Premier Séminaire francophone de formation sur les Politiques pharmaceutiques Genève, 20-24 avril 2009 Etat de mise en œuvre de la Stratégie régionale pour la promotion de la Médicine traditionnelle E Jean-Marie Trapsida Conseiller régional Gestionnaire du Programme des Médicaments essentiels

Sommaire 1. Introduction; 2. Etat de mise de la Stratégie régionale: Formulation des politiques; Développement de la production locale et conservation des plantes médicinales; Promotion de la recherche; Droits de propriété intellectuelle et savoir médical traditionnel; Renforcement des capacités. 3. Conclusion

INTRODUCTION (1) 1983 - Résolution AFR/RC33/R3 de l’OMS  relative à la promotion de la MT et de la pharmacopée africaine; 1984 - Résolution AFR/RC34/R8 de l’OMS  relative à la préparation d’une législation spécifique sur l’exercice de la MT dans le cadre de la législation sanitaire nationale; 2000 - la Résolution AFR/RC50/R3 de l’OMS relative à la promotion du rôle de la MT dans le système de santé: Stratégie de la Région africaine In 1978, the Alma Ata declaration recognized the role of traditional medicine and its practitioners as important actors for achieving health for All. Since then the WHO Governing bodies at regional and global levels and partners have made recommendations and adopted various resolutions on traditional medicine. These include on: -Legislation -Use of pharmacopoeia -Research -Development of local production -Use of traditional medicines 2. In 2000, the fiftieth session of the Regional Committee for Africa, in Ouagadougou, adopted a resolution on Promoting the role of traditional medicine in health systems. This is now the basis for supporting Member states to develop TM in terms of priority interventions. 3. A year later, 2001 in Abuja, the African Union Heads of States and Government declared that research on TMs for Malaria, HIV/AIDS, TB and Other Priority Diseases should be made a priority 4. The same year, 2001 in Lusaka, they declared the period 2001-2010 as the decade for African Traditional medicine.

INTRODUCTION (2) 2001 - la Déclaration du Sommet des Chefs d’État à Abuja sur la recherche de la MT pour le traitement du Paludisme, VIH/SIDA, Tuberculose et autres maladies infectieuses comme prioritaire (Avril) 2001 - la Déclaration du Sommet des Chefs d’État à Lusaka désignant la période 2001-2010 : Décennie de la MT africaine (juillet) 2002 La commission sur les droits des propriété intellectuelle, l’innovation et la santé publique établir par le DG de l’OMS 2002 - la Désignation par l’OMS de la journée du 31 août de chaque année comme « Journée Africaine de la MT » et approbation par les Chefs d’État à Maputo 2003 2000 - la Résolution AFR/RC50/R3 de l’OMS relative à la promotion du rôle de la MT dans le système de santé: Stratégie de la Région africaine. Ce document est comme une bible de la Médecine traditionnelle (MT) 2001 - la Déclaration du Sommet des Chefs d’État à Abuja sur la recherche de la MT pour le traitement du Paludisme, VIH/SIDA, TB et autres maladies infectieuses comme prioritaire (Avril) 2001 - la Déclaration du Sommet des Chefs d’État à Lusaka désignant la période 2001-2010 : Décennie de la MT africaine (juillet) 2002 - la Désignation par l’OMS de la journée du 31 août de chaque année comme « Journée Africaine de la MT » et approbation par les Chefs d’État à Maputo 2003

Orientations politiques et engagement des Etats membres et de l’OMS Déclaration Alma Ata, 1978 Adoption of Regional Strategy by – RC50 Comité régional,Ouagadougou 2000 Déclaration d’Abuja sur la recherche sur les MTs Avril 2001 Malaria, TB, HIV/AIDS et autres Adoption du Plan d’action, Tripoli, 2003 Déclaration sur la décennie africaine de la MT (2001-2010),Lusaka,Juillet 2001 Adoption de la Stratégie globale sur la TRM,2002-2005 par l’AMS, Genève In 1978, the Alma Ata declaration recognized the role of traditional medicine and its practitioners as important actors for achieving health for All. Since then the WHO Governing bodies at regional and global levels and partners have made recommendations and adopted various resolutions on traditional medicine. These include on: -Legislation -Use of pharmacopoeia -Research -Development of local production -Use of traditional medicines In 2000, the fiftieth session of the Regional Committee for Africa, in Ouagadougou, adopted a resolution on Promoting the role of traditional medicine in health systems. This is now the basis for supporting Member states to develop TM in terms of priority interventions. A year later, 2001 in Abuja, the African Union Heads of States and Government declared that research on TMs for Malaria, HIV/AIDS, TB and Other Priority Diseases should be made a priority The same year, 2001 in Lusaka, they declared the period 2001-2010 as the decade for African Traditional medicine. WHA56. 31, 2003

