Working Paper Review Version 1 This version is not peer-reviewed

A Review of the Public Health Act in Malawi: A Case for Reform and Consolidation

Version 1 : Received: 31 March 2020 / Approved: 2 April 2020 / Online: 2 April 2020 (12:04:52 CEST)

How to cite: Sambala, E.; Kayesa, N.; Ali, G.; Mbulaje, P.; Mkutumula, E.; Wiysonge, C. A Review of the Public Health Act in Malawi: A Case for Reform and Consolidation. Preprints 2020, 2020040017 Sambala, E.; Kayesa, N.; Ali, G.; Mbulaje, P.; Mkutumula, E.; Wiysonge, C. A Review of the Public Health Act in Malawi: A Case for Reform and Consolidation. Preprints 2020, 2020040017

Abstract

Laws and regulations make powerful contribution in addressing multitudes of public health concerns. We examined the Public Health Act (PHA) in Malawi to understand its relevance to the ever-growing and changing threats posed by infectious and non-infectious diseases. The current Public Health Act of Malawi came into effect in 1948 to protect and preserve public health. The Act has undergone several amendments, the last one being in 1975. It draws much of its inspiration and standards from the 19th century British laws on insanitary housing, poor ventilation, and drainage. Such laws are silent on emerging major public health concerns including non-communicable diseases (NCDs) such as cardiovascular diseases and diabetes as well as road traffic injuries. This makes the Act outdated and ill equipped to address the 21st century public health concerns. Although supplementary legislation such as the HIV/AIDS Act and Mental Treatment Act have recently been enacted, they are yet to be consolidated into the Public Health Act. Consequently, existing policies and strategic plans that are meant to address gaps in public health and ensure coordinated effort lack support of laws and regulations. The Act also places great emphasis on mandatory vaccinations, quarantine and isolation against smallpox, a disease that has long been eradicated. Furthermore, although the Public Health Act outlines powers, duties and penalties, it fails to reinforce acceptable behaviour due to the insignificant penalties for noncompliance. There is a need for immediate and prompt revision and restructuring of the Public Health Act based on scientific evidence. Such laws require adequate consultation and interaction with key experts and stakeholders from a wide range of disciplines.

Subject Areas

Infectious Diseases; Non-Communicable Diseases; Public Health Act; Laws and Regulations; Malawi

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