Beyond Borders: Acupuncture in Humanitarian work Moxafrica

Moxafrica is a British charity set up in 2008 to investigate the use of moxibustion therapy for the treatment of tuberculosis (TB), particularly drug-resistant TB, in resource poor environments. Moxafrica was founded by acupuncturists Merlin Young and Jenny Craig.

A Study of the Efficacy of Adjunctive Moxibustion in the Treatment of Tuberculosis

Moxafrica is carrying out research in Uganda to establish whether moxibustion can help combat TB. Moxafrica is now funding and collaborating in a Phase II Randomized Control Trial (RCT) in Uganda with Makerere University's School of Health Sciences. It is potentially one of the most exciting ventures of research in medicine today - of potential benefit to literally millions of people who are at desperate risk of drug-resistant disease.

What is Direct Moxibustion?

Direct Moxibustion consists of smoldering a rice grain sized cone of moxa (the refined herb Artemesia Princeps or commonly know as mugwort) on the skin. This treatment protocol has been used in conjunction with acupuncture, and as a stand-alone treatment, in East Asian Medicine for centuries.

Therapeutically it is known to have positive effects on blood circulation and to enhance the immune system. Direct moxibustion has a history that also includes claims of treating and curing patients with Tuberculosis (TB).

Why TB?

Tuberculosis is still a devastating disease even into the 20th Century.

•        In 1993 the WHO (World Health Organization) declared TB a Global Emergency.

•        Roughly one third of the world's population, one in three of you and me, is     infected with TB. 

•        1.3 million people died of TB in 2012

•        TB is the leading killer of people living with HIV

•        An estimated 450,000 people developed Multi-Drug Resistant (MDR)-TB in 2012

•        KPMG economist Yael Selfin estimates that there could be 76 million cumulative deaths of MDRTB by 2050

    And yet

•        TB, in the West, is often seen as a disease of the past. 

•        WHO reports an annual funding gap of US$ 1.6 billion. 

•        WHO reports only 20% of TB patients estimated to have Drug Resistant are detected and treated. 

Unfortunately, it’s much worse than that 

The WHO numbers are strongly contested 

Carole Mitnik, Professor of Global Health at Harvard Medical School, estimates only 10% of DRTB cases are treated. 

Paul Farmer and Salmaan Keshavjee of the prominent international organization Partners in Health (PIH) are less optimistic and say its only 1%.

Does moxibustion work against Drug Resistant-TB?

For Moxafrica this is the most important question of all. Theoretically, a positive immune response should help a patient recover from any type of TB. Since it was being used in Japan before TB drugs were developed, then there is good reason to speculate that it might help in cases of drug-resistance where drugs are failing. It also might help in survival rates in patients with other drug-resistant diseases.  The research Moxafrica has carried out is now in the hands of scientists - and they eagerly await their final judgment.

Are there any side effects from Moxibustion?

The Moxafrica organization can categorically state that in the course of three pilot studies and one randomized control trial they have not had one case of serious adverse reactions reported. However, there is a definite risk of infection if the treatment is used over enthusiastically, especially with patients whose immune systems are compromised. They are also very careful that patients are properly instructed to stop the treatment if there were to be any signs of infection at all and report this to their health worker. The only complaint they have had from patients is that their increase in appetite is sometimes more than can be easily supported by them. This is clearly unfortunate for them but, since TB is a wasting disease, it has to also be seen as a very encouraging sign of a strong recovery response.

Patient Feedback

Patients infected with TB, who are part of the research study in Uganda, regularly reported the following: improved appetite, weight gain, reduced joint pains, reduced peripheral neuropathy, and a general increase in strength and energy. Of special note, patients co-infected with HIV reported similar positive outcomes as the TB only group.

The health workers trained by Moxafrica in the practice of moxibustion were also convinced that patients supplementing their TB drugs with Moxa were recovering faster and with fewer side effects. 

Global Game Changer

This important work can be a global game changer when it comes to the treatment of TB. It is really impossible to grasp the potential of this project without understanding the existing complexities of treating this disease in Africa alongside HIV/AIDS, particularly as the rate of drug resistant disease rises. This is certainly an African health problem, but TB exists in many other parts of the world as well. It is clearly one of the most pressing humanitarian problems of our age.

Videos on the work of Moxafrica:

For more information on Moxafrica, TB, and their ongoing research or to support the continuation of this important work please go to: