Ester Innocent, Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

1. INDIGENOUS KNOWLEDGE

1.1. Indigenous peoples’ knowledge, language and culture in health promotion

Knowledge is a form of theoretical or practical understanding of a subject matter or situation. Knowledge, whether indigenous or modern, has the capability to transform a person or community. In other words, knowledge is an intellectual capital for development which, in the informal sectors, is intertwined in culture and beliefs. So-called Indigenous Knowledge (IK) is deeply and richly implanted in the peoples’ language they speak, food they eat, song or dance they enjoy, materials they use, etc. One such culture is Bantu, which comprises about 400 distinctive local ethnics groups covering most of the Central and Southeast part of Africa (Patin et al., 2017). Tanzania is among the countries which are dominated by Bantu people who embrace the Swahili language. Kiswahili is native to Tanzania, but it is now expanding to cover about 200 million speakers (UNESCO, 2021). Language promotes harmonious communication, unity in diversity and international understanding. No wonder Kiswahili was used in uniting people during independence and is now proclaimed by the UN as the first African language, which is celebrated on 7th July of each year (UNESCO, 2021). This language is a media for indigenous and modern knowledge exchange.

Swahili language is one of the successful innovations in health because Kiswahili by itself has no ethnicity, due to being widespread across tribes. People in coastal East Africa and even in the diaspora see themselves united by the same culture and language, which embrace brotherhood, love and peace, hence providing a massive safe, healthy environment for people to live. Peace and harmony is the number one medication for a human being. That is why both Indigenous and science knowledge now agree that a sick person is not necessarily diseased; rather, he or she can be affected due to associated surroundings. Some such ill health conditions can as well be treated/managed by/or through faith, humility and understanding, e.g. Wellness of displaced communities such as refugees requires affirmation that there shall be restoration of peace and harmony.

Harmony with one’s surroundings is an important aspect because human beings share space with animals, plants and other species in the environment, which in turn are resourceful agents in advancing wellbeing. Indigenous Knowledge (IK) provides understanding and interpretation in interacting and responding to societal events. For example, simple knowledge like the movement of winds can be an indicator to predict an event such as an outbreak of certain pandemic or contagious diseases. Also, certain patterns of behavior of insects and birds are used in the prediction of weather conditions which are relevant to responding to climate change, whether by mitigation, resilience, or coping. Gender roles in the communities, such as women, elderly community leaders and traditional healers, continue to serve as major preservation and reserve of Indigenous Knowledge in the informal sectors.

1.2. Contribution of Indigenous Knowledge to the science of health

One form of IK is traditional medicine. In the context of Africa, the WHO/AFRO Region (World Health Organization, 1978) defines African Traditional Medicine as the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to African cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. Interestingly, the term “explicable” is used to refer to both knowledge already understood that can be justified in the context of existing science and knowledge which is still in the IK domain. Myths, beliefs, societal norms and moral values are some forms of the indigenous healing/health systems impregnated to sustain the communities, but in science some do lack method and concepts that can be accounted for or explained. Thus, when addressing IK and science in the African context, one can, for instance, mirror it with what Bantu believe and its relation to health and wellbeing. Bantu believe in a holistic approach to treatment, which is the use of materia medica and some practices that are not necessarily tangible entities; some come from the cosmos. Bantu culture believes in the human body as an organic whole, which is integrated with the external environment. Thus, a human is regarded not as a purely physical entity but also taking into consideration sociological aspects (family or other), whether living or dead (ancestors) and “intangible forces” (God, gods,) of the universe.

This scenario, in the global arena, reiterates the contribution of IK to science of some practices that use non-material (non-medicines) treatments, including use of music and dances (e.g. Afro-soul music) in management of psychotic distress, e.g. stress, depression and other mental health disorders, etc.

