Traditional Chinese Medicine is Gaining Traction in Africa. Can it Also Help in the Fight Against COVID-19?

 In analysis, op-ed

As COVID-19 has ravaged the globe, governments have had to face the grim reality of overwhelmed medical systems. The impact has been morbid, with over 7 million confirmed cases and over 400,000 deaths worldwide. In the absence of therapeutics or a vaccine, alternative curatives are becoming increasingly popular, the most recent being traditional herbal medicines. Madagascar has recently come under scrutiny for its unorthodox solution to the virus: COVID-Organics, an herbal remedy with roots in African traditional healing. Despite the scrutiny, however, it raises the question “can African Traditional Medicine (ATM) play a role in the global health sector?”, and, in particular, can lessons be learned from China’s strategy to gain international recognition of  Traditional Chinese Medicine (TCM), or is TCM itself a potential threat to ATM?

What is TCM and How is it Different to African Traditional Medicine?

Traditional healing is not a homogenous healing system, but varies by culture and region. Both Chinese and African communities have had a long-standing history with traditional medicine systems. China in particular has invested huge sums of money to promote the modernization of TCM, funding clinical research and its distribution to gain international recognition. Thus, TCM has grown popular across the world, including in Africa.

According to the U.S. National Institute of Health, TCM is a millennia-old medical system that uses herbs and practices like acupuncture to address health issues. It has become popular as an alternative to Western medicine, as proponents argue TCM avoids modern medicine’s chemical side effects. With over a million Chinese migrants in Africa and a growing number of African students studying TCM, the number of practitioners is rapidly increasing. Some TCM products have been successfully developed into modern drugs, such as the antimalarial drug Artemisinin, but there is still disagreement within the scientific community over TCM’s efficacy.

Yet, data suggests that TCM is far less popular in Africa than traditional African healing. To date, only five African countries have collected the relevant information, suggesting that more efforts are needed to track TCM’s proliferation. Of these five countries, traditional medicine practitioners outweigh TCM practitioners by thousands.  TCM is also far less popular in Africa than modern medicine. Research our firm conducted in 2018 for UNAIDS and the China Chamber of Commerce for Import and Export of Medicines and Health Products (CCCMHPIE) suggested that for 21 African countries, on average TCM accounted for a slim 2% of all pharmaceutical and health exports from China to those countries, with the highest level being 5% – for Ghana. However, it is important to note that this is likely an underestimate, as some TCM products are registered as food/dietary supplements rather than pharmaceutical products.

Table showing TCM vs. TM practitioners across African countries. Sourced from the WHO 2019 Report.

TCM in Africa is typically distributed through personal networks and small local clinics. An example of a standard TCM clinic is Dr. Zhao Shi’s in Nairobi, a city with 15 registered TCM clinics. Her clinic receives 200+ new patients a month, primarily upper-middle class Chinese and Kenyan citizens. Zhao attributes TCM’s surge in popularity in Africa to its similarities with ATM, arguing that the traditional methods are healthier than modern medicine.

However, ATM goes beyond the normal scope of healing. ATM is a form of holistic health care organized into three levels: divination, spiritualism and herbalism. The traditional healer provides health services based on culture, religious background, knowledge, and beliefs that are prevalent in their community. Thus, unlike TCM, ATM is only learned from healers through oral communication because the knowledge is not written down. TCM, on the other hand, is widely accessible through coursework, including in Africa. For instance, six of South Africa’s eight medical schools offer TCM degrees (both bachelors and post-graduate level).

Yet, despite its popularity across the continent, there is still stigma against ATM (as well as TCM). Traditional remedies rely on anecdotal records of effectiveness and thus face an absence of clinical testing, leading to misinformation. For example, a claim by a Zambian healer that an African potato variety can treat HIV/AIDS was later found to be untrue, as the healer admitted that the potato only boosts the immune system. In fact, he shared that its wrongful use could even cause severe side-effects.

Regardless of the scrutiny it has faced, it is important to note that modern medicine as well as food and dietary supplements have roots in ancient medicine. It is likely that many important new remedies will be developed and commercialized in the future from African biodiversity, by following the leads provided by traditional knowledge and experiences. Moreover, African healing remedies are not only affordable but also offer a variety of expertise.

China Used Targeted Policies to Drive the Growth of TCM – but ATM Lags Behind

China has a significant medical presence in Africa, having sent over 40,000 medical practitioners since 1963, and with 46 medical teams currently across the continent. Beijing began to expand these efforts to TCM in 2000 with the China-Africa Forum on Traditional Medicine, and it has since grown popular in Africa for four reasons:

  1. China’s long history of medical support has created trust in Chinese medicine.
  2. TCM’s methods are similar to traditional African healing.
  3. Africa’s weak healthcare systems benefit TCM as an alternative.
  4. China has invested billions into clinical research and TCM exports.

