Promoting Herbal Medicine in Uganda

Traditional health practitioners and government working together

The Evolving Role of Traditional Medicine in Uganda

In Uganda, traditional medicine is not just an alternative—it is a cornerstone of the healthcare system for over 60% of the population. This widespread reliance stems from its accessibility, affordability, and deep cultural relevance, especially in rural areas where a traditional health practitioner is available for every 200-400 people, a stark contrast to the scarcity of Western-trained doctors (one for every 20,000 Ugandans).

While traditional herbal medicine has long been used to manage common ailments like malaria, respiratory issues, and skin diseases, its status is undergoing a critical evolution. The government, through the Ministry of Health, is actively working to bridge the gap between traditional and conventional medicine. This effort acknowledges the vital role traditional healers play while addressing pressing challenges such as a lack of scientific validation, issues of product safety and efficacy, and a need for stronger regulatory frameworks.

A key example of this collaboration is the partnership between the Natural Chemotherapeutics Research Laboratory (NCRL) and renowned herbalist, Hajji Zakariya Nyanzi. Hajji Nyanzi, a farmer and traditional health practitioner from Mubende, has been instrumental in this process due to his extensive experience and willingness to share his knowledge. His long-standing cooperation with institutions like the NCRL, the AIDS Support Organization (TASO), and THETA (Traditional and Modern Health Practitioners Together against AIDS) demonstrates a model for how traditional knowledge can be systematically studied, validated, and integrated.

This document examines the dynamic relationship between the Ministry of Health and practitioners like Hajji Nyanzi, highlighting its strengths and challenges, and exploring the implications for future policies that aim to professionalize the sector, ensure consumer safety, and ultimately, improve health outcomes for all Ugandans.

The Emerging Policy Framework for Traditional Medicine in Uganda

The landscape of traditional medicine in Uganda is undergoing a significant transformation, moving from the shadows into the mainstream. For decades, the contribution of traditional health practitioners was largely ignored, a legacy of colonial-era policies like the 1957 Witchcraft Act that outlawed traditional medicine and a formal education system that devalued local knowledge.

However, a shift in perspective began in the late 1980s. A 1987 Health Sector review revealed that Uganda’s healthcare system was failing, yet the overall health of the population was not as dire as expected. It was at this point that the crucial role of traditional healers in providing primary healthcare was officially recognized. This led to a recommendation to integrate them into the national healthcare system.

A New Era of Collaboration and Regulation

Today, the Ministry of Health is actively pursuing a public-private partnership model, officially recognizing traditional health practitioners as key private partners. This collaborative approach is being solidified through new government initiatives and a proactive policy framework.

• Policy and Regulation: A new Traditional and Complementary Medicine Policy has been drafted to professionalize the sector. This policy will regulate the practice of traditional medicine, promote research and development of herbal remedies, and ensure the sustainable cultivation and preservation of medicinal plants.
• Intellectual Property and Governance: A major step forward is the submission of a bill to establish the National Council of Indigenous and Complementary Medicine Practitioners. This semi-autonomous body will be tasked with fostering collaboration between conventional and traditional medicine sectors. Crucially, it will also regulate traditional practitioners while protecting their intellectual property rights—a vital move to safeguard their unique knowledge and innovations.

This shift marks a new era in Ugandan healthcare, one that embraces the country’s rich indigenous knowledge and seeks to create a regulated, collaborative, and sustainable future for traditional medicine.

Collaboration Between Modern Science and Traditional Medicine in Uganda

The landscape of traditional medicine in Uganda is no longer defined by the old division between “modern” and “traditional” approaches. Instead, there’s a growing and formalized collaboration led by institutions like the Natural Chemotherapeutics Research Laboratory (NCRL), established by the Ministry of Health in 1963. While early efforts faced challenges due to the lack of formal associations for traditional practitioners, today, these healers are organized and working closely with the government to advance their practice.

