Promotion of Public HealthCare Using African
Indigenous Knowledge
Systems and Implications
for IPRs: Experiences fromSouthern and Eastern
AfricaHassan O. KayaATPS SPECIAL PAPER SERIES No. 30

Published by the African Technology Policy Studies Network, P.O. Box 10081, 00100
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ABOUT THE AFRICAN TECHNOLOGY POLICY STUDIES NETWORKThe African Technology Policy Studies Network (ATPS) is a multi-disciplinary network of researchers,
policy makers, actors in the private sector and other end users interested in generating, promoting
and strengthening innovative science and technology policies in Africa. With a regional secretariat in
Nairobi, the network operates through national chapters in 23 countries, with an expansion plan tocover the entire sub-Saharan Africa.
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Research Paper Series (RPS), Special Paper Series (SPS) and the Technopolicy Briefs.
Papers published under the ATPS Special Paper Series are those commissioned as concept
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our knowledge brokerage function, ATPS publishes, with permission of the author(s) or
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researchers for a different purpose but judged by ATPS to be of excellent quality. Thesepapers address significant policy questions relevant to the work of ATPS and/or support
the Southern voice or an African perspective. We also consider theoretical papers that
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Acronyms

AIKS
ASF
CBD
CSIR
ECF
EVM
FAO
ICT
IK
IKS
IP
NEPAD
NGOs
SANBio
STDs
TAWG
TB
TB
THETA
UDHR
VPH
WHO

African indigenous knowledge systems
African swine fever
Convention of Biological Diversity
South Africa’s Council for Scientific and Industrial Research
East Coast Fever
Ethno Veterinary Medicine
Food and Agriculture Organization of the United Nations
Information Communication Technology
Indigenous Knowledge
Indigenous Knowledge System
Intellectual Property
New Partnership for Africa’s Development
Non-governmental organizations
Southern African Biosciences Network
Sexually Transmitted Diseases
Tanga AIDS Working Group
Tuberculosis
Tuberculosis
Traditional and Modern Health Practitioners together against AIDS
Universal Declaration of Human Rights
Veterinary in Public HealthWorld Health Organization

Table of Contents

1.

Introduction

2.

African Indigenous Knowledge and Technology Systems in
the Mitigation of Diseases

3.

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3

African Indigenous Knowledge and Technology Systems inFood and Nutrition Security

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4

Ethno Veterinary in Public Health

95

The Role of Traditional Belief Systems in Public Health

126Interfaces between African Indigenous Knowledge andWestern Knowledge System in Public Health Care

13

7

Implications for Intellectual Property Rights

16

8Conclusion and Recommendations

18

References

19

Introduction

There are various definitions of Indigenous Knowledge (IK). The term refers to a distinctive body ofknowledge and skills including practices, technologies that have been developed over many
generations outside the formal educational system, and that enables communities in their specificenvironments to survive (Mascarenhas, 2004). IK contrasts with the international knowledge systemgenerated by universities, research institutions and private firms in that:q IK is generated within communities
q IK is location and culture specificq IK is the basis for decision making and survival strategies
q IK is not systematically documented
q IK concerns critical issues of human and animal life: primary production, human andanimal life, natural resource management
q IK is dynamic and based on innovation, adaptation, and experimentation
q IK is oral and rural in nature
In the past, African indigenous knowledge systems (AIKS) were neglected and marginalized becauseof the periphery nature of Africa in the global economy. The role of AIKS in household food security
and nutrition, as well as in coping with evolving public health problems in Africa, such as the impact
of HIV/AIDS, tuberculosis (TB), malaria and other dreadful diseases have, until recently been poorly
recognized and supported by governmental and non-governmental organizations (NGOs). However,in spite of this marginalization of AIKS, a large proportion of the African people rely on IK systems fortheir daily lives. In various sectors of life, people have not adopted the modern western knowledge
and technology systems because they cannot afford them and they are also unsustainable (Kayaand Materechera, 2004).
In recent years, there has been a dramatic increase in interest in the role that AIKS and technologies
can play in sustainable development. This interest is reflected in a myriad of community based
activities utilizing AIKS for public health care including human resource capacity building in his area.
The World Health Organization (WHO) (2002) defines public health as an aspect of health services
concerned with threats to the overall health of a community. It generally includes surveillance andcontrol of infectious diseases and promotion of health behaviors among members of the community.
Public health promotes not simply the absence of disease but mental, physical, and emotional wellbeing.

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Furthermore, the globalization process has made it imperative that AIKS cannot be ignored as they
are increasingly seen as part of the global body knowledge. It was in recognition of this important roleof IKS in sustainable development that it was identified as one of the flagship programmes of the
New Partnership for Africa’s Development (NEPAD) Southern African Biosciences Network (SANBio)
Initiative. The Initiative is establishing biosciences networks of centres of excellence involved inresearch and development in the region. The holistic nature of IKS and its interface with the otherflagship areas (biotechnology & biodiversity & technology) was recognized as an important tool for
addressing the diverse challenges facing the region including public health care issues.
The challenge for African policy makers and researchers is to create the right environment for more
research on the role of IKS in promoting public health care issues and sustainable development.
They should take advantage of the forces of globalization, such as the information and communication
technology (ICT) to promote collaborative research and networking.
Using documented examples from various countries in Southern and Eastern Africa, the paper
shows the role of African indigenous knowledge in promoting public health care and associatedhuman resource capacity building. African indigenous knowledge and technology systems are usedin the mitigation of human and animal diseases; and in promoting community food security andnutrition. The paper also presents examples of the interface between African indigenous knowledge
and Western knowledge systems in promoting public health care; and the implications for intellectual
property rights (IPR).

