Malawi: Seeking an effective and humane response to MDR-TB in prisons

Case Citation: Banda & Others v the Attorney General & Others (Constitutional Case No 120 of 2018), Zomba District Registry; Makwiza & Another v the Attorney General & Others (Civil Cause No 75 of 2019), Zomba District Registry

SALC is working with the Centre for Human Rights Education Advice and Assistance (CHREAA) to support the case of seven inmates seeking an effective and humane response to multidrug-resistant tuberculosis (MDR-TB) in the prisons in Malawi and the conditions that sustain this public health threat.

Between August and September 2018, six inmates from Maula and Mzimba Prisons were diagnosed with MDR-TB, a contagious form of TB infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB drugs. Treatment for MDR-TB is long and highly toxic, with low success rates. 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 people while infectious and undergoing treatment, are a breeding ground for the spread of this drug-resistant strain of TB.

CHREAA and the six inmates filed a constitutional case in the Zomba High Court in October 2018. While that case was pending, inmates continued to get sick under the conditions in detention. A 7th inmate filed a similar constitutional case in October 2019. These two cases have been consolidated and broadly seek the following:

1. The claimants want the court to compel the government to develop two comprehensive plans: First, a plan to ensure TB is adequately screened, diagnosed, prevented, treated and managed in all prisons; Second, a  plan to reduce overcrowding in all prisons.
2. The claimants ask that the court order the government to report at regular intervals to the court to ensure that these plans are realised and implemented.
3. The claimants have also asked for the court to make various orders to ensure that inmates who become sick with drug-resistant TB in the the meanwhile receive the treatment and care that they need and are not placed in conditions that are inhumane or pose a risk for the spread of TB.

The claimants are represented by Chikondi Chijozi of Southern Africa Litigation Centre. A date of hearing for the case is yet to be given.

• For a background of conditions of detention in Malawi, see HERE.
• For a timeline of the litigation process, see HERE.
• For more information on MDR-TB and how this relates to prison conditions, see HERE.