03 May 2005, The Star
Our country contains 25 000 species of plants - one tenth of the world's known floral biodiversity, as well as diverse insects and animals and marine biodiversity. Our soils contain all kinds of minerals and trace elements, that provide the milieu for the growth of plants, and our habitat includes all the different climates of the world. Our peoples include racial groups from all over the world, and our San people have the oldest genes in the world.
These are some of the important facts we have to bear in mind as we move towards regulating various sections of the health sector. In the area of medicine control, we have identified at least 18 categories of medicines including conventional and alternative medicines that have to be regulated in the country.
We have also developed a legislative framework to encourage the development of natural products for human health through the Medicines and Related Substances Act. The Act seeks to regulate the use of complementary, alternative, African Traditional and other categories of medicines in South Africa to ensure quality, safety and efficacy. However in finalising the regulations of these medicines, we are avoiding the pitfall of putting such products in the same regulatory environment as pharmaceuticals drugs; whose testing and control is very different.
We cannot transplant models designed for scientific validation of allopathic medicine and apply it to other remedies. There is need for creativity to come up with relevant and pragmatic models to prove safety, quality and efficacy of complementary, alternative and African traditional medicines. This is what the Department of Health will seek to achieve when finalising the regulations in this area under the Medicine Control Act and in developing guidelines for evaluation of these medicines.
South African government has been at the forefront of re-establishing the traditional knowledge systems in the quest for human health. The Department of Health and other government structures have provide support for Traditional Medicine Research as well as the promotion of other fields of inquiry in Indigenous Knowledge Systems.
The study of Indigenous Knowledge Systems is not simply a scientific endeavour. It provides an opportunity to reclaim our scientific and socio-cultural heritage which was stigmatised and discredited as primitive rituals and witchcraft during many years of colonialism and apartheid. Traditional knowledge systems are indeed much older than the 150-year-old allopathic medicine, and draw on the rich heritage and knowledge of the earliest civilisations of the world in Africa, Central America, China and India.
We need to expose the false dichotomy that had arisen between natural medicine and allopathic medicine, a division fostered by the need to make money from patented drugs through discrediting the use of natural products.
The Department of Health's support for African traditional medicines research has included a R6 million grant channelled through the Medical Research Council of South Africa, for research into the safety, efficacy and quality of traditional medicines used as immune boosters by people living with HIV and AIDS. This field of research has shown promising results with completion late last year of Phase I trials in healthy human volunteers of one of the 5 candidate preparations.
We are also supporting research in our universities and science councils into the efficacy of many traditional medicines used for conditions such as tuberculosis, malaria, asthma, cancer, diabetes, anxiety and stress, and musculoskeletal disorders. In some instances our scientists have extracted and characterised the active chemical moieties for possible development as novel drugs. In other cases, the approach has been to use the natural product in native state and study its safety and efficacy.
We have ensured that Traditional Health Practitioners are not subsumed by the medical and allied health professionals; but are able to regulate their own affairs through the Traditional Health Practitioners Act. The estimated 200 000 Traditional Practitioners are consulted by over 80% of our population and therefore this field require some degree of regulation.
Our Government also supports research into the role of nutrition in human health including the use of different foods, micronutrients and vitamins in conditions such as HIV and AIDS, diabetes and osteoporosis. Indeed nutritional supplementation and traditional medicines are important components our Comprehensive Plan for Management, Care and Treatment of HIV and AIDS. This approach has been vindicated by recent studies such as the Harvard University study that showed a 30% reduction in mortality of HIV positive women in Tanzania with the use of multivitamin; and the Zambia/British MRC trial which indicated a 50% reduction in mortality in children with AIDS when given cotrimoxazole.
There were also reports on the study conducted by North-western University in Chicago which identified oleic acid - the main component of olive oil - as the main factor that protects women who consume olive oil from developing breast cancer.
The International Conference on Natural Products and Molecular Therapy held in Cape Town in January this year unravelled the molecular mechanisms that explain the effectiveness of a whole host of everyday fruits, vegetables and spices in promoting health and reduce the impact of diseases. The conference highlighted the importance of the Mediterranean Diet in heart health, particularly the centrality of monounsaturated fats such as olive oil. It helped explain the observation that such a diet containing olive oil has been shown to reduce mortality after a heart attack by 70% in the Lyon Heart Study - a figure twice that achieved by statin drugs. It reduced death from heart disease by 30% in initially healthy Greek men taking a Mediterranean Diet.
We look forward to the exciting developments ahead in this quest to use the methodologies of molecular medicine in the study of natural products. We need to better understand the functioning of our own bodies, minds and spirits; and increasingly understand how we interact with our environment. The application of such knowledge should result in the promotion of health, prevention of sickness and better management and treatment of many of the diseases that affecting humankind.
Since the study of medicine began over 5 000 years ago in the medicinal herbariums of Ancient Egypt, we should be able as Africans to come up with a sound model to evaluate safety, quality and efficacy of the remedies we have used for hundred of years.
Dr Manto Tshabalala-Msimang
Minister of Health