{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:23:52Z","timestamp":1787207032423,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Despite heavy reliance on African Traditional Medicines (ATMs) by approximately 80% of Black South Africans, South Africa exhibits a conspicuous regulatory gap characterized by a complete absence of an official regulatory framework for ATMs indigenous to its borders. On the contrary, the South African Health Products Regulatory Authority (SAHPRA) provides a comprehensive regulatory framework for non-indigenous complementary medicines under Category D. This policy and practice review argues that this unambiguous dichotomy constitutes a structural and constitutional injustice. It violates constitutional rights to equality and healthcare access and exposes consumers to significant public health and economic risks. Using a document analysis, this study examines SAHPRA\u2019s current guidelines and relevant legislation and found no evidence of ATM regulation. To rectify this disparity, we propose a simplified, layered, or risk-based model like those successfully implemented in other African nations such as Ghana, Nigeria, Uganda, and Lesotho. These ensure cultural respect, consumer safety, and legal equity within the national healthcare system.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1907885","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:28:23Z","timestamp":1787203703000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The status, or conspicuous absence, of regulation of proprietary or locally manufactured African traditional medicines in South Africa: a constitutional injustice"],"prefix":"10.3389","volume":"14","author":[{"given":"Aisha","family":"Gambo","sequence":"first","affiliation":[{"name":"Sub-Discipline of Traditional Medicine, School of Medicine, College of Health Sciences, University of KwaZulu-Natal","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nceba","family":"Gqaleni","sequence":"additional","affiliation":[{"name":"Sub-Discipline of Traditional Medicine, School of Medicine, College of Health Sciences, University of KwaZulu-Natal","place":["Durban, South Africa"]},{"name":"Africa Health Research Institute","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limakatso","family":"Lebina","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute","place":["Durban, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2024.47.146.43011","article-title":"Integrating traditional medicine into the African healthcare system post-traditional medicine global summit: challenges and recommendations","volume":"47","author":"Ikhoyameh","year":"2024","journal-title":"Pan Afr Med J"},{"key":"ref2","year":"2025"},{"key":"ref3","volume-title":"Constitution of the Republic of South Africa no. 108 of 1996 Statutes of the Republic of South Africa-Constitutional Law","year":"1996"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1308913","DOI":"10.3389\/fphar.2024.1308913","article-title":"An in vitro study to elucidate the effects of product Nkabinde on immune response in peripheral blood mononuclear cells of healthy donors","volume":"15","author":"Setlhare","year":"2024","journal-title":"Front Pharmacol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2989\/IPJP.2014.14.1.6.1238","article-title":"The intersection of culture and science in South African traditional medicine","volume":"14","author":"Sobiecki","year":"2014","journal-title":"Indo-Pac J Phenomenol"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.5772\/intechopen.83790","article-title":"African traditional medicine: South African perspective","author":"Mothibe","year":"2019"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"113204","DOI":"10.1016\/j.jep.2020.113204","article-title":"The traditional use of southern African medicinal plants for the treatment of bacterial respiratory diseases: a review of the ethnobotany and scientific evaluations","volume":"263","author":"Cock","year":"2020","journal-title":"J Ethnopharmacol"},{"key":"ref8","author":"Matsabisa","year":"2021"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"a3829","DOI":"10.4102\/phcfm.v15i1.3829","article-title":"Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa","volume":"15","author":"Tsele-Tebakang","year":"2023","journal-title":"Afr J Prm Health Care Fam Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1080\/02533950508628712","article-title":"Who consults Sangomas in Khayelitsha? 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