Is George Chaponda being subjected to a completely different set of rules on corruption probing? I think yes.

Introduction

There is a very good reason why law always ensures that all those answering to the charge of murder or treason in a formal court setting are represented in their cases. And this is the case even where it is obvious they actually committed the crime in question. The court as an independent arbitrator seeks to instill in the accused an understanding of acceptance of sorts that he was allowed to go through a normal, formal procedure and process of justice so deep inside him he will feel ‘satisfied’ with the court’s final verdict. Currently, two names—George Chaponda and Foster Mulumbe—have the highest probability of appearing in our countries dailies and radios. The two are at the centre of an issue the media have come to describe as ‘Maize-gate’ where they are suspected to have been indulging themselves in corruption, and that perhaps were stopped mid-way towards completion of the same. My analysis of this issue, I mean the so-called Maize-gate, has led me to a conclusion that the two are innocent, that those calling for their removal from office are merely using the issue to meet their objectives, objectives that have nothing to do with the welfare of the Malawi people. In this discussion, I will show why George Chaponda must never resign, and why the President, Peter Mutharika, must never budge to such strange demands to throw away a friend innocent and so close and trustworthy.

Justification for defending Chaponda and Mulumbe

One day in the mid-2000s, some lady told me a story I fail to reconcile to-date. It was about how one man found himself on the wrong side of the law for sexually assaulting his female students at some school in the country, when, in fact, according to this lady, he was never guilty at all of this ‘offence’. She told me that the man had a habit of hugging female students right there in class whenever they gave an answer that impressed him during a lecture. “The man would say,” the woman said, “‘Well, you’ve done it, please come in front, I should reward you,’” the said-reward being a hug. She said the man didn’t know some female students were taking offence at all that though they could never openly express themselves, perhaps out of fear the man would punish them when marking their examinations scripts. Later, when some land issue arose between that teacher and someone with some connection, and reasons were sought to ‘discipline’ him, the ‘hug issue’ surfaced (perhaps I should call it ‘hug-gate’, for in Malawi today, anything ‘suspicious’ is now being surnamed ‘gate’). Eventually, the man lost his employment. What baffled this woman wasn’t that the man lost his job in circumstances that never amounted to sexual harassment as claimed by those bullied by those in power, but that no one, not even herself, gathered courage to stand in defence of this man.

I once attended a class where a visiting Zambian lecturer, a dedicated Christian—he always opened his lessons with some prayer, in the course, literally kneeling in front, hands up, praising GOD—had a funny way of acknowledging hard-work in class. Whenever one did well in class, the man would say, “Good, if you were in Zambia, I would give you a second wife.” Apparently, the part of Zambia where he comes from practises this form of reward. Obviously, such a dedicated Christian would never in real life give such a reward, for that would run contrary to the principles of the faith he follows—Christianity. What I want to mean by this is that there are times when we have to use simple judgement skills to tell a joke from some serious stuff. In short, the name of the man erased from the payroll for harassing female students when all he was doing was to create an atmosphere of laughter with his kids was an example of the danger to which we subject our conscience when we keep quiet in moments we should have stood up for truth without considering how the world would label or judge us.

I believe that if our democracy is to progress, we shall have to learn to tell our ‘enemy’ the truth even if it’s at a telling cost on our part; at the same time, we should not feel ashamed to defend that ‘enemy’ when some, using lame excuses, gang up against him on charges flimsy and vexatious. When judgment shows issues being pursued merely intend to satisfy a select of minds and have nothing to do with public interest, but a mere struggle for power, we must never hesitate, but rise to the occasion, to defend those wrongly labelled. This, I believe, is what justice demands of us.

I am not pro-ruling Democratic Progressive Party in any way but I must confess that it is in me that every time they implement a policy with some positive impact on Malawians, I clap hands for them. At the same time, I never derelict from my duty to point a finger where they go wrong. Perhaps in this way, I resemble the man I admire politically in the country currently—John Chisi. I guess you’re laughing; well, I’m not surprised; you’re not the first one to have found this amusing. Honestly, I should be for the Malawi Congress Party if it had genuinely proved to me they were now a reformed grouping, but alas, they are the same old entity boasting of a Central Region base, following same tactics and approaches to issues as their predecessor, the one the country rejected at the 1993 Referendum—what an opportunity lost.

Discussion

First, let me briefly retell the story that has led to this storm in a tea cup, one that has come to be known as Maize-gate. At times I come to some funny conclusion, namely that this issue has come to rob Chaponda of his right as a person who should be presumed innocent until proven guilty by a competent tribunal or court. In this way, I repeat my stand that this whole issue is a struggle for power and an attempt to impress funders, and has nothing at all to do with public interest.

