The “fate of tailor -made medicine amidst African cultural patrimony”

By Ahedor Jessica 

The evolution of personalized medicine is gradually gaining momentum in the developed countries around the globe. Its attainment is realized through robust research, health infrastructure, data analysis, skills in bioinformatics and the availability of datasets from the control of disease cohorts. While precision medicine is improving health outcomes and producing result- oriented care for patients in other parts of the world, Africa is lagging behind.

In Africa, most people depend on traditional medicine for their primary health care needs. Contrary to the perception that the practice was evil during the colonial rule, its accessibility, availability, affordability, and cultural acceptance made the practice the preferred option to the conventional therapy. The passage of the herbal medicine practice though not necessarily formal, but embedded in the cultural patrimony of most Africans.

According to Dr Alfred Ampomah Appiah, Deputy Director at the Center for Plant Medicine Research, Ghana, Africa would have been leading in personalizing herbal medicine if not for the many setbacks the system suffered. “If the traditional medicine practice at the time was given the scientific and structural support, personalized medicine today in Africa would have gained much grounds due to the consistency of the practice, he stated”.

Published in the Journal of integrative biology 2018 by Pharmacogenomics and Drug Metabolism Research Group of University of Cape Coast, Ghana and the Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa, the researchers are convinced there is hope for Africa to personalize herbal medicine, looking at the level of awareness and knowledge garnered, but for lack of policies that will drive it to realization. 

Pharmacogenomicist, Nicolas Ekow Thomford the lead author of the publication says with the right kind of policies Africa could explore personalizing herbal medicine as an option for the Region’s (Ghana) development. For him, with 25 per cent of medicines originating from herbs is enough evidence that the concept will succeed if given the needed attention.

Currently, the enactment of appropriate policies and adequate infrastructural support couple with low level of investment into health systems with little or no technological development, and poor management remains a challenge in Africa.  Experts say, advances in diagnostics such as genetic testing and data-driven choice of dosing for therapeutics has led to the effective implementation of precision medicineacross the globe.

Dr Bright Adu, an immunologist and a Research Fellow at the Department of Immunology, Noguchi Memorial Institute for Medical Research, Ghana, said expertise in bioinformatics and the technological resources needed in Africa is scarce and expensive as a result, making decisions for personalized medicine in Africa is at its infantile stage. 

“We are now in the era of Omics however, the tools and the resources available in Africa are limited. Currently, all the key institutions at the forefront of some level of omics in Ghana are dependent on the western world for the resources for implementation, because they are not readily available in Africa.”

Therefore, fusing personalized medicine into an existing system ridden with poor service delivery and the lack of evidence-based medicine remain a major setback for many countries. 

For Dr Elorm Octhi, a consultant specialist, Africa Institute of Health care Quality, Safety and Accreditation, Ghana, quality care and regulation of the health systems in Africa is a challenge due to the systemic failures and the low level of priorities given to health care systems in terms of investment. “As it is, most care providers still do the try and error kind of treatment because of the mismanagement of health systems across Africa. This phenomenon persists due to the low level of priority given to health care”. 

Global Health report 2017, estimated 80% of the African regional health budgets have been allocated to communicable diseases in the last decade. At the same time, Ghana’s Health Care budget for the past decades has experienced some form of positive but inconsistent growth according to the Ministry of Health report on National Health Account, 2013.

Madam Edith Andrews, the officer in charge of Essential Medicines, World Health Organization, W.H.O Ghana office, asserts the limited budgetary allocation for the health sector in Africa is the main reasons countries could not afford personalized medicine, though it will improve quality of care and reduce disease burden on the continent. “The cost involved in purchasing drugs for the endemic diseases in the sub-region is still a struggle as treatment guidelines for most countries are being changed to less expensive ones”.  

That notwithstanding, if the journey of personalizing health in Africa must be a reality, a focus-driven decision must be taken for the health sector to succeed in personalizing medicine; she said.