Death and Distrust: How Failing to Proactively Embrace Traditional Medicine During the HIV/AIDS Pandemic Has Limited the Acceptance of Western Medicine

BY LISHORE KUMAR

For Onaeshegun, a tender-faced Nigerian native, medicine is more than a system of treating ailments—it’s a story. As a proud practitioner of traditional medicine, she uses recipes passed down from her grandmother to treat her aches, pains, and worries [1]. While she acknowledges that her remedies aren’t cure-alls, in times of struggle, she—along with an estimated 80% of Africa’s population—turns to time-honored methods [2].

Nowhere was this struggle more evident than during the height of the AIDS pandemic in the 1980s. While previous pandemics like the Spanish Flu and Hong Kong Flu affected a connected, globalized world, none had the uniquely enigmatic nature of HIV/AIDS [3]. With numerous opportunistic infections and a slow deterioration of health, people were fearful and unsure how to confront this indefinable disease. Breakthroughs in AIDS treatment introduced new medical solutions, heightening uncertainty, during the pandemic. Beyond these medical advancements, for many in Africa, traditional remedies like Hypoxis hemerocallidea (Magic Muthi) and Sutherlandia frutescens (Insiswa) were crucial for symptom management [4,5].

When governments dismissed these alternative therapies and pressured populations to default to Western medicine, they inadvertently rejected deeply rooted cultural practices. This disconnect between traditional beliefs and institutional medical solutions undermined public trust, hindering access to necessary care. Consequently, the international community’s failure to embrace traditional medicine during the HIV/AIDS pandemic has made it more difficult for people to accept the Western medical interventions being offered.

While many argue that embracing traditional medicine could be dangerous to populations, this concern should have motivated ruling entities to be more proactive in their research and discovery efforts. Instead of dismissing these practices outright, there was an opportunity to investigate potential benefits offered by traditional medicine, particularly as they relate to HIV/AIDS treatment and symptom management. Recognizing this need, the World Health Organization (WHO) hosted a summit in February 1989, bringing together global medical professionals—both traditional and Western—to discuss in vitro screening of traditional therapies for AIDS [5].

During the summit, after hearing from leaders about the integration of Western and traditional medicine in countries including Uganda and Tanzania, the committee proposed four approaches for biological screening of traditional medicinal practices. These included investigating remedies based on ethnomedical use, reviewing existing literature, conducting random collections of plant-based therapies, and adopting a chemotaxonomic approach, where plants from the same family were tested for scientific merit. While the first two approaches—investigating remedies and reviewing literature—were pursued, the latter two—random sampling and chemotaxonomy—were deemed too expensive [5]. Though investigating current remedies and reviewing literature would show the scientific validity of existing traditional medicine, the decision not to explore alternatives indicated that the WHO was more focused on scrutiny than on solutions. By neglecting random sampling and chemotaxonomy, they missed opportunities to discover new, safe, and innovative traditional remedies.

Considering the WHO’s reputation and their earlier proposal to integrate traditional medicine into the global response to HIV [6], their failure to preemptively research traditional remedies dampened overall international efforts. This lack of action created a gap, where the push for individuals to seek treatment in the absence of traditional remedies led to an erosion of trust between citizens and public health institutions. As trust diminished, many former practitioners of traditional medicine turned to unconventional—and often extreme—forms of therapy. This not only increased their risk of illness and death but also posed larger public health risks for the broader population [7].

Regardless of the ailment an individual faces, attributing harm to traditional medicine has systemic consequences. In the context of HIV in Africa, entry-level traditional treatments have often involved Ebenaceae (Diospyros usambarensis), a plant known for its fungicidal and cytotoxic properties [5]. While some scientific evidence supports the efficacy of these treatments, relying solely on traditional medicine is unlikely to cure the disease; however, it doesn’t necessarily cause harm either. The issue arises when organizations blame traditional medicine for a patient’s worsening condition, often without clearly distinguishing between this blame and the delayed access to scientifically-supported treatments. This perception causes practitioners of traditional medicine to view organizations as dismissive of their practices and undermining of their cultural identity [8]. 

Consequently, many individuals become resistant to pursuing Western medicine altogether. Unfortunately, this loss of trust complicates efforts to redirect individuals toward scientifically proven practices. The implications are significant: an estimated 20% of people who safely qualify for antiretroviral therapy (ART) in South Africa refuse care [9]. While there are a variety of reasons for refusing care, delays and inadequate access to healthcare access were attributed to approximately one-third of the 940,000 AIDS-related deaths in 2017 [10].  Thus, falsely blaming traditional medicine for the deterioration of an AIDS patient’s health increases the likelihood of dismissing Western methods like ART, ultimately heightening the risk of mortality. 

Solutions are possible. Throughout history, the proactive discovery of traditional medicine has improved healthcare outcomes. For example, a case study in the Central Himalayas examined the European yew tree (T. baccata) as an alternative treatment for breast and ovarian cancer. Researchers analyzed existing documentation of ethnomedical usage and conducted a three-step process involving bioassays, clinical trials, and public safety announcements. By using Western medical practices to discover traditional medications, trust in these Western approaches was slowly built among the population [11]. Even when traditional medications are deemed unsafe, the search for alternatives mirrors the familiar trial-and-error process that characterizes the discovery of historic remedies, making the approach more relatable and easier for the public to accept.

Applied to the AIDS pandemic, if institutions had sought to engage with traditional practitioners—rather than dismissing their beliefs—they could have built a connection rooted in mutual understanding. This perspective on traditional medicine is important well beyond the borders of the African continent. For example, even after the FDA pushed for the approval of antiretroviral treatments like azidothymidine (AZT), more Americans than ever turned to alternative medicine, with over 42% trying some form by 1997 [12]. Addressing the integration of traditional and western medicine has global relevance during times of pandemics.

Ohnaeshegun didn’t just stumble upon traditional medicine; it is a practice passed down through generations [1]. As we face future pandemics, we must remember her work and recognize that advocating for scientific treatments requires us to learn from the lessons of the AIDS pandemic—supporting existing traditional remedies is equally important. Innovation shouldn’t come at the expense of belief; instead, it should integrate both for the benefit of everyone.

Joshua Chen is a first-year in Pauli Murray College.

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References

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