In January 2021, the Malawian rights activist Paul Msoma wrote that he was in Kamuzu central hospital, struggling to breathe. The hospital had oxygen cylinders but no flowmeters – the necessary instrument to connect him to them. I was left wondering where the funds that had been released for the country’s Covid-19 response were going. “My situation is getting bad and l desperately need oxygen,” Msoma wrote on Facebook. “Anyone who can urgently help out there please help by donating this very gadget.”
Kamuzu central hospital is one of the biggest referral hospitals in Malawi and it did not seem right for such a big hospital not to have oxygen flowmeters, which are very basic medical equipment costing around £18 a piece. This was at a time when the government had released more than £5.6m for the Covid-19 response effort.
Tragically, Msoma died a few days later. His call for help opened a can of worms and caused many to realise that these funds were being abused. Influential Malawians organised a citizen-led Covid-19 response and the government was brought to its senses, opening an inquiry into Covid-19 spending.
An eventual report by the country’s office of the ombudsman following Nsoma’s comments indicated that 79.8% of the funds were misused, including money spent on non-Covid items like allowances for government officers. A later audit by the country’s auditor general confirmed the extensive abuse.
But, to date, none of the officers involved in the abuse of the funds have been charged, despite the president, Lazarus Chakwera, promising that all those abusing these funds would face the law. The common belief on the street is that some of the people who misused the funds were politically connected government officials who could have been sharing the spoils with politicians.
Meanwhile, as people were learning how the previous funds were used, Chakwera ordered another £15.8m – mostly from the Global Fund Covid-19 response mechanism and the IMF’s Rapid Credit Facility to help address the effects of the coronavirus – to be released.
As it stands, people are still dying and the country doesn’t have vaccines to give its entire population. Malawi had, as of 2 January of this year, a total of 1,494,459 (7.6%) people with at least one vaccination, while just 712,848 (3.6%) have been fully vaccinated. Cumulatively the country has recorded 76,295 Covid-19 cases and 2,378 deaths, a 3.1% case fatality rate.
The Covid response in Malawi has been greatly affected by rampant corruption. This affected not just procurement of vital items, but also areas like public awareness and outreach. Vaccine hesitancy is a massive problem. Currently, almost every major government hospital in Malawi including those in hard-to-reach areas has some vaccines but there are fears that even the current supply might not be fully utilised because of hesitancy. In May 2021 the country destroyed close to 20,000 doses of expired Covid-19 vaccines. This could have been better managed if funds for the epidemic response were properly used in the early stages of the disease’s spread.
Much of the vaccine hesitancy in Malawi is being driven by religious beliefs, with some religious leaders telling followers the vaccines are prophesised in the Bible and are the starting stages of the branding of a “666” mark – the mark of the beast. They say every global citizen shall be required to have a mark in order to engage in any business. There is another myth that has been taking turns, where many women believe that the vaccines will make them infertile. It is difficult to reach and counter local misinformation, as 82.57% of Malawi’s population lives in rural areas, and about 65.8% of the population is literate.
There currently seems to be more commitment by the country’s leadership to get the population vaccinated. The government, with support from different health organisations, has embarked on a nationwide campaign where people are being reached with mobile clinics within their communities and the result has been an uptick in vaccination.
The country’s health minister also recently announced that Covid-19 vaccination will become mandatory for some public servants such as police officers, health workers, teachers and journalists. But this has not gone down well with some rights groups, including the Malawi Human Rights Commission, which has argued against mandatory status on the grounds that vaccination should be a personal choice.
The recent rise in vaccination is welcome and overdue. But there is still a need for active citizen participation to hold leaders accountable on how every penny of the country’s Covid response fund is being used, and to educate others on the dangers of the virus. This, however, isn’t going to be attainable until the country’s Anti-Corruption Bureau is adequately empowered, and Chakwera commits to full transparency for all Covid spending.