Verifying and Validating Traditional Medicine

The NCRL provides crucial financial and technical support to traditional healers. The collaboration works in a few key ways:

• Scientific Validation: Healers, often through their associations, provide the NCRL with medicinal plants and products. The NCRL then conducts rigorous scientific tests to verify the efficacy and safety of these herbal medicines.
• Formalizing Products: Once a product is validated as safe for public use, the healer’s work is formally recognized. They are then encouraged to have their product notified by the National Drug Authority (NDA), which is the first step toward official recognition. This process requires ongoing collaboration and submission of additional data to track the product’s safety and effectiveness.
• Support for Professionalization: The NCRL doesn’t just validate products; it also offers training to healers on a range of essential skills. This includes herbal garden management and conservation, proper processing and packaging, and maintaining hygiene standards. This training improves the quality and presentation of herbal medicines, which in turn helps healers earn a better income.

Acknowledging and Integrating Traditional Knowledge

The NCRL acknowledges the vital knowledge provided by the traditional healers, who share detailed information about their medicines and practices. This collaboration is even recognized on the product labels of prototype medicines packaged by the NCRL, honoring the origin of the knowledge.

This partnership is yielding significant results. By the end of 2007, 80 herbal products had been officially notified as safe and effective for public consumption. With positive research findings on the effectiveness of certain traditional medicines against conditions like malaria and HIV opportunistic diseases, the World Health Organization is now funding further research in this area through the NCRL.

Beyond the scientific data, this collaboration has fostered a new appreciation for the holistic approach of traditional healers, who consider a patient’s psychological, social, and cultural environment in their diagnosis—a key insight that is now influencing the country’s broader healthcare strategy.

Hajji Zakariya Nyanzi: A Pioneer in Uganda’s Traditional Medicine Sector

Hajji Zakariya Nyanzi is a respected herbalist who has effectively bridged the gap between traditional healing and modern science in Uganda. Through his long-standing collaboration with institutions like the Natural Chemotherapeutics Research Laboratory (NCRL) and THETA, he has become a model for the professionalization of traditional medicine.

From Healer to Partner

Hajji Nyanzi began his journey by joining local and national associations of traditional healers, which allowed him to consolidate his knowledge and connect with a wider network. His active involvement led him to THETA, where his herbal remedy for malaria was first assessed and prepared for distribution. This early success encouraged him to take his products to the NCRL for further scientific validation.

Today, Hajji Nyanzi’s influence extends far beyond his local community. He supplies his herbal medicines to patients, as well as to NCRL and THETA. His products, which come in both powder and liquid form, target a range of conditions, including malaria, fibroids, and some HIV/AIDS-related ailments.

Collaboration and Validation

The partnership with NCRL has been particularly transformative for Hajji Nyanzi’s practice. The laboratory has:

• Trained him in critical areas such as proper processing, hygienic packaging, and managing his herbal gardens. This has enhanced the quality and safety of his products.
• Validated his remedies, singling out his malaria medicine as particularly effective. This scientific endorsement has added significant value and market appeal to his products.
• Facilitated the formalization of his work by helping to notify some of his products, including those for malaria and fibroids, with the National Drug Authority (NDA), moving them toward official registration.

In return for his contributions, NCRL not only pays him for his products but also provides financial support to help him manage his establishment and train other healers. The laboratory also showcases his work by referring national and international visitors to his practice for learning and exchange. This collaborative approach highlights a new era for traditional medicine in Uganda, one where ancestral knowledge is protected, validated, and integrated into the national healthcare system.

Working with a government institution like the Natural Chemotherapeutics Research Laboratory (NCRL) has brought both opportunities and challenges for a traditional healer like Hajji Nyanzi. While the partnership has helped validate his work, it also highlights the significant barriers that traditional healers face in professionalizing their practice.

The Challenges of Production and Professionalization

For Hajji Nyanzi, the primary obstacles are practical and financial. His production methods are costly and laborious. He faces high costs for local permits to harvest medicinal plants from forests, and the process of searching for and transporting these plants is physically demanding. He relies on basic tools like wooden mortars and pestles for processing, and his finished products are often stored in simple plastic containers and used bottles.

While Hajji Nyanzi has tried to expand his business by opening retail outlets, they have failed due to issues like mismanagement and a lack of proper supervision. He acknowledges that the professional skills he learned from the NCRL, such as proper drying and packaging techniques, are essential but too expensive to implement. He lacks the roughly 2 million Ugandan shillings needed to purchase the necessary equipment.

