REGIONAL WORKSHOP ON MEDICINAL PLANTS AND TRADITIONAL MEDICINE IN AFRICA

REGIONAL WORKSHOP ON MEDICINAL PLANTS AND

TRADITIONAL MEDICINE IN AFRICA

BREAKWATER LODGE C.T.                                                                       14 - 18 APRIL 1998

WORKSHOP AGENDA

TUESDAY 14 APRIL

09h00 - 10h15     Opening Session

                               

                                TRAMSO

                                ELCI

                                IDRC

                                Head of U.C.T School of Pharmacy (Key Note Address)

                                Introductions (Facilitator).

10h15 - 10h30     Tea/Coffee

10h30 -11h00      Introductory Paper

11h00 -13h00      PRESENTATIONS - TOPIC 1

                                Protection and conservation of medicinal plants and traditional knowledge and

                                implementation of article 8 (j) of the Convention on Biological Diversity (CBD)

13h00 -14-00       Lunch

14h00 - 15h00     Discussions

15h00 - 15h30     Tea/Coffee

15h30 - 18h00     Working Group Sessions

18h00 - 20h00     Dinner

20h00                    Report Ready  

WEDNESDAY 15 APRIL

08h30 - 10h15     PLENARY TOPIC 1

10h15 - 10h30     Tea/Coffee

10h30 - 13h00     PRESENTATIONS - TOPIC 2

                                Participatory research and involvement of Local Communities and

                                Traditional healers.

13h00 - 14h00     Lunch

14h00 - 15h00     Discussions

15h00 - 15h30     Tea/Coffee Break

15h30 - 17h30     Working Group Sessions

17h30 - 18h30     Report Production

18h30                    Dinner

18h30                    Report typing

THURSDAY 16 APRIL

08h30 - 10h15     PLENARY TOPIC 2

10h15 - 10h30     Tea/Coffee Break

10h30 - 13h30     PRESENTATIONS - TOPIC 3

13h00 - 14h00     Lunch

14h00 - 15h00     Discussions

15h00 - 15h30     Tea/Coffee Working Group Sessions

15h30 - 18h00     Working Group Sessions

18h00 - 20h00     Cocktail

20h00                    Report typing

SATURDAY 18 APRIL

ACTION PLAN AND FOLLOW UP

08h30 - 10h30     Brief Presentations by

1.    EL.C.I

2.    IRD.C

                               

                                Plenary discussion

10h30 - 10h45     Tea/Coffee Break

10h45 - 12h00     Plenary discussion

12h00 - 12h30     Closing

                                TRAMSO

                                VOTE OF THANKS

The workshop focused on the discussion of the four major topics identified above with each topic being allocated a full day for such discussion.  Discussion was preceded by two theme presentations by selected participants followed by two to three support presentations from those participants who had prepared papers on subject areas falling within these thematic areas.  These presentations were used to derive discussion points which provided a basis for the identification of issues for consideration during group work sessions.  Group work sessions were then followed by plenary sessions where the deliberations from the groups were presented.  Plenary sessions were used to identify areas for commonality among participants on each thematic area.

The workshop was considered useful by many participants as it brought together researchers, conservationists, traditional and "modern" medical practitioners to share experiences and discuss ways of integrating traditional and public health delivery systems.  A lot of research has been carried out in the area of medicinal plants and traditional medicine with traditional medical practitioners and those with traditional knowledge on medicinal plants being objects of such research.  This situation has resulted in bio-piracy and the unrewarded exploitation of intellectual property rights on a continent-wide scale.

Traditional medicine has historically been considered to be unscientific as medicines prescribed under this system were not standardized as is the case in western medical systems.  This situation has resulted in the creation of fences between the two medical delivery systems which has seen the two operating parallel to each other in a lot of countries in Africa.

The majority of the continent's population exclusively uses the traditional medical system on account of the system being readily accessible and less costly.  Despite this, governments in Africa continue to allocate huge sums of money to the conventional western medical delivery systems which benefit very small sections of the population.

Traditional medicines                                                                   organizing themselves into strong lobby and                               policy makers in discussions aimed at achieving greater recognition of this important                     of medicine.  There are already situations where traditional and western medicine systems are being integrated.  These organized bodies are also working with progressive researchers to standardize traditional medicines.

Traditional medicinal plants are under constant threat from a variety of pressures emanating largely from population growth, unsustainable harvesting methods and inequitable terms of international trade.  Such losses are threatening not just the biological resource but traditional knowledge systems as well.  There is need, therefore, for revisiting the whole area of ethnobotanical knowledge systems that encompass the peoples cultural heritage if the rich medicinal plant resource base of Africa is to be conserved.

Traditional and conventional medical practices should initiate open dialogue with a view to addressing the high degree of suspicion that characterizes the relationship between the two.  Both systems have something to learn from each other in order to facilitate further development of both sectors.

Research institutions working in the area of medicinal plants and traditional medical practice should be transparent in their dealings with traditional medical practitioners.  These institutions should validate their findings with these practitioners, a process which will assist in changing attitudes amongst all those involved.

Major Results of the Workshop and Facilitator's Recommendations.

A major achievement of the Cape Town Workshop was the fact that researchers, academics, conventional western medical practitioners and traditional medical practitioners were afforded an opportunity to sit together and deliberate on issues of concern to all of them.  A greater understanding of the concerns of each of the sectors represented at the workshop was realized through the interaction the workshop provided for.

