Malawi: Court stops hospitals from returning patients with 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.”

Source: ARASA