A Call for Formal Recognition and Support

Despite his long-standing collaboration with the NCRL, Hajji Nyanzi feels a sense of unfulfilled expectation. He believes that since the laboratory is profiting from his validated herbal remedies, he should receive more financial support, including funds to acquire the equipment he needs. This sentiment is rooted in his perception of a partnership that is unequal and lacks formal documentation.

Hajji Nyanzi is concerned that his relationship with the NCRL is not formalized with a letter or an official ID card. He feels this lack of official recognition undermines his credibility and makes it difficult for him to differentiate himself from other traditional healers whose products have not undergone a validation process. This desire for formal status goes beyond simply having his name on a product label; it is a request for a clear, documented relationship that acknowledges his contributions and gives him the respect and authority he has earned.

The individual case of Hajji Nyanzi and the Natural Chemotherapeutics Research Laboratory (NCRL) illustrates several broader issues affecting traditional medicine in Uganda. The challenges are not just personal but are systemic, rooted in a lack of clear policy and a history of mistrust.

A Policy Vacuum with Broad Consequences

Despite the government’s renewed interest, the traditional medicine sector in Uganda suffers from an outdated and insufficient policy framework. This “policy vacuum” is a major hurdle. It’s partly a legacy of colonial laws, like the 1957 Witchcraft Act, that are still on the books and stigmatize traditional practices. It’s also due to a lack of political and financial prioritization, meaning there’s been little effort to effectively regulate the sector, leading to a host of problems.

• Public Perception and Safety Concerns: Without official quality control and regulation, negative perceptions of herbal medicine persist. The lack of oversight allows for abuses, including human sacrifices, which further erode public trust and make it difficult to distinguish between legitimate practitioners and harmful actors.
• Intellectual Property and Mistrust: Traditional healers are often wary of outsiders, fearing their knowledge will be exploited or “stolen.” This suspicion is deeply rooted in historical disregard for their practice. A limited understanding of concepts like patents and intellectual property rights only intensifies this reluctance, causing valuable indigenous knowledge to remain hidden and preventing effective medicines from being validated or scaled up. The National Drug Authority (NDA), for example, has a registration process, but it’s often perceived as inaccessible, costly, and centralized in Kampala, creating a significant barrier for rural practitioners.

The Challenge of Sustainability and Scalability

Even when a traditional healer’s product is scientifically validated, new challenges emerge in scaling up production to meet a larger demand.

• Production and Entrepreneurship: Most practitioners, like Hajji Nyanzi, lack the capital and equipment for large-scale, consistent production. They use basic tools and are challenged by the costs of professional processing and packaging. This is compounded by a lack of business and entrepreneurial skills in areas like marketing and record keeping.
• Lack of Investment: The current policy void makes the sector unattractive to investors. Potential partners are hesitant to invest in commercial production and distribution without a clear legal framework. This leaves traditional healers without the financial support needed to expand and professionalize their operations. To attract investment and ensure profitability for all involved, a more appropriate policy environment is essential.

Moving Forward

The path to a professionalized traditional medicine sector requires more than just individual collaborations. It demands a holistic approach that includes:

• Policy Reform: Developing and enacting a new, comprehensive policy framework.
• Capacity Building: Providing financial and technical support to healers for business management, intellectual property protection, and sustainable sourcing.
• Infrastructure: Encouraging the establishment of herbal gardens to ensure the preservation and sustainable supply of medicinal plants, which are currently at risk.

Research, Resources, and Documentation: The Gaps in Traditional Medicine

Conducting research in traditional medicine in Uganda faces significant obstacles, primarily due to limited funding. The cost of validating a single herbal specimen can reach up to 40 million Ugandan shillings. This process requires specialized, expensive testing equipment and parts that are often unavailable in Uganda. Sending samples abroad for testing is also financially prohibitive. These resource limitations mean the Natural Chemotherapeutics Research Laboratory (NCRL) cannot provide substantial financial support to traditional healers, leading to disappointment and a backlog of pending applications.

The lack of resources also hinders the formalization of partnerships. While the NCRL is expected to soon gain the legal authority to enter into formal agreements with healer associations, its current status prevents it from doing so. Without proper documentation and a simplified way to communicate test results, healers struggle to understand the scientific findings on their products’ toxicity, dosage, and storage. This lack of accessible information, combined with slow validation processes, perpetuates negative perceptions of herbal medicine and makes it difficult to promote collaboration between traditional and modern medical institutions.

