Chapter 10: The demography, nature and extent of drug abuse and HIV/AIDS in Malawi by Thomas Bisika, Sidon Konyani & Immaculate Chamangwana

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Introduction
Although Malawi is one of the countries experiencing serious HIV and AIDS epidemic, its population has grown from 9.9 million in 1998 to 13.1 million in 2008 representing a 32% increase (National Statistical Office, 2008). This is a complete defiance of the worst HIV and AIDS prognosis which indicated that the growth rate for the Malawi population will decline to 2.2% annually by 2010 (Bisika, 1993).
Substance abuse is common in Malawi although the nature and extent of the problem has not yet been assessed. Recent reports based on psychiatric hospital figures indicate that the main substances of abuse in Malawi are alcohol (including home brew) and cannabis (locally known as “chamba”). The reports also indicate that Mandrax and other over-the-counter and prescription medicines like Phenobarbital, morphene and diazepam are also abused. Solvent abuse has also been reported (Parry & Pluddemann, 2003).
There has been an increase in alcohol abuse cases in treatment centres in Malawi from 15% in 1995 to 20% in 2003. It has also been observed that the problem of cannabis abuse in Southern Africa is highest in Malawi where it accounts for 88% of patients visiting treatment centres and that within the Southern Africa Development Community (SADC) region, it is only in Malawi that the situation of cannabis abuse seems to be increasing substantially (Parry & Pluddemann, 2003). In other countries, substance abuse, especially cannabis, among hospitalized psychiatric patients has also been recognized as a growing
problem (katz, Durst, Shufman, Bar-Hamburger & Grunhaus, 2008).
Several reports (Bisika, 2003a, 2003b) show that alcohol consumption in the public sector was 53.3% while smoking was only 16.1%. Alcohol consumption in the private sector was 48.7% while smoking prevalence was 20.3%. In the private sector 30.6% of the people have gone for VCT and 69.7% would like to go for VCT. Furthermore, a study conducted in three districts of Malawi (Mangochi, Ntchisi and Zomba) recorded an alcohol consumption rate of 15.2% and 11.6% for smoking (Bisika, 2003). A baseline survey for the SRH project in the tourism industry showed that 38.3% of those in this industry take alcohol of whom 9.1% drink on a daily basis and 48.1% on a weekly basis. Smoking was not as common (12.8%) (Bisika, 2002).

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