Illumination | Fall 2007

The first phase, lasting about six months, will determine safety and whether there are any side effects; the second phase, lasting at least 48 more weeks, will help researchers determine whether Sutherlandia has any measurable impact on the sample of 124 HIV-infected people who take the herbal remedy.

Cardiologist Anthony Mbewu, president of South Africa's Medical Research Council, says such trials are crucial in a nation where an estimated 80 percent of the population use traditional medicines. He cites the TICIPS research as among several projects that are examining "potential immune-boosters, testing the safety and toxicity of some South African plants." At the same time, he says South Africa is negotiating formal collaboration with China and India to study the use of traditional medicines in connection with HIV/AIDS.

UWC's Johnson says there are an estimated 200,000 traditional healers in South Africa, but only about 20,000 medical doctors. "There is currently no bridge between scientists and sangomas," he says. One step toward creating such a bridge is a pending South African law for registering traditional healers. Johnson says the healers' council requested the new law "to help distinguish between true traditional healers and the charlatans who are simply trying to make a fast buck."

In Zulu communities, a typical healer will see about 2,000 patients a year, according to Nceba Gqaleni, a professor at the University of KwaZulu-Natal's medical school and the point man for TICIPS work with traditional Zulu healers. He estimates that almost all healers are able to identify the symptoms of HIV/AIDS infection.

Gqaleni has been "essential to this project," Folk says. "Without him, we would not have had the cooperation and support of the traditional healers."

Many traditional healers have argued for wider use of Sutherlandia to help treat HIV-infected people, including South Africa's highest-ranking healer, Credo Mutwa, author of the best-selling book Indaba, My Children and a leader of the nation's main organization of traditional healers. "I don't claim this is the cure, but what it does to people is amazing," Mutwa said during a 2001 interview.

Reports of such tonic and immune-boosting qualities are the chief reason Sutherlandia is the first traditional medicine to be tested clinically. But another important question for modern medicine -- an issue likely to be addressed in future studies -- is whether the compounds in Sutherlandia influence, positively or negatively, the cocktail of drugs that a quarter million South Africans take as antiretroviral therapy against HIV infection.

"People being treated by Western-trained physicians often continue to treat themselves with traditional medicines," says Folk. "We need to find out whether this affects the success of antiretroviral treatments." Clinician Wilson agrees that, even though traditional remedies are widely used, "it is rare for people to know their potential side effects. And it is extremely important that we find out."

Now that the Sutherlandia clinical trials are on track in KwaZulu-Natal, Folk is working to expand his studies of traditional healing and HIV/AIDS to other parts of Africa. In September, he traveled to Kenya to plan "a small pilot study to document traditional healing practices used by the HIV-infected public." He hopes to set up similar studies in Zambia and Uganda.

"I have the interest and support of several of the largest antiretroviral treatment programs in Africa for such efforts," Folk says, "as they recognize their care is mixed with use of traditional medicines, about which so little is known."

Published by the Office of Research.