The workshop provided opportunities for the initiation of a network of practitioners in this important sector across the whole of Anglophone Africa.  Together with Francophone Africa which has already been through the same process, a continent-wide network on traditional medicine and medicinal plants could be set up thereby increasing the flow of information amongst practitioners on the continent.  It is recommended that the network established through this, be issue based so this area is addressed systematically.

A lot of information on medicinal plants and traditional medicine is available across the continent.  There is a need for this information to be donated in a formal                  for standardization's sake.  Researchers and traditional medical practitioners should co-ordinate their efforts around this important issue.

International and regional co-operation in the fields of traditional medicine will only be effective if they are based upon clear understanding of national situations.  Initiating co-operation with little or no understanding of local conditions might result in the perpetuation of current problems of bio-piracy.  It is recommended that those countries in Africa which have not set up formal representative bodies for the traditional medical practitioners are moving towards setting these up as they are useful in getting the issues that are important on national medical agenda.  Having said that, however, co-operation should be initiated in the area of sharing of information and experiences at both scales.  This issue is dealt with more effectively in the section dealing with networking.

Traditional medical practitioners should be more transparent with the systems they use in their practices.  Greater transparency will facilitate a clearer understanding of traditional medicine by all those who currently criticize the practice as unscientific.

Documentation and validation of traditional medicine as well as the creation of networks for information exchange will require that traditional medical practitioners themselves be involved in these processes. Further, large capital injections will be required to facilitate these processes.  There is a need, therefore, for ELCI and IDRC to arrange and initiate a process where practitioners in this sector engage the international donor community with their own project ideas for funding.  Initiatives of this nature on the ground will go a long way in operationalizing community involvement in the preservation/conservation of medicinal plant species.

Although gender is apparently not an issue in the area of traditional medicine as most of the practitioners are women, there is a need for those in decision making position, affecting the health delivery systems in Africa remain cognizant of the need to ensure that gender is a significant part of whatever programs are initiated.

SALIENT FEATURES OF THE WORKSHOP

TOPIC 1

1.1       PROPER IDENTIFICATION, DOCUMENTATION OF MEDICINAL

PLANTS

1.2       Sustainable conservation and use of biodiversity

 (medicinal plants)

Monitoring and assessment of wild population and

marketed plants

Recommendations:

·      Community gardens

·      Initiate media programmes for awareness/information and communication.

·      Collection of genetic resources

·      Policy formulation

1.3

·      Use community based participatory research method  to identify existing (threatened) cultural practices that promote sustainable use, management and conservation of medicinal plants.

Recommendation:

·      To undertake participatory/studies in this regard.

1.4

·      Promote and enforce equitable sharing of benefits arising from the exploitation of local knowledge.

·      Implementation of articles 8(j).

Recommendation:

·      Undertake research on policy issues related to article 8(j) of CBD in order to make it applicable within the African context.

1.5

·      To promote better cooperation and collaboration between the two systems.

1.6       Perceptions and Attitudes:

·   Mutual recognition and clear consciousness of both medical

          systems so that they can operate in equal relationship.

TOPIC 2

PARTICIPATORY RESEARCH AND INVOLVEMENT OF LOCAL COMMUNTIES AND TRADITIONAL HEALERS

2.1       PARTICIPATORY RESEARCH APPROACHES FOR

COMMUNITY PARTICIPATION

·      Develop and implement participatory research methodologies (PRM)

            Recommendation:

·      Organize training sessions in participatory research, methodologies for all stakeholders.

2.3       VALIDATION OF TRADITIONAL MEDICINE/ MEDICAL

PREPARATIONS AND PRACTICES

·      To develop acceptable and participatory methods to validate traditional medicine.

RECOMMENDATION:

To collect,document and implement methods of validation of traditional medicine practices and products.

2.4       PREPARATION AND DEVELOPMENT OF WRITTEN NATIONAL

PHARMACOPEA OF MEDICINAL PLANTS THROUGH INVOLVEMENT

OF ALL STAKEHOLDERS

·      To establish a broadly accessible pharmacopoeia to assist all those concerned with medicinal plants.

RECOMMENDATIONS:

·      Establish a coordinating body/ “steering committee

·      Establish a multidisciplinary research team

·      Evaluate the OAU pharmacopoeia ‘s relevance/adequacy for the country (e.g. in terms of species coverage; coverage of the major applications of the various plants)

·      Identify and collate key sources of other relevant information (databases; other pharmacopoeia)

·      Convene key actors involved: through a national workshop/meeting

·      to identify key areas for research

·      to agree on and implement the national work plan

·      to link up with regional groups.

2.5       BIOPIRACY, BIO-DIVERSITY PROSPECTING & CONSERVATION IN

THE DISTRIBUTION OF BENEFITS FROM TRADITIONAL MEDICINES

RECOMMENDATIONS:

·      To establish equitable terms of trade pertaining to medicinal plants and knowledge associated to them.

·      Develop benefit sharing models.

·       Increasing value-addition production of phytomedicines at local and regional levels.

TOPIC 3

3.1       STANDARDIZATION

Development of Standardization procedures that are adaptable to the

situation(s) at community level to address the issues of efficacy, safety

and quality of phytomedicines. 

