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"contents": "<span style=\"font-weight: 400;\">Traditional medicines are part of the cultural heritage of many Africans. About </span><a href=\"https://www.afro.who.int/regional-director/speeches-messages/african-traditional-medicine-day-2022\"><span style=\"font-weight: 400;\">80%</span></a><span style=\"font-weight: 400;\"> of the African continent’s population uses these medicines for healthcare. Other reasons include affordability, accessibility, patient dissatisfaction with conventional medicine and the common misconception that “natural” is “</span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887317/\"><span style=\"font-weight: 400;\">safe</span></a><span style=\"font-weight: 400;\">”.</span>\r\n\r\n<span style=\"font-weight: 400;\">The growing recognition of traditional medicine resulted in the first World Health Organization (WHO) </span><a href=\"https://www.who.int/initiatives/who-global-centre-for-traditional-medicine/traditional-medicine-global-summit\"><span style=\"font-weight: 400;\">global summit</span></a><span style=\"font-weight: 400;\"> on the topic, in August 2023, with the theme “Health and Wellbeing for All”.</span>\r\n\r\n<span style=\"font-weight: 400;\">Traditional medicines are widely used in South Africa, with up to 60% of South Africans estimated to be reliant on traditional medicine as a </span><a href=\"https://www.sciencedirect.com/science/article/pii/S025462991400115X\"><span style=\"font-weight: 400;\">primary source of healthcare</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Conventional South African healthcare facilities struggle to cope with extremely </span><a href=\"https://health-e.org.za/2013/09/20/national-health-facilities-baseline-audit/\"><span style=\"font-weight: 400;\">high patient numbers</span></a><span style=\"font-weight: 400;\">. The failure to meet the </span><a href=\"https://health-e.org.za/2013/09/20/national-health-facilities-baseline-audit\"><span style=\"font-weight: 400;\">basic standards</span></a><span style=\"font-weight: 400;\"> of healthcare, with increasing morbidity and mortality rates, poses a threat to the South African economy.</span>\r\n\r\n<span style=\"font-weight: 400;\">In my opinion, as a qualified pharmacist and academic with a </span><a href=\"https://scholar.google.co.za/citations?hl=en&user=FRGRtTQAAAAJ&view_op=list_works&sortby=pubdate\"><span style=\"font-weight: 400;\">research</span></a><span style=\"font-weight: 400;\"> focus on traditional medicinal plant use in South Africa, integrating traditional medicine practices into modern healthcare systems can harness centuries of indigenous knowledge, thereby increasing treatment options, and provide better healthcare.</span>\r\n\r\n<span style=\"font-weight: 400;\">Recognition of traditional medicine as an alternative or joint source of healthcare to that of standard, conventional medicine has proven challenging. This is due to the </span><a href=\"https://www.sciencedirect.com/science/article/abs/pii/S0378874115301896*\"><span style=\"font-weight: 400;\">absence of scientific research</span></a><span style=\"font-weight: 400;\"> establishing and documenting the safety and effectiveness of traditional medicines, along with the lack of regulatory controls.</span>\r\n<h4><b>What are traditional medicines?</b></h4>\r\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252219/\"><span style=\"font-weight: 400;\">Traditional medicine</span></a><span style=\"font-weight: 400;\"> encompasses a number of healthcare practices aimed at either preventing or treating acute or chronic complaints through the application of indigenous knowledge, beliefs and approaches. It incorporates the use of plant-, animal- and mineral-based products. Plant-derived products form the majority of treatment regimens.</span>\r\n\r\n<span style=\"font-weight: 400;\">Traditional medicine practices also have a place in ritualistic activities and communicating with ancestors.