Message of the WHO Regional Director for Africa, Dr Luis G. Sambo, on the occasion of the Third African Traditional Medicine Day. 31 August 2005

“African traditional medicine: Contributing to preventing HIV infection” 

Ladies and Gentlemen,

Sub-Saharan Africa is the worst HIV/AIDS-affected region in the world, with 75% of all people living with HIV/AIDS, though it accounts for only about 10% of the global population. In 2004, an estimated 3.2 million new cases of HIV infection occurred in the region. Half of newly-infected individuals are young people aged between 15 and 24 years.

The risk is especially high among young women and girls who constitute up to 75% of the young people living with HIV/AIDS in the region. Unless this situation is reversed, achieving the Millennium Development Goals will be threatened.

Prevention of HIV transmission should therefore be accorded the priority it deserves in HIV/AIDS response in Africa. Reducing the number of people who need treatment will contribute to preserve the gains from the effort to increase access to antiretroviral therapy. Mobilization of effective multisectoral action will help provide counselling and support to the communities, develop prevention programmes targeted at vulnerable groups, intensify social research in the region and use the findings of the research for local and regional action, as well as strengthen prevention interventions in health care settings and mobilize financial and technical resources.

We need to urgently implement HIV-prevention interventions on a sufficient scale and gain a better understanding of the evolution of the epidemic and progress made in the response. We need to build an enabling environment that promotes and supports the adoption of positive patterns of sexual behaviour and changes of destructive gender norms and stigma. We must continue expanding interventions targeting vulnerable groups, promoting and supporting grass-roots dialogue and the emergence of local responses that are rooted in people’s reality, experience, resources and strategies for surviving crises. We must effectively address the underlying factors that fuel HIV transmission and mobilize additional financial resources, ensuring that such resources reach operational levels. Above all, we need to increase access to quality preventive, curative and promotional interventions.

Today, Africa is celebrating the Third African Traditional Medicine Day. The theme for this year is “African traditional medicine: Contributing to preventing HIV infection”. This theme is in line with the resolution taken by the ministers of health at the fifty-fifth session of the WHO Regional Committee recently held in Maputo to declare the year 2006 as the “Year for Acceleration of HIV Prevention in Africa”. 

Why involve traditional health practitioners in prevention interventions? A traditional health practitioner is a person recognized by his/her community as competent to provide health care using plant, animal or mineral products.

In adopting the Regional strategy on traditional medicine in 2000, the ministers of health confirmed the role that traditional medicine can play in health systems and services regarding health promotion, diagnosis, treatment and prevention of diseases. This was endorsed by the Heads of State and Government who, in 2001, declared the period 2001-2010 as the Decade of African Traditional Medicine. It is for this reason that the WHO Regional Office for Africa established a 12-member WHO Regional Expert Committee on Traditional Medicine in order to assist countries to accelerate the implementation of these policy decisions.

In prevention of HIV infection, traditional health practitioners will contribute to intensive efforts that would be made to reposition prevention at the heart of the entire HIV/AIDS intervention and control mechanism. Traditional health practitioners who are well integrated in communities will intervene to improve community participation in prevention efforts.

Ladies and Gentlemen,

The contribution of traditional health practitioners will specifically involve the following areas:

Promoting prevention of HIV infection through discouraging skin piercing practices—Trained traditional health practitioners are well placed to stimulate communities and fellow traditional health practitioners to critically analyze traditional cultural practices and beliefs such as circumcision, scarification, tattooing traditions, and other practices which necessitate the cutting of the skin with non-sterilized and unwashed knives or razor blades. It is well known that using these instruments results in HIV infection or hepatitis transmission.

Promoting prevention of HIV infection through blood and blood products—Trained traditional health practitioners can play an important role in reducing the risk of transmission of HIV amongst themselves and traditional birth attendants. Efforts should be made to prepare training programmes for traditional birth attendants in obstetric techniques, especially traditional obstetric procedures, to ensure safe practices and minimum exposure to blood.

Promoting condom use—Traditional health practitioners should promote condom use and encourage negotiation between partners on the benefits of condom use. Condom disposal techniques must be clearly explained to them so that their clients can be correctly informed. As community opinion leaders, traditional health practitioners are in a unique position to participate in education programmes aimed at changing customs and traditions that are risk-factors in the spread of HIV infection and in the distribution of condoms to their clients.

Promoting prevention of perinatal transmission—By the nature of their role, traditional birth attendants can successfully reach pregnant women, adolescent girls and families with appropriate information related to family life and sexuality. They are important in initiating and motivating behaviour change, as well as encouraging safe sexual practices among women of childbearing age and promoting safer traditional delivery practices. 

Promoting prevention of HIV through discouraging community practice of child and sexual abuse—Due to their position, traditional health practitioners can sensitize communities where they live and provide correct information about the fact that having sex with a virgin or raping very young children and babies is not a cure for HIV/AIDS. Instead, this behaviour resulting from misconception should be condemned as it is detrimental to the community.

Promoting prevention of HIV through voluntary testing, counselling and referral—Through cultural approaches in their communication skills, traditional health practitioners would succeed in encouraging individuals in communities to be tested for HIV, especially those who would otherwise not access the formal health sector for fear that if the diagnosis is positive this would lead to immediate segregation from family, community and village members. Traditional health practitioners play this critical role of HIV prevention through referral to hospitals of patients who need care and treatment.

Promoting prevention of HIV through sexual abstinence and faithfulness—Traditional health practitioners are in an ideal position to play an important role in promoting abstinence and faithfulness among youth, and fidelity within marriage among adults. Such values often agree with traditional beliefs about the causes of sexually transmitted infections and other illnesses, and it is currently well recognized that reduction of the number of sexual partners is a powerful factor in reducing HIV transmission.

WHO is strongly committed to HIV prevention. Therefore, the WHO Regional Office for Africa will include HIV prevention in all programmes related to HIV/AIDS. Furthermore, WHO will provide clear guidance on actions to be taken by countries, advocate for sustained financial resources for HIV prevention, develop and disseminate appropriate technical guidance materials on HIV prevention, develop partnerships with African networks of civil society, community-based and faith-based organizations and with networks of people living with HIV/AIDS, provide support to ministries of health to strengthen health systems in countries and document and disseminate best practices in HIV prevention.

On their part, Governments need to be committed to involving traditional health practitioners as real partners, develop coherent policies, put in place regulatory and legislative actions for legal recognition of traditional health practitioners and for ensuring the quality, safety and efficacy of their services. This commitment entails the design and implementation of culturally appropriate HIV- prevention interventions.

Ladies and Gentlemen,

I take the opportunity of the Third African Traditional Medicine Day to congratulate Member States which have made the necessary effort to facilitate integration of traditional health practitioners into primary health care. I also thank the partners who have worked with countries and the Regional Office in the development and implementation of national policies and regulatory frameworks for ensuring good conduct in the practice of traditional medicine. WHO renews its acknowledgements to traditional health practitioners and reassures them that concerted collaboration within the framework of acceleration of HIV prevention in Africa will enable us to obtain remarkable and sustainable results in our WHO African Region.

I call upon all stakeholders such as government officials, civil society, partners and NGOs to strengthen their contribution to African traditional medicine in order to enable it to play its important role in HIV-prevention interventions.