B.W. Njuguna, Founder of the AGENEF Health Group- Interview Series

Not much has been written about the medical cannabis industry in Africa and one can be forgiven for assuming that it is non-existent. But how would a continent with such a rich c                                                                         annabis history (think Moroccan hashish) and some of the best indigenous strains be kept out of the global cannabis conversation?

For sure, the continent has been muzzled by internal “powers that be”, but the relentless efforts of foot soldiers will not amount to naught. The nation of Eswatini was the first to legalize cannabis followed by Lesotho and South Africa. At the moment a handful of African countries including Malawi, Zimbabwe, and Zambia have legalized cannabis. It is expected that in the next five years close to 50% of Africa will have legalized cannabis to some extent. But as Dr. BW Njuguna puts it, “religion and bureaucracy are the greatest barriers.”

Dr. Njuguna has previously served as integrative oncologist and director of oncological research at Texas-based Kotsanis Institute.  Currently he is based in Nairobi where he runs an integrative oncology center- Agenef Health Group. He is also the founder and president of the Integrative Medicine Society of Kenya. In this brief interview he discusses medical cannabis in the African context. 

Can you briefly introduce Dr. Billy Njuguna and your engagement with the cannabis industry?

Dr. Njuguna is a Kenyan born medical doctor and oncologist who is passionate about helping (cancer) patients access the best treatment at whatever stage of their cancer journey that they are in. This could be patients in need of active management (surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.). Alternatively, this could also be patients on palliative management who need symptom relief to make their lives as comfortable as it can get. 

I’m not just an oncologist, but an integrative oncologist. This means that I utilize evidence-informed interventions such as Insulin Potentiation Targeted LowDose Therapy (IPTLD) in conjunction with (not an alternative to) conventional therapies to minimize toxic side effects and also improve the clinical outcome across the continuum of cancer treatment. I believe that medical cannabis can achieve similar benefits when offered in the appropriate setup. 

Briefly introduce The Integrative Medicine Society of Kenya (IMCK) and what the organization is doing towards integrating medical cannabis with conventional medicine

I founded the Integrative Medicine Society of Kenya with the aim of providing leadership and mentorship to the integrative medicine community in Kenya and the African region. Kenya, and Africa in general, is yet to fully exploit the potential of integrative medicine. The barriers are many and mostly due to misinformation of what integrative medicine is. This has created skepticism and hence a slow uptake. Of course, trained integrative medicine specialists are merely a handful at the moment and this also impedes access. These are some of the challenges that IMSK hopes to address with the overall aim of optimizing health for all.  

What would you say are some of the things that are holding back African nations from embracing medical cannabis? 

Religion is one of the greatest obstacles to the adoption of medical cannabis in the continent. In the Kenyan context, most of the population is religious and owe their  allegiance to religious leaders which gives these leaders political sway. Religious leaders have to be on board most of the political decisions, which is good in most instances but not all. The challenge arises when religious leaders are held back by fears that are unfounded and not backed by science, as is the case with medical cannabis. 

Unfortunately, religion in the African context does not allow independent critiquing of norms such as why cannabis was prohibited in the first place and the benefits vis-à-vis setbacks of maintaining such antiquated  laws. So every time progress is made in the line of legalizing medical cannabis religious leaders and their organizations push back.

Malawian President Lazarus Chakwera is however a beacon of hope. Chakwera is not only the president of the republic of Malawi but he is also a religious leader. That said, he has championed the move to switch from tobacco as the country’s primary cash crop to cannabis. Other African countries that rely heavily on agriculture and have struggling economies  have a lot to learn from Malawi and Chakwera. 

The other issue is bureaucracy. It's very difficult to move a bill through the legislative chambers in Kenya. The process is just broken and rife with corruption. And then there is partisan politics; it would have been much easier to move the cannabis bill through parliament if it was endorsed by a major political party. 

Does cannabis have a central role to play in the treatment of cancer (oncology)? 

Yes it does!

I have been following up on a number of studies investigating the activity of cannabinoids against brain cancer cells. Some (preliminary)  studies have shown that cannabinoids (THC and CBD) can prevent glioblastoma cells from growing and disrupt blood flow to these cells, causing them to die. Glioblastomas are the most prevalent type of brain tumors in Kenya, accounting for up to 70% of the cases.

Medical cannabis also plays an important role in supportive care in cancer therapy. I say this with confidence: cannabis should be the only drug  used for pain management in cancer patients. The western world is now grappling with the opioid epidemic and we cannot afford to be initiating new cancer patients on opioids for long term treatment. Other than addiction, the side effects that come with long term opioid use are significant as well. 

Lastly, there’s cancer-related cachexia. While this is a multi-factorial metabolic disorder we cannot ignore the benefit that comes with appetite stimulation. So far, cannabis is the only thing that can stimulate appetite in cancer patients effectively. 

What’s next for B.W Njuguna?

I’m committed to helping African countries to decriminalize cannabis and tap into the full potential of cannabis as a cash crop. I’m already working with different key players in more mature markets such as South Africa and Lesotho to try and see how we can bring the entire continent on board. I’m also committed to ensuring that the indigenous communities' whose livelihoods have depended on cannabis for decades are integrated into the emerging legal cannabis industry. 

It was a great pleasure to have this conversation with B W Njuguna, Integrative Oncologist and CEO of Agenef Health Group. Readers who wish to keep up with Njuguna are  invited to do so through their website.