As the world observes Traditional Medicine Day on 31 August, South Africa finds itself at a pivotal moment to reflect on the relevance, contributions and future of African Traditional Medicine (ATM).

ATM is a contentious topic within our healthcare systems, which predominantly focus on and promote the use of Western medicine. Even though the World Health Organisation has led intervention strategies for integrating ATM into national health systems, in South Africa, there have been failed attempts to do so meaningfully. While significant research has been conducted and various organisations have been established to promote ATM, it is still not mainstream and fully recognised in our healthcare system. About 60% of the population relies on ATM as their primary source of healthcare. It is disappointing that traditional healing methods have not been prioritised in the National Health Insurance (NHI).

ATM has served as a primary healthcare source for centuries across Africa, particularly in rural and under-resourced areas. It encompasses not only healing practices but also the philosophies, spiritual beliefs and communal approaches that define African identity. In an era of rising mental health challenges, climate anxiety and antibiotic resistance, ATM reminds us that true healing requires community, tradition and balance. In the modern era, we must honour and reimagine ATM as a vital part of our collective health future.

Although ATM has existed for thousands of years, formal recognition within state health systems is a relatively recent development. South Africa passed the Traditional Health Practitioners Act in 2007 to regulate and integrate traditional healing within the broader health framework. This act proposed establishing the Traditional Health Practitioners Council, and outlined training, ethics and registration standards. This process remains challenging because the act is perceived as a document that requires traditional practitioners to undergo training and regulation that are in step with processes related to Western medicine, without acknowledging the fundamental differences between the two systems.

The dichotomy between ATM and modern medicine is often overstated. We should resist the idea that ATM and modern medicine must compete. Instead, both systems should collaborate. Instead of choosing one over the other, a collaborative model that blends the strengths of both systems is more effective. ATM should be used in contexts where cultural, spiritual and psycho-social dimensions are central to the healing process. For instance, it is highly effective in mental health, ancestral afflictions and chronic pain management.

Modern medicine, on the other hand, should be the primary recourse for emergencies, infectious disease outbreaks, surgical interventions and advanced diagnostics. Conditions such as cancer, diabetes and heart disease may require biomedical technologies. Yet even in such cases, ATM can be used in tandem to address spiritual resilience, dietary changes and emotional support. The future lies in respectful integration, where both systems coexist, refer to one another and share knowledge to benefit people-centred care.

Africans should look to countries like China, India and Thailand, which successfully use a pluralistic healthcare system while promoting their indigenous healing practices. Chinese medicine, for example, is now accessible worldwide. We should take pride in our heritage and leverage our knowledge to our advantage.

ATM offers significant advantages, particularly within the African socio-cultural and economic context. It is deeply embedded within African communities’ cultural norms, languages and belief systems. This cultural congruence enhances patient trust, compliance and perceived efficacy, factors often lacking in modern healthcare encounters.

ATM also provides a holistic approach to health. It does not isolate the body from the mind or spirit, but treats the human being as an integrated entity in relation to the community and the environment. This is especially important for conditions involving grief, stress or chronic fatigue, which modern medicine may treat symptomatically without addressing underlying spiritual or social causes.

Moreover, ATM remain more accessible and affordable to most Africans, especially in rural areas. Traditional healers often live within the same communities as their patients, speak the same language and offer payment plans or barter systems. For many people, this accessibility bridges the gaps left by an underfunded, overburdened biomedical system.

ATM also contributes significantly to prevention. Through food taboos, seasonal cleansing and rituals, communities are encouraged to live in balance with nature and one another, an approach that complements public health ideals.

Western biomedical science’s dominance has resulted in ATM’s marginalisation in both policy and practice. Often dismissed as unscientific or primitive, ATM has been pushed to the fringes of formal healthcare systems. Regulatory exclusion further exacerbates the issue. Despite the Traditional Health Practitioners Act of 2007, ATM practitioners still face accreditation, recognition and collaboration challenges with mainstream health providers. This legal gap hinders ATM’s full integration and resourcing.

Another concern is biopiracy. Multinational pharmaceutical corporations have frequently extracted indigenous knowledge and plant-based formulas without compensating local communities or healers. This intellectual property theft undermines trust and sustainability. Additionally, environmental degradation, urbanisation and climate change threaten the availability of medicinal plants. As deforestation expands, sacred groves and traditional herbariums disappear, weakening ATM’s material base.

African traditional medicine is a living legacy, a body of wisdom that speaks not only to the past but also to the future. We must commit to a paradigm where indigenous knowledge is valued, validated and integrated into healthcare systems. Institutions like the University of Pretoria can lead the way by fostering research, education and dialogue that honours the fullness of African healing.

Disclaimer: The opinions expressed in this article are solely those of the author and do not necessarily reflect the views of the University of Pretoria.

Professor Fhumulani Mulaudzi is the South African Research Chair in Nursing: Ubuntu Community Model in Nursing at the University of Pretoria