Indigenous knowledge codification of African traditional medicine: Inhibited by status quo based on secrecy?

Abstract

This paper is located within global debates about the codification of indigenous knowledge (IK) practices vis-à-vis traditional medicine in Africa. Following a theoretical research based on an extensive literature review, the paper questions whether it is possible to codify all elements embedded in Africa’s indigenous knowledge practices in traditional medicine following that the medicine encompasses esoteric and non-esoteric elements. There is a persistent plea for the elements of Africa’s indigenous knowledge practices in traditional medicine to be codified and to desist from its status-quo phenomena of secrecy for posterity. Within Africa’s indigenous knowledge (IK) practices in traditional medicine are certain aspects that it may not be possible to codify. The non-esoteric aspect of African traditional medicine can be codified as it encompasses no secret, while the esoteric aspect may not be codified as it is considered to be secret for a select few traditional healers who exploit it for livelihood. The raison d’être for the examination stems from the notion that Africa’s indigenous knowledge practices in traditional medicine has a high livelihood potential, hence needs to be protected. Traditional healers have over generations fostered relationships with other groups, creating a complex web of high levels of cooperation, exchange and support that are essential for livelihood. Their fast erosion due to internal and external factors poses a serious threat to livelihood development in the subregion. The lack of codification of Africa’s indigenous knowledge practices in traditional medicine gives an urge to western pharmaceutical companies, who make huge profits from indigenous knowledge of medicinal plants. With further theoretical research, the paper exposes the esoteric and non-esoteric elements that encompass African traditional medicinal plants and the possible reasons why the status-quo based on secrecy persists within the esoteric aspects of the medicinal plant practices and how the status-quo may be uplifted within intellectual property rights (IPR) in the form of patent and other approaches for posterity.

Keywords

indigenous knowledge traditional medicine Africa intellectual property rights patents

Introduction

According to Mwaura (2008), indigenous knowledge (IK) is knowledge of an indigenous community accumulated over generations of living in a particular environment. It covers all forms of knowledge – technologies, knowhow, skills, practices and beliefs – as well as cultural knowledge, that encompass intellectual, technological, ecological, and medical knowledge. According to Richter (2003), traditional medicines “include diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness[es]”. The purpose of this paper is to explore whether it is possible to codify all elements embedded in Africa’s IK practices in traditional medicine following that the medicine encompasses esoteric and non-esoteric epistemology.

There is an insistent plea for the elements of Africa’s IK practices in traditional medicine to be codified and to desist from its status-quo phenomena of secrecy for posterity. Following Upadhya et al. (2014), traditional medicine includes various “health practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral based medicines, spiritual therapies, manual techniques and exercises, applied singly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness”. Following this statement, it can be said that traditional medicine and practices can be broadly classified as medicine with a systematic codified body of knowledge either in the form of pharmacopoeias, or ancient scriptures like Ayurveda, Chinese and Tibetan medicine, Siddha, Unani or non-codified system of traditional medicine; folk medicine that is transmitted by oral means and is mostly acquired through trial-and-error approaches; and spiritual or shamanistic medicine that has a strong religious or spiritual element and is practiced only by highly specialized local experts (Upadhya et al. (2014).

In the context of this paper, non-codified traditional medicine encompasses folk medicine that is transmitted by oral means and involves spiritual or shamanistic medicine that has a strong religious or spiritual element and is practiced only by highly specialized local experts. Within African IK, practices in traditional medicine include esoteric and non-esoteric epistemology that encompasses “transdisciplinary [aspect] of indigenous knowledge” (Suchanandan 2018). When traditional healers trail the source of a disease, they seek to ascertain whom, rather than what, caused the disease, as for example, the infringement of secret ancestral taboos may cause many diseases (Kennedy 2011). One can argue that the non-esoteric aspect of African traditional medicine can be codified as it embodies no secret, while the esoteric aspect may not be codified as it is considered to be secret for a select few traditional healers.