In this respect, to also include capacity building amongst African research            institutions.

3.2       RECOMMENDATIONS:

·      To monitor and regulate market forces for sustainable conservation through recognition and support of traditional medicinal plant trade.

3.3       Collate, harmonize and increase awareness of legislation pertaining to     Biodiversity use and related indigenous knowledge systems.

TOPIC 4

4.1       To facilitate organizational management of traditional medicine health

 care systems and official recognition.

4.3       Initiate networking, training and information exchange and disseminate in

order to achieve complementarity between the two systems.

*********************************

1.         Develop networking to facilitate regional and international                                        cooperation in medicinal plants, traditional medicine and                                           pharmacopoeia research and development and to link up with                          other medicinal plant programmes in other region (eg.TRAMIL                          etc.).

2.         All research programmes in traditional medicine and medicinal

plants should have a gender component.

3.         As a follow up to the workshop convene a regional meeting in order

to sensitize interested donors and other international organizations

to the plan of action in view of possible support and to examine

closely policy issues in this area.

TOPIC 1

PROTECTION AND CONSERVATION OF MEDICINAL PLANTS AND TRADITIONAL KNOWLEDGE AND IMPLEMENTATION OF ARTICLE 8(j) OF THE CONVENTION ON BIOLOGICAL DIVERSITY (CBD)                                                                                 

 

1.1  IDENTIFICATION, DOCUMENTATION, PROPAGATION AND DATA           BASING.

Definition of terms:

Identification - Identification of plants using both scientific and traditional systems.

Documentation/ Data basing - All forms of documentation or storage of information such as herbaria, museums, libraries, electronic information technology, on-form documentation, etc. and how this information is disseminated to various stakeholders.

Propagation  -  Domestic and cultivation techniques, multiplication for commercial use, harvesting and drying techniques,etc.

Main Problem:

n Following the agreement and common understanding of the above terms, the group identified the main problem.  This was defined as follows: “That Medicine plants are not properly known, documented and conserved.”

Objectives:

n Thus the major objective would be to properly identify, document, and conserve medicinal plants.

Strategies:

The group discussed and agreed on a number of strategies that need to be adopted for the above objective to be achieved.

 These are :

n Identify plants with medicinal properties

n Collect existing information and generate new information through research.  Such information could be botanical, ethobotanical biochemical, agromonic, etc.

n Build up data bases as well as publish research findings and also disseminate to interested parties especially communities and Traditional healers

n Promote sustainable utilization through sustainable harvesting techniques including traditional methods as well as domestication of plants.

n Promote Community participation

Constraints/ Needs:

A number of constraints were identified that may have to be overcome in order to implement the strategies.  These were:

n Lack of recognition of the traditional health sector by most governments.

n Lack of capacity in terms of human resource, infrastructure and financial.

n Gap between traditional and western knowledge systems

n Traditional healers have tended to protect information as one way of protecting their rights (IPR), for economic reasons as well as the sacredness/ secrecy associated with traditional medicine.

n Lock of partnership among stakeholders i.e. between scientists and traditional healers and also among traditional healers themselves.

Activities:

n Provide training at all levels, informal as well as formal

n Promote collaboration between and among stakeholders

n Promote awareness through education; lobbying, etc.

n Source funding from Governments, private sectors, international and regional agencies, etc.

n Promote networking - north - south and south south

n Implement the OAU initiative on community property rights.

Main Actors:

The following actors were identified:

n Communities

n Governments

n Academic i.e. Universities, Herbaria, museums, etc.

n Traditional Healers/ Practitioners

n Private sector

n Parastatels including National Parks

1.2  IN SITU AND EX SITU CONSERVATION OF MEDICINAL PLANTS

IN-SITU”

Main Problem:

n Over-exploitation

Objectives:

n Sustainable conservation

n Increasing awareness

n Legislation establishment

n Establishment of coordination mechanism

Strategies:

n Sustainable use

n Empowerment

n Capacity Building

n Involvement of stakeholders at all levels

Constraint/ Needs

n Conflicts in resource management

n Lack of access

n Uncontrolled economic development

n Unsustainable harvesting

n Lack of enabling legislative enviroment

n Conflicting line management

Activities:

n Training (1,5,6)

n Community gardens (1,5,6)

n Workshop (all)

n Exchange visits (1,5,6)

n Media programmes(2,5)

n Policy formulation (1,2,5,6)

n Civil education (1,2,5)

Main Indicators:

n Trained people

n Reports

n # of visitors to sites

n Policy gaezetted

“EX-SITU”

Main problems:

n Over exploitation

n Establishing gene banks is only mainly for ex-situ situation for species already almost exstinct. The gene bank has not given the medicinal plants adequate attention, as they should.

