Critical Analysis of Self-Medication in Africa

Kouam Latrille outlines the risks associated with self-medication in the African context.

Image: of Salomon Djidjoho Traditional remedies often have great benefits, but do they help in a pandemic?

In January 2020, the world was hit by the first signs of the coronavirus pandemic. This consequently required a rapid and optimal response from the respective governments. Some have distinguished themselves by self-medication related solutions. Others have put forward the hypothesis of the effectiveness of hydroxychloroquine. With regard to self-medication, Madagascar distinctly stood out with its magic potion, tagged Covid-Organics (CVO). However, the controversy generated by these solutions is evidence of a glaring lack of credibility in these miracle remedies. This is evident both on the socio-institutional front and from the hazard they pose to the population.

Self-medication or self-care can be defined as the use, without medical recommendation/referral, of drugs that have been granted marketing authorization. With regard to the CVO so much-praised by the Madagascan authorities, it should be noted that this so-called drug has been invalidated by the international scientific and medical institutional community. It is in this regard that the World Health Organization (WHO) had issued a communiqué in which it recalled that: "Medicinal plants such as Artemisia annua are considered as possible treatments for Covid-19, but trials should be conducted to assess their effectiveness and determine their adverse effects”.

To make matters worse, the Government of Madagascar has launched an extensive promotion of the CVO without even disclosing the full formula of the product … which is unacceptable. The only known elements are 62% of Artemisia. How then can we ensure safeguards in the face of such scientific inaccuracies? Madagascar had also announced that Member States of the Economic Community of West African States (ECOWAS) had placed orders for the CVO. Said assertion was denied by ECOWAS in a press release.

In April 2020, the Professor Didier Raoult from a research institute in Marseille, France, hailed the Covid-19 therapy with hydroxychloroquine, a drug used to treat malaria. In spite of the fervent support for the use of Hydroxychloroquine, several studies issued in recent weeks have cast doubt on the effectiveness of this molecule. However, Chinese and French studies have shown that receiving or not receiving this treatment did not make any difference given that 76% of patients treated with hydroxychloroquine ended up in intensive care within the first 21 days, as against 75% with regard to the other patients. Other risks may arise should such treatments be validated without due observance of relevant scientific channels. This would amount to a shift in the drug market towards an informal market-based economy.

Thus, faced with serious health crises, the populations will now be led to consider local medical drug sales as a palliative to their poverty and underdevelopment problems. Such a phenomenon would expose the populations to serious health hazards.

According to Dr. Gilles Auzemery, medical advisor to the Nouvelle-Aquitaine Regional Health Agency in France, there are many cases of cardiac dysrhythmia (heart rhythm disorder) related to self-medication with hydroxychloroquine. Certain patients had developed symptoms such as dizziness, malaise and palpitations after self-medicating with the molecule. 

As for the CVO, the French National Drug Safety Agency has found that not only have Artemisia annua-based products, so far, not shown any therapeutic virtues, but also that some people who have taken it had developed serious forms of malaria during a stay abroad. This is why, in the past, this same agency had already banned several organizations from marketing products containing Artemisia in 2015 and 2017.

Developing countries do not have the same control and monitoring capacities as the major Western powers. Thus, it is scientifically unacceptable that, for a sector as sensitive as health, we are witnessing a libertine transformation and marketing of molecules instigated by local players. One thing leading to another, it will also be impossible to control the consumption of these illicit derivatives by the populations. Ultimately, all these factors considered, great caution must be exercised in the face of these ready-made solutions that are not subject to rigorous monitoring and control procedures.

Kouam Latrille is a defender of human rights and promoter of sustainable development. He is a consultant to NGOs and a university teacher. He holds a diploma in human rights from the University Saint Louis of Brussels and is a doctoral student at the Catholic University of Central Africa.