IN A NUTSHELL
Author's Note 
In my most recent role (2023-2025), I worked as a Scientific Officer at the National Institute for Scientific and Industrial Research (NISIR), Zambia. In that time, I led a team of Natural Products Research activities, including study design, methods development, report writing, results dissemination, and community outreach initiatives. I also planned, mobilised, and delivered two online public lectures: (1) “Quality and Safety of Herbal Medicines” and (2) “HERBS vs. HARDSHIP: Can Herbal Medicines Save Lives in a Post-USAID Era?”

Furthermore, I served as a member of the Technical Experts (Equipment Sub-Committee) for the $2.5 million NISIR Modernisation Project, a government initiative under the Ministry of Technology and Science aimed at enhancing NISIR's research and development capacity.

This article is a product of my time there, and it summarises the two presentations I made at scientific conferences in Mauritius and South Africa

 By Muunda Mudenda

PhD Student

Laboratory of Translational Cancer Genomics

Faculty of Medicine in Pilsen, Charles University

Czech Republic 

The Untold Story of Herbal Medicine in Zambia’s COVID-19 Response

 Why African Governments Must Invest in Traditional Health Systems

 

What Really Happened?

The recent COVID-19 global pandemic had several life-changing effects on the social and economic realities of many societies worldwide. For one, we realised how fragile life is due to the 7 million deaths resulting from more than 770 million confirmed infections.

Economically, lockdown measures translated into the loss of jobs and livelihoods for many people in both the developed and developing worlds. Some large and small businesses slowed their operations, while others had to downsize to accommodate the new reality and stay afloat.

While all this was happening, African countries also realised the gaps in their healthcare systems. We understood how underfunded the systems are, how access to healthcare is poor, how we have insufficient medications, overwhelmed staff, weak R&D (facilities, human resources), and a significant lack of manufacturing capacity for diagnostic tools and vaccines.

Interestingly, the pandemic also highlighted an untapped resource – our wealth of natural products and traditional medicine.

In the heat of the COVID-19 pandemic (2020 – 2023), Zambia experienced the power of indigenous knowledge as urban and rural communities turned to traditional herbal remedies to manage symptoms of the disease. Zambians turned to readily available herbal remedies like concoctions containing ginger, garlic, hibiscus, eucalyptus, and other unidentified herbs as key ingredients to alleviate symptoms such as fevers, headaches, loss of taste, shortness of breath, and chest pains.

Until now, the extent to which herbal medicine formulations curbed the burden of COVID-19 in Zambia has not been reported. Our lab, the Natural Products Laboratory, at the National Institute for Scientific and Industrial Research (NISIR), sought to address this gap by retrospectively investigating the use of Indigenous herbal formulations during the pandemic.

To achieve our research goal, we reviewed publications on three key aspects: scientific contributions, economic activities related to the importation of herbs and spices, and community reports about the use of herbal medicines to prevent or treat COVID-19.

Zambia’s Scientific Contribution to Herbal Medicine Research During COVID-19

Out of 1,101 research studies that were retrieved (2020 – 2023) from four reputable scientific databases (Scopus, Google Scholar, PubMed, and JSTOR), only 0.54% (6) were authored by Zambians, while 1.45% (16) referenced Zambia as one of the countries that relied on herbal medicines during the pandemic. Furthermore, none of the publications reported laboratory or clinical pieces of evidence for the use of herbal medicines as a safe and efficacious intervention. The publications were reviews that combined subjects like politics, philosophy, religion, and economics.

While such interdisciplinary reporting contributed to the description of a broader interest in herbal medicines in the country during the pandemic, it also emphasised the lack of dedicated research on the safety, efficacy, and effectiveness of herbal formulations against COVID-19.

Furthermore, successful policy formulations to support the use of medical interventions during a major public health emergency like COVID-19 demand a solid evidence base, which was lacking during Zambia’s COVID-19 experience.

Defining Herbal Medicine During

Herbal medicines, also known as phytomedicines, refer to preparations made from plants’ leaves, bark, roots, seeds, or flowers that are used in Indigenous communities for medicinal purposes.

These preparations were adopted during the COVID-19 pandemic in various traditional medicine practices across different regions of the world. For example, in India, as part of Ayurveda, in China, as part of Traditional Chinese Medicine (TCM), and in Africa, as African Traditional Medicine (ATM).

According to the World Health Organisation (WHO), these preparations are used by more than 80% of people in developing countries due to low cost, and they also serve as an important reservoir for pharmacological drug development.

The use of traditional medicine as a primary intervention during COVID-19 was also encouraged by the United Nations Educational, Scientific and Cultural Organisation (UNESCO). 

Tracing the Impact of COVID-19 on Import Trends of Herbs and Spices

From the economic point of view, we observed a positive relationship between the number of COVID-19 cases and the demand for herbal imports, particularly during the peak phase of the pandemic. For example, from December 2020 to December 2021, a marked surge in COVID-19 cases escalated from 20,725 to 150,000. Concurrently, Zambia’s import value of herbs and spices increased by 11.53% from approximately $2.95 million to $3.29 million.