Well the story is that the country’s downstream agency known by the acronym ADMARC (Agricultural Development and Marketing Corporation) was planning to buy maize from a number of countries including Zambia. There in Zambia, leader of United Progressive Party, Savior Chishimba, upon sniffing ‘corruption’ in the way the deal was being negotiated, et cetera, played the whistleblower, reporting the matter to that country’s Anti-Corruption Commission (ACC). He said something ‘corruption’ was going on in the manner the purchase contract was being either forged or performed. He wanted that country’s Chief Justice to set up a tribunal to investigate that country’s Agriculture Minister, Dora Siliya, and her counterpart in Trade and Industry, Margaret Mwanakatwe. The parties involved in the saga were or are ADMARC (from the Malawi side) and Zambia Cooperative Federation (ZCF), and in some cases, I’m not sure whether to call it an agent, middleman, party or third party, guarantor or transporter—Kaloswe Commuter and Courier Ltd. The media in Malawi, the newspapers especially, bought the story and soon it was all over. I do not think it involved any investigative journalism; it simply required innovation—casting the net wide, reading widely. The media too and the civil society, like the opposition in Zambia who wanted the Agriculture Minister condemned, demanded similar fate for George Chaponda, Malawi’s Minister of Agriculture.

Perhaps scared by the fire in the way the stories were being run in the private media, ADMARC decided to respond in equal measure—fire with fire. First, they tried to clarify things by going it the same media way, mostly using the Government boy, Malawi Broadcasting Corporation, and this they did but in a very shoddy manner, bungling it all, in the end, giving the people the picture of a guilty man running at the sight of a stationary police ambulance.

When those tactics failed, ADMARC quickly went the court way, seeking a short-time order to stop one newspaper outlet under the Times Group brand, from writing further on the issue. The boys, they are currently one of the most trusted and objective news outlet in the country, disregarded the ‘threat’ and so fed the nation with stuff upon stuff of the scandal items. It is said Government has many hands, and one hand in form of the country’s tax-collecting body, the Malawi Revenue Authority, came guns blazing, accusing Times Group of non-payment of tax. As if this was not enough, the country’s broadcasting referee—Malawi Communications Regulatory Authority or MACRA—a fella who dances and the Government pays the piper, jumped on them slam dunk on charges only they, MACRA, can explain. It was much ado about nothing, for soon the High Court was to buy none of the injunction thing, vacating it with a stroke of a pen, and MACRA’s body-busying was to be condemned as an attempt to stifle media independence in the country. And as if to assure the people of the need to guard against death of media independence, only a few days after these torments, Times Group or Blantyre Newspapers Limited received a visitor in the name of Holly Tett, new British High Commissioner to Malawi. I think the message was clear here—attack the media and risk isolation.

There were three important lessons on all this. First, that every time an entity fights the media through courts and other means deemed defensive, people’s suspicion of guilt grows. I personally stand on a principle that in Malawi the best defender of our democracy hasn’t been the courts or the legislature; it has been the media. To understand this, you just have to hear stories about MPs being paid in exchange for silence or support, and in worse cases, as consideration or prize for abandoning a party that sent them that august house. The second lesson is that where an entity fights the media on issues bordering on public interest, especially in a setting where secrecy is a creed, the benefit of doubt is always given the media. This is why it is folly for public figures to resort to action on defamation every time they feel their persons grieved or injured. Democracy where newspapers spend time fighting battles in courts won’t be what we fought for at the Referendum that June 20, 1993. Lastly, it is folly to kill the messenger because there are always times when we need the media, I mean when the tides of fortune all surge against us in the vicissitudes of times. The ruling DPP knows this last point like the back of their hand; they had relied on the same media during their sojourn in the wilderness following the sudden death of their and Malawi’s leader in April 2012.

Because the media or art in general has no room for bias, I stand here to defend Minister of Agriculture, Dr George Chaponda, and ADMARC Chief Executive Officer, Foster Mulumbe, against flying accusations that the two were indulged in corruption and so, that Chaponda must resign as Minister of Agriculture or else the President must exercise his prerogative and fire the Minister for his role in the said maize scandal, and perhaps lately, on his comments that whatever is happening against him is a manifestation of battle between North Malawi and South Malawi.

These calls for him to resign have increased to a deafening point following the revelations or findings in a Commission of Inquiry the President established in January, a body given the powers to establish exactly what had happened and make due recommendations on the same.

