Experiences and challenges of African traditional medicine: lessons from COVID-19 pandemic.

Management of COVID-19 in Africa is challenging due to limited resources, including the high cost of vaccines, diagnostics, medical devices and routine pharmaceuticals. These challenges, in addition to wide acceptability, have resulted in increased use of herbal medicines based on African traditional medicines (ATMs) by patients in Africa. This is in spite of the often-significant gaps in evidence regarding these traditional medicines as to their efficacy and safety for COVID-19. African scientists, with some support from their governments, and guidance from WHO and other bodies, are addressing this evidence gap, developing and testing herbal medicines based on ATMs to manage mild-to-moderate cases of COVID-19. Such efforts need further support to meet public health needs.

The use of traditional medicine practitioner services for childhood illnesses among childbearing women: a multilevel analysis of demographic and health surveys in 32 sub-Saharan African countries.

BACKGROUND: Insights into the use of traditional medicine practitioners (TMP)-for common childhood diseases such as diarrhea and respiratory infections are important to understand the role of Traditional Medicine (TM) in reducing the increasing childhood morbidity and mortality in sub-Saharan Africa (SSA). However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in SSA is lacking. This study aimed to estimate the prevalence of the use of traditional medicine practitioner services to treat childhood illnesses among women with children under five years old and to identify individual and community-level factors associated with TMP use in SSA. METHODS: The analysis used Demographic and Health Surveys (DHS) dataset collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness, defined as having diarrhoea or fever/cough or both. Using STATA v14, we employed the random effect meta-analysis to estimate the pooled prevalence of TMP use for childhood illness and a two-level multivariable multilevel modelling to determine the individual and community-level factors associated with consultation of a TMP. RESULTS: Approximately [2.80% (95%CI: 1.88-3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest occurring in Cote d'Ivoire [16.3% (95%CI: 13.87-19.06)] and Guinea (13.80% (95%CI: 10.74-17.57)] but the lowest in Sierra Leone [0.10%(95%CI:0.01-1.61)]. Specifically, approximately [1.95% (95%CI: 1.33-2.68)] and [1.09% (95%CI:0.67-1.60)] of women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR = 1.62;95%CI:1.23-2.12], no media access [AOR = 1.19;95%CI:1.02-1.39), who lived in a male-headed household [AOR = 1.64;95%CI:1.27-2.11], without health insurance [AOR = 2.37;95%CI: 1.53-3.66], who considered it a problem getting permission to visit a health facility [AOR = 1.23;95%CI:1.03-1.47] and who perceived the size of their children at birth to be above average[AOR = 1.20;95%CI:1.03-1.41] had higher odds of using TMP for childhood illnesses. CONCLUSIONS: Although the prevalence of TMP for childhood illnesses appeared low, our findings highlight that TMPs continue to play a critical role in managing childhood illnesses in SSA. It is essential that policymakers and service providers should incorporate the potential role of TMPs in the design, review and implementation of child health policies in SSA. Also, the interventions for curtailing childhood illnesses should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.

The role of intellectual property rights on access to medicines in the WHO African region: 25 years after the TRIPS agreement.

BACKGROUND: It is now 25 years since the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the same concerns raised during its negotiations such as high prices of medicines, market exclusivity and delayed market entry for generics remain relevant as highlighted recently by the Ebola and COVID-19 pandemics. The World Health Organization's (WHO) mandate to work on the interface between intellectual property, innovation and access to medicine has been continually reinforced and extended to include providing support to countries on the implementation of TRIPS flexibilities in collaboration with stakeholders. This study analyses the role of intellectual property on access to medicines in the African Region. METHODS: We analyze patent data from the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI) to provide a situational analysis of patenting activity and trends. We also review legislation to assess how TRIPS flexibilities are implemented in countries. RESULTS: Patenting was low for African countries. Only South Africa and Cameroon appeared in the list of top ten originator countries for ARIPO and OAPI respectively. Main diseases covered by African patents were HIV/AIDS, cardiovascular diseases, cancers and tumors. Majority countries have legislation allowing for compulsory licensing and parallel importation of medicines, while the least legislated flexibilities were explicit exemption of pharmaceutical products from patentable subject matter, new or second use of patented pharmaceutical products, imposition of limits to patent term extension and test data protection. Thirty-nine countries have applied TRIPS flexibilities, with the most common being compulsory licensing and least developed country transition provisions. CONCLUSIONS: Opportunities exist for WHO to work with ARIPO and OAPI to support countries in reviewing their legislation to be more responsive to public health needs.