Yet, despite widespread use of traditional medicine across the continent, African governments have instituted varying levels of regulations. The table below highlights different regulatory actions in Africa (not just on TCM, but on traditional medicine in general). The table shows that while African governments surpass the rest of the world in national policy, they lag in regulation and registration of herbal medicines. This lack of regulation further diminishes the credibility of traditional medicines (both TCM and ATM), harms data collection efforts, gives local clinics minimal oversight, and weakens government efforts to research and further develop herbal-based medicines. Because TCM already benefits from Chinese support, it escapes many of these issues, leaving ATM to suffer from the lack of regulation.

Figure 2. Table showing development of T&CM policies across Africa in 2018, compared to the rest of the globe and compared to Africa in 2005. Sourced from the WHO 2019 Report.

The regulatory disparities across Africa can be seen in the map below as well.

Figure 3. Herbal Medicine Regulations across the African map. Data sourced from the WHO 2019 Report.

What Lessons Can Be Learned From China for the Growth of Africa Traditional Healing?

China’s approach to TCM has facilitated its growth and security internationally, and thus, African governments can emulate the Chinese model in three ways:

1. Invest in R&D of ATM:

While Africa has over 5,000 recognized medical plants, lack of R&D spending has prevented their transition to commercial drugs. Conversely, China’s support of TCM has fueled testing, even earning recognition from WHO, which addressed TCM treatments in its influential International Classification of Diseases for the first time in 2019. In order to combat the present stigma against African healing, African governments must secure it through regulation and greater research. Without formal research backing Africa’s traditional medicine, it will never receive recognition nor spread to greater audiences.

2. Craft legislation and courses to regulate and teach ATM:

Unlike African healing, TCM is taught in medical schools across the world, making it far more accessible. Moreover, Chinese regulation of TCM has enabled improved R&D and data collection efforts. Thus, African governments should take similar steps to standardize African healing education in other African and non-African countries, as well as regulate herbal medicine usage. By taking these steps, governments can legitimize ATM while also facilitating its spread.

3. Push pan-African and global distribution networks for ATM:

Once China supported TCM through research, improved access to education, and supply chains, they were able to leverage it into a major cultural export. Similarly, with proper backing, African governments can reap the same benefits. This research backing is critical for traditional medicine’s success internationally. For example, Madagascar has gained popularity throughout the African continent for its promotion of COVID-Organics but has also received much pushback due to concerns about the effectiveness of the product. Thus, once ATM has sufficient research and regulatory backing, as well as accessible and standardized coursework, African governments can similarly push ATM as a cultural export.

COVID-19 Presents an Opportunity to “Reimagine” the Use of Traditional Medicines

While TCM usage is still dwarfed by ATM usage across Africa, China’s fervent financial and logistical support of TCM has enabled its growth internationally and presents it as a fierce future competitor. African governments have been taking greater strides to develop National Policies and Regulatory Frameworkstowards traditional medicine, but it will still take a great push to secure African traditional healing’s future. This renewed emphasis is critical, especially in light of COVID-19 and the light it has shone on medical systems across Africa.

 

Author: Chazha Ludo Macheng and Atharv Gupta are policy analysts at Development Reimagined.

This article was originally published on the China-Africa Project website on June 24 2020

Recommended Posts
Showing 2 comments
  • Anthony Rees
    Reply

    The premise that African Traditional Medicine (ATM) can be systematized and regulated in the same manner as Traditional Chinese Medicine (TCM) has some serious irreconcilable pitfalls with what the authors claim. Firstly, the African tradition of divination and herbalism is passed on through an oral lineage and ritual, plus a right of passage through esoteric means (divination, intuition, dreams and animal sacrifice to appease ancestral spirits), whereas the TCM system has been recorded and codified in writing for thousands of years. The TCM system is a complete and codified system in itself, which can be taught through textbook, monographs and applied theory. ATM is learned by through basic guidance from peers but most of the selection of plants for medicinal used is guided by divination, intuition and dream, rendering it not compatible with formalized education systems, assessment and training. Health Maladies in the ATM tradition are ascribed as imbalances related to positive or negative spiritual relation with dead ancestral spirits, and not mere binary imbalances of body system function which are measured through clinical observation and symptomology in TCM (Wet/Dry, Cold/Hot, etc).

    In one of the tables above South Africa is cited as only having 3,289 ATM healers, when in fact it is estimated to have over 180,000. In South Africa there is growing animosity between ATM healers and CTM, with indigenous healers seeing them as a threat to the formalization and recognition of their practices, due to universities and government seen to be more supportive of TCM than local indigenous medicine.

