Traditional Medicine

Thursday, March 06, 2008

Malawi seeks to oust fake AIDS healers

By,AFP, March 5, 2008

Lawmakers began examining Tuesday draft legislation aimed to rid HIV/AIDS-plagued Malawi of quacks claiming to cure the virus through such remedies as sex with virgins, health authorities said.

"When it passes into law, all traditional healers claiming to cure AIDS will be dealt with," Mary Shaba, head of HIV/AIDS issues for Malawi's health ministry, told a parliamentary committee asked to provide input to the measure before it is submitted to the full 193-member parliament later this year.

"The Act will regulate and protect people from healers who prescribe sex with albinos, the disabled or virgins as a cure for HIV and AIDS," she said of the bill drafted in collaboration with traditional Malawi healers and the World Health Organisation.

Shaba did not specify possible sanctions against bogus healing claims for a virus that has devastated this southern African country, infecting more than one in 10 people.

But under the draft legislation, the country's 30,000 traditional healers -- many of whom operate in towns and villages where hospitals are few and far between -- would be required to register with a board set up by the health ministry.

Besides direct solicitation by healers, newspaper and radio advertisements for AIDS cures are also common in Malawi.

Last year, a United Nations-funded study found that about 60 percent of people aged between 15 and 49 lacked knowledge about HIV prevention.

About 14 percent of Malawi's population of 12 million is infected with HIV, which causes AIDS, according to official figures and there are about 78,000 AIDS-related deaths and 100,000 new infections every year.


Thursday, January 10, 2008

Cameroon: Traditional healers drilled on HIV/AIDS

By, Fred Vubem, Cameroon Tribune (Yaoundé), January 9, 2008

The training was offered by a traditional doctor from South Africa.

An expert in traditional medicine from South Africa was recently in Cameroon to train Cameroonian traditional healers on how to take care of HIV/AIDS patients. The secretary for the International Society of Traditional Healers, Mercy Manci, said traditional doctors need to have information on the prevention and symptoms of the disease so as to be able to know how to care for them and refer them to the hospital when necessary. However Mercy Manci who also heads the Nyangazeziwe organisation in South Africa was quick to reassure that traditional healers don't treat AIDS. "We treat the opportunistic diseases", she said.

She regretted the fact that traditional healers in Cameroon have not benefited from any training on the part of government as in South Africa and urged countries to tolerate traditional and work towards a harmonious relationship between traditional medicine and medical science. In south Africa, research in traditional medicine has yielded some positive results as some tablets have been developed from traditional medicine which are widely used today in that country. Over 85 per cent of the public consult traditional healers. People have a right to treatment and a treatment of their choice.

Mercy Manci who is on her third visit in Cameroon said the first time she came, was to attend the international AIDS conference in which she presented a paper on traditional medicine; the second time was to train Cameroonian traditional healers on the prevention and symptoms of HIV/AIDS. The present visit which took her to some parts of the North West like in Mbengwi, was to follow-up those she trained last time and equally train others. According to the head of traditional healers in Cameroon, Fai Fominyen, the training fall in line with building the capacities of Cameroonian traditional healers, exchange experiences as well as offer treatment to some of the ailing members of the Cameroon association of traditional healers.


Wednesday, October 17, 2007

How acupuncture is working wonders for people with HIV-Aids

By, Jim Pollard, The Nation, October 14, 2007

A pilot project in Chiang Mai province to treat people who have HIV and Aids with acupuncture and traditional Chinese massage has yielded such positive results it will soon be replicated in Africa, India and elsewhere in Thailand.

The project - launched by Dr Laura Louie, a Canadian naturopathic doctor trained in the traditional Chinese medicine - has been running at the small Mae On hospital, 35 kilometres east of Chiang Mai, for more than three years.

Acupuncture has worked minor miracles for some patients, who have enjoyed a big boost in their mental, emotional and physical wellbeing.

"I noticed after two to four treatments patients were having a dramatic improvement in their symptoms. People who'd had headaches or chronic pain for years reported that they no longer felt any pain. It really balanced their body out," says Louie.

"I thought 'Wow!' It still amazes me how much it [acupuncture] can help people.

One man in his early 30s, who she prefers not to name, was stuck in a wheelchair and unable to walk because of severe numbness and pain in his legs. He had little appetite and needed someone to assist him. After treatment he gained weight and is now back walking and working.

A study from 2004 to 2005 on 27 patients showed that 96 per cent had an improvement in their physical wellbeing. The acupuncture and short massage sessions had either resolved or decreased the frequency or intensity of their symptoms.

And "86 per cent said they had improvement in their sense of wellness and emotional well-being, which is important - quality of life is a significant factor in why I did this.

