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Issued by the Centre for Human Rights Education, Advice and Assistance (CHREAA), the Southern Africa Litigation Centre (SALC), Facilitators of Community Transformation (FACT) and the AIDS and Rights Alliance for Southern Africa (ARASA)
12 October 2018
COURT STOPS HOSPITALS FROM RETURNING PATIENTS WITH MULTI-DRUG RESISTANT TB (MDR-TB) TO PRISON
ZOMBA – The Malawi High Court yesterday granted an urgent interim injunction preventing the return of six persons diagnosed with multi-drug resistant tuberculosis (MDR-TB) to prison.
Between August and September, six inmates from Maula and Mzimba Prisons were diagnosed with MDR-TB, a contagious form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB drugs. They have been receiving in-patient treatment but are due to be released from hospital. However, because all six are convicted inmates, their release from hospital would have meant a return to the prisons.
The six inmates were joined by the Centre for Human Rights Education Advice and Assistance (CHREAA) in the court application and represented by Ms Chikondi Chijozi. They argued that returning the six inmates to prison would violate not only their constitutional rights but also the rights of all other inmates and people working in and visiting the prisons who would be exposed to the risk of MDR-TB infection.
MDR-TB is spread through coughing and is highly contagious. Severe overcrowding and poor ventilation in the prisons, combined with the lack of adequate food and the absence of isolation facilities to accommodate these persons while infectious and undergoing lengthy and highly toxic treatment, are a breeding ground for the spread of this drug-resistant strain of TB. MDR-TB transmission rates are exponentially increased in congested settings.
While a constitutional case is pending to secure the setting aside of the inmates’ sentences and for other orders, the High Court granted the Applicants the interim order to stop their return to prison. While they remain in hospital, the Court granted further orders to prevent the government from chaining and shackling the men, a practice amounting to torture, cruel, inhuman and degrading treatment in their condition.
Victor Mhango, the Executive Director of CHREAA said, “We are sad that the terrible conditions of detention have led to an outbreak of MDR-TB in these two prisons. But we appreciate that the Court and the relevant government departments appear to share a sense of urgency and concern to ensure the harm is contained. While we have secured some short-term relief today, the only way to really fix the problem is for a fundamental reform of the conditions of imprisonment.”
“All prisoners have a right to life and to be held in conditions consistent with human dignity. We are pleased that the Court has recognised that returning the six Applicants to prison would risk not only the Applicants’ rights but other people’s rights too,” said Annabel Raw, Health Rights Lawyer from the Southern Africa Litigation Centre (SALC), which is supporting the Applicants’ case.
Thokozile Phiri Nkhoma, Executive Director of Facilitators of Community Transformation (FACT) said, “While MDR-TB can be deadly and its treatment long and very toxic, TB is preventable and treatable. The government’s new 2018 Tuberculosis Control Programme includes some really positive plans, including to advance access to better medications. What we need is to see these plans enforced in all places – from communities, to clinics, and to prisons – to cut the infection chain, if we are to end this disease by 2030.”
Michaela Clayton, Director of the AIDS and Rights Alliance for Southern Africa (ARASA), said, “We continue to stress the urgency of human-rights-based responses to TB in the region. These calls have recently been reaffirmed in the adoption of the Global Declaration on Tuberculosis by Heads of States, at the High Level Meeting on Tuberculosis in New York on 26 September 2018. We are happy to see this Court and the lawyer representing the Applicants today delivering such progressive responses. From here it is important to ensure that the individuals affected receive the best available treatment and support.”
For more information:
Victor Mhango, Executive Director, CHREAA: +265 999 95 22 56; firstname.lastname@example.org.
Annabel Raw, Health Rights Lawyer, SALC: +010 596 8538; AnnabelR@salc.org.za
Thokozile Phiri Nkhoma, Executive Director, FACT: (+265) 995 643 884; email@example.com
African civil society organisations applaud the adoption of the Roadmap for access to Medicines and Vaccines by African Ministers of Health.
