Health Portfolio Committee

14 November 2012

Challenges facing Traditional Healers: briefing by National Unitary Professional Association for African Traditional Health Practitioners of SA & Traditional Healers Organisation

Chairperson: Dr B Goqwana (ANC)

Relevant Documents:

Traditional Medicine Landscape in SA (NUPAATHPSA)

Traditional Healers Organisation 13 November 2012

Audio Recording

Summary

The National Unitary Professional Association for African Traditional Health Practitioners of SA and the Traditional Healers Association briefed the Committee on the current state of affairs and challenges facing traditional healers. Traditional health practitioners were widely used in South Africa but traditional medicines were merely tolerated and were yet to be formally institutionalised. South Africa had developed legislation on indigenous knowledge systems ie the Traditional Health Practitioners Act No 22 of 2007. The Act however still had to be implemented.

The challenges that remain were the total neglect on the registration and regulation of African Traditional Medicines. There was a need to test traditional medicines in clinical trials to protect consumers and to add value to African Traditional Medicines products. The Medical Control Council needed a total revamping and the proposal was that there should be a separate council for the registration and regulation of African Traditional Medicines products.

Another point was that traditional medical practitioners and complementary and alternative medicine practitioners not covered by medical schemes. The Traditional Healers Organisation wished traditional medicine and complementary medicine to be included in the National Health Insurance System.

Due to time constraints there was very limited interaction between the Committee and the presenters. Most of the questions were for clarification purposes. The Committee however agreed that another meeting would be scheduled with the presenters so that further interaction could take place.

Minutes

The Chairperson informed the Committee that the representatives from the Traditional Healers Organisation were delayed at the airport and would join the meeting a little later. In the meantime the Committee would proceed with consideration and adoption of outstanding minutes as time was of the essence.

Outstanding Committee Minutes

The minutes dated 22 August 2012 was adopted as amended after the Committee agreed to delete one of the resolutions it took.The Committee adopted minutes dated 29 August 2012 unamended.

Referring to minutes dated 19 September 2012, Ms Segale-Diswai pointed out that the Committee recommendation on primary health care in the Western Cape was not reflected in the minute. The Committee agreed that the recommendation should be added to the minute and it was adopted as amended.

Mr G Lekgetho (ANC) and Ms P Kopane (DA) stated that their apologies for not attending the meeting were not reflected in the minute of the 10 October 2012. The Committee agreed that the minute should be corrected and it was adopted as amended.

Minutes dated 12 October 2012 was adopted as amended after a spelling change was made to it.

The Committee adopted minutes dated the 9 October 2012 unamended.

National Unitary Professional Association for African Traditional Health Practitioners of SA (NUPAATHPSA)

The National Unitary Professional Association for African Traditional Health Practitioners of South Africa (NUPAATHPSA) briefed the Committee on the traditional medicine landscape in South Africa (SA). The briefing was undertaken by Mr Lizwi Solly Nduku General Secretary of theNUPAATHPSA. The status was that the majority of people in SA still relied on the services of Traditional Health Practitioners (THPs). Traditional medicines were merely tolerated and were yet to be formally institutionalised. SA had developed legislation on indigenous knowledge systems i.e. the Traditional Health Practitioners Act No 22 of 2007. The Act however still needed to be implemented.Older pieces of legislation which were obstacles to the Act were yet to be repealed. There were approximately 250 000 THPs. There were however advances made in African Traditional Medicines (ATMs). For example the National Department of Health (NDOH) had established a Directorate of Traditional Medicines. Opportunities that might emerge were that traditional medicine knowledge could be harnessed into national health programmes and that science research when fully supported, could put ATM on the global stage and possibly influence policy changes. One of the challenges that remainedwas the total neglect on the registration and regulation of ATMs. There was a need to test traditional medicines in clinical trials to protect consumers and to add value to ATM products. The Medical Control Council (MCC) needed a total revamping and the proposal was that there should be a separate council for the registration and regulation of ATM products. The MCC had not even had a meeting in two years. There was a need to institutionalise ATM. A separate ATM Directorate outside of the NDOH was needed.

All government departments that dealt with IKS and THP matters should use a proper consultative approach and engage with organised groups. THPs should be able to decide and handle matters pertaining to them and not be decided by others.

