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

Salc : Annabel Raw

Case Citation: Banda and Others v the Attorney General and Others (Constitutiona Case No 120 of 2018), Zomba District Registry

SALC is working with the Centre for Human Rights Education Advice and Assistance (CHREAA) to support the case of six inmates seeking an effective and humane response to an outbreak of multidrug-resistant tuberculosis (MDR-TB) in the prisons in Malawi.

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. The prisoners were receiving in-patient treatment but were due to be released from hospital. However, because all six were convicted inmates, their release from hospital would have meant a return to the prisons. 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 toxic treatment, are a breeding ground for the spread of this drug-resistant strain of TB.

In October 2018, the Zomba High Court granted the six inmates and CHREAA an interim order preventing the inmates from being returned to prison from the hospital. They argued that returning them 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. 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.

In January 2019, the interim order was subjected to an inter partes hearing in the Zomba High Court in which the State had an opportunity to contest the order. The Court reserved judgment.

The interim order is subject to a constitutional case (main case) which is pending certification. In the main case, the inmates and CHREAA seek orders for the release of the sick inmates to continue their treatment on an outpatient basis as well as other orders to ensure they receive adequate healthcare and support on their release, and to reform conditions that they argue led to the outbreak of MDR-TB and which exacerbate the risk of TB in the prisons.

The prisoners and CHREAA are represented by Chikondi Chijozi.

For a background of conditions of detention in Malawi, see HERE.