Introduction
Although African plants used in traditional remedies have many beneficial and healing properties, they are often perceived as obscure and excluded from modern healthcare. Dr. Pando Zéphirin Dakuyo is bringing traditional African medicine out of the shadows by applying the same rigorous standards to it that are applied to modern medicines, organizing the industry players into partnerships, and ensuring a consistent supply of plant material while preserving species diversity.
The New Idea
Dr. Dakuyo promotes the use of traditional African medicine and has integrated it into existing public health structures and distribution networks to ensure affordable and accessible medication for the Burkinabé people. He has standardized traditional African pharmacopeia by scientifically verifying its beneficial properties and developing easily producible and ingestible products, thereby giving African remedies a place next to modern medicines.
Dr. Dakuyo has also improved the traditional recipes and dosages and transformed them into medicinal products that are affordable for everyone. His reliance on modern scientific methods to certify the products has prompted health authorities to adopt a public health law that officially acknowledges traditional medicine and pharmacopeia. Dr. Dakuyo is building bridges between doctors and healers to improve the relationship that exists between them and to encourage them to collaborate. To reduce the public’s misperceptions of traditional remedies that contributes to their marginalization, Dr. Dakuyo integrates key traditional remedies into the same distribution circuit as modern drugs. Among the remedies available in pharmacies is Saye, put in tea, it is effective against malaria and only costs $.65 cents.
Dr. Dakuyo is also working to ensure the uninterrupted market supply of raw materials and the preservation of threatened plant species. He organizes traditional plant producers into a cooperative and trains them on harvesting, drying, and environmental protection techniques. Dr. Dakuyo has created a mutually beneficial system that ensures the regeneration and sustainability of threatened species, the permanent production of medicinal plants, and a guaranteed market for these products that boosts producers and healers incomes while providing affordable health treatments to all. Dr. Dakuyo is committed to working across West Africa and has partnered with other regional associations to do so.
The Problem
Despite the efforts of the Burkinabé government to ensure widespread access to medical coverage, it is still financially and geographically difficult for most people to obtain medical care. There are 600 pharmacists and 1,700 doctors in Burkina Faso, which translates to one pharmacist for every 26,000 people and one doctor for every 9,000 people. Only 30 percent of the population has access to vital medicines, and 98 percent of those medicines are imported. It is especially difficult for Burkinabé people living below the poverty line in rural areas to access public healthcare or to obtain specialist care.
As a result, many people turn to traditional medicine. However, the sacred and ritual aspects of African traditional medicine have, for a long time, been mocked, fought, and mystified by modern medicine. Modern medical practitioners reject traditional African pharmacopeia, even though early explorers have documented its richness and researchers have included traditional healing plants in many so-called modern breakthrough drugs. According to the Ministry of Health, there are more than 10,000 traditional practitioners in Burkina Faso. However, their products are not subjected to scientific control and healers’ prescriptions do not take into account individual characteristics and complicating factors such as allergies, gastric problems, and blood pressure. The consequences are complications that can sometimes lead to the death of the patient. These factors negatively affect the credibility of the healers and of traditional medicines. For these reasons, traditional pharmacopeia was not initially tolerated within the healthcare system.
As Dr. Dakuyo’s work has gained traction, it has become increasingly more difficult to gather enough plant material in the wild. The efforts of others to cultivate the plants have failed because the plants do not produce the medicinal chemicals when domesticated. About 70 percent of African wild plants have a medicinal value. However, the recent increase in demand combined with the limited resources available has caused the depletion of important species in areas where they were once abundant. Many prevention and restoration programs were established in response but it was done so without involving the producers.
The Strategy
Dr. Dakuyo began his work by seeking legitimacy for traditional healing plants using modern scientific methods. In the 1980s, he began evaluating the virtues of typical traditional remedies through clinical trials. He discovered that the same components in the drugs used to treat malaria, hepatitis, and jaundice existed in these remedies. Dr. Dakuyo introduced toxicological controls to determine appropriate dosages and conducted the laboratory testing in order to explore and standardize drying, conservation, and conditioning techniques. He transformed many of these traditional remedies into simple capsules and drugs that are easy to prepare (i.e. syrups, potions, and ointments). Poitiers University in France and the London Research Institute have validated his findings. A prominent national laboratory in Burkina Faso has also conducted bacterial tests to verify his work. As a result of this verification, the Burkinabé state revised the public health code in 1998 and officially acknowledged traditional medicine as part of the healthcare system. Dr. Dakuyo then opened an office dedicated to African pharmacopeia at the Ministry of Health.
