The Role of Traditional Medicine in Ghana Towards Achieving Universal Health Coverage: The Journey So Far.

Ghana Celebrates 20th Traditional Medicine Week

Background

Looking back on 20 years gone by, we could not have done it without you even if we tried. We started with a few but now we are many not only in numbers but also in talent, creativity and giant industry players. If there is ever a history in traditional medicine in Ghana, it will start with you and end with you for indeed you are a valued associate.

Congratulations to all who have contributed in diverse ways to the development of Traditional Medicine in Ghana, special salutations to our ancestors and forebearers whose tireless efforts had left this great legacy for posterity. We say Aryeeko to the President and members of Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM).

Traditional medicine is as old as human civilization, has been in existence for as far as prehistoric times and Africa as a continent cannot be left out of its history. However, due to industrialization and the dynamic nature of man, traditional medicine has metamorphosed into a lot of forms, hence known to be the bedrock of all modern forms of healthcare.

The role of Traditional Medicine in promoting and augmenting the health of the people of Ghana cannot be over-emphasized thus Traditional Medicine is still the first source of health care for about 80% of the population in developing countries including Ghana (World Health Organization, WHO).

Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM) with the support of the government through Ministry of Health had their first celebration in March, 2000 at the Centre for Scientific Research into Plant Medicine, now Centre for Plant Medicine Research.

In 2003, The World Health Organization-African Region (WHO-AFRO) and the African Union adopted this giant step made by Ghana to be emulated by the rest of the African continent.

Since then, the World Health Organization-African Region (WHO-AFRO) and the African Union has declared 31st August every year as African Traditional Medicine Day.

The Day is to be commemorated in all AU and WHO-AFRO Region for strengthening health systems by promoting best practices and for discouraging bad practices.

The concept was born from the realization that a well-developed Traditional Medicine System can contribute significantly to healthcare and the neglect of it would be detrimental to healthcare services in the communities

Then followed by countries such as Benin, Burkina Faso, Uganda and Mali instituted a national Traditional Medicine Week with Ghana being the first to celebrate among these countries.

What is Traditional Medicine?

Traditional Medicine also known as indigenous or folk medicine is defined by World Health Organization as the sum total of the knowledge, skills, and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. It comprises medical aspects of traditional knowledge that developed over generations within various societies and cultures before the era of modern medicine which in many cases has been orally passed for generations from person to person.

Indigenous medicine is generally transmitted orally through a community, family and individuals until “collected”. Within a given culture, elements of indigenous medicine knowledge may be diffusely known by many, or may be gathered and applied by those in a specific role of healer. Three factors legitimize the role of the healer – their own beliefs, the success of their actions and the beliefs of the community.

Types of Traditional and Alternative Medicine (TAM)

Many different areas make up the practice of Traditional and Alternative medicine (TCM).

This field includes  Herbal medicine, Psychic healers, Faith healers, Traditional Birth Attendants, Wanzams, Acupuncture, Homeopathy, Naturopathy, Hydrotherapy, Chiropractic and Osteopathic Medicine, Massage therapy, Cupping Therapy, Moxibustion, Body Movement Therapies, Yoga, Nutrition or diet, Electromagnetic therapy, Meditation, Biofeedback, Art, dance,  music etc.

The World and Ghana at large, for the past decades have embraced Traditional Medicine Practice to complement the orthodox or biomedical practice for health care delivery.

Years before the introduction of the Allopathic Medicine Practice in Ghana, the populace depended solely on Traditional healers, Faith Healers, Traditional Birth Attendants, Wanzams etc. for their healthcare needs. Even in this era of allopathic ascendency, still Traditional and Alternative Medicine practice still plays a very huge role in providing for the health needs of patients in the country. Native doctors used leaves, stem bark, roots, seeds, flowers and fruits of plants and trees for medicinal and therapeutic purposes for the treatment and management of communicable and non-communicable diseases.

All these therapies are used as alternative which are complimentary to modern medicine which takes care of the body, the mind and the senses.

Even standard or conventional medicine recognizes the power of the connection between mind and body. Studies have found that people heal better if they have balanced emotional and mental health.

World Health Organization (WHO) and West Africa Health Organization (WAHO) Strategies

The World Health Organization Regional Committee for Africa adopted Resolution AF/RC50/R3 in connection to the 2014-2023 Traditional Medicine strategy.

The principles on which the Regional Strategy is based are:

advocacy; government recognition of traditional medicine; building of traditional medicine; and partnerships.

Since then, the World Health Organization (WHO) governing bodies and countries have adopted resolutions on traditional medicine.

In response, a policy document was designed to coordinate the general policy direction in the area of Traditional Medicine in Ghana.

One key element in achieving the Regional strategy is the implementation of the “Integration policy” of TM into the main healthcare system.

The priority interventions of the Regional Strategy are

• policy formulation;
• research promotion;
• development of local production of traditional medicines including
• cultivation and conservation of medicinal plants
• protection of intellectual property rights (IPRs) and traditional medical knowledge (TMK)
• capacity building.

