INTRODUCTION Traditional Medicine is still popular as I

INTRODUCTION Traditional Medicine is still popular as I speak to You today, as it was in 2500 BC. It should be given its appropriate recognition to improve the image and standards of Practitioners This can be done through policy changes, regulations and registration and improving training and research of ATM that is lead by THPs. Thokozani I AM SHEILA MBELE-KHAMA

INTRODUCTION • While 2/3 of Central and North African States are advanced with the implementation of policies on Traditional Health Practice, South Africa, recently assented to the Act governing THPs. (10 January 2008) • The Act, without any guiding policies cannot be implemented, priority being the establishment of the Council, which will oversee the whole implementation process. • Our National Department of Health, is tasked to ensure that the Act together with all the necessary Policies are in placed to ensure successful implementation. • Pharmacists, Western Doctors and Nurses are guided by specific Code of Ethics, to ensure synchronization of policies and activities are clearly coordinated, THPs do not yet have their Code of Ethics, though they have draft documents from the National Unitary Professional Structure

INTRODUCTION • The proposed Code of Ethics, give directives to the Discipline behaviour required of all the THPs within the Society. • Best example; regulating the issuing of medical certificate to patients. For now, all THPs are not yet registered with the yet to be formed THP Council in terms of the Act, THP Act No. 22 of 2007, declaring that, all sick leave certificates issued, are illegal. • But It is up to the Business Institutions to formalize a relationship with THP forum similar to Ekurhuleni, and jointly agree – Mutual agreement on some principle issues in relation to medical certificate, to be shared with the Labour fraternity, as was proposed by Sun International (Carnival City: Management-Employees and THPs)

THE ACT Government Gazette REPUBLIC OF SOUTH AFRICA Vol. 511 Cape Town 10 January 2008 No. 30660 THE PRESIDENCY No. 42 10 January 2008 It is hereby notified that the President has assented to the following Act, which is hereby published for general information: – No. 22 of 2007: Traditional Health Practitioners Act, 2007. ACT To establish the Interim Traditional Health Practitioners Council of South Africa; To provide for a regulatory framework to ensure the efficacy, safety and quality of traditional health care services; To provide for the management and control over the registration, training and conduct of practitioners, students and specified categories in the traditional health practitioners profession; And, to provide for matters connected therewith. BE IT ENACTED by the Parliament of the Republic of South Africa.

PURPOSE OF THE ACT The purpose of this Act is to— (a) establish the Interim Traditional Health Practitioners Council of South Africa; (b) provide for the registration, training and practices of traditional health • practitioners in the Republic; and (c) serve and protect the interests of members of the public who use the services • of traditional health practitioners.

False representations, false entries in register and impersonation 43. (1) A person is guilty of an offence if he or she— (a) by means of a false representation procures or attempts to procure for himself or herself or any other person, registration or any certificate or decision referred to in this Act; (b) makes or causes to be made any unauthorized entry or alteration in or removal from a register, certified copy thereof, or extract therefrom or any certificate issued under this Act; (c) willfully destroys, damages or renders illegible any entry in the register or, without the permission of the holder thereof, any certificate issued under this Act; (d) forges or, knowing it to be forged, utters any document purporting to be a certificate issued under this Act; (e) impersonates any person registered in terms of this Act; or (f) supplies or offers to supply to any person not registered under this Act or any other law, an instrument or appliance which can be used, or is claimed to be effective, for the purpose of diagnosing, treating or preventing physical or mental defects, illnesses or deficiencies, whilst knowing that such instrument or appliance will be used by such unregistered person for the purpose of performing for gain an act which such unregistered person is in terms of this Act or any other law prohibited from performing for gain. (2) A person found guilty of an offence contemplated in subsection (1) is liable on conviction to a fine or to a period of imprisonment or to both a fine and a period of imprisonment.

Transitional Provisions 51. No person is subject to legal or disciplinary action or to any penalty contemplated, in this Act for engaging in traditional health practice during the period of one year • following the date of commencement of this Act without being registered to do so. • 52. This Act is called the Traditional Health Practitioners Act, 2007, and comes into operation on a date determined by the President by proclamation in the Gazette.

WHO (World Health Organisation) PERSPECTIVE A rich heritage • Traditional medicine: (WHO Definition) – Traditional medicine refers to the knowledge, skills, and the practices based on theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health and wellbeing, whether physical, spiritual /or mental. – Adapted from Letendre (2002): Crossing Boundaries 1(2): 78 -87 87

WHO CONT: • Countries in the African Region are having difficulties in institutionalizing traditional medicine as part of their national health policies and legislation. Some of the causes of the difficulties are: failure to establish structures and develop codes of ethics and practice for the practice of traditional medicine, non existence of Unifying Bodies of traditional health practitioners; and lack of close collaboration between the practitioners of traditional medicine and those of conventional medicine.

• WHO STRATEGY • Develop national policies on the evaluation and regulation of TM practices. ; • Create a strong evidence base on the safety, efficacy and quality of TM products and practices; • Ensure availability and affordability of TM including essential herbal medicines; • Promote therapeutically sound use of TM by providers and consumers; and • Document traditional medicines and remedies.

Legislative implications • Areas to look at: • 1. Amendment of the National Health Act by inclusion of some chapters e. g. Code of Ethics and African Traditional Medicine to facilitate planning at all levels (Minister, DG and Senior Management) • 2. Amendment of Act 101 of 1965 so that the definition of Medicine incorporates African Traditional Medicines to facilitate their regulation and registration under Act 101 • 3. Create a bill for those chapters that are not covered by THP Act in South Africa to facilitate implementation of the policy • These areas would be implemented so that African Traditional Medicine is successfully institutionalised as per WHO guidelines.

Value of ATM • Raw medicinal plants trade worth R 52 • THPs prescribe R 2. 6 bn • Herbal medicines worth R 588 m • Industry is worth about R 3 bn • One of the major service industries in South Africa: Myles Manderet al.

RECOMMENDATION • The government and Private Sector should be committed to developing traditional medicine as an alternative system of medical practice that is used by Majority 80% of South African population and it should be viewed as beneficial to health and health services development in South Africa where policies already exist, or it must be developed together with the Master (strategic) Plan. Note that plans (including this ACT) should derived from policies.

RECOMMENDATION CONT: 1. 2. 3. We encourage Business Institution to formalize relationships with THP Forums in their respective Local Government jurisdictions for accountability. (Tripartite Agreements) THP Forums are inclusive of organizations and nonaligned individuals in their respective Regions. They are expected to have a proper Constitution, adopted by THPs of that Area, witnessed (Observed) by a Local Government Institution. We have gone through a full Transitional year, we hope to come up with a proper and well representative Council which will be in a position to finalize arrangements with Private Business Institutions and Interested Parties, hopefully after National Elections.

Conclusion • “Our vision is the establishment of an excellent traditional health care system based on the African belief system that provides an acceptable quality of care to all people”. (WHO). 2001 -2010 Vision has been declared by AU (African Union) the Decade of Traditional Medicine.

THOKOZANI THANK YOU DANKIE CAMAGU MAKHOSI LESEDI

Ms. Sheila Fihliwe Mbele - Khama Ekurhuleni Traditional Health Practitioner's Forum Chairperson and Founder of Abehlangesilulu Skills Consultancy Physical Address: 72 Bushbuck Street, Leondale. Postal Address: P O Box 400, RONDEBULT, 1423. Contact: Cell Phone: +27 083 744 0965. Email : sheilambele@yahoo. com