African health officials occupied prominent roles at the World Health Summit in Berlin on October 12 and 13, championing traditional medicine integration into national health systems.
Yet when WHO’s International Regulatory Cooperation for Herbal Medicines network convened in Jakarta days later, no African regulatory bodies appeared among the 22 countries represented, revealing a troubling gap between strategic ambitions and technical participation.
The contrast matters because regulatory harmonization determines whether traditional medicines developed in one country can be sold in another. As global herbal medicine markets approach $140 billion, African nations risk becoming consumers rather than shapers of standards governing products used by up to 80 percent of the continent’s population.
At the Berlin summit, Abderrazak Bouzouita, Tunisia’s Director General of Health, told delegates that “the world is calling for more inclusive, preventive and sustainable models of health care. Traditional medicine provides that missing dimension.” He announced Tunisia’s first national centre for traditional medicine and plans for an Africa-China forum in November, declaring that Tunisia aims to evolve from being a user of traditional medicine to a global connector.
Professor Motlalepula Matsabisa of South Africa’s University of the Free State, co-chair of the WHO Summit Steering Committee, described his work bridging traditional and biomedical sciences. His message carried particular weight given his institution’s Indigenous Knowledge Systems programme, which works directly with communities to document and validate traditional practices.
Egypt’s Dr. Nessma El-Nabawy noted her country has regulated traditional medicine since 1955, though she called for “greater efforts for scientific evidence through clinical trials and standardization.” Her acknowledgment hints at the challenges African countries face in meeting international quality benchmarks, even those with decades of regulatory experience.
The Jakarta meeting, held October 13 through 16, showcased how other regions are positioning themselves to dominate herbal medicine markets. Indonesia displayed 18,000 registered herbal products, including 71 standardized herbal medicines and 20 phytopharmaceuticals meeting international benchmarks. India sent a high-level delegation led by Dr. Raghu Arackal, Advisor for Ayurveda, who presented workshop reports on efficacy and intended use of herbal medicines. South Korea’s regulatory official chaired the proceedings.
The WHO-IRCH platform comprises 49 national drug authorities working to harmonize regulations, strengthen oversight, and ensure safety, efficacy, and quality of herbal products worldwide. Participating countries gain direct input into standards that govern international trade, regulatory mutual recognition, and market access requirements.
African regulators’ absence from these technical forums creates a disconnect between political rhetoric and practical influence. While health ministers in Berlin spoke eloquently about traditional medicine’s role in sustainable healthcare, their regulatory agencies weren’t at the table where quality standards, testing protocols, and market access requirements were being negotiated.
This matters for several reasons. First, African traditional knowledge systems attract growing commercial interest from Asian manufacturers who can standardize products at scale. Without African regulators participating in quality standard discussions, products derived from African medicinal plants may be developed and marketed primarily by non-African companies.
Second, countries with robust regulatory systems aligned to international standards capture increasing shares of herbal medicine trade. Indonesia’s National Agency of Drug and Food Control is promoting “triple helix” collaboration between academia, business, and government, positioning the country not just as a producer but as a regulatory thought leader.
Third, regulatory capacity determines whether African countries can export traditional medicine products or remain limited to domestic markets. Few African products currently meet international standardization benchmarks, partly because regulators lack the technical capacity and resources that come from participating in forums like IRCH.
Dr. Shyama Kuruvilla, director of WHO’s Global Traditional Medicine Centre, noted at the Berlin summit that only 1 percent of global health research funding flows to traditional medicine despite high demand for evidence. “This is a gap that needs to be bridged,” she said. The regulatory gap may prove more consequential for African economic interests.
The WHO has scheduled a Global Summit on Traditional Medicine for December 17 through 19 in New Delhi, where this tension between strategic vision and regulatory implementation may resurface. A dedicated session on regulation of traditional medicine products during that summit will likely build upon discussions from the Jakarta meeting.
Professor Matsabisa’s Berlin comment that “communities are our living laboratories” and “we cannot exist without the communities that supply and share their knowledge” raises uncomfortable questions about whether those communities will see economic returns. Communities supply knowledge, but negotiations about how that knowledge gets commercialized happen in rooms where African regulators haven’t secured seats.