Key Takeaways and Recommendations

The growing reliance on traditional medicine in Uganda presents a unique opportunity for both public health and economic development. This collaboration between healers and modern science can benefit everyone involved:

• Healers gain from increased sales and credibility.
• The public gets access to affordable, quality healthcare.
• The Ministry of Health saves money on imported medicines.
• The national economy can benefit from exports and employment for farmers.
• Uganda’s cultural heritage is celebrated and preserved.

To turn this potential into a reality, several key recommendations must be implemented:

• Expedite the Legal Framework: The government must urgently establish the National Council of Indigenous and Complementary Medicine Practitioners to provide a clear legal framework. This body would facilitate funding, collaboration, and validation while protecting healers’ intellectual property rights, encouraging them to share their knowledge without fear of exploitation.
• Enhance Economic Value: Traditional medicine should be recognized as a viable economic sector. This means highlighting its potential for poverty reduction, creating clear memorandums of understanding for partnerships, and equipping healers with entrepreneurial skills in marketing, record-keeping, and commercial production.
• Improve Research and Documentation: There’s a critical need for expanded research facilities, including regional research and testing laboratories, to accelerate the validation process. The process for registering products with the National Drug Authority (NDA) needs to be decentralized and simplified to make it more accessible for rural healers. Research findings should be widely disseminated through popular media like radio to inform the public and dispel misconceptions.
• Prioritize Conservation and Education: Environmental sustainability must be a core part of the policy framework. Promoting the establishment of herbal gardens is essential for preserving rare medicinal plant species. Furthermore, indigenous knowledge must be incorporated into educational curricula at all levels to ensure this valuable heritage is passed down to future generations.

Traditional Herbal Remedies for Male Reproductive Health

In Uganda, a significant portion of the population (70-80%, and up to 90% in some rural areas) relies on traditional healers for daily healthcare. This highlights the vital role of herbal medicine in addressing a wide range of health issues, including male reproductive ailments. This study focuses on one such issue: erectile dysfunction (ED), or sexual impotence, which is a repeated inability to get or maintain a firm erection for sexual intercourse.

While official statistics are scarce for Uganda, global data from developed countries like the United States indicate a significant increase in ED cases. Given the high levels of poverty and limited access to modern healthcare in sub-Saharan Africa, it is clear that many men suffer from this condition in silence.

Causes and Treatments

Erectile dysfunction can be caused by a variety of factors, including physical conditions like diabetes and vascular diseases, as well as psychological factors such as stress and anxiety. While modern medicine offers treatments like Viagra and testosterone therapy, these options are often inaccessible and too expensive for the majority of Ugandans, particularly those in rural areas.

This lack of access has reinforced the reliance on traditional herbal remedies, which have been used for generations to treat ED and other male reproductive health issues. This study aimed to document these indigenous practices, which have not been previously validated or documented, as a step toward future drug discovery and development. By gathering this ethnobotanical knowledge, the research provides a foundation for scientifically evaluating the efficacy and safety of these traditional remedies.

Cultivated Medicinal Plants used in treatment of Sexual Impotence and Erectile Dysfunction in Western Uganda

Family	Scientific Name	Local Name	Habit	Parts Used	Preparation	Administration
Alliaceae	Allium cepa L.	Katunguru (NY, KI, RU) Onion (Engl.)	H	ST-BU, L, RT	chewing, cooking	oral in water and in food
Alliaceae	Allium sativum L.	Tungurusumu (KO) Garlic (ENG)	H	ST-BU, L, RT	chewing, cooking	oral in water and in food
Cannabaceae	Cannabis sativa L.	Njayi (GA) Njaga (NY) Marijuana (ENG) Mbangi (SW)	S	L	chewing, smoking	oral, inhaling fumes
Capparaceae	Cleome gynandra L.	Esobyo/Amarera (KO) Eshogi (NY)	H	L, R, FL	chewing, cooking	oral or as food
Malvaceae	Sida tenuicarpa Vollesen	Keyeyo (RU)	H	L	pounding, boiling	oral
Papilionaceae	Arachis hypogaea L.	Binyebwa (NY, RU) Ground nuts (ENG)	H	SE	roasting	oral as food
Rubiaceae	Coffea arabica L.	Mwani (NY) Arabica Coffee (ENG)	S	SE	roasting, chewing	oral as a beverage
Solanaceae	Capsicum frutescens L.	Kamurari (GA) Eshenda (NY) Red pepper (ENG)	H	FR	pounding, boiling, chewing	oral in food
Zingiberaceae	Zingiber officinale Roscoe	Ntangahuzi (NY), Ntangawizi (SW), Ginger (ENG)	H	RH	pounding, boiling	oral in tea, porridge, milk as a beverage

