Health Information Technology and Indigenous Knowledge Syst.

African indigenous knowledge systems are usually discounted when experts discuss the application of ICT to healthcare. This proposal departs from such tendencies by seeking to build a platform for the metadata analysis of proven effective indigenous knowledge systems that are applicable to the healthcare crisis facing Africa and the rest of the world with the objective of delivering sustainable solutions with Health Informatics (HI) Technologies of the self. The ancient and modern African contributions to healthcare and information technologies are too significant to be ignored in any serious attempts to offer effective solutions to existing problems. Our HI Tech solutions will do exactly that by identifying proven solutions and building a searchable database that is made accessible to mobile devices and the internet to allow Africans to improve their self-efficacy as citizen scientists who are able to participate in the discovery of new knowledge, the testing of existing hypotheses, and the dissemination of proven solutions to all that need the knowledge. Self-healing networks have been developed in ICT as simulacra of the self-healing human body. We propose a simulacra of the simulacra by designing interactive platforms that would equip Africans and the rest of the world with the technologies of the self to enhance self-efficacy and self-healing.

The methodology for developing ‘African-centered automated generation of metadata’ has been described by Abdul Karim Bangura (2012). African capabilities of collecting, analyzing and applying data are on the increase but you will never know it from reading biomedical research reports about Africa that rely almost exclusively on theories developed outside the African context with Africans contributing mainly epidemiological reports that are rarely cited (Chilisa, 2011). Bangura advocates the mining of the huge data about data (or metadata) that are generated in Africa. One area of relevance that he highlighted is the area of bioinformatics or the pluriodisciplinary field that combines interests from biology, information technology and social statistics to probe big data for patterns of genetic variations, digital imaging of the body, and simulation of natural environmental interactions. Our approach differs slightly by narrowing the focus to Health Informatics (HI) Tech and slightly away from genetic analysis and bioinformatics generally to drug-free original, alternative and complementary medicine. A brainstorming session with Dr. Ed. Fox at Virginia Tech produced the following logic diagram for the project design:

In Artificial Intelligence, self-healing networks are designed to be capable of recognizing viruses and automatically take care of the infections the way that the human body does all the time as demonstrated in the animation series featuring Chris Rock as Osmosis Jones, though Jones acted as an anti-biotic agent in the bloodstream. We propose to abstract the principles of the self-healing networks from artificial intelligence (AI) and apply them to Health Informatics (HI) for the benefit of all but especially for the benefits of poor patients in Africa who cannot afford biopharmaceutical products. Although computer scientists do not always acknowledge that the model for self-healing networks comes from the life sciences, we see the organismic algorithm as promising in the design of human self-healing ITC platforms (Quattrociocchi, Caldwell and Scala, 2014). We propose to build an interactive platform or searchable database of proven remedies accumulated by indigenous knowledge systems around the world. This database will be accessible through social media and the flow of information will allow for feedback loops that will allow readers to upload their own home remedies for evaluation by the community of e-citizens to continuously grow the available knowledge and dynamically isolate ineffective recommendations while standardizing the effective ones. Mozumder and Marathe (2007) analyzed pooled data from 1960-2004 and found that access to information and communication technologies such as telephone and television ownership correlated with the survival rates from malaria in 70 countries around the world not just because the ICT owners are more likely to be relatively wealthy and therefore more likely to be healthy but because ICT can be useful in public health education towards prevention and homecare in remote locations.

Everyone will benefit. 

Our platform will be a part of the solution to the Heinz, Mandela, Obama dilemmas. Since our recommendations are drug-free and cost-free, there will be no need for poor Mrs. Henz to die or for Mr. Heinz to commit burglary or for big pharma to sue Mandela or for churches to sue Obama over affordable healthcare. The socialized medicine in European social democracy countries would have been better answers to the Heinz dilemma except that African countries have zero social welfare plans and the public health systems are almost nonexistent. Where drugs are available in Africa, the quality is often in doubt and even when the qualities can be guaranteed, the side-effects may do more harm than good (Agozino, 2017).

Our platform poses no threat to the profit motives of pharmaceutical companies because they will continue to make healthy profits from cures for diseases that indigenous knowledge systems have not yet come up with cures for. Our platform is a win-win-win-win for all involved because patients will benefit, researchers will benefit, policy makers will benefit, indigenous communities will benefit and even pharmaceutical companies may gain new insights to translate some of our findings for commercial products. When Africans heal themselves from some epidemics that modern pharmaceutical companies are yet to cure, Africans will be able to spare more money that they could spend on other commodities that will promote better living conditions in indigenous communities while profiting manufacturers. Indigenous knowledge systems based on herbal remedies will continue to thrive because our Health Informatics Tech (HIT) does not seek to specialize in herbal medicine.

