Madagascar’s COVID-19 Remedy and the challenges of African Traditional Medicine
Madagascar, officially the Republic of Madagascar, (and previously known as the Malagasy Republic), an island country in the Indian Ocean, approximately 400 kilometres off the coast of East Africa, has been making waves recently with its claim of a herbal cure for COVID-19. The country’s President, Andry Rajoelina, 45, claimed that the herbal syrup, known as Covic Organics (CVO), led to the recovery of some 105 COVID-19 patients in his country. Officially CVO was developed by the Malagasy Institute of Applied Research (IMRA) and is being distributed to the country’s citizens free of charge. In what is clearly an influence operation, President Rajoelina decided to donate the herbal remedy to the 15-members of the sub-regional bloc, the Economic Community of West African States (ECOWAS).
The World Health Organization warned that it did not approve CVO for COVID-19 patients. In the same vein, ECOWAS dissociated itself from reports of a donation to its members. Several medical and pharmaceutical associations in Africa and elsewhere and their representatives ridiculed the claim. But Madagascar refused to back down. In an interview with some France-based media organizations President Rajoelina posed a rhetorical question to the reporters: “If it were a European country which had discovered this remedy, would there be so many doubts?'”
The refusal of Madagascar to back down from its claim probably forced the WHO to modify its position by calling for clinical trials of CVO. It was in fact reported that WHO met with 70 traditional medicine experts in a bid to find cure for the pandemic. ECOWAS was also forced to modify its earlier antagonistic ‘modern’ position by stressing that it is not against traditional or herbal contributions to health challenges but that it will endorse only products that had been scientifically tested and proven.
Amid the controversies, Buhari reportedly gave orders that the country’s own share of the CVO donation in Guinea Bissau be airlifted but must be subjected to necessary standard validation processes for medicines. While I agree with the position of the President, I feel he should have used the opportunity to call for unbiased evaluation of not just Madagascar’s CVO but also other local herbal and non-herbal claims on the cure for COVID19.
Whether Madagascar’s syrup works or not is beside the point. After all the race for cure for COVID-19 has been trial- and- error across the world, with some drugs and compounds initially touted as possible magic bullets in some Western countries failing in clinical trials. So if COVID-19 fails critical trial, it will not be the end of the world. The critical issue is the confidence the country has displayed in defending its herbal syrup – despite knowing that any announcement of a cure would bring it on collision course with several Western nations, the big pharmaceutical companies and their representatives and would also amount to challenging the unconscious but strongly-held ideology that doubts that anything good can ever come out of Africa. Most African leaders internalized such ideological and racial framings and are therefore too diffident to push for any indigenous remedy or innovation as Madagascar’s president has done. In this lies the support Madagascar and its President have received for CVO from many African media organisations, despite genuine concerns about whether the syrup has actually been properly clinically evaluated as claimed – not only to establish its claim but also for safety and side effects.
In essence, in the current COVID19 world, Madagascar, an island country of about 28 million people in the Indian ocean, (which is not even fully African), has seized the initiative to represent the voice of Africa in the search for the global cure for COVID-19. Whether the remedy works or not, Africa must not allow this to be an opportunity to ridicule its indigenous innovation through self-hatred and ‘bleaching complex’. For Nigerians who like to complain that they are not respected by other African countries that benefitted from Nigeria’s generosity in the past, the case of Madagascar and CVO is an example of why they do not. In international relations, you are respected not because of your past benevolence but because of the current leverages you can bring to the table, including providing leadership at critical points.
It is instructive that as Madagascar refused to back down from its claim, and countries became willing to at least give the syrup the benefit of the doubt, the Health Minister Dr Osagie Ehanire was reported to have claimed that ‘Artemisia annua’, the plant extract in Madagascar’s CVO, also grows in Nigeria. This again is beside the point, after all there have been several local claims of herbs (and even non-herbal remedies) that could cure the virus. The question is why did the Health Ministry not quickly organize clinical evaluation for some of the claims with a view to supporting those that showed promise and putting in place structures to shield them from inevitable ridicule and intellectual property theft from competitors, including competition for the honour of which country will discover the cure first? That would have been Nigeria showing effective leadership on a global stage, and not to announce, as the Information Minister Lai Mohammed did recently when President Trump reportedly called Buhari on the phone that “Buhari briefed him on the steps the country is staking to contain the pandemic’
There are several observations arising from the controversy over Madagascar’s CVO:
One, traditional African medicine needs to modernize itself and adopt some of the procedures of Western medical practices such as peer-review mechanism. Diagnosis in herbal medicine is often reached through spiritual or non-transparent means and a treatment is prescribed, usually consisting of prescription of herbal solution which is considered to have not only healing abilities but also symbolic and spiritual significance. This makes it difficult not only to improve on the practice (or even the efficacy of the herbs) as Western medicine does repeatedly but also creates the room for quacks to make bogus claims and swindle unsuspecting consumers. Essentially, African traditional medicine needs to address the problems of lack of research data, it needs to develop appropriate mechanisms for control of herbal medicines, information sharing, safety monitoring, and methods for evaluating efficacy and safety. It also needs regulation. All these are among the reasons many people (including my humble self) completely shun it.
Two, secrecy is one of the greatest hindrances to African science and innovation, making it difficult for others to use same procedure to get claimed result – as obtains in Western medicine. While Western medicine uses patents to protect one’s innovation from being stolen, Africans use secrecy, often claiming that the efficacy of the herbs came from their great grandfathers – or even, for effect, from water mermaids. In contrast, Traditional Chinese medicine (TCM), is an important example of how ancient and accumulated knowledge is applied in a holistic approach in present day health care. China has books on herbal remedies. For instance the book The Devine Farmer’s Classic of Herbalism, believed to be the oldest known herbal text in the world, is said to have been compiled over 2000 years ago. Where is Africa’s equivalent?
Three, herbal medicine is a potential source of huge revenue. In Africa it is estimated that up to 90 per cent of its population depends on traditional medicine to help meet their health care needs. This is a huge potential market. Usage of traditional remedies usually increases when conventional medicine is ineffective in the treatment of disease – as we have currently with COVID-19. The potential for export is also huge. For instance in 1990 expenditure associated with “alternative” therapy in the United States was estimated to be US$13.7 billion – and this had doubled by 1997. In Australia, Canada, and the United Kingdom, annual expenditure on traditional medicine is estimated to be over US$80 million, US$1 billion, and US$2.3 billion, respectively.
Four, while Africa wallows in self-hatred and ‘bleaching complex’, the Western countries are encouraging research into herbal medicine, (including on African herbs) and chances are that they will improve on the efficacy of our medicinal herbs, modernize their practice and then get our medical tourists to be their chief patronisers. For instance in 1989, the U.S. Congress established the Office of Alternative Medicine within the National Institutes of Health to encourage scientific research in the field of traditional medicine. In Europe, the European Scientific Cooperative on Phytotherapy (ESCOP) was founded in 1989 with the aim of advancing the scientific status and harmonization of phytomedicines at the European level. In 2004, the National Canadian Institute committed nearly US$89 million for studying a range of traditional therapies. When they have fully researched and harnessed traditional medical practices and herbs, including our own, we will, with our usual ‘begging bowl’ start looking up to them to donate some to us, and if we are not getting them as quickly as we want, we will accuse them of imperialism.