Impact of the COVID-19 pandemic on blood supply and demand in the WHO African Region.

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) affected millions of people worldwide and caused disruptions at the global level including in healthcare provision. Countries of the WHO African region have put in place measures for the COVID-19 pandemic containment that may adversely affect blood system activities and subsequently reduce the supply and demand of blood and blood components. This study aims to assess the impact of the COVID-19 pandemic on blood supply and demand in the WHO African Region and propose measures to address the challenges faced by countries. MATERIALS AND METHODS: A survey questionnaire was sent to all 47 countries in the WHO African Region to collect information on blood supply and demand for the first 5 months of 2019 and 2020, respectively, and on COVID-19 Convalescent Plasma therapy in September 2020. RESULTS: Thirty-seven countries provided responses. The total number of blood donations dropped in 32 countries while it increased in five countries. The proportion of blood drives also decreased in 21 countries and increased in nine countries. The blood requested and issued for transfusion decreased for blood demand and for blood issued for transfusion in 30 countries. Ten countries reported some activities of convalescent plasma. However, very few units of this product collected have been transfused to COVID-19 patients. CONCLUSION: The COVID-19 pandemic has led to a reduction of blood related activities in the region, including the supply and demand. Countries preparedness plans for health emergencies need more emphasis to maintaining blood stock.

Traditional medicine among the community of Gash-Barka region, Eritrea: attitude, societal dependence, and pattern of use.

BACKGROUND: Despite the growing conventional healthcare coverage in Eritrea, traditional medicine (TM) remains an essential source of healthcare service to the population. This study, therefore, aims at exploring the attitude, societal dependence, and pattern of TM use of the Gash-Barka community. METHODS: A cross-sectional study was conducted between December 2018 and January 2019 in Gash-Barka region, one of the six regions of Eritrea. Two-stage stratified cluster sampling design was used to provide representative sample of households. The data collected through face-to-face interview using a structured questionnaire was entered twice and analyzed using CSPro7.2 and SPSS 23, respectively. Both descriptive and analytical analyses were performed to test statistical significance. RESULTS: Of the total 210 participants, 202 completed the interview with a response rate of 96.2%. Almost 97% of the respondents were aware of the general existence of TM. About half of the respondents (47.4%) had visited traditional health practitioners (THPs) at least once in their lifetime. The majority of the respondents claimed their medical condition had been improved (63.2%), were satisfied with the outcome (76.8%), and had not encountered complications (95.2%) due to TM use. Around 40% of the respondents admitted they do not disclose previous TM use to conventional health practitioners. Females are more likely to have had ever visited THPs (AOR = 1.85, CI: 1.01, 3.38) and use TM in the future (AOR = 2.26, CI: 0.92, 5.14) than males. Moreover, those who had visited THPs before (COR = 8.30, CI: 3.25, 21.20) are more likely to use TM as a primary treatment choice and prefer to use TM in the future (AOR = 4.40, CI: 1.97, 9.83) than those who had never visited THPs. About 61% of the total families claimed they had circumcised at least one female child, and 96.8% disclosed they had circumcised at least one male child. Out of which, 89.2% of the circumcisions were done by THPs. CONCLUSION: TM is popular and widely relayed upon by Gash-Barka residents with exposure of children to harmful TM practices. Since the reliance of the community on TM is expected to continue, further representative studies are recommended to inform regulatory interventions and integrate TM into the health system.

A review of policies and programmes for human organ and tissue donations and transplantations, WHO African Region.

Several resolutions, endorsed by the World Health Assembly and the United Nations General Assembly, articulate the need to improve the availability, quality and safety of organ and tissue donation and transplantation, as well as to prevent and combat trafficking in human organs. Here we assessed the implementation of these resolutions pertaining to organ and tissue donations and transplantations by sending out a questionnaire to all 47 countries in the World Health Organization African Region. From 33 countries that provided data, we identified several obstacles and challenges. Compared to other regions, there are very limited data on organ donation and transplantation. Most countries are lacking legal and regulatory frameworks, since they did not yet establish a specific or comprehensive legislation covering donation and transplantation of human organs and tissues. Countries also have a poor national capacity to perform organ and tissue transplantations and the organization and management of national programmes are weak. Funding, both from domestic and external sources, is insufficient to implement effective transplantations programmes and patients have inadequate financial protection. To address these challenges, we propose that countries and partners should develop and implement policies, strategies, plans and regulatory frameworks for all aspects of organ and tissue donations and transplantations, including fighting against organ trafficking and transplant tourism. Where donation and transplantation programmes exist, stakeholders should develop the skills of human resources, adopt technical standards and quality management procedures to improve donation and transplantation of human organs and tissues.