Objectives:

n To conserve and protect

n Identify priority species

Strategies:

n Preserve Bio-resources under controlled conditions

n Monitoring and assessment of wild populations

n Monitoring of marketed plants

Constraints/ Needs

n Lack of exposure to natural enviroment

n Loss of gene-diversity

n Expensive

n Inadequate expertise

n Inappropriate to Community access

n Lack of mandate by genebanks

Activities:

n Collection of genetic resources (2,3,4)

n Training (1,3,4,5)

n Complement with In-Situ (all)

n Qualitative and quantitive assessement

n Wild

n Market (1,4,6)

Main Indicators:

n Gene-banks

n Plantations

n Increase genetic diversity through preparation

n Red data list

n Species report

Main Actors:

n Resource users (1)

n Policy makers (2)

n Industry (3)

n Researchers(4)

n NGO’s (5)

n CBO’s (6)

1.3  AFRICAN CULTURAL PRACTICES WHICH ARE SUPPORTIVE OF THE CONSERVATION AND SUSTAINABLE UTILIZATION OF MEDICINAL PLANTS

Problems:

n One of the causes of the problem is the erosian of cultural practices due to various factors.

n In turn, the major underlying causes of this are economic (at all levels)

Objectives:

n To increase the supply of medicinal plants by promoting useful cultural practices.

Strategies:

n Use community based participartory research methods to identify existing (and in particular “threatened” cultural practices) that are supportive of conservation and sustainable utilization of medicinal plants, e.g. traditional harvesting and propagation methods.

n Focus on potential income generating and self-sustaining activities.

Constraints/ Needs

n Lack of “self-regulatory” mechanism at the national level

n Some key stakeholders in the medicinal plant trade not adequately recognized (e.g. traders and gatherers)

n Lack of coordination between/ among different stakeholder groups, especially among traditional healer’s associations

n Need for a national unifying body of traditional healer organizations and other groups involved in the medicinal plant trade

n Inadequate recognition of other natural resource uses and users (i.e. often the same species have many competing and different uses and users)

Activities:

n Organize/ establish propagation and distribution programmes at different levels and scales as appropriate (e.g. Promotion of home medicinal/ nutritional gardens; community-based and commercial nurseries; large scale propagation efforts by private companies)

n Training programmes to promote useful cultural practices aimed at supporting local efforts of bio-diversity conservation/ sustainable utilization

n Public awareness campaigns; information dissemination to medicinal practitioners and others.

Actors:

n Traditional healers, traders and gatherers

n Appropriate government departments (e.g. community forestry; botanical gardens; reserves etc.)

n NGO’s CBO’s

n Commercial sector (e.g. forestry companies who can afford the costs of cultivating slow growing species)

1.4  MECHANISM AND STRATEGIES FOR IMPLEMENTATION OF ARTICLE        8j OF CBD/ IPR

Article 8j of the convention on biological diversity of June 1992 states that :

“Subject to its national legislation, respect, preserve and maintain knowledge, innovations and practices of indigenous and local communities embodying traditional lifestyles relevant for the conservation and sustainable uses of biological diversity and promote their wider application with the approval and involvement of the holders of such knowledge, innovations and practices and encourage the equitable sharing of the benefits arising from the utilization of such knowledge, innovations and practices.

The group has summarized the Article 8(j) as addressing three issues:

n Preservation of indigenous knowledge

n Wider application of the knowledge

n Encouragement of equitable sharing of benefits gained from indigenous knowledge.

Main Problem:

n Unfair exploitation of Traditional knowledge (violation of IPR)

Objectives:

n Promote and enforce equitable sharing of benefits arising from the exploitation of Local knowledge

            Benefits addressed to:

n Monetary benefits

n Job creation

n Acknowledgment (degrees)

n Conservation and sustainable utilization

n Accessibility to information

n Technological transfer

Strategies:

n Implementation of articles 8(j)

Constraints/ Needs:

n Inaccessibility to knowledge (Laws patents, article 8j)

n No government capacity

n Lack of awareness of article 8(j) to the community, Government, NGO and companies

n Lack of political will.

n Lack of cooperation/ coordination in the government

n Ownership of knowledge (individual, or community ) identification of community parameters.

Activities:

n Awareness of Article 8(j) through education, workshops, community involvement

n Improved coordination - intersectoral platform

n Policy and legislation, awareness of policy makers

n Institutional capacity  for enforcement and compliance

n Distribution of benefits clear definition of ownership

n Policy research for implementation   

Role and Players

n Politicians

n Government departments

n Community members

n Medicine/ pharmaceutical companies

n Universities

1.5  AFRICAN INDIGENOUS & WESTERN KNOWLEDGE SYSTEMS

Main Problem:

n Lack of systematic knowledge & negative attitudes.

Objectives:

n To promote increased understanding of the 2 systems

n To promote better cooperation between the 2 systems

n To promote communication

n To generate knowledge systems and to change attitudes.

Strategies:

n Promotion of participatory research

n Establish local & regional networks

n Establish schools of indigenous knowledge & a training programme at all levels

n Develop curricular for existing institutions.

Constraints/ Needs:

n Policy-reform programme

n Allocation of financial & human resources

n To promote institutional capacity

n Lack of perceived common concern

n Need for community-based learning systems.

Activities:

n Identification priority areas & implement research on traditional knowledge systems

n Source funding

n Policy advocacy

n Development training curricular at all levels

n Forums, meeting, newsletters, publications journals (African medicinal plant & traditional medicine journal)

n Interdisciplinary, regional joint projects

n Establish schools for training

n Evaluation & monitoring of activities.

