02/12/25

HERBACEUTICS AND THE GLOBAL HIV CURE IMPERATIVE:

Why Africa Must Lead the Next Frontier of Curative HIV/AIDS Research

By Livy-Elcon Emereonye

Abstract

More than four decades after the advent of HIV/AIDS, biomedical science has yet to produce a definitive cure. Although antiretroviral therapy (ART) has revolutionised HIV management and transformed life expectancy, it remains inherently suppressive rather than curative. Persistent viral reservoirs, viral latency, sanctuary sites, and immunological exhaustion ensure that cessation of ART typically leads to viral rebound. In parallel, Africa possesses unique advantages—biological, ethnomedical, ecological, and socio-historical—that make it an undervalued global epicentre for cure-focused research, particularly in the domain of medicinal plants and natural products. This paper advances a rigorous but polemically charged argument for African-led herbaceutics—the scientific standardisation and pharmaceutical development of medicinal plant knowledge—as a critical and overdue axis of HIV cure science. The analysis demonstrates that Africa’s vast biodiversity, deep ethnomedical traditions, high disease burden, and scientific potential uniquely position the continent to contribute curative leads. Yet epistemic, structural, and geopolitical asymmetries in global research continue to marginalise Africa’s scientific agency. The paper contends that the future of HIV cure discovery requires Africa not as a passive participant but as a central, driving force. It concludes by outlining a pathway for African scientific sovereignty in natural-product-based cure research, supported by verifiable literature.

Introduction

In 1981, the world first encountered the clinical syndrome that would eventually be known as AIDS—ushering in one of the most devastating pandemics in human history. Four decades later, HIV remains both a scientific challenge and a sociopolitical mirror exposing inequalities in research, funding, and global health power relations. ART has successfully suppressed viral replication, reduced morbidity and mortality, and transformed HIV into a chronic manageable disease for millions (UNAIDS 2024). Yet despite these gains, ART is not curative. Once treatment ceases, viral reservoirs reignite systemic infection (Siliciano & Greene 2011).

The global scientific community has attempted for years to crack the code of HIV cure science through gene editing, therapeutic vaccines, latency reversal agents, immune modulation, broadly neutralising antibodies, and stem cell transplantation. Yet despite remarkable progress, a broadly applicable cure remains elusive.

Meanwhile, another reality exists—one scarcely acknowledged in the international discourse: Africa has the world’s most extensive pharmacologically relevant biodiversity and one of the richest reservoirs of ethnomedical knowledge, yet remains on the periphery of HIV cure research. Africa’s botanical landscapes hold compounds with demonstrated anti-HIV, immunomodulatory, latency-modifying, and viral-entry-inhibiting properties (Esposito et al. 2016). Nevertheless, these potentials lie buried beneath layers of global structural inequalities, scientific neglect, and an outdated hierarchy that assumes biomedical breakthroughs must emerge from Western laboratories.

This article intentionally fuses academic analysis with polemical urgency to argue that the next frontier of HIV cure discovery must be African-led and grounded in herbaceutics. Africa must reject the passive role assigned by global research systems and instead assert its scientific sovereignty, leveraging its biodiversity, indigenous pharmacology, and emerging research capacity to drive global cure innovation.

HIV Cure Science: Current Limitations and Missed Opportunities

Despite decades of investment, HIV remains uncured due to biological complexities that stymie conventional pharmaceutical models. Chief among these are:

Viral Latency and Reservoirs

HIV integrates its genome into long-lived resting memory CD4+ T cells, forming latent reservoirs invisible to the immune system and unaffected by ART (Margolis et al. 2016). These reservoirs can persist for decades, generating replication-competent virus upon ART interruption.

Sanctuary Sites
HIV persists in anatomical sanctuaries such as the central nervous system, gut-associated lymphoid tissue, and lymph nodes, where drug penetration is often suboptimal (Estes et al. 2017).

Immune Exhaustion
Persistent immune activation and chronic inflammation weaken the cytotoxic responses necessary for reservoir elimination (McGary et al. 2017).

Viral Diversity
HIV mutates rapidly, creating heterogeneous viral populations within individuals, making therapeutic targeting complex.

Because of these challenges, leading scientists agree that a singular, monolithic cure strategy is unlikely. Instead, a combinatorial approach—incorporating latency reversal (“shock and kill”), permanent silencing (“block and lock”), immune reprogramming, and targeted cell elimination—may be necessary (Deeks et al. 2016).

However, most of these strategies are dominated by Western biomedical paradigms, which often disregard natural product pharmacology despite its historical success in drug discovery and development. The absence of Africa from this conversation represents not only a scientific void but also an epistemological injustice.

Natural products and medicinal plants in HIV research: a proven but underdeveloped frontier!

