Main points
- Corruption, waste and fraud cost an estimated 7.3% of global health spending, far exceeding the annual investment needed to achieve universal health coverage.
- Corruption risks in health procurement are shaped not only by procedural weaknesses but also by structural governance factors such as elite capture, market concentration, and weak oversight independence.
- There is a lack of systematic studies and comparable data on corruption in health procurement across the Central Asian countries. Nevertheless, isolated media reports and other sources attest to alleged corruption cases amounting to significant financial losses and health detriments.
- No single intervention is sufficient. Effective mitigation requires combining competitive procedures, enforceable legal frameworks, digital transparency tools, and independent oversight working together across the full procurement cycle.
- E-procurement and open contracting data standards are promising tools but only deliver accountability when accompanied by capable oversight institutions, reliable data quality and government transparency that allows accessing and using data. Digitalisation alone does not entirely reduce levels of corruption in the sector.
- Procurement reform requires sustained political commitment over time. Interventions should start with a rigorous analysis of structural drivers of corruption, such as political interference and power asymmetries, and prioritise building countervailing power through civil society and independent accountability mechanisms, rather than addressing the problem head-on.
- In Central Asia, significant implementation gaps persist. Progress varies across countries, with Kazakhstan and Uzbekistan pursuing comparatively more ambitious reform trajectories, while reforms in Tajikistan, Kyrgyzstan and particularly Turkmenistan remain more limited.
- In the region, procurement reforms have increasingly focused on digitalisation and legal alignment with international standards. However, the effectiveness of these reforms is often constrained by persistent reliance on non-competitive procedures and limited oversight capacity, which reduces the ability of transparency and e-procurement tools to translate into stronger accountability.
- In many countries in the region, constrained civic space - weak media freedom, limited civil society, and restricted access to information - undermines domestic participatory oversight. OECD peer review, donor conditionality, and open contracting partnerships can partially substitute, though efforts to build domestic civil society should be pursued in parallel where feasible.