Main Actors:

n Government ministries & depts

n Universities & research institutions

n NGO’s & CBO’s

n communities

n donors

n private sector

n Traditional healers & traditional healer organizations

1.6  PERCEPTIONS AND ATTITUDES

Questions: Whose perceptions and attitudes?

n Community - should know more about Traditional healers (TH) and Traditional medicine (TM)

Main Problems:

n Stereotypes of Traditional Medicine and Traditional Healers of the general public, which is typically negative (perpetuated by the media)

n Western personel never approached the Traditional healers to see where they consult and what they do

Objectives:

n Get traditional medicine and traditional healers exposed in a positive way

Strategies:

n Expose traditional healers and Western personel to each other

n Get Traditional healers and Western medicine to sit down and talk to each other

n Promote a positive view of Traditional medicine and Traditional healers

n Researchers and other (media, etc.) must go to umbrella organization for good Traditional healers

n Need enabling Government and Academic policy constraints

Constraints

n Bad publicity by the media

n Stagnate stereotypes of 50 years ago (illiterate)

n Problems of translations and words with negative connotations such as “witch-doctor” or “cure”

n Need to create understanding of Traditional healers in the general public

n These workshops, etc. have changed representations so there is no progress the same players are not coming back all the time

n Traditional healers need training in things like the pharmichological and botanical names so they can appropriately interact with Western medicine (researchers)

n Training of Lecturers to be able to teach Western medicine about Traditional medicine

n There are some charlatans (not real traditional healers) especially in urban set ups.

Activities

n Media release

n Conferences

n Newsletters about Traditional medicine

n Workshop with Traditional healers and Western medicine

n Referal system where Western medicine have a list of Traditional healers and where they live 50 Western medicine can refer patients to Traditional healers for community based health care follow ups

n Educate Western medicine and pharmacy personel at University about Traditional medicine formal part of Western medicine training

n Umbrella organizations constituted so real Traditional healers are consulted (not consultants)

n Traditional healers informed of workshops and conferences on Traditional  medicine

n In future more Traditional healers and cross sectional participation in these workshops

n Promote enabling policies

Main actors

n Traditional healers

n Western personel

n Ngo and donors

n Media

n Government agencies, offices, etc. such as Health & enviroment

n University admin, lecturers and pharmacutical students

n Researchers

n Conference organizers           

           

TOPIC 2

PARTICIPATORY RESEARCH AND INVOLVEMENT OF LOCAL COMMUNTIES AND TRADITIONAL HEALERS                                                    

2.1 PARTICIPATORY RESEARCH APPROACHES FOR COMMUNITY PARTICIPATION (CAPITALS)

Main Problem:

n Lack of community participation

Objectives:

n To promote community participation in research

Strategies:

n To develop and implement participatory research methodologies (PRM)

Constraints:

n Research not user friendly

n No feed back from researchers

n Lack of community involvement

n Fear of exploitation

n Lack of flexibility and compromise

n Mistrust by Traditional Medical practitioner on research

n Lack of cultural sensitivity by researchers

n Poorly trained researchers

Activities:

n Community workshops focused on research

n Preliminary and continuous consultations with communities

n Training and capacity building to empower communities

n Identification of problems and possible solutions in conjunction with community

Actors:

n Researchers

n Traditional healers

n Traditional leaders

2.2. Involvement of communities and researchers (capitals) in researching traditional and conventional/ orthodox medicine

Main Problem:

n Communities are not given a role in the initiation of research activities (both for Traditional and Conventional medicine)

n Communities are used to legitimate research activities and research institutions to the benefit of researchers and institutions NOT for the benefit of communities

n Communities are even less involved in research activities concerning conventional medicine

n Community and individual contributions to research activities are typically not acknowledged by researchers and research institutions (there is a lack of respect)

Objectives:

n Involve the community in research and promote the respect by researchers of the communities when researching traditional and conventional medicine

n Give the communities the ability to know and understand the activities of research institutions

n Compensation for traditional knowledge

Strategies:

n Use ethical principals for community involvement in research activities

n Liaison between traditional and conventional medical personnel in research activities where there is a true equitable treatment

n Bring traditional healers into research institutions to understand and validate the processes there

n Inform traditional healers of research findings and allow them to review findings before publication

n Identify Who, How and How much compensation should take place

Obstructions:

n Ambitions of researchers and research institutions

n Attitudes of western researchers and research institutions towards Africa (Neo-colonialism)

n Lack of exposure of poor research by the media and co-researchers

n Poor oversight of research activities by research institutions and their lack of proper research protocol

n Political tensions which effect research access

n Lack of gender and cultural sensitivity by researchers

n Lack of education on the part of local communities about their rights concerning research activities

Activities:

n Deposit of research data, findings and reports into a repository for local communities

n Creation of a national research council and national research policy concerning research activities in countries where lacking

n Research activities should be negotiated and contracted for local community involvement (local communities get a contract)

n Education of local communities on their rights and ability to be compensated (including the right to say ‘no’ to researchers)

n Create a platform for continuous interaction between traditional healers and conventional medicine

Main Actors:

n Local communities

n Traditional healers

n Western medical personnel

n Researchers

n Researchers institutions

n Government structures

n NGOs, CBOs and donors

n Industry

2.3 Validation (laboratory) of Traditional medicine/ medical preparations and practices (capitals)

REASON FOR VALIDATION: To confirm the claimed efficacy of the preparations in Traditional medical practices.