The Fiftieth Session of the WHO Regional Committee for Africa adopted the Regional Strategy on Promoting the Role of Traditional Medicine in Health Systems which has for priority interventions: Policy formulation – where countries are urged to develop tools for institutionalizing TM in health systems Capacity building – Where countries are expected to build capacities in all aspects of TM Research promotion – Countries are urged to conduct relevant research to produce evidence on safety, efficacy and quality of TMs Development of local production and conservation of medicinal plants – Countries are urged to create an enabling political, regulatory and economic environment for LP of TMs and to cultivate large-scale of medicinal plants Protection of intellectual property rights (IPRs) and traditional medical knowledge – countries are encouraged to develop/update legislation for protection of IPRs and indigenous knowledge.

“L’intégration" de la Médecine traditionnelle dans les Systèmes de Santé des Pays de la Région africaine de l’OMS (Juin 2006) A number of countries are at different stages of research and development using WHO Protocols. Here you can give an example of your own research. The ability to conduct research and the tools and guidelines do exist. However, there is need to build the culture for research in the Region.

Pays conduisant des recherches sur les maladies prioritaires A number of countries are at different stages of research and development using WHO Protocols. Here you can give an example of your own research. The ability to conduct research and the tools and guidelines do exist. However, there is need to build the culture for research in the Region.

Pays ayant élaboré une politique de Médecine traditionnelle au cours de la période 2001-2007 23 Countries with a National Policy on TM EMRO Countries Other countries without a National policy

Priority interventions (1) Policy Formulation and legal framework Regional Level: Guidelines for the Formulation and Implementation of National Traditional Medicine Policies. Model Legal Framework for the Practice of Traditional Medicine Model Code of Ethics for Traditional Health Practitioners. Institution of the African Traditional Medicine Day on 31 August of each year (commemorated at regional and country level). And support provided to countries which have requested and expressed need (technical and/or financial) for activities related to institutionalization of TM in health systems.

Pays ayant développé un cadre juridique pour la pratique de la Médecine traditionnelle au cours de la période 2001-2007 18 Countries with Legal frameworks Others countries without Legal frameworks EMRO Countries

Priority interventions (1): Country level (2001-2007) National Policy on TM (N = 20) Legal framework for the practice (N = 18) Code of Ethics for THPs (N = 13) Strategic plan on TM (N = 12) Benin*, Cameroon, CAR, Chad, Congo, Côte d’Ivoire, DRC, Gambia, Ghana, Kenya, Malawi, Mali, Mozambique, Nigeria, Uganda, Rwanda, Sierra Leone, Tanzania, Zambia, Zimbabwe. Burkina Faso, Cameroon, CAR, Chad, Congo, DRC, Ghana, Kenya, Madagascar, Malawi, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, Tanzania, Zambia. Cameroon, CAR, Chad, Congo, DRC, Ghana, Kenya, Rwanda, Sierra Leone, Tanzania, Uganda, Zambia, Zimbabwe. Cameroon, Chad, Congo, DRC, Gambia, Ghana, Guinea, Mali, Nigeria, Rwanda, Senegal, Tanzania. Country level: Many Member states in the WHO african region have been institutionalizing TM in health system.

Pays ayant élaboré un Code national d’éthique et de pratiques pour les tradipraticiens au cours de la période 2001-2007 13 Countries with Code of Ethics for THPs Others countries without Code of Ethics for THPs EMRO Countries

Priority interventions (2) Capacity building Regional level: Development and support of Field-testing of the WHO Training Tools for THPs in PHC and for Health science students and CHPs in Traditional medicine. Organization in collaboration with TDR/HQ of Training on Non Clinical Safety Testing (in Johannesburg) followed by an Experience sharing workshop on research [pre-clinical and clinical studies] (in Nairobi). Modules for training health science students and conventional health practitioners in traditional medicine reviewed and adopted. The training tool on primary health care for continuing education of traditional health practitioners reviewed and adopted. Training Modules for Doctors - Ghana and Zimbabwe …….. Training Modules for Pharmacists- Burkina Faso, Côte d’Ivoire, Ghana, Mali, Nigeria and Zimbabwe………. Training Modules for Traditional health practitiones- Botswana, Côte d’Ivoire, Gambia, Guinée, Senegal, and Zambia ……. . . Training Modules for Nurses - Ethiopia, Ghana, Zimbabwe……… Training Modules for Traditional Birth Attendants - Cap Verde, Côte d’Ivoire, Equatorial Guinea, Eritrea, Gambia, Ghana, Guinea Bissau, Lesotho, Malawi, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Sao Tomé et Principe, Zambia, Zimbabwe …

Priority interventions (2) Capacity building Country level: Ten countries field-tested WHO Training tools in PHC for THPs and in TM Health sciences students (Cameroon, Congo, DRC, Ghana, Kenya, Mali, Senegal, South Africa, Tanzania, Uganda). Before field-testing WHO Training tools, some countries have already their own curricula and sessions of training for THPs, pharmacists, nurses and medical doctor: Benin, Burkina Faso, Congo, Ghana, Ethiopia, Mali, Mozambique, Nigeria, …… Uganda, Zambia, Zimbabwe.

