THE LANCET, Vol 355, 1284, APRIL 8, 2000
A REGIONAL TASK FORCE ON TRADITIONAL MEDICINE AND AIDS
IN EAST AND SOUTHERN AFRICA
A regional Task Force on traditional medicine and AIDS in East and Southern
Africa will be inaugurated in Kampala, Uganda, on 10 April 2000. The Task
Force will co-ordinate activity related to the widespread use of traditional
medicine by people with HIV/AIDS in Africa and the role of traditional
healers in AIDS prevention. The nine-member Task Force of East and Southern
African non-governmental organisations (NGOs), international organisations,
and West African observer delegations, will share information, generate an
inventory of activities about traditional medicine, document and distribute
best practices, promote research in traditional medicine, and mobilize
resources. The Task Force will recognise the fact that in Africa, the high
cost and scarcity of many essential drugs, including anti-retroviral drugs,
means that most people with HIV/AIDS use traditional herbal treatments for
HIV-related conditions including opportunistic infections. In Uganda, there
is one traditional health practitioner for every 200-400 people, whereas the
availability of trained medical personnel is typically one per 20,000 people.
The plan to establish the Task Force arose from a UNAIDS-sponsored
conference in Kampala in February. 100 delegates from 17 African countries
met to review the effect of traditional healers on HIV prevention and care.
The meeting was hosted by THETA , a Ugandan NGO that promotes collaboration
between traditional and modern health practitioners in the fight against
AIDS. Support was provided by UNAIDS and the Association for the Promotion
of Traditional Medicine (PROMETRA), an international NGO based in Senegal.
THETA has taken the lead in East Africa in developing partnerships between
the biomedical and traditional health sectors.
Many of the conference delegates argued at the Kampala meeting that, in view
of its widespread use, traditional medicine is in a real sense carrying the
burden of clinical care for the AIDS epidemic in Africa, a trend largely
overlooked by health ministries, international agencies, and donors.
Delegates focused on collaboration between the traditional and modern health
sectors. They identified projects that meet criteria for "best practice"
responses to the AIDS epidemic in Africa. Most countries in the region
reported some initiatives involving traditional medicine and practitioners.
Dr. Sandra Anderson of UNAIDS, South Africa, noted that " traditional health
practitioners occupy a critical role in African societies and are making a
valuable contribution to AIDS prevention and care." THETA director, Dr.
Donna Kabatesi, cited clinical data on Ugandan herbal treatments effective
against herpes zoster, and HIV-associated chronic diarrhoea and weight loss.
Professor Charles Wambebe, head of Nigeria's National Institute for
Pharmaceutical Research and Development, reported preliminary clinical data
on a Nigerian herbal medicine that seems to increase CD4 levels and
improvement in HIV-related illness; controlled clinical trials are now
underway. Dr Mberesero Firmina of the Tanga AIDS Working Group presented
findings on Tanzanian herbal treatments for HIV-related fungal infections.
Although traditional health systems are locally accessible and culturally
relevant, they must first be rendered safe. Most importantly, poor
documentation, a lack of standardization and the absence of regulatory
mechanisms for traditional healthcare practice in many countries were seen
as challenges to be overcome if traditional medicine is to be more
systematically included as a key player in AIDS prevention and care. Mutual
misunderstanding between modern and traditional practitioners, weak
organization of healers, and an often sensationalist media all contribute to
the marginal status of traditional medicine in African countries. Despite
many governments and international agencies calling for 'recognition' of
traditional medicine, the lack of serious commitment and action on this was
seen as a significant impediment to identifying effective indigenous
approaches to AIDS prevention and care and to building strong partnerships
for an integrated strategy against HIV/AIDS. As a result, scores of
medicinal plants that are used daily in Africa and may have potential
effectiveness against OI or HIV remain unknown or uninvestigated, while the
great majority of Africans living with HIV/AIDS cannot afford modern drugs
with proven effectiveness.
