Ending medical dominance over the developing world

Despite the huge advances in modern medicine, most people in the developing world still rely on traditional - and effective - knowledge to treat illness and disease.

Its value in providing affordable healthcare has been recognised by the WHO, and now national and international policymakers are calling for partnerships between modern and traditional medicine to help bridge the equity gap in global public health.

But the two are fundamentally different: whereas traditional knowledge tends to be freely accessible (if culturally specific), modern knowledge is fiercely guarded by a rigid patent system, and dominates thinking in the developed world.

In the face of these differences, how can, or should, we build partnerships?

Urge to protect knowledge

Too often, past interactions have been marked by exploitation. Western biomedical scientists frequently see traditional knowledge as nothing more than an underexploited resource waiting to be systematically prospected and improved.

Such “biopiracy” has led many developing countries to focus on ways of protecting, rather than promoting, their traditional knowledge.

For example, some South American regions have tried legislating against biopiracy but have struggled to implement laws at a national or international level (see "Peruvian region outlaws biopiracy").

Several countries have reorganised their traditional knowledge into systems that Western patent offices can reference for “prior art” - existing inventions already in the public domain. India's Traditional Knowledge Digital Library (TKDL), for example, is one of the most sophisticated protective responses to the concerns of biopiracy (see "BioMed Analysis: Keep traditional knowledge open but safe").

Still others use an approach known as access and benefit sharing (ABS). This provides convenient access to traditional knowledge but demands, in return, a fair share of benefits arising from the modified use of traditional products.

For example, the Kani tribal community in Kerala receives funds from an Indian pharmaceutical manufacturer for its contribution to commercialising an anti-stress drug known as Jeevani.

But the Kani case is an exception rather than the rule and the truth is that many operational and conceptual issues concerning ABS remain unresolved.

Cross-cultural challenges

We need a better way of balancing the interests of researchers wanting to develop traditional knowledge for modern medicine and the indigenous custodians of that knowledge, who are entitled to a fair share of any rewards.