    • Kien Choong
      Reply

      Arguably, African Traditional Medicine and Chinese Traditional Medicine are going through a process of standardisation and objective scrutiny that “Western Traditional Medicine” (aka “Western Medicine”) has gone through. The standardisation process and objective scrutiny will mean abandoning some traditions, while building on other traditions.

Leave a Reply to Kien Choong Cancel reply

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt

EDMOND BOSILONG

Research Analyst

Edmond is a research analyst who is passionate about sustainable development, innovation, and the environment. Passionate about climate financing, he firmly believe there is a more reliable system to promote equality, growth, and welfare in societies without affecting the ecosystem. Through his skills, knowledge and experienced gained over 7 years, he wants to make an impact in the world of development. Edmond holds a Master’s Degree in Public Policy from Korea Development Institute and a BA Degree (Honors) in Business from University of Derby.

   HANNAH RYDER

    Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.

LEAH LYNCH

Deputy Director

Leah Lynch is Deputy Director of Development Reimagined (DR), and head of the China office. Leah has over 10 years of experience in development and has lived in China for over 8 years. Leah has also travelled extensively around Asia and Africa for research. Leah supports the strategic direction of the team across China, with a mission to deliver high quality research on sustainable development and poverty reduction. Leah is also Chair of the Sustainability Forum at the British Chamber of Commerce in China, providing direction on sustainability initiatives for British and Chinese business. Leah has also consulted on various evaluations on UK aid (ICAI) and is a specialist on development cooperation from the UK and China. Leah has also consulted on various UN projects, including providing support to the UN China team during the COVID-19 Pandemic. Prior to DR, Leah was at the United Nations Development Programme (UNDP) China, supporting the UN’s portfolio on communication strategies, China’s South- South Cooperation and the Belt and Road Initiative (BRI). Before UNDP, Leah lived and worked in Kenya developing sustainable water policies for the Kenyan government.

YIKE FU

China-Africa Policy Analyst

Yike Fu is a Policy Analyst and has been responsible for leading numerous areas of work, including on debt analysis in Africa and beyond, and China-Africa trade and investment logistics and analysis. She is the co-author of “African Debt Guide”, in which she challenged the narrative that Africa is in the midst of a new debt crisis by analysing data back to the 1970s and adopting new metrics to present the real story behind the data. She also developed a benchmark to compare the financial distribution of development partners such as the UK, US, Japan, France and China in Africa. Prior to her role at DR she worked at the International Finance Corporation and African Union Representational Mission to the US. She holds a Masters in International Affairs from George Washington University.

JUDITH MWAI

Research Analyst

Judith is a Research and Policy Analyst, where she specialises in Africa-China relations, international development, and diplomacy. During her time at Development Reimagined, Judith has co-authored several articles published in The Diplomat on debt and China-Barbados relations and was quoted by China Daily in a piece on Women Rights in China. Previously, Judith worked as a research analyst for an Advocate and Commissioner and Oats office in Kenya.

OVIGWE EGUEGU

Policy Analyst

Ovigwe specialises in geopolitics with particular reference to Africa in a changing Global Order. He is adept at critically analysing the politics of contemporary development processes and providing insight into the geopolitical interests that influence them. His work includes research, publications, tailored briefings and advising on global and regional trends, and issues at the nexus of geopolitics and development. Ovigwe appears frequently in media around the world such as Al Jazeera, TRT World, SABC, CGTN, BBC Radio, and other platforms.

JING CAI

Policy Analyst

Jing leads China-African health and agriculture cooperation research at Development Reimagined, having managed our FOCAC Policy Analysis and Advocacy project. She is also the co-author of “China-Africa Health Cooperation under FOCAC Umbrella”, in which she analysed China’s commitments around health cooperation since the first FOCAC summit and deepdived into four African countries’ health overview, challenges and cooperation with China as cases studies. Before DR, Jing worked at GIZ Cambodia on M&E of a disability advocacy project. She also worked as a translator with Chinese medical team in Benin.

PATRICK ANAM

Trade Policy Analyst

Patrick is an International Trade Policy and Trade Law Expert with over 5 years of experience. His expertise includes trade law, trade policy analysis and regional integration. He is currently engaged with Development Reimagined as a Senior Trade Analyst and was the lead author of Development Reimagined's recent Report on Africa-China Relations titled "From China-Africa to Africa- China: A Blue Print for a Green and Inclusive Continent-Wide Strategy Towards China." and “Reimaging FOCAC Going Forward.” Patrick has previously consulted for the East African Community, UNECA and for the Kenya Ministry of Trade.

ROSIE FLOWERS

Senior Policy Analyst 

Rosemary is our Senior Policy Analyst. She is a skilled policy analyst and has previously worked as a UK civil servant. She is studying Human Rights at Birkbeck, University of London with a research focus on international law in the context of health crises such as the COVID-19 pandemic.

