information sharing and educational programmes have resulted in TPs
providing correct HIV/AIDS advice as well as demonstrations of condom
use. An estimated 1510 TPs were trained by these programmes and an
estimated 845 600 of their patients reached with AIDS/sexually transmitted
infection (STI) prevention messages during the first 10 months of the
programme. Similar programmes have been undertaken in Mozambique,
Zambia, Zimbabwe, Botswana and Malawi. UNAIDS^72 has observed that,
in addition to serving as effective agents in the dissemination of
prevention/education messages in respect of HIV/AIDS, TPs are able to offer
affordable and effective treatments, particularly for opportunistic infections
and STIs. In Uganda, an indigenous NGO known as THETA (Traditional
and Modern Health Practitioners Together against AIDS and other diseases)
is dedicated to collaboration between traditional and allopathic practi-
tioners in education, counselling and improved clinical care for people with
STIs, including HIV/AIDS.^73 According to Marshall,^70 the outstanding
feature of Uganda’s public healthcare system is the cooperation between
western allopathic practitioners and TPs.
Malaria, a second major public health problem in sub-Saharan African,
also lends itself to local collaborative programmes between TPs and allo-
pathic practitioners. Primarily a disease of the rural poor in Africa, Plas-
modium falciparum malaria causes more deaths than any other infectious
agent in young African children and is responsible for almost 40% of these
deaths. Up to 75% of malaria sufferers use locally available TMs,^74 because
these remedies are often the only option in remote rural areas. The efficacy
of such remedies has been demonstrated by the successful development of
modern antimalarials from traditionally used Cinchonaand Artemisia
spp.^75 Traditional preparations of Artemisia annuaL. have been shown to
be effective^76 for the treatment of semi-immune patients (adults and older
children) in malaria endemic areas, where complete parasite clearance is
probably unnecessary.^77 However, the issue of possible recrudescence after
incomplete parasite clearance needs to be taken into account. Evaluation of
the efficacy of locally available TMs (as selected by TPs) in the treatment
of uncomplicated malaria and involvement of TPs in malaria control
programmes at the local level would enable scarce resources to be allocated
to dealing with more severe cases. The Research Initiative for Traditional
Systems of Health (RITAM) has recently produced a publication dealing
with many issues pertinent to the use and evaluation of traditional herbal
antimalarials, including a review of clinical trials.^78
Attention to the unsustainable use of medicinal plant resources
Olayiwola Akerele, former manager of WHO’s Traditional Medicines
Programme, noted: ‘logically, the investigation, utilisation and exploitation
of medicinal plants by a country should also include measures for their
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