"We know we've got the [anti-retroviral] drugs to help them live for a long time, but what's their quality of life?"

About half of the patients say acupuncture has cut their physical symptoms and allowed them to work more, thus reducing their financial worries and enabling them to participate more in community and social activities.

The beauty of the programme is that it's cheap. "Acupuncture has few serious side-effects if used correctly," says Louie. "And it's very cost effective. It costs just US$6 (Bt216) to treat a person for one month, which is one session a week.

"It also treats the side-effects of anti-retroviral drugs - digestive problems, loss of appetite, numbness in the extremities or headaches. They are good drugs; however, they don't come without several side-effects. Those cause people to stop taking the drugs, so acupuncture is a very good regime to use in parallel.

"There are also secondary benefits - many patients came back saying 'I have more energy, better appetite, less stress and better sleep'. They were not treated for these conditions but acupuncture is a holistic medicine that balances out the whole body."

Louie, 47, has been practising acupuncture for 12 years. Originally from Vancouver, she has been coming to Thailand about three times a year for periods of between six and 12 weeks to train and supervise the staff at Mae On, plus helping with any problems or concerns.

Highly positive results from trial treatments in early 2002 prompted her to propose a programme of acupuncture training and treatment to the hospital director to complement the anti-retroviral drug programme already in place. The idea was accepted and Louie went home and started raising money.

"The official training programme started in April 2004 with two nurses who volunteered to do a course in traditional Chinese medicine in their own time."

By August they had undertaken 110 hours of classroom training. "We then opened the acupuncture clinic. I think we raised C$35,000 (about Bt1 million at the time) - both from my friends and family. We are not a registered charity, so it was just people who believed in me."

The money was spent on training the nurses - specially chosen by the hospital - in the fundamentals of traditional Chinese medicine, acupuncture points and meridians.

It also paid for Louie's airfares plus the basic equipment and materials for a small clinic at Mae On Hospital.

"At the start, I taught them how to locate the acupuncture points and insert the needle. We'd interview patients and teach what questions to ask [to assess people's health]. Some patients had specific problems; others just said 'unwell'.

"Acupuncture is very individualised. You find imbalances and do acupuncture to help that. It's 3,000 years of knowledge that determine this system. That includes the depth the needle goes in, the angle and the function of the acupuncture point - points have particular functions associated with them - resolving dampness, or clearing heat, removing blood stagnation, etc."

As well as acupuncture, patients also get a 10-minute tui na massage -an ancient Chinese technique.

"It appears to help decrease the stigma of HIV because it's done without using gloves or a mask unless indicated," Louie explains.

"When I first volunteered, I'd be giving the tui na massage and many concerned individuals would ask why I wasn't using gloves. This gave me the opportunity to explain how one contracts HIV and this helped to decrease the stigma."

"The acupuncture clinic has also helped create a very nice support network. People can talk safely and there's laughing and telling jokes. Some even say the nice social atmosphere is why they come.

"I want to make sure the programme is a success and the nurses get good results. But now it's been running for three years, they know they can do it on their own."

Louie has spoken internationally about the Mae On Project, which she now plans to replicate in Tanzania and India. Early last year, she presented a talk on her findings from Mae On at the Global Summit on HIV/Aids, Traditional Medicine and Indigenous Knowledge held in Accra, Ghana. She met a doctor from Tanzania who asked her to set up a similar clinic in his country.

"People were very receptive. They like the fact that it's very easy to implement and also that's is so inexpensive.

"At home in Canada and in the US, lots of people with HIV use acupuncture and traditional medicine. I'd assume it's happening in China too."

American acupuncturists working for a US non-profit group treating Africans with HIV in Uganda have reported "the same dramatic results we get here in Thailand", she adds.

The only drawback for Thailand is that nurses are not allowed to undertake acupuncture unless supervised by a medical doctor.

"They're not allowed to sit exams to become licensed acupuncturists. Whereas in all Western countries that I know of - England, Canada and the US - nurses can go on and become licensed acupuncturists."

On the Net:


Tuesday, June 05, 2007

South Africa's traditional healers help fight HIV

By, Rebecca Harrison, Reuters, June 4, 2007

South Africa - Tryphina Ngwenya slides a pink condom over the magic wooden stick normally used to conjure up ancestral spirits, unleashing a ripple of laughter among her audience of traditional South African healers.

"You see it's easy -- there's nothing poisonous or dangerous about condoms," she told the group of some 80 sangomas -- as traditional healers are locally known -- draped in brightly colored wraps, animal hides and beads.

Ngwenya has recruited the sangomas -- sometimes called witchdoctors -- as foot soldiers in the fight against HIV, which has infected about one in three adults in this deeply traditional corner of rural South Africa.

