Recognition and respect for African traditional medicine
Nowhere in the world has AIDS had a more devastating effect than in Africa. Tens of millions of people throughout the continent are known to be HIV-positive. The costly treatments developed by the pharmaceutical industry in the North are too expensive for most Africans, and are not widely available. Little wonder then that most people continue to turn to traditional healers for help in combating the disease. And despite the skepticism of many, there are signs that some of the plant-based remedies offered by the healers may be not just affordable, but also effective, according to Dr Sekagya Yahaya Hills who is both a modern dentist and a traditional healer in Uganda.
On the Trail of a Treatment for AIDS
Dr Sekagya Yahaya Hills straddles two worlds of medicine — he is both a dental surgeon and a traditional healer. The soft-spoken Ugandan told delegates at the International Symposium on Biodiversity and Health about his work as president of PRO.ME.TRA-Uganda. This nongovernmental organization is part of the international PRO.ME.TRA network that brings together African physicians and traditional healers with their colleagues in Europe and the United States to promote traditional medicine.
PRO.ME.TRA conducts scientific and cultural research, and provides training to traditional practitioners of traditional medicine using a curriculum that is both scientifically based and culturally specific. It covers topics ranging from family planning to maternal and child health care to HIV/AIDS. Some 2500 traditional healers have completed the PRO.ME.TRA training program, Hills said.
In terms of scientific research, the organization is currently studying the effectiveness of medicinal plants in the treatment of a number of diseases, but the emphasis is on HIV/AIDS. A three-year study involving 62 HIV-positive patients who were treated with a combination of African herbal medicine known as METRAFAIDS showed positive results in 85% of the patients, with no adverse reactions. PRO.ME.TRA has already filed five patent applications relating to the use of medicinal plants in the treatment of HIV/AIDS.
In September 2003, Dr Hills represented Uganda and PRO.ME.TRA at the 13th International Conference on AIDS and STIs in Nairobi, where he presented recommendations from traditional healers on how traditional medicine could best be incorporated into the campaign to fight HIV/AIDS in Africa.
For more information about PRO.ME.TRA its research projects and other activities, visit their web site at www.prometra.org, or send an email to firstname.lastname@example.org. Dr Hills spoke at the International Symposium on Biodiversity and Health, held in Ottawa in October 2003. He outlined the work being done by PRO.ME.TRA, an “international organization for the preservation and restoration of the ancient arts of traditional medicine”. Long-term studies using a combination of African herbal medicines have shown positive results, and PRO.ME.TRA has already filed five patent applications for the use of medicinal plants in the treatment of AIDS (see related sidebar: On the Trail of a Treatment for AIDS).
According to Dr Hills, the Declaration of Traditional Healers — which he presented to the 13th International Conference on AIDS and STIs in Africa, held in Nairobi in September 2003 — well summarizes the role of traditional medicine in Africa. “As traditional healers, we are the most trusted and accessible health care providers in our communities,” the declaration states. “We have varied and valuable experience in treating AIDS-related illnesses and accept the great responsibility of continuing to do so.”
The declaration also recommends that traditional healers be involved in AIDS research, that there should be increased collaboration between conventional and traditional medicine, and that appropriate treatment and care for AIDS patients should include safe and effective traditional healing therapies.
Affordable and accessible
HIV/AIDS is far from the only ailment seen by traditional healers. The great majority of Africans routinely use the services of traditional healers for primary health care. One estimate puts the number as high as 85% in sub-Saharan Africa. According to Francois Gasengayire, Nairobi-based specialist in biodiversity and traditional medicine with the International Development Research Centre (IDRC), there is one healer for every 200 people in the Southern Africa region — a far higher doctor-to-patient ratio than is found in North America.
Recognizing that traditional medicine is “the most affordable and accessible system of health care for the majority of the African rural population,” the Organization for African Unity (now the African Union) declared 2001-2010 to be the Decade for African Traditional Medicine. The goal is to bring together all the stakeholders in an effort to make “safe, efficacious, quality, and affordable traditional medicines available to the vast majority of our people.” This goal is supported by the World Health Organization and IDRC, among others. IDRC played a major role in the process that led to the declaration of the Decade.
