South Africa's Higher Education, Science and Innovation Department has reassigned R15m from existing indigenous knowledge projects to support COVID-19 interventions, including the herb touted by Madagascar's president as a cure for the disease.
Higher Education, Science and Innovation Minister Blade Nzimande is quoted in a New24 report as saying: "We are in the process of implementing multiple interventions including the use of African medicines as immune modulators and anti-coronavirus therapeutics. The programme has been working with the African Medicines COVID-19 Research Team in researching several South African herbs and formulations, with documented evidence for treatment of respiratory infections, signs and symptoms," he said.
According to the report, Nzimande said one of the herbs the team is working on, is Artemisia afra, also known as umhlonyane in the Nguni languages. It is the source of an ingredient used in a malaria treatment. The medical use of the umhlonyane herb became popular after President Andry Rajoelina of Madagascar said artemisia is among the herbs being used in his country to cure COVID-19. However, the WHO warned that the herb "should be tested for efficacy and adverse side effects".
The director general of science and innovation Dr Phil Mjwara said the department was working with Madagascan authorities to find the active ingredients.
"The study is conducted in partnership with the Council for Scientific and Industrial Research in Pretoria, so our scientists are working with the Madagascan researchers to try and look for the active ingredients that the minister referred to in the plants to look at whether this plant is able to have [an] effect on the immune modulation of the virus," he said in response to a query about the artemisia plant.
"This is a work in progress. These things take time but we are working with our Madagascan researchers in order to make sure that proper protocols are being followed and the effective ingredients, once found, the clinical research is done and the data is profiled to be given to health and products regulatory authority (sic)," he said.
The department said it places a high value on conducting ethical and responsible research, development and innovation initiatives as it continues to build on previous work with the World Health Organisation African Regional Office (WHO-AFRO) in the development of guidelines for the evaluation of traditional medicines.
The BBC reported that the artemisia drink was launched as COVID-Organics and was marketed after being tested on fewer than 20 people over a period of three weeks. The Tanzanian president’s chief of staff Lova Hasinirina Ranoromaro is quoted in the report as saying a number of African countries, including Guinea Bissau, Equatorial Guinea and Tanzania had ordered supplies.
As earlier reported in Mail&Guardian, both the Africa Centre for Disease Control and Prevention and the World Health Organisation have expressed reservations over the Madagascar president's claims. “We would caution and advise against countries adopting a product that has not been taken through tests to see its efficacy against COVID-19 and its safety in different population groups,” said Matshidiso Moeti, the WHO’s Africa region director. “
We are concerned that touting this product as a preventative measure might make people feel safe to do other things (against medical recommendations, such as neglecting social distancing).”
South Africa's Health Department says, meanwhile, the message to traditional health practitioners (THP) is to refer patients to the next level of care if they present symptoms of the novel coronavirus. News24 reports that as the country fights the COVID-19 pandemic, the department says it is only an assumption – yet to be proven – that the majority of South Africans opt to see traditional healers before going to a medical doctor.
"THPs play an important role in addressing the burden of diseases in South Africa within the primary healthcare system. The message to THPs is to refer patients presenting with symptoms of coronavirus infection to the next level of care," Health Department spokesperson Popo Maja is quoted in the report as saying.
The department has further placed on record that it values the contributions of THPs in the fight against COVID-19.
Lecturer and PhD candidate in public health pharmacy at the Sefako Makgatho Health Sciences University, Mncengeli Sibanda, says it is too early to tell whether indigenous plants could have a healing potency to treat the virus.
The report says Sibanda mentioned that countries, such as China and Madagascar, have announced traditional remedies with purported benefits against the virus. "The effectiveness and safety of the traditional medicines against COVID-19 still needs to be tested using randomised clinical trials.
In an article in The Conversation, Dr Moses Alobo, programme manager for Grand Challenges Africa, African Academy of Sciences, who is heading the Academy’s COVID-19 response efforts, has laid out the results of an extensive survey of hundreds of the continent's scientists, to identify COVID-19 related research priorities across a range of disciplines.
The Conversation Africa’s Natasha Joseph asked Alobo to explain the survey’s findings and how they couldd be applied:
What was the purpose of the survey, and who took part?
