During the first decade and a half after Nigeria returned to democracy in 1999, the country struggled to adequately fund its primary health care system. Despite a nearly 10-fold increase in the size of the economy, Nigeria in 2014 was still spending only US$11 per capita on health care—equal to only 6% of total government expenditure and far below regional norms and the nation’s own stated aspiration. As a result, Nigerian citizens were paying 69% of their medical expenses out of pocket, and the cost discouraged many from seeking treatment. A new National Health Act, adopted in 2014 after a decade of delay, raised hopes for a solution by stipulating that at least 1% of the government budget go into a new fund to improve basic services provided at the thousands of primary health care clinics located throughout the country. However, owing to Nigeria’s longstanding neglect of primary health care, there was a real risk that the fund might never become reality. To demonstrate the viability of the program and press for its implementation, the federal health ministry, led by Minister Isaac Adewole, developed operational procedures that spelled out crucial steps to ensure financial accountability and transparency, won international backing for a pilot project that would validate the system, and built a support coalition that spanned the government and civil society. The effort took three years, but in 2018 the Nigerian legislature passed an appropriations bill that for the first time included the 1% allocation for the fund—significantly boosting the resources available to improve the quality and accessibility of primary health care services across Nigeria. Even more significantly, in September 2019, the government declared the fund a statutory allocation that it would automatically renew every year, and clinics in three states began receiving the new resources in November 2019.

Leon Schreiber drafted this case study based on interviews conducted in Abuja, Nigeria, in July and August 2019 with the help of Bunmi Otegbade. Case published November 2019.

Gabriel Kuris drafted this study based on interviews conducted in Jakarta, Indonesia in February and March 2012. For a look at the establishment, structure and first-term leadership of the commission, see the Innovations for Successful Societies companion case study “‘Inviting a Tiger Into Your Home’: Indonesia Creates an Anti-Corruption Commission With Teeth, 2002-2007.” Note: many Indonesians have only one name, while others prefer to be referred to by their first names rather than their surnames. This study follows the naming conventions used by local media and individuals themselves. Case posted September 2012.

Associated Interview(s):  Erry Riyana Hardjapamekas

In 2010, the government, private businesses, and local universities in the northern Mexico state of Nuevo León forged an unusual alliance to design and implement sweeping law-enforcement reforms in a challenging context. At the time, powerful drug cartels were fighting increasingly bitter and bloody wars to control their turf—which intimidated an existing police service already hampered by low pay, weak morale, corruption, and disorganization. Public confidence in the state’s ability to maintain order had evaporated. During the next five years, the public–private partnership oversaw the creation of an entirely new police service that, in tandem with other reforms, significantly strengthened the state’s capacity to ensure public safety and helped rebuild public confidence.

Patrick Signoret drafted this case study based on interviews conducted in March and April 2018 and on earlier research carried out by Ariana Markowitz and Alejandra Rangel Smith in October 2014. New York University’s Marron Institute helped support Alejandra Rangel Smith’s participation. Case published July 2018.

In the late 1990s and early 2000s, governments and activist organizations around the world set their sights on ending the business of human trafficking. Many groups emerged to assist victims of the crime, but few made progress toward eliminating the roots of the problem. Duncan Jepson, a lawyer for a Hong Kong–based bank, said he believed too little was being done to spotlight the shadowy criminal networks that typically crossed government jurisdictions and sometimes included otherwise legitimate businesses. Jepson decided that disrupting the trade in human beings required new types of collaboration to unravel criminal networks and confront the organizations that abetted their activities. In 2012, he founded a nongovernmental organization called Liberty Asia, which aimed to bridge institutional gaps and approach human trafficking from an economic perspective by using increasingly robust anti-money-laundering tools that were at the disposal of banks and bank regulators. This case profiles Liberty Asia’s efforts and focuses on the challenges associated with coordinating many different types of organizations to confront a common challenge.

Ann Toews drafted this case study based on interviews conducted in March 2017 and January 2018. Case published March 2018.

In 2014, Ghana began to implement its National Anti-Corruption Action Plan, adopted a decade after the West African country signed the United Nations Convention against Corruption.  With over 120 goals, the plan’s strategy was wide-ranging and ambitious. The goals included strengthening the public service code of conduct, improving the asset declaration system, and expanding freedom of information, as well as adopting many new laws. About 15 other countries around the globe had announced similar aims, though few included as many goals in their plans or required as many statutory changes. Ghana’s Commission on Human Rights and Administrative Justice, which was responsible for translating the strategy into practical accomplishments, faced stiff challenges, including limited coordination capacity, electoral disruption, reluctant legislators, and a few scandals that drew the government’s credibility into doubt. By the early months of 2017, the commission was still struggling to implement important parts of the strategy, but there were a few signs of progress: more public agencies were beginning to report regularly on the actions they had taken to meet their goals, a memorandum of understanding to improve coordination among parts of the anticorruption system was in place, and the Electoral Commission had stepped in to require asset declaration by candidates—even while bigger changes remained mired in the legislature. Ghana’s experience illuminated the challenge of introducing broad anticorruption policies in the face of embedded opposition and the ways that dedicated citizens and officials could take smaller but still significant steps to improve governance.

