传统中药正在非洲发展。它能帮助对抗COVID-19吗?

 In op-ed, 分析

随着新冠肺炎疫情席卷全球,各国政府不得不面对一个严峻的现实—不堪重负的医疗系统。这所带来的影响是病态的,全世界确诊病例超过700万,死亡40万人。在没有救治方案或疫苗的情况下,替代治疗方案越来越流行,最新的替代方案则是传统草药。马达加斯加最近因其对病毒的非常规解决方案而受到审查—COVID-Organics,一种源于非洲传统疗法的草药。尽管进行了仔细的审查,但是它提出了一个问题:“非洲传统医学(ATM)能否在全球卫生部门中发挥作用?”。同时,非洲传统医学可以从中医获得世界认可策略中学到些什么吗?还是说,非洲传统医学(ATM)会变成中医(TCM)的潜在威胁?

什么是中医?它和非洲传统医学又有什么不同?

因文化和地区不同,传统康复医学在各国也有不同表现。中国和非洲社区在传统医学体系方面都有悠久的历史。特别是中国投入了巨额资金来促进中医药的现代化,资助临床研究及其分配以赢得国际认可。因此,中医药在包括非洲在内的世界各地越来越受欢迎。

根据美国国立卫生研究院的说法,中医拥有一千多年的历史,它使用草药和针灸等方法来解决健康问题。支持者认为中药可避免现代医学的化学副作用,因此它已成为西药的替代品。随着非洲已经拥有超过一百万的中国移民,及越来越多的非洲学生学习中医,中医从业者的数量正在迅速增加。一些中药产品已成功开发为现代药物,例如抗疟药青蒿素,但科学界对中药的功效仍存在分歧。

然而,数据表明,中医在非洲的流行程度远不如传统非洲医学。迄今为止,只有五个非洲国家收集了中医相关信息,这表明需要更多的努力来追踪中药的扩散。在这五个国家中,传统医学从业人员比中医从业人员多出数千人。中医药在非洲也远不如现代医学流行。睿纳新咨询于2018年为联合国艾滋病规划署(UNAIDS)和中国医药保健品进出口商会(CCCMHPIE)进行的研究表明,在21个非洲国家中,中药平均仅占中国所有药品和保健品出口的2%。而在这些国家中,最高水平为5%来自加纳。但是,需要注意的是,中医在非洲的影响力可能被低估了,因为某些中药产品被注册为食品/饮食补充品,而不是药品。

非洲的中医药通常通过个人网络和小型当地诊所进行分发。以ZS医生在内罗毕的标准中医诊所为例,内罗毕拥有15家注册中医诊所。ZS的诊所每月接收200多名新患者,主要是中上阶层的中国和肯尼亚公民。ZS认为中医在非洲的普及是由于其与非洲传统医学的相似性,大多数人认为传统方法比现代医学更健康。

但是,非洲传统医学超出了正常的治疗范围。非洲传统医学包括了一整套医疗保健,分为三个等级:占卜,精神治疗和草药治疗。传统的治疗师根据社区中普遍存在的文化、宗教背景、知识和信仰提供医疗服务。因此,与中医不同,非洲传统医学仅是通过口头交流从治疗者那里学习的来,因为该知识并未被记录下来。另一方面,通过包括非洲在内的课程学习,中医的知识可广泛飞很多人获得。例如,南非的八所医学院中有六所提供中医学位(学士学位和研究生学位)。

然而,尽管中医和非洲传统医学在整个非洲大陆很受欢迎,但大多人仍然对非洲传统医学(以及中医)感到羞耻。传统疗法依赖于有效性的轶事记录,因此面临缺乏临床测试的情况,从而导致错误信息。例如,赞比亚治疗者声称非洲马铃薯品种可以治疗艾滋病的说法后来被发现是不正确的。实际上,他分享说,错误使用它甚至可能导致严重的副作用。

无论经过何种审查,都必须注意,现代医学以及食品和膳食补充剂都源于古代医学。遵循传统知识和经验提供的指导,非洲生物多样性将来可能会开发许多重要的新补救措施并将其商业化。此外,非洲的治疗方法不仅价格便宜,而且还提供各种专业知识。

中国使用有针对性的政策来推动中医药的发展但在这方面,非洲传统医学落后于中国

中国在非洲拥有重要的医疗力量,自1963年以来已派出40,000多名医生。目前中国在非洲大陆拥有46个医疗队。从2000年的中非传统医学论坛开始,北京将这些努力扩展到中医药领域,此后在非洲越来越流行,其原因有四个:

  • 中国长久以来对非洲的医疗帮助已经在当地形成了对中医的信任。
  • 中医的方法和非洲传统医学有相似之处
  • 非洲不完善的健康医疗系统使得中医称为替代品
  • 中国对于中医临床研究和出口投入了巨大资金

然而,尽管非洲大陆广泛使用传统医学,但非洲各国政府已制定了不同级别的法规。下表突出显示了非洲的各种监管行动(不仅针对中医药,而且还针对传统医药)。该表显示,尽管非洲各国政府的国家政策超过了世界其他国家,但它们在草药的监管和注册方面却滞后。缺乏监管进一步削弱了传统药物(中药和非洲传统医学)的信誉,损害了数据收集工作,使当地诊所受到最小程度的监督,并削弱了政府研究和进一步开发基于草药的药物的努力。由于中药已经从中国的支持中受益,因此它避免了许多此类问题,使非洲传统医学(ATM)缺乏监管。

非洲可以从中医的发展中学到什么?

中国的中医药方法在国际上促进了其发展和安全,因此,非洲各国政府可以通过三种方式效仿中国模式:

1.对非洲传统医学的研发加大投入

尽管非洲有5,000多种公认的药用植物,但由于缺乏研发支出,阻碍了它们向商业药物的过渡。相反,中国对中医药的支持推动了测试的发展,甚至赢得了世界卫生组织的认可。世卫组织于2019年首次在其有影响力的国际疾病分类中论述了中医药的治疗方法。没有正式的研究来支持非洲的传统医学,它将永远不会得到认可,也不会传播给更多的受众。

2. 制定法规和课程来监管和教授非洲传统医学:

与非洲的传统医学不同,世界各地的医学院都有教授中医,这使得它变得更加容易获得。此外,中国对中医药的监管使研发和数据收集工作更加完善。因此,非洲各国政府应采取类似步骤,标准化其他非洲和非非洲国家的非洲康复教育,并规范草药的使用。通过采取这些步骤,政府可以使非洲传统医药合法化,同时也促进其普及。

3. 推动非洲传统医学泛非洲和全球分销网络:

一旦中国通过研究、改善受教育机会和供应链为中药提供支持,他们便可以将其用于主要的文化产品出口。同样,在适当的支持下,非洲各国政府也可以获得相同的好处。这一研究支持对于传统医学在国际上的成功至关重要。例如,马达加斯加因推广COVID-Organics而在整个非洲大陆广受欢迎,但由于担心该产品的有效性,也受到了很多回击。因此,一旦非洲传统医药具有足够的研究和监管支持以及可访问的标准化课程,非洲政府就可以类似地将非洲传统医药推向文化出口。

新冠肺炎提供了重新构想传统药物使用的机会

尽管非洲各地的传统医药使用量与中药的使用量相形见。但中国对中药的强大财政和后勤支持使中医在国际上得以发展,并使其成为未来的激烈竞争者。非洲各国政府在开发针对传统医学的国家政策和监管框架方面已迈出了更大的步伐,但仍将为确保非洲传统治疗的未来做出巨大努力。重新强调这一点至关重要,尤其是考虑到新冠肺炎及其对整个非洲医疗系统的影响。

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