Dr Nambatya’s struggle, wins through 5 herbal medicines 

Uganda’s herbal medicines have suffered bad reputation as outright fake or crude concoctions offered by quack herbalists, but scientists and reputable practitioners such as Dr Grace Nambatya are changing that perception in the complimentary primary healthcare system.

Dr Nambatya is the director of research at the Natural Chemotherapeutics Research Institute (NCRI) based in Kampala. 

The laboratory undertakes research in natural products, including plants, animal and mineral substances, which are used by traditional medicine practitioners in Uganda with a view to justifying their therapeutic claims of efficacy and safety.

Dr Nambatya, a phytomedicine expert, has identified priority medicinal plants to research and process. 
With support from government and partners, she hopes to exploit the curative properties of these plants. 

Under her leadership, the laboratory, which falls under the Health ministry, has conducted research to find herbal remedies for ailments such as hypertension, ulcers, diabetes mellitus II management, and malaria, which is Uganda’s deadliest killer disease.

NCRI has developed five herbal therapeutic products to manage Covid-19, which include Excel Sanitizer, with a herbal extract from Warbugia Ugandensis or Mukuzannume in Luganda, and Abasi in Kiswahili. This comes with additional benefits of antibacterial and antifungal properties of the herbal extract. The sanitiser has been certified by the National Drug Authority (NDA) and can be found in pharmacies.

The Warbugia Herbal Cough Syrup is one of the official products that the laboratory is developing. Warbugia Ugandensis works as an antibiotic in this syrup, which is currently supporting the fight against Covid-19-related chest infections. 

“The institute is making it in bulk and soon, it will be distributed through the pharmacy chain. It has already been notified by NDA,” she says.  
The South African Journal of Botany says Warbugia Ugandensis is used to treat more than 20 ailments. 
The NCRI Immuno Booster organic drink is the institute’s latest formulation for supporting body immunity as a potential channel of prevention of viral attacks. 

Dr Nambatya is one of the top female scientists leading the current clinical trial of a locally-developed herbal medicine to treat Covid-19 at the Mulago National Referral Hospital in Kampala. 
On January 28, President Museveni launched the clinical trial of the natural formulation that has been used by Ugandan communities for more than 20 years against viral attacks. 

According to Dr Nambatya, who is the principal investigator, “A Phase II randomized double-blind, placebo-controlled clinical trial to determine the preliminary safety and efficacy of UBV-01N in adult patients infected with SARS-COV-2 (Covid-19) in Uganda” is Uganda’s effort in reference to Objective (h) of the Traditional and Complementary Medicine Act, 2019, yet to be implemented.

“The study is progressing well and soon, data will be analysed to inform the proper direction regarding use of the study material that is sourced from the communities where it has a record of use in management of viral health challenges for more than 20 years,” she says. 

“The results are to inform on its status regarding effectiveness and safety. If found useful in terms of management of Covid-19, it will go a long way in supporting the fight against the emerging variants as witnessed in this second wave of the pandemic that the country is subjected to,” she adds. 

Dr Nambatya says: “…the importance of traditional medicine in Ugandan health system can be envisaged in light of what our natural heritage in form of plants, animals and minerals, can contribute to access healthcare if well-harnessed for processing of pharmaceuticals, as well as leverage in terms of nutritional benefits accruing to functional foods naturally occurring in our biodiversity.”

Challenges
She singles out lack of funding, laboratory infrastructure and human resource as some of the challenges hindering the operations of NCRI. 
“Evaluation of toxicity of herbal formulations can be done through various methods in animal or human body models. Lack of an Act to regulate Traditional and Complementary Medicine (TCM) over the years has hampered apportioning of appropriate budgets to put in place technical infrastructure to carry out elaborate toxicological studies as it is done elsewhere in the world,” she says.

“Toxicology carried out to date is limited to basic pharmacological evaluation of herbal medicines in rats and mice. These are also dependent on availability of funds. So this is an area requiring intensive support in terms of laboratory infrastructure and identification of appropriate human resource. Capacity building towards toxicology studies is also urgently needed,” she adds. 

Asked how far the laboratory has reached in scaling up extraction of key components from herbs and producing herbal medicines on an industrial scale, Dr Nambatya, says: “We have recently during the Covid-19 pandemic received equipment to enable extraction (for example, sugarcane extraction) and preparation of primary decoctions for concentration into source concentrates for future purification to enable analysis of phyto-components.” 

Apart from the quack herbalists, colonialism also played a big role in discouraging Africans from using their herbal medicine in favour of Western medicine. The negative perception about herbal medicine in the past would have perhaps been the same today had it not been for the likes of Dr Nambatya, who has been championing herbal medicine. With the tangible results her prescriptions have had on people’s health, many have embraced it. 