Noting the need for a regional network of organisations currently working in
isolation with traditional medicine and HIV/AIDS, the Kampala meeting
proposed the establishment of the Task Force, for which THETA will serve as
the Secretariat. Task Force members include the Traditional Health
Practitioners Association of Zambia, and the Zimbabwean National Traditional
Healers Association. There will be observer groups from the West African
nations of Ghana, Nigeria and Cameroon. International partners are UNAIDS,
WHO/AFRO and the Global Initiative For Traditional Systems (GIFTS) of Health
and its partner organisation the Commonwealth Working Group on Traditional &
Complementary Health Systems.
GIFTS has accepted responsibility to lay the groundwork for a network of
researchers and institutions to build a research programme which will
identify, assess, and develop safe and effective local treatments for
HIV-related illnesses. The programme will use simplified but controlled
clinical protocols to conduct rapid evaluations of promising treatments. It
will build databases for information sharing on the successes and failures
of local treatments. It will be grounded in an intellectual property rights
framework to protect the rights of local knowledge holders, learning lessons
from a few existing programmes in Africa. Recognizing the global,
unsustainable pressure on wild stocks of medicinal plants, sustainable
horticulture will be promoted for priority species.
A solid government research infrastructure, backed by international
agencies, will need to be developed to ensure a rapid research response to
promising preliminary findings. This strategy will be designed to guide
promising herbal treatments through to the stages of production and
development of safe, effective and affordable medicines. It will emphasize,
where applicable, the local production and dissemination of useful herbs at
the national, community and family level, towards an African solution for
combating AIDS in Africa.
Dr. Gerard Bodeker, Green College, University of Oxford, UK;
Dr. Donna Kabatesi, & Rachel King, THETA, Uganda;
Dr. Jacques Homsy, Médecins Sans Frontières, Uganda.
==
-------------------------------------------
Dr. Gerard Bodeker
Chairman, GIFTS of Health
& Commonwealth Working Group on Traditional&Complementary Health Systems
Green College, University of Oxford
Oxford OX2 6HG, UK
Tel:01865-274770 Fax:01865-274796
Web site: <http://users.ox.ac.uk/~gree0179>
A REGIONAL TASK FORCE ON TRADITIONAL MEDICINE AND AIDS
IN EAST AND SOUTHERN AFRICA
A regional Task Force on traditional medicine and AIDS in East and Southern
Africa will be inaugurated in Kampala, Uganda, on 10 April 2000. The Task
Force will co-ordinate activity related to the widespread use of traditional
medicine by people with HIV/AIDS in Africa and the role of traditional
healers in AIDS prevention. The nine-member Task Force of East and Southern
African non-governmental organisations (NGOs), international organisations,
and West African observer delegations, will share information, generate an
inventory of activities about traditional medicine, document and distribute
best practices, promote research in traditional medicine, and mobilize
resources. The Task Force will recognise the fact that in Africa, the high
cost and scarcity of many essential drugs, including anti-retroviral drugs,
means that most people with HIV/AIDS use traditional herbal treatments for
HIV-related conditions including opportunistic infections. In Uganda, there
is one traditional health practitioner for every 200-400 people, whereas the
availability of trained medical personnel is typically one per 20,000 people.
The plan to establish the Task Force arose from a UNAIDS-sponsored
conference in Kampala in February. 100 delegates from 17 African countries
met to review the effect of traditional healers on HIV prevention and care.
The meeting was hosted by THETA , a Ugandan NGO that promotes collaboration
between traditional and modern health practitioners in the fight against
AIDS. Support was provided by UNAIDS and the Association for the Promotion
of Traditional Medicine (PROMETRA), an international NGO based in Senegal.
THETA has taken the lead in East Africa in developing partnerships between
the biomedical and traditional health sectors.
Many of the conference delegates argued at the Kampala meeting that, in view
of its widespread use, traditional medicine is in a real sense carrying the
burden of clinical care for the AIDS epidemic in Africa, a trend largely
overlooked by health ministries, international agencies, and donors.
Delegates focused on collaboration between the traditional and modern health
sectors. They identified projects that meet criteria for "best practice"
responses to the AIDS epidemic in Africa. Most countries in the region
reported some initiatives involving traditional medicine and practitioners.
