Need for Malawi to initiate harm reduction strategy to minimize medical care spending

* One of the biggest buyers of Malawi tobacco, Phillip Morris International (PMI) has invented the IQOS

* A smoke-free innovation that continues to attest that the modified risk-free tobacco product is less harmful than tobacco cigarettes

* Majority of people in Malawi are not conversant about vaping products because they are not on open market yet

* These gadgets should be added to the country’s health regulations so that they can be easily accessed for people

* Who want to quit smoking but are failing to do so due to strong withdrawal effects

By Duncan Mlanjira

Several African countries have responded to calls from the continent’s and global health experts and scientists to embrace Harm Reduction Strategy in health care institutions — and Malawi needs to follow suit in order to minimize medical care spending.

This was observed by Chimwemwe Ngoma — Malawi’s advocate for tobacco harm reduction — during the second Harm Reduction Exchange conference for African journalists held at Kempinski Hotel in Nairobi, Kenya in his contribution to the definition of strategies towards reducing health risks associated with nicotine use.

Ngoma, who works at Knowledge-Action-Change as assistant program manager, took note that Malawi’s health care systems are not well developed; that civic education on harm reduction is not available in health institutions — such that the country spends a lot in working towards curing its people as opposed to containing the harm to health before it becomes a crisis.

Globally, over 8 million people who smoke die from smoke-related illness every year and this must be regarded as a global concern — a pandemic-like issue that needs to be addressed — especially for Africa.

Thus the conference in Nairobi discussed that the continent is lagging behind in as far as the calls for African scientists and experts is concerned — for the adoption of tobacco and substance harm reduction public health strategies and tobacco control.

Ngoma, who has five years working experience as a journalist at National Publication Limited and Times Group, also promotes the use of safer alternatives for smokers and implements programs and practices to minimize the adverse health, social and legal impacts of drug use.

He observed that safer nicotine devices are a strange phenomenon in majority of Malawians, taking note that it’s only those who are financially sound that can afford to buy.

He thus encouraged the Malawian health authorities to consider campaigning on people who smoke to opt for alternative smokeless and safe nicotine products such as snus, bubblegum and vaping devices known as e-cigarettes.

There are many scientific innovations that cigarette manufacturers are coming up with that are in line with reducing tobacco harm, but they are yet to infiltrate the African market.

One of the biggest buyers of Malawi tobacco, Phillip Morris International (PMI) has invented the IQOS — a smoke-free innovation that continues to attest that the modified risk-free tobacco product is less harmful than tobacco cigarettes.

Ngoma said majority of people in Malawi are not conversant about vaping products because they are not on open market yet, emphasizing that “these gadgets should be added to the country’s health regulations” so that they can be easily accessed for people who want to quit smoking but are failing to do so due to strong withdrawal effects.

“It’s a multi-sectoral stakeholder issue that should involve the health industry, the civil society and the media because tobacco cigarette smoke is negatively affecting many people who do not smoke.”

Ngoma, who has a PhD. Sociology, MA, Media Studies and an BSc. Agricultural Education, discouraged disinformation of such harm reduction products by authorities, the civil society and the media — emphasizing that if people’s health is improved, the country can minimize on spending and work towards developing health care systems.

In her presentation, Dr. Vivian Manyeki from Kenya said tobacco Harm Reduction has a solid scientific and medical basis, and it has a lot of promise as a public health measure to assist millions of smokers.

“Many smokers are unable, or at least unwilling, to achieve cessation through complete nicotine and tobacco abstinence,” she said. “They continue smoking despite the very real and obvious adverse health consequences and against the multiple public health campaigns.

“Conventional smoking cessation proposals should be complemented with alternative but more realistic options through Harm Reduction.”

Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smoking — the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease.

In his contribution, Dr. Kgosi Letlape — an ophthalmologist and president of Africa Medical Association and also president of the Association of Medical Councils of Africa — said: “Nicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality.

“Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction.”

Thus the media is encouraged to campaign that tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer — that abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases.

The task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking — thus, the development of novel strategies to reduce smoking is imperative.

Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.

Bernice Apondi, a policy manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said: “The Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts.

“In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants.”

This second Harm Reduction Exchange attracted journalists drawn from Southern, West and East African countries — Malawi, Lesotho, Mozambique, Namibia, Eswatini, Botswana, South Africa, Zambia, Zimbabwe, Tanzania, Uganda, Ethiopia, Kenya, Rwanda and Nigeria.

They debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction, and science-led regulation.

It brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions.

The key note speakers included Prof Abdoul Aziz Kasse, Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.