ARVs on sale in Malawi

As the Malawi grapples to find ways of putting more HIV patients on the life-prolonging antiretroviral drugs (ARVs), a Weekend Nation undercover investigation in Thyolo and Mulanje has revealed rampant pilferage of the drugs, which are sold to some individuals who are not patients but instead use them to fatten animals or distil alcohol.

I visited the two districts last week and posing as both a supplier and buyer he established that ARVs are on high demand among some farmers to fatten pigs so that they fetch more money.

Distillers of mtonjane and kachasu (home brewed liquor) use the ARVs to make their products more potent.

Because of our investigation the police arrested one supplier who has since been convicted and sentenced to six months imprisonment with hard labour for selling the ARVs.

A farmer from Katundu Village in Traditional Authority Chimaliro in Thyolo (in southern Malawi), Maxwell Hapala, confirmed the practice in an interview on Sunday.

Hapala said the rationale behind the use of ARVs by some people on animals is to fatten them faster and boost productivity as is the case with humans.

—On the blackmarket—

He said some farmers and alcohol distillers are currently buying an ARV tablet at a negotiable price of K25 each (6 US cents).

“But you can suggest a different and much higher price if you have them. I desperately need the tablets to fatten my pigs. My pigs are taking too long to grow. At what price would you want to sell your ARVs?” Hapala asked.

On the other hand, some farmers and kachasu distillers in Kamoto Village said they had enough in stock having been supplied the drugs a few days earlier allegedly by health surveillance assistant (HSA) for the area, Justin Chikopa.

Chikopa had reportedly gone to attend an engagement ceremony at Makande when Weekend Nation visited his home, this time posing as a buyer of the ARVs on Sunday.

But his wife—Getrude Chikopa—sold our reporter a bottle of ARVs containing 30 tablets at K3 500 (about $8).

She claimed the husband gets the drug from officers at Chisoka Health Centre at Goliati in T/A Chimaliro in Thyolo.

“Per bottle sold, medical officers get K2 000 (about $5) while my husband gets K1 500 ($3). As such, I can give you at K3 500. That’s the last price because this money is shared between my husband and the medical officers,” claimed Chikopa.

She, however, did not disclose names of the medical officers in question.

Both Thyolo district health officer (DHO) Dr. Michael Murowa and his boss, Dr. Chris Kang’ombe, Principal Secretary (PS) for Health, said they were not aware of the drug abuse.

However, Kang’ombe pleaded with us to immediately report the matter to police for the law enforcers to take action.

“Please, do me a favour. Report this issue to the nearest police station so that these ARV peddlers should face the law,” he requested.

We duly reported the matter to Mikolongwe Police Post.

Officer-in-charge Assistant Superintendent Macoffman Yamungo said after the search of Chikopa’s house, six more bottles of ARVs were recovered, leading to the arrest of the couple on allegation of illegal possession and sale of government drugs.

“The two were taken to Midima Magistrate’s Court where the wife, Getrude, pleaded guilty. She was fined K15 000 (about $40) or serve a six-month imprisonment with hard labour (IHL) sentence in default. But the magistrate acquitted the husband because the State didn’t have strong evidence against him,” said the officer incharge yesterday, adding the police would appeal upon gathering more evidence to incriminate the HSA.

—Consumers at risk—

While expressing knowledge about the rampant misuse of ARVs in some parts of the country, a Blantyre-based veterinary technician, Ramsey Mkandawire, warned that some drugs used in animal feed can have serious side effects.

Mkandawire said, for instance, residue of drugs in the penicillin family can cause allergic reactions in some people while neomycin, gentamicin, streptomycin may have toxic side-effects, such as deafness and kidney trouble after high doses and prolonged use.

He said the situation can even be worse where farmers do not observe ‘withdrawal time’ after feeding the animals with human medicines to ensure drug residues are below a determined maximum residue limit (MRL).

Withdrawal time, as relating to veterinary medicine, is a time required after administration of a drug to an animal before it is slaughtered for meat.

“Generally, it’s not safe for people to consume meat from animals which were fed human antibiotics. Consuming meat from such animals may develop drug resistance in the long run,” said the veterinarian.

“In fact, some cancer cases could be a result of this practice. People need to know that it’s a requirement that farmers must observe this period after drug administration to any food animal where drug residue may be found in marketed meats, eggs, organs, or other edible products. We’re not sure if the concerned farmers are doing this,” he said.

—Effect on health—

Another veterinary officer, Juliet Mfutso, said some studies support the concern that use of medicines meant for humans in food animals impacts negatively on the health of the people.

Mfutso also warned that farmers could be risking lives of their animals through administration of human drugs since humans and animals ‘cannot share prescriptions’.

“The question, therefore, should be: What mechanisms do these farmers or alcohol distillers use to determine the right amount of the drugs to give an animal or apply in alcohol respectively?” she asked.

ARVs are meant to slow down progression of the dreaded HIV virus, thereby reducing the destruction of CD4 cells. This leads to people living with HIV and Aids (PLWAs) being able to stay healthy and maintain good weight.

A member of the Goliati Aids Support Group [who did not want to be named] said she had been noting a deterioration of health among persons who are on ARVs, which may confirm that the drugs given to them are used for other purposes.

“Many are weak and their CD4 count has dropped drastically, there are many cases of people defaulting on treatment,” he said.

But authorities at both the Ministry of Health and National Aids Commission (NAC) expressed ignorance about the abuse of the drugs.

Malawi relies on donors, particularly the Global Fund, to provide funding for the procurement of ARVs required to treat the four million people currently on ART because the local taxpayer cannot tame the cost.

NAC executive director Dr. Thomas Bisika said it is unfortunate that expensive drugs that are aimed at prolonging the lives of people are being given to animals for quick cash.

Bisika explained that his office has been receiving reports of ARV stock outs across the country and that “we have all along suspected that pilferage is the main cause for this”.

“We’ve since written the Ministry of Health to give us a report on these stock outs,” he said.