**4. Barriers to the use of TCAM**

Limiting factors to the use of TCAM in Africa include absence of scientific evidence supporting TCAM practices, lack of belief in safety and efficacy, lack of appropriate dose, unhygienic preparations [43], unregulated TCAM practitioner practice, and lack of education and proper training of practitioners. There are also no standard regulations as in orthodox medicine such that fake, ineffective substances and practices may be commonplace. The World Health Organization (WHO) further advocates that for future existence and integration of TCAM into conventional healthcare, attention ought to be paid to overcome the following hurdles: lack of research data, lack of mechanisms to monitor the safety of products, lack of expertise within national health authorities and control against appropriate mechanisms to monitor and regulate practitioners and products, lack of cooperative channels between national health authorities to share information about TCAM mechanisms to monitor the safety of products, and lack of mechanisms to control and regulate TCAM advertising and claims [4]. In addition, the lack of control of overharvesting and the conservation of endangered species and dwindling biodiversity due to climate change, thereby resulting possibly in extinction, are of great concern [44]. All these present major challenges to any effort to optimize TCAM.
