Rethinking corruption: a decolonial inquiry into the intersection of historical systems and anti-corruption efforts

Objectives Corruption in the health sector is particularly harmful as it undermines equitable access to quality medicines which are essential for healthcare delivery. Despite anti-corruption efforts, success has been limited, often due to a gap between policy design and on-the-ground realities in low- and middle-income countries. This article argues that colonial and neocolonial legacies continue to shape environments where corruption thrives, necessitating a re-conceptualization of the field of anti-corruption through a decolonial lens. Methods This article provides a critical overview of the literature relevant to corruption in the health sector, and the enduring impacts of colonialism and neocolonialism. Key findings Re-conceptualizations of corruption must avoid the superficial sloganism and tokenism that have characterized the decolonization discourse in recent years. Effective anti-corruption efforts require decentring Western ideologies as the dominant framework for understanding corruption and to consider the colonial and neocolonial processes that make corruption a survival tactic in some contexts, and a part of the moral economy in others. Moreover, this approach calls for critical reflection on how corruption is defined by (neo)colonial legacies, global power structures, and neoliberal agendas. Conclusions Addressing corruption in the health sector requires a shift away from Western-centric frameworks and a deeper engagement with the colonial and neocolonial contexts that enable it. By adopting a decolonial lens, anti-corruption efforts can become more attuned to the complexities of local realities and global power structures, paving the way for more effective and equitable solutions.