I grew up under a father who was a priest-physician with a specialization in the healing of dysentery. As a child, he taught me the herb used in healing dysentery and swore me into secrecy never to reveal it to others. When he was away at the farms and patients visited our home for the cure, I would go and get the herbs and prepare them for them to drink with almost instant cure. Like the ancient official priest-physicians in ancient Egypt, my father taught me to practice this healing without charging a huge fee lest the efficacy of the herb vanishes with the profit motive or someone is left to suffer for lack of money. He only collected a token fee of six pence from each patient or gave away the cure free of charge to those who could not pay. 

As I grew up and went off to attend university in a distant city, I challenged myself to seek ways of healing myself without herbs because I may not find our local herbs in the distant city. Already as a child, my training by my father may have sensitized me to observe my bio-feedback mechanisms and thereby learn to prevent some common diseases without herbs, especially during the Nigeria-Biafra war when we were forced to flee our home as refugees or internally displaced people without easy access to doctors. At the university, I was taught research methods and I applied the principles of systematic observation and quasi experimentation to my awareness of bio-feedback mechanisms. I have continued my research since and the result is the book, ADAM: Africana Drug-Free Alternative Medicine, which has benefited many readers (Agozino, 2006; Agozino, 2017). The book is the basis for my proposal to develop a virtual clinic using ICT and indigenous knowledge systems to combat some of the health crises plaguing Africa and the rest of the world.

Two undergraduate students of Computer Science served as my consultants for their class project and they succeeded in building a sample website for the platform and they exhibited their design at a campus event.

I am also collaborating as PI with colleagues in Nutrition and in Computer Science on a proposal submitted to the National Library of Medicine at NIH with the specific aim of mining archives for effective indigenous healing practices that are neglected. The proposal is still under review.

In April 2020, I blogged about indigenous knowledge systems that coukld be contributing to the resilience of Africans in the face of Covid-19 risks. I am glad to say that one of my recommendations, open windows to let the wind sweep through the homes and offices daily, has become standard advice from the CDC. Yet, my two other recommendations - not to blow the nose but to sniff it in and spit it out and to go on a 24 hours fast with water only, are yet to be recognized as part of the therapeutics though they work:

https://massliteracy.blogspot....

The project will benefit from the technological skills of partner Solvers who will build the interactive platform for a cost-free health information technology that people are free to try without side-effects because our recommendations are drug-free and herb-free. 

Users who benefitted from the recommendations are free to donate to the project as they wish but there will be no charge for accessing the platform or for subscription. 

Partnership with community organizations will help to spread the information widely for the benefit of all.

Like human beings everywhere, Africans had their indigenous systems of healthcare long before their contact with Europeans. Unfortunately, Europeans saw African practitioners as rivals and set about suppressing them as ‘witch doctors’. European priests preached against them, colonial administrations outlawed them, and European pharmaceutical manufacturers and doctors frowned upon them rather than integrate them into a holistic synergy of indigenous and modern technologies of health the way that China did under Mao or the way South Africa did under Mandela (Turshen, 1984; Fanon, 1965). At the same time, the poor economic conditions in Africa force the majority of trained medical personnel to migrate abroad in search of greener pastures. The result is that while the poor cannot afford decent healthcare, the rich go abroad for treatment and medical checkups. It is high time we recognized that indigenous knowledge systems of healthcare could help to fill some of the gaps in research, innovation and service.

Build and test the interactive platform.

Indigenous Knowledge Systems applications in the health sector tend to be exclusively based on herbal therapy, yoga, acupuncture or shamanic incantations and prayers. Health Informatics Technology (HIT) seeks to radicalize this system by offering drug-free, herb-free and virtually cost-free nutritional and behavioral changes that are already known to be effective for the treatment of some conditions in Africa and around the world. There is a huge opportunity here for investors to come in and support the project at the early stage before we go public, allowing the investors to cash out and exit if desired while allowing us to sustain the project and expand it according to the scale of our resources.

Feedback from users who have benefitted from our drug-free approaches

The platform will be able to keep a count of the number of visitors.

The volume of donations from users who benefitted and wish to support the program.

The number of undergraduates and graduate students applying to work on the project as research assistants or as post-doctoral researchers.

The number of grants applications for clinical trials submitted by partners in the project.

The number of peer-reviewed publications and presentations at professional meetings.

The number of hits on social media search engines.

The demand for alternative and complementary medicine is huge and our solution disrupts this multi-billion dollar market by offering effective cures for free. People do not always value free stuff but once they try it, they will sustain it when they see the results.

