Small Island Developing States (SIDS), including Saint Lucia, face a complex web of structural vulnerabilities, ranging from narrow economic bases and limited fiscal space to high climate exposure and underdeveloped institutional frameworks. Within this fragile context, corruption and weak governance represent more than isolated inefficiencies, they pose systemic risks to national resilience, social equity, and long-term prosperity. The stakes are especially high in small states, where each dollar misallocated and siphoned can have far-reaching consequences for development outcomes.
In response to these challenges, the World Bank has launched the Anti-Corruption for Development (AC4D) initiative and the International Corruption Hunters Alliance (ICHA) to support countries in building integrity-based institutions, combating corruption, and fostering public trust. These global initiatives are particularly relevant for SIDS such as Saint Lucia, where several high-profile cases—including the St Jude Hospital reconstruction project—highlight the developmental cost of institutional fragility and governance failure.
The St Jude Hospital case: A live illustration of governance failure
One of the most emblematic examples of stalled development in Saint Lucia is the prolonged and troubled reconstruction of St Jude Hospital. The facility, which served the island’s southern region, was gutted by fire in September 2009, triggering a national commitment to rebuild. Yet over a decade later, the hospital remains incomplete, caught in a web of construction delays, scope creep, political controversy, and cost overruns.
Multiple audits, shifting design plans, and poorly coordinated project management have led to ballooning costs. The prolonged delay has forced patients to receive care in makeshift facilities housed in the George Odlum Stadium, an arrangement widely criticised for compromising the quality and dignity of care. The failure to complete the project reflects not only a misuse of public funds but a broader institutional failure in procurement, accountability, and political stewardship.
The St Jude Hospital case starkly demonstrates how weak institutions, and ineffective governance can obstruct even the most urgent and publicly supported development initiatives. It also underscores the human cost of systemic mismanagement, as thousands of citizens continue to endure substandard healthcare conditions more than a decade after the original facility was destroyed.
Historical parallels: The 1966 World Bank education loan to Jamaica
The St Jude case echoes a broader pattern of development derailment tied to institutional weakness and corruption in the Caribbean. A notable historical parallel is Jamaica’s 1966 World Bank loan for education, one of the earliest and largest such investments in a newly independent country. Valued at US$9.5 million, the loan aimed to build 56 new schools to expand access to secondary education.
Instead, the programme became a cautionary tale. Only 29 schools were actually built—many substandard or missing facilities, due to widespread corruption, inflated contracts, and political interference. Rather than catalysing upward mobility and human capital development, the initiative contributed to entrenched inequality and economic stagnation. For decades, this misstep has been cited as a turning point in Jamaica’s post-independence development trajectory, showing how corruption can have lasting intergenerational effects.
The cost of corruption in small states
As these cases illustrate, corruption in small island states carries an outsized developmental cost. In environments with limited fiscal resources and constrained human capacity, mismanagement and weak public service delivery, undermine investment confidence, and delay critical infrastructure projects. The economic and social toll of corruption is further compounded by the opportunity cost—what could have been achieved had resources been properly allocated and managed.
Beyond economics, corruption corrodes the public trust necessary for democratic governance. It deepens political polarisation, discourages civic participation, and fosters widespread disillusionment, especially among youth. In countries like Saint Lucia, where the state plays a central role in delivering health, education, and infrastructure, weak institutions and systemic opacity pose serious threats to sustainable development.
What can be done and what is being done?
The World Bank is leading the charge to tackle corruption through the Anti-Corruption for Development (AC4D) initiative which offers a powerful blueprint for institutional transformation. Anchored in prevention, detection, enforcement, and trust-building, AC4D supports countries in reforming procurement systems, enhancing public financial management, and leveraging technology to improve transparency and service delivery.
For Saint Lucia and other SIDS, AC4D can help address chronic issues such as:
- Ineffective project execution, as exemplified by St Jude Hospital
- Procurement inefficiencies and political interference
- Institutional bottlenecks in audit and accountability frameworks
The International Corruption Hunters Alliance (ICHA) complements these efforts by enabling cross-border cooperation, capacity building, and technical support for complex investigations. For small states with limited resources, ICHA can play a pivotal role in enhancing transparency, tracing illicit financial flows, and recovering misappropriated assets. ICHA also facilitates the establishment of peer learning networks and supports the professionalisation of public integrity institutions, both of which are critical to institutionalising anti-corruption reforms in small, capacity-constrained contexts.
Reclaiming development through institutional reform
From the historical failures of Jamaica’s 1966 education loan to the prolonged saga of Saint Lucia’s St Jude Hospital, the Caribbean is replete with examples of how weak institutions and poor governance can derail development, erode public trust, and waste precious resources. In a region marked by climate vulnerability, fiscal constraints, and global scrutiny around programmes such as the citizenship by investment, clean governance is not merely desirable, it is indispensable.
The World Bank’s AC4D framework and the ICHA platform offer Caribbean SIDS the tools, partnerships, and expertise needed to build integrity-based governance systems. By strengthening institutions, ensuring transparency in CBI programmes, and holding public officials accountable, small states can reclaim their development agendas and chart a more resilient and inclusive path forward.
As one Caribbean voice aptly put it: “If we do not strengthen our institutions, our progress will always be vulnerable—to the next scandal, the next storm, or the next generation’s disillusionment.”