As the pandemic transitioned into its second year (December 2021 to December 2022), COVID-19 case numbers fell to 100,000, potentially due to successful vaccine campaigns, improved public awareness, or accumulated natural immunity within the population. Correspondingly, the import value of herbs declined by 8.81% to around $3.00 million.

In the final phase from December 2022 to December 2023, COVID-19 cases continued to decrease to 79,287. Yet, contrary to expectations of a further decline in herb importation, the import value saw a slight rebound to $3.05 million, a 1.67% increase.

This observed relationship between the number of COVID-19 cases and the import value of herbs and spices underscored the influence of public health crises on health-seeking behaviours, particularly in the context where 70% of the Zambian population depends on traditional medicine.

Further research into the long-term impacts of such trends could inform strategies that integrate complementary medicine into public health frameworks, optimising resilience against future public health emergencies.

Community Claims and Use of Herbal Medicines During COVID-19

While the pandemic was partly managed using vaccines and other repurposed drugs such as Chloroquine and Hydroxychloroquine, these interventions came more than a year after the first case of COVID-19 was reported. Zambia received its first consignment of Oxford’s AstraZeneca COVID-19 vaccine on 12^th April 2021, and yet Zambians still had to survive the disease.

Before the vaccine, the situation was worsened by depleting resources in an already burdened health system with poor access, a lack of bed spaces and drugs, and a dilapidated healthcare infrastructure. Moreover, preventive measures such as the use of hand sanitisers, hand washing soap and nose masks proved expensive for communities that lived below the poverty line.

Vaccine hesitancy was also a major area of concern as many African countries showed scepticism about the safety and efficacy of the COVID-19 vaccines. A report by Afrobarometer about COVID-19 vaccines in Zambia said, “About half of Zambians would choose prayer over a vaccine to prevent getting COVID-19”. Such sentiments about vaccines fueled the use of home-based traditional herbal concoctions, which 70% of the country has relied on since pre-COVID-19 times for various other illnesses.

Interestingly, the use of these remedies was encouraged by both local and international organisations such as the Ministry of Health (MoH), the World Health Organisation (WHO), the United Nations Educational, Scientific and Cultural Organisation (UNESCO), and the United States Agency for International Development (USAID).

According to the World Health Organisation (WHO), herbal medicines were widely used due to ease of access, low cost, and strong cultural heritage. Local communities embraced herbal medicines to treat SARS-CoV-2 infection symptoms, such as fevers, headaches, diarrhoea, coughs, and fatigue. All this usage was despite the lack of scientific evidence about the safety and efficacy of such herbal concoctions against the disease.

Interestingly, trends about increased use of herbs and spices to prevent and treat COVID-19 were also observed in several other African and non-African countries. For example, Madagascar promoted an Artemisia plant-based herbal tonic called COVID Organics for prevention and treatment. The use of Artemisia annua was also reported in other countries, including Tanzania and China. 

What Needs to Change for Herbal Medicine to Work Better as a Strategy During Public Health Emergencies

There is strong scientific, economic, and social evidence, albeit anecdotal, to suggest that herbal medicines contributed significantly to the reduction of both mortality and morbidity.

Our study concluded that herbal medicines can be leveraged as a strategy to mitigate public health emergencies. This conclusion is also supported by the historical use of herbal medicines during local outbreaks such as HIV/AIDS and Cholera, as well as existing high acceptance rates for solutions that come from herbal medicines.

However, to use herbal medicines as a successful strategy to create pandemic-ready health systems, several efforts must be made:

Establish minimum research funding benchmarks. Currently, research funding remains critically inadequate. African Union member states should commit at least 1% of their national budgets to R&D, which in turn should have a dedicated allocation to traditional medicine research. This would create budget lines with peer accountability through annual AU reporting mechanisms.

Develop national and regional centres of excellence. Each African country requires at least one fully equipped herbal medicine research facility with complete capabilities from phytochemical analysis, pharmacological testing, clinical trials, and GMP-compliant production. These centres should operate under harmonised continental protocols through the regional centres and the African Medicines Agency. This would enable mutual recognition of validated products and rapid deployment during emergencies.

Implement structured public-private-community partnerships. The structures could be designed to include: Tax incentives (5-10 year holidays), matching grants, and benefit-sharing frameworks that attract private investment while protecting traditional knowledge holders. Furthermore, communities must receive royalties from commercialised formulations, with prior informed consent protocols preventing biopiracy.

Integrate herbal medicine into health systems. This includes incorporating evidence-based modules into medical curricula, creating strategic reserves of validated herbal products, and establishing continental pharmacovigilance networks for real-time safety and efficacy monitoring during outbreaks.