Natural products have long been foundational to global pharmacology. Nearly half of modern pharmaceuticals are derived from or inspired by natural compounds (Newman & Cragg 2020). In the realm of HIV research, several plant-derived compounds have shown promise:

Prostratin
Originally isolated from Homalanthus nutans, used traditionally in Samoa, prostratin is a potent protein kinase C (PKC) agonist capable of reactivating latent HIV, making it relevant to the “shock-and-kill” cure strategy (Korin et al. 2012).

Betulinic Acid and Bevirimat
Betulinic acid, found in various African plants including Syzygium species, is a precursor to bevirimat, a maturation inhibitor that reached clinical trials (Kanamoto et al. 2001; Martin et al. 2007).

Michellamine B
Extracted from Ancistrocladus korupensis, a rainforest vine discovered in Cameroon, michellamine B displays potent anti-HIV activity against multiple strains (Boyd et al. 1994).

Calanolides
Derived from Calophyllum lanigerum, calanolide A is a notable NNRTI with favourable safety profiles in early human trials (McKee et al. 1996).

These compounds prove that Africa’s botanical wealth is not theoretical—it has already yielded molecules with global scientific relevance. Yet the majority of these discoveries were identified, isolated, and patented by institutions outside Africa. This pattern highlights the persistent coloniality of global biomedical knowledge production. The primary reason might be with us.

Africa’s biodiversity and ethnomedical systems: a foundation waiting for scientific exploration and validation.

Africa is home to more than 45,000 plant species, many of which possess unique chemical architectures previously unstudied by modern science (Cunningham 2018). Traditional African medical systems—including Igbo, Yoruba, Akan, Zulu, Swahili, Amharic, and others—have documented, preserved, and refined plant-based therapies for centuries. These knowledge systems, when viewed through an academic lens, constitute an enormous bioassay-guided screening platform.

This indigenous knowledge, passed through generations, represents a powerful empirical filter—identifying plants with antiviral, immune-boosting, detoxifying, and inflammation-modulating properties long before the invention of chromatographic columns or PCR machines.

In a continent disproportionately afflicted by HIV, it is morally and scientifically indefensible that this wealth remains underutilised or exploited without compensation.

Herbaceutics: Africa’s scientific response to epistemic marginalisation!

Herbaceutics is not traditional medicine romanticised—it is traditional medicine scientised. It is the disciplined transformation of raw plant knowledge into pharmaceutical-grade interventions through:

• systematic phytochemical profiling
• bioassay-guided isolation
• pharmacodynamic and pharmacokinetic evaluation
• toxicological analysis
• standardised extraction and formulation
• regulatory-compliant clinical testing

Herbaceutics bridges indigenous wisdom and modern pharmacology, turning Africa’s botanical wealth into verifiable therapeutic candidates.

Academically, herbaceutics is the missing middle between ethnobotany and drug discovery. Politically, it is Africa’s scientific declaration of independence—an assertion that the continent will no longer provide raw materials for external pharmaceutical profit while remaining scientifically subordinate.

Why Africa must lead HIV Cure Discovery (HCD)

It’s no more news that Africa has the most skin in the game!

Sub-Saharan Africa accounts for two-thirds of global HIV infections and the majority of AIDS-related deaths (UNAIDS 2024). Moral logic dictates that the continent most affected should not be the last to contribute to the cure.

Africa has unmatched Natural Product Diversity (NPD).

The molecular scaffolds found in African flora—triterpenoids, alkaloids, saponins, lignans, polyphenols, terpenes, and a host of other secondary metabolites—represent chemical spaces largely uncharted in modern antiviral drug development.

Africa holds deep pharmacological knowledge.

Traditional medicine remains the first point of healthcare for an estimated 80% of Africans (WHO 2013). This knowledge is not superstition; it is empirical, adaptive, and deeply rooted in biological observation.

Africa’s scientific capacity is rising

The continent now hosts world-class research institutions, from South Africa’s CAPRISA to Nigeria’s NIPRD, Ghana’s CSIR, Kenya’s KEMRI, and numerous university research centres capable of molecular biology, medicinal chemistry, and natural product screening.

Yet global systems fail to take Africa seriously as a knowledge originator.

This must change.

The polemical imperative: ending Africa’s role as a Biological Resource Colony (BRC).

The world extracts African plants, patents African molecules, publishes African ethnomedical knowledge, and commercialises African biodiversity—while African scientists are sidelined, underfunded, and expected to applaud from the margins.

Africa cannot cure HIV from the passenger seat of global science. It must seize the driver’s seat.

The continued exclusion of Africa from cure science is not an accident. It is the legacy of extractive research paradigms that treat African flora as global property and African scientists as global assistants.

This system is unethical, unsustainable, and scientifically foolish.

