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      The ethics of improving African traditional medical practice: Scientific or African traditional research methods?

      research-article
      *
      Acta Tropica
      Elsevier
      African traditional medicine, Research, Ethics

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          Abstract

          The disease burden in Africa, which is relatively very large compared with developed countries, has been attributed to various factors that include poverty, food shortages, inadequate access to health care and unaffordability of Western medicines to the majority of African populations. Although for ‘old diseases’ knowledge about the right African traditional medicines to treat or cure the diseases has been passed from generation to generation, knowledge about traditional medicines to treat newly emerging diseases has to be generated in one way or another. In addition, the existing traditional medicines have to be continuously improved, which is also the case with Western scientific medicines. Whereas one school of thought supports the idea of improving medicines, be they traditional or Western, through scientific research, an opposing school of thought argues that subjecting African traditional medicines to scientific research would be tantamount to some form of colonization and imperialism. This paper argues that continuing to use African traditional medicines for old and new diseases without making concerted efforts to improve their efficacy and safety is unethical since the disease burden affecting Africa may continue to rise in spite of the availability and accessibility of the traditional medicines. Most importantly, the paper commends efforts being made in some African countries to improve African traditional medicine through a combination of different mechanisms that include the controversial approach of scientific research on traditional medicines.

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          Ethical and regulatory issues surrounding African traditional medicine in the context of HIV/AIDS.

          It has been estimated that more than 80% of people in Africa use traditional medicine (TM). With the HIV/AIDS epidemic claiming many lives in Africa, the majority of people affected rely on TM mainly because it is relatively affordable and available to the poor populations who cannot afford orthodox medicine. Whereas orthodox medicine is practiced under stringent regulations and ethical guidelines emanating from The Nuremburg Code, African TM seems to be exempt from such scrutiny. Although recently there have been calls for TM to be incorporated into the health care system, less emphasis has been placed on ethical and regulatory issues. In this paper, an overview of the use of African TM in general, and for HIV/AIDS in particular, is given, followed by a look at: (i) the relative laxity in the application of ethical standards and regulatory requirements with regards to TM; (ii) the importance of research on TM in order to improve and demystify its therapeutic qualities; (iii) the need to tailor-make intellectual property laws to protect traditional knowledge and biodiversity. A framework of partnerships involving traditional healers' associations, scientists, policy makers, patients, community leaders, members of the communities, and funding organizations is suggested as a possible method to tackle these issues. It is hoped that this paper will stimulate objective and constructive debate that could enhance the protection of patients' welfare.
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            How not to compare Western scientific medicine with African traditional medicine.

            In his commentary on Aceme Nyika's paper 'Ethical and Regulatory Issues Surrounding African Traditional Medicine in the Context of HIV/AIDS', Godfrey B. Tangwa charges the author with inappropriately using expressions, terminology and criteria of evaluation appropriate in Western scientific medicine to judge African traditional medicine (TM). He seriously frowns on Nyika's suggestion that African TM needs to be incorporated into, and subjected to the canons of Western scientific medicine. Such a suggestion, he believes, is a prescription for invasion, colonization and exploitation so characteristic of the relationship between Africa and the Western world. However, he thinks that African TM is quite compatible with Western scientific medicine.
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              Intellectual property rights and traditional medicine: policy dilemmas at the interface.

              Traditional medicines play an important role in the provision of health care in many developing countries. Their use is also significant in developed countries, increasing their commercial value. Several 'high-profile' cases of patenting of traditional medicines, without consent from or compensation to their holders, have further focussed attention on their importance. Traditional medicine usually involves biological resources and the knowledge of local and indigenous peoples and/or healers regarding their medicinal use; thus, it is interlinked with biodiversity conservation and indigenous peoples' rights over their knowledge and resources. At this multi-faceted interface, complex ethical questions arise. This article provides an overview and discussion of key issues, dilemmas and challenges. It points to possible modifications and at ways to devise new forms of intellectual property ownership that may better suit the needs of those who seek to protect traditional medicine. Yet it also questions whether such protection, which may restrict access, is the preferred option. While intellectual property protection for traditional medicines has multiple and diverse objectives, the priorities are often not clear and the strategies which could be deployed may interfere with each other, as well as with the prioritization of objectives. This is further aggravated by differences in stakeholders' concepts on ownership of knowledge and by uncertain or paradoxical effects of some potentially useful strategies. Thus, policymakers should address the multiple, multi-layered issues and questions, and try to develop a range of solutions in order to address and balance the various objectives and interests.
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                Author and article information

                Contributors
                Journal
                Acta Trop
                Acta Trop
                Acta Tropica
                Elsevier
                0001-706X
                1873-6254
                13 August 2009
                November 2009
                13 August 2009
                : 112
                : S32-S36
                Affiliations
                African Malaria Network Trust (AMANET), P.O. Box 33207, Dar es Salaam, Tanzania
                Author notes
                [* ]Tel.: +255 22 2700018; fax: +255 22 2700380. anyika@ 123456amanet-trust.org
                Article
                S0001-706X(09)00240-X
                10.1016/j.actatropica.2009.08.010
                7092799
                19682966
                873effed-4ade-456c-97d3-6addfc797a51
                Copyright © 2009 Elsevier B.V. All rights reserved.

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                Ecology
                african traditional medicine,research,ethics
                Ecology
                african traditional medicine, research, ethics

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