Priority interventions (3) Research promotion Regional Level: Development of Guidelines for clinical study for the management of the 5 priority diseases (HIV/AIDS, Malaria, Sickle cell anaemia, Diabetes and High blood pressure). Supports (financial and technical) provided to countries undertaking ethnobotanic studies, pre-clinical and clinical study for assessment of Safety, efficacy and quality of TMs for the management of the above-mentioned diseases. For the five identified as priority disease, the following countries indicated that they were conducting pre-clinical and/or clinical evaluation of traditional herbal medicines used for the managementof Malaria: Burkina Faso, DRC, Ghana, Kenya, Madagascar, Mali, Nigeria, Tanzania and Zimbabwe; for HIV/AIDS: Benin, Burkina Faso, DRC, Ghana, Cote d’Ivoire, Kenya, Mali, Nigeria, South Africa, Tanzania, Togo, Uganda and Zimbabwe; for diabetes: Benin, Burundi, Ghana, Madagascar, Mali, Nigeria and Tanzania; for sickle-cell anaemia: Burkina Faso, Togo and Nigeria, and for hypertension: Cote d’Ivoire, Ghana, Kenya, Madagascar and Mali.

Priority interventions (3): Country level Malaria HIV/AIDS SCA Diabetes HBP Benin x Burkina Faso Burundi Côte d’Ivoire DRC Ethiopia Ghana Kenya Madagascar Mali

Priority interventions (3): Country level Malaria HIV/AIDS SCA Diabetes HBP Mozambique x Nigeria Senegal South africa Tanzania Togo Uganda Zambia Zimbabwe

Priority interventions (3): Country level Malaria HIV/AIDS SCA Diabetes HBP Number of countries 14 4 8

Priority interventions (4) Development of local production of TMs Regional Level: Strategic plan for strengthening local production capacity of traditional medicines (2006 – 2010). Guidelines for registration of traditional medicines in WHO AFRO region. Country level: Situation analysis and Needs assessment on local production of Traditional medicines. Support provided to countries to establish and strengthen MRA. Small Scale of production of TMs: Burkina Faso, Cameroon, DRC, Gabon, Gambia, Ghana, Madagascar, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Seychelles, Zimbabwe. Delivery of Marketing Authorizations. Feasibility study for domestic production of dihydroartemisinin for treatment of uncomplicated Pl. falciparum malaria. Cultivation of commonly used medicinal plants for local production:

Priority interventions (5) Protection of TMK and IPRs related to Traditional medicine Regional Level: Development of tool for documenting African Traditional Medicine. Development of Guidelines on national policy for the protection of indigenous and traditional medical knowledge and regulation of access to biological resources in WHO African Region. Draft WHO Model legislation for the protection and promotion of Traditional medical knowledge and access to biological resources in WHO African Region. Country level: Workshops and meetings organized at country level to strengthen local capacity and framework on the protection of TMK and IPRs in some countries (Ghana, Tanzania, ….)

LE LOGO DE LA MEDECINE TRADITIONNELLE AFRICAINE C’est le Logo de la Médecine traditionnelle africaine. Je voudrais soulignée et vous rappeler que la Médecine traditionnelle c’est notre culture, notre patrimoire et notre avenir. Si nous les africains nous ne pensons pas à la développer, personne d’autre ne viendra pas à notre place pour le faire. La plante dans la carte de l’Afrique - est d’origine du Madagascar (periwinkle, cantharanthus roseus) avec le quelle la vinblastine et la vincristine qui sont médicament essentielle pour le traitement du cancer sont fabriquer et explique la source du matière de base pour les remèdes traditionnels La carte de l’Afrique vert – explique l’appropriation de la Médecine traditionnelle L’eau auntorn de la carte – un’altre source du matière de base pour les remèdes traditionnels Bord d’or/Contour en or – explique la biodiversité de l’Afrique et l’avantage comparative de l’Afrique par rapport autre continent.

Merci de votre attention Vive l’organisation Mondiale de la Proppriete Intellectuelle (l’OMPI) Vive la république du Mali Vive le department du Médecine Traditionnelle