2023 Africa Traditional Medicines Day
Open pill with leaves coming out.
Happy Africa Traditional Medicines Day! This day honors the role that traditional medicines have had for generations on the continent. The first day was commemorated in 2003 and this year marks the 21st time this day is being commemorated. In recognizing the importance of integrating traditional medicines within health systems, the World Health Organization Regional Office for Africa (AFRO) has implemented a Regional Strategy for Promoting and Enhancing the Role of Traditional Medicines in Health Systems.
Traditional and Cultural Medicines (T&CM) are used in 88% (170 member states) of World Health Organization (WHO) member states. T&CM are part of indigenous knowledge systems (IKS) which have been central to many African societies as well as indigenous communities around the world and are a very valuable resource that should be protected at both the national and international level. T&CM are important for health and wellness especially as it considers health in a holistic manner rather than just focusing on a biomedical approach. Traditional plants are a common form of healing used and are easily accessible to many.
Traditional healers provide traditional medicines and provide information, counseling, and treatment to patients in a personalized way while understanding the patient’s environment. The continent has a large amount of biodiversity and there is the potential to use many of these for medicinal purposes. Documenting the use of these plants is important due to the loss of biodiversity and traditional knowledge. Traditional knowledge on herbal medicines has historically been stolen, to produce goods in the pharmaceutical industry. Major drugs such as quinine, salicylic acid, and artemisinin have been created from traditional knowledge. Quinine was used by Peruvian Indians, salicylic acid was derived by bark in a tree used to traditionally treat inflammation in cultures worldwide, and artemisinin is a plant used in traditional Chinese medicine. The world market of herbal medicine based on traditional medicine is estimated to be worth US $165.66 billion in 2022.
Here are a few examples of traditional plants used on the African continent.
Aloe ferox, closely related to aloe vera, is native to South Africa and Lesotho. The leaf gel is known to alleviate symptoms and or prevent common non-communicable diseases like cardiovascular disease, cancer, and diabetes. A. ferox contains two juices, the yellow bitter juice is used as a laxative, and the white aloe gel is used in drinks and to create skin care products.
Aspalathus linearis, commonly known as Roobois, is endemic in South Africa. It is used as a herbal tea and to add value to products such as beverages, food, and cosmetic products. Aspalathin, a sugar found in rooibos, helps stimulate glucose uptake in muscles in individuals with type 2 diabetes. Due to the known benefits of rooibos, it is becoming increasingly popular in Western countries.
Shea Butter, which is commonly used in West Africa to rub on skin. From lived experience, I know shea butter has some medicinal properties as growing up, it was always rubbed after an injury. Shea butter has been shown to have anti-inflammatory properties and it also relieves pain.
Traditional medicines have lots of known therapeutic and medical benefits to individuals encouraging their use for generations. Investing more in T&CM research and studying these benefits allows us to better understand the uses of plants, the benefits, and the doses that should be used. While these plants are used in pharmaceutical products, it is important that the origins and the uses of these plants are recognized as well as remembering the contributions of traditional medicine to public health. For stronger health systems on the African continent, it is imperative for traditional knowledge and biomedical approaches to coexist. Key areas in the future should focus on patenting, sustainable production, and driving research and innovation on traditional medicines while engaging communities.
Currently, traditional knowledge has little protection under the International Property Rights and copyright system. This is because IKS are owned by families and communities and the requirement includes novelty, inventive step, and commercial viability. Also, traditional knowledge is passed down from generation to generation making it difficult to follow the 20-year patent rule. For global health lawyers, this is an area for future work and demonstrates the interdisciplinary nature of public health. More work needs to be done to ensure that indigenous communities also benefit from economic gains from their knowledge.
The WHO Global Report on Traditional and Complementary Medicine states ”Improving equitable access to safe, quality and effective T&CM services can potentially meet communities’ needs and build sustainable and culturally sensitive primary health care.” It is important to integrate this into primary health care, and sustainable production is needed to be well adapted into the health system. To improve public health on the continent, traditional ways of healing, if they are not harmful, should be integrated with biomedical approaches.
For example, in post-independent Nigeria in 1966, the Ministry of Health authorized the University of Ibadan to research traditional herbs to standardize and regulate them. Traditional medicine can be cheaper than going to a primary care hospital and for many individuals’ cultures is important for healing, which this approach prioritizes. There are instances in which traditional medicines have caused many avoidable fatalities and there are also several medicines that have proven benefits to human health. Traditional medicines are holistic and involve both the mind and body and they have been the focus of many toxicological, chemical, and pharmacological studies.
Between 2005 and 2018 in AFRO, significant progress was made in developing national policies, laws and regulations, and national plans for T&CM. This region has done very well compared to the others in most indicator measurements, but governments and policy advisors need to ensure the sustainability of medicine and the protection of the environment. In August 2023, the World Health Organization had its first global summit on traditional medicines recognizing the need for more commitments towards integrated T & CM into health systems. These medicines can also be used to create wealth and share local knowledge to improve health systems.
Traditional medicines tend to be discouraged due to issues of quality, efficiency, and efficacy. Promoting more research on these medicines can help resolve these concerns and strengthen health systems on the continent that are already heavily dependent on traditional medicine. Integrating these into the health system will account for the local context of the health system. Regulation and registration of herbal medicine need improvement. The lack of research data in the AFRO makes this a challenge. Ensuring more research will allow for the integration into health services as it will ensure the quality and registration of these treatments. Africa CDC supports the use of traditional knowledge and medicines in health systems. I look forward to seeing how traditional medicines will be integrated into health systems.
Further Reading
Sustainable Production of Traditional Medicines in Africa chapter by O. A. Osunderu
Traditional medicines as a mechanism for driving research innovation in Africa by Ivan Addae-Mensah, Foluke Fakorede, Andreas Holtel, Solomon Nwaka (2011)
Towards universal health coverage: advancing the development and use of traditional medicines in Africa by Ossy Muganga JuliusKasilo, Charles Wambebe, Jean-Baptiste Nikiema, Juliet Nabyonga-Orem (2019)
Herbal Medicines in African Traditional Medicine by Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka Chinwe (2019)
Traditional medicines in Africa: An Appraisal of Ten Potent African Medicinal Plants by M. Fawzi Mahomoodally (2013)
