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The Protection of Indigenous Knowledge for Peoples Health

Rose Khatri Liverpool John Moores University

Indigenous knowledge (IK) has recently been regarded as an important
commodity in global health development. Although recommendations by the
World Health Organisation in the Health for All Declaration (1978) highlighted
the need to include local people, their traditions and practices in Primary
Health Care (PHC), this was largely ignored. Evidence suggests that up until
recently IK and Traditional Medical Practice (TMP) was largely seen as a
barrier to modernization and progress. This case study will discuss these
changes and identify both positive and negative aspects of these trends.

Indigenous Knowledge
Most simply IK is knowledge that is locally situated and related to a more or
less set of common values, beliefs, experiences and practices held by a
particular tribal group, kinship or indigenous community. It is also referred to
as “traditional knowledge”, “folk knowledge”, “ancient wisdom” or “ethno
science”. Woyek & Gorjestani (1998:iv) include the following traits that they
suggest distinguish IK from scientific or western knowledge (SK).
       Unique to a particular culture and society
       Basis for local decision making in agriculture; health; national resource

       Embedded in community practices, institutions, relations and rituals
       Essentially tacit knowledge based on; oral forms of communication;
      experiential learning.
Whilst IK is currently seen as an important facet of both local and global
development this, however, has not always been the case.

The Exclusion of IK in Health Development
Development statistics are a useful starting point for identifying areas and
forms of inequalities and therefore social exclusion. These statistics, however,
cannot show how people have been excluded from development processes
by their very nature, in terms of who they are and what they represent. It
cannot identify the historical and contemporary globalizing practices which
have excluded or silenced people and their history, values and knowledge.
(Freire 1985; Napoleon 1997; Shiva 1997)
Communities and groups who adhered to traditional belief systems and local
knowledge in health and development practices were often represented as ill
educated, backward, even un-civilised. (Kolawole 2001) Shrestra (2002:107)
wrote of how “missionaries mocked our local medical practices, and made us
feel ashamed of them”. Yet as Gesler (1984:72) reminds us that before the
Europeans came to Uganda “ the Buganda people had developed a complex
and effective medical system”. Indigenous systems of health knowledge and
healing practices have had to meet the needs of the local communities over
many centuries and continue to do so. Nevertheless, there has been a clear
assumption from a global perspective that “west is best”, and all peoples of
the world at some stage, if they want to survive and indeed progress, must
succumb to the universal western values of health and development.

From Exclusion to Inclusion of IK in Global Development
Global development strategies have changed in recent years. People’s
participation and inclusion is now high on the development agenda, including
IK is the latest trend in this change. Although it was once seen as a barrier to
development, IK is now firmly accepted by most lead development
organizations, including WHO, the United Nations Development Programme
(UNDP) even the World Bank. (WHO 1996; 2003; World Bank 1998) This
increasing acceptance has both a local and global dimension to it.

The Local Use of IK in Development Programmes
Brokensha et al (1980) recognised IK as a useful tool in community
development. Something as complementary to western knowledge, which
encouraged participation, emphasised local need and resources, and
enhanced local pride1. Not least from an outsiders position the inclusion of IK
in local development dialogue would seem to be a common courtesy. Ho et al
(2003) alongside researchers such as Chambers (1983; 1994) and Sillitoe et
al (2002) consider IK as an important yet under-utilised component of global
knowledge for development.
Although still under-utilised IK is no longer excluded. IK is utilized in local
sustainable development activities, especially environmental protection and
agriculture. It is increasingly used in palliatative health care for HIV and Aid’s
sufferers in Asia and Africa. (Bodeker 2001; Morris 2001; Marco & Kananurak
2002) The use of IK for local development is largely seen as unproblematic,
something long overdue. The use of IK in the global health market, however,
can be viewed as something more challenging to local level development.

The Globalization and Exploitation of IK
The most profound interest in IK has taken place amongst the large
Multinational Pharmaceutical Corporations (MNPC’s) and their intrepid
scientists. Advances in biotechnology have increased the exploitation of IK
particularly with reference to medicinal plants and the genetic resources they
harbour. Utilization of this knowledge by the global health industry is evident
with MNPC’s as ever in competition to find the next “cure” or “magic bullet” for
a whole series of modern diseases and ailments. A key question is who will
benefit the most from this exploitation? Some suggest that benefits to the
local communities and source of the IK are negligible. (Shiva 1997;
Seneviratne 2000) Another set of concerns regards the protection and
sustainability of IK, as some view the globalization of IK as a further threat to
the worlds’ cultural, linguistic and biological diversity.