If a cure emerges from an African plant but is discovered and patented elsewhere, it will be another chapter in the book of global biopiracy.

Toward a framework of Herbaceutical renaissance.

To lead cure discovery, Africa must establish:

• Pan-African Herbaceutics Research Institutes
• Centres that integrate phytochemistry, virology, immunology, and pharmacology under one roof
• Natural product libraries owned by Africa
• Digitally catalogued, geographically secure, and legally protected from biopiracy
• High-Throughput screening facilities equipped to test African plant extracts against HIV latency, replication, integration, and immune modulation

There is urgent need to integrate Traditional Healers into research not as symbolic participants, but as intellectual partners and co-owners of knowledge even if it will warrant some interpretation and retraining.

There should also be new funding models that will be less dependent on donor agendas, but more aligned with continental priorities.

Also important is a holistic Intellectual Property Protection (IPP).

A Pan-African treaty ensuring African ownership of African-derived therapeutics will go a long way to encourage more people to submit their work for evaluation, peer-review and validation.

There will also be the need for Continental Clinical Trial Networks capable of running phase I–III trials on herbaceutical cure candidates that may give way to possible functional groups modifications.

African HIV cure research cannot be outsourced.
Scientific ownership-collaboration is the only path to breakthrough.

Indeed, if the global scientific community is serious about achieving an HIV cure, it must confront an uncomfortable truth: the next major antiviral, immunomodulator, latency-reversing agent, or reservoir-disrupting molecule may very well lie hidden within African biodiversity.

But biodiversity alone does not produce cures.
Scientific agency does.
Research autonomy does.
Herbaceutical integration does.

Africa must rise as a central actor, not a peripheral beneficiary, in cure-focused HIV research. Anything less is an injustice to the continent’s scientific potential—and a betrayal of the millions living with HIV across the continent.

A cure discovered for Africa but not by Africa will be another tragedy of global inequity.

A cure discovered through Africa will be a triumph of science, sovereignty, and civilisation.

There’s no problem without solution even at infinity.

The plants are waiting.
The science is possible.
The imperative is urgent.
The world must listen.
HIV curative moiety might be within our reach.

Let’s look inward for the sake of humankind.

Ps: Dr. Emereonye could be reached on: +234 803 3922 445

References (Harvard Style)

Boyd, M.R. et al. (1994) ‘Michellamine B, a novel plant alkaloid, is a potent inhibitor of HIV-1 and HIV-2 in vitro’, Antiviral Research, 23(1), pp. 45–53.

Cunningham, A. (2018) Applied Ethnobotany: People, Wild Plant Use and Conservation. Earthscan, London.

Deeks, S.G. et al. (2016) ‘HIV cure strategies: The road ahead’, Nature Reviews Immunology, 16(8), pp. 507–518.

Esposito, F. et al. (2016) ‘Natural products in anti-HIV drug discovery’, Phytochemistry Reviews, 15(6), pp. 1155–1177.

Estes, J.D. et al. (2017) ‘HIV persistence in lymphoid tissue: Mechanisms and consequences’, Current Opinion in HIV and AIDS, 12(2), pp. 123–131.

Kanamoto, T. et al. (2001) ‘Anti-HIV activity of betulinic acid and its derivatives’, Biochemical and Biophysical Research Communications, 288(5), pp. 1200–1207.

Korin, Y.D. et al. (2012) ‘Activation of latent HIV-1 by prostratin via PKC pathways’, Journal of Biological Chemistry, 287(22), pp. 16930–16941.

Margolis, D.M. et al. (2016) ‘Latency reversal and HIV eradication strategies’, PLOS Pathogens, 12(6), e1005535.

Martin, D.E. et al. (2007) ‘Bevirimat: Clinical development of a maturation inhibitor for HIV-1 therapy’, Antiviral Chemistry & Chemotherapy, 18(1), pp. 37–49.

McGary, C.S. et al. (2017) ‘Persistent T cell exhaustion and HIV reservoir persistence’, Nature Medicine, 23(8), pp. 885–890.

McKee, T.C. et al. (1996) ‘Isolation and structure determination of calanolides from Calophyllum lanigerum’, Journal of Natural Products, 59(3), pp. 435–437.

Newman, D.J. & Cragg, G.M. (2020) ‘Natural products as sources of new drugs over the nearly four decades from 1981 to 2019’, Journal of Natural Products, 83(3), pp. 770–803.

Siliciano, R.F. & Greene, W.C. (2011) ‘HIV latency’, Cold Spring Harbor Perspectives in Medicine, 1(1), a007096.

UNAIDS (2024) Global AIDS Update 2024. Geneva: UNAIDS.

WHO (2013) WHO Traditional Medicine Strategy 2014–2023. Geneva: World Health Organization.