People in Malawi are buying life-saving antiretroviral drugs meant for people living with HIV, and misusing them to brew gin as well as fattening livestock.
Some brewers who are fermenting maize husks in the antiretroviral drugs (ARVs) to produce a traditional gin known as 'kachasu' claim the resulting gin is very strong and matures quickly.
There are also some small-scale commercial chicken and pig farmers misusing ARVs, adding them to broiler feed believing it will enhance weight gain so they can sell them quicker.
The farmers' activity has resulted from their observations made of people living with HIV who gain weight as their health improves once they are on the medication.
The appalling revelations were made in Malawi's Weekend Nation newspaper report of 16 August and it is believed that some people were arrested as a result.
According to the paper, one bottle of gin is selling at Malawi Kwacha 3,500 (US$8.40) and business is brisk in the southern region districts of Thyolo and Mulanje which have the highest numbers of people living with HIV.
Civil society reaction
John Kapito, renowned human rights activist and executive director of the Consumer Association of Malawi (CAMA), described the misuse as worrisome and disappointing.
"This is very unfortunate. Apart from threatening people's lives, it also shows that there is a breakdown in the security of drugs in our hospitals," said Kapito.
He called upon the government to empower communities to ensure hospital staff do not abuse their positions and misuse government resources.
An audit of Global Fund grants to Malawi by the Office of Inspector General in 2010 identified US$3.9 million in ineligible and unsupported expenditure. The country has been refunding the Global Fund since 2012 with US$500,000 paid in October 2012, and a further US$937,905 in April 2013. This has negatively affected the national response to HIV, particularly in terms of scaling up prevention and treatment.
Kapito said: "It is surprising that at a time when the country is experiencing drug shortages, someone is selling the little that we have. What message are these people sending out there?"
More action needed
Kapito is calling on the government to take action against the culprits involved in this business saying they should make sure drugs in public hospitals are kept secure.
He urged the public to tip off the police with any information that may lead to the arrest of the culprits.
Billy Banda, executive director of Malawi Watch, criticised the government for its lack of interest in dealing with drug theft. Banda wants the government to punish pharmacists who divert drugs for sale.
Currently Malawi is struggling to sustain and increase the number of patients taking ARVs due to financial resources.
The national response
Since 1985, when the first case of HIV was discovered in Malawi, HIV prevalence has been declining and stabilizing. More people are receiving treatment and fewer people are passing the virus on which adds up to fewer new infections.
In 2012, UNAIDS reported that Malawi recorded a 73 per cent reduction in the rate of new HIV infections. In June 2013, UNAIDS reported that Malawi was one of seven sub-Saharan African countries that had reduced new HIV infections among children by more than 50 per cent since 2009.
Almost half of the population of Malawi - more than seven million - have been tested for HIV and received their results, and nearly half a million people have been put on life-prolonging medication. In July 2013, Malawi started transitioning the final group of ARV clients to a better treatment regimen which has fewer side effects as recommended by World Health Organization (WHO).
And in 2011, Malawi pioneered the development of a simplified public health approach for preventing mother-to-child transmission (PMTCT) of HIV and treatment that offers all pregnant women lifelong antiretroviral therapy, popularly known as Option B+.
Although Malawi has a strong track record of combating HIV, people diverting ARV drugs from their rightful destination threatens to undermine the country's major achievements.