As the second – more deadly – wave of the Coronavirus sweeps through Africa sending infection and death rates soaring, citizens without access to modern medical services and unsure if any vaccines will ever reach them have turned to traditional medicines whose efficacies and safety are unknown.
A booming voice from a hailer announces the arrival of Sekuru Sithole in Hopley, an unplanned and crowded settlement on the outskirts of Zimbabwe’s capital, Harare, where the poorest of the poor live. The grey-haired herbalist is slowing driving a battered pick-up truck laden to the brim with bunches of a green shrub known locally as Zumbani. Little known until now, this shrub – whose botanical name is Lippia javanica – has suddenly become the most sought after commodity in this southern African country where it is being touted as a cure for the deadly novel Coronavirus.
“This herb is not only the best at fighting any flu, but also boosts one’s immune system,” the herbalist explains to his clients. “Our forefathers used this and many other herbs which explains why most of them had very long lives,” he added.
There is no need for him to preach to the converted as the anxious residents are already sold to the idea that this shrub can cure them. Even if one has any doubts, there is no viable alternative within their immediate reach.
So high is the demand for this shrub by the desperate residents, who are already enduring a 30-day lockdown that is reinforced with a dusk-to-dawn curfew, that in less than an hour, the herbalist is driving his empty truck out of the suburb – most likely to get another truckload from the bush where it grows in wondrous abundance during this rainy season.
Many who have tested positive for COVID-19, or have had what they suspect to be its symptoms attribute their survival to this shrub and a bewildering range of other herbal cocktails that are spreading throughout both urban and rural communities at a rate that matches their fear of the virus. Every household has its own cocktails that it relies on to – prayerfully – keep the virus at bay.
Some private hospitals are demanding anything from US$5,000 upfront for admission – an amount that would take most workers in the country several years to earn – leaving them with no option but to reconcile themselves to the reality that herbs are their only hope in the face of the ravages of the pandemic.
Zimbabwe’s public health sector has been in doldrums for a long time, with doctors and nurses repeatedly going on strike – citing poor salaries and a critical shortage of drugs, equipment and consumables in hospitals. The Coronavirus has only compounded an already bad situation in a country 98% of whose medical drug supply comes from donors.
The reality of the threadbare health system meant that, soon after the Coronavirus outbreak reached Zimbabwe in March last year, the Ministry of Health quickly authorised herbalists like Sithole to treat patients showing symptoms of the virus.
In the absence of adequate modern health systems, the reality for many countries in Africa is that traditional medicine fulfils the role of primary care. In recognition of this, some countries have long attempted to professionalise traditional medicine, with debatable success. For example, Zimbabwe passed the Traditional Medical Practitioners Council Act as far back as 1981.
The uncertainty that Zimbabweans face is shared by the bulk of the African continent’s 1.2 billion citizens, most of who, not only live without any modern health facilities but also whose governments lack the financial resources to acquire vaccinations outside of the COVAX framework, which is itself beyond their control. Only South Africa, the country worst affected by the pandemic on the continent, has made arrangements to secure some 20 million vaccine doses on its own.
The first wave of the virus had a minimal effect on Sub-Saharan African countries, but the second wave that started in December is proving to be deadlier, forcing many countries across the continent to renew strict lockdown measures. The increasing desperation is driving most Africans to rely on herbs whose efficacy is not scientifically proven.
Even in China, where the Coronavirus is believed to have originated, the initial reaction was to resort to traditional remedies, which Chinese and other Asian communities have used for centuries. Africa is not different. According to the World Health Organisation (WHO), 83% of Africans rely on traditional herbal remedies.
From Zumbani in Zimbabwe to Covid-Organics in Madagascar, to Dawa in Kenya, to African wormwood in South Africa, almost every country has its own array of traditional herbal concoctions that its citizens are using. Most of these remedies have been used in their cultures before the new Coronavirus and are now being used in both its prevention and treatment.
For centuries, especially in countries where modern medications, prescriptions and hospital visits are largely inaccessible (physically, economically or both), people have always relied on remedies passed from one generation to another. So desperate is the need that some even refer scriptures such as Ezekiel 47:12 and Revelations 22:2 as direct instruction from God for them to use herbs for medical purposes.
Word of Caution
The African Union, through the Africa Centres for Disease Control and Prevention (Africa CDC), has cautioned that currently there is no herbal remedy validated to prevent or treat COVID-19.
“As the pandemic continues to spread in Africa, there are increasing messages promoting the use of herbal-based traditional medicines for COVID-19. Currently, no herbal remedy has been validated for use to prevent or treat COVID19,” the centre said.