Of interest is that the Commission of Inquiry established that ADMARC was ‘grossly negligent’ for not negotiating a lower price under the contract with Zambia Cooperative Federation. The people have taken issue with the two on this despite the fact that Mulumbe had already explained this off by saying the demand for maize in the Southern African region necessitated that they should grab the opportunity to buy the maize at the soonest time possible or else they would lose the grain to those who were equally and desperately looking for the same for their people—kind of beggar-has-no-choice scenario. I do not think this a serious thing to necessitate all the fuss on the issue. There are times in life when demand necessitates haste or you lose the best you could have. In law of tort (negligence) or even in contract (fraud), to prove that these people were fraudulent or negligent is not as simple as people think. And, from their explanation of the issue, I have no doubt, no independent court can fault them for such negligence or fraud unless you are using a completely different yardstick to those courts normally use in cases of this nature.

The Inquiry also established that at entering the contract with ZCF, ADMARC did not inform the ADMARC Board and did not seek a specific approval from ODPP (that’s the national public procurement body) on the contract. Mulumbe explained this, saying the exigencies of the situation on the ground did not allow that they should delay. I would look at all this in this manner: If a woman fell suddenly, and I use my judgment and reasonably believes that her apparels are the cause of the sudden fall, I would not consider etiquette, and I would not shirk from removing her dress to save her life. This is the same scenario in cases involving funerals at workplaces—people go straight to arrange for food to the funeral, for coffin and other emergency issues even before alerting the top guys who believe in bureaucracy for their own ends. Many have claimed that there was no such emergency in the country to necessitate such breaching of procedures, or perhaps that the ‘emergency’ was exaggerated because Mulumbe and Chaponda wanted to steal. I don’t know how the people define emergency, but if I were Mulumbe and Chaponda, and the World Food Programme said the following in May 2016, I would do exactly what they did:

Across Southern Africa, harvests are well underway, temporarily alleviating some market pressure and allowing for food price improvements in pockets of the region as people consume for their own production. However, crop expectations remain poor following one of the driest seasons in 35 years with seasonal rainfall deficits experienced throughout the region, and particularly in central and southern Malawi. For this reason, food prices, which have remained unusually high as compared to the seasonal trend, are expected to increase again in the coming months.

To date, six countries in Southern Africa (Malawi, Zimbabwe, Lesotho, Swaziland & Mozambique and parts of South Africa) have made declarations of drought-induced disasters, emergencies or alerts. According to FEWSNET (April 2016), poor households across the southeastern part of the region that were hit hard by drought this season will atypically continue to experience food consumption gaps during the post-harvest period (April—September). [WFP Malawi Relief Operation Final Situational Report, (April, 2016)], p. 1, available at www.wfp.org).

I do not believe claims that speaking of emergency was exaggerated; in fact, for me this was a kind of house-on-fire scenario that necessitated breaking in to save the desperate child from the engulfing flame of hunger.

When the DPP lost power to fate in 2012, Goodall Gondwe was so soon retained in the government of Joyce Banda as Economic Planning Minister. On January 10, 2013, Nyasa Times ran a story bearing the title “Goodall clears mist on corruption case: ‘I did the right thing for Malawi’. The story was talking about a 2004/05 fertiliser subsidy deal where it was alleged the man had meddled in the awarding of a contract to a Saudi Arabian company. The story goes on to say, “Gondwe was found by the country’s Anti-Corruption Bureau to have acted corruptly in a fertiliser deal (2005/05, sic, farming season) that cost Malawi $6.8 million.” This must have been quite a fortune, as the exchange rate in 2004/05 was not as biting as it is today.

According to the article Gondwe insisted he “had done the right thing for Malawi”.

The article quotes him again:

“It is true I have been under ACB probe for the past seven years over the awarding of contract to a Saudi Arabian company to supply fertiliser for the subsidy programme. But as you are aware, that year it was our first time as a new government and as a country to start implementing the farm input subsidy programme. . . As such, I and the Late President Bingu wa Mutharika had to make swift decisions to save the programme as it were heading for a disaster. To avoid such a disastrous scenario, I had to bypass government’s bureaucratic rules just to make sure that the programme sees the light of day.”

What Goodall is saying is that in times of emergencies, you never operate with the same ease and sense of adherence to bureaucratic rules as in time peace and plenty. This is the same line Mulumbe and Chaponda are proffering, but for whatever reason, Mulumbe’s and Chaponda’s versions are repudiated outright as blue lies, all this where Goodall’s was received as truth. Law does not and must never function with such obvious bias.

