The Sunday Mail
Shamiso Yikoniko
Mbare Musika, known as the country’s biggest fresh produce market, now houses “pharmacies” illegally dispensing medicines that require medical practitioners’ prescriptions.
Mupedzanhamo Flea Market and some streets in Harare’s CBD have also joined in the illicit trade.
Though the selling of illegal and counterfeit drugs has in the past been conducted clandestinely, it is now being done openly.
Drugs on sale include Ibuprofen, Diclofenac, anti-retroviral medications, family planning tablets and skin-lightening creams.
Medicinal drug peddlers display empty sachets of their wares on pavements, sometimes clashing with health and law enforcement officers.
With conventional and registered medical services beyond the reach of many, some people are now self-prescribing for common ailments like fevers, colds, coughs and headaches.
But those who buy medicine on the streets risk developing complications because there is no expert advice given by the unlicensed hawkers, and neither is there a guarantee that they will work.
Purporting to be a client, this reporter witnessed a vibrant drugs trade in Mbare.
Ms Tarisai Mutare (not her real name), a seller, said selling drugs was a lucrative business. She sells a cocktail of medicines and she has full knowledge of the existence of counterfeit drugs and the illegality of her trade.
“Selling medicinal drugs is a brisk business though we constantly clash with the police and Medicines Control Authority of Zimbabwe officials, that is why I only display empty boxes of the type of medicines I sell but I keep my wares in a secret place,” she explained.
“I began this business in 2010 and I’m managing to cater for my children’s needs as well as pay rent for three rooms in the Mbare National area. My supplier says (the medicines) come from Zambia but there are rumours that they come somewhere further, away but I’m not quite sure where exactly.”
Other traders were reluctant to open up about their trade.
Labels on most of the drugs show they are made in India and China, and indications are that they come via Tanzania and the DRC. Other allegations are that they are smuggled into Zimbabwe on canoes from Zambia across the Zambezi River.
And sometimes the trade is driven by sheer ignorance.
For instance, some women buy birth control pills on the streets for US$1 instead of accessing them for free at clinics, or from pharmacies where there are sold for the same price.
Other drugs that can be found on the black market are antibiotics such as Amoxicillin and Cotrimoxazole; as well as the addictive cough syrup Broncleer.
MCAZ medicines assessor, Dr Zivanai Makoni, urged people to desist from self-prescribing medicines as these are contributing to the antimicrobial resistance (AMR) threat.
“The public must desist from buying medicines from unregistered pharmacies and the sad part is the public isn’t aware of the dangers,” said Dr Makoni.
“Counterfeit and illicit medicinal trade is a multi-sectoral issue which requires all the concerned parties to come together to fight this animal.”
Dr Makoni said medicines must be kept under certain conditions and exposure to either direct light or heat saw them lose their original chemical compositions and potentially become poisonous.
MCAZ is mandated to protect public health by ensuring that medicines and medical devices on the market are safe, effective and of good quality.
The World Health Organisation says the illicit counterfeit medicine trade is a lucrative business, with criminal networks raking billions annually across the globe. The international health body is working with Interpol to curb the scourge.
AMR is a worldwide problem and Zimbabwe has not been spared the problem. WHO anticipates that AMR will lead to 10 million deaths each year globally.
AMR is defined as a resistance of a micro-organism to an anti-microbial drug that was originally effective for treatment of infections caused by it.
In 2012, WHO reported a gradual increase in resistance to HIV drugs. Since then, further increases in resistance to first-line treatment drugs were reported, which might require more expensive drugs in the near future.
Zimbabwe has approximately 15 337 people are on second line ARV drugs treatment.
In 2013, there were about 480 000 new cases of multi-drug resistant tuberculosis worldwide with 820 cases recorded in Zimbabwe.
Both Ibuprofen and Diclofenac are in a group of drugs called non-sterodial anti-inflammatory drugs. They work by reducing hormones that cause inflammation and pain in the body.
Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps or minor injuries.
Locally, diclofenac is a prescription-based medicinal drug while ibuprofen can be bought over-the-counter.
In the same fashion, United Kingdom banned the buying of diclofenac over the counter in January 2015 due to a small risk of heart problems.
Health and Child Care Ministry principal director for curative services, Mr Douglas Mangwanya, said the use of unregistered and illicit medicines was fueling drug resistance.
“The black market for drugs in Mbare and other areas is building resistance especially among anti-biotics such as Amoxycilin and Cotrimozaxole due to the fact that most of them are fake coming from countries such as Nigeria,” he said.
All medicines used in Zimbabwe are supposed to laboratory tested and MCAZ-approved.
In 2014, the Thematic Committee on Peace and Security noted that Zimbabwe’s 51 informal border crossing points made it easy for smugglers to operate.
This means untested medicines find their way into the country and are sold cheaply on the streets.
“ARVs are the most sought-after since some people don’t want to disclose their statuses,” said Ms Mutare in Mbare.
A month’s supply of ARVs costs between US$18 and US$5, but on the streets a patient can get them for between US$10 and $20.
Dr Makoni said getting rid of illegal medicine peddlers was difficult because of the evident consent between buyers and sellers.
“Over the years we have launched blitzes together with the police against some of these peddlers but it only works for a short time.
“They later resurface and their regular customers seem to keep on supporting them,” Dr Makoni said.