The technology and the knowledge already exist but what is missing is a team of pluridisciplinary leaders willing to synthesize and synergize the extant technology and knowledge to solve persistent problems in the health sector.

The major ethical threat to this design is that indigenous knowledge systems are at the risk of losing intellectual property protections if shared in the electronic commons. This platform could be accused of seeking to exploit the knowledge of Africans for personal gains without giving back to the African communities that developed such knowledge. How can we assure that harm will not be done to the intellectual property interests of those who developed indigenous knowledge systems that could be robbed and patented by big pharmaceutical companies for huge profits at the expense of Africans?

One immediate answer to this question is that the database will start with my own indigenous knowledge systems that I have already published in a book and in some articles. Given that my approach is drug-free, herb-free and cost-free (except the purchase of the book by those who could afford it), there is nothing to sell and so there is nothing to patent. However, we plan to get a trademark protection for Health Informatics Tech (HIT) to support our search for the advancement of science through effective discoveries. Africans have shared such knowledge for self-preservation without obsessing about intellectual property protections. Revenues could be generated by the platform through the sale of advertisements and through grants-seeking and donations which would be ploughed back into African communities to build sustainable living.

It is possible that patentable products could be developed for the commercialization of some of the healing recommendations that will be included in the database. However, to avoid keeping the remedies out of the reach of the poor, we do not plan to charge a fee for accessing the database. Rather, we plan to offer the service as a free ware with the option for those who are satisfied to make donations to support the continuation of the research and the dissemination of results. Our HI Tech (HIT) platform will be like WEBMD with the exception that our focus will not be biomedical pharmacology. We will focus on alternative, complementary and original African indigenous medicine and similar drug-free knowledge available from different parts of the world. Users will be invited to voluntarily add to the database their own knowledge for the benefit of Africans and for the benefit of the whole world. HI Tech (HIT) will be like a Wikipedia for indigenous knowledge systems in healthcare with open source verifications of claims and endless peer-reviews to improve quality while enhancing access.

The platform will be designed, built and ran by our staff, volunteers and activists. Already we have scholars from all over the world expressing interest in participating in the project. All we need now is funding to get us started. Once sustainable financially, we may decide to issue IPOs to generate more revenues for expanding the service, conducting more research and developing the platform to include indigenous knowledge systems from all over the world.

The Council for the Development of Social Research in Africa (CODESRIA) has been providing a series of workshops and publications on the ethical threats facing the digitization or commercialization of Indigenous Knowledge Systems without copyright protections and royalties for the originating indigenous communities (Mazonde and Pradip, 2007; Ng’etich, 2005; and Ezeanya, 2015). This problem is acute especially in the exploitation of African herbal formulas that are often commercialized at huge profits while the original discoverers of the remedies tend to be too poor to purchase the commodities fashioned from their indigenous knowledge while losing the financial benefits to those holding the patent. 

The advocacy of CODESRIA and others may have contributed to the passage of the South African Traditional Knowledge Protection Intellectual Property Amendment Act signed by President Jacob Zuma in 2014. Despite controversies surrounding the passage of the Act, it appears that both the government and the opposition agreed on the need to protect indigenous knowledge rights. The controversy was whether it would be more effective to protect indigenous knowledge as intellectual property sui generis, as is (according to the opposition), rather than try to bring indigenous knowledge systems into the regimes of copyright law as the Act intended? The Congress of Traditional Leaders of South Africa applauded the Act and suggested that indigenous knowledge should not be patented without the approval of indigenous leaders with the hope that such patents would ensure that indigenous communities would benefit financially from their knowledge. 

We caution against using traditional leaders as the custodians of indigenous knowledge systems because traditional leaders tend to be ignorant of scientific developments that may advance indigenous knowledge in a dynamic way instead of seeing indigenous knowledge systems as property to be kept in the pockets of traditional leaders. We also caution that overemphasis on commercial benefits may be counter-productive in healthcare given that many indigenous knowledge systems in healthcare defy commercialization while commodity fetishism may keep discoveries out of the reach of indigenous communities. Besides, the African house is on fire and we cannot afford to be distracted or discouraged by the temptation to chase the juicy rats of commercial profits when we should be putting out the fire. We hope that the existing fair use clauses in copyright law would protect the use of indigenous knowledge systems to heal the sick without the commercial profit motive. We envisage a platform that will mine data globally to build a database of effective indigenous knowledge systems of healthcare technologies that are accessible to Africans through nutritional and lifestyle changes. Such a platform will operate like social media platforms that offer free wares to millions around the world without charging a subscription fee. We are confident that the sale of advertisements on our platform will be enough to attract investors to buy shares when we make our initial public offers to raise the funds to support the expansion of our good work to more communities worldwide. With the profits from the service of the platform, we will be able to award grants to community projects that would benefit indigenous knowledge communities.

