The United Nations World Health Organization (WHO) defines traditional medicine as “the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness”, and encourages countries to develop their traditional medicine (WHO, 2024, 2020). In South Africa, the service provided by traditional health practitioners (THPs) is particularly important for black communities, often as first caregivers, as 72-80% of black South Africans seek treatment from them (Groner et al., 2022; King, 2012; Van Wyk, n.d).

An Interim Council of Traditional Health Practitioners of South Africa (ITHPC) was established under the Traditional Health Practitioners Act, 2007 with the objective to formalise and professionalise traditional health services and promote interest through research, education and training. The ITHPC serves as a regulatory body with an estimated 200,000 active THPs in South Africa (Zuma et al., 2016), although a comprehensive national register of THPs is absent.

THPs are recognised for their roles in maintaining cultures and indigenous knowledge, but have received less recognition as environmental custodians (Mathibela et al., 2015; Zuma et al., 2016). Media articles, particularly, tend to ascribe wildlife losses to traditional medicine practices (Carnie, 2022), possibly due to a combination of limited public understanding of the use of traditional African medicine (King, 2012), narratives by some wildlife authorities (Segawa, 2016), and attention on the conservation decline of certain high-profile species used in traditional medicine in South Africa and beyond (Soewu et al., 2019), such as the decline of pangolin populations linked to their commercial exploitation for traditional Chinese medicine (Wang et al., 2023). South African traditional medicine ingredients include wild animal and plant species, and the percentage of local communities utilising THP services can lead to the consumption of unsustainable quantities. Groner et al. (2022) estimated that annually more than 70,000 tonnes of plant material is consumed for this purpose in South Africa.

Despite growing recognition of the importance of collaborative knowledge generation with the engagement of multiple stakeholder groups in the pursuit of solutions to complex problems such as the ongoing biodiversity crisis (Gerlak et al., 2023), and the THPs as an important stakeholder given the sector’s consumption of wildlife, conservation decision making in South Africa is primarily undertaken by professional conservationists and wildlife management authorities to the exclusion of local and indigenous communities (Holmes-Watts and Watts, 2008). Calls to include Traditional Ecological Knowledge (TEK) (Mekonen, 2017) in biodiversity decision making have increased due to recognition of valuable knowledge contributions (IPBES, 2019).

Following such calls to acknowledge and address the inclusion of South African THPs in conservation stakeholder dialogues, a two-day workshop was co-hosted by Organisation A and Organisation B/C in Johannesburg in November 2023 to initiate engagement with this key stakeholder group on conservation issues. Critical questions explored included the role of THPs in South Africa, their regulations and knowledge exchange as well as how wildlife products are used in practice and future adaptations for product usage. We outline the main findings of the workshop and advocate for a more collaborative way forward in which THPs are further recognised as environmental stewards and custodians.

The initial objective for the workshop was to understand South African THPs’ wildlife usage and bring together multiple stakeholders including THPs, conservation organisations, wildlife management authorities to identify possible wildlife conservation collaborations. However, after reviewing the limited existing relations between the THPs and the authors’ organisations and the even more limited existing relations between the THPs and other conservation stakeholders, it was decided that a workshop engaging only with THPs would better act as a pilot for future cross-sectoral engagement, encourage more open and honest discussions to obtain a better understanding of the landscape of THP work in South Africa and their wildlife product usage. This resulted in a more focused participant recruitment.

THPs were invited through Organisation A’s established contact with members of the THP community and expanded using a snowball method in which the established contact sent a request for participation to their network. The sample included 22 THPs with wide-ranging expertise (from trainee THPs, to emerging THPs with less than 10 years working experience, and senior practitioners) from urban and rural backgrounds from six of the nine South African provinces. All interested individuals were provided with an information and consent form via email and/or WhatsApp, and confirmed their consent before and at the start of the workshop.

The exploratory workshop aimed to develop an open and cooperative relationship and obtain a better understanding of the role THPs can play in wildlife conservation and reducing wildlife consumption. The COM-B model posits that behaviour is influenced by the person’s capability, motivation and opportunities (West and Michie, 2020). A semi-structured group discussion guide was prepared (Appendix A) to map out the following:

These discussions were audio recorded and transcription notes were taken by two researchers in attendance. Sections that directly addressed the points above were transcribed verbatim. The texts were coded using thematic analysis to extract commonalities across the dataset with the aid of NVivo14 software. The coding and themes were cross-checked between the first two authors for consistency.