Am I saying Goodall was wrong? No, not at all. In fact, in public administration under the concept of management by results, the very one whose workshop Goodall presided over a few weeks ago when he told civil servants the truth about working in the public sector, we judge a person by results. This is referred to as management the ex post way. Get me right here, I am not saying people should break laws or flout procedures, but that it is context that justifies how a case is handled. No two cases are handled the same if their level of exigencies are different. Put simply, there are issues you can handle at a rate synonymous with pleasure and leisure, but there are issues where judgment requires breaking the door or even going through the window.

Goodall was saved by the results which stood to challenge those who were baying for his blood. No one has waited for Chaponda and Mulumbe to show the world such results, and all this where the Commission of Inquiry Report says no money had exchanged hands.

Now my question here is simple: Should we allow only Goodall Gondwe to apply management by results and not Chaponda and Mulumbe? Did Goodall Gondwe who had been investigated for seven years resign to pave way for the said investigation? Maybe he did, but if he did not, why should Chaponda’s case be treated with a different dose of justice? Do not law and justice tell us to use the same yardstick we use on one on another and on all others?

I am not saying this is a question of issues of tribes as Chaponda had suggested, no. It is a question of forgetfulness and inconsistency. Put simply, why do we forget that only four years ago Goodall had justified the same approach and we all had kept quiet, yet today, the same thing becomes an issue when it is Chaponda and Mulumbe claiming the same kind of doctrine of necessity? In law doctrine of necessity is invoked where there is great fear letting things operate normal would create a vacuum and jeopardise the status quo.

I know that some are blaming him for being regionalistic; it is true the suggestions he made were unfortunate coming from a man of his stature, but we must understand that he is a man facing many battles. Perhaps out of anger he could say that, but we have to call to duty our high faculties of reason and forgiveness to appreciate and understand that a man in his situation, in an attempt to make people understand, could say these things, though I would not believe he meant to destroy the unity we all fight to maintain and preserve in the country.

In 2008 Late Gwanda Chakuamba openly inflamed people at a rally to go out and beat up any Lhomwe person in the country, because Lhomwes were becoming ‘cheeky’ and needed some sound thrashing. But eventually as a nation we understood our man was only human and perhaps he had said it in the heat of the moment. It is the same with Late Chakufwa Chihana who once threatened to unleash the dogs of war to have his way in the same manner the fashion of the Mau Mau uprising of Kenya. We had to reason beyond all else and forgive him. I think this is what Malawi must do, to learn to forgive, talk and find a common ground, and surge forward as one people.

Chaponda says he and Mulumbe acted the way they did because they feared letting this thing move at a rate everybody wanted would lead to a chaos of untold proportion—the child crying in the engulfing flames inside the Malawi house would die. If they acted in this fear, wasn’t it something necessary for this nation? How then do we gang up and come rushing, baying for this man’s blood? I have one explanation and one explanation only—struggle for power.

There are things against which as a nation we need to be bold and speak out because democracy demands of us to. We must never fear anyone or anything, because the job to make the wheels of Malawi move lies in our oil of debate. We must never jump on people because we believe they are the people who influence politics and so kicking them out of the way would soften the scene.

And there is the issue of fire at Chaponda’s office. Some have already concluded it was all set to immolate documents of incriminating evidence. As a human being, there is always room for me to doubt, but I must caution myself to make conclusions where I have no evidence with which to so do. Until investigations are done, it is important to wait and see.

I sound like I’m joining the DPP, but I never accept to see my ‘enemy’ suffer on issues I am not sure of myself. I must never accept to see another suffer on an issue I know I have no evidence on. If I want power, it must come the normal way.

In one entry I posted on my blog (on January 22) I made it clear, the only ‘wrong’ the Commission of Inquiry would establish would be to do with ‘breach of procedures’, but we have seen Goodall did that and he was exonerated by results. If you approach this issue in this way, you would agree with me there is nothing in this issue; it is a total waste of money and energy, a detractor, a huge diversion at a time we needed to come together and debate on issues that require our immediate attention—saving our environment, building unity for development and prosperity—through work.

I also hear some people are organising demonstrations. Well, the people have a constitutional right to demonstrate, but I feel the best we can do for our country at this point should have been mobilizing the people to grow more trees, to brainstorm on how best to help those suffering as a result of heavy rains in some parts of the country. This is no time for politicking; if we want that then it should be through talking.

Only a few days after the inauguration of Donald Trump as President of the United States, Pope Francis made the following remarks that so impressed upon my heart: “In times of crisis, we lack judgement, and that is a constant reference for me. . . That is why I always try to say: talk among yourselves, talk to one another.” What the Pontiff was saying, in short, is that when a nation is facing problems of some mind-boggling proportion the answer does not lie in taking to the streets; it lies in talking, talking amongst ourselves to arrive as solutions as a people conscious of their destiny.