2.
African Indigenous Knowledge and Technology
Systems in the Mitigation of Diseases

The knowledge of and uses of specific plants and animals for medicinal purposes (often referred toas indigenous or “traditional medicine”) is an important component of African indigenous knowledge
systems (AIKS). Saray (2001) shows that in most African countries, traditional medicine is used byroughly 70-80 percent of local populations to deal with their basic health care needs. Like in theother regions of the continent, the Eastern and Southern African regions have some of the richest
flora and fauna in the continent. Lowlands, highlands, inland lakes and a variable climate produce
a multitude of biotopes: semi- deciduous or humid forests, savannah and steppe, Miombo forests, allcontribute to this exceptional bio-diversity of these regions. As will be shown in the following sections
some of the plant species have considerable economic, medicinal and nutritional values for therural populations.
Both Eastern and Southern African regions have been severely affected by the HIV/AIDS pandemic.
Various efforts including the use of AIKS are currently being promoted in various countries to mitigate
the spread of the pandemic. For instance, a documentation of the activities of traditional healers invarious parts of Tanzania involved in HIV/AIDS mitigation indicates that the immune system of HIV/AIDS patients could be boosted by indigenous medicinal plants with enzyme rich food stuffs. These
include oils from plants, such as soya, cashew and shea butter saturated fats, and wild fruits.
Vegetables with high fibre content that patients were encouraged to consume were helpful in cleansing
the body system. Though these diet and nutritional therapies did not cure the disease, they, however,improved the immune system of the patients. The therapy also involved the elimination of stressbound foods and liquids from patients’ diet, such as coffee, black tea, sugar, salt, white flour as wellas concentrated carbohydrates, such as white rice. Experience shows that the treatment helps toreduce the physical and psychological symptoms that go with the AIDS disease, such as rashes,
blisters, respiratory syndromes and stress/depression. The documentation also shows that natural
juices, and traditional foodstuffs and medicinal preparations can improve the immune system of
AIDS patients and may be far less tedious in relation to their effects and cheaper than a treatment
based purely on western- oriented medication (Marecik, 2002).
Tanzania is one of the countries in Africa most affected by the HIV/AID pandemic. For many years
there have been no drug for the management of the disease. Therefore, due to scarcity of drugs forthe management of the disease many people, in both rural and urban areas, opt for African indigenous
health and medical services for the control of the disease. For example, Muhanse M4® is a traditional

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herbal preparation prescribed by the Munufu Traditional Medicine Research Clinic in Dar es Salaam.
Muhanse M4® has a long history in herbal medicine for boosting the body immunity of people invarious parts of Tanzania, particularly in Mufindi and Kilombero districts. Muhanse M4® is just astandard infusion or weak decoction of ready prepared powder from whole plant or its parts. It has
been in use since 1987. In spite of the current availability of modern anti-retrovirals (ARVs), thisindigenous medicine is in continual use among local communities due to its affordability (Mhame,2004).
In South Africa, an indigenous African potato (Hypoxis) that is a medicinal plant growing in KwaZuluNatal Province among the Zulu people is traditionally used to treat chronic viral and bacterial diseases.
Traditional healers have been using it to treat cancer of the bladder and prostate, and sexuallytransmitted diseases (STDs). Studies done on the plant have shown that it contains two substances
called sterols and sterolins that are essential dietary fats or lipids. The plant has helped many people
to recover quicker from chronic and other diseases. It is a partly poisonous root, but with the rightpreparation and dosage, it is an approved immuno booster to assist the body’s natural defence
system. The University of Stellenbosch (South Africa), for instance, has conducted extensive researchon this traditional medicinal plant and has developed easy to take tablets. There are indications that
although the potato is not a sufficient treatment on its own, it could be extremely helpful whencombined with other forms of treatment. Studies in the same university on HIV care revealed that theplant had shown the ability to increase CD4 counts (the amount of white blood cells in the body);
stabilise the patient; increase the weight of patients; and decrease the amount of HIV in the body (deKlerk, 2004).
Malaria is another dreadful disease killing millions of people, especially children, in many parts ofAfrica. The Tugen people in Kenya, who are part of the Kalenjin ethnic group living in the Rift Valley
Province, believe in natural and non-natural causes of illness. Some of the Tugen, for example,
believe that malaria is caused by Cheko che makiyo (fresh unboiled milk), dirty water, and ikwek(vegetables), such as Solanum nigram and Gynadropis gynadra. Tugen aetiological beliefs onmalaria are logically valid, especially within the ecological context in which they live. The kipsaketinik(herbalist) generally prescribes and dispenses aqueous medicines prepared from roots, leaves,bark, and other plant or animal part. According to the Tugen indigenous diagnoses, esse (malaria)
is the result of excess bile in the body. The bile has to be expelled before healing can take place.
Thus purgation is regarded as the key treatment regimen for malaria. On the basis of this knowledge,
different forms of herbal medications are prescribed according to the severity of the illness (Aman,
2000).
In Tanzania, indigenous people are actively involved in a malaria control research project in Mtwara
and other areas of the country. They assist in identifying the type of trees whose leaves, barks or roots
are used as medicine to cure malaria. They also identify plant species that are repellent to mosquitoes(mosquitoes are vectors of malaria parasites). This is based on the acknowledgement that many
indigenous groups have excellent knowledge of cures and treatments for some of the most common
diseases that afflict them, and should be involved in studies regarding these diseases (Saifert, 2005).

