President Peter Mutharika’s Executive Order No. 1 of 2026 issued on February 16, 2025 explicitly barring all public health workers from owning, operating, or holding shares in private clinics and pharmacies is based on a good intention but is wrongly enforced. For that reason, it is bound to face resistance.
The order aims to eliminate conflicts of interest, prevent the redirection of patients to private facilities, and stop the leakage of government drugs. The order gave health workers 30 days to divest from such businesses or face summary dismissal and criminal prosecution. The development is a direct reaction to a joint investigative journalism report by local media houses which exposed malpractices including soliciting payments for non-paying services in public hospitals.
The need to curb drug pilferage in public health facilities cannot be faulted. It is on authority that a third or 30 percent of the country’s drugs is lost through theft. A substantial amount of such medicines end up either in private clinics or are sold on the open market.
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Needless to say, public health workers are the first suspects and rightly so. But is barring them from owning private clinics, or holding shares in such facilities, the solution? Can it stand the test of the law?
In terms of the legality of the directive, for me, the closest is the Malawi Public Service Regulations (MPSR). These are general rules that prohibit civil servants from “placing themselves in a position of conflict of interest”, requiring their full professional attention to government duties. MPSR also prohibits civil servants from engaging in unauthorized private business that interferes with official duties or involves the use of government resources is classified as misconduct.
The Medical Practitioners and Dentists Act (Cap. 36:01): is the principal legislation governing the medical profession. On licensing, under Section 38, it says no practitioner may engage in private practice or be employed by a private practitioner without a specific license issued by the Medical Council of Malawi.
On its own, this statute does not prohibit public servants from owning private clinics or practising because if you check all those medics who run private clinics are licensed. But there are moonlighting restrictions for public sector medics. Regulations under this Act generally require them to seek express authorization before engaging in part-time private work (moonlighting).
The Health Rights and Education Programme has come close to explaining how many public sector health workers, such as medical doctors run private clinics. The development came about because of the severe brain drain of medical doctors from Malawi in the 1990 and early 2000s. While the country only established its first medical school in 1991, significant numbers of its few native-born personnel emigrated shortly after qualifying.
At one time a joke run that there were more Malawian medical doctors practicing in Scotland than in Malawi. In 2004, Malawi had only 1.1 doctors per 100 000 people with approximately 250 doctors serving the entire country. At the time, the regional average was 22 doctors per 100 000.
The main reason for the brain drain was poor remuneration and working conditions and a lack of essential medicals supplies. To address the crisis, government launched the Emergency Human Resources Programme in 2005 which provided salary top-ups, introduced bonding and expanded training.
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