A plant that helps people with AIDS is causing a stir in South Africa - but can patents be kept at bay? Ferial Haffajee reports.

The rolling ranges of the Magaliesburg mountains are where I get my first sighting of Sutherlandia: a plant from the pea family with a bright red flower that's got alternative medical circles excited. Its adherents say it has properties remarkably similar to the anti-retroviral drug combinations that can downgrade AIDS from a death sentence to a life-threatening disease - if you've got the bucks or the medical insurance.

In South Africa, the apartheid of healing is stark. Middle- and upper-class (mostly but not all white) people living with AIDS can afford anti-retroviral drugs and have had the horror significantly numbed; for the largely black rest, life has become a fear of dying.

Forty-five minutes outside Johannesburg, here in the Magaliesburg, the life-prolonging qualities of anti-retroviral drugs are a faraway dream. Not even one per cent of people living with AIDS can obtain the drugs - even a year and a half after the South African state won a landmark judgment against Big Pharma, in which the country won the right to parallel imports of lifesaving medicines.

We remain entwined in political stasis, between a President who doubts that hiv exists and a Health Ministry which seems to have lost the fire in its belly. AIDS activists battle valiantly - bringing in high-profile shipments of patented drugs like AZT and flucanazole (from countries where it is cheaper) and generic equivalents from Brazil. In the meantime, the Government is being wooed by the pharmaceutical industry, which has offered to slash prices to ward off the generic onslaught. Most of the people who matter most, those with immune systems under attack from hiv, are marginalized from a debate they should be central to.

Photo: Tim Nunn / Panos Pictures

Finger on the pulse
That's why a trip to the 80-year-old sanusi (traditional healer) Credo Mutwa in the Magaliesburg is refreshing. The blood red Sutherlandia plant grows wild outside Mutwa's home and that's the way he wants to keep it. His views on traditional knowledge and health are an antidote to the global debate on cheap drugs.

For instance, here are his instructions for cultivating Sutherlandia: 'You sandpaper each seed and you plant it in a small blompot (flowerpot). And you allow it to grow until it is about maybe four inches, three inches high. Then you take it and you plant it in big veld (grassland)... They just grow. There are farmers who have already planted them but they are too few. This is a world emergency and we must not be selfish.'

And there, an elder decked out in his healing regalia in a tiny house on an African mountain, has put his finger on the problem with patents: selfishness. It's not a word you'll find in the reams of material written on the pros and cons of intellectual property, the umbrella system that protects patents.

The wizened and unlikely revolutionary, says the cultivation of Sutherlandia should be taken over by the United Nations so that its curative powers can be spread to the rest of Africa, to Latin America and Asia. His ideas of abundant growth and of sharing are not only those of a 21st century shaman, but of a wily man schooled in the game of evading the patent-masters on the look-out for traditional knowledge to colonize. International laws hold that nothing which is in general usage can be patented.

'This plant should not be the plaything of greedy businessmen. It should not be the plaything of thieving pharmaceutical organizations that steal Africa's treasures and lock them up in computers and call them their intellectual property.'

People's plant
From Magaliesburg, I follow the trail to Cape Town, headquarters of a company called Phyto Nova. Mutwa is a director of Phyto Nova, a company passionate about African traditional medical knowledge and about spreading it beyond rural communities.

Its focus is on the four 'most profound' African medicinal plants: Sutherlandia, Sceletium (an African St Johns Wort), Warburgia (a natural antibiotic) and Siphonochilus (a flu treatment).

'Phyto Nova does not believe that the use of a medicinal plant for any indication should be patented,' says Dr Carl Albrecht. Plants are communally owned - in the widest sense of the word - and can never, ever be patented. 'A further complication would be the question of the ownership of the intellectual property. Who would be the owners? Phyto Nova? Mrs Winifred Grobler who gave us the raw material of the plant and has been selling it for 10 years as a medicinal tea? The ancient Koi San peoples of southern Africa?'