I would say the same, let us talk, talk and talk until we begin to speak with the same voice as one people.

People must avoid giving Chaponda more powers by portraying him as a victim or rather turning him into a DPP martyr of sorts. This is the same danger the ruling party, the DPP, is currently curving for itself, bringing out the issue of jet sale at a time when they are embroiled in corruption suspicion over procedures in the procurement of maize in the country. The issue of jet sale is similar to Chaponda’s issue, and I believe similar too to the fertiliser issue in one major way—at the centre of decisions to follow those paths was the fear, apparent or otherwise, that public interest was in danger, and prudence necessitated ‘flouting’ of procedures to save a country tittering on the edge of destruction or death. Chaponda has described this using the analogy of a house burning inside which is a child, where, he says, you do not go about looking for a key; you simply have to go it the savage way, breaking it to rescue that little precious life inside.

It is an important principle of criminal law (and the Chaponda issue is not a criminal issue, for me it is a contract issue, or a tort issue, or administrative issue) that you must never pass a verdict of guilty unless through consensus or admission before a competent tribunal or court. By a competent tribunal it means it must be the right forum, by a particular or right type of court as provide the Laws of Malawi, and by a person or people invested with the authority to do that. It also means one not guided by undercurrent bias.

The problem with many people is that they think that the fact that Retired Chief Justice Msosa was in the Inquiry meant the Commission was a kind of court. These people (the Inquiry team) were given the mandate to establish and recommend, not to prosecute, and they were not prosecuting. In other words, their findings can be proved right or wrong, depending on the findings of the court. Put simply, recommendations are only possible indicators or leads to help objective investigations narrow the investigations to within the confines of red light. Recommendations are not, as many people believe or lead themselves to believe, a verdict of guilty.

There was no way Dr Chaponda’s ministry, i.e. Ministry of Agriculture and Water Development, as the upstream or rather oversight or line ministry under which ADMARC Chief Executive Officer, Foster Mulumbe and his troops reported, would not have a role to play in procurement of maize for the country. It is the degree of his involvement, however, that the people must assess with absolute objectivity.

The ongoing public sector reforms emphasize management by results, a form of management in which set targets are given a manager, robust reporting mechanism set in place, and the manager is judged by the results. The reporting mechanism is aimed at tracing the various stages in which the project is so as to ensure adherence to principles of financial management, et cetera. This tracing is the responsibility of the oversight ministry. To demand that a line ministry should be answerable to activities of a downstream agency is, to say the least, missing the hub of the whole concept of management by results. This does not mean that people must not follow procedures, but we must understand the need for us to balance the need for procedures and the demand of us to perform with efficiency, and efficiency incorporates in it an element of time and money, where time is money and money is time.

There is no doubt that Chaponda is Peter Mutharika’s closest ally, and some go as far as suggesting he is being groomed to take over from him after the expiry of Mutharika’s legal mandate to rule (if Mutharika is re-elected at the 2019 Presidential Polls, that is). I personally think the whole thing, I mean how the various parties have handled the maize saga, smells of some nasty struggle for power. On this, I keep asking myself whether, if this was a different person, the media and all other people calling for his neck would have handled the matter with the same passion and interest, or whether whatever has come out is enough to label Chaponda a ‘thief’; and whether this thing isn’t turning itself into a kind of serious campaign with the objective to humiliate a figure you have failed to in open space.

Conclusion

The ruling DPP has its weaknesses certainly, but this does not justify that we must throw away objectivity and independence simply because we want them go. We must do to A what we can do to B under similar facts or circumstances, otherwise our efforts are bound to be interpreted for something unpalatable. Dr Chaponda as Minister was not supposed to be grilled as though he was the commander on the ground. Dr Chaponda merely plays the oversight role; the job was in the hands of Mulumbe, who too, in my eyes, has no case to answer, being a man who was putting his life and reputation in the line for the sake of Malawians. When Goodall Gondwe was being investigated by the ACB, Late Bingu wa Mutharika never threw him out; it would be a sad thing for Peter Mutharika to throw away a friend so close simply because others allege his conduct is questionable. No money changed hands, please, let us find a better reason to crucify Chaponda.

Reference

World Food Program, WFP Malawi Relief Operation Final Situational Report, April, 2016, p. 1, available at www.wfp.org).

Corruption and the Looming Health Crisis in Malawi—Are we fiddling while Rome burns?

