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African traditional medicine could be a solution for Africa and the world’s health emergencies

31 August 2022 | Story Prof Motlalepula Matsabisa | Photo Andrè Damons

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

Moshoeshoe - lessons from an African icon - by Prof Frederick Fourie

2004-11-03

(The full text of the article that appeared in City Press and Sunday Independent)

Our understanding of history informs our understanding of the present. No wonder the contestation over historical figures in South Africa’s past is so fierce and so divisive.
The question is: could it be any other way? I would like to think that it could; that black and white South Africans, across linguistic, cultural, religious and other divides, can develop a shared appreciation of our history – at least with certain periods and personalities as a starting point.

One such personality whose legacy I believe offers a possible platform for unifying our still divided country is King Moshoeshoe, who lived from 1786 to 1870, and is acknowledged as the founder of the Basotho.

King Moshoeshoe is the topic of a documentary that has been commissioned by the University of the Free State as part of its Centenary celebrations this year. It is part of a larger project to honour and research the legacy of Moshoeshoe. The documentary will be screened on SABC 2 at 21:00 on November 4th.

Moshoeshoe rose to prominence at a time of great upheaval and conflict in South Africa – the 19th century, a time when British colonialism was entrenching itself, when the Boer trekkers were migrating from the Cape and when numerous indigenous chiefdoms and groupings were engaged in territorial conquests. It was the time of the Difaqane, a period when society in the central parts of the later South Africa and Lesotho was fractured, destabilised and caught in a cycle of violence and aggression.

In this period Moshoeshoe displayed a unique and innovative model of leadership that resulted in reconciliation, peace and stability in the area that later became Lesotho and Free State. It made him stand out from many of his contemporaries and also caught the attention of his colonial adversaries.

Such an evaluation is not a judgment about which model of leadership is right and which is wrong, or which leader was better than another; but merely an attempt to explore what we can learn from a particular exemplar.
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Historians point to the many progressive leadership qualities displayed by Moshoeshoe which he used effectively in establishing the Basotho nation and in defending it.
First, there is his humanism and sense of justice worthy of any great statesman. Confronted by a situation in which cannibals murdered and devoured his grandfather, Moshoeshoe chose not to take revenge. Instead he opted to rehabilitate them and feed them as he believed hunger drove them to cannibalism.

Secondly, there is his skilful alliance-building with his contemporaries such as Shaka in an attempt to neutralize those rivals who were intent on attacking his followers. This is also displayed in the way he sought the protection of the British to keep the Boer forces at bay.
Thirdly, his emphasis on peaceful options is also seen in his defensive military strategy which saw him retreat to a mountain fortress to be able to protect and build a burgeoning nation in the face of the many forces threatening its survival.

Fourthly, there is his remarkable inclusivity and tolerance for diversity which saw him unite disparate groups of refugees from the violence and hunger that displaced them and then weld them into the Basotho nation. He also engaged with French missionaries, inviting them to stay with him and advise him on Western thought, technology and religion.
These are but some of the qualities which belie the notion that all 19th century African leaders were merely marauders and conquerors that gained their ascendancy through violence. Instead Moshoeshoe is a prime example of the human-centred, democratic and pluralist roots of South African, indeed African society.

The Moshoeshoe project that we have initiated (of which the documentary, called “The Renaissance King”, forms but one part) derives from our location as a university in the Free State, a province with a particular history and a particular political culture that developed as a result of this very model of leadership. This province has benefited tremendously from leaders such as Moshoeshoe and president MT Steyn, both of whom many observers credit with establishing a climate of tolerance, respect for diversity of opinion, political accommodation and peaceful methods of pursuing political objectives in the province. Their legacy is real – and Moshoeshoe’s role can not be overstated.
In addition the project derives from the University of the Free State being a site of higher learning in a broader geo-political sense. As a university in Africa we are called upon to understand and critically engage with this history, this context and this legacy.
Besides the documentary, the UFS is also planning to establish an annual Moshoeshoe memorial lecture which will focus on and interrogate models of African leadership, nation-building, reconciliation, diversity management and political tolerance.

In tackling such projects, there may be a temptation to engage in myth-making. It is a trap we must be wary of, especially as an institution of higher learning. We need to ask critical questions about some aspects of Moshoeshoe’s leadership but of current political leadership as well. Thus there is a need for rigorous academic research into aspects of the Moshoeshoe legacy in particular but also into these above-mentioned issues.
While the documentary was commissioned to coincide with the University of the Free State’s centenary and our country’s ten years of democracy, it is a project that has a much wider significance. It is an attempt to get people talking about our past and about our future, as a campus, as a province and as a country – even as a continent, given the NEPAD initiatives to promote democracy and good governance.

The project therefore has particular relevance for the continued transformation of institutions such as universities and the transformation of our society. Hopefully it will assist those who are confronted by the question how to bring about new institutional cultures or even a national political culture that is truly inclusive, tolerant, democratic, non-sexist, non-racial, multilingual and multicultural.

I believe that the Moshoeshoe model of leadership can be emulated and provide some point of convergence. A fractured society such as ours needs points of convergence, icons and heroes which we can share. Moshoeshoe is one such an African icon – in a world with too few of them.

Prof Frederick Fourie is the Rector and Vice-Chancellor of the University of the Free State

* The documentary on “Moshoeshoe: The Renaissance King” will be screened on SABC2 on 4 November 2004 at 21:00.

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