From Brazil to the Philippines, secretive governments across the world are responding to the COVID-19 pandemic by covering up data and bypassing public procurement rules, undermining trust in health systems, fuelling anti-vaxxers and putting immunisation campaigns at risk.

Clandestine contracts for medical goods and services have become the norm in many countries, while data on COVID-19 cases and deaths has been manipulated and underreported.

Authorities and heads of states have used the pandemic as an opportunity to gut public bodies dedicated to openness and communication, with the worst offenders forming a rogues’ gallery of coronavirus offenders.

In the global South, the repercussions for already struggling health and governance systems could be catastrophic.

Corruption outbreak

This is a tale of two pandemics, says Jonathan Cushing, who leads on global health at the anti-corruption non-profit Transparency International.

“You have COVID-19 and then what we’ve seen over the past year is this lack of transparency—the utilization of direct procurement legislation because of the emergency needs at the time,” Cushing tells SciDev.Net.

“We’ve seen repeated cases of corruption, and that is the second pandemic in many ways.”

Malpractice, says Cushing, has been reported “around the world, in the Philippines, in Uganda, we’ve seen cases raised in Kenya, Latin America as well”.

“As the pandemic has progressed, we’ve seen the shift from the rush to buy [personal protective equipment] and ventilators … to the procurement of vaccines,” says Cushing.

“What we’re seeing now is a complete lack of transparency.”

Tanzanian President John Magufuli may have been a victim of his own refusal to acknowledge the presence and seriousness of SARS-CoV-2, the virus that causes COVID-19.

In June, Magufuli declared that “the corona disease has been eliminated by God”, leaving Tanzania “coronavirus-free”. The government stopped publishing data on case numbers, while disease surveillance and advocacy wound down.

Magufuli’s death—officially from heart problems, but widely believed to be connected with COVID-19—was announced on 17 March.

Residents of Tanzania’s largest city, Dar es Salaam, told SciDev.Net it remained to be seen whether Tanzania’s government would reverse Magufuli’s increasingly authoritarian policies. But new president Samia Suluhu Hassan has already marked a departure from her predecessor, pledging to form a scientific advisory committee on COVID-19.

Epidemiologists say statistics will be central to any new evidence-driven response. For now, the data deficit remains as people continue to fall ill.

“What’s lacking now in Tanzania is an enabling environment that allows scientific enquiries on such things as pandemics,” says Frank Minja, a Tanzanian doctor and associate professor of neuroradiology at the Yale School of Medicine’s radiology and biomedical imaging department, in the US.

“Of course, science doesn’t work in isolation, it needs economic and political decisions. But science is a tool that should be used to solve our problems.”

Data in the dark

For the countries that are publishing statistics, many of these have been massaged to reveal a rosier version of reality.

Data manipulation is a key marker of COVID-19 corruption, according to Transparency International. This can have devastating consequences, such as resources misallocation, spikes in case rates as citizens are encouraged to carry on as normal, and increased mistrust in governments when reality does not match with the official version of events.

Multiple studies, including those based on rates of population with COVID-19 antibodies, have suggested that SARS-CoV-2 is more prevalent in many countries than official statistics reveal.

One such study, carried out in Zambia and published in the BMJ, observed “a surprisingly high prevalence of COVID-19 mortality”.

The research team, led by Lawrence Mwananyanda from Right to Care, said: “Contradicting the prevailing narrative that COVID-19 has spared Africa, COVID-19 has had a severe impact in Zambia. How this was missed is largely explained by low testing rates, not by a low prevalence of COVID-19.

“If our data are generalisable to other settings in Africa, the answer to the question, ‘Why did COVID-19 skip Africa?’ is that it didn’t.”

In response, pathologists from the Ministry of Home Affairs and Zambia’s University Teaching Hospital said the conclusions from the Lusaka study were “highly questionable” and could not be extrapolated to all of Sub-Saharan Africa.

Researchers in India found that COVID-19 infections had been grossly underestimated and could be up to 95 times higher than the official numbers. Health and development economist Anup Malani told SciDev.Net that the high seroprevalence—the number of people who tested positive for COVID-19—in the rural areas studied was due to mass migration from the cities to escape lockdown restrictions.

In Brazil, the country’s health ministry removed cumulative COVID-19 data from its website in June as President Jair Bolsonaro declared that the statistics did not “reflect the moment the country is in”.

The supreme court ordered that the data be restored, and the figures now indicate that Brazil is among the worst affected countries in the world, as the government appoints its fourth health minister since the pandemic began.