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31 August 2022 | Story Prof Motlalepula Matsabisa | Photo Andrè Damons
Prof Motlalepula Matsabisa
Prof Motlalepula Matsabisa, Professor and Director of Pharmacology, Faculty of Health Sciences, University of the Free State. He is also leading Africa’s fight against the COVID-19 pandemic after being appointed as chairperson of the World Health Organisation’s (WHO’s) Regional Expert Advisory Committee on Traditional Medicines for COVID-19.

Opinion article by Prof Motlalepula Matsabisa, Professor and Director of Pharmacology, Faculty of Health Sciences, University of the Free State.
As we celebrate African Traditional Medicine Day on 31 August to promote the important role of the continent’s rich biodiversity in improving well-being, one needs to acknowledge the role that COVID-19 played in shining a spotlight on African traditional medicines (ATMs). Responding to the pandemic, rapid vaccine research and development and the repurposing of drugs in the fight against COVID-19 happened on great scales. Traditional medicines also benefited from renewed interest as a possible solution for this deadly disease. This year the World Health Organisation (WHO) Regional Director has approved the theme for the celebration of the 20th anniversary of African Traditional Medicine Day as ‘Two Decades of African Traditional Medicine Day: Towards Achieving Universal Health Coverage’. Countries will be celebrating individually, while WHO will hold a virtual celebration on the day. 

Even though ATMs, similarly to other traditional medicines such as those from China and India, have been used by African people long before the advent of “modern” medicine, and still continue to be used for the treatment of a range of diseases, most people still do not believe in its value as medicines for serious and chronic illnesses. This might be because of the lack of scientific research behind these remedies, and the dominance of the Western knowledge system and its wide acceptance by younger generations who value more Western values and lifestyles while being oblivious to ATMs. But in Africa, where about 80% of the population are said to rely on traditional medicine for their basic healthcare needs (according to the WHO), ATMs should be given a more prominent role. They should be more visible on shelves in big pharmacies, prescribed by healthcare practitioners beyond just traditional health practitioners (THPs), and should be more mainstreamed than what is currently the case. 

UFS Department of Pharmacology made great strides researching ATMs

Over the past few years, the University of the Free State (UFS), through its Department of Pharmacology, has made great strides in researching the possibilities and potential of ATMs. My team and I, together with other role-players in the institution, are in the process of establishing one of the most advanced modern pharmacology GLP-accredited research and development laboratories in the country, and possibly in the region, after receiving a grant of R58 million from the government. The UFS is recognised as a national leader in pharmacology as well as research and development of indigenous knowledge systems (IKS) and traditional medicines. The UFS has developed and built infrastructure in this field of scientific research, and has the best modern equipment for the training, teaching, and development of prototypes and products for commercialisation based on IKS. Interdisciplinary and interfaculty research is undertaken in this study area, and we have an excellent track record of sound community engagement with relevant stakeholders. 

The department has also been awarded an annual Technology and Innovation Agency Platform (TIA) grant of R17 million for the next five years. This research and teaching programme, known as African Medicines Innovations and Technologies Development (AMITD), will help to recruit and employ the best skills throughout the research, development, and herbal-medicine manufacturing value chains. We received a DSI high-end infrastructure (HEI) grant to build a laboratory, which will be a centre of excellence for the government, the WHO, and the African Union’s Commission for Social Development. The grant will also be used to build a herbal medicines production facility, as well as to pilot a health facility for traditional medicines. I am pleased that a multinational private pharmaceutical company has come forward and will be collaborating with us to realise these plans – joint manufacturing and business development, and joint engagement in the integrated health facility. We are now, together with the WHO and the aforementioned company, entering into a collaboration agreement to work together on key projects in traditional medicine manufacturing and training. 

Traditional medicine therapies emerged as possible cures or remedies for COVID-19

As part of the COVID-19 response, traditional medicine therapies have emerged as possible cures or remedies for the deadly disease. The pandemic has certainly helped to improve the profile of ATMs. In Cameroon, for example, two complementary therapy products for COVID-19 have been approved by the government, while Madagascar’s herbal remedy, COVID-Organics Plus Curative, has been in phase II clinical trials.  Encouraging preliminary results have been reported around this clinical trial. Similar trials on traditional medicine products for COVID-19 – conducted according to WHO protocols – are also underway in other African countries, including Democratic Republic of Congo, Nigeria, Uganda and South Africa, according to the World Health Organisation (WHO).