</span>\r\n\r\n<span style=\"font-weight: 400;\">South Africa is rich in indigenous medicinal fauna and flora, with about </span><a href=\"https://www.sciencedirect.com/science/article/pii/S0254629913000215\"><span style=\"font-weight: 400;\">2,000 species of plants</span></a><span style=\"font-weight: 400;\"> traded for medicinal purposes. The provinces of KwaZulu-Natal, Gauteng, the Eastern Cape, Mpumalanga and Limpopo are trading “hot spots”. The harvested plants are most often sold at traditional medicine </span><a href=\"https://www.sciencedirect.com/science/article/pii/S0254629919304776\"><span style=\"font-weight: 400;\">muthi markets</span></a><span style=\"font-weight: 400;\">.</span>\r\n<h4><b>Uses of medicinal plants</b></h4>\r\n<a href=\"https://www.sciencedirect.com/science/article/pii/S0254629911001190\"><span style=\"font-weight: 400;\">Medicinal plants</span></a><span style=\"font-weight: 400;\"> most popularly traded in South Africa include buchu, bitter aloe, African wormwood, honeybush, devil’s claw, hoodia, African potato, fever tea, African geranium, African ginger, cancer bush, pepperbark tree, milk bush and the very commonly consumed South African beverage, rooibos tea.</span>\r\n\r\n<span style=\"font-weight: 400;\">The most commonly traded medicinal plants in South Africa are listed below along with their traditional uses:</span>\r\n\r\n<b>Buchu</b><span style=\"font-weight: 400;\"> — Urinary tract infections; skin infections; sexually transmitted infec-tions; fever; respiratory tract infections; high blood pressure; gastrointestinal complaints.</span>\r\n\r\n<b>Bitter aloe</b><span style=\"font-weight: 400;\"> — Skin infections; skin inflammation; minor burns.</span>\r\n\r\n<b>African wormwood</b><span style=\"font-weight: 400;\"> — Respiratory tract infections; diabetes; urinary tract disorders.</span>\r\n\r\n<b>Honeybush</b><span style=\"font-weight: 400;\"> — Cough; gastrointestinal issues; menopausal symptoms.</span>\r\n\r\n<b>Devil’s claw </b><span style=\"font-weight: 400;\">— Inflammation; arthritis; pain.</span>\r\n\r\n<b>Hoodia</b><span style=\"font-weight: 400;\"> — Appetite suppressant.</span>\r\n\r\n<b>African potato</b><span style=\"font-weight: 400;\"> — Arthritis; diabetes; urinary tract disorders; tuberculosis; prostate disorders.</span>\r\n\r\n<b>Fever tea</b><span style=\"font-weight: 400;\"> — Respiratory tract infections; fever; headaches.</span>\r\n\r\n<b>African geranium</b><span style=\"font-weight: 400;\"> — Respiratory tract infections.</span>\r\n\r\n<b>African ginger</b><span style=\"font-weight: 400;\"> — Respiratory tract infections; asthma.</span>\r\n\r\n<b>Cancer bush</b><span style=\"font-weight: 400;\"> — Respiratory tract infections; menstrual pain.</span>\r\n\r\n<b>Pepperbark tree</b><span style=\"font-weight: 400;\"> — Respiratory tract infections; sexually transmitted infections.</span>\r\n\r\n<b>Milk bush</b><span style=\"font-weight: 400;\"> — Pain; ulcers; skin conditions.</span>\r\n\r\n<b>Rooibos </b><span style=\"font-weight: 400;\">— Inflammation; high cholesterol; high blood pressure.</span>\r\n\r\n<span style=\"font-weight: 400;\">There are many ways in which traditional medicine may be </span><a href=\"https://www.sciencedirect.com/science/article/pii/S0254629913002615\"><span style=\"font-weight: 400;\">used</span></a><span style=\"font-weight: 400;\">. It can be a drop in the eye or the ear, a poultice applied to the skin, a boiled preparation for inhalation or a tea brewed for oral administration.</span>\r\n\r\n<span style=\"font-weight: 400;\">Roots, bulbs and bark are used most often, and leaves less frequently. Roots are available throughout the year. There’s also a belief that the roots have the strongest concentration of “medicine”. The harvesting of the roots, however, poses concerns about the conservation of these medicinal plants.</span>\r\n\r\n<span style=\"font-weight: 400;\">The South African government, with the draft policy on African traditional medicine Notice 906 of 2008, outlines considerations aimed at ensuring the conservation of these plants through counteracting </span><a href=\"https://www.gov.za/documents/policy-african-traditional-medicine-south-africa-draft\"><span style=\"font-weight: 400;\">unsustainable harvesting</span></a><span style=\"font-weight: 400;\"> practices.