African Traditional Medicine Day: 31 August 2026

Some statistics worth examining 

Traditional medicine is an important component of African health systems yet surprisingly little is known about the true extent to which people use these services. In South Africa, approximately 200 000 traditional health practitioners are estimated to be active, greatly exceeding the number of doctors registered with the Health Professions Council of South Africa3^3,4.   Though traditional medicine utilisation is poorly quantified, the sheer number of practitioners implies that it has an important role. Millions of health decisions are made in consulting rooms or spaces outside the formal healthcare system. On African Traditional Medicine Day, marked since African health ministers adopted the founding resolution in Ouagadougou in 2000, we can ask what the health system intends to do about this.

Rising global interest in Traditional Medicine 

Four forces are converging. 

Policy

In May 2025, the Seventy-eighth World Health Assembly adopted the Global Traditional Medicine Strategy with four objectives: strengthen the evidence base, ensure safety through regulation, integrate what is safe and effective into health systems, and optimise the cross-sector value of traditional, complementary and integrative medicine (TCIM).⁵

The second WHO Global Traditional Medicine Summit in New Delhi in December 2025 produced the Delhi Declaration, with time-bound commitments from 26 Member States, including South Africa, to establish national policies, laws and research centres.⁶

Epidemiology

The global health burden is shifting toward non-communicable disease in an ageing population. Chronic care is long-term, relational and dependent on self-management, the areas in which traditional medicine practitioners operate.

Economics

The goals of universal health coverage (UHC) are colliding with constrained budgets and declining donor funding. A large, trusted, already-deployed workforce is a potential asset.

Sovereignty

At the World Health Summit Regional Meeting in Nairobi in April 2026, panelists urged African leaders to move beyond symbolic endorsement toward budgeted, funded national workplans, and to develop intellectual property protocols that keep the value of indigenous knowledge on the continent.⁷

Notably, this is not just an African issue:
170 countries (88% of WHO Member States) report some use of TCIM.⁸

But what is African Traditional Medicine, actually? 

WHO-AFRO defines traditional medicine as “the diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singly or in combination to maintain well-being and to treat, diagnose or prevent illness”.⁹

African Traditional Medicine is therefore holistic: health and illness are understood as products of body, mind, emotion and spirit. The associated knowledge is largely oral, passed down through the generations. This oral transmission may be seen as problematic but is also a marker of trust.

It is certainly a regulatory challenge. Traditional medicine includes bark decoctions, bone-setting techniques and spiritual diagnosis, things that cannot all be evaluated, standardised or regulated in the same way.

South Africa’s cautionary tale 

In the early 2000s the SA government embraced AIDS denialism, with tragic consequences. The then Minister of Health, Dr Manto Tshabalala-Msimang, became infamous for promoting garlic, beetroot, lemon and the African potato. Modelling has estimated that more than 330 000 lives were lost between 2000 and 2005 because an ARV programme was not implemented, and that 35 000 infants were needlessly born infected with HIV.¹⁰

The systemic failure during this unfortunate period was not the consideration of traditional remedies as such but that traditional remedies were used to displace therapies of proven benefit, without evidence, and at scale, by the state.

There is a pointed footnote: laboratory work in SA subsequently showed that Hypoxis hemerocallidea (African potato) and Sutherlandia frutescens inhibit cellular processes that govern antiretroviral activity. The investigators warned that administering these herbs with ARVs can lead to treatment failure, viral resistance or drug toxicity. A later clinical study found reduced ARV (atazanavir) blood levels in HIV patients after consumption of Sutherlandia.^11,12 A remedy promoted as the alternative to ARVs may well have been undermining them.

Other important drawbacks  

• Lack of evidence. For most traditional preparations there is no defined active constituent, no standardised dose, and there have been no controlled clinical trials. “Used for generations” may be true but is not solid justification for uncontrolled use.

• Risk of toxicity. “Natural” is not necessarily “safe”. Impila (Callilepis laureola), contains atractyloside, a liver and kidney toxin, with adult and paediatric deaths documented in South Africa since the 1970s. Because patients often die before reaching hospital, and often do not disclose consumption, the true incidence of harm is unknown.¹³

• Drug interactions and dose error. Concurrent use of traditional medicines creates risky polypharmacy that is often invisible to the medical prescriber. Active constituents of traditional remedies vary with species, season and soil. One local reported case of kidney failure followed a self-administered dose at least eight times what the healer had prescribed.¹³

• No pharmacovigilance. There is, in practice, nowhere for a clinician or a healer to report a suspected adverse reaction to a traditional preparation.

• No curriculum, no register. The provisions of the Traditional Health Practitioners Act 22 of 2007 are still not in force. Nearly two decades later, no functional national register exists, enforcement mechanisms are absent, and the interim Council is expected to regulate the sector on an allocation of less than R7 million.¹⁴

• Cost. Integration of TCIM is not free. Co-location, training, registration systems and research all draw on the same limited health budget. Any claim on this budget deserves the same scrutiny we would demand of a new medicine – i.e., we would want to know which outcome improves, by how much, and at what cost.