She is teaching them basic AIDS awareness and prevention.

Many of the healers once believed HIV was a curse from the spirit world and patients had been bewitched. Some claimed they could cure AIDS -- and many who have not been trained continue to claim this.

But while they still prescribe roots and herbs for ailments and mutter incantations to dispel evil spirits, these sangomas now also issue condoms, refer patients to clinics for HIV tests and urge them to take life-prolonging anti-retroviral drugs.

"Before, I didn't even know what this HIV animal was, but the training has brought sophistication to my work," said Miriam Tembe, who has been consulting the spirits for tips on treating patients for 25 years.

The training helped her with the practice of scarring a patient then rubbing herbs or powder into the wound: "I used to use one razor for five people -- I used to kill people," she added. "Now I teach them how to protect themselves."


The project linking traditional parishioners with modern health systems is being run by African Medical and Research Foundation (AMREF), which says more than two-thirds of people in rural Africa consult sangomas before attending a clinic.

Sangomas are revered and trusted in rural communities and play multiple roles as spiritual guide, healer and counselor. Mostly but not always woman, they might offer tips to a young couple on their sex life, advise on proper burial rites, or concoct a treatment for toothache -- all in a day.

AMREF wants sangomas to keep providing spiritual succor and basic healthcare, and also to use their influence and authority to promote HIV-testing and modern medicine in areas where many people are distrustful of hospitals, clinics and ARV drugs.

"Traditional healers are so important in these communities. People trust them more than they trust us nurses," said Ivy Mdletshe, a nurse who works in AMREF's HIV testing centre.

Zandile Bukhosini has benefited from the system. When her feet swelled up and she developed a hacking cough she assumed she had been bewitched and went straight to see Tembe -- her local sangoma.

Fortunately, Tembe knew how to spot the symptoms of tuberculosis, which often accompanies HIV infection. She consulted the spirit world as usual, then sent Bukhosini for an HIV test. The results were positive.

"When Miriam sent me for a test I was skeptical, but her medicine had helped me before so I decided to trust her," said the 25-year-old, hunched inside a mud and straw hut, the bitter aroma of burning incense wafting from the corner.

Now, with Tembe's support, Bukhosini is taking anti-retroviral drugs and looks happy and healthy.

"Miriam encouraged me to take the medicine the doctors gave me," she said. "But she also gives me her own treatment and tells me if I need to slaughter a chicken to appease the ancestors."


The AMREF project has particular resonance in South Africa, where Health Minister Manto Tshabalala-Msimang has angered AIDS activists by appearing to question accepted science and emphasizing treatments such as lemon, garlic and the African potato.

Ngwenya insists the two approaches are not mutually exclusive, and argues sangomas can help treat some of the side effects of HIV -- such as skin problems or coughs and colds -- and break down the stigma attached to it.

"Obviously there is not a traditional healer who can cure AIDS but they can help treat the symptoms and help support patients by giving them what they want to believe," she said.

But she also says much more must be done. An estimated 200,000 traditional healers are practicing in South Africa -- there are almost 900 in this small district of some 200,000 people -- and organizations like AMREF have trained just a handful.

Many healers still tell patients anti-retroviral drugs are toxic, condoms are infested with disease-carrying worms and killing a goat will appease ancestral spirits and cure the sick.

And while a few weeks of basic training can halt dangerous practices like razor-sharing, healers may continue to promote traditional methods over modern medicine.

But most sangomas see little conflict between the two approaches, and say learning about orthodox healthcare has helped improve their traditional practice.

"How can the ancestors be angry with me?" said sangoma Philile Gumbi when asked what the spirits thought when she encouraged patients to turn to modern medicine: "Both me and the hospitals are doing the same thing -- we are saving lives."

Wednesday, November 29, 2006

FEATURE-Believers seek AIDS cure at Ethiopian springs

By Tsegaye Tadesse, Reuters AlertNet, November 29, 2006

ADDIS ABABA - Shivering under a tattered blanket, a young woman tries to sleep at the foot of the mist-shrouded Entoto Mountain, north of the Ethiopian capital, Addis Ababa.

Nearby, a mother and child huddle together in the early morning cold.

"I decided to come to Entoto to seek a cure from the holy water after a doctor told me that I am HIV-positive," Abebech Alemu, 35, said.

"I am a follower of the Orthodox faith. I strongly believe that I will be cured by drinking the holy water rather than drugs," she added.

Ethiopia is one of the countries hardest hit by the AIDS epidemic, with more than 1.5 million people, including 100,000 children, living with the HIV virus.

