Bubble-wrapped pills are scattered across the crude table in a busy open air street market beside crumpled boxes of lightening creams and other remedies – movet, diprison, sexpills, paracetamol and anti-fungal powder.
A young man approaches in company of a girl and whispers a few words. The vendor shuffles through the piles of sexual aids that cover the table – generic viagra, dubious-looking condoms -before cutting a section containing two antibiotic capsules off a sheet of pills.
He hands them over, collecting in return 50 cents. Such vendors ply their trade on the streets of every city and town, selling pharmaceuticals, often counterfeit or substandard, at reduced rates.
Some strides have been made over the past few years to ensure drugs are safe and effective, but medical practitioners still cite the sale of substandard and counterfeit drugs as one of the largest obstacles in their fight to save lives.
Pharmacies are regulated under the Drugs Act. Enforcement has been stepped up substantially in recent years, but what to do about those vendors on the streets remains elusive. Vendor Ben Shoko says the majority of his supply comes from Botswana, where drugs are sold at cheaper prices and easily smuggled in through Zimbabwe’s infamously porous borders.
At other times, he buys them from local retailers. He’s been selling since the healthcare system disintegrated in the 1990s – paving the way for expensive clinics, available only to the moneyed few.
Another vendor, identified only as Keti, who plies his trade at Mupedzanhamo market, said he had never had a complaint about his products. He recommends drugs and explains to his customers how to take them, although he can’t read most of what is written on the packaging.
Keti says police frequently harass vendors. Occasionally, authorities seize his drugs and arrest him. Sometimes he even goes into the police cells for a while.
“But there are no job opportunities, so even if we are arrested, we’ll start selling the drugs again when we are released,” says Keti. “We are doing this to survive.”
According to the latest Zimbabwe Pharmaceuticals and Healthcare Report, the outlook of modest growth for Zimbabwe’s pharmaceutical sector should be treated with caution as poor monitoring and recording practices, along with the country’s reliance on aid from various sources, make market figures unreliable.
The report adds that pharmaceutical spending will be driven mainly by imported medicines with demand owing to a high communicable-disease burden. However, low purchasing power, a declining economy and ongoing political tensions pose high risk and uncertainty for the market, deterring multinational drug makers.