When people talk of corruption as an incubus in the health sector, their eyes are often set on the consequences of that large scale corruption at Capitol Hill, Malawi’s seat of Government, the scandal that forced the donor community to withdraw budgetary support to the country, leaving the poor to pay for the sins of their masters—a select elite entrusted with the duty to defend and protect the public purse. It is true that following revelations of corruption of obscene nature in the civil service, the Western world had reacted by quickly withdrawing budgetary support, and this has dealt the health sector a telling blow. Most hospitals and health clinics now run on inadequate supplies. This is just one of those burdens corruption has brought on the Malawi race. But to measure the true breadth and length of corruption in the public health sector, we need to go deeper than this. This is what I will do in this discussion, digging deeper in order to demonstrate that corruption, apart from depriving the poor of the much-needed drugs and other equipment useful in any hospital setting, also triggers a devastating undercurrent whose consequences are dire and can harm alike both the culprit rich and the victim poor. I will thus demonstrate that we are standing on the edge of a chasm, and that if corruption in the health sector is not checked once and for all, the evil threatens to bring upon us all a catastrophe nothing human can cope with.

Corruption, hospital supplies and deaths

Corruption affects hospital supplies in a number of ways, directly and indirectly. First, grand corruption in the public sector gives the fatigued donor community a reason to flee the scene, often abandoning projects mid-way, some of which were directly involved in procurement and purchase of drugs and equipment for our hospitals and clinics. That way, the health sector simply collapses, forcing hospitals and clinics to live in names only. The unavailability of essential drugs and equipment in hospitals means absence of treatment, and the result is that simple ailments end up getting complicated, eventually leading to more complications and deaths. In this way, corruption by a few greedy fools ends up punishing the poor masses, people with nothing to hold on to. Eventually, through corruption by a few greedy foes, the cycle of poverty continues, taking a more virulent strain at every turn.

Corruption also leads to further spread of diseases which, otherwise would have been contained in the early stages. This is exactly what happened in Sierra Leone some three years ago. Sierra Leone is among the West African countries that were hard hit by Ebola then. In that country alone, the disease killed nearly 4,000 people. Among this number were 200 health workers in that country.

Latest audit revelations in that country show that some of those deaths could not have occurred if the funds from both national coffers and private donations released towards fighting the deadly virus there had been used for the intended purpose. But as it was, some people had diverted a large chunk of that money for their own private end, accepting to see their country go down because they wanted to earn where they did not sow. One can just imagine what they say now after the level of devastation they had caused upon their own people! So many thousands of people who should have contributed in some significant way to the growth and development of Sierra Leone were sent to an untimely grave, thanks to corruption in the high places.

In one article by Umaru Fofana of the BBC entitled “Where are Sierra Leone’s missing Ebola millions” dated 23 January 2017 and available at www.bbc.com, Alhassan Kemokai, a survivor from the disease wishes all the essential supplies had reached the hospitals, for then many lives would have been saved. The article says this gentleman had contracted the disease from his mother who was a hospital worker and that she had contracted it while helping an unsuspecting Ebola patient. Sadly, she mother succumbed to the illness, and article quotes Mr Kemokai as saying his mother would not have contracted the disease if the hospital where she was working had basic things such as gloves. In other words, if those entrusted with disbursing money meant to contain Ebola in Sierra Leone had exercised that high level of honesty expected of people in that position, Sierra Leone would not have lost up to 4,000 people to Ebola.

According to Jamie Hitchen in “Sierra Leone: Mismanagement of Sierra Leone’s Ebola Spending”, available at www.allafrica.com, a report by the country’s Internal Auditor had found that as much as 30% of the approximately US$19 million meant for the fight against Ebola in May-October 2014 alone, had been disbursed without proper supporting documents. According to the article, in some cases, hospital ghost workers were created and paid for using money meant to fight the disease.

In short, where people indulge in corruption especially in a context of some health crisis, the result is devastating especially among those front-line hospital workers as well as the people coming to access the services. Because they are not being given essential hospital supplies, these workers end up contracting the disease, in some cases leading to deaths, all this in a context where it is a toll order to train medical personnel. On the other hand, the people seeking medical help end up losing their lives after receiving no proper treatment owing to lack of resources following diversion of funds meant for the purchase of hospital supplies and drugs.

Another devastating consequence of corruption to the health sector is something most of us do not take time to think on—the issue of antimicrobial resistance or simply drug resistance.

Corruption and drug resistance

According to the World Health Organization “antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Microorganisms that develop antimicrobial resistance are sometimes referred to as ‘superbags’” (“Antimicrobial Resistance” Fact sheet, available at www.who.int, updated September, 2016, accessed 2 February 2017).