“Colonialism influenced the enactment of the Witchcraft Act (1957), which depicts traditional medicine as evil and only referred to in terms of people using it to harm others. This influenced its relegation to evils like human sacrifices and casting spells. Our national curricula at various levels are devoid of delving into indigenous systems of health, thus further denying an inquisitive mind into unravelling the science in nature that would end up supporting vibrant health systems,” she says. 

“The Covid-19 era has contributed to awakening the world, Uganda inclusive, into searching the environment around us for a potential cure or portions that can help us to unravel the mystery of this pandemic,” she adds.
Dr Nambatya, who has been championing the use of natural or herbal medicine for close to two decades, says there is increased confidence in the uptake of traditional remedies in Uganda today.  

“Teaching people that herbs are important in protecting their lives has not been a simple task,” she admits. “But I am happy that today, confidence in herbal medicine has gone up by over 50 per cent. The reluctance by most Ugandans to use herbal medicine in favour of Western medicine was due to a colonial residual mentality.”

Recently, the Cross-Cultural Foundation of Uganda (CCFU) recognised Dr Nambatya, honouring her with the first prize in the Intangible Cultural Heritage category at the 2021 National Cultural Heritage Awards. She was recognised for outstanding contribution to preserving and promoting Uganda’s national cultural heritage.  

This year’s jury says for nearly 20 years, Dr Nambatya has taught communities about the importance of traditional and indigenous medicine. She has changed perceptions on the use of herbal medicine through her research and education. “Many Ugandans, especially those infected with chronic illnesses, are turning to herbal medicine and supplements for relief due to her contribution,” the statement by jury reads in part.

Dr Nambatya received the prize during the 4th National Cultural Heritage Awards ceremony at the Uganda National Museum in Kampala on May 24. 
Upon being rewarded, Dr Nambatya, said: “I felt a sense of accomplishment in my long-term career embracing promotion of traditional and complimentary medicine (TCM) by Ugandans and the world at large.” 

The head of the Uganda Herbalists and Cultural Association (UHCH), Mr Lutaakome Ssentamu, said: “Dr Nambatya is a scientist who is devoted to traditional medicine. She is tolerant, patient and respects people’s ideas before taking decisions.” 

The other acclaimed herbalists in Uganda include Victor Kiwalabye, Fr Anatoli Wasswa, Dr Yahaya Sekagya, and Mr Lutaakome Ssentamu. 
UHCH says there are only 5,211 registered herbalists in Uganda, locking out a large number of practitioners. 
Some practices by unscrupulous herbalists, such as bogus herbal concoctions or making incisions to draw out ‘bad blood’ from unsuspecting clients, are dangerous and call for regulation. 

Despite its challenges, traditional medicine is still popular as evidenced by Ugandans, who have rushed to use herbal concoctions to fight the deadly Covid-19 pandemic – although some treatments are dangerous to human health. 
This newspaper reported on June 17 that medical doctors have warned of an increase in the number of patients with peptic ulcers, attributing it to high intake of herbal concoctions. 

There has been an increase in the use of the concoctions with the belief that they boost immunity against Covid-19, which is currently ravaging Uganda. 
But medics warn that herbal concoctions are doing more harm than good since they are being taken in large quantities and on empty stomachs. The most commonly used concoctions are mixture of lemon, ginger, red pepper, onions and garlic, which are being blended or boiled. Some people also add marijuana to the mix. 

The National Policy on Public-Private Partnership in Health (2012) states that 60 per cent of the population use TCM for primary healthcare. 
Reasons cited include them being more widely available and accessible than the conventional medicine. 

Another being ratio of traditional medicine practitioners to the population being 1:200 and 1:400, while that of conventional practitioners is 1:20,000 or even less.
Similarly, Dr Nambatya says: “Currently, traditional medicine is expensive due to the limited production capacity of good quality herbal products. It further becomes expensive because of potential toxicity due to poor standardisation. One may set out to use a herbal product claimed to be an anti-malarial, only to end up with a damaged liver or kidney.”

On whether Uganda may adopt traditional medicines in its entire healthcare system as is in China, Dr Nambatya says this may only come with substantive integration of TCM in Uganda’s educational curricular to ensure sustainability of organised knowledge acquisition. 
For her case, Dr Nambatya says she was inducted into traditional medicine at an early age by her maternal and paternal grandparents, who were very knowledgeable in the practice.  

Who is Dr Nambatya?

Dr Grace Nambatya was born in April 1962, to Mary Perepetwa and Charles Sonko of Ssaza in Masaka District, central Uganda. 
She attended Villa Maria Primary School (P1 to P5), Kimanya Blessed Primary School (P6), and Nkoni Primary School (P7) and proceeded to Trinity College Nabbingo for O and A-Level.

Dr Nambatya holds a BSc in Chemistry and a Postgraduate Diploma in Education from Makerere University. She holds MSc in Medicinal Chemistry and a PhD in the same field from Loughborough University of Science and Technology, UK. 
She has authored and co-authored several research papers that have been published in scientific journals.  