Success stories 

But, there are modern success stories with traditional medicine that suggest paths to implementation; here are two.

China: scientific evaluation of traditional remedies 

In 1967, a Chinese research team compiled 640 folk remedies, screened 2 000 recipes and prepared 380 extracts. Sweet wormwood (Artemisia annua) was repeatedly noted as a traditional remedy for “intermittent fevers” but early extracts were pharmacologically disappointing until a 1 600-year-old text, written around 340 CE, suggested a method of low-temperature extraction that preserved the active compound, artemisinin. Artemisinin-based therapy is now first-line treatment for falciparum malaria, has saved millions of lives, most of them African children, and earned Tu Youyou the 2015 Nobel Prize in Physiology or Medicine.¹⁵

India: institutional spread of TCIM  

In 2014, India upgraded its traditional medicine department to a full “Ministry of Ayush”. The sector now includes roughly 750 000 registered, institutionally qualified practitioners, more than 700 Ayush colleges with attached hospitals, some 12 500 Ayush wellness centres, and services co-located in about 26 600 primary health centres, 6155 community health centres and 759 district hospitals. Medical interns now take electives in Ayurveda, Unani and Siddha; Ayurveda curricula may include up to 40% modern content; and collaborative trials are run with prominent academic institutions.^8,16

Both China and India also illustrate the risk. Institutional enthusiasm can outrun evidence, and critics argue that the state’s promotion of TM has moved faster than trials would justify.

An important lesson from Asia is not that “traditional medicine works” but that registration, training standards, referral pathways, research councils and pharmacovigilance make it possible to assess outcomes and value.

Contextual factors: workforce, relationships, safety and evidence 

Five things follow from this.  

1. Patients are already using TM 

Medical pluralism is the norm: people move between traditional and modern systems. Typically, however, practitioners on either side are unaware of each other, and that needs to change for safe and effective use.

2. A workforce is hiding in plain sight 

In a cluster-randomised trial in rural Uganda published in The Lancet Global Health, traditional healers were trained to offer point-of-care HIV testing. All 250 clients (100%) in the intervention arm were tested within 90 days, against 23% of those referred to clinics; ten new diagnoses were made in the intervention arm and none in the control; no adverse events occurred, and the model was highly acceptable to healers and clients alike.¹⁷

In SA, the Vanderbilt–Wits “Know your Status” trial is testing healer-initiated testing and adherence support with the Kukula healers’ association in 42 clinic catchment areas, including healers accompanying clients to a first appointment and WhatsApp links to nurses.18 At a 2025 national event in Moruleng, practitioners trained with WHO support demonstrated their skills in recognising and referring diabetes, hypertension and cancer.¹⁹

3. Therapeutic relationships matter 

Traditional healers routinely offer what busy clinics struggle with: time, explanation in the patient’s own idiom, continuity, attention to family and social context, and an account of why the illness happened. Experience in the medical system confirms that expectation, ritual and the therapeutic relationship measurably affect symptom experience, adherence and satisfaction.

4. Patient safety is non-negotiable 

TCIM should not make claims to cure HIV, TB or cancer, or offer treatments that delay or substitute for a therapy of proven benefit. Two-way referrals should be the norm, so patients are not asked to choose sides. A functioning register should be in place, so that a trained traditional medicine practitioner can be distinguished from a fraud. And a route by which suspected adverse reactions are recorded for national pharmacovigilance.

5. Research must be done on African terms  

The 2026 Nairobi meeting established important principles: context-relevant evidence generation, robust regulation, and intellectual property protocols and benefit-sharing that reflect African priorities and value for local institutions and other contributors.⁷

Reasons for optimism 

More than 40 countries in the WHO African Region had national traditional medicine policies by 2022, up from only eight in 2000.20 Twenty-six member states, South Africa included, now have policy commitments. But our country has unfinished business – proclaiming regulations, funding the Council, and populating the practitioner register are achievable administrative factors that would do a lot for patient safety.

Science is not a set of approved facts but a method for finding out, and it is perfectly capable of being directed at traditional medicines, practices and practitioners.

Artemisinin was introduced when a 1,600-year-old prescription was taken seriously and tested properly. Africa has thousands of documented medicinal plant species and hundreds of thousands of practitioners with knowledge that has never been written down, let alone evaluated. Somewhere in this inheritance is another artemisinin, a body of practice worth confirming as safe and effective, as well as some things worth retiring.

On 31 August, the attitude toward traditional medicine should be respectful, curious and scientifically rigorous.