The term antimicrobial resistance is thus an umbrella term for all drug resistance posed by bacteria, viruses, fungi and parasites. If the resistance is caused by bacteria it is referred to an antibiotic resistance.

Antimicrobial resistance is becoming serious by the day and “medical pundits are now warning of a return to the pre-antibiotic era; a recent database lists the existence of more than 20,000 potential resistance genes (r genes) of nearly 400 different types, predicted in the main from available bacterial genome sequences” (Julian Davies and Dorothy Davies, 2010: 147). In other words, what is happening as far as drug resistance is concerned is as if we are going back to the era before various antibiotics were discovered, the era when a slight bacterial or viral attack would end up in deaths of many.

But what are the dangers of drug resistance?

According to Dr Tom Frieden in Antibiotics Resistance Threats in the United States, 2013, p 5: “When first-line (those standard drugs or therapy ordinarily used for a particular pathogen or parasite) and then second-line (those used after those we normally rely on have failed) antibiotic treatment options are limited by resistance or are unavailable, healthcare providers are forced to use antibiotics that may be more toxic to the patient and frequently more expensive and less effective. Even when alternative treatments exist, research has shown that patients with resistant infections are often much more likely to die, and survivors have significantly longer hospital stays, delayed recuperation, and long-term disability.”

The threat of drug resistance is real. According to the World Health Organization Antimicrobial Resistance: Global Report on Surveillance 2014, “Globally, 3.6% of new TB cases and 20.2% of previously treated cases are estimated to have multidrugresistant TB (MDR-TB” p xii.

The same report says that “the yearly cost to the US health system alone has been estimated at US $21 to $34 billion dollars, accompanied by more than 8 million additional days in hospital” p xix. I am sure that estimates for an African country of the stature of Malawi would be mind-boggling.

Today I read an article by James Gallagher on the problem of resistance on malaria. The article entitled “Malaria drugs fail for first time on patients in UK” says doctors in the UK have said that “a key malaria treatment has failed for the first time in patients being treated in the UK.” The article says between October 2015 and February 2016, four people there were treated with artemether-lumefantrine (also known as Coartem) which is a combination drug, and they responded to it only to be readmitted when the infection reappeared. All the four had contracted the parasite when two visited Uganda, one Liberia, and the other one, Angola. This suggests that there could be a type of parasite spreading in Africa resistant to malaria drugs. However, the article quotes a team at the London School of Hygiene and Tropical Medicine that it was too early to panic.

On the cause of resistance, Davies and Davies, say, “The development of generations of antibiotic-resistant microbes and their distribution in microbial populations throughout the biosphere are the results of many years of unremitting selection pressure from human applications of antibiotics, via underuse, overuse, and misuse” p 419.

The World Health Organization 2001, also speaks of underuse, overuse and misuse when it says, “The emergence of antimicrobial resistance is a complex problem driven by many interconnected factors, in particular the use and misuse of antimicrobials” WHO Global Strategy for Containment of Antimicrobial Resistance, p 3. It is therefore important that “antimicrobial drugs (i.e. the drugs we use against bacteria, viruses, fungi and parasites) be used exactly as they are prescribed, or else they can contribute towards antimicrobial resistance” (“What is Antibiotic Resistance? What is Drug Resistance?” by James McIntosh, available at www.medicalnewstoday.com, updated January 22, 2016).

Corruption can force the people to practise underuse and misuse of antibiotics or indeed any drug.

The other day a friend of mine working in the health sector told me a story of how one security guard went to a hospital where he was given some antibiotics after diagnosis. The security guard who was able to read noticed a discrepancy between the prescription on the cover of the medicine bag and the number of capsules inside it. He went to his boss and asked whether this was normal. It was not normal, he was told, and the boss took up the matter where it was found there was a kind of syndicate whereby a few pills were being removed into a separate collection, for money.

The guard in question was able to read and detect the discrepancy, but the majority of Malawians are illiterate. In other words, they can take in whatever can be given them, taking for gospel truth everything the nurse or medical assistance or clinical officer can give them. Indirectly, such people can be forced to ‘abuse’ or ‘misuse’ the drug, a situation that can lead to drug resistance. This is the reason my brother or sister on antiretroviral therapy is entreated to always take the medication as prescribed in order to keep the infection to a mere chronic, manageable condition, thus enabling one to live as normal as everybody else. Unfortunately, the moment one stops taking their medication, the virus which is never eliminated but remains dormant or inactive in some immune cells starts replicating or multiplying again, and the consequences can be dire. This is why antiretrovirals have to be taken for life, the very point stressed by the World Health Organization when it observes: “To limit the impact of HIV drug resistance on the effectiveness of ART, it is essential to ensure high quality treatment and care services” p 53. But how can we ensure high quality treatment and care services when the resources meant to meet these services are diverted through corruption? Indirectly thus, corruption can lead to drug resistance through provision of low quality treatment and care services.