Dr Brian Davy, Senior Program Specialist at IDRC, calls it, “a decision that was vital for the health of African populations who depend largely on traditional medicines and medicinal plants.” That view is supported by Dr Philippe Rasoanaivo, who is responsible for traditional medicine in the Ministry of Health in Madagascar. The Decade has given an impetus to the development of a traditional medicine program in Madagascar, he said. This included a draft national policy on traditional medicine, a focus on traditional medicine in the business plan of the Ministry of Health, and the formation of a committee of scientists and lawyers to formulate laws and regulations regarding traditional medicine.
In addition, a computerized inventory of the country’s medicinal and aromatic plants was developed with funding from IDRC. The inventory, which contains some 6000 plants, is now available on CD-ROM from the Institut malgache de recherches appliquées (IMRA) and from IDRC’s regional office for Eastern and Southern Africa in Nairobi.
Several delegates at the International Symposium on Biodiversity and Health warned, however, that many of Africa’s medicinal plants are under threat. Gasengayire explains that although increasing population, deforestation, and desertification are partly responsible, poor harvesting techniques also kill many plants unnecessarily. For example, the bark of Prunus Africana contains ingredients used in the treatment of prostate cancer, he says. Many people will strip a tree of its bark, thus killing the tree. However, if bark was taken from only one side of the tree, it would survive and produce more bark for future harvesting.
African products for African consumers
Myles Mander, of the Institute of Natural Resources in South Africa, agrees that forest clearing and desertification have affected supply, “so that both quality and quantity are dropping.” He told the Symposium that as many as 80% of the plants used will probably die as a result of harvesting. “Local extinctions are occurring,” he added. “There is no incentive for cultivating and sustainable development.”
That incentive, Mander believes, will come only with the development of a modern industry based on medicinal plants that will produce “African products for African consumers.” He pointed out that despite having a market of over 500 million consumers, traders in medicinal plants are not involved in the development of the industry and are not well organized, so have little influence with their governments. “The result is reduced supply and increased costs, with little product development and poor quality products,” he said.
Messanvi Gbeassor, of the University of Lomé, Togo, agreed that there is an urgent need to improve harvesting and processing, and to develop an effective African industry to produce and market plant-based medicines. He stated bluntly that “there is no real pharmaceutical industry in Africa, and no coordinated research. There is a lack of entrepreneurs to help build an industry.” Development of an industry based on medicinal plants has the potential to strengthen both health care systems and people’s livelihoods, he added.
Growing recognition of the value and importance of traditional medicine is producing solutions, however. One that has much potential, says Gasengayire, is the IDRC-supported Network on Medicinal Plants and Traditional Medicine in Eastern Africa. This network brings together traditional healers, researchers, communities, entrepreneurs, development partners, and governments. Its goals include the sustainable, safe, and effective use of medicinal plants as well as the integration of traditional medicine in public health services.
“By pulling together all the different stakeholders the network makes it easier to get both results and recognition. We want to raise awareness of the problems and improve management of the resource,” says Gasengayire.
New Network to Conserve Africa’s Medicinal Plant Resources
A wealth of medicinal and aromatic plants ensures the primary healthcare and livelihoods of the poor in sub-Saharan Africa. Of the close to 6400 plant species used in tropical Africa, for instance, more than 4000 are used as medicinal plants. Up to 80% of the population relies on these traditional medicines. However, says the Network on Medicinal Plants and Traditional Medicine (Eastern Africa), loss of these genetic resources and their habitat is escalating. The loss of related indigenous knowledge is even greater.
Launched in September 2003, the network is supported by IDRC and coordinated by IDRC’s François Gasengayire in Nairobi. The goal, says Gasengayire, is to help reverse this trend by promoting the conservation and sustainable, safe, and effective use of medicinal plants and herbal products. The network also seeks to integrate traditional medicine in public health services in Africa and to promote appropriate policies. And as Gasengayire points out, the collaborative network offers all stakeholders — traditional healers, communities, researchers, governments, and others — the opportunity to share information and experiences, harmonize their approaches, and develop collaborative projects.
The network’s steering committee brings together leading institutions from three East African countries — the National Museums of Kenya, the Institute of Traditional Medicine in Tanzania, and the National Chemotherapeutics Research Laboratory in Uganda — as well as other key institutions, including government, traditional healer associations, and donors. Because partnerships are vital to the network’s success, interested development agencies and international and private organizations are invited to join this initiative.
Bob Stanley is an Ottawa-based freelance writer and editor.