Focus on Malawi –
A THRSP Success Story

With a total of nine Scholars and four Enhanced Scholars over the first three years of the THRSP, Malawi has benefited from significant investment from the Programme. This support has been rewarded both with excellent results for individual Scholars and with broader high-level impacts, including, in 2020, a commitment from the Ministry of Health to incorporate tobacco harm reduction elements in forthcoming national policy. But why focus on Malawi – and what’s behind the Programme’s success here?

The Context: an Economy Tied to Tobacco

✓ Malawi is one of the world’s poorest countries, with an economy that is heavily dependent on agriculture.

✓ 65% of the country’s GDP comes from the production of tobacco, which employs an estimated 75% of the population.

✓ Families depend on tobacco as a key income source; it may be the only crop they grow.

✓ Global demand for tobacco is in decline, leading to ever lower market prices.

✓ As a mainstay of the economy, tobacco is deeply politicised.

✓ Consequently, while smoking is a common risk factor for non-communicable diseases in Malawi, tobacco control structures and support for smokers to quit are lacking.

✓ Recently the Government of Malawi has been leading calls for agricultural diversification, with tobacco farmers encouraged to move to crops such as groundnuts, soy beans or industrial hemp.

✓ The scale of the economic transition required is substantial – but the political will is there.

"We need an exit strategy to transition our farmers to crops that are more sustainable and more profitable. I am calling on the Ministry of Agriculture to begin consultations with all stakeholders to come up with a timeframe within which Malawi’s economy will be completely weaned from tobacco."

Dr. Lazarus Chakwera, President of Malawi, speaking at the opening of tobacco trading season in April 2020.

THR Malawi

Since 2018, a comprehensive and sophisticated network of mutually supportive Scholars and ambassadors has grown from nothing, mainly under the aegis of THR Malawi. A well-functioning tobacco harm reduction network has been established in a country which does not have tobacco control structures.

Chimwemwe Ngoma set up THR Malawi as an information dissemination project during his first Scholarship in 2018. He reflects on the organisation’s development.

“THR Malawi has evolved from an information dissemination project into a consumer group, registered with the Malawi Government. We’re here to break the misconceptions some people have around safer nicotine products and how they relate to reducing smoking harms in Malawi.

“We participate in local and international conversations on tobacco harm reduction. Scholars in Malawi work together to maximise impact, and THR Malawi has recruited 101 THR volunteer ambassadors, some of whom have gone on to become Scholars in their own right. We’ve introduced journalists and health professionals to the concept of tobacco harm reduction at workshops, which were also attended by officials from Malawi’s Ministry of Health.

“In 2020, the Deputy Director for Non-Communicable Diseases at the Ministry expressed a commitment to and made a public announcement about the Ministry’s intention to incorporate the use of tobacco harm reduction products in their mental health and capacity strategy. This felt like a major step forward, for THR Malawi and for the future health of our country’s people.”

THR Malawi plays an active part in national and international conversations about tobacco harm reduction, partnering with the pan-African Campaign for Safer Alternatives (CASA), the International Network of Nicotine Consumer Organisations (INNCO), the World Vapers’ Alliance, EU for Snus and other groups.

In 2019, representatives travelled to Kenya to attend the CASA launch and, later that year, THR Malawi hosted a conference in Lilongwe, with a range of regional and international speakers including Patrick Kuyokwa, THRSP Scholar, Gregory Conley, President of the American Vaping Association and Jon Derricott, the THR Scholarship Programme Manager.

THR Malawi has also hosted launches for K•A•C’s Global State of Tobacco Harm Reduction (GSTHR) project. A two-day event for the Malawian launch of the No Fire, No Smoke report was attended by government representatives, academics, farmers, advocates, NGOs and journalists, and in 2020, THR Malawi co-hosted the global launch of the second GSTHR report Burning Issues with a live-streamed event.

As well as continuing to direct the activities of THR Malawi from Lilongwe, Chimwemwe Ngoma has recently joined the team as THR Scholarship Manager.

THR Scholarships Timeline in Malawi

2018/2019

Two Malawian Scholars began their projects in the first year of the Programme. Wilfred Jekete considered the potential health and socioeconomic impacts of THR in Malawi while Chimwemwe Ngoma established the information dissemination campaign THR Malawi as a powerful online and social media presence (see above).

2019/2020

The success of these first two Malawian Scholars was recognised when both were chosen for Enhanced Scholarship places the following year. Thanks to their outreach, around 40 applications were received from the country for the 2019 Programme, leading to the recruitment of five new Scholars whose projects examined:

Factors affecting the adoption of vaping devices in Malawi.
Tobacco use and THR in Malawi. This short film was a joint project by Blandina Nkhata and Sahan Lungu, and was shown on two Malawian TV stations, leading to interviews about tobacco harm reduction with the filmmakers (see the Meet Our Scholars section for more on the experiences of Blandina and Sahan).
Education on tobacco harms and safer use.
The use of THR products in Malawi and of possible locally made alternatives to combustible tobacco.

2020/2021

Chimwemwe Ngoma was recruited as a THRSP Mentor following successful completion of his Enhanced Scholarship and three Enhanced Scholars from Malawi examined:

Use and toxicity of a local oral tobacco product, ngirimbo. Use of this home-produced or small-scale product was discovered during THR Scholar Vita Mithi’s first project. With tobacco growing and use embedded in indigenous people’s cultures, Vita conducted a toxicology study to determine whether ngirimbo could be promoted as a culturally available and acceptable safer nicotine product. This landmark research revealed the product has the potential to become a tobacco harm reduction tool.
Whether it was possible to produce snus using Malawian-grown tobacco leaf. Patrick Kuyokwa’s project concluded that snus could be locally produced, providing an economically viable safer nicotine product for consumers in Malawi.
The feasibility of local snus use. Patrick’s work is being developed further by Sahan Lungu, whose project has received technical input from the Malawian Ministry of Health. From Sahan’s findings to date, there are strong indications snus can now be considered a suitable potential safer nicotine product for many tobacco users in Malawi thanks to the country’s history of oral tobacco use and the low cost of snus production.

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Focus on Malawi – A THRSP Success Story