Traditional and Alternative Medicine in Africa: A Synopsis on the Progress and Challenges as the 3rd Decade begins
The 31st of August is African Traditional Medicine Day. Since the year 2000 when this day was first inaugurated, we have recognized the immense contributions traditional medicine (TM) or complementary/alternative medicine (CAM) has made towards good and healthy living for us, Africans, and as well celebrated the milestones reached in improving the standards and outcomes of TM/CAM practice on the continent. It has thus been two decades of running the boom-and-bust of global interest in African traditional medicine, and we are gladdened by the tremendous progress hitherto made. As we proceed into the third decade of action and development, it is deserving that we reflect on the achievements recorded and challenges encountered thus far, as this can in turn illuminates our way into the future.
For generations, Africa has drawn on its rich biodiversity of aromatic and medicinal plants to build homegrown solutions to the health challenges facing Africans. Traditional medicine, thus born, has endured as a key component of the healthcare system for most countries in Africa, as it is accessible, trusted, affordable and is sometimes the only available health system for many communities, especially the rural ones.
The World Health Organization (WHO) estimates that, in Africa, about 80% of the people depend on one or more forms of traditional healthcare services. The Grassroot reality is that many people consult traditional health practitioners (THPs) as much as they visit orthodox medical professionals for health concerns and, sometimes, even combine therapies from both systems, which reflects the entrenchment of local trust in traditional medicine and the need for its recognition as a critical system for primary health care.
In effect, stemming from the collaborative efforts of the WHO, the African Centre for Disease Control and Prevention (Africa CDC) and various African national governments, many countries have made notable advancements towards integrating TM/CAM into their national health programmes and regulatory framework. In her progress report following the 20 years of implementation of the strategies for the development of Traditional medicine in Africa, the WHO recorded the advancements as follows:
- About 40 countries in Africa have now developed policies and frameworks to integrate and/or regulate TM/CAM and THPs, up from just 8 countries in 2000.
- In about 24 countries, academic institutions now offer traditional medicine courses to medical and pharmacy students.
- In 17 countries, referral pathways have been established between THPs and orthodox health practitioners. And 8 countries are reinforcing their health systems for integrated delivery of traditional and conventional health services. In Ghana, for example, between 2012 and 2020, the availability of integrated services has risen from 19 to 40 facilities.
- In line with the goals of universal health coverage, South Africa, Mali and Ghana have now provided partial health insurance coverage for TM/CAM products and services to ease financial hardship posed by health challenges.
- More than 34 research institutes dedicated to traditional medicine have now been established across Africa. And 15 countries regularly allocate public funding for traditional medicine research.
- About 90 domestic marketing authorizations have been issued to TM/CAM products and more than 40 of such medicines have been included in national essential medicine lists.
- Large-scale cultivation of medicinal plants is rapidly expanding, along with increasing local manufacture of herbal medicines.
- Since the COVID-19 Pandemic, effective and safe therapies are being developed via TM/CAM research. In Cameroon, 2 herbal products have been approved by the Ministry of Health for use as complementary therapies for Covid-19 in the country. Also, Madagascar's herbal remedy, Covid-Organics Plus Curative, has reached Phase III of clinical trials. Similar other herbal products are also undergoing trials in about 12 countries including Nigeria, DR Congo, South Africa and Uganda.
- Through training facilitated by WHO, Africa CDC and the European and Developing Countries Clinical Trials Partnership, capacities of researchers, traditional health practitioners and national regulatory authorities have been built and collaborations have increased which can foster more integration and strengthen the health systems across Africa.
- The Regional Expert Advisory Committee on Traditional Medicine for COVID-19 Response, commissioned in 2020 by the trio of WHO, Africa CDC and the AU, is accelerating the pace of research by promoting collaboration among countries to conduct clinical trials of TM/CAM products in accordance with international standards.
These feats were nonetheless gleaned after battling numerous challenges some of which, still, have not yet given way. These include; firstly, the poor political will from the side of many national governments in funding research into traditional medicines. Alliances created to facilitate clinical trials, as above, are often hindered by a lack of financial resources to effectively deliver on their mandates.
Also, unjust political interference and lack of transparency during the developmental process of traditional medicine remedies often taint the public trust in herbal products. For example, according to Dr Jean-Baptiste Nikiema, a regional adviser on essential medicines at WHO Africa, at the height of the pandemic, despite the push for widespread use of Covid-Organics in Madagascar and export to other countries, the Scientific Committee of Madagascar were not very transparent with the data from the phase I and Phase II trials of the herbal remedy.
In addition, the communication gaps between THPs and scientists need to be bridged to empower THPs in enforcing quality within their ranks. Nevertheless, climate change also poses a significant risk to the rich flora and fauna of Africa, and in effect traditional medicine, and this thus calls for urgent mitigative efforts
These challenges, therefore, highlight the areas for improvement to further raise the standards and reliability of traditional medicine in Africa, just as it is gaining traction in other non-African countries like China and India.
At IPSFAfRO, we lend in our voice to call on all national governments and other multilateral organizations in Africa to further commit enough resources to promote traditional medicines, increase production and expand access to safe and effective local medicines in order to improve well being and save more lives in Africa.
P.S. As a way of promoting research in this area, interested researchers may register to participate in this upcoming conference on traditional medicine as a means to build more capacity and foster collaboration in traditional medicine research.