Malawi is yet to register a single case of the coronavirus, but a health system in decay and a tumultuous political crisis has left the country bracing for a nightmare if — or when — the virus arrives.
Authorities are yet to ban travel or stop large gatherings, despite the virus edging closer. Neighbouring Zambia and Tanzania confirmed their first cases of coronavirus this week, while South Africa — the country’s main trading partner, connected by regular two-hour flights — is battling an outbreak that has so far infected 116 people.
The country is effectively in campaign mode as it prepares for new presidential elections on May 19. These were scheduled after last year’s poll — won by President Peter Mutharika — was annulled by the Constitutional Court in February due to widespread irregularities.
Mutharika, who analysts argue is preoccupied by the political crisis, has yet to address the nation on the subject. On Tuesday, however, he sacked army chief General Vincent Nundwe — a decision described by analysts as politically motivated.
“The president was supposed to take [the] lead but is yet to even deliver a speech. It’s like there is no war out there. It’s small people like us and churches who are leading the fight,” said Dorothy Ngoma, a health rights advocate who previously served as adviser on maternal health issues to former president Joyce Banda.
In the absence of political leadership, Ngoma says the government response has been “slow, haphazard and disjointed”, saying community mobilisation has been mostly left to church leaders.
The only political leader to publicly address the issue so far has been Vice-President Saulos Chilima, who has been ostracised from the ruling party and is running against the president. “We need to take all the precautionary measures against the disease. There is a need for concerted efforts to prevent the disease from coming here,” he said at a rally in Blantyre.
Henry Chingaipe, a political analyst, said that Malawi’s leadership has ignored the coronavirus because it is preoccupied with the country’s ongoing political crisis. He described the recent creation of a cabinet committee to tackle the outbreak as a “smokescreen”.
Chingaipe further raised doubts that political rivals in government and opposition would be able to work together to agree to emergency measures and produce a collective action plan. He said that attempts to ban public gatherings would be seen by many as an attempt to suppress opposition.
“The situation is now life and death for the politicians, the coronavirus is about life and death for the people. But the politicians are focusing more on their political survival. Even allocation and deployment of resources has been negligent, but millions of taxpayer money is being spent on the political fight,” said Chingaipe.
Mutharika dissolved his whole cabinet last weekend, just days after the appointment of a cabinet committee to handle the outbreak. By Wednesday he had yet to appoint a new cabinet.
Even assuming that political will exists to tackle the coronavirus crisis, Malawi’s ailing health system and a severe shortage of medication will make it difficult for the government to respond effectively. According to leaked minutes, seen by the Mail & Guardian, the government’s Drug and Medical Technical Working Group believes that the medicine shortage should be declared a national emergency.
According to the minutes, poor funding to the Central Medical Stores Trust (CMST) — a public institution mandated to procure and supply drugs on behalf of all public hospitals — has left the country especially vulnerable.
“Currently remedial actions by the CMST are not yielding lasting results. The CMST has made efforts to procure more medicines to fill up their pipeline, however the quantities of medicines being procured will be consumed within weeks of arrival and the stock-outs we see will persist,” reads part of the minutes.
The report said supervision visits have shown empty shelves in hospital medication stores, and called upon donors to immediately commence emergency supply kits.
Another area of concern is the country’s prisons which are some of the most congested in the world.
According to a statement released by the Southern Africa Litigation Centre — a South African- based rights body — alongside several Malawians NGOs, Malawi prisons which were designed to host 5 000 inmates currently have 14 000 inmates, a figure mounting to over 260% of its capacity.
“We believe that prison health is public health and therefore, we cannot be fully prepared as a nation for the disease, if we do not deal with the risk that congestion poses to both the prison population and the broader community,” said a coalition of five civil society organisations on Wednesday.
Joshua Malango, Malawi ministry of health spokesperson, said that the country has adequate facilities, equipment and medication to handle the crisis.
“We now have started testing. We so far have no suspects, test kits arrived last week. We have also upgraded our laboratory. We are working with the College of Medicine. We have centres for Ebola cases which are fully equipped across the country, these are what we will use,” said Malango.