Denmark, New Zealand and Finland topped the list of least-corrupt countries while South Sudan, Somalia and Syria were rated worst.
The U.S. slipped another two spots during the final year of Donald J. Trump’s presidency to 25th, down from 16th in 2017.
Challenges from his administration to the oversight of a $1 trillion relief package was an example of how new measures to deal with the virus post risks to transparent governance, Transparency said.
It "raised serious anti-corruption concerns and marked a significant retreat from longstanding democratic norms promoting accountable government," the report said.
In places where corruption already flourished, authorities tended to confront the outbreak with cash-strapped health services. Countries scoring in the highest third of the graft index spent on average 6.2 per cent of gross domestic product on health care, compared with 3.5 per cent for the middle third and just 1.8 per cent for the lowest third, according to the report.