Traditional healers fight for recognition in South Africa's AIDS crisis

A majority of South Africans rely on traditional healers and medicines. Credit: James Watson

The prominent AIDS activist group Treatment Action Campaign (TAC) is finding itself at the center of a controversy as South Africa's traditional healers clamor for greater recognition of their value in treating HIV/AIDS.

In late November, protesters representing South Africa's Traditional Healers' Organisation (THO) marched to the TAC offices, chanting slogans against the TAC, pharmaceutical companies and the media for downplaying the role of traditional medicines in fighting AIDS.

The spat highlights a major issue in South Africa: deciding what role traditional healers and medicines should play in an epidemic that afflicts about 5.1 million people in the country.

Shunned by former governments, traditional healers are now being increasingly recognized, particularly in rural areas where conventional health care is scarce or expensive. Their influence is significant: the Department of Health says as many as 70% of South Africans consult the country's estimated 200,000 healers.

To regulate this, the government in September passed the Traditional Healers' Bill, giving practitioners legal recognition, but restricting them from diagnosing or treating HIV/AIDS or any other terminal disease. South Africa's Medical Research Council (MRC) also has a dedicated research unit for testing traditional medicines.

But the THO is charging that the TAC, which campaigns for equitable and affordable access to AIDS treatments, is overlooking traditional remedies. Phepsile Maseko, the THO's national coordinator, says although some traditional healers are members of the TAC, the group only promotes 'modern medicines'. “We want them to stop the monopoly [of the drug companies] and consider other forms of medicines,” Maseko says.

“We want them to stop the monopoly [of the drug companies] and consider other forms of medicines. Phepsile Maseko, Traditional Healers' Organisation”

The TAC, led by the iconic Zackie Achmat, has been the country's most effective voice of opposition against the government's slow reaction to the AIDS crisis. As an organization with substantial reach, Maseko says, the TAC has a responsibility to ensure that all alternatives are known to the public.

The TAC agrees that traditional healers can be important in fighting AIDS, particularly as a source of accurate information and psychological support. The group is also willing to consider any medicine proven to be safe and effective, but this has not been forthcoming for traditional medicines, says TAC national manager Nathan Geffen. “We have not received a single bit of evidence from the THO of a traditional medicine with safety and efficacy for treating AIDS,” he says.

Among the THO's supporters are the Rath Foundation and South African health minister Manto Tshabalala-Msimang, who advocate using multivitamins to treat AIDS. Msimang has slammed the media for not giving enough coverage to the role of multivitamins.

The MRC is reviewing ten remedies that claim beneficial health effects for AIDS but no traditional medicines have yet been approved, notes Motlalepula Gilbert Matsabisa, head of indigenous knowledge systems at the agency. Seven remedies have gone through preclinical testing, and two have successfully completed phase 1 trials. Phase 2 trials are set to begin in February.

Some traditional medicines may prove effective, but their use must be carefully monitored, says Eric Goemaere, head of Médecins Sans Frontières' South African mission. For instance, some patients are known to mix their antiretroviral drugs with traditional remedies, which could have unexpected side effects.

“Unfortunately, a huge majority of traditional healers are using a type of treatment that incites diarrhea and vomiting, because the traditional approach is to get the sickness out,” adds Goemaere. “This can be very dangerous.”

But there is no doubt that traditional healers have an important role to play, he says. “No patient that we see has not gone to a traditional healer first—it's a mandatory first step,” he says. “We would like to make an alliance with them, as they can provide a useful complementary role.”

Related links

Related links in Nature Research

Debate escalates on source of sub-Saharan Africa's AIDS epidemic

www.nature.com/nm/special_focus/hiv/

http://www.nature.com/news/specials/aids/archive.html

Related external links

Treatment Action Campaign

South Africa Medical Research Council