JADE SCARFE

Project Manager and Africa-China Communication Assistant

Jade is a Project Manager for Development Reimagined’s flagship project Africa Unconstrained, which focuses on financing needs and debt vulnerabilities of African countries. Her research focuses on China-Africa development finance alongside debt vulnerabilities, infrastructure needs and South-South cooperation. She has worked with a breadth of stakeholders from China, Africa and the wider international community, including governments, private sector, NGOs and civil society. Her writing has appeared in a number of publications, including The Africa Report, The China-Africa Project, The Diplomat and more. Jade holds a Master’s in China and Globalisation studies from King’s College London.

ROSIE WIGMORE

Programme Manager

Rosie is the Project Manager of Africa Reimagined (AR) at Development Reimagined (DR) where she supports high-end African brands with entering the Chinese market by operating services such as trademark protection, Chinese market research, Chinese partnership building, and Africa to China logistical support and import/export services. Rosie has worked with DR for over two years now with proven success in helping high-end African brands navigate the Chinese market. She is extremely passionate about her work because more African brands selling in the Chinese marketplace means African countries can export MORE value-added goods, create MORE jobs and foster MORE innovation in African countries.

Rosie is also alumni of the School of International Studies at Peking University in Beijing where she is also an editor at the Peking Africa Think Tank. PATT is led by a diverse group of scholars who specialise in African Studies within the context of Sino-Africa relations.

LAUREN ASHMORE

Consultant

Lauren has lived in six countries from the Americas to Europe and Asia and speaks both French and Spanish proficiently. At Development Reimagined, Lauren’s research focuses on climate action both in the Asia-Pacific and in Africa, and how countries are using tools such as SDGs and Covid-19 action to build a more climate-resilient future. She holds a Masters in International Relations from Leiden University.

ETSEHIWOT KEBRET

Consultant

Etsehiwot holds a Masters’s degree in Development Studies from the London School of Economics. She has diverse experience in humanitarian and development issues by working in both multilateral organizations and international non-governmental organizations. Etsehiwot is currently a consultant focusing on the SDGs and development finance.

DIBEKULU MULU

Economist Consultant

Dibekulu is an economist by training. He holds an MSc in International Development Studies from Palacky University Olomouc, an MSc in Development Economics from the University of Clermont Auvergne, and an MSc in Economics, Finance, and International Integration from the University of Pavia. At Development Reimagined, he works as an Economist consultant. He has strong data analysis skills, with research interests centring around development finance, impact assessment, food security, and agricultural insurance.

OSARU OMOSIGHO

Project Manager

Osaru is a health professional with an MSc in Health Systems Policy and an interest in women’s health and population management. At Development Reimagined, she applies her health sector experience to global health research and collating locally applicable development insights from China.

PIER FERDINANDO CINOTTO

Research Analyst

Ferdinando’s research at Development Reimagined is centred on South-South Cooperation dynamics, specifically on the analysis of Chinese investment and debt flows in Africa and their linkages to African industrialisation. He is currently a Yenching Scholar at Peking University, after having graduated from the University of Cambridge with an MPhil in Development Studies.

DAVID TINASHE NYAGWETA

Research Analyst

David is a Research and data analyst at Development Reimagined. His scholarly focus is mostly on interdisciplinary research in demographic economics and development with interests in migration, economic development and policy, education, health and subjective well-being. He is currently a PhD scholar at Nelson Mandela University from which he also holds B.com Economics and Statistics and M.com respectively.

IVORY KAIRO

Research Analyst Kenya

Ivory is a Kenyan lawyer with experience in policy research and analysis. She also supports the communications team at DR. Ivory speaks English, Swahili and French.

JOY ENE

Research And Data Analyst China 

Joy Ene is a Research and Data Analyst at DR. Joy is passionate about African/global development, poverty eradication and trade policies between underdeveloped and developing countries. She is also a fourth-year student of International Economics and Trade at the  Liaoning University, Shenyang, China. She serves as the President of the Student Union, Liaoning University, International Students chapter.

CHENSI LI

Research Analyst 

Chensi Li is a research analyst. She has previously worked for local NGOs in Nigeria and Cameroon and think-tanks in China.  Her research areas include Sino-African relations, African foreign affairs, public diplomacy, state-building and national governance.

Yixin Yu

Research Analyst 

Yixin is a Junior Research Analyst and her focus areas is on public-private partnership and entrepreneurship. She has over three years of working experience in both private and public sectors in Ethiopia. She was the China Liaison Officer for project ‘Partnership for Investment and Growth in Africa’ at International Trade Centre, where she accumulated rich experience in investment and trade promotion

HANNAH RYDER

Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.