Foundation Presentation for ARSO/THC 13, African
Traditional Medicine
Standards – Key to unlocking the
value in African Traditional Medicine
Presentation to ARSO GA
Yaoundé, Cameroon
By: Amanda Gcabashe
Aims of Presentation
• Provide an overview of the WHO view of the
role of TM in society
• Standards and Traditional Medicine
– WHO
– ISO
– SABS
• South African Case Study
• International benchmarks for developing TM
• Standards the key to unlocking the value
in ATM
Definition of Traditional Medicine
“The sum total of the knowledge, skills and
practices based on the theories, beliefs, and
experiences indigenous to different cultures,
whether explicable or not, used in the
maintenance of health as well as in the
prevention, diagnosis, improvement or treatment
of physical and mental illness”
WHO estimates 80% of population in Africa
depend on TM for their primary healthcare
Quote from OECD in 2003
“Culture can be the engine for ECONOMIC, SOCIAL and
ENVIRONMENTAL TRANSFORMATION of the space in
which we live. Culture is not passive; rather it is one of
the fastest growing and most labour intensive industries
in advanced nations.”
(own emphasis)
La culture peut être le moteur de la transformation
économique, sociale et environnementale de l'espace
dans lequel nous vivons. La culture n'est pas passive,
mais plutôt qu'il est l'un des plus rapides industries à
forte croissance et le plus de travail dans les pays
avancés
WHO and TRADITIONAL MEDICINE
• Since 1978, with the Alma Ata Declaration, WHO has called for the integration of
TM.
• WHO Africa declared 2001 – 2010 Decade of TM and has had to declare a 2nd
Decade of TM (2011-2020) due to inadequate progress made by member
nations.
WHO TM Guidelines, 2002-2007
• Minimum requirements of registration of herbal
medicines
• Technical guidelines for safety, efficacy & quality
• Good agricultural and collection practices
• Monographs on selected medicinal plants
• GMP for herbal medicines
• Assessing quality of herbal medicines with
reference to contaminants and residues
• Consumer information on proper use of TM
• Basic training guidelines for providers of TM
(focus on TCM modules)
ISO and Traditional Medicine
• June 2009, ISO TMB established ISO/TC 249
TCM (provisional)- 1st Plenary in June 2010
• 21 countries, 11 observer countries
• Africa: Ghana, South Africa and Tunisia
• May 2013 – held SADCSTAN Capacity Building
Workshop and ATM Conference as part of
hosting ISO/TC249
– South African THP’s observers of ISO standardisation
SABS and Traditional Medicine
• SABS TC1097 African Traditional Medicine held
1st meeting in May 2013 (work began in 2011!)
• April 2013 – SADCSTAN established exploratory
TC on ATM
• Why is the development of ATM in SA @ SABS
and not Ministry of Health?
Excluded Economic Impact of ATM
• In excess of 400 000 employment opportunities
• South African ATM industry valued by latest
SEDA report at approximately R20 billion per
annum – approximately 5% of GDP
• Not counted in National Stats because of the
“informal” nature of the industry
• Despite this phenomenal contribution, not much
has changed in the landscape of ATM in South
Africa
Current ATM Support Structure in SA
Main funding for
Biotechnology research
with small number of
knowledge holders
Funding for
cultivation on
limited small
scale
Interim THP
Council
Research facilitated by
Ministry of Science &
Technology.
Aim: Novel Drugs from
ATM
Funded primarily by Ministry
of Science & Technology
Established by Ministry of Health;
focus on regulating Practitioners
as per the THP Act
TM Sector Support Required
• Industrialisation of ATM will naturally lead to biotech
industries.
