Sun, May

Traditional medicine under the microscope. Image credit: Africa Research Institute

Thoughts From Afar
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The laissez-faire attitude with which herbal medicines are advertised on electronic media with claims of one product treating multiple diseases states some chronic and others infectious is known to us all.

“My love affair with nature is so deep that I am not satisfied with being a mere onlooker, or nature tourist. I crave a more real and meaningful relationship. The spicy teas and tasty delicacies I prepare from wild ingredients are the bread and wine in which I have communion and fellowship with nature, and with the Author of that nature.” Euell Gibbons

Humans encounter with herbs predates civilisation. Early records indicate that Stone Age men obtained healing for various ailments from the wild. In recent times there is well documented scientific evidence of the link between many allopathic medicines and plants, some of which are in use in our nation. Locally, there is also a considerable body of research into the medicinal property of many local plants.

Records indicate that there are more traditional medicine practitioners than allopathic doctors. The World Health Organisation (WHO) estimates that “about 70% of the population depend exclusively on traditional medicine for their healthcare.” Though I struggle to believe this high exclusive percentage, there is no complimentary data to prove otherwise. WHO further indicates that “there is approximately one traditional medicine practitioner for every 400 people”, compared with one allopathic doctor for every 9043 Ghanaians. More importantly, these practitioners seem to be evenly spread across the country compared with the uneven distribution of medical doctors, nurses and other conventional health practitioners. This coupled with the relatively cheaper initial cost of treatment makes accessibility to traditional medicine easier.

However, there is a large body of evidence regarding the dangers associated with the use of these traditional practitioners. To start with, many of their products are not standardised and therefore doses vary from one practitioner to the other. Even with the same practitioner, it is known that there may be variations in the concentration of their products due to unstandardized methods by which they formulate. There are also serious concerns about hygiene, quality of care, patient confidentiality and documentation. There is also concern that often these practitioners complicate otherwise simple disease states resulting in patients arriving late in orthodox healthcare facilities. In some instances, these complications have been known to have cost patients their lives.

In 1999 government realising the role traditional medicine played in the health delivery system put steps in place to obtain a regulatory framework that will bring sanity into the practice. As a result of extensive consultation, the Traditional Medicine Practice Act 595 came into force on the 23rd of February 2000. Years later, following further consultation, it was identified that the law had failed to achieve the objectives for which it was promulgated. With the help of donors, the nation through the Ministry of Health drafted Policy Guidelines on Traditional Medicine Development which was accepted in 2005. This document was to bring closure to all the problems that had prevented Act 595 from becoming operational.

Yet, thirteen years after in 2018, our traditional medicine practice is no better than it was in 1999. In fact, in some aspects, it has gotten worse. The laissez-faire attitude with which herbal medicines are advertised on electronic media with claims of one product treating multiple diseases states some chronic and others infectious is known to us all. Spurious claims of sexual enhancement made with many aphrodisiacs are also known.

It is important that as a society we undergo some introspection to understand why with a law and a policy we still cannot bring sanity into traditional medicine practice. I am of this view because traditional medicine irrespective of its obvious shortcomings is a job creator. If the statistics of the WHO is to be accepted, then with a population of approximately 29 million, Ghana must have at least 72,500 practitioners who contribute to the gross domestic product of the country. Secondly, the large segment of the population who rely on these practitioners for their health care cannot be left to their own devices. This, in my view, is a failure in a duty of care on the part of successive governments.

The time has come for us to relook traditional medicine and its practice.

It may be important to start our introspection with this statement from the preamble of our traditional medicine policy. “In Ghana successive governments have recognized the importance of traditional medicine. The formation of the Ghana Psychic and Traditional Healers Association in 1961 and the establishment of the Centre for Scientific Research into Plant Medicine in 1975 attest to this fact. Also in 1991, the government established a unit for the coordination of Traditional Medicine (which is now Traditional and Alternative Medicine Directorate) which was followed by the setting up of the Food and Drugs Board in 1992, which among others, is to certify the sale of Traditional Medicine products to the public. In 2000, the government enacted the TMPC Act, Act 575 for the establishment of Traditional Medicine Council which is tasked with the responsibility for the registration of all Traditional Medical Practitioners in the country. An Alternative Medicine Bill is yet to be passed in parliament.”

With this statement in mind, we need to understand the financial commitments we have made as a nation since independence and decide whether the current position has provided value for money. If it has not, we need to decide whether we want to treat these commitments as lost national investments, sunk cost or that we see potential in traditional medicine and want to get it right.  Whatever our decision, we need to also remember all the parastatal institutions and directorates that have been set up to champion the cause of traditional medicine and consider the impact of our decision on them.

This is why I advocate an urgent review of both the Traditional Medicine Practice Act 595 and Policy Guidelines on Traditional Medicine Development. I am of the opinion that such an action followed by a policy dialogue will help identify the bottlenecks that ensure that the status quo is maintained. Especially when indications are that the policy of 2005 was drafted with all the necessary stakeholders at the table. In the end, we should be able to chart a course that will ensure the benefits of Traditional Medicine are obtained whilst the risks are relegated to the barest minimum. Burying our heads in the sand is not an option.

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