The esoteric aspect of Africa’s traditional medicine is exploited by traditional healers for livelihood as it is a specialty within their profession (Overview on Medicinal Plants and Traditional Medicine in Africa 2004). Following Suchanandan (2018), Africa’s indigenous knowledge practices in traditional medicine have a high livelihood potential, hence need to be protected. The rationale for the examination stems from the notion that within Africa’s IK practices in traditional medicine “they have over generations fostered relationship[s] with other groups, creating a complex web of high levels of cooperation, exchange and support that are essential for sustainability. Their fast erosion due to internal and external factors, poses a serious threat to [livelihood] development in the sub region. The lack of codification of [Africa’s IK practices in traditional medicine] gives an urge to western pharmaceutical companies who make huge profits from indigenous knowledge of medicinal plants” (Eyong 2007). Following the World Health Organisation (WHO) (2000) “traditional medicine may be codified, regulated, taught openly and practised widely and systematically, and benefit from thousands of years of experience”. Nasir (2011), defines medicinal plants “as a group of plants that possess some special properties or virtues that qualify them as articles of drugs and therapeutic agents, and are used for medicinal purposes”.

In order to explore whether it is possible to codify all elements embedded in Africa’s IK practices in traditional medicine, this paper first examines the rationale for the codification of Africa’s traditional medicine. Secondly, the paper explores the esoteric and non-esoteric elements of Africa’s traditional medicine practices. Elements that may be codified and not codified are revealed. Thirdly, the paper examines possible reasons why esoteric elements of Africa’s IK on traditional medicine may not be codified. Finally, the paper proposes measures within intellectual property rights (IPR) in the form of patent and other approaches, based on an extensive literature review, that could be implemented for the esoteric element of the medicine to be codified.

Rationale for codification of Africa’s traditional medicine

Among the reasons for the codification of Africa’s traditional medicine is that it belongs to a “sophisticated knowledge of the natural world [that] is not [entirely] confined to science” (Nakashima et al. 2000), as “science and technology seldom embrace the values of local knowledge and traditions” (Posey, 2000). Within Africa’s traditional medicine are plants used to address both physical diseases such as malaria, ulcers, and headache as well as less physical diseases such as infringement of secret ancestral taboos that are considered mental and spiritual. African traditional medicine in its varied forms is holistic, involving both the body and the mind. The traditional healer typically diagnoses and treats the psychological basis of an illness before prescribing medicines, particularly medicinal plants to treat the symptoms (Mahomoodally 2013).

According to Elujoba et al. (2005), traditional healers are recognized by the community as people who are competent to provide an all-round health care treatment. Following Magoro (2008) in characterizing the medicinal properties of plants used by traditional healers, “indigenous taxonomies often ascribe identity and spiritual values to plants”. It is believed that “restoring health requires the forging of a relationship with the spiritual realm” (Waldron [n.d.]). Ross (2010) says, “diseases and disorders are believed to arise from natural, social or psychological disturbances that create disequilibrium expressed in the form of physical or mental problems”. Following Sackey and Kasilo (2001-2010), diseases are viewed as the “failure of complex social and spiritual relationships, and begins with an examination of both human and supernatural interactions”. One can argue that while the physical diseases can entirely be confined to science, the less physical diseases cannot entirely be confined to science. For example, it has been proved scientifically that there is an all-round treatment for malaria by boiling and drinking Artemisia afra leaves that also belong to the Asteraceae family (Okello et al. 2010; Odugbemo et al. 2007). On the other hand, the treatment for an infringement of secret ancestral taboos cannot be entirely confined to science, as it encompasses herbal products and an invocation of spirits that is considered a secret and cannot be scientifically proven (Taye 2009). For example, in cases that a particular sickness is associated with the infringement of secret ancestral taboos, although medicinal plants may be used, traditional healers may be compelled to depart to a special place – shrine – with the medicinal plants to perform certain rights that may entail the pouring of a libation that cannot be scientifically proven, to call on ancestors to lend a hand in treating the patient (Offiong 1999). Following Rukangira ([n.d.]), the features and application of traditional medicine are pretty diverse from western medicine.

