This issue of the ISE Newsletter focuses on ethnomedicine, sometimes used as a synonym for traditional or indigenous medicine. Ethnomedicine usually refers to the health beliefs, knowledge and practices derived from indigenous cultures, as opposed to the conceptual and practical frameworks of biomedicine or modern medicine, a misnomer since ethnomedicine is still a modern tool in many countries. However, contemporary medical anthropology goes beyond this distinction and considers biomedicine as a form of ethnomedicine, i.e., a medical system among others. The way disease and well-being are perceived and experienced, people’s health-seeking behavior, and their knowledge about natural remedies such as plants and animals are greatly influenced by their cultural and natural context, which make these subjects a field of special interest for ethnobiologists.
The relevance of ethnomedicine has never been as great as nowadays and it goes much beyond the exotic curiosity of the early anthropological studies of the 1920s on beliefs about sorcery and witchcraft. According to the World Health Organization (WHO, 2008), as much as 80% of the population of some developing countries relies on traditional medicine and medicinal plants to respond to their health care needs. The widespread use of indigenous medical systems cannot be explained only because formal health care is not affordable or accessible, as one might think. Instead, these practices are used mostly because they are socially and culturally adapted and correspond to local views on disease and well-being.
Most indigenous people now live in pluralistic medical settings, where different medical traditions coexist and are adopted. This is also true in metropolises of the world, where ethnic groups continue to reproduce their medical knowledge and practices. There is also an increasing recognition of the limitations of biomedicine to provide global well-being and respond to the multiple physical and psychological ailments faced by people. This leads to a growing interest in industrialized countries for indigenous forms of medicine, which are considered to be more holistic than biomedicine. Last but not least, the importance of ethnomedicine lies in the potential benefits for humanity in terms of traditional pharmacopoeias serving as a basis for new drug discovery. Because of all these assets, WHO passed a resolution in 2009 (Beijing Resolution 62.13), in which they emphasized the importance of the following:
- respecting, preserving, promoting and communicating ethnomedicine ;
- creating national policies, regulations, and standards within the national health system to ensure safe and effective use of ethnomedicine ;
- integrating ethnomedicine into national health systems;
- further developing ethnomedicine based on the “Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property” adopted at the 61st World Health Assembly in 2008;
- establishing systems for the qualification, accreditation or licensing of ethnomedicine practitioners;
- strengthening communication between conventional and ethnomedicine providers and establishing training programs for health professionals, medical students and researchers.
This brings us to the ethical questions related to ethnobiological research in general, and especially in the case of investigating natural remedies. Sharing ethnomedicine is still a great concern for many indigenous people because of possible biopiracy and, at the same time, they are very much aware of the loss of knowledge as younger generations show less interest in ethnomedicine. Ethical implications and the Nagoya Protocol (related to prior-informed consent and benefit sharing) have since gained wide acceptance amongst ethnobiologists, but implementation of proper policies are still wanting in many countries. This is particularly true for countries such as Canada and the USA, where patents and natural health products based on ethnomedicine have been produced without any benefits for First Nations peoples. Furthermore, some industries have looked at the access and benefit sharing (ABS) regime as a free ticket to genetic resources, even though they would need to comply with returning benefits to communities. This is in part due to the word “Access” in ABS; local communities and people may not want to share their knowledge and they should be respected. Also, monetary benefits seem to be the main focus of discussion, although the Nagoya Protocol has a list of non-monetary benefits, which may well be of greater importance to native people (Cuerrier et al., 2012). In Canada, because of lack of policies regarding genetic resources linked to ethnomedicine , First Nations, Inuit and Métis may wish to develop a Research Agreement that protects their knowledge to some extent (Cuerrier et al., 2012). Even though the Protocol will finally be in place, there are still some major problems in fully implementing it. For instance, who should benefit? The Nation? The community? A group of individuals (Healers)? Medicinal plants are often used by multiple indigenous groups.
Further research by ethnobiologists, medical anthropologists, and researchers from related disciplines is needed in order to improve ongoing understandings of Indigenous and biomedical medical systems and how they integrate in people’s everyday health-seeking behavior. Such ethnomedical studies can provide invaluable recommendations for improved health policies, both in rural and urban settings, regardless of where we live on the planet.
In this issue of the ISE Newsletter, Karim-Aly Kassam and his research group at Cornell University take us on the journey of indigenous communities in the Himalayan Range, the Pamir Mountains, the Siemen Mountains and Northern Maine towards health sovereignty, while Nemer Narchi shares the history of marine medicines. We travel with him to China, the Roman Empire and Dioscorides’ writing.
WHO: Traditional Medicine, Fact Sheet N°134. Geneva: World Health Organization; 2008.
Cuerrier, A., Downing, A., Patterson, E & P.S. Haddad. 2012. Aboriginal antidiabetic plant project with the James Bay Cree of Québec: An insightful collaboration. Journal of Enterprising Communities: People and Places in the Global Economy 6(3): 251-270.