ministros, Art 5.2 Ley No 29976 que crea la Comision de Alto Nivel Anticorrupcion, Art 3
13(1)	Ley No 27806, Ley de Transparencia y Acceso a la Informacion Publica, Art 1 Ley No 29976 que crea la Comision de Alto Nivel Anticorrupcion, Art 3
13(2)	Decreto Supremo No 044-2018-PCM, se aprobo el Plan Nacional de Integridad y Lucha contra la Corrupcion, 2018-2021, Art 4 Decreto Supremo No 042-2018-PCM que crea la Secretaria de Integridad Publica en la Presidencia del Consejo de Ministros, Arts 4, 8.1
15	Codigo Penal, Arts 397, 393, 425
17	Codigo Penal, Arts387, 389
18	Codigo Penal, Art 400
19	Codigo Penal, Arts 376, 382-384
20	Constitucion Politica del Peru, Art 41(2) Codigo Penal, Art 401
21	Codigo Penal, Art 198
25	Codigo Penal, Arts 409, 365
26(1)	Codigo Procesal Penal, Art 90 Ley No 27785, Ley Organica del Sistema Nacional de Control y de la Contraloria General de la Republica, Art 41
30(1)	Codigo Penal, Art 93
30(6)	Codigo Procesal Penal, Art 298
30(7)	Codigo Penal, Art 36
32(1)	Codigo Procesal Penal, Arts 247-249
33	Ley No 29542 de Proteccion al Denunciante, Art 8
34	Ley No 30225, Ley de Contrataciones del Estado, Art 138 Codigo Penal, Art 105
60(1)	Decreto Supremo No 042-2018-PCM que crea la Secretaria de Integridad Publica en la Presidencia del Consejo de Ministros, Art 51-B
Philippines
8(2)	Code of Conduct and Ethical Standards for Public Officials and Employees, s. 7 Department of Health Administrative Order No 2007-0043, 27 December 2007, s. 2 Code of Conduct of the Philippines Health Insurance Corporation, s. 14
8(3)
8(5)	Code of Conduct and Ethical Standards for Public Officials and Employees, s. 8 Food and Drug Administration Act, 2009 (Republic Act No 9711), s. 7(g) Guidelines on Compliance with Section 35(b) of Republic Act No. 11223 (Universal Healthcare Act) by All Drug, Medical Device, Biological and Medical Supplies Manufacturers to Submit Reports on Disclosure of Financial Relationships with Health Care Providers and Health Care Professionals, s. 5
8(6)	Code of Conduct and Ethical Standards for Public Officials and Employees, s. 11
9(1)	Philippines Government Procurement Act, 2003, ss. 21, 24, 33, 6, 63, 55
9(2)	Government Auditing Code of the Philippines (Presidential Decree No 1445) The National Archives of the Philippines Act (Republic Act No 9470) Philippines Government Procurement Act, 2003, s. 3
10	Philippines Constitution, 1987, Art II, s. 28 Philippines Administrative Code, 1987, s. 43
13(1)	Philippines Government Procurement Act, 2003, s. 13
13(2)	Ombudsman Act, 1989, ss. 13, 15
15	Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 3 Republic Act No 3815 (Revised Penal Code of the Philippines), Art 210 Philippines Administrative Code, 1987, s. 46
17	Republic Act No 3815 (Revised Penal Code of the Philippines), Art 217
18	Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 4 Code of Conduct for Relatives and Close Personal Relations of the President, Vice-President and Members of the Cabinet, s. 2
19	Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 3
20	Act Declaring Forfeiture in favour of the State any property found to have been unlawfully acquired by any public officer or employee and providing for the proceedings, s. 2 Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 8
21
25	Ombudsman Act, 1989, s. 36 Presidential Decree No. 1829 Penalising Obstruction of Apprehension and Prosecution of Criminal Offenders, s. 1
26(1)	Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 2(d)
30(1)	Philippines Anti-Graft and Corrupt Practices Act, 1960 Republic Act No 3815 (Revised Penal Code of the Philippines), Art 211A Philippines Administrative Code, 1987
30(6)	Philippines Constitution, 1987, Art XI Philippines Administrative Code, 1987, s. 51 Civil Service Code, s. 34 Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 13 Republic Act No 3815 (Revised Penal Code of the Philippines), Arts 210–211
30(7)	Philippines Anti-Graft and Corrupt Practices Act, 1960, s. 9 Omnibus Election Code, s. 68