The rationale for the codification of Africa’s traditional medicine can be attributed to the fact that it “encompass [a] sophisticated arrays of information, understandings and interpretations that guide human societies around the globe [with regard to]…struggles against disease and injury…” (Nakashima et al. 2000). Pharmaceutical companies around the world use information, understandings and interpretations of Africa’s traditional medicine to manufacture drugs to treat diseases and injuries. For example, the National Cancer Institute (NCI) of the U.S.A. used information, understandings and interpretations of the Maytenus buchananii plant from the Simba Hills of Kenya that was used by the Digo communities to treat cancerous conditions for many years (Mugabe 1998). Also, in Cameroon, Plantecam, a French owned pharmaceutical industry, used information, understandings and interpretations in the exploitation of the bark of a tree - prunus africana- which contains active biochemicals used for the treatment of prostate gland disorder (Bodeker 2000), and Ancistrocladus abbreivatus plants that also contain anti-HIV potential (Okigbo et al. 2008).

According to Mahomoodally (2013), modern medicine has its root in African traditional medicine that is “estimated to contain between 40 and 45,000 species of plant with a potential for development and out of which 5,000 species are used medicinally”. For example, extracts from the root of the Brazilian plant ipecacuanha were used to cure cough (OSB 2013); Acacia Senegal, also known as gum Arabic has been used medically to treat infections such as “bleeding, bronchitis, diarrhea, leprosy, typhoid fever, and upper respiratory tract infections” (Mahomoodally 2013). Furthermore, medical doctors are seen “advising their patients to go and try traditional medicine – the domain of traditional healers - when they meet complicated cases” (OSB 2013), which may involve chasing away spirits. If a patient, for example, tells a medical doctor that he was beaten all night in his bed, a traditional healer “will understand him and help him chase way the spirits” (Hillenbrand 2006). Traditional healers “understand the social problems and cultural experience of their communities [and] use this knowledge in their diagnosis to better treat the invalids, to whom they are very close” (Hillenbrand 2006).

Following that pharmaceutical companies view Africa’s traditional medicines “as possible sources of potent molecules that may be replicated synthetically and patented as sources of new and profitable pharmaceutical products” (Bodeker 2003-2004), provides credit to the codification of the medicine. According to Elujoba et al. (2005), plants that formed the foundation of traditional medicine systems for many years were initially instrumental to early pharmaceutical drug and industry. This is because plants contain mixtures of different phytochemicals “that may act individually, additively, or in synergy to improve health” (Mahomoodally 2013). In Europe and the United States the natural products industry is interested in traditional medicine. In these countries “where the phytomedicine industry is thriving, extracts from medicinal plants are sold in a purified form for the treatment and prevention of all kinds of diseases” (Overview on Medicinal Plants and Traditional Medicine in Africa 2004).

It is reported that approximately 44% of all new conventional drugs are obtained from natural products (Suleiman et al. 2010). Most drug industries exploit medicinal properties in plants to treat illness (Mugabe 1998). Following Mugabe (1998), “pharmaceutical industries have increased their interest in natural products as sources of new biochemical compounds for drug, chemical and agro-products development. Of the 119 drugs developed from higher plants and on the world market today, it is estimated that 74% were discovered from a pool of traditional herbal medicine”. According to Nasir (2011) “modern drug discovery is characterised by the production of vast quantities of compounds”. African traditional medicines contain chemical composition that pharmaceutical companies replicate to produce new drugs that are patented. For example, the isolation of artemisinin from Artemisia annua, gave rise to the discovery of new antimalarial drugs (WHO 2003), and the use of Salix alba, the willow plant containing the salicylates for fever and pain, led to the discovery of aspirin (Elujoba et al. 2005). Furthermore, a US Plant Patent No. 5,751 on ayahuasca, a secret and medicinal plant, was granted to researchers of the Colorado State University (Sahai 2002).