These interventions require commitments, primarily from domestic budgets supplemented by development partners. Success metrics should include validated products available, research capacity built, and mortality reduction during health emergencies. With high community acceptance rates already established, these evidence-backed investments will create resilient, locally-grounded pandemic preparedness systems across Africa.

Conclusion

We have the evidence, the community support, and the historical precedent. What we lack is political will. African governments must commit to measurable targets such as publishing national herbal medicine strategies by 2026, doubling research funding by 2027, and establishing regional centres by 2028. Our people deserve pandemic preparedness rooted in solutions that have already saved lives. Once we partner across borders, validate together, then we can deploy everywhere, and our next pandemic response can be built on African solutions.

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IN A NUTSHELL
Editor's Note
 Innovative reflections here on how parents should see their child with a disability, as part of the Author’s engagement in behavioral economics to design policies that advance disability inclusion as a core economic and workforce issue.

 As per her belief, ‘...smarter policy starts with human behavior, stronger institutions are built through inclusion, and the most effective global strategies are the ones that work for people first...’

By Andrea Cilliers 

Civil and Human Rights Advocate through the Lens of Behavioral Economics

Washington, D.C., USA

Let’s Change the Way Parents See Their Child with a Disability

 

Growing up, I often heard my mom say, “You can fix the medical issue, but you often create an emotionally stunted child.” She said this while spending years at the Children’s Hospital beside my sister as she battled leukemia. My mother had to push through her own fear to let my sister live fully, even in the heaviness of illness. She encouraged other parents to do the same: to give their children as normal a life as possible, despite their circumstance.

Years later, while working with the U.S. Special Advisor on International Disability Rights, she shared an idea that has stayed with me: “Parents are the biggest enablers—and disablers—of their children with disabilities.” It’s not a moral judgment, it’s a systems observation. Parents must navigate medical equipment, protocols, therapies, and services, all while making their child feel seen, valued, and capable. Families who succeed show us that children with disabilities are not “special cases” to overcome they are human beings to understand and support, just like anyone else.

Many families do the opposite by perpetuating language like “special needs” and “differently abled” in attempt to make a child feel loved. Despite the positive intent, this language signals difference, othering, and a paternalism. By labeling a child’s needs as “special,” we imply that others are doing them a favor by accommodating them. Over time, this framing can reinforce social separation and internalized feelings of being abnormal. Term “differently abled” can call out the way that child with a disability navigates the world when in fact every one is differently abled. Other language we heard included “normal” and “abnormal” children to be able to differentiate between children with and without disabilities. Words shape perception and perception shapes reality.

The challenge is global. In meetings with government officials from former Soviet countries, we discussed efforts to close large institutions in favor of community-based living. Despite the international community calling on governments to deinstitutionalize and the internal desire of these governments to close these institutions, a larger problem of how to change the mindset of parents with children with disabilities looms. Policies alone cannot succeed if parental attitudes remain trapped in fear. Parents naturally want to protect their children, but fear and the social stigma that often accompanies disability can unintentionally limit opportunity. Around the world, harmful practices persist: children are shackled, excluded, or hidden because families lack guidance or support. Change begins not with law alone, but with how parents perceive the worth and potential of their child.

Behavioral economics offers surprisingly practical ways to shift behavior without shaming anyone. For starters, fear can be reframed. Parents are exquisitely loss-averse, so instead of highlighting what could go wrong, we can focus on what might be lost: “Avoiding age-appropriate experiences now can quietly limit independence later.” Growth can be made the default: automatic inclusion in activities, short trial periods, and a presumption of competence allow for parents to take a first step.

Clarity reduces fear. Rather than vague encouragement, concrete pathways help parents understand exactly what will happen, with safety nets in place: “Here’s what happens on day one, week three, and if it doesn’t work.” Peer stories matter more than expert advice—parents trust other parents who share their experience. Hearing that “we didn’t think our child was ready either” and “here is how we navigated the barriers” can normalize risk and make inclusion feel possible.

It’s important to acknowledge that a parents’ natural instinct is to protect their child. Rather than telling a parent that they shouldn’t be so protective, we can redirect. Instead of “letting go,” parents can “add supports so their child can try.” Instead of “pushing,” they can “practice independence safely.” Small, time-bound experiments can build confidence, reshape beliefs, and create momentum. And professionals must model the right behavior; over-cautious language or deficit-focused reports inadvertently reinforce parental fear.

Parents aren’t holding their children back intentionally, they’re responding rationally to systems that over-penalize risk and under-support growth. Behavior change rarely happens all at once. It unfolds gradually through repeated experiences, small successes, and supportive structures. Over time, habits shift, expectations rise, and even identity transforms.

At its core, this isn’t just about parenting or policy—it’s about designing environments that unlock human potential. When growth is easier and safer than caution, children with disabilities can thrive. Parents, freed from fear, can act with both love and possibility. And the world begins to see, not just what could go wrong, but everything that could go right.