The Use and Outcomes of Complementary and Alternative Medical Systems in the Fight against COVID-19 Pandemic

LETTERS TO THE EDITOR, 22 Mar 2021

Prof Hoosen Vawda – TRANSCEND Media Service

Global and South African Perspectives: A Holistic Approach

18 Mar 2021 – The SARS Cov-2 Pandemic has presented several challenges to the general medical profession in terms of the medications used in the pharmacological armamentarium in counteracting the virus infections[1]. The wide variety of mainline prescription medication purported to benefit victims of SARS Cov-2 virus were used by healthcare professional worldwide often in a desperate last stand therapeutic measure in patients who were terminal[2]. These ranged from old established medication, repurposed for use in COVID-19 infections as well as newcomers to the scene.  The former President Donald Trump’s, news of being infected with the Covid virus and use of chloroquine[3], Remdesivir[4] with Dexamethasone[5] gave official “approval”[6] and credibility to the use of these medication in patients.

Other medication such as Ivermectine[7] is widely used but banned in South Africa[8], where the law enforcement officers were hunting down easy, soft targets like pharmacist and General Practitioners[9] who obtained the medication through veterinary channels[10] and using it in patients to good effect.  The law enforcement officers were deployed to do so by individuals with vested interests instead of apprehending dangerous criminals and corrupt officials[11].  It is interesting to note that as soon as the vaccine roll out was given to over 160,00 health care workers, the South Africa Regulatory authorities unbanned the medication for general use, on 17^th March 2021[12].  There were also several legal actions against the South African Government by General Practitioners, as well as lawyers, to have the Ivermectin freely available.  Needless to mention, that the prohibition of Ivermectin use, lead to several entrepreneurs running a lucrative black-market business with the drug[13].

While the Covid Pandemic[14] was at its height during the initial outbreak and even during the Third wave[15], it is also to be noted that the mainline registered medical practitioners in the Western world, as well as South Africa, were conspicuous by their silence, often accompanied by ridicule and derogatory remarks about the entire body of knowledge of Complementary and Alternative Medical Systems[16]. The CAMS are presently designated as Integrative Medicine[17].

Alternative Medicine is any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested, untestable, or sometimes proven ineffective[18].  Complementary Medicine, Complementary and Alternative Medicine, Integrated Medicine or Integrative Medicine, and Holistic Medicine are amongst the many re-brandings of the same entity. Alternative Therapies share the basic tenets, that they reside outside medical science and rely on pseudoscience[19] according to some authors who are cynical about these medical treatment systems. Traditional practices become “alternative” when used outside their original settings, without proper scientific explanation and evidence. Frequently used derogatory terms for the alternative are new-age or pseudo, with little distinction from quackery, according to current mainline, medically trained healthcare professionals.  They often do not realise that such systems of therapy have been tested and used for many millennia by various civilisations, such as during the Pharaonic Egypt.[20].

In general, the term “alternative therapy” refers to any health treatment not standard in Western medical practice. When used alongside standard medical practices, alternative approaches are referred to as “complementary” medicine.[21]

Many different areas make up the practice of complementary and alternative medicine (CAM). In addition, many parts of one field may overlap with the parts of another field. For example, acupuncture is also used in conventional medicine. In the U.S., CAM is used by about 38% of adults and 12% of children.[22]

There are many systems of CAMS and depends on which part of the world is under consideration for the acceptance and usage of such a system of medical treatment.  These systems may be listed as follows, although by no means complete: –

1. Ayurvedic Medicine[23]
2. Chinese Traditional Medicine[24]
3. Unani Medicine[25]
4. Traditional Healers in Africa[26]
5. Indigenous Medical Systems: Amazon[27]

The use of these diverse medical knowledge and treatment systems by the general public, in the different countries, have increased exponentially in various communities during the pandemic, especially due to the fact that the treatment modalities offered by standard medical practices have not yielded acceptable outcomes and has resulted in high mortalities[28], once the person is infected with the SARS Cov-2 virus[29].  The mortality is further increased by the emergence of numerous variants specific to each country[30].  In addition, the initial suspension of the Astra Zeneca vaccine[31] in certain countries as well as the continued suspension by certain countries, has resulted in a lack of public confidence in vaccinations[32], in general although the European regulators have subsequently declared the vaccine safe despite reports of thromboembolic adverse reaction in some patients[33].