De nombreuses résolutions approuvées par l'Assemblée mondiale de la Santé et l'Assemblée générale des Nations Unies ont souligné le besoin d'améliorer la disponibilité, la qualité et la sécurité des dons et de transplantations d'organes et de tissus humains, de même que celui d'assurer la prévention et la lutte contre le trafic d'organes. Dans ce document, nous avons étudié la mise en œuvre de ces résolutions relatives aux dons et transplantations d'organes et de tissus, par le biais d'un questionnaire envoyé aux 47 pays appartenant à la région Afrique de l'Organisation mondiale de la Santé. Nous avons identifié de nombreux obstacles et défis dans les 33 pays qui nous ont transmis des données. Par rapport à d'autres régions, il existe très peu d'informations à ce propos. La plupart des pays ne possèdent pas de cadres juridiques et réglementaires car ils n'ont pas encore établi de législation spécifique ou exhaustive couvrant les dons et transplantations d'organes et de tissus. Certains manquent également de moyens au niveau national pour réaliser des greffes d'organes et de tissus, tandis que leur organisation et leur gestion des programmes nationaux sont inadaptées. Tant les fonds provenant de l'intérieur que ceux fournis par l'extérieur ne permettent pas d'instaurer des programmes de transplantation efficaces. Enfin, les patients ne bénéficient pas d'une protection financière suffisante. Afin de pouvoir relever ces défis, nous proposons que ces pays et leurs partenaires développent et appliquent des politiques, stratégies, projets et règles pour tous les aspects liés aux dons et transplantations d'organes et de tissus, y compris la lutte contre le trafic d'organes et le tourisme de la transplantation. Et là où des programmes de dons et de transplantations existent, les intervenants devraient acquérir des compétences en ressources humaines, mais aussi adopter des normes techniques et des procédures de gestion de la qualité afin d'optimiser les dons et transplantations d'organes et de tissus.

Diversas resoluciones que la Asamblea Mundial de la Salud y la Asamblea General de las Naciones Unidas aprobaron articulan la necesidad de mejorar la disponibilidad, la calidad y la seguridad de la donación y el trasplante de tejidos y órganos, así como de prevenir y combatir el tráfico de órganos humanos. En el presente documento se evalúa la implementación de estas resoluciones relacionadas con la donación y el trasplante de tejidos y órganos por medio del envío de un cuestionario a los 47 países de la Región de África de la Organización Mundial de la Salud. De los 33 países que suministraron los datos, se identificaron varios obstáculos y desafíos. En comparación con otras regiones, existen muy pocos datos sobre la donación y el trasplante de órganos. La mayoría de los países carecen de marcos normativos y legales, ya que todavía no han establecido una legislación específica o integral que aborde la donación y el trasplante de tejidos y órganos humanos. Los países también tienen una capacidad nacional deficiente para realizar los trasplantes de tejidos y órganos, además de que la organización y la gestión de los programas nacionales son débiles. El financiamiento, tanto de fuentes nacionales como internacionales, es insuficiente para implementar programas de trasplantes efectivos y los pacientes tienen una protección financiera inadecuada. Para hacer frente a estos desafíos, se propone que los países y los socios elaboren e implementen políticas, estrategias, programas y marcos normativos de todos los aspectos de la donación y el trasplante de tejidos y órganos, incluida la lucha contra el tráfico de órganos y el turismo de trasplantes. Cuando existan programas de donación y trasplante, las partes interesadas deberían desarrollar las habilidades de los recursos humanos y adoptar estándares técnicos y procedimientos de gestión de calidad para mejorar la donación y el trasplante de tejidos y órganos humanos.

Towards universal health coverage: advancing the development and use of traditional medicines in Africa.