Sutherlandia clearly belongs to the people. It has a name in the major languages of southern Africa and botanists trace its use back to the great flu epidemic of 1918. From then on the Zulu people called it unwele, the great medicine. For the Tswana, it was mukakana - for its treatment of sexually transmitted diseases - and the San called it insisa - the one that wards off darkness, perhaps for its use in treating depression.

Its qualities, as listed by the company on its website, include 'enhanced well-being, increased appetite and body mass as well as increased tolerance for exercise'. Mutwa puts it more simply, 'I have treated people who were told by the doctors at the hospital to "go home and die" and they are still alive today, three years after they should have died.'

Phyto Nova's mission is to 'empower ancient traditional African medicinal plants through good science, good medicine, good manufacturing and good business,' says Albrecht.

With Sutherlandia, this means the company produces teas, gels and powders from the plant, marketing and selling them as cheap, alternative anti-retrovirals, affordable to all. Profits count, but they are not the defining imperative. And this, too, is as refreshing as the sanusi's succinct dismissal of patents.

With drugs treatment out of most people's reach, Sutherlandia in the value-added forms manufactured by Phyto Nova is catching on among a range of doctors and healers.

The local hospital in Kuruman in the Northern Cape is like most state hospitals: it has no anti-retrovirals and a bursting in-patient load. Here, Virginia Rathele has started a clinic for hiv/AIDS patients and the hospital regularly refers patients to the traditional healers and sangomas (soothsayers) who work with her. A number of traditional remedies, including Sutherlandia, help ease the symptoms of AIDS and Rathele's clinic is a well-used complementary medical centre.

Testing times
Informal studies on Sutherlandia at centres like hers have prompted the Medical Research Council (MRC) to undertake trials using vervet monkeys and humans (the process is currently underway) to establish a safety platform for Sutherlandia.

'Having standardized the product, it could be tested for safety by the MRC... without an exact dose, this could not have been done,' says Albrecht. Such standardizing will make clinical trials possible.

This is essential as South Africa is awash with quack cures for AIDS - a husband-and-wife team have, for example, been trying to flog something with industrial solvent as its base compound. On the streets of Johannesburg, a sludgy black liquid sells like hot cakes. Its crude label promises that it will cure everything from AIDS to impotence to the more mundane flu.

Sutherlandia's advocates have been very careful not to claim it as a cure. Last year, Phyto Nova director Nigel Gericke told a BBC magazine that: 'The claim we are making is that we can significantly and dramatically improve the qualify of life of many ill AIDS patients... We are certainly not making the absurd claim that Sutherlandia is a cure-all or a cure for AIDS.'

Phyto Nova's somewhat unusual band of botanists, traditional healers and medical doctors are continuing to study Sutherlandia, to understand what in its make-up is making people feel better.

'Isolation of an active compound will increase the credibility of the plan enormously,' says Albrecht, adding, 'It will be a contribution to science and medicine for the whole world.'

But who should own that knowledge and who should benefit should this contribution come to fruition? That debate is still one being entertained by Phyto Nova and its associates.

Here Albrecht's take on patenting is a bit different. He believes it can be made to work toward a greater good. A patent brings much-needed funding and the isolation of an organic compound could see Mutwa's dream come alive - Sutherlandia could, in this way, be made available to millions.

'Between 10 to 20 tons of dried leaves are needed per month to make enough tablets for one million people,' calculates Albrecht. 'A good example of this is aspirin. Originally made from the bark of a willow tree, today it is made synthetically.'

Patenting a compound locally would enable community trusts to benefit, while a patent owned by a multinational headquartered outside South Africa would mean the knowledge and any benefits would be lost for good. Such co-operation with community trusts is also being discussed within Phyto Nova.

I can see Albrecht's argument and activists must surely listen to them. But while I muse, Mutwa's words persist - Sutherlandia should not be 'locked up in computers and called intellectual property'. And this too resonates.

Photo: Gisele Wulfsohn / Panos Pictures