1.3. Contribution of IK to pharmaceutical products

Nevertheless, IK on use of materia medica, especially medicinal plants, has been resourceful and effective in drugs discovery, e.g. vincristine and vinblastine from the Madagascan periwinkle Catharanthus roseus as cancer drugs (Karasov, 2001). The methods of drug discovery from biodiversity often follow a bio-prospecting approach, which is a complicated process. Bio-prospecting involves identification of bioactive ingredients from a medicinal plant, understanding the mechanisms of action and possibly its synthetic route. Thus, often the original natural products isolated from the plant are not used in industrial production. For example, despite the widespread (Figure 1), traditional use of Securidaca longipendunculata in Africa in relief of headache and inflammation (Mongalo et al., 2015), its uses remain indigenous. One of the active ingredients in this plant is methyl salicylate, but it is labile (Jayasekara et al., 2002). The plant is a tree, but since it is life sustaining, communities have learned how to harvest the medicines from the roots in a sustainable manner (Figure 1).

However, in order to have a useful drug agent for clinical use, several layers of knowledge had to be created to improve methyl salicylate in order to arrive at the pharmaceutical production of Aspirin (Figure 2). Thus, the original active ingredient from the plant only served as a mirror to reflect on, during laboratory experimentation, to inform an understanding of the actual alternative chemical structures that can be used in pharmaceutical synthesis (Figure 2). Through bio-prospecting, there are several useful hospital medicines, such as quinine, ephedrine, amodiaquine, primaquine, chloroquine, mefloquine, atropine, reserpine, digoxin, metformin, scopolamine, taxol, calanolide A, etc., which are synthetically made from a structure of an initial, naturally isolated compound from medicinal plants (Innocent, 2016).

1.    PERSPECTIVE OF INTELLECTUAL PROPERTY COMPENSATIONS

2.1.   The borderline between Bio-prospecting and Bio-piracy

Bio-prospecting principles go hand in hand with intellectual property (IP) and access and benefit sharing (ABS) in a fair and equitable manner when potential commercial value is realized by partners (CBD, 2017; Ramos, 2021; WTO, 1994). However, some areas in the bio-prospecting approach which need careful considerations include IK documentation as a prior art. There should be:

a)    A clear way to ascertain originality of IK and who really owns the knowledge during filing for IP, because IK has developed over time; it is exchanged and ever-changing. Therefore, IK being a living knowledge can cut across related cultures in the communities.

b)    Progressive upgrade and compensation of IK as it grows. Otherwise, relying on documented prior art limits innovativeness at communal levels.

c)    Flexibility of translation of IK along the transformation through research and development of other related future advancements, e.g. Hoodia gordonii being known for thirst and hunger by the San people, with the end product in bio-prospecting being a slimming product in IP systems (Wynberg et al., 2009).

Basically, any knowledge is transformative to the intent, and research is just one of the couriers/carriers of transformation. When such transformation is done through research in a fair and equitable term it results in bio-prospecting (Figure 3).

In some circumstances, during transformation there is a great intent of misappropriation, misinterpretation and misrepresentation of IK holders, resulting in the so-called bio-piracy (Figure 3). The pertinent loopholes to bio-piracy are in the memorandum of understanding (MoU), material transfer agreements (MTA) and specific clauses under non-disclosure, IP, and obligations of parties in the memorandum of agreements (MoA).

1.2.     Some Mechanisms to Resolve IP Issues, Including Linking Synthetic Pharmaceutical Products and IK

Therefore, exploration of pharmaceutical products from biodiversity through a bio-prospecting approach requires a balance of cultural rights of IK holders, intellectual property rights, and global justice to access of medicines. Traditional medicinal (TM) plants within the ecosystem of the communities continue to be relied on for survival. However, in large-scale production, modification of knowledge through research and development resulting in synthetic pharmaceutical products remains a sustainable way. Nevertheless,

    i.       Strengthening mechanisms of fair and equitable benefit-sharing may increase market status of TM associated with IK for global access and products development, as well as curbing bio-piracy. This may further reduce secrecy by IK holders as a preferred IP protection over other forms of IP that are transferable for product development and promotion of global health.