Problems:

n There is need for validation of Traditional medical practices so that this sector can get rightful place in the healthcare system

Objectives:

n To establish scientific basis for the use of traditional medicine

n To promote a wider use of traditional medicine

n Scientific: repeatable

Strategies:

n To develop acceptable methods to validate traditional medicine

n To win confidence of Traditional medical practitioners

Constraints:

n Lack of facilities suitable for validation of traditional medicines

n Lack of protocols for ethical procedures

n Lack of legal protection of property rights

n Lack of information from the side of traditional medical practitioners on the:

n preparation methods

n collection methods

n posology/ dosages

n constraindications/ Aetiology

n mechanism of action of the preparations

n toxicity/ antidote

n Lack of collaboration among the stakeholders

Activities:

n Establish and enable anenable enviroment for exchange of information

n legal aspects

n benefits

n seminars

n workshops

n Protection of IPR

n Collection & documentation of methods for validation of traditional medical practitioners

n Development of validation methods by the Traditional healers

n lab

n physic

n clinical

n subclinical

n customary

Main Actors:

n Traditional medical practitioners

n Community/ patients

n Biomedic

n Researchers

n Governments

n Public & private organizations

n NGOs

n Funding agencies

n Students

2.4 Preparation and development of written national pharmacopea of medicinal plants through involvement of all stakeholders

DEFINITIONS:

Pharmacopoeia: - Different types in existence i.e. including different types of                                      information and different modes of development

2 major types can be identified:

n Analytical pharmacopoeia

n very detailed information on the phytochemical and biological  properties

n developed through extensive laboratory experimentation and analysis

e.g. includes tissue-level and the “weight of burnt matter/ashes”

n Traditional pharmacopoeia

n based largely on the documentation of traditional knowledge available on both the biological characteristics as well as the uses of the plants & support of the information through additional scientific data

Main Problem:

n Lack of comprehensive/ written national; pharmacopoeia

Objectives:

n To establish a broadly accessible pharmacopoeia to assist all those concerned with medicinal plants.

Strategies:

n Starting point!: refer to the African pharmacopoeia developed under the auspices of the OAU;

n refer to other sources of relevant information: i.e. existing traditional documents

n devise a multidisciplinary approach in the gathering/ analysis of information

n national-level coordination of ongoing activities

n identification of core/ essential data required

n identification of available resources (including human, financial, technical/ infrastructural)

Constraints/ Needs:

n Achieving national level coordination: a challenging undertaking in itself! Many different actors and interest groups in existence…

n Too many species to be addressed: need for prioritization!

n Documentation technology/ expertise and facilities may be inadequate or lacking

n A large amount of information necessary

n Overall: a time consuming endeavor!

Activities:

n Establish a coordinating body/ “steering committee”

n Establish a multidisciplinary research team.

n Evaluate the OAU pharmacopoeia’s relevance/ adequacy for the country (e.g. in terms of species coverage; coverage of the major applications of the various plants)

n Identify and collect key sources of other relevant information (databases; other pharmacopoeia)

n Convene key actors involved: through a national workshop/ meeting

n to identify key areas for research

n to agree on and implement the national work plan

n to set up regional groups

Main Actors:

A. Formal sector organizations/

1.  Research institutions/ Universities

2.  NGOs with specific objectives; interests; activities relevant to medicinal plants

3.  Community/ state herbaria

4.  Government bodies/ parastatals

5.  Pharmaceutical companies

6.  Hospitals and clinics

B. Specialists/ community members

7.  Mothers

8.  Traditional healers

9.  Ethnopharmacologist/  Ethnobotanists/ Medical anthropologist

10. Medical doctors; nurses

11. Public health workers/ practitioners (involved in preventive/ primary health care)

12. Botanists/ Taxonomists/ Ecologists/ Agronomist

13. Phytochemists/ Pharmocologist/ Toxicologists

14. “Documentalists”; (information technology expertise)

2.5 Biopiracy, bio-diversity prospecting & conservation in the distribution of benefits from Traditional Medicines (capitals)

Main Problems:

n Unequitable distribution and exchange of benefits from bioprospecting.

Objectives:

n Equitable terms of trade

n Biodiversity conservation

n  

Strategies:

n Increase awareness (consumers and communities)

n Develop negotiating capacity

n Develop benefit sharing models

n Develop multilateral agreements

n Develop incentives for biodervisty conservations

Activites:

n National, regional and local awareness campaign (government, public & private sector) economic and financial, - rights information

n Establish process for assistance - negotiation and legal

n Survey & analize benefit sharing case studies

n Review existing legislation and international obligations and implement policy reform

n Regional Pharmonisation of policy & legislation

n Green labels and standards in companies

n Pressure groups in communties

n Increase value - added production at local and international level

n Promote cultivation by local commercial growers

n Monitoring biodiversity

Constraints:

n Lack of resources - technical, financial and human

n Trade research and surveys

n Lack of political will

n Community property rights

n Fragmentation of stakeholders (inter & intra national)

Main Indicators:

n Number of sharing models adopted

n Legislation adopted

n Number of value added (national enterprises)

n Number of protocals/ agreements adopted

n Number of agronomic practices adopted

n Threatened species registered.                       