32(1)	Republic Act No 6981 (Witness Protection, Security and Benefit Act), ss. 17, 8
33
34	Republic Act No 3815 (revised Penal Code of the Philippines), s. 45 Philippines Government Procurement Act, 2003, s. 41 Philippines Corporate Code, s. 144 Republic Act No 9160 (as Amended by Republic Act No 9194) (Anti-Money Laundering Act), s. 14
60(1)	National Anti-Corruption Program of Action
Uganda
8(2)	Uganda Constitution, 1995, Art 233 Public Procurement and Disposal of Public Assets Act, 2003, Fifth Schedule, s. 93(1)
8(3)
8(5)	Uganda Constitution, 1995, Art 233 Uganda Leadership Code Act, 2002, s. 4 Government Central Purchasing Corporation Act, Schedule s. 5(5):5(1)
8(6)	Uganda Leadership Code Act, 2002, s. 35
9(1)	Public Procurement and Disposal of Public Assets Act, 2003, ss. 58, 63, 70, 52, 71, 7, 89 Government Central Purchasing Corporation Act, 1990, s. 6
9(2)	Uganda Constitution, 1995, Art 164, 196 Public Finance Act, 1962, s. 2
10	Uganda Constitution, 1995, Art 41
13(1)	Zero Tolerance to Corruption Policy, 2019 National Anti-Corruption Strategy, 2019-2024
13(2)	Uganda Whistleblowers Protection Act, 2010, Art 4
15	Anti-Corruption Act, 2009, ss. 2, 4, 5
17	Anti-Corruption Act, 2009, ss. 2(c), 6, 19
18	Anti-Corruption Act, 2009, ss. 2(e)
19	Anti-Corruption Act, 2009, s. 11
20	Anti-Corruption Act, 2009, s. 31
21	Anti-Corruption Act, 2009, s. 2-4
25	Uganda Penal Code, 1950, s. 103 Anti-Corruption Act, 2009, ss. 18, 39
26(1)	Uganda Constitution, 1995, Art 257(10) Uganda Penal Code, 1950, s. 2(t)
30(1)	Anti-Corruption Act, 2009, ss. 26, 34
30(6)	Uganda Constitution, 1995, Art 107
30(7)	Uganda Constitution, 1995, Art 235 Anti-Corruption Act, 2009, s. 46
32(1)
33	Uganda Whistleblowers Protection Act, 2010, ss. 2, 3, 11
34	Public Procurement and Disposal of Public Assets Act, 2003, s. 94
60(1)	Zero Tolerance to Corruption Policy, 2019 National Anti-Corruption Strategy, 2019-2024
Zambia
8(2)	Anti-Corruption Commission Act, 1996 Constitution of Zambia (Amendment) Act, 2016, Art 52 Health Profession Code of Ethics and Conduct, prescribed under the Health Profession Act No. 24, 2009, s. 61 Zambia Parliamentary and Ministerial Code of Conduct Act, 1994, Art 4 Public Procurement Act, 2020, s. 19
8(3)
8(5)	Zambia Parliamentary and Ministerial Code of Conduct Act, 1994, Arts 5, 6 Anti-Corruption Commission Act, 1996, Art 10 Anti-Corruption Commission (Disclosure by Public Officials of Interest in Contracts and Proposed Contracts) Regulations, 2004, Art 13 Medicines and Allied Substances Act, 2013, Schedule I, ss. 3(3), 5(1) National Health Services Act, Schedule to s. 3: 7(1)
8(6)	Code of Ethics for the Public Service, s. 13
9(1)	Public Procurement Act, 2020, ss. 14, 59, 60, 6, 14, 101
9(2)	Constitution of Zambia (Amendment) Act, 2016, Arts 3, 118 Public Finance Act, 2004, Art 10
10	Freedom of Information Act, Art 10 National Archives Act, 1969, s. 9
13(1)	Public Procurement Act, 2020, s. 53 Anti-Corruption Commission Act, 1996, s. 9
13(2)	Anti-Corruption Commission Act, 1996, s. 9 Public Interest Disclosure (Protection of Whistleblowers) Act, 2010, s. 23
15	Anti-Corruption Commission Act, 1996, Art 40 Anti-Corruption Commission Act, 2010, s. 19
17	Anti-Corruption Commission Act, 2010, s. 33 Zambia Penal Code, s. 277
18
19	Code of Ethics for the Public Service, Para 12 Zambia Penal Code, s. 97
20
21	Anti-Corruption Commission Act, 1996, ss. 20, 23
25	Anti-Corruption Commission Act, 1996, ss. 24, 30
26(1)	Anti-Corruption Commission Act, 2010, s. 46
30(1)	Anti-Corruption Commission Act, 1996
30(6)	Constitution of Zambia (Amendment) Act, 2016, Art 87 Part VI(1) Zambia Parliamentary and Ministerial Code of Conduct Act, 1994, Art 3
30(7)	Anti-Corruption Commission Act, 1996, s. 45
32(1)
33	Public Interest Disclosure (Protection of Whistleblowers) Act, 2010, ss. 10, 13, 45, 47
34	Public Procurement Act, 2020, s. 19
60(1)	Anti-Corruption Commission Act, 1996, s. 16(6)