The paper is divided into six sections focused on specific areas of the health sector, where misconduct may occur in a time of extraordinary circumstances.

1. Procurement systems

Governments around the world are forced to enact legislation in a short time-frame to respond to a rapid spread of the coronavirus by ensuring that their health systems are properly equipped under a simplified procedure. However, while emergency legislation is time-efficient to procure critical medical supplies, it may soften the necessary “checks and balances” on public procurement and make it a vulnerable target for corruption.

Therefore, GRECO stresses the importance of complying during the pandemic with Principle 14 of the Twenty Guiding Principles for the Fight against Corruption, which calls on the member States to adopt appropriately transparent procedures for public procurement that promote fair competition and deter corruptors and to carry out systematic analysis of public procurement in the health sector to detect its vulnerabilities.

In addition, GRECO recommends preventing conflicts of interest of public officials responsible for preparing and carrying out procurement procedures: these individuals should be prohibited from being employed by any businesses that bid for or win a public contract.

2. Bribery in medical-related services

The issue of petty bribery has also arisen in the pandemic context: citizens resort to bribery to gain priority access to medical services, tests and equipment and to circumvent quarantine rules even in countries where this was uncommon.

Therefore GRECO highlights the need to comply with:

• the provisions of articles 7 and 8 the of the Council of Europe Criminal Law Convention on Corruption that require States parties to establish as criminal offences active and passive bribery in the private sector;
• Principle 2 of the Twenty Guiding Principles for the Fight against Corruption that recommends criminalizing national and international corruption;
• Resolution 1946 (2013) of the Parliamentary Assembly of the Council of Europe on equal access to health care that calls on the member States to introduce measures to combat corruption in the health sector, in close cooperation with GRECO.

3. Corruption in new product research and development

Another area vulnerable to corruption is the investment in research and development of drugs and vaccination against COVID-19. In order to minimize corruption risks in this area it would be necessary to increase the capacity of State institutions entrusted with control functions, adopt relevant measures for the management of conflict-of-interest situations, including through responsive advisory, and to ensure the legal regulation of lobbying activities.

To this end, GRECO recommends developing a strategy to improve integrity and the management of conflicts of interest with respect to persons entrusted with top executive functions and to introduce codes of conduct for public officials in accordance with Committee of Ministers Recommendation No. R (2000) 10 on codes of conduct for public officials. As regards lobbying, countries are invited to be guided by Committee of Ministers Recommendation CM/Rec(2017)2 on the legal regulation of lobbying activities in the context of public decision making and by other GRECO recommendations in this area.

4. Risks of COVID-19-related fraud

In addition to the increased corruption risks in the health system the cases of fraud, including in relation to falsified medical products, have become more frequent because of the high demand and supply constraints.

In this regard GRECO reminds member States of the need to criminalize manufacturing, keeping in stock and supplying of medical products without being in compliance with the conformity requirements in accordance with the Council of Europe Convention on the Counterfeiting of Medical Products and Similar Crimes Involving Threats to Public Health.

5. The protection of whistleblowers in the health sector

In the context of the pandemic of particular importance is the need to ensure the protection of persons (whistleblowers) reporting suspicions of corruption, irrespective of the reporting lines they choose to pursue. Disclosure of such information can be key in the fight against corruption in the public and private sectors, including the health sector. Therefore, GRECO calls upon the member States to create favourable conditions for whistleblowing in accordance with Committee of Ministers Recommendation CM/Rec(2014)7 on the protection of whistleblowers.

6. The private sector

The private sector also faces high corruption risks during the crisis. This regards, in particular, facilitation of bribes to push ahead business processes that may have stalled due to the introduction of restrictions, falsification of documents to meet the conditions of State aid schemes, etc.

In order to prevent corruption in the private sector GRECO recalls the need to be guided by:

• articles 7 and 8 of the Council of Europe Criminal Law Convention on Corruption: to establish as criminal offences active and passive bribery;
• Principle 5 of the Twenty Guiding Principles for the Fight against Corruption: to provide appropriate measures to prevent legal persons being used to shield corruption offences;
• the findings of GRECO’s 2nd Evaluation Round (for instance, the recommendations on accounting and auditing, corporate liability and compliance programmes, and due diligence obligations).