The World Health Organization (WHO) recently issued a fact sheet warning about the corruption and unethical practices that are endemic to every step of the pharmaceuticals business.

“Corruption in the pharmaceutical sector occurs throughout all stages of the medicine chain, from research and development to dispensing and promotion,” the fact sheet reads.

The medicine chain refers to each step involved in getting drugs into the hands of patients, including drug creation, regulation, management and consumption. According to WHO data, unethical practices such as bribery, falsification of evidence, and mismanagement of conflicts of interest are “common throughout the medicine chain.”

The fact sheet also highlights other forms of corruption specific to particular steps in the chain. For example, clinical trials may be conducted without proper regulatory approval, royalties may be collected through manipulation or disregard of the patent system, and products may be registered with incorrect or insufficient information. Drugs may be produced through substandard or counterfeit methods, leading to products that are less effective at best, and hazardous at worst. Corruption can also occur during the drug inspection process, allowing such shoddy products to be given a government seal of approval.

Once drugs have been produced for the market, corruption can occur via the selection of non-essential drugs for different governments’ lists of “essential” medications. Unethical marketing strategies — both legal and illegal — are common throughout the drug business. Vendors may collaborate with pharmaceutical companies and doctors might be unduly influenced to dispense drugs to gain the greatest profit rather than to produce the greatest benefit for the patient.

This corruption can have serious consequences, the WHO warns.

“Medicines are only beneficial when they are safe, of high quality, and properly distributed and used by patients,” the fact sheet says.