Wild-harvested Medicinal Plants used in treatment of Sexual Impotence and Erectile Dysfunction in Western Uganda

Family	Scientific Name	Local Name	Habit	Parts Used	Preparation	Administration
Anacardiaceae	Rhus vulgaris Meikle	Mukanja (NY) Mukanza (RU)	S	B, R, L	chewing, boiling	oral and eaten as raw fruits
Asclepiadiaceae	Mondia whiteii Skeels	Mulondo (GA)	H-CL	R	chewing, boiling, pounding	oral in water, in tea and in food
Asteraceae	Vernonia cinerea (L.) Less.	Kayayana (GA)	S	L, R	chewing, boiling	oral
Balsaminaceae	Impetiens sp.	Entungwabaishaija (NY)	H	WP	chewing, boiling	oral
Caesalpinaceae	Cassia didymobotrya Fresen.	Mugabagaba (NY) Mukyora (RU) Mucora (KO)	S	L, R	chewing, boiling	oral
Caesalpinaceae	Cassia occidentalis L.	Mwitanzoka (NY, KO)	H	L, R	chewing, boiling	oral
Canellaceae	Warburgia ugandensis Sprague	Mwiha (RU)	T	B, L, R	pounding, boiling	oral in tea or porridge
Celastraceae	Catha edulis	Mairungi (NY, RU), Miira (SW)	S	L, ST	chewing	oral by chewing fresh leaves and young stem.
Euphorbiaceae	Flueggea virosa (Willd.) Voigt	Omukarara (RU) Omukalali (KO)	S	L, R	pounding, boiling	oral
Euphorbiaceae	Tragia brevipes Pax.	Engyenyi (NY)	H-CL	L	pounding, boiling	oral
Mimosaceae	Acacia sieberiana Scheele	Munyinya (NY, RU)	T	B	pounding, boiling	oral
Mimosaceae	Dichrostachys cinerea (L.) Wight & Arn.	Muremanjojo (RU)	T	B	pounding, boiling	oral
Myricaceae	Macrotyloma axillare (E.Mey.) Verdc.	Akaihabukuru / Kihabukuru (RU)	H-CL	L, RT	pounding, boiling	oral
Myricaceae	Myrica salicifolia Hochst. ex A.Rich.	Mujeje (NY)	S	R, B	pounding, boiling	oral
Palmae	Phoenix reclinata Jacq.	Akakindo (NY), Mukindo (NY)	S	L, R	pounding, boiling	oral
Phytolaccaceae	Phytolacca dodecandra L’Herit	Muhoko (NY) Ruhuko (KO)	S	L, R	pounding, smearing	smear on ripe banana and roast
Polygonaceae	Coffea spp.	Mwani (NY) Wild Coffee (ENG)	S	SE	roasting, chewing	oral as a beverage
Polygonaceae	Hallea rubrostipulata (K.Schum.) J.F. Leroy	Muziiko (NY)	T	B, R	pounding, boiling	oral
Polygonaceae	Rumex abyssinicus Jacq.	Mufumbagyesi (NY) Mufumbijesha (RU) Kasekekambaju (GA, KO)	S	L, ST	chewing	oral
Polygonaceae (S.Moore) Bremek.	Tarenna graveolens Munywamaizi (NY)	Munyamazi (KO, RU)	S	B, L, R	pounding,	oral boiling
Rutaceae	Citropsis articulata Swingle & Kellerman	Muboro (NY, RU) Katimboro (KO, TO)	T	B,R	pounding, boiling, chewing	oral as beverage in tea
Sterculiaceae	Cola acuminata Schott & Endl.	Ngongolia (SW), Engongoli (KO, RU) Cola nut (ENG)	T	FR	Roasting, pounding, chewing	oral in tea, porridge, milk as a beverage
Tiliaceae	Grewia similis K. Schum.	Mukarara (RU)	S	L, B	pounding, boiling	oral
Urticaceae	Urtica massaica Mildbr.	Engyenyi (NY)	H-CL	WP	pounding, boiling	oral