Government efforts to develop TAM

The World and Ghana at large, for the past decades have embraced Traditional and Alternative Medicine (TAM) practice to complement the orthodox or biomedical practice for health care delivery.

In 1978, the World Health Organization (WHO) adopted the “Alma Ata Declaration” which edged all governments to protect and promote health for all especially in developing countries.

Ministry of Health as a critical sector contributes to the Socio-Economic development of this country by promoting Health and vitality through access to quality health to all people living in Ghana using well motivated personnel to ensure a healthy and productive population that reproduces itself safely.

In Ghana successive governments have recognized the importance of traditional medicine.

The formation of the Ghana Psychic and Traditional Healers Association in 1961 by our first president, Osagyefo Dr. Kwame Nkrumah so they can adhere to standards and ethics of practice.

The establishment of the Centre for Scientific Research into Plant Medicine in 1975 among other things to research and develop herbal medicine in Ghana.

National policy/legislation for practicing TM in Ghana.

The promulgation of Food and Drugs Laws 1992, PNDCL 305B to regulate herbal medicines and the practice of Traditional medicine in 1992 with the mandate among others, to certify and regulate the sale of Traditional Medicine products to the public.

In 1991 the government established a unit for the coordination of Traditional Medicine which was upgraded into full Directorate in 1999, which is now the Traditional and Alternative Medicine Directorate. With the mandate to formulate, initiate, coordinate and monitor all activities involving Traditional Medicine so as to influence to move in accordance with public policies.

Ghana Federation of Traditional Medicine Practitioners Associations GHAFTRAM was established in 1999 by the then government under the auspices of the Council for Indigenous Business Associations (CIBA) in Ghana.

The Traditional Medicine Practice Council (TMPC) Act, (Act 575), which was promulgated in the year 2000 to promote, control and regulate the practice of Traditional Medicine in the country. There is a review of the Act to include Traditional and Alternative Medicine Practice which is currently a Bill at the cabinet for consideration (TAM Bill, 2018)

Achievements

Over the years we have seen the evolution and reinvention of traditional medicine in its various forms, to play a true significant role in the delivery of healthcare in this country. This is not by accident.  It is the result of a deliberate policy to redefine and encourage the enhancement of capacities and capabilities of various players in this sector.  These players include, but are not limited to, the practitioners largely represented by GHAFTRAM and regulated by the Traditional Medicine Practice Council (TMPC); the Manufacturers and Marketers who are ably regulated by the Food and Drugs Authority (FDA); researchers at the Centre for Plant Medicine Research in Mampong Akuapem and the various universities; and the policymakers here at the Ministry of Health led by the Traditional and Alternative Medicine Directorate (TAMD)

These players have worked largely together to bring us to this stage where traditional medicine can be confidently celebrated.

Challenges

All these successes are not to paint an all “rosy” picture in Traditional Medicine in the country. Indeed, some hurdles have been encountered, some we have jumped, others, yet to be. However, they are worth mentioning to make us aware as we enter the next stage of development.

1. Regulation- (Quackery and Charlatans)

Amidst the existence of a strong and effective framework, clumping down of quacks and charlatans is unfortunately on the ascendency. They have remained major hinders in Traditional medicine development and their eventual infiltration into the airwaves and misinformation of the public does not make the situation any better. They constantly propagate the “one medicine cures all syndrome” and their deeds continue to cloud the good work being done by stakeholders.

2. Information, Education and Communication

The misrepresentation and lack of enough information to the general public also seems to make it easier for these quacks and charlatans to have their way.

3. Research and Development

Even though a lot of research had carried out, there seem to be a gap of meeting the world class standard. Research in TM has moved from belief based to evidence based research therefore it is necessary to undertake series of researches especially clinical trials to ascertain the efficacy of most of our promising herbal medicines.

4. Collaboration between stakeholders (Practitioners), regulators and Media

This will help to curb the activities of quacks and charlatans from giving false information to the public.

5. Funding-separate traditional medicine development fund.

Way Forward

1. Develop more proposals for funding of TM activities
2. Government must set aside special fund for TAM development.
3. There should be a nation -wide sensitization program to create awareness. Encourage public lectures and symposia on Traditional Medicine
4. Setting up of TM information centers
5. Incorporation of TM in the curriculum of secondary and tertiary institutions.

Conclusion

Over the years, traditional medicine has evolved through the stages of metamorphosis.

and here we are today celebrating two decades of tireless work and commitment. Now the butterfly is out: and it is up to us to color it as beautiful as we want it to be. Admitting we still have a long road to cover does not take away our pride in how far we have come. We should however brace ourselves for the journey ahead. Hopefully with such a solid foundation having been laid, it will be a smooth one.

Long Live Traditional Medicine! Long live Ghana!

By Dr. (Mrs.) Anastasia Michaelina Yirenkyi, Traditional and Alternative Medicine Directorate – Ministry of Health