Windhoek, Namibia. Tuesday, 18 September, 2018
Four African civil society organisations working towards increasing access to diagnostics, medicines and vaccines in sub-Saharan Africa, applaud the leadership shown by African Ministers of Health in endorsing a “roadmap for access for the years 2019-2023 - Comprehensive support for access to Medicines and Vaccines”, at the sixty-eighth session of the WHO Regional Committee for Africa, hosted in Senegal, from 27-31 August 2018.
“As civil society organisations who have worked hard to push against barriers to affordable medicines, we welcome the roadmap as it presents an opportunity for African countries to advance some of the recommendations of the UN High Level Panel on Access to Medicines (UN HLP), which seek to remedy the policy incoherence between trade rules, international human rights law, and public health,” said Michaela Clayton, Director of ARASA. “The approval of proposals to implement this roadmap is a clear indication that our Ministers of Health have grabbed the bull by its horns, in addressing the health crises that continue to undermine the right to health of most Africans. We are hopeful that leadership from the African continent will improve affordable access to medicines for all,” she stated in addition.
The burden of non-communicable diseases is increasing and is already responsible for the deaths of 2 out of 3 women each year globally. Sub-Saharan Africa is home to highest number of people affected by communicable and non-communicable diseases worldwide. Due to various economic and other barriers, including exorbitantly priced commodities the vast number of people affected by these diseases remain under-diagnosed and often untreated. 118 million people, representing 11.4% of the population of African member states, are faced with catastrophic spending on health. Furthermore, the Africa and Asia regions account for 97% of the 97 million people impoverished due to expenditure on health 1.
This roadmap presents new hope for a continent which has weak manufacturing capacity, meaning that most of the African member states are not able to manufacture quality and affordable medicines, which meet the international quality control standards set by the World Health Organisation. Rather the continent continues to rely heavily on countries such as India - “the pharmacy of the South” - to provide less costly, generic medicines for the treatment of both communicable diseases such as HIV and non-communicable diseases, while public health interventions face competition for the dwindling donor resources available. This is a cause of concern as the continent continues to bandage an ongoing problem which, instead of addressing the root cause.
Over the last 15 years, African Member States have adopted numerous progressive policies, including the 2012 Pharmaceutical Manufacturing Plan for Africa (PMPA), which aims “to pursue, with the support of our partners, the local production of generic medicines on the continent and to making full use of the flexibilities within the DOHA Declaration on the Trade Related-Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health”, the African Medicines Regulatory Harmonization Initiative and more recently, the launch of the African Medicines Agency.
“All these policies offer opportunities for achieving the objectives of Africa 2063, by ensuring the good health of Africans,” said Simon Kabore, Director of RAME. “But these opportunities will only be realised if civil society is placed at the forefront of the implementation of these policies to ensure that processes are accelerated, and to be the bulwark against lobby groups with interests that are contrary to the well-being of African populations”.
The adoption of the ‘Roadmap for Access 2019-2023’ is another critical step towards increasing access to the diagnostics, medicines and vaccines that most of Africa’s citizens desperately need by providing a clear pathway to set African countries on the trajectory of progressively realising access to quality, safety and efficacy of medicines and vaccines - a crucial indicator of the Sustainable Development Goals 2.
“While we appreciate the progress, we are aware that the Roadmap would be more effective if it committed the WHO to further UN HLP recommendations, including improving the transparency of research and development (R&D) costs and prices, and implementing ‘de-linkage’ Research & Development models. We encourage Member States to strengthen these aspects by calling for the operational language suggested by civil society organisations in a letter to the WHO Director-General dated 3rd August 2018, as well as clear timelines and milestones for key activities, which are currently missing in the roadmap. We also urge Member States to continue meaningfully engaging civil society to ensure progress towards the full implementation of the recommendations by the UN High Level Panel on Access to Medicines 3”, stated Clayton.
Further, African Member States should call for a special session of the UN General Assembly on Access to Medicines and Vaccines in 2019 with a view to galvanize member states political will to ensure the implementation towards the ‘Roadmap for Access 2019-2023’.
For more information, contact:
AIDS & Rights Alliance for Southern Africa
Tel: +27 81 550 8558
Directeur exécutif Réseau Accès aux Médicaments Essentiels (RAME)
Tel: +22 67 02 44 455
Skype : kaboresimon
Center for Health, Human Rights and Development (CEHURD)
Tel: +265 414 53 22 83