Denying indigenous people access to the fruits of their own labor is a type of alienation that has been condemned as unethical even in the form of the digitization of archival documents to preserve them for posterity without providing the infrastructure to ensure that the digital archives are accessible and accountable to the indigenous communities that originated such documents. Archives, like health research and policies, are recognized as sites of ideological, ethical, political, economic and scholarly struggles for rights of access and control of access. Britz and Lor (2004) and Lor and Britz (2012) summarized the issues arising from the desire to digitize archival materials to preserve them and to make them more accessible. Some of the issues raised include the control of the copyrights of individual authors and community owners, the need to avoid using the immense resources of industrialized countries to effect an imperialist control of the archival resources of African countries, and the need to respect the human rights of all when attempting to digitize archival materials. Our project will adhere to the ethical principles of IRB protocols to ensure that there is no risk of harm to human subjects from the project. By collaborating with African colleagues, there will be no chance of foreign domination by the Virginia Tech based researchers. We will make sure that the digitized materials will be accessible to communities of scholars and patients based in Africa and in the rest of the world.

The more difficult issue to deal with is the exploitation of indigenous knowledge for translation and commercialization by pharmaceutical companies. One solution to this problem is for African countries to fund start-up pharmaceutical companies that would be community-based to help to protect communal intellectual properties. The issue of local patent protections by governments in Africa may serve to prevent the looting of indigenous knowledge systems for private gains. The expenses involved in obtaining international patents may be prohibitive to many communities with patentable knowledge that has commercial potentials in Africa and so indigenous patent protocols may be needed to reduce costs and make intellectual property rights protection more accessible.

However, we must make sure that the protection of intellectual property rights does not end up blocking the urgent need to tackle the health disparities that plague Africa today. Internationally, the practice is for researchers to rush and publish their findings in order to be the first in line to obtain relevant patents and recognition. The fear of knowledge theft has worked against Africa in this respect by keeping the indigenous knowledge systems secret with the result that some of the knowledge is lost when those who possess them pass away as Diop warned. African researchers should be encouraged to publish their knowledge and the knowledge of their communities especially when the pure and applied knowledge defies commercialization. For instance, I have published my findings on drug-free medicine but my findings are almost impossible to commercialize, making them unattractive to pharmaceutical companies. Such findings that rely on social and behavioral changes to combat disease will not pose threats to the intellectual property rights of indigenous knowledge systems. Rather, they will provide recognition and more support for research and dissemination in this area for the benefit of humanity. More research will enable Africans to systematically test the indigenous knowledge claims and identify the effective ones while discouraging those that prove ineffective or harmful. As Frantz Fanon concluded after examining the negative consequences of making possessors of indigenous knowledge feel inferior by practitioners of colonial medicine, the people eventually embrace innovation after regaining their independence: ‘The people who take their destiny into their own hands assimilate the most modern forms of technology at an extraordinary rate’ (Fanon, 1965: 145).

We value and pursue increasing diversity as a contribution to excellence. This can be illustrated with my video, IE: Inclusive Excellence, which was funded with an internal grant and involved collaborations with colleagues in the School of Performing Arts at Virginia Tech. The short video documents the history of exclusion and inclusion in Virginia Tech's 150 years to show that as diversity and inclusion increased, so also did excellence. I produced and directed the video and it premiered on Blue Ridge PBS and was selected for a film festival.

Our drug-free recommendations are cost-free for all to use. However, parents of little children and those caring for old people will be able to help them try some of recommendations when relevant. Those satisfied will be free top make donations ass they see fit to help to sustain the project.

The social and customer value proposition is that many of the conditions that we have found effective drug-free solutions for are said to be chronic or incurable. Once users try our solutions, they are likely to be satisfied especially since there is no cost to prevent the poor from accessing our services.

Our social impact can be measured by the number of users visiting our platform, the number of testimonies, number of researchers willing to partner, the number of technology experts will top collaborate, the number of peer-reviewed publications, and the size of research grants activity.

Any surplus from donations will be invested in further research and development to scale up the solution and reach more people worldwide.

Corporate wellness is a huge business due to the fact that sick days cost a lot to employers. Although our services are offered without cost to individual users, we plan to pitch big corporations to fund workshops on drug-free wellness for their workers.

We also plan to publish books that people could buy.

The social model of free service with the option to donate is now established firmly as a social business model. We plan to allow advertising on our site and we plan to consult on corporate wellness to bring in more revenues.

However, our business model does not rely on a huge outlay once the platform is set up. The outreach can be scaled according to the resources available.

We also plan to apply for research grants to support our research programs