African traditional medicine (ATM) and traditional health practitioners (THPs) could make significant contributions to the attainment of universal health coverage (UHC). Consequently, the WHO provided technical tools to assist African countries to develop ATM as a significant component of healthcare. Many African countries adopted the WHO tools after appropriate modifications to advance research and development (R&D) of ATM. An analysis of the extent of this development was undertaken through a survey of 47 countries in the WHO African region. Results show impressive advances in R&D of ATM, the collaboration between THP and conventional health practitioners, quality assurance as well as regulation, registration and THP integration into the national health systems. We highlight the various ways investment in the R&D of ATM can impact on policy, practice and the three themes of UHC. We underscore the need for frameworks for fair and equitable sharing of all benefits arising from the R&D of ATM products involving all the stakeholders. We argue for further investment in ATM as a complement to conventional medicine to promote attainment of the objectives of UHC.

Enhancing the Role of Traditional Medicine in Health Systems: A Strategy for the African Region

In line with Resolution AFR/RC50/ R3 (Promoting the role of traditional medicine in health systems: A strategy for the African Region; 2000); Member States took steps between 2001 and 2012 to promote traditional medicine by developing national policies and regulatory frameworks and by implementing some priority interventions. By 2012; a total of 40 countries had national policies; 19 had strategic plans and there were 28 national research institutes that conducted research on traditional medicine products used for malaria; HIV/ AIDS; sickle-cell disease; diabetes and hypertension. In addition; seven countries included traditional medicine products into their national essential medicines lists (NEML) and nine adopted national frameworks for the protection of intellectual property rights and traditional medicine knowledge related to practices and products. Despite the progress made; countries continue to face challenges in implementing Resolution AFR/RC50/R3. This article introduces an updated strategy ( Regional Strategy on Promoting the Role of Traditional Medicine in Health Systems reproduced at the end of this article) that proposes key interventions to address these challenges and builds on the successful promotion of the positive aspects of traditional medicine in national health systems. The focus is on strengthening of stewardship and governance; the development and use of tools; the cultivation of medicinal plants and conservation of biological diversity; research and development; local production; the protection of intellectual property rights and traditional medicine knowledge; intersectoral coordination and capacity building

Herbal medicine use in the districts of Nakapiripirit, Pallisa, Kanungu, and Mukono in Uganda.

BACKGROUND: Traditional medicine (TM) occupies a special place in the management of diseases in Uganda. Not with standing the many people relying on TM, indigenous knowledge (IK) related to TM is getting steadily eroded. To slow down this loss it is necessary to document and conserve as much of the knowledge as possible. This study was conducted to document the IK relevant to traditional medicine in the districts of Mukono, Nakapiripirit, Kanungu and Pallisa, in Uganda. METHODS: An ethnobotanical survey was conducted between October 2008 and February 2009 using techniques of key informant interviews and household interviews. RESULTS: The common diseases and conditions in the four districts include malaria, cough, headache, diarrhea, abdominal pain, flu, backache and eye diseases. Respondents stated that when they fall sick they self medicate using plant medicines or consult western-trained medicine practitioners. Self medication using herbal medicines was reported mostly by respondents of Nakapiripirit and Mukono. Respondents have knowledge to treat 78 ailments using herbal medicines. 44 species, mentioned by three or more respondents have been prioritized. The most frequently used part in herbal medicines is the leaf, followed by the stem and root. People sometime use animal parts, soil, salt and water from a grass roof, in traditional medicines. Herbal medicines are stored for short periods of time in bottles. The knowledge to treat ailments is acquired from parents and grandparents. Respondents' age and tribe appears to have a significant influence on knowledge of herbal medicine, while gender does not. CONCLUSION: This survey has indicated that IK associated with TM stills exists and that TM is still important in Uganda because many people use it as a first line of health care when they fall sick. Age and tribe influence the level of IK associated with herbal medicine, but gender does not.