Tristan Dreisbach drafted this case study based on interviews conducted with the assistance of Gordon LaForge in Accra, Ghana, during September 2016, February 2017, and August 2017. The British Academy-Department for International Development Anti-Corruption Evidence (ACE) Progamme funded the development of this case study. Case published September 2017.

In 2010, Indonesia planning agency official Diani Sadiawati acquired a mandate to expand the government’s anticorruption measures. Sadiawati sought to bring the country in line with its obligations under the United Nations Convention against Corruption. The country’s powerful anticorruption agency already had a full agenda and there was plenty more to do. With support from top-level officials, especially reform-minded Vice President Boediono, Sadiawati and her colleagues focused on prevention of corruption. With help from the president’s delivery unit, they began to coordinate actions among a large number of government agencies, overcome resistance to reform, and develop a system for monitoring impact and tracking progress. By 2014, the agencies had met 88% of the targets they had committed to. Civil society observers said the program had not treated many of the root problems, however, thereby underscoring the need for further work. In 2017, new President Joko Widodo leant his support but asked for a number of changes as the program moved into its next phase.

Tristan Dreisbach drafted this case study based on interviews conducted in Jakarta in May and June 2017. The British Academy-Department for International Development AntiCorruption Evidence (ACE) Program funded the development of this case study. Case published August 2017.

When he took office as South Africa’s finance minister in 2009, Pravin Gordhan found that government officials responsible for purchasing goods and services were wasting billions of dollars every year as a result of inefficiency, errors, and corruption. Gordhan wanted to confront all three problems by consolidating and strengthening control over procurement. In February 2013, he tapped longtime finance ministry official Kenneth Brown to serve as the country’s first chief procurement officer. Brown had to restructure systems, tighten procedures and regulations, and build effective oversight. He assembled a skilled team and persuaded skeptical politicians and business interests to support Gordhan’s goals. His office reviewed and renegotiated costly contracts, provided crucial market analysis and advice on procurement strategies for other departments, and took first steps toward creating an online system. Brown strengthened funding, built a staff, and put new systems in place. By the time he retired in December 2016, his efforts had sharply reduced opportunities for corruption, increased transparency in the procurement process, and slashed the time required to process tenders. The new office helped South Africa better comply with some of its obligations under the United Nations Convention against Corruption, even though Brown and Gordhan faced opposition from people at some of the highest levels of government.

Tristan Dreisbach drafted this case study based on interviews conducted in Johannesburg, Pretoria, and Cape Town, South Africa, in March 2017. The British Academy-Department for International Development AntiCorruption Evidence (ACE) Program funded the development of this case study. Case published June 2017.

In 2003, reform-minded civil servants saw an opening to combat pervasive corruption within the government of Brazil. A new president who had promised to end political graft had just come into office. The question was how to secure the right legal instruments, overcome lack of capacity, and create the coordination needed to detect, prosecute, and sanction wrongdoers. The reformers organized an informal, whole-government network to combat money laundering and corruption. They identified shared priorities, coordinated interagency policy making, and tracked progress. Leaders in the judiciary, executive, and prosecutor’s service drafted enabling legislation, strengthened monitoring, improved information sharing, and built institutional capacity and specialization. Gradually, those efforts bore fruit, and by 2016, authorities were prosecuting the biggest corruption case in the country’s history and had disrupted an entrenched political culture.

Gordon LaForge drafted this case study based on interviews conducted in Brazil from December 2016 to February 2017. The British Academy-Department for International Development Anti-Corruption Evidence (ACE) Program funded the development of this case study. Case published February 2017. 

Citizens of the Indian Ocean nation of Mauritius worried openly about corruption and petty bribery in government, just after the millennium. Surveys revealed that civil servants often took advantage of archaic and overly bureaucratic procedures, offering to reduce delay in return for cash. In 2009, Anil Kumar Ujoodha, director general of the national government’s Independent Commission Against Corruption, introduced a new prevention program. He proposed a bottom-up strategy to reduce opportunities for bribe taking, nepotism, and conflicts of interest in the public service. Rather than handing down orders, policies, and procedures for fighting corruption, Ujoodha and his top staff shifted responsibility for the revision of practices to government agencies and their employees. Commission staff guided each agency through the process of setting up an anticorruption committee, assessing institution-specific corruption risks, developing solutions, and monitoring implementation. After piloting the new approach with the police and the Civil Status Division, the commission scaled up the initiative; and by 2016, more than 70 of the island nation’s more than 200 agencies had agreed to implement more than 380 different measures to address corruption risks. Although the coordinated strategy purposely sidestepped certain major concerns such as the influence of money on elections, it succeeded in reducing the incidence of highly visible forms of graft that undermined government credibility at the grassroots level. The measures also helped the government meet its obligations under the United Nations Convention against Corruption and other international agreements.

Tristan Dreisbach drafted this case study based on interviews conducted in Mauritius in December 2016. The British Academy-Department for International Development Anti-Corruption Evidence (ACE) Program funded the development of this case study. Case published February 2017. ​