Centro de Información de la Universidad Peruana de Ciencias Aplicadas

It is now becoming increasingly recognized that the healthcare system in Uganda as it stands today does not adequately address itself to solving the multitudes of health problems and concerns for all Ugandans. In this context, therefore, it is apparent that the integration of traditional and complementary medicine into the national healthcare system has the potential to augment, strengthen and promote better healthcare for all in line with the national vision. The Uganda National Health Policy recognises the role of Traditional Medicine in the health care delivery system of the country and calls for collaboration between government and the TCM sub-sector.

In Uganda, 60% of the population use traditional medicine for primary healthcare and TCM continues to enjoy widespread usage in the national healthcare system because it is much more widely available and accessible than allopathic medicine, among other factors. In addition, the ratio of TM practitioners (including traditional healers, bone setters and herbalists) to the population is between 1:200 and 1:400. This contrasts with the availability of allopathic practitioners for which the ratio is 1:20,000 or less. Finally, TM is sometimes the only affordable and available source of healthcare, especially among the poor and deprived members of our population.

This notwithstanding, there has not, till now, been an explicit national policy framework to promote, guide and regulate the utilisation of TCM in the country. Furthermore, in order to fully exploit the potential of TCM as a source of healthcare, a number of issues relating to policy, safety, efficacy, quality, access and rational use have to be addressed. This policy document attempts to address these issues and concerns and creates a formal policy environment in the above regard. The National Policy is therefore put in place with the aim to harness the potential of TCMP while at the same time preserving our medicinal heritage and the environment.

The policy defines the role of TCMP in the country’s healthcare delivery system and constitutes the basis for the development of the pertinent regulatory and legal framework that will promote and maintain good practice that is accessible, equitable, authentic and safe. The policy also lays the foundation that will ensure adequate provision of financial and other resources for research, education and training in the TCMP sub-sector. Finally, it provides a framework to coordinate activities related to the development of TCMP in the public and private sectors and creates an enabling environment for the full and sustainable utilization of TCMP in addressing some of the challenges facing the national healthcare system.

11.2. Definition

This policy covers traditional and complementary medicine as far as its use and formal integration into the national healthcare delivery system is concerned. For the purposes of this policy, traditional medicine (TM) is taken to include the locally and traditionally available diverse health care practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral-based medicines, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness. This Policy shall not cover spirituality as a practice under TCMP.

On the other hand complimentary medicine (for the purposes of this policy) is taken to be any other broad set of healthcare practices, (other than traditional medicine) that are not part of Uganda’s own tradition and that were, at the inception of this policy, not integrated in the country’s national healthcare system.

11.3 Organization and Structures of TCMP

Today, a number of institutions and organisations are involved in various aspects of TCM research, development, application and practice. Within the national research system, NCRL is spearheading research in traditional medicine and medicinal plants. Makerere University, the National Agricultural Research Organisation (NARO) and Mbarara University of Science and Technology are the other notable actors in the sub-sector, while the Uganda National Council for Science and Technology (UNCST), by virtue of its statutory mandate, provides the overall research coordination in all aspects of science and technology.

In the private sector, several TCM associations and other actors do exist, some of which have loose links with the MoH. The efforts in the public and private sectors however remain fragmented and the full exploitation and harnessing of TCM remains constrained by inadequate infrastructural provisions coupled with lack of a clear definition of roles of the various institutions. There is therefore a need to strengthen institutional mechanisms in the TCM sub-sector.

11.4 Contribution to the Health sector

11.4.1 Research and Development

There is no national research agenda in this regard and the different actors lack a coherent approach and programme to link their research to development in science and technology. What is currently on ground is mostly fragmented research whose nature and direction keep changing depending on availability of funds or institutional interests.

11.4.2 Industrial Application and Commercialisation

The potential for TCM to contribute to the national economy through industrialization and commercialization has not yet been fully exploited in Uganda. The low level of industrialisation in the country is partly responsible for this. In addition, there is no explicit policy to encourage foreign and local investment in the sub-sector. This inter alia calls for the establishment and strengthening of inter and intra-institutional collaboration and forging strategic partnerships and investment in research, development and commercialisation of TCM products.

11.4.2 Financing

The limited national awareness of the potential of TCM coupled with low commercial applications, and the apparent absence of a national programme for TCM development in Uganda has led to inadequate funding for the sub-sector. Public-private partnerships, joint ventures and franchises in TCM remain weak or non-existent as a result of low awareness, limited applications, and limited interaction among key players. There is need for government to put in place appropriate mechanisms to attract investment and ensure equitable resource allocation to the sub-sector.

The development of the TCM sub-sector thrives inter alia on the formation of strategic alliances amongst local stakeholders on the one hand and between the local and the international stakeholders on the other. There are weak inter and intra institutional linkages in the areas of TCM. The existing linkages are mainly informal, ad hoc, and not co-ordinated. This calls for systematic development and strengthening of mutually beneficial partnerships in all aspects of TCM in the national healthcare system.

11.4.4 Public Awareness

There is limited public awareness with respect to the potential opportunities that could be tapped from TCM for the health sector. Furthermore, there is much misinformation and lack of understanding on the nature and scope of TCM. The situation is compounded by the limited documentation about the sub-sector. The real benefits of TCM have often tended to be obscured by the negative aspects. There is therefore need for Government to mobilize all stakeholders to create more public awareness of the potential of TCM.

11.4.5 Conservation of Biodiversity and Indigenous Knowledge

The TCM sub-sector largely relies on the exploitation of the country’s rich biodiversity and indigenous knowledge. But there is lack of an adequate coordination mechanism between the sub-sector and other authorities within which Uganda’s rich resources could be sustainably exploited for the benefit of her peoples. There is therefore need for an integrated, multi-sectoral framework to promote conservation of the local bio-diversity and utilization of indigenous knowledge for the sustainable utilization and development of the sub-sector.

11.4.6 Code of Ethics

There is an apparent lack of a generally acceptable code of ethics in various aspects of TCM Practice and product development. Ethical considerations, if any, have for long been left to the discretion of individual practitioners, institutions or associations. A well laid down code of ethics should enable the development and exploitation of TCM in accordance with acceptable moral and societal norms. This is a key factor in shaping public attitude and consumer acceptance of the products and services of TCM.

11.3.9 Legal and Regulatory Framework

To date, there is no appropriate and comprehensive legal and regulatory framework to guide, regulate and control the practitioners and practice of traditional and complementary medicine in Uganda. However, a number of statutory instruments that have a bearing on various aspects of TCM are in place. But these are scattered in various pieces of legislation, which makes enforceability difficult. Furthermore, most of this legislation is out of tune with current national and international realities and therefore needs reviewing. A policy on TCM calls for biodiversity conservation, utilization and protection of indigenous knowledge and intellectual property rights through the enactment and harmonization of relevant legislation.

11.3.10 Mainstreaming TCM

Although over half of Uganda’s population use TCM as their first point of contact for primary healthcare, the sub-sector is currently not formally recognized and is not mainstreamed in the planning, implementation and monitoring systems of the healthcare system. Government needs to bring on board authentic TCM practitioners and practices in order to comprehensively address the health needs of the people of Uganda.