Zimbabwe: TB patients turn to truck drivers

GUMISAYI Bonzo (standing) making her presentation during the 3rd Regional Capacity Strengthening Convening for African National Human Rights Institutions in Johannesburg, South Africa.

ASKING a truck driver to buy you tuberculosis (TB) drugs outside your country because of a critical shortage may sound unusual, but some patients in Zimbabwe are reported to be using truckers to buy the drugs in neighbouring Zambia.
Gumisayi Bonzo, a former prisoner who once suffered TB while in prison, says the right to treatment for some TB patients in Zimbabwe is as absurd as prison conditions.
During the 3rd Regional Capacity Strengthening Convening for African National Human Rights Institutions (NHRIs) in Johannesburg, South Africa, Gumisayi said the challenge of accessing TB drugs in hospitals at home is threatening the chance of most patients to complete therapy to achieve cure.
Although she has put her horrific experience in prison as a TB patient at the back of her mind to concentrate on advocacy work, Gumisayi says the situation is worse in correctional facilities where poor conditions and overcrowding fuel the TB epidemic.
Highlighting Zimbabwe’s problem regarding TB and human rights, Gumisayi said the rights of prisoners are further limited by lack of TB drugs because they have no means to send truckers to buy them drugs in Zambia.
To show the prevalence rate of TB in Zimbabwe’s prisons, Gumisayi cited an assessment carried out by Jointed Hands Welfare Organisation, which indicates that 14 percent of prison inmates in three correctional centres tested positive for TB.
“Many inmates in Gwanda, Shurugwi and Blue Hills probation centres in Midlands Province tested positive to TB due to overcrowding. The situation has been made worse because most of them have limited or no access to information. However, if some rights have been limited, it does not mean that sick inmates have no rights to health care,” she says.
With the supply of TB drugs in most Zimbabwe’s health facilities further sliding into a crisis, Gumisayi says some individuals with TB take risks by using some cross-border truck drivers to buy drugs in Zambia.
Gumisayi, who is founder and director of Trans Smart and Trust, an organisation focusing on human rights advocacy and sensitisation, said in an interview that while aware of the legal consequences of buying the medicine without prescription, truck drivers hide TB drugs to avoid detection at the border.
“The trend also includes some individuals who cash in on the shortage of drugs in most hospitals in Zimbabwe. They travel to Zambia to buy TB drugs from some pharmacies and resell them to TB patients back home,” she says.
Gumisayi could not disclose quantities of TB drugs some people buy from Zambia, but said the situation has been particularly bad in the last two months.
“If you ask some people who run drugstores near the bus terminal in Lusaka, they will tell you that most of their clients who buy TB drugs come from Zimbabwe,” she says.
Mr David Banda, a clinical pharmacist in Zambia, says he understands that there is a shortage of essential drugs such as TB, malaria and HIV drugs in Zimbabwe but points out that it is impossible to buy TB drugs without a prescription.
“It is very difficult to buy medicines for someone in Zimbabwe as TB drugs are prescription-only drugs. The prescription from Zimbabwe cannot be dispensed in Zambia as Zambia enjoys its sovereignty,” Mr Banda says.
But Mr Banda says with high illegal drug dealers and unethical practices of some health workers, there is a possibility of some truck drivers buying TB drugs on behalf of patients in Zimbabwe.
“However, the drugs are not transported and stored in standard conditions, which may result in drugs losing their efficacy and potency and cause more harm to the recipients. Moreover, they may not get accurate dosage,” he says.
He advised health workers who are in the habit of assisting foreigners by stealing government drugs to desist from the practice because they are not helping their clients.
“Let them buy from registered clinics for their safety as once life is lost, it cannot be recovered,” Mr Banda says.
Zimbabwe is listed among 30 high-burden TB countries according to World Health Organisation (WHO).
The country is also listed by WHO among eight low-income high-burden TB countries, which include Afghanistan, Cambodia, the Democratic Republic of Congo, Ethiopia, Mozambique, Tanzania and Uganda.
However, the horrific situation in Zimbabwe is a stark reality of the failure by most health systems in Africa to ensure that all persons have the right to access health care.
According to statistics made available by AIDS and Rights Alliance for Southern Africa (ARASA)’s Southern and East Africa Regional Programmes Lead Lynette Mabote during her presentation, Africa accounts for more than 53 percent of the 30 high-burden TB countries.
Ms Mabote explained that Africa is the only region in the world to have experienced an increase in TB incidence since 1990.
In 2016, an estimated 2.5 million people fell ill with TB, representing a quarter of new TB cases worldwide.
This resulted in an estimated 417,000 people dying from the disease in the African region.
According to WHO, TB is also the leading cause of deaths among people living with HIV.
The meeting of NHRIs in Johannesburg, organised by ARASA, observed that lack of access to medication amounts to violation of the right to health care services.
Annabel Raw, a health rights lawyer from Southern Africa Litigation Centre (SALC), says people living with, and disproportionately vulnerable to tuberculosis may be marginalised in many ways. These include sex workers, undocumented migrants and people who use drugs.
However, the NHRIs present at the workshop committed themselves to addressing the rights of key populations with TB and HIV.
It was also noted that NHRIs could assist with documenting these cases of violation of the rights of patients and build jurisprudence and state guidelines for access to justice/recourse when people experience side effects from toxic drugs.
This comes in the backdrop of the African Union (AU) adopting a Tuberculosis Common Africa Position (CAP) in July this year.
It is envisaged that with African leaders recognising that TB is now the leading public health threat to Africa’s socio-economic transformation agenda, the plight of TB patients in Zimbabwe who are using truck drivers to buy drugs in Zambia will be addressed.

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