Another rationale for the codification of Africa’s traditional medicine is that it is the major source of health care for approximately 80% of the populace in rural areas (Kasilo and Trapsida 2010). Following Abdullahi (2011), “it [is] the only source of medical care for a greater proportion of the population”. Miller et al. (2000) are of the view that rural dwellers prefer traditional medicine to conventional medicines because the latter are more incompatible with their beliefs and values. In Africa, IK practices in traditional medicine are enforced mainly by the “taboo systems and effective control systems for community compliance” (Magoro 2008). For example, it is believed that sickness is caused by physically evident diseases such as colds and ulcers and less physically evident diseases such as the infringement of secret ancestral taboos. While diseases such as colds could be treated by chewing Tagetes minuta plant leaves that belong to the Asteraceae family, and ulcers by boiling and drinking the root of Heteromorpha trifoliate that belong to the Apiaceae family (Okello et al. 2010), infringement of secret ancestral taboos could not be treated by simple herbs. In order to treat cases that involved infringement of ancestral taboos, traditional healers use traditional knowledge in their “diagnosis to better treat the invalids, to whom they are very close” (Hillenbrand 2006). This form of sickness was treated by traditional healers for livelihood as it involved herbal products and the invocation of spirits to attain an all-round treatment (Taye 2009).

According to Mohamedbhai (2013), “there is a rich body of indigenous knowledge embodied in Africa’s cultural and ecological diversities, and African people have drawn on this knowledge for hundreds of years to solve specific developmental and environmental problems”. Following Mahomoodally (2013), medicinal plants, unlike conventional medicine, have “several chemicals working together catalytically and synergistically to produce a combined effect that surpasses the total activity of the individual constituent”. Furthermore, due to the high cost of conventional medicine and inaccessibility of modern health care facilities in most rural settings (Galabuzu et al. 2010), coupled with the notion that conventional medicine does not cure chronic health problems (Clement et al. 2006), the majority of African dwellers use traditional medicines as a source of health care. Magoro (2008) says the historical use and practice of traditional medicine has demonstrated the safety and efficacy of the medicine. Following Galabuzu et al. (2010), traditional medicine as opposed to conventional medicine has the tendency to decrease the occurrence levels of illnesses. In rural dwellings for example, the leaves of Hippobromus pauciflorus are administered to patients for the treatment of malaria, dysentery, diarrhoea, conjunctivitis and livestock diseases (Pendota et al. 2010).

Esoteric and non-esoteric elements of Africa’s traditional medicines practices: Which elements for codification?

African traditional medicine encompasses herbal and non-herbal components. The herbal elements that may be considered non-esoteric comprise “herbs, herbal materials, herbal preparations and finished herbal products that contain parts of plants or other plant materials as active ingredients” (Mahomoodally 2013). It can be said that these aspects of African traditional medicines can be codified as they do not encompass esoteric epistemology that is exploited by traditional healers for livelihood. Furthermore, it is possible for example, for Western pharmaceutical companies to use the herbal elements of Africa’s medicinal plants as “many plant drugs even in the crude form are well known in the international markets” (Elujoba et al. 2005). Western pharmaceutical companies can use the herbal elements for the isolation of single purified drugs, for example, “digitoxin extracted from digitalis and vincristine from Catharanthus rose”, and extract saponins to produce sapogenins required to manufacture steroids (Kuipers 1997). One can argue that these plants can be codified as they are non-esoteric and do allow pharmaceutical companies to develop modern medicine for posterity.

