Traditional medicines are part of the cultural heritage of many Africans. About 80% of the population of the African continent uses these medicines for health purposes.
Other reasons include affordability, affordability, patient dissatisfaction with conventional medicine, and the common misconception that natural is safe.
The growing recognition of traditional medicine led to the first World Health Organization global summit on the subject, in August 2023, with the theme Health and well-being for all.
Traditional medicines are used extensively in South Africa and it is estimated that up to 60% of South Africans rely on traditional medicine as their primary source of health care.
South African conventional healthcare facilities struggle to cope with extremely large numbers of patients. Failure to meet basic health standards, with rising morbidity and mortality rates, poses a threat to the South African economy.
In my view, as a trained and academic pharmacist with a research focus on the traditional use of medicinal plants in South Africa, integrating traditional medicine practices into modern healthcare systems can leverage centuries of indigenous knowledge, increasing options for treatment and providing better health care.
Recognizing traditional medicine as an alternative or joint source of health care to that of standard conventional medicine has proven challenging. This is due to the absence of scientific research establishing and documenting the safety and efficacy of traditional medicines, coupled with a lack of regulatory oversight.
What are traditional medicines?
Traditional medicine encompasses a range of health practices aimed at preventing or treating acute or chronic ailments through the application of indigenous knowledge, beliefs and approaches. Incorporates the use of plant, animal and mineral based products. Plant-based products make up the majority of treatment regimens.
Traditional medicine practices also have a place in ritual activities and in communication with ancestors.
South Africa is rich in native medicinal fauna and flora, with around 2,000 plant species traded for medicinal purposes. In South Africa the provinces of KwaZulu-Natal, Gauteng, the Eastern Cape, Mpumalanga and Limpopo are trading hotspots. The harvested plants are often sold in traditional medicine muthi markets.
Uses of medicinal plants
Medicinal plants most commonly traded in South Africa include buchu, bitter aloe, African wormwood, honey, devil’s claw, hood, African yam, fever tea, African geranium, African ginger, cancer bush, pepper bark tree, bush of milk and the south very commonly consumed. African drink, rooibos tea.
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The most commonly traded medicinal plants in South Africa are listed below along with their traditional uses:
Buchu Urinary tract infections; skin infections; sexually transmitted infections; fever; respiratory tract infections; hypertension; gastrointestinal disorders.
Aloe amara Skin infections; skin inflammation; minor burns.
African wormwood Respiratory tract infections; diabetes, urinary tract disorders.
Honey cough; gastrointestinal problems; symptoms of menopause.
Devil’s claw inflammation; arthritis; Ache.
Hoodia Appetite Suppressant.
African potato arthritis; diabetes; urinary tract disorders; tuberculosis; prostate disorders.
Tea against fever Respiratory tract infections; fever; heachache.
African geranium Respiratory tract infections.
African ginger Respiratory tract infections; asthma.
Cancer bush Respiratory tract infections; menstrual pain.
Pepper bark tree Respiratory tract infections; sexually transmitted infections.
Milk bush pain; ulcers; skin conditions.
Rooibos inflammation; high cholesterol; hypertension.
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There are many ways traditional medicine can be used. It can be a drop in the eye or ear, a poultice applied to the skin, a boiled preparation for inhalation, or a tea prepared for oral administration.
Roots, bulbs and bark are used more often, while leaves less frequently. The roots are available all year round. There is also a belief that the roots contain the strongest concentration of medicines. Root harvesting, however, raises conservation concerns for these medicinal plants. The South African government, with the draft policy on traditional African medicine Notice 906 of 2008, outlines considerations aimed at guaranteeing the conservation of these plants by contrasting unsustainable harvesting practices.
Obstacles to the use of traditional medicine
The limited research investigating the interactions posed when a patient uses both traditional and conventional medicine is cause for concern.
During the COVID-19 pandemic, many patients have used traditional remedies for infection prevention or treatment.
Understanding which traditional medicines are used and how, their therapeutic effects in the human body and how they interact with conventional medicines would help determine the safety of their combined use.
Some combinations may have beneficial interactions, increasing the efficacy or potency of medicines and allowing for reduced dosages, thus reducing potential toxicity. These combinations could contribute to the development of new pharmaceutical formulations.
WHO in its report on Traditional Medicine Strategy for 2014-2023 highlighted the need to use traditional medicine to achieve better health care.
Key players in both healthcare systems need to be able to share information freely.
The need to develop policies is paramount. Both conventional and traditional medicine practitioners should be aware of and interact with patients about all medications they are taking.
Understand the whole patient
Patients often seek treatment from both conventional and traditional sources, which can lead to side effects or drug duplication.
A complete understanding of the patient’s health profile simplifies care.
This could also prevent treatment failures, promote patient safety, prevent adverse interactions and minimize risks.
A harmonious healthcare landscape would combine the strengths of both systems to deliver better healthcare for all.
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