   ii.       Mechanisms that recognize originality of initial information and material sources should be strengthened through IP systems. Accessing parties should be obliged to specify the origin of the genetic material and all the associated traditional knowledge that gave a clue to the discoveries.

  iii.       Strengthening IP institutions and those which deal with access and benefit sharing (ABS) could eventually help promote disclosure of use of medicinal plants and practice that would enable the valuation of the services and proper documentation of prior arts to serve as a reservoir for referencing, but not as signatures of the status quo.

3. IK HOLDERS’ PARTICIPATION IN A SUSTAINABLE VALUE CHAIN

IK holders have fear of losing ownership of knowledge because they are not informed of the incentives that would impact their socio-economy. This is why a lot more traditional medicinal plants used by different communities in Tanzania and Afro-region have not yet penetrated the markets, despite the fact that they still serve about 60-80% of the population, in one way contributing to primary health care and to universal health coverage. African countries continue developing education curricula for training TM experts as a way of disseminating traditional medical knowledge and practices embedded in African culture (Innocent, 2016; Innocent et al., 2022). In particular, countries such as Ghana, South Africa, Tanzania, etc. that have developed education curricula also have traditional medicines registered and sold over the counter (Innocent, 2016). The Covid-19 pandemic in Tanzania left a remarkable emphasis on the use of evidence-based traditional medicine, also being a landmark in formalization of the integration of traditional medicine in the Tanzania referral hospital (Tarimo et al., 2023).

Otherwise, IK holders continue sharing practices and materia medica associated with certain knowledge in trade systems. For example, the growth of the global market for herbal products is at the rate of 7%, with a forecast expectation of $5 trillion by 2050 (Fao, 2005; Jadhav et al., 2020). Most worldwide traded medicinal plants include spices as medicines or raw materials for pharmaceutical developments. In Tanzania, exports of spices are dominated by cloves (HS Code 090710) which in 2021 made it the 3^rd largest exporter of cloves (Syzygium aromaticum) (HS Code 090710), which in 2021 made it the third largest exporter in the world with an export value of 93.2 million (Nderitu, 2021). Eugenol extracted from cloves bears huge industrial applications, particularly in pharmaceutics. In dentistry, eugenol is the main ingredient in dental preparations with zinc oxide for root canal sealing and pain control. Also, eugenol is used as a flavouring of foods, perfumes, and cosmeceutics. Other significant exports from Tanzania are cardamom, pepper (of the genus Piper) and ginger, neither crushed nor ground, both having classified health benefits of global concern (Nderitu, 2021). The use of spices as medicines by the Swahili people of the coast of East Africa is a common practice. The spices are impregnated in food preparation depending on a desirable carrier, method of administration and the disorder or condition to be treated. For example, for digestive and respiratory disorders they can be prepared as spiced teas, sauces, soup, etc. Spices are thus significant in the local market as well as contributing to the export earnings.

4.          CONCLUSION

The contribution of IK in advancing science that addresses local and global health challenges is significantly acknowledged. Bio-prospecting should recognize and remunerate indigenous people for ethno-ecological knowledge and biodiversity conservation. Transformation of IK through research, development, innovations and trade systems is inevitable. Thus, fair and equitable sharing of benefits creates a motivation to biodiversity protection/conservation to curb climate change, as well as continuing to offer mankind medicines and leads in pharmaceutical production.

ACKNOWLEDGMENTS

The Author is grateful to the Vatican Pontifical Academy of Sciences (PAS) for sponsorship to the conference on Indigenous Peoples’ Knowledge and the Sciences – Combining Traditional knowledge and science on innovations for resilience to address climate change, biodiversity loss, food security and health, held on 14-15 March 2024 and to Muhimbili University of Health and Allied Sciences for granting permission to participate.

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