Traditional Healers, Constitutional Rights and Cannabis: Where Culture Meets Regulation in South Africa

Key links & references

•  Traditional Health Practitioners Act 22 of 2007: https://www.gov.za/documents/traditional-health-practitioners-act

•  SAHPRA position on “traditional healers’ cannabis licences”: reported across industry and legal commentary (Cannabis Law Report / Cannabiz Africa summaries of official warnings)

•  Cannabis for Private Purposes Act and draft regulations context

•  Interim Traditional Health Practitioners Council registration and regulation process

•  Constitutional rights framework (dignity, culture, freedom of trade/occupation, privacy – Prince judgment lineage)

South Africa’s Constitution recognises the country’s cultural and linguistic diversity and protects the right to participate in the cultural life of one’s choice. Traditional health practice — the work of izangoma, izinyanga, herbalists, traditional birth attendants and related practitioners — is one of the most widely used health systems in the country. Estimates consistently place the proportion of South Africans who consult traditional healers, often as a first port of call, in the majority, especially in rural and peri-urban communities.

At the same time, cannabis occupies a complicated place in both traditional practice and modern regulation. The plant has long formed part of indigenous pharmacopeias and cultural life in parts of the country. Colonial and apartheid-era drug laws criminalised it. The 2018 Constitutional Court judgment in the Prince matter decriminalised private adult use and cultivation. The Cannabis for Private Purposes Act and its still-emerging regulations attempt to give that judgment statutory shape. Medical cannabis is tightly controlled through SAHPRA. Commercial adult-use supply remains largely closed.

Into this contested space has stepped a persistent claim: that registration or recognition under the Traditional Health Practitioners Act somehow authorises the sale or dispensing of cannabis. Regulators have repeatedly rejected that claim. This article examines the constitutional and statutory position of traditional healers, the limits of the Traditional Health Practitioners Act in relation to cannabis, the current regulatory reality, and the deeper questions of cultural recognition, economic inclusion and patient safety that the overlap raises.

Constitutional Starting Points

Several constitutional rights are relevant.

Section 15 protects freedom of religion, belief and opinion. Section 30 and 31 protect cultural rights and the rights of cultural, religious and linguistic communities. Section 22 protects the right to choose a trade, occupation or profession freely. Section 27 protects the right of access to health-care services. Section 14 protects privacy — the right that grounded the Prince judgment’s protection of private adult cannabis use and cultivation.

These rights do not operate in isolation. They are limited by section 36 and must be read alongside the state’s obligations to regulate medicines, protect the public from harmful practices, and combat dependence-producing substances where the law still requires it. Traditional health practice is therefore constitutionally recognised as a legitimate sphere of cultural and occupational life, but it is not a constitutional free-pass from medicines or drugs legislation.

The Traditional Health Practitioners Act

The Traditional Health Practitioners Act 22 of 2007 was enacted to bring traditional health practice into a statutory regulatory framework. It establishes the Interim Traditional Health Practitioners Council, provides for registration of practitioners and students, and aims to promote safety, quality and ethical conduct. Categories contemplated include divination, herbalism, traditional birth attendance and certain traditional surgical practices.

Implementation has been slow. Key provisions came into force in stages; full operationalisation of registration, training standards and professional discipline has lagged. Draft regulations published in recent years seek to give practical effect to registration requirements, training benchmarks and the conditions under which registered practitioners may issue medical certificates recognised under labour law. Until a practitioner is properly registered with the Council, many of the Act’s protective and enabling consequences remain incomplete.

Crucially, the Act’s definition of “traditional medicine” is limited. It covers objects or substances used in traditional health practice for diagnosis, treatment, prevention or the maintenance of health and well-being, but it explicitly excludes dependence-producing or dangerous substances or drugs. This definitional boundary is the core of the regulatory conflict over cannabis.

SAHPRA’s Clear Line

The South African Health Products Regulatory Authority has stated, repeatedly and publicly, that there is no such thing as a “traditional healer’s cannabis licence” that authorises the commercial sale of cannabis or cannabis products to the public. SAHPRA and SAPS have warned that businesses purporting to operate lawfully under the Traditional Health Practitioners Act while selling cannabis are operating illegally.

The reasoning is straightforward. Cannabis that is not exempted under the Medicines and Related Substances Act remains subject to that Act’s controls. The Traditional Health Practitioners Act does not create an alternative pathway for the sale of scheduled or dependence-producing substances. Franchise models or storefronts that claim traditional-healer authorisation as their legal basis have been treated as unlawful. Earlier waves of “dispensary” and franchise activity that relied on this theory attracted enforcement attention and public regulatory warnings.

