Are herbs undermining fight against malaria?

Dec 03, 2021

Some of the herbs may suppress the symptoms without destroying the malaria parasite in the body.

Studies conducted have suggested that asymptomatic carriers are more infectious than symptomatic.

Umar Weswala
Journalist @New Vision

HEALTH | HERBS | MALARIA

Aida Mukite, 41, of Nama in Mukono district survived dying from malaria during her third pregnancy.

The mother of five says she wrongly believed that the malaria prevention medicine provided to pregnant women at health facilities were disguised contraceptives. Instead, she resorted to using traditional herbal remedies, such as leaves of Mululuza shrub (bitter leaf) whenever she felt mild fever. 

“I came to my senses when I almost lost my third pregnancy to severe malaria,” Mukite recalls. “Friends rushed me to the hospital when I was unconscious.”

However, Mukite’s is not an isolated case. Using herbal concoctions against malaria is an age-old practice in Uganda. About 182 plant species from 63 different plant families are used for malaria treatment across several communities in Uganda, according to a 2019 journal article by Dr Denis Okello of Makerere University College of Natural  Sciences. 

The use of plants for the treatment of malaria extends to at least three continents, including several countries in Africa, America and Asia, according to Iranian scientist Prof. Faraz Mojab.

Of late, some promoters of herbal medicine are taking advantage of the loopholes in the health sector to the extent of openly decampaigning conventional medicine without evidence to support their assertions.

However, although a patient may feel some relief from fever after using herbal concoctions, experts blame the high cases of asymptomatic malaria carriers on the unregulated use of herbs and herbal extracts.

Abiaz Rwamwiri, the public relations manager at NDA, says they have not cleared or issued any notification for any herbal medicine for malaria treatment. 

Abiaz Rwamwiri, the public relations manager at NDA, says they have not cleared or issued any notification for any herbal medicine for malaria treatment. 



Studies conducted outside Uganda have suggested that asymptomatic carriers are more infectious than symptomatic ones. 

A study titled “Asymptomatic malaria carriers and their characterisation in hotspots of malaria at Mangalore”, published by the Tropical  Parasitology journal last year, states that as these asymptomatic cases do not get medical attention, they persist in the community and this expands the risk of transmission during much of this time, and overall, it constitutes a high proportion of transmission.

Mary Kamya, a private midwife in Lutengo, Mukono district, says asymptomatic malaria could be linked to the high use of herbal medicine to ‘treat’ malaria.

She says some of the herbs may suppress the symptoms without destroying the malaria parasite in the body.  “Once the fever and headache go away,  people claim they have healed and started recommending the herb to others. At the end of the day,  you have many people treating symptoms,  not malaria itself,” Kamya says.  She says these could be the people who later show up at health facilities with severe or cerebral malaria.

Denis Kibira, the executive director of Coalition for Health Promotion and  Social Development (HEPS Uganda),  recently told Saturday Vision that a  single asymptomatic carrier puts the entire immediate family at risk.  “It is time to empower people to take charge of their health by adopting proper health-seeking behaviours,” Kibira says.

Don't treat malaria with herbs 

Dr Daniel Kyabayinze, an epidemiologist at the Ministry of  Health Malaria Control Division,  says the ministry is currently not promoting any herbal medicine for treating malaria. 

“We are cognizant of the fact that there are medicinal herbs which were also used by our forefathers,” he said.  Kyabayinze, however, stresses that medicines from these herbs have been categorised as traditional and complementary medicine; meaning they can only be used as supportive or preventive medicines rather than curative.

This, he says, is on condition that such medicines go through mandatory clinical trials to establish their efficacy, safety and quality.

Dr Kyabayinze says any malaria treatment outside what the World  Health Organisation (WHO) and the National Drug Authority (NDA) have approved should be avoided.

Abiaz Rwamwiri, the public relations manager at NDA, says they have not cleared or issued any notification for any herbal medicine for malaria treatment. 

“Malaria has evolved into a very tricky disease that cannot be treated on trials,” he said.

Rwamwiri said like conventional medicine and in line with the  Traditional and Complementary Medicine Act  2019, herbal candidates for malaria treatment must go through clinical trials, and so far, none has made it this far.

Frank Kigenyi

Frank Kigenyi



He, however,  clarifies, that NDA has no issues with herbal potions that meet the standards of immune boosters or food supplements.

He says once these are cleared by the relevant authorities,  they can be used alongside the recommended malaria treatment.

According to Dr Kyabayinze,  the Ministry of Health’s position on herbal medicine is not hostile. 

He cites the Traditional and  Complementary Medicine Act and other regulatory mechanisms that he says are in place not to frustrate but to regulate the production and consumption of herbal medicine.

The Act, which came into force on September 14, 2020, defines and standardises traditional and complementary medicine in relation to conventional medicine, establishes a council to control and regulate the practice of traditional and conventional medicine, as well as registering and licenses practitioners,  among other matters.

Herbs with toxic compounds

According to Kyabayinze, extracts from some of the herbs people use contain highly toxic compounds that could injure the body due to lack of a defined dose or mode of administration.

This is particularly serious when it comes to pregnant women Mary Adong, a midwife at Mulago National Referral Hospital, says some pregnant women are ‘self-medicating with herbs, putting their pregnancies and their lives in danger. 

She cites medical complications, such as severe malaria, drug resistance and premature delivery as possible outcomes of relying on herbs to treat malaria. 

“Herbs and pregnancies do not mix. Pregnant women should avoid herbs at all costs,” Adong said.

Cases of women taking herbs during pregnancy are common, especially in rural settings, where access to health facilities is difficult.

Cases of women taking herbs during pregnancy are common, especially in rural settings, where access to health facilities is difficult.



Cases of women taking herbs during pregnancy are common, especially in rural settings, where access to health facilities is difficult.

However, Adong insists that there must be better alternatives than self-medication with herbs. Public health facilities provide free malaria prevention medicine to all pregnant women, in addition to free insecticide-treated and long-lasting mosquito nets.

Adong thinks this is a  good deal that should not be missed.  “Many of these women are not aware of the health risks of using herbs,” Kamya says. S

She also blames the never-ending adverts that target pregnant women with herbal concoctions.  “I wish the Government could be as  aggressive as herbalists when it comes to promoting health products and  services.”

In his journal article, Prof. Mojab  noted that “It is vital that the efficacy  and safety of traditional medicines be  validated and their active constituents be identified in order to establish  reliable quality control measures.”

Prevalence reduces 

According to the recently released  Uganda Malaria Reduction and Elimination Strategy 2021-25, the entire population of over 40 million is at risk of malaria, with 95% in areas of stable transmission, while 5% are characterised as areas of unstable transmission. The good news is that in the last  10 years, there has been a significant reduction in malaria prevalence from 42% in 2009 to 9% in 2019.

With a malaria prevalence rate of less than 1%, Kampala and Kigezi sub-region are on the blink of being declared malaria-free zones following years of unrelenting campaigns against the disease.

In south Buganda,  the prevalence has dropped to 1%,  putting the sub-region in ‘pole position’ in the race to zero malaria.

(This story is part of the CABI, SciDev.Net and Robert Bosch Stiftung Script science journalism project)

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