Zambians pay price of costly drugs

By Penny Dale
BBC, Lusaka

Two months ago, Elias Phiri and his sick wife Miriam queued up among the coughing children and other patients at one of busy government clinics in the Zambian capital, Lusaka.

Elias: My wife died because she did not get the right medicine

Miriam, 32, was diagnosed with tuberculosis, an infectious disease that attacks the lungs. She was not treated.

According to her husband, the clinic said it did not have in stock the drugs she needed.

Instead she was given painkillers, vitamins and a prescription to go and buy from a private chemist what by right she should have been given free of charge at the government clinic.

The Phiri family did not have enough money and two weeks ago Miriam died. Left alone to look after four young children, Elias is bitter.

"My wife was only 32 years old and she died just because she did not get the right medicine. I went to the doctor and he just gave me some panadol and vitamin C, these light medicines because they said they did not have medicine."

Elias said he did not have money to buy the prescribed drugs from the chemist. "But that is where you find the right medicines, not in hospitals and clinics where they just say they do not have any drugs."

Anti-retrovirals

Zambia has one of the highest rates of TB in the world. There are about 65,000 patients a year, and out of them about 70 per cent also have HIV or Aids, making diagnosis and treatment complicated.

The government has responded by introducing a policy of free TB drugs, but not anti-retrovirals.

Health minister Brian Chituwo says that Zambia's past chronic shortages of TB drugs have now been resolved. He says that there are sufficient stocks in the country to last until December and that every hospital and health centre is supplied with the dosage of TB drugs they require, when they require them.

Why then was Elias's wife not given the drugs? Elias suspects foul play: he believes that someone at the clinic stole the drugs and then sold them privately.

The minister admits that a black market in drugs does exist in Zambia and is a problem that could have cost someone like Miriam Phiri her life.

The BBC World Service programme, Africa Live! will be debating these and others issues on Wednesday at 1630 and 1830 GMT.

Use the form to send us your comments, some of which will be published below.

If you would like to take part in the discussion, e-mail us with your telephone number, which will not be published.

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Your Comments:

It is unfortunate that a young lady can die when our leaders are busy spending billions of money globe trotting. One cannot explain the justification of leaders being flown to South Africa for treatment when millions of those that elected them to power still remain vulnerable to death which can be avoided if our leaders were genuine and sincere.
Harrison Musonda, Zambian in USA

The situation here in Chikuni Zambia is at times very bad. How do you give medication just by the patient's complaint without examining the real problem. If you complain of headache, you will be given chloroquine for they believe it is malaria. Sometimes the medicine is there but it is stupidly reserved for the nursing staff. They also lack motivation, their salaries are not high and as such they resort to taking good drugs for their children and relatives.
Matongo Maumbi, Zambia

Availability of affordable and reliable drugs to a majority of Africans is to say the least poor. Currently in Nigeria there has been an increase in the cases of kidney related deaths among young people, this has been related to the usage of adulterated and fake drugs. I think it is time African governments started paying attention to locally produced drugs which are indigenous to us. We are fond of condemning what we have and blindly embracing everything from the west. The fact is these western pharmaceutical companies are not charity organisations and they would not give in to producing cheap drugs for Africans.
Thomas Ayeni, Lagos Nigeria

Well, there is no doubt that Africa needs a good outlet for a stable health system. However, I believe that before we think about any sort of medicine that might help easing the several diseases that frequently overwhelm Africa causing dire and dreadful consequences on social and economic spheres, we have to think about the life of the Africans. Many of the African countries are desperately poor and find it difficult to raise the living standards of their populations that are still living below the poverty line. This situation compels the African civil society to the great vulnerability brought by different diseases.
Leonel Muchano, Maputo Mozambique

Africans will continue dying from minor illnesses until we revert to our roots and accept what our forefathers have left us with - the herbs. We have for the past decades relied on Western medicines which are very expensive and difficult to come. Diseases such as tuberculosis, hypertension, typhoid, malaria, etc., can be treated with our local herbs which are engulfing us everyday, but since we have neglected our God given herbs we will continue to die from these minor illnesses.
Edward Adarkwa

Having lived in the 3rd World for several years, the fundamentals of basic hygiene and clean water will go a long way to solving problems - educating populations that garbage must not be thrown in canals and pollution causes diseases; education about the causes and transmission of Aids/HIV, sexual morals changed so that young girls have the right and freedom to say no, will do more to help Africans than pumping yet more billions of 'Aid' which rapidly disappears into the pockets of the few and does nothing to help the situation of the majority. Africa has become far too dependent on aid, allowed corruption to become endemic. I cannot see the situation there changing in the next 100 years.
Jan, US/UK

It is very sad to hear about such things, I do agree that there is pilferage at the hospitals but it should not go to the extent of prescribing vitamins and panadols to some one with TB, I mean how can a trained medical personnel prescribe that kind of treatment? Governments should be responsible for the health of poor people as well.
Chisha Simpokolwe, Russia

Africa should make use of her stock of herbs and intelligent herbalists instead of continued reliance on so called rich west for health delivery. China has developed her health delivery system through the use of her god given herbs. Why can we not do the same? Africa wake up!
Freeman Tettey, University of Ghana

At the moment Africa needs emergency medical aid to combat these medical disasters that have returned its health system to pre-history. However, it must be done within working, transparent and accountable medical systems which unfortunately are lacking in this continent. Secondly, Africa should be encouraged to manufacture drugs for its own use. It is not the entire Africa which is hopelessly corrupt and inept, though this is a formidable problem. Alternatively, Africa should be allowed to source cheap medicine from countries such Brazil and India. If I may give the example of Kenya, in the year 2000 after AIDS was declared a national disaster, the intellectual property rights act was repealed to allow the government to source cheap HIV medicine by either importation or local production.This piece of legislation never saw the light of the day. You and I know that it went against the grain of World Trade Organisation (WTO) rules!
Dr. Ndiritu Ndirangu, Kenya

It is a pity that the Western countries are turning a cold shoulder when it comes to donating money to Africa to help fight diseases. I have been in Africa for seven years now and find the health care system in total shambles. In many countries, there are some manufacturers ( Indians) who provide cheaper and better alternatives to the otherwise extremely expensive medicines from the Western drugs multinationals.
RAJA, Accra, Ghana

As long as there is poverty, ignorance and corruption in this fertile and rich continent, the question of affordable health care to millions will be a far cry!
Srinivasan Toft, Denmark

Drugs are important, as is reducing their price, increasing distribution, and developing new ones. However, control of diseases can only be achieved if more effort is also put into public health measures (clean water, sanitation, mosquito nets, pesticides, etc); and dropping hypocritical and paternalistic patent and trade restrictions. Public health measures are extremely cost-effective and enhance efforts made with drugs. The West has a moral obligation to assist its fellow human beings, but this must be concentrated in long term development measures rather than 'Aid', and must be empowering rather than paternalistic.
Chris Hopkins, UK