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: Achieving better Health for Africa in the New Millennium

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas: 1) leadership and governance for health; 2) health services delivery; 3) human resources for health; 4) health financing; 5) health information systems; 6) health technologies; 7) community ownership and participation; 8) partnerships for health development; and 9) research for health. This paper describes a framework constructed for implementing the necessary activities in each of these priority areas; and proposes recommendations for consideration by Member States in the development of their own country frameworks. The frameworkfor implementing activities related to health information and research for health which have been taken into account in the Algiers Framework are discussed separately elsewhere in this issue

An Overview of the Traditional Medicine Situation in the African Region

"WHO estimates that about 80of the population in developing countries depends on traditional medicine for their Primary Health Care (PHC) needs. Traditional medicine and its practitioners were officially recognized by the Alma Ata Declaration in 1978 as important resources for achieving Health for All. Since then; member states and WHO governing bodies have adopted a number of resolutions and declarations on traditional medicine. Notable among these are resolution on ""Promoting the role of traditional medicine in health systems: A Strategy for the African Region"" adopted by the WHO Regional Committee for Africa in Ouagadougou; Burkina Faso; in 2000 and the declaration on the Decade of African Traditional Medicine (2001-2010) by the Heads of State and government in Lusaka in 2001. This article will focus on the achievements of countries in the implementation of the priority interventions of the Regional strategy since its adoption in 2000. The article will also cover the challenges countries are facing in implementing the Regional strategy and propose the way forward."

Overview of Traditional Medicine in ECOWAS Member States

Traditional medicine has been the main source of healthcare for the vast majority of people in the Economic Community of West African States (ECOWAS). It is currently estimated that between 70-80of West Africans use traditional medicine for the management of both communicable and non-communicable diseases. In 2007; the West African Health Organization (WAHO) conducted a situational analysis to assess the level of development of traditional medicine in its member states. The findings showed that although there was strong political will from West African governments for the development of traditional medicine; the disparities in the level of development among the countries were very huge. For instance; it was observed that whist some countries had advanced to the stage where they had established training institutions and had herbal medicines on their essential medicines lists; others had not even developed national traditional medicine policies and legal frameworks; codes of ethics and strategic plans for implementation of national policies. Although all countries have made very good progress in the area of sensitization and popularization of traditional medicine; some others have made good progress in the development of national traditional medicine policies (11 out of 15). However; no country has a health insurance coverage for TM; alternative and complementary medicine. Intellectual property is still a relatively new area and this situation delays the development of frameworks for the protection of traditional knowledge and access to biodiversity in majority of Member States

Regulation of Traditional Medicine in the WHO African Region

In many developing countries traditional medicine is still the main source of health care for about 80of the population; because of its cultural acceptability; affordability and accessibility. In the last few years; there has also been an upsurge of interest in the use of traditional medicine in developed countries; where it is usually referred to as complementary and alternative medicine. Owing to countries' efforts to institutionalize traditional medicine in health systems and calls made by the WHO Regional Office for Africa over the last two decades; more than half of the countries in the African Region have developed national policies on traditional medicine and regulation is one of the components of such policies. Eighteen countries have developednational codes of ethics to ensure the safety; efficacy and quality of traditional medicines. However; less than half of the countries are yet to implement these policies and therefore; only a few countries have developed regulations for traditional medicine. Twenty-one countries have developed legal frameworks that provide for accreditation; registration of traditional health practitioners (THPs) and the establishment of a THP Council for regulation of traditional medicine practice and products. Non-regulation of traditional and herbal medicines poses a health risk to the populations. This paper discusses the regulation of traditional medicine practices and products; and highlights the challenges posed by attempts to regulate the sector. It also outlines quality; safety and efficacy assessment; product registration; marketing; distribution and post-marketing surveillance

Clinical Practices of African Traditional Medicine

In African traditional medicine; the curative; training; promotive and rehabilitative services are referred to as clinical practices. These traditional health care services are provided through tradition and culture prescribed under a particular philosophy; e.g. ubuntu or unhu. Norms; taboos; tradition and culture; which are the cornerstones of clinical practice of traditional medicine; are the major reason for the acceptability of traditional health practitioners in the community they serve. The philosophical clinical care embedded in these traditions; culture and taboos have contributed to making traditional medicine practices acceptable and hence highly demanded by the population. This paper discusses the different traditional health care services; such as curative services; general traditional healthcare; mental healthcare; midwifery; bone setting; rehabilitative and promotional services that increases health awareness and developing positive attitudes and behaviour towards healthier living)

Collaboration between traditional health practitioners and conventional health practitioners: some country experiences