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As already indicated, traditional medicine plays an important role in public medical and health carein Africa because most people cannot afford Western medical services. In most rural and urban
areas of Eastern and Southern Africa, traditional medicine vendors are a common scene in themarketplace where they are traditional healers and pharmacists. They are the local population’s
main medical resource. They are known to possess a special connection to plants, and for theirknowledge of sacred artefacts used to invoke their healing power. Their knowledge comes fromexperience, from trial and error with plant remedies, from methods passed down from generation to
generation. Thus, for example, the Maasai in East Africa use vine to deaden pain; the bark of thebaobab tree that is boiled down to a broth to relieve back pain. Since the baobab tree is held sacred,only the needed portion of the bark is cut. Moreover, the leaves and barks of certain trees are used tostimulate gastric juice secretion in the treatment of digestive disorders. In addition, building on local
traditional medicinal knowledge, a tea made of dried stem barks of ‘Strychnos myrtoides’, is used by
the Zigua, Ndorobo and Maasai in East Africa to enhance the action of chloroquine against resistantparasite in the treatment of malaria ( Kindamba, 2002).
African indigenous knowledge is also widely used in other areas of public health in the two regions.
Saifert (2005) observed that the Sambaa and Zigua in Tanzania and Zulu people in South Africa use
plant-based contraceptive methods dating from ancient times. The local people in these ethnic
groups are sensitive to the issue of unwed-mothers who would tarnish the family image, and are also
concerned about women’s health. Women are considered an essential pillar in the family structure.
For these reasons, girls are forced by their parents into practicing traditional forms of birth control.
They are given herbal preparations to take on their first menstruation day each month. This plantbased medicine is also used by women who have just given birth to assist their recovery and for thepractice of child-spacing. A number of elderly women in these ethnic groups have been the keepersof this knowledge for generations.
In Ethiopia, local communities in both rural and urban areas use a mixture of coffee powder andhoney, known as, mar ba buna, prescribed by local healers throughout Ethiopia as a medicine totreat diarrhoea, and is reported to be efficient. The coffee has to be roasted and grounded, and thehoney is supposed to be taken from bees preferably in October, when most varieties of flowers
flourish. About 50 to 100 grams of freshly grounded coffee powder are mixed with an equal amountof honey in a cup. The patient takes the mixture orally. It is said that diarrhoea stops after taking one
dose of this traditional medicine. This is an easy-to-prepare and cost-effective traditional medicine
that could be transferred to other African communities.
Illnesses of the lung, such as asthma, pneumonia, tuberculosis are known by traditional healers inmany parts of Southern and Eastern Africa and treated as such. For instance, there are two types ofhealers in Ethiopian countryside treating various types of diseases: The bone setter called wogesha
who treats fractures, and the medicine man or knowledgeable person called medihanit awakge(medihanit means medicine, awakge means wise) who treats other common illnesses and dispenses
herbal remedies. The medihanit awakge provides herbal medicine to treat asthma. Asthma isdistinguished from colds, pneumonia, tuberculosis and other illnesses of the lung by Ethiopian