Traditional Healers Organisation (THO)

Ms Phephsile Maseko National Coordinator for the THO undertook the second leg of the briefing. She noted that she would not be repeating aspects already covered by Mr Nduku. The THO had been established in 1970 and in 2011 its membership sat at 72000. The conduct of its members was regulated by the Traditional Health Practitioners Council which fell under the NDOH. In terms of healthcare practitioners in SA there were some 34 000 doctors but there were 185 500 traditional medicine practitioners. There were also 3600 complementary and alternative medicine (CAM) practitioners. The issue however was why traditional medical practitioners and CAM practitioners were not covered by medical schemes. Traditional medicine trade in SA was a large and growing industry. There were some 27 million consumers of traditional medicine. In 2006 trade of these medicines contributed R2.9bn to the SA economy. Traditional medicine created 133 000 income earning opportunities and 72% of SA’s black African population used traditional medicine. In terms of medical scheme benefits, hospital and specialist expenditure had escalated faster than any other areas. There was a massive shift to cover hospital and specialist visits away from primary care. Primary care was covered more from the pocketsof consumers.

Traditional healers were disappointed after SA became democratic in 1994. Traditional medicine was relegated to the periphery and was not recognised in the mainstream. A change was needed and government needed to review its policies. The THO wished traditional medicine and complementary medicine to be included in the National Health Insurance (NHI) System. Consumers had the right to choose in terms of their cultural heritage and belief systems. There was greater consumer action on ATM. Some challenges on ATM were funding for the development of the industry, the inclusion of the ATM into the NHI, lack of political will and stimulating the cultivation of medicinal plants. The THP Act of 2007 also needed to be implemented.

Discussion

Ms B Ngcobo (ANC) noted that if there were THPs who did not know about the THP Act of 2007 why was the THO not educating the persons. She noted that research should be done by researchers, how was the THO to be part of it. She asked what could be done to bring members of the THO together? THO members were so fragmented and all over the place. Besides they were also jealous of each other.

She noted that the MCC was in the process of transformation. The Committee had also been concerned about it.

Ms Maseko said that breakthroughs also happened in traditional medicine. There were benefits through investment in drug development. None of the funds made its way back to traditional medicine even though lots of drugs had their basis in traditional medicine. Traditional medical plants were used for drug development.

Mr Nduku said that the THO had been involved in the process of the THP Act and engaged with THPs.

Ms M Segwale-Diswai (ANC) pointed out that the problem was organising THPs under one roof. There were so many different THPs. At the end of the day they were not under one roof. How then were they going to be united under one council?

Mr Nduku addressed the issue of unity of THPs and said it was being looked at. THPs had been marginalised and a further complication was that the sector was complex.

Ms R Motsepe (ANC) asked what could the THO do about HIV/Aids. She pointed out that there were THPs who professed to be able to take care of unwanted pregnancies without hassles and pain. They were often located near to stations and malls. How was the THO dealing with it?

Mr G Lekgetho (ANC) asked whether the THO had interacted with the NDOH about being included in the NHI. If no meeting had taken place as yet what was the delay.

If it was correct that the MCC had not met in two years the Committee needed to look into the matter.

Ms T Kenye (ANC) noted that if research in SA was taking a positive turn what did it entail. Was it correct that the THO wished to have a separate council for ATM. Given the different categories of health care practitioners which ones were monitored by the THO.

How did the THO distinguish credible healers from non credible ones. Did the THO have strategies in place to advertise the benefits of THP.

Ms Maseko stated that the work of the THO was based on the THP Act. Persons not falling within the four categories provided by the Act could not be covered. People used spiritual feedback, the THO focussed on science.

The Chairperson commented that life was dynamic and that SA was in an era of information. How did the THO connect health with traditional health practises.

Ms Cheryl Dudley (ACDP) asked whether the THO had spoken to the NDOH over the issue of a Traditional Health Practitioners Council. If there were 185 500 practitioners how many people were there using them. If people were happy with THPs why then were there so many people flocking to the public health system.

The Chairperson said that the Committee should agree that the topic of traditional health practitioners was an important one. Due to time constraints the Committee would have to interact with the presenters at another opportunity.

Ms P Kopane (DA) asked if the 185 500 THPs registered annually with the THO and whether they paid an annual fee. Were inspections done to check on whether THPs complied? She also asked if there were 133 000 employment opportunities what was the benefit in rand value. Where did the statistics come from? She addressed Mr Nduku and asked how many times he had tried to arrange a meeting with the Minister of Health.

Ms Maseko explained that the statistics were taken from a survey of the SA Health Review 2007.

The Chairperson stated that the presenters would not be able to answer all questions due to time constraints.

The Chairperson apologised for cutting the presenters responses short due to time constraints. He emphasised that the issues of false claims and registrations could only be resolved if the THP industry was to be elevated.

Mr Nduku said that the rest of the responses to questions would be forwarded to the Committee.

The meeting was adjourned.