The COVID-19 crisis is global, and scientists are still trying to understand this SARS-CoV-2 virus. The African Academy of Sciences recognised there was an urgent need to help scientists, researchers and practitioners on the continent in pharmaceutical and non-pharmaceutical mitigation efforts. We need to provide guidance and resources that will help address COVID-19 by shifting the focus to specific needs that may be unique to the African continent. This is part of our work in providing advisory and think tank functions to, among other things, consolidate the continent’s scientific research efforts.
The survey helped to develop a prioritisation list for research and development for the COVID-19 pandemic in Africa. Most of those priorities were based on the World Health Organisation’s (WHO) Research Roadmap. We asked researchers to rank the priorities listed by the WHO to get an understanding of how Africa’s scientists are thinking about the pandemic. The Academy also hosted a webinar with nearly 300 participants before launching the survey, and some priorities not identified by the WHO were discussed there.
There have been several public health methods to combat COVID-19. Social distancing, movement restrictions and wearing protective clothing like masks are all important, practical steps.
This report focused on another element of the “what next” around the virus: quite simply, we’re going to need a lot of research. And that research will need to be multidisciplinary. That’s where the variety of our members’ research interests is so important: we had respondents from the biomedical sciences, clinical and epidemiological research, social sciences, policy making and management sciences, among others.
In total, 845 respondents from 56 countries globally took part – 39 of those were African countries. Seventy-nine percent of all respondents were based at an African institution and working in Africa; 12% reported being affiliated with an institution outside Africa but working in Africa at the time of the survey. The remaining respondents did not identify themselves geographically.
Which priorities topped the list for most respondents?
Most thought there should be a greater focus on clinical management. On this point, they particularly identified the need to develop protocols for managing severe disease in places that lack intensive care facilities. Another important point they made was the need to determine interventions that improve clinical outcomes for patients infected with COVID-19.
Infection prevention and control emerged as another key area. Respondents wanted to understand how effective movement control strategies are in preventing secondary transmission in both health care settings and communities.
Most respondents also felt that understanding the virus’s natural history, transmission and diagnostics was important. This, they explained, could be used to support work to develop cheaper, faster and easier antigen tests for detecting the virus while out in the field. Essentially, they are calling for work towards cost-effective diagnostic tools that can accurately and efficiently pick out viral particles from infected people.
There was a call for epidemiological studies that help describe COVID-19’s transmission dynamics. These studies can be used to understand the spread of the virus nationally, regionally and globally.
So what happens next? How can these findings be applied?
The findings will be vital in streamlining research efforts. Some are based on the WHO Roadmap. Other priority areas – like waste management, mental health, food and nutritional security, and the indirect effects of the pandemic in areas like maternal and newborn health and management of other chronic conditions – were added by researchers in Africa. This is key: these new, emerging priorities may become more important with time, both on the continent and elsewhere.
Of course, the flip side is also true. As further work is undertaken and we start to understand some research areas better in various contexts, priorities may shift again. Those shifts will need to be based on various communities’ needs and on what interventions are available.
The report can also help to inform governments’ investments in research and development. Ministers of education, science and technology from several African countries have met to prepare a response to COVID-19 in terms of interventions in education, science and technology. After their deliberations, the ministers recommended that research and development funds should be set up specifically for fighting pandemics.
But there was no clarity as to what kind of research should be funded. Our priority-setting work represents a step towards addressing this issue and ensuring that governments know what scientists believe is important when it comes to funding research and development into COVID-19 and other pandemics.
[link url="https://www.news24.com/news24/southafrica/news/science-and-innovation-dept-to-research-traditional-medicine-for-covid-19-fight-20200708"]Full News24 report[/link]
[link url="https://www.medicalbrief.co.za/archives/au-silence-greets-madagascar-presidents-claims-of-covid-19-cure/"]Full earlier report: AU silence greets Madagascar president's claim of Covid 'cure'[/link]
[link url="https://www.medicalbrief.co.za/archives/tanzania-joins-the-list-of-african-countries-importing-madagascars-covid-19-cure/"]Full earlier report: Tanzania joins list of Africa countries importing Covid 'cure'[/link]
[link url="https://www.news24.com/news24/southafrica/news/covid-19-this-is-the-role-traditional-medicine-practitioners-can-play-health-dept-20200709"]Full News24 report[/link]
[link url="https://theconversation.com/africas-scientists-set-out-their-covid-19-research-priorities-141288"]Full report in The Conversation[/link]