It is now 16 years since Malawi embraced local production of biotechnology products. Insect-resistant cotton, known as BT cotton, was the first genetically-modified crop for which confined field trials were conducted in Malawi, starting in 2008 and finally released for commercial use in 2019.

Now, the country is conducting trials on genetically modified maize that would be resistant to the fall armyworm. Having successfully conducted trials on GM cotton and maize, is it time for Malawi to consider using biotechnology in the health sector given the successes registered on the international scene?

In countries such as the United States, China, South Africa and India medical biotechnology is already advanced. According to the WHO, the revolution in DNA technology has made it possible to produce safe and effective drugs and vaccines, as well as extremely sensitive diagnostic tools for prevention, detection and treatment of disease.

Should Malawi borrow a leaf?

Senior lecturer in the Biotechnology Department at the Lilongwe University of Agriculture and Natural Resources (LUANAR) Dr Kingdom Kwapata first explains the role biotechnology is playing in the health sector worldwide.

“Pharmaceutical is a very big industry commercially. Economically, I think it has also helped my countries to develop. And one area is biotechnology. It is being used to improve the production of drugs, vaccines, diagnosis of disease and all that,” he says.

Over the past two decades, advances in molecular and cellular biology have begun to explain the complex mechanisms that affect immunity, genetic disorders and the progression of various diseases, adds Dr Kwapata.

Further, WHO says biotechnology is providing a lot of approaches to the diagnosis and treatment of noncommunicable diseases such as heart and kidney problems, but admits that, though limited, its application in the health care is a success.

According to Dr Kwapata, while it appears new in the country, since time in memorial, Malawi has been a recipient of many biotechnology products in medicine such as the polio vaccine, malaria vaccine, cholera vaccine, Covid 19 vaccine and insulin for treatment of diabetes.

“We have been recipients of some other drugs that have been formulated through biotechnology. For example, Covid 19 vaccine which is an mRNA vaccine. It is a biotechnology product. A lot of vaccines come from biotechnology. As a country, we need to be able to develop these things within the country so that we have the capacity,” explains Dr Kwapata.

Rabecca Kachere, a 31-year-old resident of Area 25 in Lilongwe, the capital of Malawi, has a condition which she believes could be minimized through medical biotechnology.

She underwent a heart surgery in 2022 at a hospital in India where doctors replaced and fixed her heart valves, treatment that cost her a lot of money.

“We have many people here in Malawi suffering from these kinds of diseases and cannot access the treatment like the one I had. If our country manages to offer this kind of treatment, I am sure they can save a lot of lives.”

Dr Kwapata, says developing countries like Malawi, have not leveraged on the benefits of biotechnology in the health sector as most of the technology is owned by international organizations.

He says the country has enough expertise to conduct research and produce medicine from biotechnology locally but lacks funding.

“It is incumbent upon the government now to take upon itself to start financing research in health biotechnology in our universities using our local scientists. That is the only way we can make headway.”

Despite having regulatory and safety laws in place, genetic engineering remains a divisive topic in Malawi, both in the academic circles and among the citizens. How does Dr Kwapata look at this considering the cultural values and religious values of Malawi, especially on the idea of transplanting animal organs into humans.

“I think organ culture is the better approach than taking it from animals. Organ culture is the cutting edge of this type of science where people now grow hearts in labs, or liver muscles and other organs that are vital for human survival. So maybe that would be the better approach because you are using one’s own cells to reconstitute the organ, other than taking it from a different animal such as pigs or monkeys… I think those raise questions that would be undesirable.”

Professor Wisdom Changadeya, a lecturer in the Biology Department at the University of Malawi says with the increase in disease burden, Malawi must consider conducting research in medical biotechnology.

However, he says civic education is crucial for people to understand the safety of medication developed through genetic modification.

“Vaccines have used microbes for a long time and therefore they are an application that uses biotechnology, and in this country, I think vaccines have continuously helped us from time in memorial,” he observes, “That is the message that should be sent to people out there.”

Professor Changadeya concurs with Dr Kwapata on the need to invest in infrastructure, among other areas for Malawi to embrace genetic engineering in the field of medicine.

“But it is an issue of possibly labs and equipment because I think people in the College of Medicine or indeed Kuhes [Kamuzu College of Health Sciences] as it is known now may have expertise because most of them have been trained elsewhere. But otherwise, it might be the issue of lab equipment as well as capacity within the lab and funding for the same,” he adds.

With the continued rise in the country’s population and emergence of new diseases, health rights activist Maziko Matemba says there is a need for the country to invest more resources in new technology in the health sector, including biotechnology.

He says where it is fully adopted, Malawi could be able to produce its own vaccines and medicines and conduct organ transplants and thereby saving resources.

“I think at the moment, you know in our health system we have doctors who are trained to help in giving medication. But in terms of having transplants and producing vaccines and all that, I think it is an area to focus on now.

“I think with the private sector engagement framework, which is being implemented now, we might see some of these technologies happening,” says Matemba.

The ministry of agriculture is the policy holder in the health sector. Adrian Chikumbe is the spokesperson for the Ministry of Health. He admits that Malawi is far behind in using biotechnology products in medicine.

He says currently the country only uses biotech products from other countries as it does not have the capacity to produce its own due to a lack of specialised laboratories and equipment.

Nonetheless, he says Malawi is working towards adopting the technology.

“We are relying on expertise from our partners and back home we have the College of Medicine which is planning to have a medicine production plant so that we do not have to keep on ordering medicines from out here. Apart from cutting costs in terms of importation, it will also help in saving forex.”

It is no secret that biotechnology remains a decisive top not just in Malawi but across the globe, especially where consumable products are concerned. On the other hand, commercialization of biotech products has ushered in a new era of healthcare technology, improving the approach to diagnosis, treatment, and prevention.

These innovations have improved treatment and inspired hope for a future where previously-incurable diseases could become manageable or curable. These are benefits which Malawi should not miss out on in the quest to have a healthy nation.

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