• Driver of this is the development of Standards
Aim: creation of new ventures and economic
opportunities through industrialisation of ATM
TM Biotechnology
Creation of TM
healthcare delivery
system
Consolidation of practices through
self regulation
Existing Sector – unregulated and unsupported
-dominated by individual practitioners; own clinics
& medicines
Chinese State Administration of TCM
To plan, guide & coordinate TCM structures
Formulate & implement technical
plans on TCM research
Supervise & co-ordinate integration of
western and TCM
Perform other tasks assigned by
the minister of health
Guide exploration, summarization &
improvement of TCM theories
Conduct international exchange &
collaboration on TCM
Promote and guide the protections of
Chinese medicinal plants
Give advice on protection of TCM
Intangible Cultural Heritage;
protect endangered practices
Formulate plans & relevant
standards
Formulate & implement
TCM education standards
Indian State Administration of AYUSH
Improve AYUSH
educational standards
Protection of India’s Traditional
Knowledge
Quality control & standardisation of
drugs
Evolve pharmacopoeial standards for
Indian Systems of medicine
Improve availability of medicinal
plant material
Generate awareness of AYUSH
efficacy domestically &
internationally
Schemes for the promotion,
cultivation & regeneration of
medicinal plants
Strengthen & sustain
research & development
into AYUSH
Global Trade in TM
Source: SABS Traditional Medicine Intervention Report - Unpublished
Globalisation of TM
• Global traditional medicine trade in 2010 estimated at
US$83 billion
o Dominated by western herbal medicine, TCM and
Ayurveda
o African share of this is insignificant
• Herbal medicine is growing at between 10% - 20%
p.a.
• Revision of WHO ICD11 codes to include TM – but
which ones?? WHO TM processes have focused on
TCM and Ayurveda
Where do we start????
Globalisation of ATM through standards
• African wealth in plant biodiversity makes it a
bio-prospecting hot spot
• ATM has not received the institutional support
that is necessary to bring the practice into the
21st century without losing its cultural
significance
• Traditional medicine is an
recognised healthcare option.
internationally
• Either we support & develop African Traditional
Medicine (has consumer base of 800million) or
we exclusively adopt other TM – which is it?
Globalisation of ATM through standards
• ATM is our common heritage
• NEPAD/AU Pharmaceutical Strategy speaks about
local production of medicines including TM
• Inter-regional trade in medicinal plants is reality
• Standards for ATM codify indigenous knowledge
which leads to protection and preservation
• Standards will lead to development of the ATM
supply chain which has direct implications for:
– Rural job creation through cultivation
– New manufacturing industries
– Traceable and reliable healthcare system
Possible Standards in ATM
• Procedures for
processing medicinal
plants
• Packaging and labelling
of raw materials
• Storage of raw materials
• Sustainable harvesting
• Good Agricultural and
Cultivation practices
Possible Standards in ATM
• Packaging of ATM
remedies
• Certification of production
facilities
• Preparation of ATM
remedies
• Storage of prepared ATM
remedies
• Minimum labelling
requirements for ATM
remedies
• Testing of ATM for residues
and contaminants
Possible Standards in ATM
Consumer
guidance
on how to prepare
ATM remedies
What can standards achieve?
1912 Market – Picture from
K. Flint book titled Healing
Traditions
Picture of Faraday
Market taken in 2012 by
Amanda
What can standards achieve?
Picture of TCM Market,
Guangzhou, China. Taken in 2011
Processed medicinal plants (called
decoction pieces) ready for use in a
herbal decoction at a pharmacy.
Picture taken in Incheong, Korea, May
2012
What Can Standards Achieve?
Ayurveda Commercial
Products
TKM Commercial Products
What can standards achieve?
Documenting of Korean Medicine recognised as a World Heritage by UNESCO
Picture taken at KIOM, May 2012
What Can Standards Achieve?
Innovations in traditional medicine
Chair to facilitate enema (ukuchata)
Source: Google Images
Electric ceramic pot for boiling herbal
medicine
What can standards achieve?
Exhibition of Traditional Korean Medicine taken at KIOM, May 2012
Summary
• Integrated Standards are key for ATM to be recognised
as a “Globally Significant” traditional medicine
• Process supports the stated aims of the WHO to
integrate TM into national healthcare systems
• Supports the creation of a new industries in countries:
– manufacturing sector on the continent – beneficiation of the
“Green Gold” of the continent
– Cultural tourism ventures, including Museums and African spas
Reclaims the African pride – humanity originates from
Africa and so does healing and healthcare
THANK YOU