Sick economy fuels growth of fake drug market

Zimbabwe's deteriorating health services have made room for a thriving parallel market for drugs, many of them counterfeit, warn concerned health professionals.

The sale of genuine as well as fake medicines on the streets was "big, booming business," said Dr Paul Chimedza, the president of the Zimbabwe Medical Association (ZIMA). "The health system has been adversely affected by the poorly performing economy. There is a general shortage of drugs within the country and unscrupulous dealers are capitalising on the situation by selling medical drugs on the streets."

Among health professionals the overriding concern is that there is no quality control of the drugs available on the streets.

Drugs are much cheaper in the parallel market - Zimbabweans pay between five and eight times less than they would for any drug from a registered pharmacy. A month's course of antiretroviral medication could cost anywhere from US$200 to $400 in the parallel market, against almost $1,200 from a legitimate source.

But with the low prices comes high risk. "In some of the cases, those who need the drugs are not even aware of the dangers that are posed by buying from the streets. Even where the drugs are genuine, they pose great danger to the sick because they are not stored under prescribed conditions and can cause side effects," said Chimedza.

Galloping inflation, now hovering around 1,200 percent annually, and a scarcity of foreign currency have crippled the health sector, creating shortages of drugs, medical equipment and even medical personnel, who have migrated in search of better salaries and living conditions.

"There is also a growing trend whereby unregistered practitioners are opening surgeries and administering wrong injections on patients, in addition to prescribing incorrect drugs," added Chimedza. "But this is a very cruel and immoral way of trying to earn a living."

Most of the medicines on the parallel market were smuggled from neighbouring countries, particularly Zambia and Botswana, where they were cheaper, Chimedza said, but the employees of pharmaceutical companies and hospitals also stole drugs and sold them to street traders.

He suggested that the health ministry and medical doctors carry out campaigns at health centres to educate people about the dangers of buying drugs from unregistered dealers. ZIMA also urged law enforcement agencies to be more aware of the problem and to crackdown on the smuggling of medicines.

The flourishing illegal drug market is not limited to conventional medicine. Jason Siyachitema, 40, has AIDS. He was showing signs of recovering from tuberculosis after being put on ARV therapy two years ago, until it became unaffordable. Unemployed and unable to spend $1,200 a month on ARVs, he sought the help of a self-proclaimed herbalist.

"It was desperation that drove me to the traditional healer. His medicine was much cheaper, but it turned out that he was selling me a powder ground from common tree leaves," Siyachitema told IRIN. "As a result, my condition deteriorated to the extent that I thought that I was going to die any time." Timely intervention by a nongovernmental organisation helped him to obtain free ARVs, which saved his life.

Exnevia Gomo, director of traditional medicine in the Health Ministry, admitted that the number of fake herbalists has grown. "Traditional medicine is considered much cheaper, and is becoming more credible and popular following the government's decision to officially recognise it ... in direct proportion, there are more cases of people selling fake drugs to desperate patients," Gomo told IRIN.

Minister of Health David Parirenyatwa said in October that the government did not have enough resources to roll out free ARVs to more people. Only 42,000 of an estimated 310,000 Zimbabweans in need of ARVs are receiving the drugs from state institutions.

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