Dr Nambatya received the British Council Award for Women Achievers in 2006, and the Nalubaale National Award for Service delivery in the Health Sector on Women’s Day, 2008. 
She has lectured Chemistry and Pharmacy at the College of Health Sciences, and College of Natural Sciences at Makerere University. She was also an external examiner at the College of Natural Sciences and Veterinary Sciences at Makerere University for 10 years.

Dr Nambatya has been a Board member of the National Drug Authority (NDA) since 2008, representing researchers in natural products.
She has also chaired the Public Private Partnership for Health (PPPH) Working Group for three years now. 

She is also a member of the Top Management Committee of the Health ministry.
Dr Nambatya is also member of the Steering Committee in the ministry of Science, Technology, and innovation and represents research interests in natural products. She is a gender champion at the Uganda National Council of Science and Technology. 

Dr Nambatya has also served on boards of schools and parents-teachers associations (PTA) at Trinity College Nabbingo, and Uganda Martyrs Namugongo SS for seven years, and at St Mary’s College Kisubi for six years, and also at Mugwaanya Preparatory School Kabojja. 
She is married to Dr Robert Kyeyune, a union that has been blessed with five children. 

Dr Nambatya and laws on local medicine

Dr Nambatya was the brains behind the Indigenous and Complementary Medicine Bill of 2015. The Traditional and Complementary Medicine Act, 2019, which is meant to regulate the use of traditional and complimentary medicines, was passed by Parliament on February 5, 2019. President Museveni assented to the Act on September 14, 2020. 

The object of the Act is to define traditional and complementary medicine in relation to modern medicine, to establish a council to control and regulate the practice of traditional and complementary medicine, to register and licence practitioners and to provide for related matters.

Reacting to President Museveni’s assent, Dr Nambatya, said: “I felt so good for the accomplishment of that milestone in the history of development of traditional medicine system that would support delivery of healthcare in compliment to disease management, which is the highlight of healthcare in the present times.”

“The Act was passed on February 5, 2019, and seeks to regulate the use of traditional and complementary medicines. It provides for a fine of Shs20 million ($5,593) for herbalists and other providers of complementary medicine who advertise or operate without a licence. 

The Uganda National Health Policy 2000 recognises the role of traditional medicine in the healthcare delivery system as a step towards improving health services delivery in Uganda.” 

“The Act, if well implemented as guided by the World Health Organisation (WHO), would lead to a well-organised traditional and complimentary medicine (TCM) sector in terms of support to human resource and office structures that are guided by TCM Act in agreement with the current Public and private partnerships for health structures. That kind of arrangement, if well implemented, gives assurance of weeding out traditional medicine quacks and meeting the objectives of the Act,” she adds.

“The TCM Act will bring sanity in the industry, whereby the sector will be legally streamlined and registration itself will eliminate fake practitioners. And the council will do the monitoring to enforce sanity,” Ssentamu says. 

Who is Dr Nambatya?

Dr Grace Nambatya was born in April 1962, to Mary Perepetwa and Charles Sonko of Ssaza in Masaka District, central Uganda. 

She attended Villa Maria Primary School (P1 to P5), Kimanya Blessed Primary School (P6), and Nkoni Primary School (P7) and proceeded to Trinity College Nabbingo for O and A-Level.

Dr Nambatya holds a BSc in Chemistry and a Postgraduate Diploma in Education from Makerere University. She holds MSc in Medicinal Chemistry and a PhD in the same field from Loughborough University of Science and Technology, UK. 
She has authored and co-authored several research papers that have been published in scientific journals.  

Dr Nambatya received the British Council Award for Women Achievers in 2006, and the Nalubaale National Award for Service delivery in the Health Sector on Women’s Day, 2008.

She has lectured Chemistry and Pharmacy at the College of Health Sciences, and College of Natural Sciences at Makerere University. She was also an external examiner at the College of Natural Sciences and Veterinary Sciences at Makerere University for 10 years.

Dr Nambatya has been a Board member of the National Drug Authority (NDA) since 2008, representing researchers in natural products.
She has also chaired the Public Private Partnership for Health (PPPH) Working Group for three years now. 

She is also a member of the Top Management Committee of the Health ministry.
Dr Nambatya is also member of the Steering Committee in the ministry of Science, Technology, and innovation and represents research interests in natural products. She is a gender champion at the Uganda National Council of Science and Technology. 

Dr Nambatya has also served on boards of schools and parents-teachers associations (PTA) at Trinity College Nabbingo, and Uganda Martyrs Namugongo SS for seven years, and at St Mary’s College Kisubi for six years, and also at Mugwaanya Preparatory School Kabojja. 
She is married to Dr Robert Kyeyune, a union that has been blessed with five children.