On the other hand, the non-herbal elements that may be considered as esoteric include herbs, animal and mineral material used for physical as well as spiritual purposes. It can be said that the non-herbal elements may not be codified as they are mostly tacit (Sackey and Kasilo 2001-2010). The form of traditional medicine that encompasses spiritual, supernatural, magical, mystical, or metaphysical procedures cannot easily be investigated, rationalized, codified or explained scientifically. For example, the explanation for the use of oracular consultation in diagnosis and treatment of diseases, or the use of incantations for healing purposes, is “beyond the ordinary scientific human intelligence or intellectual comprehension” (Elujoba et al. 2005). In many African cultures, health, disease, success or misfortunes are considered the result of the active influence of individuals or ancestral spirits (Mckean 2007). Traditional healers use traditional medicine as “a form of holistic health that combines spiritual beliefs and herbalism to treat patients” (Kennedy 2011), as traditional medicine “accepts that disease can have supernatural causes” (Hillenbrand 2006). One can argue that the inclusion of the herbal and spiritual elements to treat illnesses by African traditional healers’ stems from the fact that when extreme illnesses arise, traditional healers use “herbal medicines for equalizing unbalanced relationships within the social or spiritual order” (Kennedy, 2011). This is because traditional medicine spreads beyond the medicines themselves. It covers a wide scope of experiences, practices, and products, including herbal medicine, spiritual practices and exercises (Mpinga et al. 2014). According to Kale (1995), traditional medicinal notion is that disease is a mystical wonder administrated by a hierarchy of powers starting with a most commanding “deity followed by lesser spiritual entities, ancestral spirits, living persons, animals, plants, and other objects”. Following that the spiritual aspect is esoteric, it cannot be codified as traditional healers exploit this aspect for livelihood. In practicing their healing trade with medicinal plants, traditional healers continuously maintain the secret aspect of their practice in treating cases that deal with, for example, the infringement of ancestral taboos, as it is alleged to be associated with spiritual, herbal and technical knowledge (Homsy et al. 2003).

Possible reasons why esoteric elements of Africa’s indigenous knowledge on traditional medicine may not be codified

The esoteric elements of Africa’s traditional medicine may not be codified because they embrace spiritual elements that are considered as secret since time immemorial and recognized by ethnic communities (Gervais 2003). Overview on Medicinal Plants and Traditional Medicine in Africa (2004), reports that rural African populations have relied upon the spiritual and practical skills of traditional medicinal practitioners, whose botanical knowledge of plant species and their ecology and scarcity is irreplaceable. Following Waldron ([n.d.]), Africa’s traditional medicine is “premised on the interrelationship between the living and the nonliving, natural and supernatural elements and the material and the immaterial”. For anyone to gain access to the secret part of traditional medicine one will need to be initiated into the practices of traditional healers. This is because African health systems focus on diseases originating in the body and beliefs that people hold about spiritual diseases and cures that are inherited from past generations (Waldron [n.d.]).

Notwithstanding that there are calls to dispel the mystery and secrecy of African traditional medicine through modern research and useful publications (Makinde 1988), the medicine may not be codified in its entirety as traditional healers hand down part of the knowledge of the medicine by word of mouth. Olatokun and Ajagbe (2010: 122) opine that knowledge of traditional medical practice is revealed orally. Ismail and Fakir (2004) are of the view that among the characteristics of IK is that it is informal and unwritten. Traditional medicines embrace herbal and non-herbal elements. While traditional healers may reveal the former, the latter may not be revealed as it involves spiritual features (Sackey and Kasilo 2001-2010), that are not to be violated for fear of being killed. It is believed that if the secret elements of traditional medicine are revealed by a traditional healer the supernatural creature can inflict injuries (Tlhagale [n.d.]), such as death (Offiong 1999), to the healer. Following Yinegar and Yewhalaw (2007), indigenous knowledge transfer is based on oral transmission. The non-release of the full content of traditional medical knowledge – the herbal and non-herbal elements - by traditional healers renders the medicine ineffective as “no single active constituent is responsible for the overall efficacy” (Tarkang et al. 2012). Sackey and Kasilo (2001-2010) are of the view that traditional medicine has “different components that could be considered on their own merits”. In cases involving the infringement of ancestral taboos both the herbal and non-herbal elements of traditional medicine are considered inseparable (Waldron [n.d.), as it encompasses an all-round treatment.