The World Health Organisation traditional medicine strategy: 2014-2023 [34] Publication states that globally, Traditional Medicine (TM) is either the mainstay of health care delivery or serves as a complement to it. In some countries, traditional medicine or non-conventional medicine may be termed complementary medicine (CM).  In addition, the publication gives the field official approval and mentions that Traditional & Complementary Medicine is an important and often underestimated part of health care. T&CM is found in almost every country in the world and the demand for its services is increasing. TM, of proven quality, safety, and efficacy, contributes to the goal of ensuring that all people have access to care. Many countries now recognize the need to develop a cohesive and integrative approach to health care that allows governments, health care practitioners and, most importantly, those who use health care services, to access T&CM in a safe, respectful, cost-efficient, and effective manner. A global strategy to foster its appropriate integration, regulation and supervision will be useful to countries wishing to develop a proactive policy towards this important – and often vibrant and expanding part of health care[35].

The World Health Organisation’s goals of the strategy are to support Member States in harnessing the potential contribution of TM to health, wellness and people centered health care and promoting the safe and effective use of TM by regulating, researching and integrating TM products, practitioners and practice into health systems, where appropriate.

In China, the use of Chinese CAMS has increased tremendously since the SARS Cov-2 pandemic and the use of standard medicine has proportionately decreased. Traditional Chinese medicine (TCM) is a branch of traditional medicine in China. TCM is said to be based on Compendium of Materia Medica and Huangdi Neijing.[36] The practice includes various forms of herbal medicine, acupuncture, cupping therapy, Gua sha, massage[37] (Tui na[38]), Bonesetter[39] (Die-da)[40], Qigong[41], and dietary therapy.[42] TCM is widely used in the Sinosphere[43]

In the Indian sub peninsula Ayurvedic medicine is also used to treat SARS Cov-2 infections. A confirmed positive patient treated entirely with Ayurveda is documented using herbal medicines very much similar to Traditional Chinese Medicine (TCM). TCM which was extensively used to control the epidemic in China, also consists of herbal medicines similar to Ayurveda.[44]

In Africa and particularly in South Africa, the Traditional Healer is highly respected and consultations in case of most ailments is deeply entrenched in the culture of the indigenous people.  Often this modality of treatment is concomitantly used with mainstream medicine.  During the Covid pandemic, these consultations and use of traditional medication has increased tremendously. In June 2020, Artemisia afra[45] was in high demand on the streets of Johannesburg in South Africa to treat COVID-19 symptoms, the indigenous herb’s silvery leaves were for sale at roadside vendors and in the city’s popular traditional markets. People in the region have consumed the bitter plant for centuries to treat illnesses from ranging from common colds to intestinal worms. With deaths rising as South Africa battled its first COVID-19 wave, people have turned to A. afra and other traditional medicines, including cannabis.[46]

COVID-19 is a life-threatening infectious disease and has no existing cure or treatment. Recent studies are trying to understand how the immune system is reacting to fight the coronavirus[47]. Unani Medicine has a rich literature regarding infections’ invasion over the body, the causes of disease, curative measures and treatment for epidemics and pandemic, such as, acute catarrh and Covid pandemic. Unani scholars prescribed many drug formulations for the prevention and treatment of infectious diseases. Most importantly, they recommend using Tiryaq Wabai[48] (antidote), to evacuate the lethal matter out of the body. [49]

The Indigenous Medical Systems[50] comprise a multitude of treatment modalities encompassing the centuries old therapies used by indigenous people around the world. Of note, is the treatment devised by the Amazonian people, who have passed on their treatment plans from generation to generation, verbally.  The news that a tribe in the Amazon, the Matsés[51] or Mayoruna peoples of Brazil and Peru have created a 500-page encyclopedia of their traditional medicine, is indeed remarkable.[52] The encyclopedia, compiled by five shamans[53] with assistance from conservation group Acaté[54], details every plant used by Matsés medicine to cure a large variety of ailments.

