Monday, July 6, 2020

If No Evidence, Then What? :  Is Complementary Medicine a Panacea for Covid-19 Response?

Researchers say at least 4 308 055 cases have been confirmed worldwide, while at least 293 514 people have died. The figures collected by John Hopkins University are likely to be a great underestimate of the true scale of the epidemic. Lesotho, the last country in Africa left unaffected, announced its first case recently. As The Covid-19 continues to impact countries around the world, many commentators are now calling for the use of the alternative medicine in Madagascar. 

The World Health Organisation recently made shocking revelations with their recently released study that predicts between 209 Million to 44 Million could become infected in the first year of the pandemic if containment measures fail. This would overwhelm the available medical capacity in much of Africa where there are only nine intensive care unit beds per million people, according to WHO. The WHO warned that there could be 10 Million infections on the continent within six months, however, the experts say the pandemic would depend on governments’ actions.

The Director of the WHO’s Africa Region, Dr Matshidiso Moeti, recently stated that ‘While Covid-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,”.  “Covid-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat.”

To date more than 51,000 people in Africa have been infected and 2012 have died. The total number of cases have risen sharply. Most countries have imposed lockdowns of varying severity that appear to have slowed the spread of the virus. Africa has carried out a fraction of the number of tests in other regions and there are fears that the official statistics do not reflect true extent of the pandemic in Africa. For instance it has been reported that the East African country Somalia was recently forced to dramatically revise official statistics after it became clear that the deaths of hundreds of people from the virus had gone unrecorded.

Elsewhere, in West Africa it has been reported that authorities in Nigeria also initially denied that a major outbreak in the northern city of Kano was Covid-19, and there are now widespread concerns that Tanzania might be concealing the severity of its outbreak to protect the president, John Magufuli, who has refused to ban religious services and large gatherings. Tanzania has declared at least 480 confirmed cases and 18 deaths, the fourth highest total in eastern Africa. It has been reported that the President of Tanzania, Magufuli said that the imported coronavirus test kits were faulty after they returned positive results on a goat and a pawpaw fruit.

Despite the challenges that Africa has been faced with in the response to the Covid-19 tsunami, it  must be applauded, many African countries have done a lot even though they are incapacitated, have weak and poorly resourced health systems. Projections were that we Africans would be dying like flies, they would simply be a in a war situation by now, but because of the measures taken by governments and communities, transmission rates are lower than we’ve seen elsewhere in the world. It is important to note that testing in many African countries has been limited by difficulties in getting enough kits, which are the subject of fierce international competition.

It is on the basis of the weak and poorly resourced health systems in Africa and more particularly the reality on the ground that there is yet no Magic bullet Vaccine for Covid-19 globally and calls have been made by many people to resort to Complimentary or Alternative Medicine (CAM). In Botswana, social media has been in overdrive with some calling to resort to using indigenous health care, traditional medicine, “Lengana” (Artemisia), as an alternative cure. The African Union is also said it is having discussions with Madagascar over Covid organics (CVO), a herbal drink that is said to prevent and cure patients suffering from the novel coronavirus. It is said once finished the African Centers for Control and Prevention (Africa CDC) will review the scientific data gathered so far on the safety and efficacy of Covid organics.

President of Madagascar former disc jockey Andry Rajoelina officially launched the CVO, a herbal mixture, claiming that it can prevent and cure patients suffering from the novel coronavirus. The drug was developed by the Malagasy Institute of Applied Research. However, the World Health Organisation has warned against any self-medication and it has not recommended any medicine as a cure for Covid-19. In response WHO said, it supports scientifically proven traditional medicine.

“ WHO welcomes every opportunity to collaborate with countries and researchers to develop new therapies and encourages such collaboration for the development of effective and safe therapies for Africa and the world”, it said in a statement.

On the other hand, Rajoelina stated that his government was already collaborating with foreign doctors and researchers on the matter, looking for alternative research possibilities but still on the trail of the Artemisia plant – the main component of CVO.

It is important to note that the use of Complementary and Alternative Medicine (CAM) remains prevalent in most developing countries including Botswana. Research has demonstrated that health care provisions in most African countries depend on both orthodox and traditional systems. For example, in one study carried out on the use of alternative medicine in Southern Africa, in the International Journal of Herbal Medicine, it showed that approximately eighty percent of individuals in Southern African member states use traditional medicine to meet their health care needs.

The World Health Organisation defines traditional medicine (TM) as native health practices, approaches, knowledge and beliefs that maybe applied either singular or combination to treat, diagnose and maintain wellbeing. The terms complementary medicine and alternative medicine have been used interchangeably with traditional medicine. The former (complementary/alternative medicine) often refers to TM practiced in a country where it did not originate.

Some countries within the Southern African Region such as Zimbabwe and South Africa have developed deliberate policies applicable to traditional medicine legislation. South Africa has made significant strides in Complementary and Alternative Medicine (CAM) Policies as well as in implementing policies on traditional medicine. As to whether that is the case in Botswana with respect to having a deliberate policy on the role of CAM and working together with members of Dingaka Association as a relevant stakeholder and as to whether they are part of the COVID-19 Task force is subject for clarity both from the relevant policy actors and stakeholders.

Several countries have enacted policies that legitimize traditional medicine along with allopathic health care systems so as assume an integrated approach. Thus the traditional medicine practitioners played a significant role as a relevant stakeholder in agenda setting and policy formulation and legislative framework in their respective countries detailing the role played by the traditional healers in the policy making process, role of non-governmental organizations (NGO’s) both as funding and capacity building agents, inaction by the government, actions by government which led to discourse between the allopathic medical practitioners and traditional healers as well as the pros and cons of the policy making process.

According to World Health Organisation (WHO) recommendations in the Alma Ata Declaration of 1978, there was a need to recognise the role of Traditional Health Practitioners in providing health care. The declaration highlighted the need to research and develop appropriate policies enabling use of traditional medicine as officially recognised Complementary and Alternative Medicine. This WHO proposal, coupled with domestic pressure from indigenous health practitioners necessitated the need to research, design and implement empowering policies on traditional medicine. Some researchers have been quick to point out that most indigenous Africans preferred traditional medicine despite its demonization and its criminalisation through the Witchcraft Suppression Act of 1889. Traditional medicine has been used for many years for so many reasons in many African countries and has saved many lives. Is it not time for the Scientists to consult and learn from the traditional healers and they give the traditional healers the respect they deserve as opposed to the other way around.

This leaves us with the BIG question, in the absence of the COVID-19 vaccine, what alternative methods can be used and or employed by using  indigenous knowledge systems? Is Science the only true exit strategy for the Covid-19 crisis?

Thabo Lucas Seleke, Researcher & Scholar Global Health Policy Analysis

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