A Closer Look at Herbal Remedies;

In Uganda, a number of medicinal plants are frequently used to treat conditions like sexual impotence and erectile dysfunction (ED). Many of these plants, such as Citropsis articulata and Cola acuminata, are already being sold for this purpose. A number of them are even common food items, including onions (Allium cepa), garlic (Allium sativum), ginger (Zingiber officinale), and red pepper (Capsicum frutescens), and are readily available in local markets.

One particularly popular plant, Mondia whiteii, is widely recognized as a natural aphrodisiac for both men and women. The roots of this plant are an old trade commodity, especially in urban centers like Kampala. Its popularity has led to the commercialization of products like “Mulondo Wine,” a patented drink believed to have aphrodisiac qualities that is now sold on both national and international markets.

Traditional Preparation and Modern Validation

Traditional healers typically prepare these herbal medicines by pounding, chewing, or boiling the plant parts. The remedies are often consumed orally, sometimes mixed with local beers, fermented milk, or porridge. Researchers believe that the alcoholic content in these mixtures may enhance the extraction of active compounds.

While these practices have a long history of use, scientific studies are now beginning to validate their potential. For example, research has shown that some of the plants used in these remedies may indeed have aphrodisiac and stimulant properties.

• Cola acuminata: Widely used in ED remedies, its fruits contain caffeine and other stimulants that are known to treat conditions like migraines and fatigue.
• Coffee: Wild coffee species are considered potent nervous system stimulants due to their high caffeine content.
• Garlic (Allium sativum): Known to reduce blood sugar and cholesterol levels, which are direct causes of ED, it is also used to prevent the hardening of arteries.
• Ginger (Zingiber officinale): The volatile oils in ginger rhizomes are used to stimulate nerves.
• Red Pepper (Capsicum frutescens): Contains capsaicin, a compound that acts as a powerful stimulant and is believed to promote good circulatory health.

Social and Cultural Dimensions of Erectile Dysfunction

Erectile dysfunction is a pervasive and often silent issue in Ugandan society. It is considered a private matter, and men who suffer from it often seek help secretly. This secrecy can lead to devastating social consequences, including extramarital affairs, broken marriages, and an increased risk of sexually transmitted diseases like HIV/AIDS.

Culturally, ED is deeply stigmatized, especially in traditional communities. For example, in the Banyankore ethnic group in Western Uganda, a man with ED might be called “Kifabigyere,” a term that literally means “one who has no legs,” implying a loss of manhood. In the past, such men were often excluded from positions of leadership and faced social ridicule.

While modern medicine offers expensive solutions that are out of reach for most Ugandans, particularly those in rural areas, the majority continue to rely on traditional healers. The challenge lies in bringing these two worlds together to create a formal, regulated, and safe healthcare system that incorporates the best of both.

Moving Forward: The Need for Documentation and Conservation

The continued use of traditional remedies highlights the importance of preserving this indigenous knowledge. According to the Convention on Biological Diversity (CBD), nations have an obligation to protect the traditional knowledge and practices of indigenous communities.

However, the increasing demand for medicinal plants poses a serious threat to the environment. The wild harvesting of plant parts like roots and stems, particularly from rare species, puts them at risk of extinction. To ensure the long-term sustainability of this sector, it is crucial to:

• Document the indigenous knowledge of these herbal remedies.
• Promote conservation strategies like the establishment of herbal gardens for targeted species.
• Foster collaboration between traditional healers, researchers, NGOs, and the Ministry of Health.
• Create a clear policy framework that allows for the licensing and regulation of traditional medicines by bodies like the National Drug Authority (NDA).

This holistic approach would not only improve the health and well-being of many Ugandans but also preserve a valuable part of their cultural heritage and unlock significant economic potential.