“The Matsés Traditional Medicine Encyclopedia marks the first-time shamans of an Amazonian tribe have created a full and complete transcription of their medicinal knowledge written in their own language and words,” Christopher Herndon, president and co-founder of Acaté, told Mongabay[55] in an interview.[56] The Matsés have only printed their encyclopedia in their native language to ensure that the medicinal knowledge is not stolen by corporations or researchers, as has happened in the past. Instead, the encyclopedia is meant as a guide for training new, young shamans in the tradition and recording the living shamans’ knowledge before they pass.  Some of mankind’s most important pharmaceuticals, such as quinine and aspirin, have been developed through learning from traditional healers. Due to the political climate and international fears of biopiracy[57], it is challenging for even well-intentioned pharmaceutical companies committed to equitable profit-sharing agreements to undertake such initiatives[58].

It can be seen that, in these great rain forests[59], in different parts of the world are now in danger of decimation[60].  These forests extend from the equatorial regions of the Latin Americas[61], to the jungles of Central Africa[62] and the dense forests of the Far East the greenery of Papua New Guinea and Borneo[63]. Here, is a wealth of indigenous knowledge[64] and therein lies the secrets of treatment of various diseases and many more pandemics to inflict mankind in the future. It is indeed unfortunate that Big Pharma[65] only sees the research for treatment of new diseases in terms of material amassments and not for the betterment of humankind.[66]

References:

[1] https://www.sciencedirect.com/science/article/pii/S1201971221000461

[2] https://www.researchgate.net/profile/Jerome_Singh/publication/343193843_COVID-19_therapeutics_How_to_sow_confusion_and_break_public_trust_during_international_public_health_emergencies/links/5f1f0ae592851cd5fa4b8da5/COVID-19-therapeutics-How-to-sow-confusion-and-break-public-trust-during-international-public-health-emergencies.pdf

[3] https://www.afro.who.int/publications/effectiveness-use-chloroquine-hydroxychloroquine-covid-19-case-management

[4] https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/

[5] https://www.covid19treatmentguidelines.nih.gov/immunomodulators/corticosteroids/

[6] https://edition.cnn.com/2020/03/19/politics/fact-check-chloroquine-trump-fda/index.html

[7] https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/ivermectin/

[8] https://www.iol.co.za/capeargus/news/sa-drugs-regulator-bans-miracle-covid-19-treatment-as-unsafe-4e36c339-c65c-4cc6-93d2-d7e748eefcb6

[9] https://allafrica.com/stories/201510010339.html

[10] https://www.drugs.com/vet/ivermectin-injection.html

[11] https://voices.transparency.org/the-terrible-consequences-of-police-corruption-in-south-africa-294e6fd8922

[12] https://www.polity.org.za/article/group-of-health-practitioners-take-sahpra-to-court-to-fight-for-use-of-ivermectin-2021-02-12

[13] http://www.umich.edu/~eng217/student_projects/nkazmers/organizedcrime2.html

[14] https://time.com/5791661/who-coronavirus-pandemic-declaration/

[15] https://www.nytimes.com/article/coronavirus-timeline.html

[16] https://medpharm.tandfonline.com/doi/pdf/10.1080/20786190.2016.1248146

[17] https://www.nap.edu/read/11182/chapter/9

[18] https://en.wikipedia.org/wiki/Alternative_medicine

[19] https://en.wikipedia.org/wiki/Pseudoscience

[20] https://www.al-monitor.com/pulse/originals/2019/08/pharaonic-recipes-make-new-trend-in-egypt.html

[21] Alternative Medicine: The Science Behind 10 Alternative Therapies (greatist.com)

[22] https://www.hopkinsmedicine.org/health/wellness-and-prevention/types-of-complementary-and-alternative-medicine

[23] https://www.ayurtimes.com/ayurvedic-medicine/#:~:text=Ayurvedic%20Medicine.%20Ayurvedic%20Medicine%20%28also%20called%20Ayurveda%29%20is,benefits%20in%20preventive%20as%20well%20as%20curative%20treatment.

