Nyika Aceme
Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
Dev World Bioeth. 2007 Apr;7(1):25-34. doi: 10.1111/j.1471-8847.2006.00157.x.
It has been estimated that more than 80% of people in Africa use traditional medicine (TM). With the HIV/AIDS epidemic claiming many lives in Africa, the majority of people affected rely on TM mainly because it is relatively affordable and available to the poor populations who cannot afford orthodox medicine. Whereas orthodox medicine is practiced under stringent regulations and ethical guidelines emanating from The Nuremburg Code, African TM seems to be exempt from such scrutiny. Although recently there have been calls for TM to be incorporated into the health care system, less emphasis has been placed on ethical and regulatory issues. In this paper, an overview of the use of African TM in general, and for HIV/AIDS in particular, is given, followed by a look at: (i) the relative laxity in the application of ethical standards and regulatory requirements with regards to TM; (ii) the importance of research on TM in order to improve and demystify its therapeutic qualities; (iii) the need to tailor-make intellectual property laws to protect traditional knowledge and biodiversity. A framework of partnerships involving traditional healers' associations, scientists, policy makers, patients, community leaders, members of the communities, and funding organizations is suggested as a possible method to tackle these issues. It is hoped that this paper will stimulate objective and constructive debate that could enhance the protection of patients' welfare.
据估计,非洲超过80%的人使用传统医学(TM)。随着艾滋病在非洲夺走许多人的生命,大多数受影响的人依赖传统医学,主要是因为它相对价格低廉,且贫困人群能够负担得起,而这些贫困人口买不起正统医学。正统医学是在源自《纽伦堡法典》的严格法规和道德准则下实施的,而非洲传统医学似乎不受此类审查。尽管最近有人呼吁将传统医学纳入医疗保健系统,但对伦理和监管问题的重视程度较低。本文概述了非洲传统医学的总体使用情况,特别是用于治疗艾滋病毒/艾滋病的情况,随后探讨:(i)在传统医学的伦理标准和监管要求应用方面相对宽松的情况;(ii)对传统医学进行研究以改善并揭开其治疗特性神秘面纱的重要性;(iii)量身定制知识产权法以保护传统知识和生物多样性的必要性。建议建立一个由传统治疗师协会、科学家、政策制定者、患者、社区领袖、社区成员和资助组织参与的伙伴关系框架,作为解决这些问题的一种可能方法。希望本文能引发客观且建设性的辩论,从而加强对患者福利的保护。