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ATPS SPECIAL PAPER SERIES NO. 30(Amharic) traditional healers. Pneumonia is very common, associated with exposure to cold air, andtreated with cupping in the home. Tuberculosis or samba nkersa (samba means lungs, nkersa
means cancer) is recognized as a more serious and severe illness, treated by isolation due to its
communicability. There is no stigma or taboo associated with asthma. People are aware that one
can die from asthma. Although it is occasionally seen among children, it is more common among
the elderly. Children are also thought to grow out of their symptoms. The etiology of asthma is
unclear. Some think it is contagious to some extent because it is associated with tuberculosis (TB)
that is known to be communicable. Asthma is dealt with by changing residence and moving awayfrom a climate or environment; this makes it worse. It can also be prevented, according to thehealers, by avoiding dust and pollen that make it worse (dust, pollen). It is treated by using a special
honey called tazma mar, also used for other types of cough. The healing secrets of the medihanit
awakge are passed down from generation to the next (ZIRCIK, 2002).
The Suri of the Käfa Region in the Ethiopian Southwest use the crushed leaves of the Evolvulus
alsinoides (L.) plant, (locally known as, kéya-guy) to apply to fresh burns. Young Suri children often
fall into the fire in the centre of the dark Suri hut. Therefore, this is a common community problem.
The Suri and other ethnic groups also use the Rhus natalensis Bernh. ex Krauss plant, (locallyknown as keyáy) leaves as medicine for bleeding wounds. The leaves are chewed and mixed withsaliva and then applied to the open wounds. This indigenous medicinal practice is also used forsimilar treatment of wounds by other ethnic groups in both Eastern and Southern Africa such as theZigua and Sambaa in Tanzania, the Shona in Zimbabwe and Tswana and Zulu in South Africa.
The Giriama community in Eastern Kenya depend on “Arabuko-Sokoke” coastal forests for their
supplies of medicine and food security. They use plant species to prevent or treat infectious diseases
for wounds, boils, scabies, diarrhoea, dysentery, gonorrhoea, and syphilis. Annonaceae, Fabaceae
and Vitaceae are the most commonly used plant families. Laboratory tests confirmed that most of theplant species used traditionally to manage bacterial and fungal infections showed strong effects
against tested pathogens. The unique Arabuko-Sokoke forests are an endangered biotop due toexpanding settlements and other utilization. In the case of its disappearance, the Giriama could losea source of medicinal plants and several unique species of fauna and flora would lose their habitat
too. The knowledge of the habitat by the Giriama is useful for managing the endangered resourceand provides the basis for its sustainable use (Marecik, 2002).

3.
African Indigenous Knowledge and Technology
Systems in Food and Nutrition Security

Like in other parts of the Africa, food insecurity and malnutrition are major problems facing most of
the countries in the Southern African and Eastern regions. This is partly due to the arid and semi
conditions that exist in most of these countries. The average annual rainfall is less than 600mm.
These arid conditions have adverse effects on food production and expose many households toproblems of food and nutritional insecurity. However, local communities in these countries have over
the years developed different food security strategies and mechanisms for surviving in these
conditions. These strategies include various technologies of food production, processing, preservationand storage that have not received much attention from policy makers and extension workers. They
tend to be underrated and their potential has not been documented and exploited for sustainablecommunity livelihood (Sibanda, 2004).
Indigenous vegetables, for example, often referred to as traditional vegetables, are a common
household food in most of the Southern and Eastern African countries. The majority of the local
farmers cannot always produce and eat exotic vegetables, such as cabbages, carrots, or beet roots
due to unavailability of seeds and/or high production costs associated with these exotic vegetables.
They, therefore, depend on traditional vegetables as a regular side dish or sauce accompanying thestaple foods, such as maize, cassava, sweet potatoes, millet, and sorghum. The staple foods provide
calories needed for the body energy but are very low in other nutrients, while traditional vegetables,such as Amaranthus, Solanum aetiopicum, Manihotesculenta (cassava leaves) and Ipomea batatas(sweet potato leaves), have high nutrient nutritive value (World Bank, 2004).
Most of the indigenous vegetables are produced mainly in home gardens tended by women andchildren. These home gardens are characterized by intercropping systems. This cropping system
has several advantages to the farmer and the community: it extends the harvesting period and helps
to alleviate seasonal food shortages, thus enhancing the stability of household food access; they
reduce erosion risks by providing increased soil cover and additional crop residues for use as green
manure and mulch. Such characteristics offer gains in sustainability and in stability for the foodsupply system; the choice of intercrops usually includes legumes and/or oilseeds such as melon
seed, groundnut, soybean or sunflower, together with cereals as the dominant crop. In dietary balance,
grain legumes, or pulses, contain more protein than cereals and about ten times as much protein as
most roots and tubers (FAO, 1991).

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Sun drying of fruits, vegetables and edible insects are common indigenous knowledge andtechnological practices in most of the Eastern and Southern African countries. In Zimbabwe and
Botswana, for example, sun drying of food is usually done in two main ways. One method (commonlyused for vegetables) is to immerse the fresh vegetables in salty boiling water for a few minutes toavoid nutrient loss. The vegetables are then dried in the sun for about three days and stored in a safe
dry place. This method is also applied for drying caterpillars, termites, white ants and other edible
insects. Another method is to directly spread the food in the sun. The food is first salted if there isdanger of decaying during the drying process as in the case of mushroom or tomatoes. Food drying
is an important activity for women as they bear responsibility for food preparation even during wintertimes and the dry seasons. Sun drying is an affordable technology requiring little or no intervention
under most conditions. Elderly women are the bearers of this knowledge (Zanini, 2002).
In Kenya, the National Museums of Kenya implemented the Indigenous Food Plants Program that
also involves human resource capacity building and awareness in 1989. Local communities incoastal, central, north-western and western of the country have taken it up as a response tocommunities’ concern over the future of local food resources. Poverty, famine, and malnutrition arecommon in most rural areas despite the fact that local foods are readily available due to the limited
awareness among individuals and households about the nutritional value or cultivation potential ofindigenous edible plants. The younger generation, particularly, tend to reject their traditional foods infavour of exotic and more ‘modern’ foods that most community members cannot afford. In addition,
several important species, or varieties of species, are on their way to extinction due to deforestation,
overgrazing, burning drought, desertification and bio prospecting.
The Indigenous Food Plants Program in Kenya also promotes the cultivation, consumption andmarketing of African indigenous foods through field demonstrations, educational materials and the
media. Local communities wanted to determine which species could be consumed, draft guidelines
on nutrient content and methods of propagation, assess the general value of the species, anddocument the vernacular names. A database containing detailed information on more than 850
indigenous food plant species of Kenya is now available to researchers. Local fruits and vegetables
can now be sold at the marketplace, which encourages their cultivation and enhances the local
economy. By raising the status of indigenous knowledge in the eyes of local communities, thepractice not only helps to alleviate poverty but also increases people’s respect for their own culture(Saifert, 2005).