Dr. Sandra Anderson of UNAIDS, South Africa, noted that " traditional health
practitioners occupy a critical role in African societies and are making a
valuable contribution to AIDS prevention and care." THETA director, Dr.
Donna Kabatesi, cited clinical data on Ugandan herbal treatments effective
against herpes zoster, and HIV-associated chronic diarrhoea and weight loss.
Professor Charles Wambebe, head of Nigeria's National Institute for
Pharmaceutical Research and Development, reported preliminary clinical data
on a Nigerian herbal medicine that seems to increase CD4 levels and
improvement in HIV-related illness; controlled clinical trials are now
underway. Dr Mberesero Firmina of the Tanga AIDS Working Group presented
findings on Tanzanian herbal treatments for HIV-related fungal infections.
Although traditional health systems are locally accessible and culturally
relevant, they must first be rendered safe. Most importantly, poor
documentation, a lack of standardization and the absence of regulatory
mechanisms for traditional healthcare practice in many countries were seen
as challenges to be overcome if traditional medicine is to be more
systematically included as a key player in AIDS prevention and care. Mutual
misunderstanding between modern and traditional practitioners, weak
organization of healers, and an often sensationalist media all contribute to
the marginal status of traditional medicine in African countries. Despite
many governments and international agencies calling for 'recognition' of
traditional medicine, the lack of serious commitment and action on this was
seen as a significant impediment to identifying effective indigenous
approaches to AIDS prevention and care and to building strong partnerships
for an integrated strategy against HIV/AIDS. As a result, scores of
medicinal plants that are used daily in Africa and may have potential
effectiveness against OI or HIV remain unknown or uninvestigated, while the
great majority of Africans living with HIV/AIDS cannot afford modern drugs
with proven effectiveness.
Noting the need for a regional network of organisations currently working in
isolation with traditional medicine and HIV/AIDS, the Kampala meeting
proposed the establishment of the Task Force, for which THETA will serve as
the Secretariat. Task Force members include the Traditional Health
Practitioners Association of Zambia, and the Zimbabwean National Traditional
Healers Association. There will be observer groups from the West African
nations of Ghana, Nigeria and Cameroon. International partners are UNAIDS,
WHO/AFRO and the Global Initiative For Traditional Systems (GIFTS) of Health
and its partner organisation the Commonwealth Working Group on Traditional &
Complementary Health Systems.
GIFTS has accepted responsibility to lay the groundwork for a network of
researchers and institutions to build a research programme which will
identify, assess, and develop safe and effective local treatments for
HIV-related illnesses. The programme will use simplified but controlled
clinical protocols to conduct rapid evaluations of promising treatments. It
will build databases for information sharing on the successes and failures
of local treatments. It will be grounded in an intellectual property rights
framework to protect the rights of local knowledge holders, learning lessons
from a few existing programmes in Africa. Recognizing the global,
unsustainable pressure on wild stocks of medicinal plants, sustainable
horticulture will be promoted for priority species.
A solid government research infrastructure, backed by international
agencies, will need to be developed to ensure a rapid research response to
promising preliminary findings. This strategy will be designed to guide
promising herbal treatments through to the stages of production and
development of safe, effective and affordable medicines. It will emphasize,
where applicable, the local production and dissemination of useful herbs at
the national, community and family level, towards an African solution for
combating AIDS in Africa.
Dr. Gerard Bodeker, Green College, University of Oxford, UK;
Dr. Donna Kabatesi, & Rachel King, THETA, Uganda;
Dr. Jacques Homsy, Médecins Sans Frontières, Uganda.
==
-------------------------------------------
Dr. Gerard Bodeker
Chairman, GIFTS of Health
& Commonwealth Working Group on Traditional&Complementary Health Systems
Green College, University of Oxford
Oxford OX2 6HG, UK
Tel:01865-274770 Fax:01865-274796
Web site: <http://users.ox.ac.uk/~gree0179>
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