The World Health Organisation (WHO) says the epidemic was previously an urban problem, but the virus has started to spread to rural areas where an estimated 85 percent of the country's 75 million people live.

In Ethiopia's remotest corners, awareness of health and medical issues is very low, and many in isolated communities believe HIV infection is akin to a plague or curse from God.

Abebech is among thousands of Ethiopians who trek from far-flung parts of the Horn of Africa nation to what they believe are holy springs, searching for cures. Many hope to rid themselves of HIV/AIDS.

At the site of the holy spring on Entoto near St. Mary Church -- built by Emperor Menelik II at the end of the 19th century -- a priest holding a large wooden cross stands on high ground.

Below, partly naked and trembling patients line up to be immersed in the water and blessed by the priest. Each patient carries away about five litres of the water, which they drink every day believing it will cure their ailments.

Monks have built awnings made of sticks and straw around St. Mary Church to shelter the wealthier visitors, but most live in the open, surviving by begging.


"I know about the free distribution of HIV medicine, but I have decided not to take it. I am convinced I could be cured by the holy water," Abebech said.

Head priest Bahetawi Gebremedhin Demise said he came to Entoto 10 years ago after God told him in a dream to go to the deep ravine under the mountain where a holy spring would cure the sick.

"Once they feel better, I send them back to the hospital where they were declared HIV-positive. They come back with a negative certificate," he said.

Bahetawi Gebremedhin said 1,390 HIV-positive people had been cured in the past year alone, according to his records. He said the spring had healed more than 500,000 people, including many foreigners, suffering from different ailments.

"This is a place of God where all those who believe in the Almighty are being cured. People from all walks of life who seek God's mercy come to us and we try and help everyone irrespective of their creed, religion or nationality," he said.

But Dr. Solomon Zewdu, administrator of Johns Hopkins University HIV/AIDS Drugs Distribution Centre in Addis Ababa, said he had appealed to the Orthodox Patriarch to tell HIV-positive people that they can take anti-retroviral drugs (ARVs) along with the water.

"HIV drugs are life-saving. Those who are drinking the holy water can also take the drugs. I do not see any contradiction," he said, adding he had seen patients abandoning their hospital beds and the ARV regime, opting for holy water.

Only 33,000 people in Ethiopia are receiving ARV treatment, according to the WHO. In many developing countries, life-saving drugs are either unavailable or too expensive for millions living with the virus.

"Those possessed by the devil come in chains, others on a wheelchair or on the backs of men, still others, who lost their eyesight, are led here by friends," Bahetawi Gebremedhin said.

"After a few weeks of intense prayer and religious rites, they are baptized with the holy water and they get cured."


Thursday, August 31, 2006

Medicinal plant "fights" Aids

A South African indigenous medicinal plant may hold the key to the treatment of millions of poor people living with HIV and Aids, helping them relieve the symptoms of Aids.

For the first time in South Africa's medical history, the plant, Sutherlandia Frutescens, sub-species Microphylla, is to undergo clinical trials to assess its immune-boosting propertie

The Medical Research Council will conduct the trials early next year and results are expected within three to six months.

Anecdotal evidence is already mounting, suggesting that this plant can improve the quality of life of thousands of people both with HIV and full-blown Aids.

Sutherlandia Frutescens grows wild in the Western Cape and in the hills of Zululand.

Cancer bush

A particular variety of the plant has been used for centuries as a potent medicine by South Africa's indigenous San people who call it "Insisa" - the one that dispels darkness. They used it as an energy booster and a powerful anti-depressant.

Traditional healers have been using it for decades Zulu sangomas or traditional healers know it as "Unwele", the great medicine that was used to ward off the effects of the devastating 1918 influenza pandemic which claimed 20 million lives worldwide.

The Tswana people know it as "Mukakana" for its power in treating gonorrhoea and syphilis, while the Afrikaners call it the "Kankerbossie" or cancer bush, because of its properties in treating people suffering with internal cancers and wasting.

Molecular combination

A local company specialising in the development of indigenous plant medicines, Phyto Nova, first started researching the bio-chemical properties of Sutherlandia about three years ago.

A multi-disciplinary team headed by Dr Nigel Gericke, a botanist, medical doctor and indigenous plant specialist, found that Sutherlandia contained a powerful combination of molecules which have been identified and used in the treatment of patients with cancer tuberculosis, diabetes, schizophrenia and clinical depression and as an antiretroviral agent.

Phyto Nova were so convinced that Sutherlandia could be used as a tonic for people infected with HIV and Aids, that they contracted farmers to plant acres of the bush, to prevent wild supplies being over-harvested. They have been manufacturing high quality Sutherlandia tablets, gel and powder.

Having determined that the product was safe when administered with a balanced food diet, the company distributed Sutherlandia to Aids patients.