4.

Ethno Veterinary in Public Health

In 1999, the World Health Organization (WHO) convened a conference of experts from industrialized
and developing countries in Teramo, Italy, in collaboration with the Food and Agriculture Organizationof the United Nations (FAO). The major purpose of the conference was to consider the contributions
on a global basis of Veterinary Public Health (VPH) programmes to human health, with a particularemphasis on the future contributions that VPH could make in developing countries. The consensus
definition of VPH at the Teramo meeting was:“The contributions to the physical, mental, and social well being of humans through anunderstanding, and application of veterinary science”.
This definition, therefore, replaced the original definition of VPH in the 1975 joint FAO/WHO technicalreport ‘The veterinary Contribution to Public health Practice’(2) “ as a component of public healthactivities devoted to the application of professional skills, knowledge and resources to the protection
and improvement of human health.” It was believed that this new definition was more consistent withthe original WHO definition of health and also with the values, goals, and targets of the WHO vision‘Health for all in the 21st century”. The scope of VPH was seen to be multidisciplinary, involving not
only veterinarians in government and non-governmental sectors, but other health professionals andscientists as well as paraprofessionals who treat, control or prevent diseases of animal origin.
However, one area that tends to be neglected is the contribution of ethno veterinary to public health.
Ethno veterinary medicine (EVM), for instance, knowledge in African countries is largely contained
within oral tradition. Past prejudice has prevented this indigenous knowledge system from becoming
the subject of scientific investigation. In other parts of Africa, such as Cameroon, substantial benefit
to resource-poor farmers has been shown to be achievable through the evaluation of traditional
medicines and the subsequent delivery of appropriate information to farmers/livestock managers(Martin, 2003).
In Eastern and Southern African indigenous knowledge and technologies are used to address the
problem of expensive and erratic supply of veterinary drugs and services to seek a sustainable wayof improving animal and human health by a complementary utilization of indigenous and orthodox
medicines. Benefits are a reduction of dependency on imported drugs and supplies, the possibilityof discovering new drugs and the use of natural drugs with fewer side effects. The communicationand contacts between livestock owners and veterinarians have improved.

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As is the case with other Southern African countries, Malawi suffers from major cattle healthproblems viz East Coast fever (ECF), babesiosis, anaplasmosis, heartwater, and endoparasites.
ECF accounts for up to 50% mortality in calves in the Central Region of Malawi and up to 60% losses
in calves and weaners in the Mzuzu area. In chickens the major constraints are Newcastle disease
and ectoparasite infestation. Control of these health problems using Western drugs by local farmers
is not a viable option because of the high cost. Although the Malawi government supplies someveterinary services to the farmers, modern veterinary sector is plagued by numerous constraints,
including the erratic supply and prohibitive expense of veterinary drugs and supplies, poor
communication facilities, and a shortage of manpower.
Therefore, besides the existing veterinary support services, farmers in these rural areas use traditional
medicines to treat livestock. In the northern region of Malawi, local farmers crush local plants orparts of them and mix them into drinking water for chickens to prevent or cure Newcastle disease
and diarrhoea. They also used Mucuna puriens and Tephrosia vogelii as insecticides against externalparasites, such as fleas in chickens. The farmers use leaves, barks, roots or whole plant as medicinal
materials that they claim to treat 17 of the 29 animal ailments. However, the farmers were unable totreat tuberculosis (TB), pneumonia, rabies, and poisonous caterpillars in ruminants and stillbirthand African swine fever (ASF) in pigs.
Indigenous veterinary remedies are mainly made from plants, but also from animal parts, salt, andsoil. The materials are commonly used in combinations; remedies made from only one ingredientwere rare. The local farmers expressed concern that since plants are the most common ingredients,
scarcity of plants may decrease the usage of indigenous veterinary remedies. Hence, there is needto encourage the conservation of medicinal plants by both farmers and institutions by establishingbotanical gardens.
The local farmers in the area claimed that ethno veterinary was a common practice in most parts ofNorthern Malawi. Most of the community members have a wide knowledge of indigenous veterinary
remedies. They learn about the remedies from parents or relatives including ancestors. Association
with ancestors made it difficult for some of the farmers to reveal knowledge about the remedies
because of fear of being cursed by the spirits of their ancestors. Interviews with some of the farmers
indicated that they have been using these remedies for many years. Some of them could not remember
when they started using these remedies. The practice was part of the community life. The elders areconcern that this knowledge will be forgotten as more and more young people go to school and stopusing or collecting the indigenous medicines (Kambewa, 1997).
The pork tapeworm, Taenia solium, is a zoonotic tapeworm and increasingly recognized as a publichealth challenge worldwide. This disease is considered one of the neglected diseases by the World
Health Organization (WHO). Though WHO identified it as a potentially eradicable disease, it is now
becoming prevalent disease in Eastern and Southern Africa.
The rural people in various parts of the two regions use numerous ethno veterinary plants for thetreatment of worm diseases in livestock and in humans in the developing world. Plants, for example,

