Political actors that are “major players” and control the procurement process, the markets and quality assurance have an influence on the health care system in Iraq. “A similar dynamic also holds in the Kurdistan Region of Iraq (KRI), where specific affiliates of the two dominant parties firmly control the healthcare procurement process, pharmaceutical markets, and quality controls,” the Konrad Adenauer Foundation (KAS) reported on health care corruption in Iraq and the Kurdistan Region.
“Instead of responding to identified needs and hazards in medical facilities, procurements are orchestrated to maximize the profits of the ruling parties and affiliated businesses,” the report states.
“The line between life and death is thin in all hospitals, and especially in COVID-19 wards, where a poorly maintained medical device or a worn-down oxygen tank is all it takes to ignite a fire.”
Iraq saw two deadly hospital incidents this year. A catastrophic fire at Baghdad's Ibn al-Khatib hospital for coronavirus patients was sparked by the explosion of an oxygen cylinder in April, killing an estimated 130 people. Another fire tore through Nasiriyah’s al-Hussein hospital for coronavirus patients in July where at least 60 people were killed.
“To take meaningful steps forward in mitigating fire risks in COVID-19 wards, reactive strategies such as installing fire safety equipment are necessary but not sufficient. Fires in oxygen rich environments burn faster and hotter than normal fires and require a robust preventative approach. Ideally, the Government of Iraq would make urgent and comprehensive capital investments to update public hospitals, installing centralized oxygen supply systems and sound electrical infrastructures, while also instituting and enforcing ongoing upkeep practices and electrical testing,” the KAS report said.
Iraq began developing its health care sector in the 1950s, financed from the state budget. By the 1960s, new, modern hospitals had been built throughout the country. The development of Iraq's health system continued in the 1970s with more hospitals and health centers built, including in villages and rural areas, until it became one of the best in the Middle East.
The health sector entered a dark era at the beginning of the 1990s as a result of international sanctions, which led to shortages of medicines and medical equipment. Death rates among children and women notably grew and the fragile health infrastructure could not accommodate a rapidly increasing population.
After the fall of Saddam Hussein in 2003, the ruling political class attempted to redevelop the health system. However, it collapsed as a result of corruption, lack of political will, and the deteriorating security situation.
“The post-2003 political economy of healthcare is not organized around responding to patients’ needs and systemic risks. It is organized around maximizing revenues from the very medical supply chains that are so crucial to maintaining safe and secure hospitals,” the report noted.
Cancer patients at Sulaimani’s Hiwa Hospital struggled with medicine shortages as a result of the Kurdistan Regional Government’s (KRG) Ministry of Finance being indebted to medicine companies since 2020. In response, the companies stopped supplying medicines until they were paid.
