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Treating HIV in South Africa -- A Tale of Two Systems

April 17, 2001

As South Africa faces the second phase of a legal struggle with pharmaceutical companies over drugs for HIV/AIDS, the reality of health care in that country is that many Africans cannot afford to purchase transportation to a clinic, much less cut-price drugs.

There is another health care system in South Africa, "one that reaches some 80 percent of people across the continent," wrote the author. It is, "generally efficacious, cheap, individualized and culturally appropriate." Its practitioners outnumber allopathic doctors by ten to one.

This system has received little attention from the South African government even though "many experts now accept that this second system -- indigenous knowledge that encompasses traditional healing and folklore remedies -- is actually bearing the brunt of HIV/AIDS care and support in Africa." In an HIV/AIDS clinic at Ngwelezane hospital in KwaZulu-Natal province, for example, only a handful of the 300-400 patients are suitable for antiretroviral medications -- those that have the money and the knowledge to use them. But all patients do benefit from scientifically researched "plant remedies and supplements supplied by the University of Zululand ethnobotanist Anne Hutchings," which includes unwele (Sutherlandia frutescens), an herbal medicine that has proven anticachexia and anti-AIDS actions.

Many traditional healers, including "sangomas (diviners) and inyangas (herbalists) have already proven beneficial in spreading HIV prevention messages . . ." according to the author. Seven hundred healers have had formal examinations at the KwaZulu-Natal traditional healer's council. These healers provide their expertise informally through patient support groups. The development of phytomedicines has no investment and little interest "from the Ministry of Health, the Medical Research Council, or the President's office," according to the author.

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Internationally, however, there is wide support for incorporating traditional practice into government-run health care. The World Health Organization (WHO) and UNICEF adopted resolutions to that effect in 1978. WHO guidelines state that "if a traditional medicine is in customary use with no reported side-effects, a fast-track toxicology regimen is sufficient to start simplified, rapid, phase III clinical trials." Countries such as Nigeria and Ghana are moving to fast track the integration of traditional medicine into mainstream health care, according to Gerald Bodecker of the Global Initiative for Traditional Systems of Health who founded the HIV/AIDS Research Initiative on Traditional Healthcare in Africa. However, this still leaves traditional healers lowest in the health care system, with allopathic health care workers taking a dim view of their practices.


Back to other CDC news for April 17, 2001

Previous Updates

Adapted from:
Lancet
04.14.01; Vol. 357, No. 9263. Kelly Morris



  
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
 


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