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are used for the removal of the pork tapeworm (Taenia solium). This parasite causes a serious
disease in humans, neurocysticercosis, and results in epilepsy and often death. The highest
prevalence of juvenile neurocysticercosis in the world is in the Eastern Cape Province of South
Africa. Porcine cysticercosis affects pigs and is a serious agricultural problem in the same province(Kindamba, 2002).
There are several recent reports of indigenous plants used by resource-poor farmers in Tanzania
and Kenya to treat cysticercosis in pigs and the adult stages of T. solium in humans. One example
is lodwa (Embelia schimperi) given by farmers in the treatment of this disease in Tanzania. The
Masai people crush the seeds of this plant and drink it in milk. Embelia spp. also grows in South
Africa and the status of its use by local farmers needs investigation. There are also reports in Tanzaniaof a root being used by farmers to “cure” their pigs of infection with cysts (Ngowi, 2003),

5.

The Role of Traditional Belief Systems in Public
HealthThe role of African traditional belief systems in public health care tends to be neglected by individuals,
government and development agencies. They often dismiss beliefs and social behaviour as
superstitions and overlook their intrinsic values and functions. In many cases, the superstitions ortaboo are not meant to convey ‘scientific’ facts but to shape thinking, and to control behaviour.
Taboos are ‘social’ rules engrained through the socialization process. Fear is meant to develop
owing to the belief that violation causes infliction of punishment. In various parts of continent, forexample, there are taboos “regulating” the extraction medicine from plants. These are meant toprotect and preserve medicinal species from extinction.
In central and eastern Zimbabwe and Western Mozambique, there are various indigenous ways andbelief systems of protecting water sources. One of them is to prohibit members of a community toindiscriminately use their household utensils to fetch water from a source. It is not allowed to use
pots, cups, or buckets from the users’ homes. Rather, members of the community use a special
gourd, mukombe, that is permanently kept at the spring for only this purpose. Mukombe has a very
long handle that safely prevents the hands or fingers (of the person fetching water) from dipping into
the spring, thus avoiding a potential contamination hazard. Taboos and customs enforce compliance(Sandomba, 2002).
Among the Zigua and Ndorobo in Tanzania, there is a belief that the bark of a tree for use as
medicine should be removed from the sides facing the East and West of the tree only. Extracts fromother sides of the tree are believed to be ineffective because of breaking this rule. This protects thetree from total destruction and hence it survives the extraction.

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6.

Interfaces between African Indigenous
Knowledge and Western Knowledge System in
Public Health CareAs already stated, due to commercial and sustainable development reasons, African indigenous
knowledge systems (AIKS) are increasing becoming an integral part of the global body of knowledge.
Granier (1998), states that indigenous knowledge systems (IKS) can be compared and contrasted
with the counterpart global knowledge system to uncover mechanisms for evaluating the strengths
and weakness of each system. This interactive flow has already resulted in mutually beneficial
exchanges of knowledge that have enhanced the capacity of the formal research system to solve
priority problems identified within local communities. Both multilateral and bilateral donor agencies
are now recognizing the role of indigenous knowledge in sustainable development including thepromotion of public health care.
Anand (2005) explains how in most African countries, modern Western systems of thought and life,
exist alongside African indigenous knowledge systems. Both systems can be found in all sectors ofsociety, including agriculture, public health, political organizations, conflict transformation, culture,
education, technology and even lifestyle. As a result of its affordability and easy access in most local
communities, indigenous knowledge continues to provide the building blocks for development andpublic health in most African countries, while seeking cooperation with modern knowledge for themutual benefit of the two systems. The following examples from various parts of the two regions
show this interface between African indigenous knowledge and modern western knowledge systems.
The Tugen people in Kenya treatment of malaria is based on a several interlinked elements: beliefs
related to causation, the action of effectiveness of ‘modern’ medicines, and the availability of plant
treatments. In the treatment of these two diseases, the Tugen also use Western-based health carefacilities and over-the-counter medications. The use of the different forms of treatment iscomplementary. In some instances, retail drugs are displayed for sale alongside herbal medicines.
The fact that these divergent forms of treatment are sold and used either concurrently or alternately,suggests that there is no perceived conflict between the two traditions. Tugen indigenous medicine
has weathered the test of time, especially in view of the widespread Western forms of treatment. And
as long as the Tugen culture exists as an identifiable cultural entity, this autonomous body ofindigenous knowledge for the treatment of disease will remain, because it is both culturally relevant
and efficacious.
In Northern Malawi, local farmers practicing ethno veterinary work in collaboration with research
and academic institutions, such as Bunda College of Agriculture (University of Malawi) and the

