Lancet Global Health: Traditional healers to improve access to quality health care in Africa

10 January, 2022

Citation, extracts and a comment from me below.

CITATION: Comment| volume 9, issue 11, e1487-e1488, november 01, 2021

Traditional healers to improve access to quality health care in Africa

Yap Boum et al. Lancet Global Health

Published: November, 2021 DOI:


In The Lancet Global Health, Radhika Sundararajan and colleagues report [] on the use of traditional healers to improve HIV testing in Uganda. Like many African countries, the 90-90-90 strategy for HIV management remains a failure, despite a few countries that have achieved this target. The first 90, which requires 90% of people to know their status, is the key entry point to the HIV care cascade and remains low (eg, 20% in the Ugandan male population). Innovative and homegrown solutions are needed to increase the proportion of people being tested for HIV and therefore aware of their status. Sundararajan and colleagues implemented a cluster-randomised trial to determine the effectiveness of traditional healers delivering HIV testing in rural southwestern Uganda, a high HIV prevalence setting. They found that the delivery of point-of-care HIV tests by traditional healers to adults of unknown serostatus significantly increased rates of HIV testing, with 100% of patients being tested in the intervention group (vs 57% in the control group), and 70% of those being tested linked to care (vs none in the control group). This is a major finding that could be applied across Africa with potential for impact on the HIV epidemic...

The study by Sundararajan and colleagues has important implications for health-care delivery in Africa. The authors showed that it is possible to successfully integrate traditional medicine as a catalyst for accessing quality health care...

COMMENT (NPW): I think there is a confusion here when the authors say the study 'showed that it is possible to successfully integrate traditional medicine'. The paper by Sundararajan indicates to me that traditional healers can be used to deliver an allopathic intervention (HIV test). It does not support integration of traditional *medicine* (my emphasis). There is a big difference between 'leveraging traditional healers as enablers of allopathic medicine' and 'integrating traditional medicine'. I look forward to comments from others.

Best wishes, Neil

Neil Pakenham-Walsh, HIFA Coordinator,