Registered traditional health practitioners may, within the scope of their practice and subject to other laws, use or recommend substances that properly fall within the definition of traditional medicine. They may not, on the strength of the THPA alone, run commercial cannabis retail operations.

Private Use, Medical Channels and the Missing Middle

The current legal architecture creates three distinct lanes:

1.  Private adult use and cultivation — constitutionally protected and in the process of being given clearer quantitative expression through the Cannabis for Private Purposes Act and its draft regulations.

2.  Medical/scientific cannabis — available only through SAHPRA-authorised channels (section 22C licences for cultivation/manufacture/export, and limited patient-access mechanisms).

3.  Everything else — including most domestic commercial supply — remains outside a clear licensing system and is treated as unlawful dealing.

Traditional healers sit uncomfortably across these lanes. As private individuals they may, like any other adult, possess and cultivate within the private-use bounds. As healers they may work with traditional medicines that do not cross into controlled-substance territory. What they cannot do under current law is convert cultural recognition into a commercial cannabis retail licence.

This produces a practical and ethical tension. Many patients already move between biomedical and traditional systems. Some seek cannabis-based relief through informal or semi-formal channels precisely because formal medical access is limited, expensive or administratively heavy. Healers who wish to incorporate the plant in a culturally coherent way have no clear, lawful commercial or professional pathway to do so. The result is either avoidance, informal practice that carries legal risk, or the misuse of THPA language that regulators have already rejected.

Cultural Recognition versus Regulatory Capture

The deeper policy question is whether South Africa’s emerging cannabis framework will make space for indigenous knowledge systems and traditional practitioners, or whether formalisation will remain confined to high-capital, SAHPRA-style pharmaceutical models and a narrow private-use sphere.

Government policy documents on hemp and cannabis commercialisation periodically acknowledge the importance of indigenous knowledge and legacy growers. The Traditional Health Practitioners Act itself is an attempt to give statutory form to a major indigenous health system. Yet the operational interface between that Act and cannabis regulation remains largely negative: the THPA is cited to explain what it does not authorise, rather than to create a positive, culturally grounded pathway.

A rights-consistent approach would require more than prohibition-by-default. It would require clear rules that allow registered traditional health practitioners, under appropriate safeguards, to work with cannabis in ways that respect both cultural practice and public-health standards — or an honest acknowledgment that no such pathway currently exists and that the cultural claim is being subordinated to pharmaceutical and private-use categories.

Patient Safety and Public Trust

Regulation is not only about exclusion. Bogus healers, exploitative initiation practices and unsafe preparations are real problems that the CRL Rights Commission and traditional-healer organisations themselves have highlighted. Proper registration, training standards and ethical oversight serve legitimate protective purposes. The same logic applies to cannabis: quality, dosage, contamination and honest claims matter.

The challenge is to design safeguards that do not simply reproduce the exclusion of the very knowledge systems the Constitution and the THPA were meant to recognise. Safety regulation that only large, capitalised operators can meet will leave traditional practitioners and their patients in the informal economy — the opposite of both cultural recognition and effective public-health governance.

The Road Ahead

Several processes are relevant:

•  Full operationalisation of the Traditional Health Practitioners Council and its registration system.

•  Finalisation of private-use regulations under the Cannabis for Private Purposes Act.

•  Development of the broader cannabis commercialisation policy and the promised overarching Cannabis Bill.

•  Ongoing SAHPRA control of medical cannabis and any future decisions about complementary or traditional-medicine pathways that might touch cannabinoids.

•  Policy work on indigenous knowledge systems and benefit-sharing.

Until these processes produce a coherent interface, traditional healers will remain in a position of partial recognition: culturally acknowledged, partially regulated as a profession, and largely shut out of the formal cannabis economy. Patients who trust traditional practitioners will continue to navigate a fragmented system. And claims that the THPA authorises cannabis dealing will continue to be met with regulatory rejection and enforcement risk.

Conclusion

Traditional health practice is a constitutional and social fact in South Africa. Cannabis is both a cultural plant and a tightly regulated substance. The current legal framework recognises the former in principle while largely excluding it from the commercial and professional pathways that would allow healers to work with the latter in a lawful, transparent way.

Closing that gap is not a matter of simply “allowing healers to sell dagga.” It is a matter of designing regulation that takes indigenous knowledge, patient safety, constitutional rights and economic inclusion seriously at the same time. Until that design work is done, the tension between cultural recognition and cannabis control will persist — and the people who move between the two systems will continue to carry the practical and legal consequences.