AS she walked out of a pharmacy empty-handed — at the fourth attempt — a hypertensive patient Chiedza Mhungu (56) of Mabvuku suburb could not hide the engulfing distress on her face.
Visibly in pain, she lumbered towards the door before stopping to catch a breadth on a bitter Monday evening this week.
She dragged herself across the street, feebly negotiating her way through honking cars as she walked to the next drugstore in the vain hope of finding cheaper medicine.
But, as it was the case with the four pharmacies she had visited, the drugs were priced well beyond her reach.
Hopeless and resigning to fate, she headed for home without the life-saving medication.
Mhungu has been on a hypertension medication for the past five years, during which time she was consistently taking her drugs.
However, since October last year when the Reserve Bank of Zimbabwe separated foreign currency and RTGS accounts through the mid-term Monetary Policy Statement, Mhungu has struggled to purchase the life-saving medication.
The monetary policy resulted in the local currency losing value against the US dollar and a spiralling of prices, at a time Finance minister Mthuli Ncube also introduced a 2% tax on electronic transactions, compounding the situation.
She has been frequently defaulting — not by choice, but because of affordability — putting her life at risk.
“I could not afford the medication. They said I need US$3 for a course of 30 days and when I asked them how much it was in bond notes, they said $35. I cannot afford to buy medication at that price and Nifedipine is not the only drug I take,” Mhungu said, after her futile trip.
She said that the cocktail of medication that she needs monthly costs US$16, which translates to RTGS$160 at the prevailing parallel market rates.
Unemployed and saddled with other financial obligations, Mhungu says she has no means to raise the money, be it in local currency or the elusive US dollar.
She is not alone in this predicament.
For many other people suffering from otherwise manageable health complications like diabetes, hypertension and asthma among others, a medical prescription now reads like a death warrant as they are struggling to access medication.
A good number of them have sadly succumbed to curable or manageable diseases.
Other than steep prices, some essential drugs are not readily available in hospitals and pharmacies further straining the lives of patients, particularly those who are chronically ill and require regular medication.
The search for some drugs is now akin to the proverbial impossible task of finding a needle in a haystack.
This includes basic drugs sold over the counter such as Solphyllex, a cough syrup, mainly used by asthmatic patients.
Solphyllex has over the past few months disappeared from the pharmaceutical shelves.
The situation is worse for HIV patients, who cannot access the all-important anti-retroviral drugs.
Charles Kutaura, chairperson of the Zimbabwe National Network of People Living with HIV, says the health is in a crisis because of the shortage and unaffordability of drugs.
“There is a current crisis emerging from a short supply of second line drugs called Arbacovir (ABC). Due to the increase in cost of medication, people who used to obtain medication from the private facilities are now migrating to public hospitals. The challenge now is government is not geared to cater for the sudden increase in number, hence the department is overwhelmed, threatening the citizens’ constitutional right to health,” Kutaura said.
Mental health patients have not been spared by drug shortages and the steep prices.
Sacrifice Chirisa, a psychiatrist who runs the Highlands Halfway House, which specialises in psychiatric consultancy, said the medical subfield was in distress.
This comes as Health minister Obadiah Moyo last week said that about one million of Zimbabweans are suffering from mental illnesses, representing a 7,4% of the country’s population.
According to the Health Ministry, at least 1,3 million people in the country are living with mental illness.
In Zimbabwe, mental illness is sometimes associated with superstition — avenging spirits, witchcraft and demons — and this contributes to serious discrimination.
While the number of mental health patients has grown, mental health services, including drugs, remain in chromic short supply. Drugs such as Fluphenezine deconoate (FD) and Chlorpromazine (CPZ) are scarce.
FD is a lifetime drug for mental health problems and it is administered as an injection once a month, after which oral tablets (CPZ) are taken daily for management of the condition.
It is not available in most public health facilities, which means families of those affected have to buy it in pharmacies every month. FD costs not less than US$10 and given the economic challenges that the country is facing, the majority cannot afford to buy the drug.
In most cases, those with mental challenges are even abandoned by their families and in the absence of medication, their conditions can worsen.
Chirisa says the unavailability of drugs results in mental patients being stigmatised, thereby affecting their stability and their emotional state.
“When somebody becomes mentally ill, one of the things that they lose is their ability to generate income. They either lose their jobs or are unable to work, and when prices are that much, they are not able to get those medications,” Chirisa said.
“But if they are not able to get that medication, they become unstable. They relapse and they become a nuisance to their families; to the society. They will break windows; they will shout and this is what then drives the stigma among people.
“Basic drugs are still costing the same amount in US dollar, but the pharmacies are using the parallel market, so drugs have gone up 10 times over, making them unaffordable to some.”
Pharmaceutical Society of Zimbabwe president, Portifa Mwendera admits that the pricing situation has heavily weighted on chronic.
He, however, attributes high prices to the cost and currency of importation.
“The declining economic environment is characterised by declining value in our clients’ earnings. Our patients on chronic medications are suffering the most and indications are that some are now going without their medication, which then complicates their status,” Mwendera said.
“Unfortunately, the cost of medication is denominated in foreign currency (US dollar) because medication and raw materials for locally-manufactured medication are imported, thus their acquisition becomes unaffordable for our population which is still earning in $RTGS.”
Mwendera said pharmacies were also suffering under the harsh economic climate.
“The pharmaceutical industry is suffering from price distortions that arise from how product finance has been sourced,” Mwendera said.
“Sales have been affected by the declining economic environment which has seen the real incomes of majority of our population slashed by the prevailing rate of exchange. Goods have maintained prices in US dollar, while earnings are still denominated in RTGS$. That is what has affected the buying patterns of Zimbabweans.”