           

TOPIC 3

STANDARDIZATION PROCESSES AND PROTOCOLS FOR RESEARCH OF NEW DRUGS AND FOR PRODUCTION OF PLANT DERIVED DRUGS AND DEVELOPMENT OF TRADITIONAL MEDICINE INDUSTRY

3.1       INFLUENCE OF STANDARDIZATION OF PHYTOMEDICINES ON INDIGENOUS KNOWLEDGE AND CONSERVATION OF MEDICINAL PLANTS AND BIODIVERSITY

DEFINITION OF STANDARDIZATION:

Processes involved in producing a product with reproducible effect and quality

                   -  for efficacy and safety

PROBLEM:

·      Exploitation of indigenous  knowledge

·      Depletion of medicinal plants and biodiversity

OBJECTIVES

To ensure that standardization procedures take into account the potential impact on indigenous knowledge, conservation of medicinal plants and biodiversity.

STRATEGY

·      Develop methods of impact assessment

·      Ensure involvement of traditional healers / Ensure community-participatory approach at all stages

·      Ensure conservation measures that promote sustainable

     

CONSTRAINTS:

        

·      Lack of  trust among stake-holders

·      Lack of funds

·      Lack of suitable models ( methods and tools )

·      Insufficient human resources ( in terms of capacity and indigenous expertise )

ACTIVITY:

·      Hold meetings, promote dialogue with and feedback to communities

·      Draw up and agree upon contract or other legal mechanisms as appropriate ( short and long term )

·      Develop or promote existing and new national legislation of traditional medicine

·      Creation / establishment of  institutions for development and standardization of traditional medicine

·      Draw up proposals for funding for government bodies and /or other donors

·      Creating income generating activities

·      Capacity building involving: Traditional Medical Practitioners and Researchers.

ACTORS:

1.    Traditional Medical Practitioners

2.    Politicians and Governments

3.    Researchers & Institutions

4.    Funding agencies

5.    Communities in general

3.2       ROLE AND IMPACT OF MARKET FORCES ON MEDICINAL PLANT USES AND CONSERVATION

DEMAND SUPPLY             DISTRIBUTION                              PURCHASING POWER

 

RKET FORCE

 

REGULATION                                            LAND TENURE                              INTERNATIONAL LOCAL

PROBLEMS:            §Demand / Supply Imbalances      

§Ultimately impact on environment

§  No control over market forces

OBJECTIVES:         §To monitor/regulate and organise market forces

                                       for sustainable conservation through recognition

                                       and support of traditional; medicinal plant trade

STRATEGIES:         §Draft supportive legislation

§Create national/regional/international regulation

§Regulate market force

§  Encouragement of land provision for medicinal plant cultivation

§  Small business protection

CONSTRAINTS/NEEDS

§Lack of information

§Lack of capacity

§Lack of co-ordination

§Lack of political will

§Competition

§Poor pricing (standardization)

§Socio-economic factors

ACTIVITIES:           §Monitor the market forces and evaluation

                                    §Create awareness

§Create an enabling environment

§Business training : capacity building

§Encourage local communities cultivation at various

levels through training (e.g.home gardens with both         food and medicinal plants)

§Develop ecological medicinal garden as training    centres

§Establish nurseries to encourage dissemination to             provide people who want to cultivate medicinal plants

MAIN ACTORS:      §Local communities

                                    §Governments

                                    §Chamber of Commerce

                                    §Botanist/Universities/National Centre for Seeds

                                       (Research Institutions)

                                    §Banks

                                    §Financial Institutions

§Private Sector (plants suppliers both local and international

3.3       CONSERVATION AND RIGHTS (TRADITIONAL RESOURCE RIGHTS)

PROBLEMS	OBJECTIVES	STRATEGIES	ACTIVITIES	MAIN ACTORS	CONSTRAINTS
(Who owns resources and knowledge?) Lack of ownership of resources Lack of ownership of knowledge Survival rights of resources - but not at the expense of  people’s rights	Ensure sustainable utilisation of resources Recognition and protection of owners of knowledge	Establish status of plants - first at local level and then national/continental/international Strategies for conservation of resources in situ and ex situ to preserve genetic diversity Use local as well as other knowledge for cultivation and propagation of plants Incentives for income generation opportunities at local and then other levels	Situational  analysis (health, demand biological etc) and needs analysis (status of plants) at local and then other levels Establish criteria for prioritisation and develop action plans Identify and allocate responsibilities in terms of activities (in and ex situ) Identify gaps and propose activities; include local knowledge Initiate value added activities at local level and then other levels	Researchers and local interest groups Local interest groups; local government/”tribal” representatives; facilitators All appropriate stakeholders Researchers and local interest groups Local interest groups and individuals;technical, social and legal experts;private	Multi-national corporations MAI
				sector.

Establish resource use management systems involving all resource users (co-management) Integrate different systems of legislation affecting different rights

Identify stakeholders and initiate co-management plans. Capacity building for conflict resolution. Capacity building at all level and activities Initiate advocacy process and review legislation and international commitments under conventions. Propose legislative changes harmonising different rights. Implement legislation

All community/ resource users Training institutions; local experts NGOs, civil society organisations Experts (eg legal) and government; stakeholders Government

OBJECTIVES

STRATEGIES

ACTIVITIES

MAIN ACTORS

CONSTRAINTS

TOPIC 4

INTEGRATION OF TRADITIONAL MEDICINE IN PUBLIC HEALTH SYSTEMS

4.1 STRENGTHENING OF TRADITIONAL MEDICINE AND PROMOTION OF COMPLEMENTARITY BETWEEN TRADITIONAL AND WESTERN MEDICINES (LEARNING FROM SUCCESSFUL EXPERIENCE, EX. ZINATA)

OBJECTIVE:

·Strengthening of TM Organization

ACTIONS:

·      Provincial/district umbrella through organization

·      National Association

·      Legislation for legal recognition and status

·      Independent T.H. Council (by act of parliament, regulation and governance

CONSTRAINTS/NEEDS:

·      Political power play between healer organization

·      Public perceptions of T.M.