Information sources 

1. Africa Check. No data shows 80% of Africans use traditional medicine for “basic health needs” [Internet]. Johannesburg: Africa Check; 26 August 2016 [cited 7 August 2026]. Available from: https://africacheck.org/fact-checks/spotchecks/no-data-shows-80-africans-use-traditional-medicine-basic-health-needs 

2. Oyebode O, Kandala N-B, Chilton PJ, Lilford RJ. Use of traditional medicine in middle-income countries: a WHO-SAGE study. Health Policy Plan. 2016;31(8):984–91. doi:10.1093/heapol/czw022 

3. Bhekisisa Centre for Health Journalism. By 2025, sangomas will likely be unable to practise without registration [Internet]. 11 November 2024 [cited 7 August 2026]. Available from: https://bhekisisa.org/health-news-south-africa/2024-11-11-by-2025-sangomas-will-likely-be-unable-to-practise-without-registration/ 

4. Street RA. Unpacking the new proposed regulations for South African traditional health practitioners.
S Afr Med J. 2016;106(4):325–6. doi:10.7196/SAMJ.2016.v106i4.10623 

5. World Health Organization. Global traditional medicine strategy 2025–2034 [Internet]. Geneva: WHO; 2025. ISBN 978-92-4-011317-6 [cited 7 August 2026]. Available from: https://www.who.int/publications/i/item/9789240113176 

6. World Health Organization. Second WHO Traditional Medicine Global Summit: Member State commitments [Internet]. New Delhi; December 2025 [cited 7 August 2026]. Available from: https://cdn.who.int/media/docs/default-source/who-global-traditional-medicine-centre/2nd-traditional-medicine-summit-commitments.pdf 

7. World Health Organization. Turning commitments into care: Africa accelerates action on traditional medicine [Internet]. News, 14 May 2026 [cited 7 August 2026]. Available from: https://www.who.int/news/item/14-05-2026-turning-commitments-into-care–africa-accelerates-action-on-traditional-medicine 

8. Nesari T, Nesari M, Ruknuddin G, et al. India’s journey in mainstreaming Ayush in primary health care – from tradition to integration. Front Med (Lausanne). 2025;12:1629515. doi:10.3389/fmed.2025.1629515 

9. World Health Organization – Regional Office for Africa. African Traditional Medicine Day, 31 August [Internet]. The African Health Monitor. 2010; special issue [cited 7 August 2026]. Available from: https://www.afro.who.int/sites/default/files/2017-06/ahm-special-issue-14.pdf 

10. Chigwedere P, Seage GR 3rd, Gruskin S, Lee T-H, Essex M. Estimating the lost benefits of antiretroviral drug use in South Africa. J Acquir Immune Defic Syndr. 2008;49(4):410–15. PMID: 19186354 

11. Mills E, Foster BC, van Heeswijk R, et al. Impact of African herbal medicines on antiretroviral metabolism. AIDS. 2005;19(1):95–7. doi:10.1097/00002030-200501030-00013 

12. Ondieki G, Nyagblordzro M, Kikete S, Liang R, Wang L, He X. Cytochrome P450 and P-glycoprotein-mediated interactions involving African herbs indicated for common noncommunicable diseases. Evid Based Complement Alternat Med. 2017;2017:2582463. doi:10.1155/2017/2582463 

13. Popat A, Shear NH, Malkiewicz I, Stewart MJ, Steenkamp V, Thomson S, Neuman MG. The toxicity of Callilepis laureola, a South African traditional herbal medicine. Clin Biochem. 2001;34(3):229–36. doi:10.1016/S0009-9120(01)00219-3 

14. Parliament of the Republic of South Africa, Portfolio Committee on Health. Health Portfolio Committee raises alarm over delays in regulating traditional health practitioners [Internet]. Media statement, 27 May 2026 [cited 7 August 2026]. Available from: https://allafrica.com/stories/202605280354.html 

15. Nobel Prize Outreach. Tu Youyou [Internet]. Stockholm: The Nobel Foundation [cited 7 August 2026]. Available from: https://www.nobelprize.org/stories/women-who-changed-science/tu-youyou/ 

16. Press Information Bureau, Government of India. Integration of Ayush with modern medicine [Internet]. New Delhi: PIB; 2025 [cited 7 August 2026]. Available from: https://www.pib.gov.in/PressReleasePage.aspx?PRID=2154258 

17. Sundararajan R, Ponticiello M, Lee MH, Strathdee SA, Muyindike W, Nansera D, King R, Fitzgerald D, Mwanga-Amumpaire J. Traditional healer-delivered point-of-care HIV testing versus referral to clinical facilities for adults of unknown serostatus in rural Uganda: a mixed-methods, cluster-randomised trial. Lancet Glob Health. 2021;9(11):e1579–88. doi:10.1016/S2214-109X(21)00366-1 

18. Vanderbilt University Medical Center. Traditional healer-initiated HIV testing and care expands in South Africa [Internet]. VUMC News, 25 April 2024 [cited 7 August 2026]. Available from: https://news.vumc.org/2024/04/25/traditional-healer-initiated-hiv-testing-and-care-expands-in-south-africa/ 

19. World Health Organization. South Africa celebrates African Traditional Medicine Day with national commemoration [Internet]. News, 2 September 2025 [cited 7 August 2026]. Available from: https://www.who.int/news/item/02-09-2025-south-africa-celebrates-african-traditional-medicine-day-with-national-commemoration 

20. Moeti MR. African Traditional Medicine Day 2022: message of the WHO Regional Director for Africa [Internet]. Brazzaville: WHO-AFRO; 2022 [cited 7 August 2026]. Available from: https://afro.who.int/regional-director/speeches-messages/african-traditional-medicine-day-2022