“There have been several declarations by institutions in member states on the use of herbal-based traditional medicine for the prevention of SARS-CoV-2 transmission or treating people with a presumptive or definitive diagnosis of coronavirus disease 2019 (COVID-19). Many of the claims are difficult to verify because of the lack of documented evidence showing that these remedies prevent or clear SARS-CoV-2 infection and/or improve clinical outcomes of those suffering from COVID-19.”
Clinical Trials Underway
In September last year, a Regional Expert Committee on Traditional Medicine for COVID-19 formed by the World Health Organization (WHO), the Africa CDC and the African Union Commission for Social Affairs endorsed a protocol for phased clinical trials of herbal medicine for COVID-19 as well as a charter and terms of reference for the establishment of a data and safety monitoring board for herbal medicine clinical trials.
“Just like other areas of medicine, sound science is the sole basis for safe and effective traditional medicine therapies,” said Dr Prosper Tumusiime, Director of Universal Health Coverage and Life Course Cluster at WHO Regional Office for Africa.
“The onset of COVID-19, like the Ebola outbreak in West Africa, has highlighted the need for strengthened health systems and accelerated research and development programmes, including on traditional medicines,” said Dr Tumusiime.
Politics of COVID-19 Vaccine
With the much-awaited COVID-19 vaccines now becoming available, the stampede in accessing them has served to highlight the jaw-dropping inequalities in the global health system as rich countries have reportedly resorted to a “me-first approach”, even going to the extent of getting them outside the framework of the COVAX facility.
This is a global pooled procurement mechanism for COVID-19 vaccines through which COVAX seeks to ensure fair and equitable access to vaccines for all 190 participating economies, using an allocation framework formulated by WHO.
While most Africans are still rubbing palms expectantly – not knowing when the vaccine may reach them – citizens of most wealthy nations have already started getting vaccinated as these countries bypass the COVAX framework to hoard the vaccines straight from the manufacturers.
This has prompted WHO Director-General Tedros Adhanom Ghebreyesus to express fear that “even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots.”
“Even as they speak the language of equitable access, some countries and companies continue to prioritise bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong,” Tedros said while addressing WHO board executives.
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A disappointed Tedros reported that so glaring is the disparity of the vaccine’s distribution outside COVAX that while 39 million doses had, as of January 17, been administered in nearly 50 richer countries, only 25 had been given in one lowest income nation (Guinea).
“I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries”, he added.
The “Vaccinationalism” Threat To Vaccine Access
United Nations Secretary-General António Guterres also stressed that COVID-19 vaccines must be a global public good, available to everyone, everywhere.
Speaking in New York at a ceremony for the world’s developing nations, he underlined the need for funding for medicines and diagnostics to defeat the virus.
“We need manufacturers to step up their commitment to work with the COVAX facility and countries around the world, in particular the world’s leading economies, to ensure enough supply and fair distribution,” Guterres said. “‘Vaccinationalism’ is self-defeating and would delay a global recovery.”
Africa’s Back-Up Plan
On January 13, the African Union announced that it had secured a provisional 270 million COVID-19 vaccine doses from manufacturers for member states to supplement the COVAX programme.
South Africa’s president, Cyril Ramaphosa, who chairs the Africa Union, said Pfizer, AstraZeneca – through the Serum Institute of India – and Johnson & Johnson, would supply the vaccines. “These endeavours aim to supplement the COVAX efforts, and to ensure that as many doses of vaccine as possible become available throughout Africa as soon as possible.”
Ramaphosa said while the COVAX initiative, co-led by the WHO, was vital to Africa’s response, the African Union was doubtful that the volume that COVAX would release between February and June would meet the needs of frontline health care workers, even though the stated aim of the COVAX facility is to make available 2 billion doses of safe and effective COVID-19 vaccines by the end of 2021.
Hopeful Pandemic Not Worse Than AIDS
As the politics of access to the Coronavirus vaccine play out, those of limited means in Africa would continue to seek solace in herbs, hoping that the vaccines may reach them just in time to save them.
There is a powerful lesson to be drawn from history. During the HIV epidemic, the woeful state of health systems meant that traditional medicine was the only option for most Africans. The tragic outcome was that these snake-oil ‘cures’ proved woefully ineffective when deployed in the treatment of HIV-AIDS resulting in Sub-Saharan Africa losing tens of millions of its citizens to disease.
Is history about to repeat itself?
Featured Image: Madagascar’s president, Andry Rajoelina, launching the Covid-Organics drink even though the African CDC has stated there’s no evidence to back up its claims. Credit RIJASOLO/AFP via Getty Images