E-DRUG: Integrating Traditional medicine into health systems
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[press release of the 50th WHO/AFRO Health Ministers conference,
held last week in Ouagadougou, Burkina Faso. WB]
INTEGRATING TRADITIONAL MEDICINE INTO HEALTH SYSTEMS:
THE EXAMPLE OF BURKINA FASO
Ouagadougou - One of the six resolutions adopted by the just-concluded 50th
session of Health Ministers from the African Region of WHO in Ouagadougou
called on Member States to consider the development of mechanisms and the
establishment of institutions for enhancing the positive aspects of traditional
medicine in their health systems.
Burkina Faso, which hosted the Health Ministers' meeting for the first time
from 28 August to 2 September 2000, appears to provide a good example of how
this can be done.
In Burkina Faso, there is a health facility where Western science and African
tradition are combining creatively and with synergy to restore hope, even
life, to hundreds of People Living With AIDS (PLWA) in the West African
country of 13 million people.
The health centre, run by a public-spirited organization has now enlisted 320
patients with AIDS since January 2000, some of these patients are in hospital at
the present time. Here, Western-trained medical personnel and scientists versed
in the time-honoured "scientific method" of clinical investigation, work
hand-in-hand with traditional health practitioners, whose medicines are the
only ones used to treat patients, many of whom have experienced dramatic changes
for the better in their clinical conditions.
On August 30, a high-powered WHO delegation, led by the Organization's Regional
Director for Africa, Dr Ebrahim M. Samba, visited the health facility and was
pleasantly surprised at the successes so far achieved in assuring a better
quality of life for patients there.
In the absence of a cure for their medical condition, and with no one to look
after them, most of the patients had been brought to the centre for terminal
care to, as it were, die a dignifying death at the hands of caring care
givers.
However, the medical team at the centre told Dr Samba of appreciable progress
being made in improving the quality of life of some of the patients.
They confirmed, for example, that blood tests to monitor the level of
immunity (CD4 and CD8 counts) of the patients, all of whom are being treated
exclusively with traditional medicines, had shown a marked increase in blood
cell counts. Similarly, they said, other laboratory investigations conducted
on the patients, such as viral load tests, also showed a significant decrease
in viral load. They also reported a dramatic improvement in the patients'
clinical condition.
The medical team further explained: "We have patients gaining up to 20
kilogrammes within eight months of being treated with these
locally-produced medicines".
The question that arises, therefore, is: how do the modern and the traditional
systems of medicine co-exist at this centre ? In what may be described as a
classical example of the integration of traditional medicine into a modern
health system, the government constituted a team comprising scientists at the
centre, Health Ministry officials and the Burkinabe Association of Traditional
Health Practitioners, among others, to develop a protocol for the management of
patients.
The agreed protocol provides for, among other things, standard scientific
procedures such as the conduct of liver and kidney toxicity tests on patients,
as well as their categorization according to the classification recommended
by the Centers for Disease Control based in Atlanta, in the United States of
America.
Some of the objectives of the protocol include: the selection of traditional
health practitioners with experience in the treatment of HIV/AIDS; offering such
practitioners a framework for the better management of patients; evaluating
the efficacy of traditional medicines in the dosage regimens used for the
treatment of HIV/AIDS; optimizing the efficacy of traditional medicines which
have shown significant results in terms of biological indicators, and in the
clinical conditions of patients; and the standardization, local production
and assurance of quality control of medicines which have been shown to be
efficacious.
Impressed by what he saw at the centre, Dr Samba remarked: "What we have seen in
Burkina Faso is positive proof and conclusive evidence that there are positive
aspects in African traditional medicines. WHO will provide technical assistance
to this health facility in Burkina Faso, and to similar ones elsewhere in
the Region, with a view to ensuring the integration into health systems of
traditional medicine and practices for which evidence of safety, efficacy and
quality is available, and the generation of such evidence where it is lacking."
Reiterating the point made by Dr Samba, the Regional Adviser on Traditional
Medicine at the WHO Regional Office for Africa, Dr. O.M.J Kasilo, said that
while 80 per cent of the people
in the African Region used traditional medicines, the need existed to ensure
that such medicines were validated for safety, efficacy and quality. Thereafter,
mass production should be undertaken to ensure their wide availability for
popular use. She also listed other weakness which must be urgently addressed.
These include, inadequate polices; insufficient evidence on safety and
efficacy; a lack of research on knowledge, attitudes, practices and
behaviours; a lack of standardization of dosage regimens; mutual distrust
between Western-trained and traditional health practitioners; poor
documentation, and the absence of an intellectual property rights framework to
protect the rights of local knowledge of holders, particularly traditional
health practitioners.
Experts say that despite the frequent call by governments and international
agencies and donors for a "recognition" of traditional medicine, a lack of
serious commitment had constituted a key impediment to building partnerships;
to identifying effective indigenous approaches for the prevention and
management of HIV/AIDS, and for the treatment of such conditions as
diabetes, sickle cell anaemia and hypertension, for which local remedies are
known to be available.
Dr Samba hoped that other countries will follow the example of Burkina Faso and
other Member States making similar efforts; and that international agencies
and donors will provide the necessary support. Countries in the Region will not
only strengthen and develop traditional medicine, but will also improve
partnerships between modern and traditional systems of medicine so as to enhance
the integration of traditional medicine into national health systems for the
benefit of the their peoples.