</span>\r\n<h4><b>Obstacles to traditional medicine use</b></h4>\r\n<span style=\"font-weight: 400;\">The limited research investigating </span><a href=\"https://www.sciencedirect.com/science/article/pii/S1744388121000852\"><span style=\"font-weight: 400;\">interactions</span></a><span style=\"font-weight: 400;\"> posed should a patient be making use of both traditional and conventional medicine is a concern.</span>\r\n\r\n<span style=\"font-weight: 400;\">During the </span><a href=\"https://pubmed.ncbi.nlm.nih.gov/35615091/\"><span style=\"font-weight: 400;\">Covid-19 pandemic</span></a><span style=\"font-weight: 400;\">, many patients used traditional remedies for the prevention of infection or treatment.</span>\r\n\r\n<span style=\"font-weight: 400;\">Understanding which traditional medicines are being used and how, their therapeutic effects on the human body, and how they </span><a href=\"https://pubmed.ncbi.nlm.nih.gov/28686181/\"><span style=\"font-weight: 400;\">interact with conventional medicines</span></a><span style=\"font-weight: 400;\"> would help determine the safety of their combined use.</span>\r\n\r\n<span style=\"font-weight: 400;\">Certain combinations may have advantageous interactions, increasing the efficacy or potency of the medicines and allowing for reduced dosages, thereby reducing potential toxicity. These </span><a href=\"https://pubmed.ncbi.nlm.nih.gov/28686181/\"><span style=\"font-weight: 400;\">combinations</span></a><span style=\"font-weight: 400;\"> could assist in the development of new pharmaceutical formulations.</span>\r\n<h4><b>Sharing information</b></h4>\r\n<span style=\"font-weight: 400;\">The WHO, in its </span><a href=\"https://www.who.int/publications/i/item/9789241506096\"><span style=\"font-weight: 400;\">Traditional Medicine Strategy 2014-2023</span></a><span style=\"font-weight: 400;\"> report, emphasised the need for using traditional medicine to achieve increased healthcare.</span>\r\n\r\n<span style=\"font-weight: 400;\">Key role players from both systems of healthcare need to be able to share information freely. The need for policy development is key. Both conventional and traditional medicine practitioners would need to be aware of and engage with patients regarding all the medicines they are taking.</span>\r\n<h4><b>Understanding the whole patient</b></h4>\r\n<span style=\"font-weight: 400;\">Patients often seek treatment from both conventional and traditional sources, which can lead to side effects or duplication of medications.</span>\r\n\r\n<span style=\"font-weight: 400;\">A comprehensive understanding of a patient’s health profile makes care easier. This could also prevent treatment failures, promote patient safety, prevent adverse interactions and minimise risks.</span>\r\n\r\n<span style=\"font-weight: 400;\">A harmonious healthcare landscape would combine the strengths of both systems to provide better healthcare for all. </span><b>DM</b>\r\n\r\n<i><span style=\"font-weight: 400;\">First published by </span></i><a href=\"https://theconversation.com/south-africas-traditional-medicines-should-be-used-in-modern-health-care-211382\"><i><span style=\"font-weight: 400;\">The Conversation</span></i></a><i><span style=\"font-weight: 400;\">.</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">Zelna Booth is a pharmacist and academic lecturer at the University of the Witwatersrand.</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">This story first appeared in our weekly </span></i><span style=\"font-weight: 400;\">Daily Maverick 168</span><i><span style=\"font-weight: 400;\"> newspaper, which is available countrywide for R29.</span></i>\r\n\r\n<img loading=\"lazy\" class=\"size-full wp-image-1875516 alignnone\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2023/09/China.jpg\" alt=\"DM168 front oage\" width=\"720\" height=\"915\" />",
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