Quality of life

"Anecdotally we are accumulating evidence that wasted patients with Aids, TB and cancer pick up weight, regain energy and appetite," says Dr Gericke.

"The claim we are making on the basis of this, is that we can significantly and dramatically improve the quality of life of many ill Aids patients... We are certainly not making the absurd claim that Sutherlandia is a cure-all or a cure for Aids."

Whatever comes of the clinical trial, word of the plant's properties is already spreading among South Africa's traditional healers.

At the same time as Phyto Nova was conducting its research, one of the country's most venerated traditional healers, Dr Credo Mutwa, 80, was using Sutherlandia to treat Aids patients.

"My aunt Minah, who is 103 years old, told me that we should use the great medicine against Aids," said Dr Mutwa. "I said to her: 'But aunt, the white people tell us there is no cure for this disease'.

"And my aunt said: 'For every disease there is a treatment. Try this medicine'. And I tried it."


"I have treated people who were told by the doctors at the hospital to 'go home and die' and they are still alive today, three years after they should have died. This plant is near-miraculous, I can say that with certainty," he says.

Testimony to the efficacy of the plant continues to mount.

Anne Hutchings, an ethno-botanist and lecturer at the University of Zululand has been using Sutherlandia, together with a range of other indigenous plant medicines, to treat Aids patients who attend the weekly Aids clinic at Ngwelezane Hospital.

She has 176 patients who all testify that Sutherlandia has helped them to live a fuller, healthier and more productive life.

No response

In the Northern Cape town of Kuruman, nurse and sangoma, Virginia Rathele is using Sutherlandia at her clinic to treat more than 300 Aids patients.

She says an integral part of the treatment is to tell patients to eat healthily. "Sutherlandia does not work properly just on a diet of porridge. You have to have vegetables," she said.

One client, who weighed 26kg and was close to death in April this year, now weighs 45kg and is helping Ms Rathele run the clinic.

Patents cannot be taken out on plants which have well-documented folk use, which means that Sutherlandia should remain accessible to anyone.

At present, one month's supply of Phyto Nova tablets costs a little under $2.50 and two months' supply of the powder form of the medication can be bought for under 50 cents.

Phyto Nova has approached the South African Government in a bid to persuade them to grow the plant on a massive scale for use in public health treatment.

So far they have had no response.

Source: Carolyn Dempster, BBC News

Traditional medicine

What is traditional medicine?

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.

Countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. In industralized countries, adaptations of traditional medicine are termed “Complementary“ or “Alternative” (CAM).

Increasing use and popularity

TM has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries.
  • In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
  • In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
  • WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
  • In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
  • In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
  • 70% of the population in Canada have used complementary medicine at least once.
  • In Germany, 90% of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10 800.
  • In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US $17 billion was spent on traditional remedies in 2000.
  • In the United Kingdom, annual expenditure on alternative medicine is US$ 230 million.
  • The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily.

Safety and efficacy issues

Scientific evidence from randomized clinical trials is only strong for many uses of acupuncture, some herbal medicines and for some of the manual therapies. Further research is needed to ascertain the efficacy and safety of several other practices and medicinal plants.

Unregulated or inappropriate use of traditional medicines and practices can have negative or dangerous effects.

For instance, the herb “Ma Huang” (Ephedra) is traditionally used in China to treat respiratory congestion. In the United States, the herb was marketed as a dietary aid, whose over dosage led to at least a dozen deaths, heart attacks and strokes.

In Belgium, at least 70 people required renal transplant or dialysis for interstitial fibrosis of the kidney after taking a herbal preparation made from the wrong species of plant as slimming treatment.

Biodiversity and sustainability

In addition to patient safety issues, there is the risk that a growing herbal market and its great commercial benefit might pose a threat to biodiversity through the over harvesting of the raw material for herbal medicines and other natural health care products. These practices, if not controlled, may lead to the extinction of endangered species and the destruction of natural habitats and resources.

Another related issue is that at present, the requirements for protection provided under international standards for patent law and by most national conventional patent laws are inadequate to protect traditional knowledge and biodiversity.

Tried and tested methods and products

  • 25% of modern medicines are made from plants first used traditionally.
  • Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia.
  • Yoga can reduce asthma attacks while Tai Ji techniques can help the elderly reduce their fear of falls.
  • TM can also have impact on infectious diseases. For example, the Chinese herbal remedy Artemisia annua, used in China for almost 2000 years has been found to be effective against resistant malaria and could create a breakthrough in preventing almost one million deaths annually, most of them children, from severe malaria.
  • In South Africa, the Medical Research Council is conducting studies on the efficacy of the plant Sutherlandia Microphylla in treating AIDS patients. Traditionally used as a tonic, this plant may increase energy, appetite and body mass in people living with HIV.