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ATPS SPECIAL PAPER SERIES NO. 30

National Herbarium in Zomba for botanical identification of the indigenous medicinal materials.
They collaborate on trials that can verify the claims of the farmers by using Western scientific methods.
The main goals of the collaboration are to promote the complementary use of indigenous andconventional veterinary medicine for sustainable livestock production, and to promote theconservation of medicinal plant resources. The practice and collaboration is considered a ‘bestpractice’ because ethno veterinary knowledge provides an integrated approach to livestock healthcare that is sustainable economically, environmentally and culturally.
In Tanzania, The Tanga AIDS Working Group (TAWG) strives to alleviate suffering of HIV/AIDS
patients by using indigenous knowledge. The group has treated over 2,000 AIDS patients with herbs
prescribed by local healers since it started in 1990. The advantage of the traditional healers is thatthey are more accessible to local people and have gained their communities’ trust through pastexperiences. Traditional healers, modern physicians and health workers have joined forces in
TAWG’s programs to effectively treat patients with HIV/AIDS. The impact has been most significant
in alleviating the opportunistic diseases brought on by the AIDS virus. The patients who have responded
most positively have lived longer, by up to five years.
The Tanga regional hospital has allocated a floor to TAWG workers to enable them to test patientsfor HIV, treat them and provide counselling. They have also set up an information centre in town that
conducts active AIDS awareness campaigns and offers a support network to people living with AIDS.
TAWG plans to involve their healers, people living with AIDS and staff working with patients to provide
medical care and alternative income generating opportunities, in exchanges of IK with similar
communities in Tanzania and possibly Kenya and other parts of the continent. Integrating local
healers in AIDS prevention and mitigation strategies increases effectiveness of approach and accessfor poorer patients.
Prometra Uganda is an Association for the Promotion of Traditional Medicine and is promoting
traditional medical knowledge and practices for improved health through mutual co-operation among
health care systems. The organization strengthens collaboration between traditional and other healthcare practitioners to encourage knowledge sharing. They advocate and disseminate traditional
knowledge while fighting against harmful practices through local educational programs.
The Traditional and Modern Health Practitioners Together against AIDS (THETA) is anotherorganization in Uganda where traditional and modern health care practitioners work together to fightAIDS and other diseases. Traditional healers are trained as community counsellors and educators
to assist with basic HIV/AIDS patient care. The organization processes and packages herbal
medicines and also maintains a herbal garden. THETA also hosts a library, publishes a newsletter,organizes monthly speakers and advocates for traditional medicine.
A World Bank-supported initiative in Zambia working to conserve biodiversity for HIV/AIDS treatment
established botanic gardens and forest reserves for medicinal plants. Some of the seeds come fromspiritual forests that have been preserved because of the traditional values, norms and taboos

PROMOTION OF PUBLIC HEALTH CARE USING AFRICAN INDIGENOUS KNOWLEDGE SYSTEMS AND IMPLICATIONS FOR IPRS

15

associated with them. In addition, training and capacity building activities for traditional healers
focus on behaviour modification in relation to HIV/AIDS, understanding eco-systems and legal training.
Knowledge of biodiversity and HIV/AIDS is disseminated through newsletters, radio, TV and theatre.
The project includes an electronic database on medicinal plants and publication of a handbook for
traditional healers to be used in their practice. A literacy program helps illiterate healers register theirpatients and document their indigenous knowledge for future dissemination.

7.

Implications for Intellectual Property Rights

The above discussion and examples from the various countries in the two regions show the great
contribution and potentiality of African indigenous knowledge and technology systems in the promotionof public health care. Like in other parts of the world, African Indigenous people put great importancein the use of biological materials for medical treatment and food security, conservation and sustainable
use of natural and genetic resources, and a wide range of cultural practices and innovations (Harte,1996).
Since the adoption of the Universal Declaration of Human Rights (UDHR) in 1948, intellectual
property (IP) has been considered a fundamental human right for all peoples. Article 27 of the
Declaration states that everyone has the right “to the protection of the moral and material interests
resulting from any scientific, literary or artistic production of which he is the author.” Since 1948,
many international human rights instruments and documents have reinforced the importance of IP
as a human right.
Intellectual property rights (IPRs) are the legal protections given to persons over their creative
endeavours and usually give the creator an exclusive right over the use of his/her creation or discovery
for a certain period of time. IP protections may include patents, copyrights, trademarks, and trade
secrets. IP is codified at an international level through a series of legally binding treaties (Fourmille,
1996; Petern, 1995).
As interest in traditional medicine is increasing, worldwide, indigenous knowledge of the cultivation
and application of genetic resources is becoming exploited at an alarming rate. World sales of
herbal medicine alone were estimated at US$30 billion in the year 2000. IPRs should guarantee
both an individual’s and a group’s right to protect and benefit from its own cultural discoveries,
creations, and products. But Western IP regimes have focused on protecting and promoting the
economic exploitation of inventions with the rationale that this promotes innovation and research.
Western IP law that is rapidly assuming global acceptance, tend to facilitate and reinforce a processof economic exploitation and cultural erosion. It is based on notions of individual property ownership,a concept that is often alien and can be detrimental to many local and indigenous communities. An
important purpose of recognizing private proprietary rights is to enable individuals to benefit from theproducts of their intellect by rewarding creativity and encouraging further innovation and invention.
But in many indigenous world-views, any such property rights, if they are recognized at all, should be

