TM/CAM in South Africa

The introduction below is based on the chapter on Traditional and Complementary Medicine by Qqaleni, Moodley, Kruger and McLeod and in the South African Health Review 2007.

The topic of traditional medicine was escalated to the national health agenda by the African National Congress Health Plan of 1994 where it was stated that “traditional healing will become an integral and recognised part of health care in South Africa. Consumers will be allowed to choose whom to consult for their health care, and legislation will be changed to facilitate controlled use of traditional practitioners”. The plan contained a powerful statement as the basis for policy which noted, “people have the right of access to traditional practitioners as part of their cultural heritage and belief system”.

The formal recognition of complementary and alternative medicine practitioners in South Africa has taken many years.Chiropractors, herbalists, homeopaths, naturopaths and osteopaths were able to register during a six month period in 1974, following which the registers were closed. In the early 1990s, the Confederation of Complementary Health Associations of South Africa (COCHASA) lobbied for the recognition of complementary practitioners.

On 29 November 2000 the President signed the renamed Allied Health Professions Act providing for the establishment of the Allied Health Professions Council. This brought CAM onto an equal legislative footing with other healing modalities. The Allied Health Professions Act allowed for ten treatment modalities to be registered: Ayurveda, Traditional Chinese Medicine, Osteopathy, Chiropractic, Homeopathy, Naturopathy, Phytotherapy and the three therapeutic professions of Aromatherapy, Massage Therapy and Reflexology. The Act made provision to accommodate other modalities at a later date and an eleventh modality, Unani-Tibb, has been recommended for inclusion.

Complementary medicine practitioners are controlled by Professional Boards of the Allied Health Professions Council of South Africa (AHPCSA). The Boards may recommend Council to approve training schools; conduct examinations and grant certificates, recommend Council to register students, interns and practitioners and investigate the professional conduct of registered practitioners. The AHPCSA had 3,622 registered complementary medicine practitioners, interns and students across all modalities in March 2007.

The long-awaited Traditional Health Practitioners Act was signed into law on 7 January 2008. The Act allows for the establishment of the Interim Traditional Health Practitioners Council which will be appointed to assist with the development of Regulations. The registration, training and conduct of practitioners will in time also be regulated by this Act, in line with similar protocols followed by other health professions. The implementation of the this act will ensure that traditional healers are placed on an equal footing with other types of health care practitioners in South Africa.

The Traditional Health Practitioners Act classifies traditional healers as:

•Diviners (Izangoma / Amagqirha)

•Herbalists (Izinyanga / amaxhwele)

•Prophets / faith healers (abaprofeti / abathandazeli)

•Traditional surgeons (iingcibi)

•Traditional birth attendants (ababelethisi / abazalisi)

At this stage it is not possible to determine the number of healers in each category and an assessment will only be available once the Act has been implemented and formal registration of practitioners has occurred. The authors determined that there were 185,477 traditional practitioners across all categories in South Africa in 2007. This compares to 34,324 medical practitioners registered with the Health Professions Council of South Africa in 2007.

The Department of Health issued the Patients Charter in 2002, emphasising the right of patients to choose a particular health care provider for services.

The Minister of Health announced at the African Traditional Medicine Day in September 2007 that the following Initiatives have been completed or are underway:

•work on the policy framework on African Traditional Medicine by the Presidential Task Team;

•the prioritisation of registration and the regulatory framework for practitioners;

•work undertaken with the Medicine Regulatory Authority by the Ministerial Task Team to facilitate the registration and regulation of African Traditional Medicines;

•making funds available for research and development of medicines; and

•the establishment of a unit for TM within the DoH.

The Minister further announced that consideration is being given to the establishment of an Institute for African Traditional Medicine for research and training.