·      Education level of Healers

·      Political Will

·      Attitudes towards traditional medicine

·      Erosion of culture

[1]

OBJECTIVE:

·      To promote complimentarity between traditional medicine and western medicine.

ACTIONS:

·      Information sharing

·      Training of traditional healing in formal education systems for western doctors.

·      Combination of traditional healing and western medicine at primary health care and clinics level.

·      Strong referral system and report back.

·      Hospital/clinics for traditional healing.

·      Improving professionalism - efficacy of medicine, hygiene, standardization, training of healers.

·      Remove legislative barriers that prevent complimentarity and create legal framework to allow complimentarity.

·      Strong research and development in traditional medicine.

·      Regional co-operation of Healer Associations.

·      Needs for joints workshops between traditional medicine and western medicine.

CONSTRAINTS/NEEDS:

·      Continued resistance by western medicine and traditional medicine.

·      Political will

·      Negative public perception of traditional medicine

·      Lack of respect

·      Deceit

·      Appropriate legislation

·      Equitable sharing of government and donor resources.

MAIN ACTORS:

·      Traditional healer Associations

·      N.G.O. e.g. Tramso

·      Government

·      Medical Council (western & traditional community)

·      Universities

·      Funding agencies.

                                               

4.2       SUITABLE APPROACHES IN THE PROMOTION AND DEVELOPMENT OF TRADITIONAL MEDICINE THROUGH PARTICIPATORY METHODOLOGIES (LEARNING FROM SUCCESSFUL EXPERIENCES, EX. TRAML NETWORK)

PROBLEM:

·      Isolated efforts among key players

·      Non participatory methodologies in the promotion and development of traditional medicine (top down).

OBJECTIVES:

·      Coordination of efforts through participatory methods for promotion of research and development.

STRATEGIES:

·      Insist on community and traditional healer participations at all levels.

·      Prioritization of areas for promotion and development in a participatory manner.

·      Networking of key players

·      Delegating specific tasks to specific people.

CONSTRAINTS/NEEDS:

·      Lack of coordination among key players

·      Lack of media of publication on traditional medicine in Africa

·      Lack of technical expertise

·      Top-down approach by donors governments and policy makers especially WHO

·      Lack of uniform professional standards

·      Negative attitudes towards traditional medicine by some institutions.

ACTIVITIES:

·      Launch an african journal on traditional medicine.

·      Media releases on the aspects of traditional medicine (e.g. Radio, newsletters, local newsletters).

·      Fund raising for community identified activities.

·      Development of a regional, clear and timely plan of action.

MAIN ACTORS:

·      All country representatives at this meeting.

·      Communities.

4.3       TRAINING AND DIFFUSION OF INFORMATION WITHIN THE HEALTH CARE DELIVERY SYSTEMS (BRIDGING THE GAP BETWEEN THE SYSTEMS)

PROBLEM:

·      Lack of common understanding and communication and poor co-operation between traditional medicine and western medicine on causes and treatment of disease.

·      Limited integrated approach to health care delivery.

·      Prejudices on both sides (traditional medicine and western medicine).

·      Limited training system and resources which incorporates both health care systems.

OBJECTIVES:

·      Provide health care system appropriate to the community it serves.

·      To achieve a complementary/collaborative approach to health care delivery.

·      Promote an understanding and tolerance of the two world views and learning from one another and promote an awareness of the value of both systems.

STRATEGIES:

·      Set up channels of communication within existing structures and identify key players.

·      Define areas of common ground and needs of the communities in need of health care and the operating systems (western and traditional) between all three.

·      Inventoring existing resources Chuman, infrastructure, institutions, plants, organisations, governments, departments).

·      Identify gaps.

·      Facilitate access to resources.

·      Create national training programmes starting at local levels and then other levels (PHC, Propogation, conservation).

·      To achieve government recognition at an appropriate H.C. ? health community/healer community? System.

ACTIVITIES:

·      Meeting of representatives of all relevant stakeholders to establish plans of action (media, workshop, education material, etc.)

·      Evaluate coping skills and implement better wage/meet needs (focus at local level first).  Improve institutional systems to avoid ----? And abuse.

·      Information dissemination and establish health care facilities.

·      Develop suitable educational materials and develop further mechanisms and lobby authorities.

NEEDS AND CONSTRAINTS:

·      Limited resources (human, infrastructure, etc.)

·      In both systems - waste, duplication, abuse, lack of controlls - no accountability.

·      Lack of motivation and political will.[2]

·      Lack of consultation within/between institutions and government departments.

·      Lack of clarity about restructuring and agendas (S.A.)

·      Lack of organisation between institutions and government departments

·      Lack of unity between healer organizations.