Research insights into the causes of medicine theft in Malawi

Ryan Jablonski
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Originally published on GI-ACE

Malawi continues to struggle to ensure its citizens receive the medicines they need, and the struggle is no secret: Malawi’s major newspaper, The  Nationfeatured a report by the Global Fund which estimates that 23 percent of the medicines it purchases to fight HIV and AIDS, tuberculosis (TB), and malaria in Malawi ”vanish” at various levels in the distribution system.  Our research is directed at this very issue.

Baseline surveys[1] explored Malawians’ experiences with accessing their medicines. In our last post, we reported the following findings from our sample:

  • 42 percent have been told in the last 3 months that their clinic could not provide needed drugs, indicating significant hurdles in obtaining these medicines;
  • 30 percent observed the illegal sale of medicines, indicating that drug theft seems widespread; and
  • more than 50 percent believe that theft is an important reason why their community does not receive better health care.

Some additional analysis of the survey results sheds light on why Malawians believe individuals are motivated to steal drugs. Not surprisingly, respondents believe that the benefits from drug theft are high, the probability of detection is low, and the consequences – even if caught – are slight:

  • More than 80 percent think that officials can make a lot of money by stealing and reselling drugs;
  • 30 percent believe that officials are unlikely to get caught stealing medicines; and
  • only 50 percent believe that persons found to have stolen medicines are highly likely to face consequences.

Many Malawians indicate that their lack of knowledge may contribute to the prevalence of drug theft. Nearly 80 percent of respondents believe individuals may be motived to steal drugs because citizens do not know about it at their clinics, and that those same thieves understand that citizens have few effective means to report any diversions they might see.

We will continue to explore these data – and additional data we will collect after new programs to prevent drug theft are implemented — to understand and improve Malawians’ access to health care and life-saving medicines.

[1] Enumerators implemented the survey in a representative sample from areas that included 97 clinics, resulting in responses from 3,360 citizens.

Ryan Jablonski
Ryan Jablonski
Assistant Professor, Department of Government, London School of Economics and Political Science

Ryan Jablonski’s research focuses on the politics of international development. He is particularly interested in explaining how international organizations and politicians make decisions about development spending and the role of technology in improving political accountability. In other strands of research, he studies the economic effects of transnational crime and the reasons why politicians sometimes choose to use electoral fraud and violence to win elections. Jablonski’s work is largely based in Sub-Saharan Africa, and he has conducted field research in Malawi, Kenya, and Uganda.

Brigitte Seim is Assistant Professor of Public Policy at the University of North Carolina-Chapel HIll. Her research examines the relationship between citizens and political officials, with a particular emphasis on accountability in developing countries in sub-Saharan Africa. 


Mariana Carvalho Barbosa is a Ph.D. student in Political Science at the University of California, San Diego. Her research focuses on causes and consequences of political violence, politics of crime, and corruption.


Clark Gibson is Professor of Political Science and Director of the International Studies Program at the University of California, San Diego (UCSD). His current research focuses on the accountability between governments and citizens in Africa, especially during the electoral process and in the provision of public services.

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