Dr. Dakuyo understood that he would need to effectively integrate these products and ideas with the practices of modern doctors and pharmacists to make traditional remedies affordable and available throughout Burkina Faso. His organization, Phytofla, was established in 2001 and is dedicated to processing and marketing phytomedicines that are 90 percent less expensive than Western pharmaceuticals. Dr. Dakuyo obtained authorization to promote and sell four products after providing the Ministry of Health with scientific documentation of his research and proof of the product’s benefits. He then organized more than 200 pharmacists to integrate the products into the formal pharmaceutical distribution network. Other traditional medicines (about 50) are sold through Phytofla’s network but are subject to public health codes and the Ministry of Health.
Dr. Dakuyo then turned his attention to shifting the medical professions’ and the publics’ negative perception of traditional medicines. He works with public health agents to remove their prejudices against African pharmacopeia and he urges them to prescribe phytomedicines. This enables patients to learn about these remedies, understand how these two typically dichotomous types of medicine can be complementary, and freely choose their type of treatment. Such collaboration is currently underway in more than ten health districts.
At the same time, Dr. Dakuyo developed relationships with traditional practitioners to more actively integrate them into the public health system, bolstering their belief in their capacity to contribute to public health. And improving the relationship between traditional healers and modern medical practitioners. Healers now have membership cards and collaboration certificates that enable them to be treated for free in public hospitals. The relationship between these two groups has improved to the point that some doctors send their patients suffering from prostate problems, hepatitis, and certain types of cancer to traditional practitioners.
Having created a new approach to validating traditional medicine, Dr. Dakuyo is focused on the supply of plant material. With the increase in demand for medicinal plants, he is working to ensure the sustainability of the raw materials and their quality. He conducted a census to create a producers’ directory and organized 250 producers into a cooperative. To improve processing techniques and ensure environmental protection, Dr. Dakuyo hired a forester to train the producers on harvesting and drying techniques and on environmental preservation. In 2010, he set up medicinal plant orchards with the assistance of the National Center for Forest Seeds. This new concept boosts plant production and ensures the continuation of endangered plant species. Orchards are planted in wild areas and focus on six endangered species. The gardens utilize a new watering system that results in rapid growth with minimal effort from the producer and has been copied by many agriculture schools and institutes. The orchards help to continue the production and the regeneration of nature, and they generate greater income for the producer than other crops. Over 1,200 plants currently grow in the orchards and Dakuyo’s objective is to involve 1,000 producers nationally who will each care for a one hectare orchard.
Dr. Dakuyo is also ensuring the next generation of practitioners understands the benefits and uses of traditional remedies. He has designed a curriculum for a three-year training program on herbal medicine in the national languages—the first class of 40 students just graduated. Dr. Dakuyo receives trainees and supervises university thesis candidates who are researching related topics. He also has an agreement with the Ministry of Health to send assistants to pharmacists each year.
To spread his idea beyond one region of Burkina Faso, Dr. Dakuyo has begun the process of registering Phytofla products in Mali, Cote d’Ivoire, Niger, and Senegal for distribution. He organized a regional association composed of Phytofla and two other producers following in Phytofla’s wake; this association serves as a peer group and creates momentum for policy change. One of the group’s objectives is to persuade the Economic Community of West African States (ECOWAS) to enforce the law for the free circulation of products in the region. In this way, the traditional medicinal products that are approved in Burkina Faso by the Ministry of Health can be easily traded with ECOWAS countries.
The Person
Dr. Dakuyo adopted the “consommer Burkinabé” way of life as his own. For him, Africa cannot afford to buy chemical drugs from the North, especially given its rich traditional pharmacopeia and ancient knowledge about healing remedies. As a whole, he saw that Africa needs to develop its own drug industry. Acquiring the taste for research on pharmacopeia when he was student in Dakar (Senegal) in 1983, he transformed the manager’s abandoned toilets at Banfora Hospital into a laboratory. Dr. Dakuyo obtained the initial remedy formulas from the healers in the Comoe Province and confirmed, through tests and clinical trials, their virtues. Instead of modern research material, he often used craftsmen’s tools such as the mortar. When people saw him grinding the roots, they often mistook him for a fool.
Dr. Dakuyo has drawn wisdom not only from traditional practitioners but from farmers. That was how he “discovered” the antimalarial properties of a plant that the region’s farmers pick to heal hepatitis: Cochlospermum planchonii, a shrub of the African savannah, commonly known by its Bambara name, N’Dribala.