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DEPARTMENT OF PRIMARY HEALTH CARE
African Traditional Medicine
Gerard Bodeker PhD
Beijing Declaration on Traditional Medicine (July, 2008)
WHO Director General, Dr Margaret Chan: “Let me begin with the current reality, which on at least one level is
quite straightforward. Traditional medicine is generally available, affordable, and commonly used in large parts of Africa, Asia, and Latin America… For many millions of people, often living in rural areas of developing countries, herbal medicines, traditional treatments, and traditional practitioners are the main – sometimes the only – source of health care.
In the universal rise of chronic non-communicable diseases, such as heart disease, cancer, diabetes, and mental disorders (…) traditional medicine has much to offer in terms of prevention, comfort, compassion, and care. The time has never been better, and the reasons never greater, for giving traditional medicine its proper place in addressing the many ills that face all our modern – and our traditional – societies.
h
African Traditional Medicine
The sum total of all knowledge and practices, whether explicable or not,
used in diagnosis, prevention and elimination of physical, mental, or societal imbalance, and relying exclusively on practical experience and observation handed down from generation to generation, whether verbally or in writing.
Traditional medicine might also be considered to be the sum total of all practices, measures, ingredients and procedures of all kinds, whether material or not, which from time immemorial had enabled the African to guard against disease, to alleviate his suffering and to cure himself.”
(Regional WHO Office, Brazzaville. Meeting of experts, 1978)
.
The World Health Organization Global Atlas of Traditional & Complementary Medicine.
Designed to record, analyze and map the status of policy on Traditional & Complementary Medicine
around the world.
.
Traditional Medicine use in Africa
80% or more of the population of most African countries rely on traditional medicinal practices for primary health care
(WHO Global Atlas on TCAM: Bodeker et al. 2005).
More recent reports - use of traditional medicine in Africa is reported as being as high as 85% in sub-Saharan African populations (WHO-AFRO 2010).
Often, this is the only health care system that is within people’s
means, especially in rural areas. In many African countries, the number of traditional health
practitioners (THPs) outnumbers doctors. Ghana and Swaziland have reported 25,000 and 10,000 patients respectively for every medical doctor, while for every THP there are approximately 200 and 100 patients respectively (WHO-AFRO 2010).
The Business of Traditional Medicine (TRM)
The global economic value of TRM is projected to reach $114bn by 2015 (PRWeb 2012).
Some countries have begun to take advantage of the potential in this developing market.
In Ghana in 2010, for example, it is estimated that 950 tonnes of raw medicinal plants were sold nationally, valued at GH$7.8 million, not including the value of exported medicinals, reported to be over GH$15 million in 2008, all supplied by 30,000 wild collectors (GhanaWeb 2013).
RESEARCH: South African
Herbal Science and Medicine Institute (SAHSMI)
Some
History
&
Some modern
problems
Colonial policy – 19th & 20th cent : Divide & rule. Isolating the
Health Minister (i.e. head trad doctor) from his. Convert ruler
to new medicine & new religion. Create dependency.
Cecil Rhodes – Zulu king & morphene = Rhodesia.
Ghana & Asantehene – Ghana degree in African herbal med
Uganda & Kabaka – public health role;
Witchcraft Acts
Current problematic issues: dangerous practice,
including fake medicines; poorly trained THPs
Traditional religion – FGM, etc.
.
AFRICAN TRADITIONAL MEDICINE:
SOME HIGH PROFILE CASES
of
IPR & CONSERVATION
Rosy Periwinkle (Catharanthus roseus)
.
Prunus africana
.
.
SAN PEOPLE & HOODIA (Hoodia gordonii )
Multi-disciplinary University Traditional Health Initiative:
Building Sustainable Research Capacity on
Plants for Better Public Health in Africa
EU 7th Research Framework Programme – Theme HEALTH,
Coordination and support action
Grant Agreement No.: 266005
Multi-disciplinary University Traditional Health Initiative (MUTHI)
MUTHI was established with European Union funding to build more sustainable plant research capacity and research networks between key institutions in selected African countries (Mali, South Africa, and Uganda) and a group of partner European research institutions to attain enhanced health in Africa.
Through the MUTHI project’s 4-year capacity-building program, African researchers are trained in the necessary research skills to produce and commercialize safe and standardized improved traditional medicines. They are also trained in access and benefit sharing principles.
Partners: EU: Univ of Oslo, Univ. of Oxford, Univ of Amsterdam AFRICA: Makerere U, Uganda; UFS & UWC Sth Africa; Univ of Mali
Objectives of MUTHI The MUTHI project commenced in January 2010 and has focused on 6 broad thematic areas:
1. Medical anthropology and ethnopharmacology.
2. Quality control of phytomedicines and nutraceuticals.
3. Investigative bioactivity and safety of phytomedicines and nutraceuticals, with the objectives
of assessing the needs of African institutes and developing capabilities of researchers for:
bioassays, data management, quality assurance, bioactivity evaluation, safety aspects and
developing guidelines.
4. Identify researchers’ needs for clinical and public health training and to build capacity of
improved traditional medicine researchers on all aspects of the subject, including writing and
data analysis.
5. Ethics and intellectual property rights, aiming to assess training and education requirements
for stakeholders about intellectual property rights, biodiversity legislation and regulation, access
and benefit sharing, and ethics of traditional medicine and research methods.
6. Project management.
MUTHI represents but one of a range of herbal development strategies emerging across Africa
where science and tradition work together to generate safe and effective contributions to the pro-
motion of Africa’s health.
MUTHI’s goal: evidence-based
“improved traditional medicines””
Workshop: Makerere University, Kampala (Feb 2013)
.
Future plans
Fifty-four (96%) of the researchers are planning future
clinical trials of herbal medicines
54 possible future trials:
15: treatment of HIV/AIDS
13: malaria
9: primary care (including diabetes, hypertension,
obesity, low back pain, fever)
4: mental health
4: gastroenterology
4: dermatology
RITAM Research Initiative on
Traditional Antimalarial Methods
So far, over 200 Members from 30 countries
Disciplines:
Preclinical: pharmacologists, chemists,
anthropologists, ethnobotanists, entomologists,
parasitologists
Clinical: doctors, traditional healers
Health systems: public health, funders, social
scientists, Medical IT
Aims of RITAM: to evaluate the potential for traditionally
used plant-based antimalarials
to contribute in a systematic way to the prevention and treatment of malaria.
RITAM Research Initiative on
Traditional Antimalarial Methods
Achievements over the past 15 years: Working groups
Book
Publications
Partnerships
At least one new antimalarial phytomedicine & others in pipeline
www.giftsofhealth.org/ritam
http://globaltraditionalmedicine.tghn.org/key-areas/
Wellness
Increasingly, as part of a global push towards managing lifestyle
diseases countries are looking to promote lifestyle change – diet & exercise – according to local customs.
Some Africa spas have engaged ethnobotanists and THPs to provide local wellness offerings through the spas; and are putting part of their profits back into community schools – e.g. Gibbs Farm in Tanzania.
AFRICAN TRADITIONAL MEDICINE: THE FUTURE
Increased regulation of the sector
Training for practitioners and researchers
New & ‘improved’ traditional medicines for the consumer market
Wellness & spa presence
Continuing mistrust between modern & traditional medicine sectors.
Continued drug development research from African medicinal plants: HIV; malaria; possibly Ebola…
RESEARCH