The situation isn’t entirely bleak. Tunisia’s announcement of an Africa-China traditional medicine forum signals growing South-South cooperation. Several African countries are working to strengthen domestic regulatory frameworks. The WHO Global Traditional Medicine Strategy 2025–2034, scheduled for discussion at the Seventy-eighth World Health Assembly, will support member states in integrating traditional medicine into primary health care.
However, integration into domestic health systems differs from capturing international market share. African countries can simultaneously embrace traditional medicine at home while losing out on global commercial opportunities if their regulators don’t participate in standard-setting forums.
India signed a memorandum of understanding on quality assurance with Indonesia during the Jakarta meeting, demonstrating how bilateral cooperation reinforces regulatory capacity. African countries pursuing similar partnerships need regulatory officials with technical expertise developed through participation in international networks.
The resource constraints are real. African health budgets are stretched thin, with limited funds for sending officials to technical meetings overseas. Many African regulatory agencies lack the staffing and technical capacity to engage substantively in complex discussions about pharmacopoeia standards, quality control protocols, and regulatory mutual recognition agreements.
Yet the cost of not participating may prove higher. As Asian countries strengthen their positions in herbal medicine markets through sophisticated regulatory systems and international collaboration, African nations could find themselves relegated to supplying raw materials rather than developing value-added products.
The Jakarta meeting included workshops on regulation and safety, standardization and quality control, sustainability of medicinal plant resources, and integration of herbal medicine into modern healthcare systems. These aren’t peripheral topics but core issues determining who benefits economically from traditional knowledge.
China reportedly funded 30,000 Africans to study there between 2015 and 2018, while Russia expects to provide government scholarships to 10,000 African students in 2024, and India pledged to fund 50,000 Africans through 2025. These state-sponsored educational strategies include training in traditional medicine, positioning these countries to collaborate with African partners while also developing their own herbal medicine industries.
For African regulators, the challenge is competing in an environment where well-resourced Asian agencies actively participate in standard-setting forums, conduct sophisticated research on medicinal plants, and develop regulatory frameworks that facilitate international trade. Simply showing up at meetings isn’t enough; regulators need technical capacity to engage substantively.
Some African countries are making progress. South Africa has relatively advanced pharmaceutical regulation, though challenges remain in traditional medicine oversight. Egypt’s decades of experience regulating traditional medicine provides a foundation, though Dr. El-Nabawy’s call for greater scientific evidence suggests gaps remain. Morocco and Kenya have developed traditional medicine regulatory frameworks, though their international engagement varies.
What’s missing is coordinated African participation in international forums where standards get set. Individual countries acting alone lack the collective weight to shape agendas. Regional coordination through African Union health structures could amplify African voices, but that requires political will and resource allocation.
The upcoming New Delhi summit in December offers another opportunity for African health officials to participate. Whether regulatory agencies send technically qualified staff to engage in working groups on quality standards, or whether only ministerial delegations attend high-level plenary sessions, will indicate whether the gap between strategic ambition and technical capacity is narrowing.
The outcomes of Jakarta deliberations contribute directly to implementing the WHO Global Traditional Medicine Strategy 2025–2034, which emphasizes research, regulation, integration, and cross-sector collaboration. African countries that weren’t part of those deliberations now must implement strategies they didn’t help shape.
The disconnect between African leaders’ prominent roles at the Berlin political summit and their regulators’ absence from the Jakarta technical meeting illustrates a broader pattern. African countries often participate enthusiastically in high-level policy discussions but struggle to maintain presence in the technical forums where implementation details get worked out.
For traditional medicine, those implementation details determine everything: which testing protocols prove affordability and accessibility, which quality standards balance rigour with practicality, which regulatory pathways facilitate market access without compromising safety, and which intellectual property frameworks protect traditional knowledge while enabling innovation.
These aren’t questions that resolve themselves through political declarations or strategic visions. They require regulators at the table, negotiating details, building relationships with counterparts, and ensuring African perspectives shape technical standards.
Whether communities that supply and share traditional knowledge see economic returns depends partly on negotiations happening in rooms where African regulators have yet to secure seats. Until that changes, African countries risk celebrating their traditional medicine heritage while others capture its commercial value.
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