But how can the situation affect those practising corruption eventually?

Misuse of drug prescription can force the virus or bacterium to acquire a more formidable appearance, forcing the body to fail to respond to that new threat regardless of the nature of medicine administered. The danger with this is that drug resistance spreads beyond the one in whom the virus or bacterium has strained. Put simply, if a bacterium turns into a strain or form that will not die after administration of a drug that normally kills it, bacteria born from that bacterium will equally or even more refuse to respond to that drug. If bacteria of that strain spread into other people, their bodies too will fail to respond to a drug that would normally kill or eliminate those bacteria. If this can spread in the environment in which we live, the situation eventually becomes a danger to us all, those practising corruption inclusive.

One way to prevent drug resistance is to make a “commitment to always use antibiotics appropriately and safely—only when they are needed to treat disease, and to choose the right antibiotics and to administer them in the right way in every case—(and this) is known as antibiotic stewardship” Antibiotic Resistance Threats in the United States, 2013, p 30. But this is never easy where corrupt officials use people’s ignorance by giving them low quality treatment and services, having diverted a large chuck of the same to sell for their personal end.

Corruption has also forces people to lose faith in public hospitals. As a result some people just resort to finding their own means of getting the drugs through buying from unauthorized dealers who can give them wrong prescription. This may end up creating an environment in their bodies for microbes to develop resistance.

A person who buys drugs from some unqualified person by the roadside, the drugs themselves stolen from some public health warehouse, pharmacy or dispensary, such a person may end up overusing or underutilising the drugs. It is common to find people buying only a few pills because they do not have enough money, and stop taking the drug once the pills they bought have been consumed.

It is important to note that “(such) societal factors accelerate the spread of resistance. Undertreatment through suboptimal doses or inadequate treatment durations—for example, when a patient does not complete a prescribed course of antibiotics—leads to resistant strains of disease-causing microorganisms. Resistance is also encouraged by unnecessary treatment of viral or noninfectious diseases with antibiotics and the use of broad-spectrum drugs in patients whose infections could be treated with more-targeted drugs” Health Affairs, September 2010, Aaron S Kesselheim and Kevin Outterson, p 1690.

Although WHO and other organisations rarely talk of corruption as a possible contributor to drug resistance through forcing the people to abuse or misuse drugs, a deep tracking of the link shows a strong connection between corruption and development of drug resistance in viruses, bacteria, parasites, and fungi.

Conclusion

The fight against corruption though crucial elsewhere, has a more telling implication in the health sector because one can be forced into drug abuse and misuse out of poverty and ignorance. Those indulging in the evil must realize that they are creating for this population a dirty bomb of sorts in antimicrobial resistance, and GOD forbid, if such can strike, we cannot escape each other, for nature always finds a way for us all to interact in some form. I am talking about those forms.

References

Aaron S Kesselheim and Kevin Outterson (September, 2010) “Fighting Antibiotic Resistance: Marrying New Financial Incentives to Meeting Public Health Goals” Health Affairs

Fergus Walsh, “Why talk of a cure for HIV is premature” dated 3 October, 2016 available at www.bbc.com accessed 1 February, 2017

James Gallagher, “Malaria drugs fail for first time on patients in UK” dated 31 January 2017, avaible at www.bbc.com accessed 1 February 2017

James McIntosh, “What is Antibiotic Resistance? What is Drug Resistance?” available at www.medicalnewstoday.com, updated January 22, 2016, accessed 2 February 2017

Jamie Hitchen, “Sierra Leone: Mismanagement of Sierra Leone’s Ebola Spending”, available at www.allafrica.com, accessed 1 February 2017

Julian Davies and Dorothy Davies, 2010, “Origins and Evolution of Antibiotic Resistance” Microbiology and Molecular Biology Reviews,74(3). American Society for Microbiology

Umaru Fofana, “Where are Sierra Leone’s missing Ebola millions” dated 23 January 2017, available at www.bbc.com, accessed 1 February 2017

World Health Organization, World Health Organization Antimicrobial Resistance: Global Report on Surveillance 2014

World Health Organization 2016 “Antimicrobial Resistance” Fact sheet, available at www.who.int, updated September, 2016, accessed 2 February 2017)

WHO 2001, WHO Global Strategy for Containment of Antimicrobial Resistance