The secret element of Africa’s traditional medicine may not be codified because it is not revealed to non-practitioners for fear that it will be stolen and exploited without the consent of the possessors of the resources and knowledge. Following Britz and Lipinski (2001), IK of underdeveloped peoples is a sought-after commodity in today’s marketplace in developed countries. It is reported that Western science makes a lot of money from medicinal plants “without the consent of the possessors of the resources and knowledge” (Sahai 2002). Yalae (2008), reports that “foreign companies see medicinal plants as commercial commodities to profit from”. For example, following Mugabe (1998), the National Cancer Institute (NCI) of the U.S.A. collected and traded Maytenus buchananii from Simba Hills of Kenya in the 1970s that the Digo communities used to treat cancerous conditions without the recognition of the Digo communities. According to Rees (1999), pharmaceutical industries have “reached a sense of exhaustion in the development of synthetic drugs, and are now focusing their attention onto higher plants for potential cures”. Following that African traditional medicine is a source of livelihood to traditional healers (Galabuzi et al. 2010), traditional healers may not want to reveal the spiritual elements implanted in traditional medicines for fear of relinquishing the economic gains they derive from the medicine. Sackey and Kasilo (2001-2010) are of the view that economic sustainability is an ingredient of traditional medicine. According to Mbogo (2009), traditional healers have ceaselessly resisted attempts by conventional medicine to disclose the active ingredients of their medicines, for fear that their knowledge will be stolen and they will be prevented from generating income from the use of their medicine. According to IK Notes (2003), traditional healers are accustomed to procuring economic gains from medicinal plants.

Also, it can be said that the esoteric elements of Africa’s traditional medicine may not be codified following the low level of education of the practitioners of the medicine, that makes them see those that are not in their trade as wanting to steal their knowledge. Following a study conducted by Upadhya et al. (2014), it was discovered that traditional healers were illiterate and fell into the older age group of 61 years and above. Only 21% of traditional healers had higher education up to bachelor’s level and a large number had “only primary education and left school once they learnt reading and writing”. Olatokun and Ajagbe (2010) are of the view that the low level of education of traditional healers denies them “access to knowledge that could improve and make their services…more relevant to the health needs of…society”. It can be argued that where the educational level of traditional healers is high, it “can help them identify plants with market potential that can generate incomes” (Weldegerima 2009). On the contrary, where their educational level is low, they “stand to be robbed of their knowledge of traditional medicine and income because of ignorance about what value their medicines carry’ (Tjaronda 2008).

Furthermore, the esoteric elements of traditional medicine may not be codified because of the inadequate recognition of traditional practice by most African governments, notwithstanding that “for centuries man has used self-coined traditional means for treating ailments, and continues to use them alongside modern medicine even today” (Olatokun and Ajagbe 2010). Most African governments believe that traditional medicine cannot be relied upon because it is not documented (Olatokun and Ajagbe 2010). Sambo (2003) opines that traditional medicine is not included into Africa’s national health care systems because the medicines are not politically recognized because of their method of preparation. According to Kasilo and Trapsida (2010), traditional medicine is associated to inappropriate preparation. Selby (2009) is of the view that most traditional healers employ unhygienic methods when preparing and administering traditional medicine.

The non-integration of traditional and orthodox medicine practices may be a reason for the non-codification of the esoteric elements of traditional medicine. Olatokun and Ajagbe (2010) are of the view that while traditional healers’ environment is “pervaded by secrecy, knowledge of the practice is mostly undocumented…orthodox medical practitioners constantly disseminate knowledge of their practice in documented and electronic formats”. It is reported that the non-integration of both traditional and orthodox medicine stems from the fact that traditional healers are of the view that orthodox doctors are ignorant on the potency of their medicine, the “orthodox doctors [do] not believe in tradition or what traditional [healers claim] to be capable of doing with regard to the treatment of ailments and diseases, and orthodox doctors [do] not accept traditional ways of diagnoses and treatment” (Olatokun and Ajagbe 2010). Also, according to Okulo (2009), orthodox doctors disapprove of traditional medicines for lack of peer review and scientific scrutiny that are supported by research findings. Following Kasilo and Trapsida (2010), the quality test and production standards of traditional medicines are less thorough. Whitehead (2003) is of the view that traditional medicine is subject to the scientific scrutiny of orthodox medicines. Kasilo (2003) opines that traditional medicine lacks enough data on the evidence-based safety, efficacy and quality of its product.

