Our vision is to develop and mainstream community health approaches synergizing bio-resources and traditional knowledge. Building on experiences made and lessons learned by our partners working on issues around biodiversity and community health worldwide, the BaCH Initiative addresses following six core issues:
(1) Linking conservation and community health
Integrating conservation priorities in health system planning needs more attention, with sufficient research on evidence of safety, efficacy and quality standards. Further, there has been inadequate reflection on how community health approaches can be integrated into institutional delivery mechanisms, more specifically within the contexts of local pharmacopeia and the mainstream requirement for standardized products. Experiences made e.g. within the framework of the programme on Medicinal Plant Conservation Areas (MPCAs) initiated by the Foundation for Revitalisation of Local Health Traditions (FRLHT) in India highlight the need and success of an integrated approach of in situ and ex situ conservation. This example affirmed the role of cultivation as a complementary approach to conservation emphasizing the need to consider local biological and cultural diversity as well as local development priorities.
(2) Integrating traditional medicinal practices into mainstream health systems
For traditional medicine to be contemporarily relevant it necessarily has to have a full understanding of the contextual dynamics and expertise underlying it and further translate this understanding to practical community programmes. A best practice example is the Intercultural Hospital approach applied in Chile . Integrating Mapuche medicine into the mainstream health system provided through the establishment of intercultural hospitals and clinics created an ideal platform for dialogue among traditional and allopathic medicinal practitioners. Building on experiences made, there appears to be a clear need for designing a radical and innovative approach to integrate traditional medicine into mainstream health systems. This would require full institutional backing from various related governmental and non-governmental agencies that link supply chains of medicinal resources with health practitioners and consumers with the highest standards of quality, safety and efficacy determined by an interdisciplinary panel of experts.
(3) Promoting sustainable enterprise development and livelihoods
Implicit to decentralized conservation measures is the need to strengthen local innovations through livelihood programs and local enterprises. Linking with economic development objectives – It is no surprise that the various dimensions associated with community health relate to multiple sectors. Promoting enterprise development based on medicinal and nutritional resources and services, and development of new, appropriate and feasible technologies that could enhance productivity, would further complement conservation measures. A successful case is the community-owned enterprise by women’s self-help groups (SHGs) in Tamil Nadustate of India, called Gram Mooligai Company Limited (GMCL ), promoted by FRLHT. It supplies medicinal raw materials through collection and cultivation including women’s groups as shareholders in the company. GMCL has developed ecosystem-based herbal products. The SHG shareholders directly benefit through buy-back arrangement of the herbs, employment for distribution of products through the Sangha (group) network as well as through profit sharing. Mechanisms for protection of traditional knowledge resources, prevention of their erosion and linking with scientific research are related areas that need attention. Traditional health promotion and related conservation schemes, focused chiefly on medicinal plants, were seen more as avenues for economic development and hence expected to become self-supporting over time. To realize self-sufficiency, costs of delivery of various related services from resource collection to distribution and infrastructure to identify and support healers need to be thought out more comprehensively. There is a critical need for innovative approaches for funding mechanisms in the area such as innovative Public Private Partnership (PPP) Models.
(4) Developing capacities for self-reliant health care
In many developing societies, health costs predispose rural indebtedness. A self-reliant approach to managing simple, common health conditions can reduce the health expenditure for poor rural households. Besides, at the community level, erosions in family fabric and support system, and alienation of primary health care from households into the premises of government-delivered health systems are big contributors to the decline of health care. Home herbal gardens, as conceived by FRLHT , are a collection of 15 to 20 prioritized medicinal and nutritional plants and have become a good model for a self-reliant community health programme. Studies conducted show that there is substantial health cost saving on account of usage of home remedies (Hariramamurthi et al., 2006). Self-reliance holds the key and it is necessary to focus on instilling confidence and capacity among households to handle diet, nutrition, lifestyles, conduct and primary health care. This goes along with developing capacities of traditional medicinal practitioners.
(5) Promoting knowledge integration and protection
We often see that the dominant education and research systems tend to enhance knowledge and technologies using universal standards, without much attention to the capacities and needs of specific regions or populations (Haverkort et al., Ancient Roots New Shoots, 2003). A dearth of comprehensive theoretical approaches to assessing the role, economic potential and policy implications of traditional knowledge is believed to be key to the disregard of traditional cultures (Jenkins, Putting Postmodernity into Practice, 2000). This then calls for the design and implementation of culturally appropriate pedagogical methods with an intercultural inclination and transdisciplinary approach, and their integration into formal and informal learning processes. Here it is further necessary to take into account the capacity development for facilitating agencies such as NGOs and public sector organizations. A successful example is Capacity and Theory Building for Universities and Research Centres on Endogenous Development (CAPTURED) – an accumulation of experiences and initiatives that aim at revitalization of endogenous knowledge systems in a context of ongoing decolonization and development of culturally appropriate systems of higher learning and research. As such, CAPTURED builds on the locally available resources, local knowledge, culture and leadership while also taking into account outside knowledge and practices.