WHO efforts in promoting safe, effective and affordable traditional medicine

The World Health Organization launched its first ever comprehensive traditional medicine strategy in 2002. The strategy is designed to assist countries to:

  • Develop national policies on the evaluation and regulation of TM/CAM practices;
  • Create a stronger evidence base on the safety, efficacy and quality of the TAM/CAM products and practices;
  • Ensure availability and affordability of TM/CAM including essential herbal medicines;
  • Promote therapeutically sound use of TM/CAM by providers and consumers;
  • Document traditional medicines and remedies.

At present, WHO is supporting clinical studies on antimalarials in three African countries; the studies are revealing good potential for herbal antimalarials.

Other collaboration is taking place with Burkina Faso, the Democratic Republic of the Congo, Ghana, Mali, Nigeria, Kenya, Uganda, and Zimbabwe in the research and evaluation of herbal treatments for HIV/ AIDS, malaria, sickle cell anaemia and Diabetes Mellitus.

In Tanzania, WHO, in collaboration with China, is providing technical support to the government for the production of antimalarials derived from the Chinese herb Artemisia annua. Local production of the medicine will bring the price of one dose down from US $6 or $7 to a more affordable $2.

In 2003, WHO support has so far facilitated the development and introduction of traditional and alternative health care curricula in seven tertiary education institutions in the Philippines.

Training workshops on the use of traditional medicines for selected diseases and disorders have also been organized in China, Mongolia and Vietnam.

Priorities for promoting the use of traditional medicines

Over one-third of the population in developing countries lack access to essential medicines. The provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care.

While China, the Democratic People’s Republic of Korea, the Republic of Korea and Vietnam have fully integrated traditional medicine into their health care systems, many countries are yet to collect and integrate standardized evidence on this type of health care.

70 countries have a national regulation on herbal medicines but the legislative control of medicinal plants has not evolved around a structured model. This is because medicinal products or herbs are defined differently in different countries and diverse approaches have been adopted with regard to licensing, dispensing, manufacturing and trading.

The limited scientific evidence about TM/CAM’s safety and efficacy as well as other considerations make it important for governments to:

  • Formulate national policy and regulation for the proper use of TM/CAM and its integration into national health care systems in line with the provisions of the WHO strategies on Traditional Medicines;
  • Establish regulatory mechanisms to control the safety and quality of products and of TM/CAM practice;
  • Create awareness about safe and effective TM/CAM therapies among the public and consumers;
  • Cultivate and conserve medicinal plants to ensure their sustainable use.

Source: WHO

Saturday, May 06, 2006

Global Summit on Traditional Medicine, Indigenous knowledge and HIV/AIDS

Accra, Ghana, March 14 -18 2006

HDN Key Correspondent Conference Report

This short report is in three sections: an overview of the conference, its aims and objectives; a consideration of the various interventions that were presented; and a broader discussion around how the approach to traditional medicines contrasts with the allopathic (orthodox medicine).

This paper does not claim to be a full report of the event, but rather aims to highlight the key issues and - more importantly - ensure that traditional medicines in HIV care receive due consideration.

80% of Africans utilise traditional healers (TH) dispensing traditional medicines (TM). Stated by Dr Richard Fru of Cameroon during the opening presentation of this important conference, held in the Ghana Institute of Management and Public Administration, Accra, Ghana, this stark fact set the scene for the rest of the week.

Though allopathic medicine has achieved almost global hegemony; it is local, community-driven and culturally relevant interventions that are the primary source of treatment for millions of people - their first point of contact. The 'ancient', or indigenous knowledge that informs traditional medicine was often contrasted here in Ghana with the relatively recent, and therefore more youthful allopathic interventions.

The purpose of this summit - opened by an enthusiastic Health Minister of Ghana, the Hon Courage Quarshigah - was to remedy the imbalance between allopathic and traditional medicine, and at the same time promote a paradigm of care allowing the two approaches to co-exist. Presenters at the summit hailed from African nations, and beyond, including: Zambia, Tanzania, Ghana, Cameroon, Belgium, Malawi, Canada, Hong Kong, the United States and the United Kingdom.

In spite of the geographical variety, there did seem to be for the majority of delegates a united and unifying desire to emphasise alternative approaches to the care and treatment of PLWHA rooted in local knowledge, drawing on a long cultural heritage that in many instances predates modern interventions by centuries, perhaps millennia. Given most people attending the conference were from Africa, many of the topics focused on herbal and plant-based interventions.