The absence of guidelines for policy standardization, formulation, regulation, promotion and development of traditional medicine may be another reason for the non-codification of esoteric elements of African traditional medicine. Following Kasilo and Trapsida (2010), the lack of guidelines on traditional medicial products has the potental to lead to patients taking larger quantities of the product than required on the premise that traditional medicine products carry little risk as they are naturaly opposed to orthodox medicines. According to Sambo (2003), traditional medical products lack regulatory and legal guidelines for practice. Lewis (2009) say traditional medicine does not carry specific warnings about interactions with other medicines and statements on whether its effectiveness has been demonstrated in clinical trials. Hence, it is possible for traditional healers to deceive their clients as to the effectiveness of their medicines. For example, traditional healers deceived patients that orthodox drugs worked temporary as a cure for TB and malaria and that homeopathic preparations were cheap and effective alternatives with fewer effects (Sample 2009). Miller et at. (2000) say that traditional medicine products lack uniform standardization by which ingredients of a herb are identified, and that all batches of the herb created by a single manufacturer enclose the same amount of active ingredient. Kasilo and Trapsida (2010) opine that the standardized preparation method of traditional medicine products is more complex as it is difficult to perform quality controls on the raw materials. Owing to the complexity of traditional medicine products, Kasilo and Trapsida (2010) assert that the products are subjected to rigorous guidelines like orthodox medicines to guarantee their safety, quality and efficacy. Upadhya et al. (2014) asserts that “present regulatory policies are not fully capable of defining traditional medicine in terms of quality control with respect to medicine or practice”.

Possible measures for the esoteric element of the medicine to be codified?

One can argue that traditional healers may reveal the secret elements of traditional medicine if, for example, a mechanism is put in place to guarantee the healers a continuous flow of income when they release the secret, as the secret “knowledge is intangible” (Britz and Lipinski 2001). Such a mechanism could be a legal agreement that would state that all proceeds acquired from the medicine would be shared with herbalists that revealed the plant with its spiritual elements (Gamaniel 2003), for possible codification. According to Ismail and Fakir (2004), it is possible for compensation to be shared with traditional healers by cartels established to “manage differing interests of multiple indigenous owners”. This could be that a legal agreement of the governments of countries where the traditional healers come from that would enact proper intellectual property rights in the form of patent laws to back the agreement. The motivation for patent protection is to enable the traditional healers to prevent others from making, selling, or using their product. Upadhya et al. (2014) are of the view that “firm and strong initiatives are required, both at the national and international levels, to protect the intellectual property rights of traditional [healers]”. Britz and Lipinski (2001) are of the view that plants can be patented, and “a large number of patents has been granted on generic resources and knowledge obtained in developing countries” (Sahai 2002). According to Wilder (2001), “countries are obliged to provide patent protection for any inventions, whether products or processes, in all fields of technology”. It can be said that through patent laws the secret elements of traditional medicine may be revealed as the patent would give traditional healers a “legal monopoly with the right to profit economically” (Britz and Lipinski, 2001). Following Ismail and Fakir (2004), patents offer “rewards for the inventors via the prevention of free-riding”. This is because a patent contains a “statement of claims about the thing patented” (Britz and Lipinski 2001).