(6) Biodiversity for Food, Nutrition and Health
Today there is high erosion of traditional knowledge and practices related to food production and a rapid reduction of food source diversity. There is a need to develop approaches to reverse these trends e.g. through documentation, identification and research and training on relevant aspects of food and nutrition. An approach that integrates socio-economic as well as cultural and local epistemological frameworks enhances understanding of the various inter-related issues. This could lead to nutritional guidelines based on local knowledge and practices and further strengthen local production and consumption systems. A best practice example is the Chao Phraya Abhaibhubejhr Hospital Foundation (CAF) in Prachin Buri, Bangkok approach of institutionalizing traditional knowledge. The foundation focused on conservation of traditional knowledge, resources, revitalizing of traditional local practices of food, healthy lifestyles, and cultural traditions apart from clinical care. A self-reliant community health care model has been established through these approaches. There is also a need to consider the WHO’s suggestion to switch from nutrition-based dietary guidelines to food-based dietary guidelines (WHO Western Pacific Region, Development of Food-based Dietary Guidelines for the Western Pacific Region 1999). Such an approach is necessary to understand and integrate traditional food practices. Health food traditions relate to various dimensions from agricultural practices, food processing and cooking methods to consumption practices.
Our four activity packages:
The Initiative will build on its partners’ long-standing experiences in the field of policy research and advocacy, capacity development, networking and knowledge exchange on issues related to biodiversity and health. To further understanding, awareness and contribute to the building of more robust, peer-reviewed evidence about the importance of the interlinked domains of biodiversity conservation, health and nutritional security goals, and the use of different knowledge systems to achieve them, the Initiative aims to conduct a wide range of activities such as: policy research, capacity development, policy advocacy as well as supporting establishment of centres of excellence.
- Policy Research
The BaCH Initiative aims to establish a policy research network addressing issues related to biodiversity and community health such as the biophysical resource flows to health and nutritional sectors. Within the network participating stakeholders from multiple disciplines will conduct case studies on key issues such as enterprise development for sustainable livelihoods or resource flows and the implications for community health addressing issues related to endangerment of species such as medicinal plants, fauna, other resources, trade as well as health delivery and access. The Initiative will further develop tools related to e.g. the validation of community knowledge and practices relevant to biodiversity conservation, health and nutrition security as well as policy briefs and toolkits e.g. elaborating on the use of tools and research findings.
Expected outputs of related activities are:
- Peer-reviewed policy research papers targeted to different relevant audiences such as policymakers, civil society organizations, local communities and researchers are drafted and published
- Manuals and books including good practices and methods e.g. for mobilizing biodiversity to improve health outcomes are developed and implemented are drafted
- Tools for relevant processes such as validation of local health practices and resource use are developed and implemented
- A dynamic and continuous portal to document a series of global bio-cultural case studies as a platform to share case studies beyond the project period is established
- Capacity Development
The BaCH Initiative is further planning to design and implement various capacity development activities addressing issues around biodiversity and community health. One of the proposed activities of the Initiative is to enable and foster participatory, rapid and integrated assessment of biological resource use and health practices. It is planned to design appropriate resource inventories, including assessment of conservation status and resilience to human use applying e.g. participatory GIS to community based mapping. Apart from that it is planned to conduct activities to validate community level health practices. Capacity development activities also include developing relevant and associated enterprises owned by communities i.e. producers companies or cooperatives as well as underlying support in business plan development through identification and/or creation of health sensitive value chains. Additionally, it is foreseen to foster equity and livelihoods through ensuring an increased understanding by the market and positive involvement of business for fair trade and good practices. The project will also address increasing the use of available voluntary standards, including the FairWild Standard, for ensuring harvesting and trade in resources is sustainable and fair.
Expected outputs of related activities are:
- Training manuals including modules on various aspects such as participatory mapping, validation of traditional medical practices are developed and disseminated
- Peer-reviewed books and papers such as recipe books on traditional and local pharmacopia as well as foods have been drafted and disseminated
- Training of Leaders/Champions in biodiversity for health and nutrition security have been designed and conducted
- How-to-Manuals on e.g. using voluntary standards for ensuring harvesting and trade are developed and trainings based on these Manuals are conducted
*As it comes to the capacity development activities, the Initiative follows a holistic approach ensuring to create and support selected agents as ‘multipliers’ from partner organizations at the local and regional levels. These agents will be equipped with the required capacities and knowledge through trainings, workshops, seminars, etc.
- Policy Advocacy
The BaCH Initiative further aims to conduct policy advocacy related activities. As such, targeted inputs will be provided to specific policy forums such as the Secretariat of the Convention on Biological Diversity (SCBD), World Health Organization (WHO), Committee on Food Security, Open Working Group on Sustainable Development Goals (SDGs) on relevant aspects related to ecosystem services, sustainable use, public health, access to health and livelihood security.
Expected outputs of related activities are:
- Institutional mechanisms for linking different sectors across biodiversity conservation, health security are identified and implemented
- Relevant advocacy measures are carried out
- Policy briefs and meetings are conducted
- Documents and guidance for mainstreaming biodiversity conservation for health security are drafted
- Supporting Establishment of Centres of Excellence
Apart from the above mentioned activity packages, the project will further support establishing two centres of excellence in each of the WHO regions in Asia, Africa and Latin America with co-financing from host member states. These Centres of Excellence will function as nodal centres for capacity development, policy advocacy and policy relevant research. As part of their mandate, they will focus on regionally relevant issues in the nexus of biodiversity and community health and will raise resources for the establishment of local networks of centres of expertise. These centres will further be networked through a global portal. The centre heads will further represent and be part of the international coordination committee for advancing the program beyond the period of the project.
Expected outputs of related activities are:
- Six Centres of Excellence are established – two in each region in the South
- A global portal for networking the activities of these regional centres of excellence are established
- An international coordination committee is set up
Biodiversity & Community Health 