IK: Protection, Sustainability and Rights
These core concerns were first raised internationally at the Earth Summit at
Rio in 1993 with the subsequent production of the International Convention on
Biological Diversity. The three main goals of the convention as cited by Cox
(2000) are:
    1. Respect, preserve and maintain traditional knowledge
 To understand the extent of how local knowledge and beliefs have been eroded by western
approaches see the work of Napoleon (1997)

    2. Promote wider application of traditional knowledge
    3. Encourage equitable sharing of benefits from traditional knowledge
The convention is an important step in the protection of IK but there are
concerns that it does not go far enough to protect IK from bio-piracy.
(Takeshita 2001; Oxfam 2003) Unequal power relations in international
relations and international law are clear obstacles to both justice and
adequate protection in many cases.
Issues of rights and laws to protect IK, and ensure that the holders of the
knowledge are rewarded equitably are currently under review (Swideska
2002; Ho et al 2003; Tobin 2004; WHO 2004). Timmermans (2003:751) talks
of the importance of establishing links between “commercial, conservational &
developmental goals, and to formalize and, thus, reinforce, the (moral) rights
of the holder over their knowledge”. Swideska (2002:2) suggests a number of
clauses to protect IK, and with specific reference to the ancestral rights of
indigenous communities. He insists that the local community must decide how
IK is used, with the state/technical experts as facilitators, and that local use is
prioritised over commercial/scientific use.
One of the ironies in this area of health research and development as
Earthwatch (1994:73) stated is that whilst “one quarter of the worlds modern
medicines are derived from or copy compounds found in tropical plants. Yet
the cultures that collected such lore over generations are now in danger of
forgetting it.” Colonialism and approaches to development based on
modernisation theory have, to some extent, been successful in educating,
persuading or convincing people to regard their own local culture, beliefs,
values and knowledge as redundant; something that is no longer required or
needed for their own development and well-being, nor that of others. This new
surge of interest in IK and traditional wisdom may come as a bit of a surprise
to many. Tauli-Corpuz (2002:65) writing on behalf of the Indigenous Peoples’
International Centre for Political Research and Education states that “current
forces of globalization continue to regard our rights, our political systems, our
economic systems, and our culture and knowledge systems as backward,
unrealistic and romantic”. Yet this seems to be at odds with current
developments in the exploitation of IK.

Health and Development: Universal Knowledge and Values
It could be argued that no knowledge is or should be universal. With specific
reference to IK, anthropologists warn about the dangers of abstracting what is
after all situated knowledge. Giarelli (1995:) warns that IK systems “cannot be
reduced to the empirical knowledge they contain”. Indeed indigenous health
knowledge and TMP are usually part of a wider system of knowledge about
health, illness and the relationship between humans and nature. (Lama 2000)
Takeshita (2001:8) supports this with his concern over the use of IK as a
“biomedical utility”; as if it were just matter of fact information rather than
knowledge which is “embedded in beliefs about life, death, disease, healing
and ancestral heritage and are anchored in peoples cultural identity”.
A more positive view of these globalizing tendencies however, would argue
that the extraction of specific IK for global health medicine is surely a good
thing, something worthwhile and in the interest of all? This, however, must be
balanced by the increasing lack of equity in global health research and
development. The burden of disease still falls predominantly on the third world
countries, yet resources are disproportionately skewed towards the health
maintenance of the western world. (Baum 2001) The health transition
promised by the WHO in the post war era initially and then again in 1978 has
not happened nor is it likely to happen in the near future.
Also whilst WHO are making significant moves in the attempt to find a level
playing field with regard to IK and its use for international health there are still
many problems not appreciated at this level. The 10 members who make up
the Commission on Intellectual Property Rights, Innovation and Public Health
whilst international in spectrum, are all representatives from government,
industry, law or research. (WHO 2004) There is no one to represent civil or
political movements, no one from the numerous organisations or networks
who represent the interests of these excluded groups and individuals, in other
words no alternative voice or voices to challenge the dominant interests.

Clearly indigenous knowledge, values and belief systems are important and
surprisingly robust considering the history of western domination and
exclusion. There is no point in romanticising IK as something, which will
fundamentally bring about global health for all, for either the third world or the
west. IK will have specific uses just like biomedicine, neither can be truly
universal nor without problems. Questions arise as to whether the recent
embrace of IK by the large development institutions and organisations are
merely a smokescreen, another way of avoiding questions about or solutions
to the gross inequalities that persist on a global scale. IK is not a panacea for
development. It is something, which should be respected, protected and
allowed to flourish in the communities it stems from.

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