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17

extended to the entire community. They are a means of maintaining and developing group identity as
well as group survival, rather than promoting or encouraging individual economic gain.
Problems experienced by indigenous peoples in trying to protect their knowledge systems under IP
laws stem mainly from the failure of indigenous knowledge to satisfy requirements for intellectual
protections. Alternatively, where IP protection could potentially apply to such knowledge, the prohibitive
costs of registering and defending a patent or other IP right may curtail effective protection. There
has been a clear bias in the operation of these laws in favour of the creative efforts of corporations,for example, pharmaceutical and other industries in industrialized nations. Within the context ofscientific progress, modern IP laws have allowed these industries and companies to monopolize thebenefits derived from their use of indigenous knowledge with disregard for the moral rights andmaterial (financial) interests of indigenous peoples themselves.
Most of the governments in the Southern and Eastern African regions are working both domesticallyand internationally as part of increasing efforts to identify effective means of preserving and protecting
these indigenous knowledge systems (IKS) for future generations, promoting their broader adoption,and protecting them from unauthorized appropriation and commercialization.
On-going discussions in various countries are considering, as one possible approach, theappropriateness of protecting certain kinds of indigenous knowledge systems as a form of IP and, if
appropriate, the best means of applying IPR. On March 24, 2003, for example, after years ofnegotiations and uncertainty, representatives of the San peoples of southern Africa and representatives
from South Africa’s Council for Scientific and Industrial Research (CSIR) signed a benefit-sharing
agreement for a drug being developed from a traditional mainstay of the San diet, that is, the Hoodia
plant.
The Hoodia has been traditionally used by the San to treat stomach pain and eye infections, among
other applications. On long hunting trips through the desert, the San chewed on the stem of the
Hoodia to suppress their hunger and thirst and boost their energy. In 1995, CSIR researchers
discovered its qualities as an appetite suppressant, isolated the compound, called P57, in the plantthat curbs hunger, and obtained a patent for it in 1996. The San pointed out that the Hoodia’s
distinctive properties were the exclusive traditional and communal knowledge of the San, passed
down for centuries. Seeking acknowledgement of this fact, and of the collective ownership of thisknowledge by the broader San community, they sued in 2000. This began a long process ofnegotiation with CSIR that only recently succeeded. The San stand to receive six percent of all
royalties when the drug reaches the market. They plan to invest the money, and only tap into theinterest generated to fund community projects. This benefit-sharing agreement between a local
research council and the San people represents enormous potential for future collaboration, notonly for the San but also for other holders of traditional knowledge (Stahl, 2004).

8.

Conclusion and Recommendations

The above discussion and examples from the various countries in the two regions show the great
contribution and the potentiality of indigenous knowledge and technology systems in the promotionof public health care, in both human and animal health. The access of the poor local communities
to their biodiversity including the use of their indigenous knowledge (IK) is the primary means of theirlivelihood and health security. Therefore, the ‘piracy’ of their indigenous biological resources andinnovations through patents and the diversion of their biological resources to global markets
undermines their livelihoods. It also threatens the biodiversity base that they have protected overyears because their survival has depended upon it.
The Convention on Biological Diversity (CBD) as an international legally binding agreement recognises
the sovereign rights of countries to their biological resources and also the indigenous innovation bycommunities. The CBD gives governments an opportunity to change the regime of bio piracy at the
global level and replace it with a sustainable and just system in which biodiversity and diverse
knowledge systems, and rights of communities whose survival depends on this biodiversity andknowledge are simultaneously protected.
The paper recommends the following:
q The importance of increasing in country, regional and continental research anddocumentation of the various uses and commercial value of underutilized plants and otherbiological resources including their contribution to the promotion of public health, foodsecurity and income generation for rural communities
q The country examples stipulated above show that indigenous medicine and knowledge atlarge are both culturally relevant and efficacious. They should be officially recognized andgiven the status they deserves; need to combine Western and traditional medicines intreating terminal illnesses to develop developing efficient treatments;
q There is need to recognize certain African belief systems that could play an important rolein promoting public health. Communities could consider developing new taboos for the
management of natural resources that have become scarceq It is important to develop and harmonize the country’s IKS policies for promoting sustainable
development and public healthq There is need for countries to develop and promote regional and continental IKS in thebiosciences networks for researchers and other stakeholders to share experiences.

18

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Dr Hassan O. Kaya, is the Coordinator of the Indigenous Knowledge Systems (IKS) Programme at
the North West University, South Africa. Email: kayah@uniwest.ac.za

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