Since the early 1970s; the WHO has repeatedly advocated for the recognition of Traditional Health Practitioners (THPs) as Primary Healthcare (PHC) providers and for the integration of traditional medicine in national health systems. Several calls have been made on governments to take responsibility for the health of their people and to formulate national policies; regulations and standards; as part of comprehensive national health programmes to ensure appropriate; safe and effective use of traditional medicine. One of the priorities of the African Regional Strategy on Promoting the Role of TM in Health Systems is promotion of collaboration between practitioners of traditional and conventional medicine. However; despite the health benefits such collaboration could bring to the populations; decades of disregard of traditional medicine practices and products has created mistrust between the two sectors hampering all the efforts being made to promote this potentially useful partnership. This article outlines the strategies that have been adopted by the WHO to ensure the integration of traditional medicine into national health systems; examples of ongoing collaboration between research institutions and THPs based on research and management of patients; and between THPs and conventional health practitioners in HIV/ AIDS prevention and care and HIV/AIDS/STI/tuberculosis programmes; factors that have contributed to sustaining these partnerships as well as mechanisms for strengthening such collaborations

L' introduction de plantes medicinales dans le traitement de l'infection a VIH : une approche reussie au Burkina Faso

La recherche et le developpement de medicaments traditionnels anti-VIH/SIDA est un processus complexe qui integre de nombreux defis. Ce processus comprend les evaluations precliniques et cliniques ainsi que la valorisation industrielle; avec la mise sur le marche de medicaments respectant des normes de qualite; d'innocuite et d'efficacite therapeutique. Si de nombreuses plantes africaines ont deja fait l'objet d'evaluations precliniques avec des resultats encourageants; les etudes cliniques comparatives sont encore insuffisantes. L'espoir est cependant permis; comme nous le montre l'experience du Burkina Faso; notamment a travers le developpement de deux medicaments qui ont franchi aujourd'hui avec succes l'etape d'essai clinique Phase II; et surtout l'identification des plantes medicinales pouvant avoir une interference negative avec les traitements antiretroviraux

Promotion de la medecine traditionnelle du Burkina Faso : essai de developpement d'un medicament antidrepanocytaire; le FACA

La recherche et le developpement de medicaments antidrepanocytaires est une priorite en Afrique; ou vivent la grande majorite des personnes souffrant de drepanocytoses. C'est dans ce sens que le FACA a ete developpe au Burkina Faso; a partir de la Medecine Traditionnelle et avec le soutien du bureau regional de l'OMS. Les proprietes antifalciformantes; anti-inflammatoires; antipyretiques et myorelaxantes ont ete evaluees. Il en est de meme de la toxicite. Les plantes composant le FACA; agissent en synergie contre les principaux symptomes de la crise drepanocytaire. Administre en evaluation clinique; le FACA est bien tolere et reduit de maniere significative; la frequence des crises. Apres son autorisation de mise sur le marche; le FACA fait maintenant l'objet d'une production industrielle

Recherche sur la medecine traditionnelle africaine: hypertension

Les institutions de recherche creees pour developper la medecine traditionnelle encouragees dans ce domaine par l'OMS menent des activites vers des maladies prioritaires comme le paludisme; le VIH/SIDA; la drepanocytose; le diabete et l'hypertension arterielle. La prise en charge de l'hypertension arterielle par les medicaments conventionnels est tres elevee amenant plusieurs patients a s'orienter vers la medecine traditionnelle dont les produits ayant l'innocuite; l'efficacite et la qualite prouvees doivent etre utilises. Differents organes des plantes utilisees par les tradipraticiens ont fait l'objet d'etudes phytochimiquediuretique; et antihypertensive au Departement de Medecine Traditionnelle a Bamako et a l'Institut de Recherche en Sciences de la Sante de Ouagadougou: Cymbopogon giganteus; Gynandropsis gynandra; Portulaca oleracea; Jatropha gossypiifolia et une recette de tradipraticien. L'infuse de Portulaca oleracea a la dose de 37;5 mg/kg avec une excretion urinaire de 163;10a donne une importante activite diuretique. Une elevation de la pression arterielle provoquee par l'adrenaline a la dose de 75?g/kg a ete inhibee par le macere aqueux de Jatropha gossipiifolia 94;64a la dose de 20mg/kg. Ces travaux viennent en complement des tests de toxicite pour permettre l'evaluation de l'evidence ethnomedicale sur des recettes a base de ces plantes suivie d'autres tests biologiques de formulation galenique et des essais cliniques. Peu de phytomedicaments de la medecine traditionnelle africaine ont obtenu l'autorisation de mise sur le marche a l'exception du Guinex-HTA produit en Guinee