August 29, 2015

Traditional Medicine & Safety: keeping the balance

by G. Damr | Medicine is certainly an old science and profession. Preoccupation with the afterlife, and, our immense fear of death were, perhaps, among the principal driving forces behind its advancement. No wonder medicine is now one of the most advanced sciences.

Traditional Medicine, embedded as it is in culture and religion, was the foundation of the modern health systems. And, surprising as it may sound, traditional medicine remains a widely practiced profession in many developing countries and a basic health service in many parts of Africa even in these contemporary times when the health system has been revolutionized to its limits.

Traditional medicine almost always shuns professional safety, rigorous standards and regulatory control.  As such, it inadvertently entails, occasionally, severe health complications that sometimes lead to death.  Aware of the vexing role and challenges that traditional medical practices pose to modern health services, the WHO and almost all national health systems in the developing world have devised several global and regional mechanisms and protocols to optimize its benefits while mitigating its unintended adverse consequences.

Eritrea too has been handling this delicate balance with the requisite prudence.  In a speech delivered at the opening session of a multi-stakeholders’ workshop, the Eritrean Minister of Health, Ms. Amina Nurhusien stated “….traditional medicine has a long history in our society and is widely practiced. It originates from a strong historical and cultural heritage at the local level and is practiced by well-known and respected members of the community. The community had – and has – confidence and strong beliefs on practitioners’ abilities and remedies….”.

The Traditional Medicine multi-stakeholders’ workshop was conducted at the Orotta Conference Hall, in Asmara from 29-30th July, 2015.  The principal objective of the workshop was to deliberate on draft documents on Traditional Medicine Policy which was prepared by the National Medicines and Food Administration (NMFA) in consultation with the WHO.  The NMFA is a regulatory body within the Ministry of Health entrusted with the tasks of formulating/monitoring standards for drug quality and food safety.

In addition to the overall functions of NMFA, the Ministry of Health had charted out specific provisions for traditional medicine practices which were incorporated in the Eritrean National Medicines Policy and in the National Health Sector Policy.

These National policies stipulate requirements for identification, documentation and regulation of traditional medicinal practices in use so as to safety and to promote efficacy.  The policy documents also recommend and encourage networking among traditional healers for exchange of information and emulation of best practices.   This horizon is also broadened to envisage suitable networking with professionals in the formal health sector.

To this end, the Ministry of Health established a Traditional Medicine Unit (TMU) within the National Medicine and Food Administration. The mandate of the TMU was to formulate policy guidelines that govern the practices of traditional medicine; to register traditional healers; and to monitor safety; to conduct public education as well as to conduct/encourage research on traditional medicine.   These tasks are carried out with other stakeholders.  The purpose of the Stakeholders’ Conference last June was to assess performance in the past years and consolidate further the pronounced objectives.

Traditional Medicine practices are usually shrouded in secrecy – under the false belief that their potency would be diminished otherwise – and passed from one generation to the next as family secrets.  As a consequence, there is little or nil standardization. The absence of explicit and uniform procedures of application of the antidotes among its practitioners has been, and remains, one of the most fundamental hurdles in harmonizing it with the modern health system. In the event, the need for scientific validation and standardization of the products is palpable to integrate Traditional Medicine into existing health services and to address critical issues of safety, quality and efficacy.

The Ministry of Health acknowledges the fact that traditional medicine is filling an important vacuum in terms of providing basic health coverage in remote parts of the country.   But it is also keenly aware of the potential drawbacks since some, if not all, of the practices may inevitably expose patients to avoidable hazards due to unqualified practitioners and unsafe practices.

To mitigate these potential hazards, the NMFA has already taken some concrete steps. First off, the NMFA undertook situational assessment through visits and physical inspection of all known Traditional Medicine practitioners.   A preliminary policy draft was subsequently prepared and shared with WHO experts who visited the country from 19-31 July last month.

These documents were then thrashed out in focus group discussions, individual discussions and interviews with relevant government officials, medical professionals and some traditional health practitioners (THPs).  The WHO experts also visited relevant academic institutions within the country.  Finally, the consultants made their findings and observations available to the participants of the workshop in Traditional Medicine.

Mr. Iyassu Bahta, Director of the National Medicines and Food Administration, submitted an assessment paper on the current situation of Traditional Medicine in the Multi-stakeholders’ workshop on TM.   Mr. Iyassu highlighted the commitment of the Ministry of Health to ensure the safety of TM practices through the provision of appropriate support.  The will and commitment of relevant institutions in formulating legislation and regulatory frameworks is highly invaluable in such cases. The establishment of a Traditional Medicine Unit within the National Medicine and Food Administration is indeed a tangible proof of the political good will of the MOH to encourage TM practices under strict safety regulations.

WHO statistics on Traditional Medicine establish that almost 80% of the African people resort to, and utilize, alternative, traditional, medical services.  These are facts that cannot be ignored or glossed over.    When this reality is juxtaposed to the WHO 2015 global agenda and declaration of promoting Universal Health Coverage (UCH), it is clear that sidelining Traditional Medicine would be unwise and impractical; at least in the short term.   The truth is Traditional Medicine will not go away easily and quickly.  The judicious route may lie in formulating robust regulatory frameworks to ensure harmonized and high standards of safety.

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