With regard to South Africa, my team and I and FARMOVS received approval from the South African Health Products Regulatory Authority (SAHPRA) to conduct the first multicentre controlled phase II clinical trial of a plant-based product, PHELA, on mild- to moderate-symptom COVID-19 patients.

The main purpose of the clinical trial is to confirm that the product can treat COVID-19 and be registered by the South African Health Products Regulatory Authority. We confirmed in vitro and in vivo that the medication works as an immune modulator to modulate the cytokine storm due to COVID-19, and also restores and normalises the patient’s immune system. This pivotal study is based on the modification of the WHO master protocol for clinical trials. The study is ongoing at three sites, and we are considering the addition of two more sites, to make a total of five clinical-trial sites. The development of PHELA has taken place under stringent scientific scrutiny in both preclinical and clinical research. The efficacy of PHELA as both an immune modulator and an anti-SARS-COV-2 treatment has been proven in in vitro and in vivo studies with reproducible results, conducted by three independent research institutions and a science council. PHELA is a herbal product made of four medicinal plants. Traditionally PHELA has been claimed for use for a historical disease called muyaga, but recently it has been scientifically tested and found effective as an immune modulator that benefits persons with a compromised immune system.

African Traditional Medicines Day: a reminder of the value and contribution of traditional medicines

The celebration of African Traditional Medicines Day annually on 31 August reminds all of us of the value and contribution of traditional medicines. This year’s theme on the role of ATMs in universal health coverage (UHC) is most befitting, as we know that medicines from natural products are affordable, accessible, have almost no side effects, and are proven enough because they have been advised for many generations, and they have been quite efficient in treating 90% of all currently known human diseases. The annual celebration, therefore, aims to gain more support for the continent to fast-track the research and development, as well as the local manufacturing, of well-researched ATM products, and for them to be made available through our national health systems. This also encourages the training of younger generations in this field of science and research.

Support for local manufacturing of ATMs will help bring traditional medicinal products into mainstream health systems and formal economies, creating jobs and wealth throughout all the ATM-manufacturing value chains – commercial cultivations, research and development, manufacturing, distribution, logistics, and marketing. This will help move the continent from dependency on aid from rich Western countries. Aid has not given Africans any independence, and has never been sustainable. It is, instead, enslaving the continent. If we want to be independent of big Western pharmaceutical companies and their expensive medicines, inequities and discrimination – as seen during the COVID-19 pandemic, African countries were left wanting when it came to access to personal protective equipment, diagnostics, therapeutics, and vaccines – Africa does not need aid. We need technical skills, technology development, and skill transfer. Aid makes African dependent, not independent. We need investment –  financial, research and resources – into developing our own, locally and regionally sourced herbal-based medicine. Africa and her people need African solutions to its health problems –and who could be better suited to create them than the continent’s people through its indigenous knowledge systems. 

Africa should be a leading force 

In August health ministers from Africa met at a special event – the WHO Health Ministers Regional Committee for Africa, in Lomé, Togo. The theme of the meeting was ‘Building Back Better: Rethinking and rebuilding resilient health systems in Africa to achieve UHC and health security’. The WHO Africa Regional Office hoped to develop a collective roadmap for building resilient health systems through integrated efforts that coordinated actions across all clusters and teams in the WHO’s regional office and country offices, and with national, regional and global partners supporting African countries as they ramp up efforts to recover from the pandemic-induced disruption and build back better toward achieving UHC and being prepared for future health emergencies.

As Chairperson of the Regional Advisory Committee on Traditional Medicine for COVID-19 Response (REACT), I gave a presentation on fast-tracking research and development and local production of herbal medicines during the second session, with the theme ‘Lessons to guide strengthening of health product manufacturing in Africa’. I am of the view that COVID-19 helped to prepare the continent for the next major event, and Africa will be better suited to deal with it. We cannot, again, be caught off guard and found wanting, and be at the mercy of the West for donations. I presented ways to put in place systems for supporting local manufacturing of therapeutics, with participation through the African regional economic blocks. 

News Archive

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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