Non-African interventions included traditional Chinese medicine (TCM), and the use of acupuncture for HIV/AIDS symptom relief in northern Thailand, by Dr Laura Louie - the Mae On Project. Promoting acupuncture as a cost-effective intervention which does not interact with ARVs, is cost effective and improves quality of life, Dr Louie's presentation confirmed that 'ancient' treatments still have a role to play in the management of 'modern' disease', a notion confirmed throughout this event.

So, what are the benefits of traditional medicines? Primarily, is the fact it uses a holistic approach, taking into account the physical, mental, emotional and spiritual aspects of an individual, which are invaluable for healing/health and often overlooked by allopathic medicine.

Treatments were not the only focus of the summit - many of the presentations and discussions also considered issues around equity, the need for mutual respect between TM and allopathic practitioners, and intellectual property rights. Some presentations described methods used by empirical science to evaluate the application of TM in HIV treatments - including a paper by Dr L Pieters of the University of Antwerp in Belgium, describing the development of research studies to evaluate the effectiveness of herbal remedies, and the specific modes of action of particular herbs.

Another paper, by Dr Mary Richardson of the National Foundation for Alternative Medicine, Washington, highlighted the continuing need to regulate traditional medicines, to maximise safety and efficacy - especially around contamination. The urgency in developing research paradigms and appropriate independent verification would, she suggested, lead to more effective low cost medication.

These and similar papers did reveal an especially difficult facet in the evaluation of TM - consistency of the product. If one herb being used for a treatment is to be evaluated for example, when in the lifecycle of the plant is the medication to be extracted? From where?

These and similar questions pose serious challenges for traditional African medicine, but one common feature reiterated throughout the week here in Ghana is the relative affordability, low toxicity, and ease of manufacture of TM. Their effectiveness against the 'monster' of HIV/AIDS - as suggested by one of the first speakers - is also a feature that many at the summit felt significant.

It is the strong cultural relevance of TM, derived from knowledge within the local community that is perhaps their most potent characteristic. They are - literally - owned by the populace. Indeed, Dr Rokia Sanago of the University of Mali suggests that because TH live in the 'same reality' as their community, their impact is especially powerful: subtly suggesting perhaps that practitioners of allopathic medicine are less adept at engaging with their clients.

Clearly, TM has resonance with the local community. However, issues of regulation of practitioners remain important, a fact highlighted by Dr Dabra VI during his description of a local project in which TH were provided with additional information about HIV in a bid to ensure that their practice was safe. The results of the project - a marked increase in knowledge and understanding of HIV/AIDS - demonstrated that TH could also play a vital part in the community for HIV prevention, because they are often the most trusted practitioners.

A similar project, in Mali, also suggested that, in the right circumstances, TH were willing to engage with education programmes designed to ensure that TM was practiced safely - in a way that would not diminish its uniqueness or relevance, but also to ensure risk of HIV transmission was minimised (e.g. during circumcision rituals). Dr Rokia Sanago of the University of Mali described a study in which 249 TH took part.

Following culturally sensitive education, 97% altered their practice to minimise HIV transmission. Other examples - for example, ensuring the TH are aware of interactions between anti-retroviral (ARV) medication and TM, suggest it is possible to integrate traditional and 'modern' knowledge in meaningful and beneficial ways, as has been often demonstrated in the context of western naturopathic medicine.

TM is founded upon indigenous knowledge, and is therefore local and immediate. People seeking treatment are already part of the 'world' of the TH, whose approach is also shaped by the cultural history of the region, or predicated on the need for close and meaningful interactions between the healer and the patient.

However, defining this indigenous knowledge is difficult, for at best it is a nebulous concept - still not well-understood even by the 'custodians of this knowledge themselves', according to Dr Luis Sambo, Director of the regional office of the WHO in the Democratic Republic of Congo. As a result, it is imperative there is a legal framework, national plan and a need to protect the intellectual property rights (IPR) of TH: and this was a leitmotif of the event - the nature and ownership of knowledge.

Dr Esther Kibuka-Sebitosi of the University of South Africa discussed the meaning of indigenous knowledge, and - perhaps most significantly - the ways that the knowledge held by traditional healers can be protected from unscrupulous or excessively acquisitive organisations and companies.

Based on a survey carried out in the region, traditional healers, she suggested, are afraid of exploitation, and wary that they would not get fair recompense from the passing of knowledge to 'outside' organisations. She raised interesting additional points that resonated with others during the conference - the very nature of traditional healing and indigenous knowledge is that it is, by definition, local and rooted in the immediate culture.

