Last week’s blog about corruption risks in natural disaster situations triggered some interesting feedback. Many observers are seeing the same as I am in the international response to the covid-19 pandemic – namely, that there are striking similarities with the response to earthquakes, tsunamis and other natural disasters in the past.

“Unprecedented” comes up again and again in commentaries on covid-19. But as I listen to more of my colleagues’ and other experts’ reflections on corruption in relation to the pandemic, it strikes me that we’ve seen many of the same features and corruption risks before.

The enormity of the situation brought about by the COVID-19 pandemic invites – or rather forces – us to reflect on the nature and effectiveness of our systems of governance. And not just of health systems, but more broadly the governance of our very complex societies and their transnational flows.

I start with some definitions, as the term governance is itself broad and contested.

Relationships of power, responsibility and accountability between health systems actors are considered central to health governance. Despite increasing attention to the role of accountability in health governance a gap remains in understanding how local accountability relations function within the health system in Central Asia. This study addresses this gap by exploring local health governance in two districts of Tajikistan using principal-agent theory.

The results of the study:

Every day, an unknown number of elephant tusks, rhino horn, pangolin scales and other wildlife products – alive and dead – cross the oceans in container ships and cargo flights for use in traditional medicine, crafts and the illegal pet trade. Rare trees are felled in ancient forests and shipped out under false certificates.

They leave behind the butchered carcasses of the last remaining animals of many species, scarred and emptied landscapes, legal livelihoods undermined by corruption and criminal activity, and communities ravaged by organised crime networks.