The findings corroborate existing literature on the integral role of THPs in the continuation of important cultural practices (Mathibela et al., 2015; Zuma et al., 2016) and providing a necessary point of contact for those seeking guidance on physical, mental and spiritual matters (Thobakgale et al., 2024). The THPs’ strong identification as custodians of not only culture but the environment, and their connections with local communities make them a valuable stakeholder group to mobilise community-based conservation efforts.

When exploring the environmental and social context of THPs’ practices, significant time was taken up by the attendees to voice their frustration over repeated stigmatisation of THPs through legislation and media reports. This resulted in a lack of time to cover some of the questions in the prepared guide such as those on reducing the use of wildlife or changing to substitutes, but the authors felt it was important for the long-term engagement with this stakeholder group to allow them to speak freely. The grievances voiced by the attendees reaffirms the hurdle of creating trust between THPs and other conservation stakeholders when the THP community is often overlooked in national and international strategies on biodiversity protection and sustainable development (Xaba et al., 2022; Chebii et al., 2020). To progress towards collaborative, multisectoral efforts to preserve biodiversity, targeted efforts by policy makers, conservation organisations and other stakeholders to reduce alienation and encourage THP participation are desirable.

Biodiversity loss reduces climate resilience, while climate change and pollution are causing millions of deaths globally (Ihsan et al., 2024). As such, any overexploitation that threatens the survival of wildlife species undermines traditional medicine’s goal to improve human wellbeing. Despite the fact that the attendees were unanimous in their belief that each THP only uses small quantities of wildlife products, the large number of active THPs in South Africa suggests the quantity of wildlife products consumed by the sector can be significant (Nieman et al., 2019). Attendees recognised that little is currently known about the scale and nature of the muthi trade, how wildlife products are sourced, making this a topic of further investigation. This became important in light of poaching for species like vultures (Mashele et al., 2021), and the sourcing of products from captive-bred lions - which may be considered impure and undesirable by the THPs. While only two THPs stated they had benefited directly from the captive lion industry (Green et al., 2022), there may be a reporting bias, and it is possible that some attendees have benefited unknowingly given the limited knowledge of the source of the muthi sold at markets. Research and engagement with muthi traders remains crucial for wildlife conservation and the sustainability of THP practices, as buying from markets is often the only option for THPs to obtain muthi even though this may not be desirable, ethical, sustainable or legal.

Our findings are limited by the small sample size of the workshop attendees, however, it provided some important insights. With reportedly over 200,000 THPs (Zuma et al., 2016) across South Africa, future research would benefit from expanding the sample size and scope. This workshop primarily focused on the usage of wildlife products, especially from lions, but may be expanded to include further fauna and flora. It became evident that the THPs wanted solutions regarding the unregulated nature of the sector, lack of consultation in policy decisions, and the lack of recognition. These issues were outside the scope of the two-day workshop and warrant further attention. We hope to be able to build on the relations from this workshop to conduct follow-up research and workshops to further develop relationships between THPs, the conservation sector and decision makers to improve conservation impacts in the future.

Despite limitations, the workshop elicited valuable lessons in collaboration and engagement across sectors for the benefit of protecting biodiversity and cultural practices. Desired future collaborative steps include forums for regular exchange between THPs and stakeholders on environmental issues and dispelling misconceptions regarding THPs’ environmental impacts, and facilitated engagement with South African policy makers for more effective regulation of the THP sector and management of natural resources.

The findings suggest that significant gaps remain in the inclusion of stakeholders in current efforts of wildlife protection and addressing the loss of biodiversity. The THPs highlighted a desire and need for effective, genuine collaboration between their community and the conservation sector towards the mutually beneficial goal of environmental protection. In turn, this would significantly promote the voices of THPs in decision-making spaces regarding policy and legislation in South Africa.

The THPs identify themselves as guardians of the environment and view wildlife not as commodities, but as having an inherent value important to South African cultures. Collaboration across the THP and conservation sectors may facilitate the integration of knowledge and promote recognition of the diversity of traditional cultures in South Africa.

Cross-sector engagement between wildlife conservation and THPs is beneficial for all stakeholders and biodiversity conservation, as it serves to dispel stereotypes; improve communication and collaboration; and create opportunities to connect the two sectors with policy-makers for more inclusive policy decisions in South Africa. It is pertinent for the conservation sector to learn about THPs’ needs and challenges related to environmental matters to effectively mobilise the THP community.