[24] https://en.wikipedia.org/wiki/Traditional_Chinese_medicine

[25] https://en.wikipedia.org/wiki/Unani

[26] https://theculturetrip.com/africa/south-africa/articles/different-types-healers-south-africa/#:~:text=Different%20Types%20of%20Healers%20in%20South%20Africa%201,4%20Welcoming%20new%20lives%20into%20the%20world.%20

[27] https://news.mongabay.com/2015/06/amazon-tribe-creates-500-page-traditional-medicine-encyclopedia/

[28] https://ourworldindata.org/excess-mortality-covid

[29] https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html

[30] https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html

[31] https://www.bing.com/news/search?q=suspension+of+the+astrazeneca+vaccine&qpvt=suspension+of+the+Astra+Zeneca+vaccine&FORM=EWRE

[32] https://www.weforum.org/agenda/2020/11/fewer-people-say-they-would-take-a-covid-19-vaccine-now-than-3-months-ago/

[33] https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-prac-investigating-cases-thromboembolic-events-vaccines-benefits

[34] 9789241506090_eng.pdf;jsessionid=CE7DC6AE5BD05EBF3A22DB11A1AB1860 (who.int)

[35] https://shamanism.org/news/world-health-organization-acknowledges-traditional-medicine/

[36] Traditional Chinese medicine – Wikipedia

[37] https://www.goodhousekeeping.com/beauty/anti-aging/a28985005/what-is-gua-sha/

[38] https://www.sciencedirect.com/topics/medicine-and-dentistry/tui-na

[39] https://en.wikipedia.org/wiki/Bonesetter

[40] https://en.wikipedia.org/wiki/Die-da

[41] https://en.wikipedia.org/wiki/Qigong

[42] Traditional Chinese Medicine, National Center for Complementary and Integrative Health, Traditional Chinese Medicine: An Introduction Archived 26 June 2015 at the Wayback Machine

[43] Experience Hong Kong’s traditional rituals and ceremonies like a true local | Hong Kong Tourism Board (discoverhongkong.com)

[44] Ayurvedic treatment of COVID-19/SARS-CoV-2: A case report – PubMed (nih.gov)

[45] https://en.wikipedia.org/wiki/Artemisia_afra

[46] In South Africa, COVID-19 Pits Traditional Medicine Against Clinical Trial Rules – The Wire Science

[47] https://www.dw.com/en/the-immune-systems-fight-against-the-coronavirus/a-53048894

[48] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171853/

[49] https://www.researchgate.net/publication/344351635_COVID-19_PANDEMIC_UNANI_MEDICINE_AND_IMMUNOMODULATION

[50] https://en.wikipedia.org/wiki/Traditional_medicine

[51] https://www.survivalinternational.org/tribes/matses

[52] https://news.mongabay.com/2015/06/amazon-tribe-creates-500-page-traditional-medicine-encyclopedia/

[53] https://www.britannica.com/topic/shamanism

[54] https://acateamazon.org/

[55] https://mongabay.org/

[56] http://www.digitaljournal.com/news/environment/amazon-tribe-writes-first-ever-traditional-healing-encyclopedia/article/437113

[57] https://open.uct.ac.za/bitstream/item/4399/thesis_law_bastuckc_2006.pdf?sequence=1

[58] https://www.researchgate.net/publication/278403522_Fair_and_Equitable_Sharing_the_benefits_from_use_of_genetic_resources_and_traditional_knowledge

[59] https://www.bing.com/search?q=great+rain+forests&aqs=edge..69i57.496066j0j1&pglt=299&FORM=ANNTA1&PC=U531

[60] https://dissidentvoice.org/2019/09/decimation-of-the-rainforests-and-the-money-men/

[61] https://en.wikipedia.org/wiki/Latin_America

[62] https://elle.in/article/into-the-wild-central-africa/

[63] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069679

[64] https://yiba.co.za/africas-generational-wealth-through-indigenous-knowledge-ip/

[65] https://www.bing.com/search?q=Big+Pharma&aqs=edge..69i57.392197j0j1&pglt=299&FORM=ANNTA1&PC=U531

[66] https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-017-0215-8

______________________________________________

 Prof.  Hoosen Vawda, BSc, MBChB (Natal), ATLS, ACLS (NZ), PhD (Wits):
-Community Health and Indigent Programme Services–Social Outreach, Medical Programme (Not for Profit Organisation)
-Lifestyle Change Management – PR: 1501305, MP: 0193801
-email: vawda@ukzn.ac.za

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