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In midst of COVID-19 pandemic, drug shortages, smuggling increase in Zim

At Harare’s bustling Fife Avenue Shopping Centre, a group of men sit outside a pharmacy waiting for their next potential customer.As a woman emerges empty-handed from the building, they signal her to ask if she got what she needed. By Vanessa Gonye “We can help you look for exactly what you need,” said one of them. “We have anything you might think of as long as you have the money.”Zimbabwe’s health system was in tatters before the COVID-19 outbreak, amid chronic medicine shortages and strikes by health workers over the lack of drugs and poor working conditions. Nurses have been on strike for better pay since June. The coronavirus pandemic has exacerbated the decline. The country is struggling with its worst economic crisis in a decade, marked by foreign exchange shortages and inflation, driving prices of fuel, medicine and food beyond most people’s reach. Insulin pens, which normally cost between US$10 to US$14 at pharmacies, now sells for US$18 on Harare’s streets. A vial of insulin, which usually lasts two weeks, now costs US$15, far higher than the normal US$8 to US$10. With medicine in short supply, smuggling from neighbouring countries like Mozambique, South Africa and Zambia has increased.Several pharmacy owners acknowledged they had resorted to smuggling medicine to remain in business. “I have no choice but to smuggle in drugs that are near-expiry dates because they will be cheaper for me to bring in the country,’ said a pharmacy owner, who spoke on condition of anonymity. The reliance on smuggling means shortages of supplies and higher prices.Anesu Rangwani, a doctor at Bulawayo's Mpilo Hospital, said there were more patients with diabetes-related complications because many could not afford insulin, which is necessary to regulate glucose in the blood. “It’s a vicious cycle because even when they get the insulin as in-patients they go on to default again on discharge,” Rangwani said. “This is causing unnecessary loss of lives.” Mirirai Kandelya, a diabetic, said insulin bought at some pharmacies and on the streets was often expired. “I would have headaches each time I used insulin that I had bought from a certain pharmacy until I realised that the insulin would have expired,” said Kandelya, who often cannot afford to buy insulin. Efforts by the drugs regulator, Medicines Regulatory Authority of Zimbabwe, to remove medicine smugglers off Harare’s streets have not succeeded in stopping the lucrative illicit trade. For smugglers, business is booming. One truck driver, who spoke on condition of anonymity to protect his job, said he made up to US$3 000 in a single trip running medicine for a client. “Smuggling medicines is what every inter-country driver looks for,” said the driver, who regularly travels to Mozambique and Zambia. “It gives us more money than what we are paid.” “I have built a house through those dealings,” he added. A health official, who spoke on condition of anonymity because he was not authorised to speak to the media, said Zimbabwe loses an estimated US$1,5 million a year from the smuggling of

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