From a legal and ethical perspective, therefore, trying to define what actually needs protecting is difficult - names of plants and interventions will vary between regions; taxonomies will inevitably be different. She therefore highlighted the urgent need to develop appropriate mechanisms to protect the interests of traditional healers, avoid bio-piracy and develop radical frameworks to preserve the intellectual property rights of those in possession of 'indigenous knowledge

Throughout the event, the unifying factor underpinning all activities was a firm belief in community, and the power derived from approaches to illness and treatment rooted within the local social and cultural system. A fear of losing this ancient knowledge was reiterated many times - Health Minister Courage Quarshigah suggested people had unfortunately 'decided to disconnect [themselves] from indigenous knowledge' - partly, he suggested, because scientists have 'no use' for it at all.

He declared his ardent support for TM - perhaps a sign that in Ghana at least, there will be additional prominence given to policies that protect and encourage traditional medicine.

The essential contrast between allopathic and traditional medicine was illustrated well by one particular presenter, a practising allopathic doctor - Wisconsin-based Dr Richard Nagler. He was incisive in his critique of the inflexibilities in western medicine, with its 'different goals and different approaches to the use of knowledge', and which often sees alternative approaches as competition.

Nagler's argument is clearly central to the whole question of validity and acceptability of TM, and close to the view of anthropologist Arthur Kleinman writing in the 1980s, who argues that all approaches to illness are essentially relative, and equally valid. What is perceived as the 'orthodox' approach is simply just another approach, and from the perspective of culture, no more or less valid than any other - it is simply a matter of point of view.

Nagler concluded with a call for all governments and organisations to have as their goal the 'support and respect' of TM. Dr Richard Atleo Hereditary Chief of the Ahousaht in British Columbia, Canada also confirmed the contrasts between knowledge generated by traditional science - through research; and that from traditional medicine - based on outcome.

To western ears, this may sound like heresy, and indeed, when evaluating the efficacy of TM, orthodox western driven research paradigms may not be the best approach.

Clearly, what is important is the need for a model of treatment and care drawing on the best of both paradigms - the scientific approach of western medicine (valuable for many medical emergencies) and traditional medicine rooted in indigenous knowledge and often best suited to chronic conditions unresponsive to western interventions.

As this conference confirmed, whilst this may seem a perfectly rational way of dealing with contrasting paradigms, in many instances the allopathic, 'scientific' approach usurps the traditional, with the result that interventions offered to patients received are founded entirely upon an alien paradigm.

On the final day of the conference, Dr. Godfrey Swai proposed a self-sustaining integrated medical clinic featuring allopathic medicine, traditional Africa medicine, acupuncture, nutrition and health maintenance programs, as an example of a useful model for development. He described how over the centuries, the rise and fall of colonialism and slavery was inversely related to the dominance of traditional medicines in African cultures, and he feels now is the time for truly holistic interventions in the relief of HIV/AIDS symptoms, especially as the provision of ARVs and associated treatments were falling short of expectations - and promises.

The summit here in Ghana was driven by a desire to encourage mutual trust and respect between traditional and allopathic medicine. Both have value, and the search for a holistic and integrated approach between these two types of medicine, was clearly the intention of this conference. Dr Rodwell Vongo, President of the Traditional Health Practitioners Association of Zambia perhaps provided the most revealing statement: 'do western doctors believe in demons or ghosts? Do TH believe in psychosocial issues?'

At other times this week, words not normally heard at events dealing with 'treatments' were heard: dreams; visions; myths; stories, and whilst Vongo was clearly encouraging the development of TH in mainstream treatments, he also went on to comment on the lack of progress on both sides for not expanding their understanding of other approaches and paradigms - but he was also clearly aware of the stigmatisation of TH, and proposed that allopathic and traditional healers 'join forces', and achieve a level of synergy that is currently lacking.

As HIV/AIDS continues to ravage many parts of the developing world, and the roll out of ARV lags far behind the targets set by international agencies, traditional medicine offers an accessible alternative, especially when allied with allopathic treatments that are already well established, such as treatments for TB. The campaign AIDS-Care Watch is one initiative that wishes to highlight the value of TM, especially in areas starved of ARV but with access to other allopathic treatment.

TM is not dependent on external and often culturally novel treatments that for many are too expensive or simply unavailable. They provide - in this case - a resolutely African solution for an African problem, and as argued throughout this summit, when grafted on to other forms of treatment, result in an overall package of care with an impact far beyond that of individual components.

Following the conference, the declaration included these words - summing up the spirit of the event and challenging governments and agencies to act:

'...We urge State parties, governments and multilateral organizations to respect the customary laws and practices that define access and availability of indigenous cultural knowledge, and to ensure adequate and mutually acceptable exchanges.'

The full declaration can be found here:

More information about AIDS-Care Watch can be found here:

Source: AF-AIDS eForum