Furthermore, for traditional medicine to be codified, it may be germane for the global scientific community and policy makers to investigate the issues between traditional healers and orthodox practitioners to understand how they can be integrated to “overcome the constraints in traditional medicinal practices and maximize its utilization” (Upadhya et al. 2014). According to Olatokun and Ajagbe (2010), “those who believe in the practice, including social scientists, ethno medical scholars and health workers as well as government policies have advocated the integration of traditional and orthodox medicine”. This is a common practice in other parts of the world. For example, in Sri Lanka, “traditional medicine (called Ayurveda medicine) has been integrated into the health care delivery system and it is accorded the same status as orthodox medicine” (Olatokun and Ajagbe 2010). It is reported that traditional healers refer some of their patients to the orthodox doctors for thorough medical examination, diagnosis and treatment and orthodox doctors come to seek information from traditional healers for the “treatment of sickle cell anaemia” (Olatokun and Ajagbe 2010). The integration of traditional medicine and orthodox medicine has the potential to generate fruitful discussions among the practitioners of traditional medicine and orthodox medicine and the public at large, as was reported in Nigeria (Olatokun and Ajagbe 2010). However, where there is integration of traditional medicine and orthodox medicine, the “issues of integration, cooperation and collaboration between traditional and orthodox medicine have [to be] clearly defined” (Olatokun and Ajagbe 2010). It can be said that when there is integration of traditional and orthodox medicine, orthodox doctors may not be ignorant on the potency of traditional medicine, orthodox doctors will believe in tradition or what traditional healers claim to be capable of doing with regard to the treatment of ailments and diseases, and orthodox doctors will accept traditional ways of diagnoses and treatment.

In order to codify traditional medicine, tailormade systems, such as associations that are buttressed by governments, need to be established by traditional healers to prove the science of traditional medicine. Through the associations the interest of practitioners would be safeguarded, and their knowledge conserved (Upadhya et al. 2014). This is because the “associations could…collect information about the practices of their members, and subject them to some open debate [within the associations], then good practice might drive out less effective practices…and the associations would be in a better situation and have a basis to accredit…[traditional healers]” (Olatokun and Ajagbe 2010). Traditional healers pay more allegiance to associations. Following a survey conducted in Nigeria, it is reported that a significantly high percentage of traditional healers sourced information from master healers, their colleagues and local associations, while fewer of them claimed to source information from orthodox doctors. Also, the levels of cooperation among traditional healers were high because of the “associations they belonged to” (Olatokun and Ajagbe 2010). Olatokun and Ajagbe (2010) opines that traditional healers “devotion to and faith in the local associations to which they [belong], especially the professional associations, [influence] their disposition to information [they receive] from sources outside their practice”.

Also, for traditional medicine to be codified, traditional healers should be encouraged to attend any formal training institutions or colleges of traditional medicines to be able to test the efficiency of their medicine. Following their low level of education, it can be argued that they lack the modern research methods to test the efficiency of their drugs (Olatokun and Ajagbe 2010). When traditional healers are educated, they will be able to identify and classify their medicines according to family, gender and species to avoid confusion or error (Ranaivoravo 2003). Furthermore, traditional healers will be able to source information from many sources and avoid the fear that their medicine will be stolen and exploited without their consent. With better educational background, they will be able to source more information from newspapers, magazines, libraries, the Internet, seminars, workshops, conferences and medical journals as opposed to their colleagues, master healers and associations. It is reported that because of the low level of literacy among traditional healers they source most of their information from the latter instead of the former sources (Olatokun and Ajagbe 2010). According to Olatokun and Ajagbe (2010) ‘the low level of education coupled with the culture of secrecy that pervades traditional medical practice predisposed the practitioners to believe a trusted colleague rather than any formal source of information. Hence, when traditional healers are educated, the factors for the rejection of their medicine that encompass lack of education and training will be overcome.

Conclusion

Notwithstanding that Africa’s IK practices in traditional medicine can be codified, only the non-esoteric elements can be codified. It may be difficult if not impossible to codify the esoteric aspect of traditional medicine, as traditional healers use the esoteric elements as a source of livelihood. In order to codify the esoteric elements of the medicine, traditional healers may have to be compensated financially through patents, as they are the ones to “identify plants and animals used in particular treatments” (Ismail and Fakir, 2004: 181). One can argue that not until the financial aspects, policy and advocacy cease to be the cardinal points through which traditional healers make their livelihood and instead provide avenues through which IK could be codified, it will be impossible or difficult to codify all aspects of traditional medicine, especially those used by traditional healers to treat infringement of traditional taboos.

Footnotes

ORCID iD

Charles Akwe Masango

References

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