NOMFUNDO MTHEMBU | Whose science counts?

Each year on April 7, the world observes World Health Day — a moment to reflect on the fundamental right to health and the systems that make it possible. This year’s theme, “Together for Health: Stand with Science”, invites a critical question: whose science are we standing with?

In South Africa, a nation shaped by inequality, resilience and transformation, this question cannot be separated from the constitutional promise of dignity, equality and freedom.

The country’s constitution enshrines the right of access to health care and places a duty on the state to “respect, protect, promote and fulfil” the rights in the Bill of Rights. It also protects academic freedom and freedom of scientific research, recognising that “everyone has the right to freedom of expression … which includes academic freedom and freedom of scientific research”.

Health extends far beyond hospitals and clinics; it is shaped by social conditions, environmental wellbeing, cultural practices and access to knowledge. To realise the right to health fully, we must recognise that access to — and participation in — science are themselves human rights, inseparable from the broader right to health. This means everyone, whether in rural villages or urban areas and regardless of income, should not only benefit from scientific advances and health technologies but also have the opportunity to contribute to their development.

At an international level, the Universal Declaration of Human Rights (UDHR) affirms that “everyone has the right to enjoy the benefits of scientific progress and its applications”. Similarly, the International Covenant on Economic, Social and Cultural Rights (ICESCR) commits states to ensuring that all people can enjoy these benefits. The African Charter on Human and Peoples’ Rights likewise recognises the right to the best attainable standard of health, emphasising that access to knowledge and medical care is a shared responsibility of society and the state.

Historically, science in South Africa has been framed through a narrow, colonial lens that systematically marginalised African systems of knowledge, particularly in health, often dismissing them as informal or unscientific. This exclusion continues to affect cultural recognition, as well as the inclusivity and effectiveness of health and science interventions. To genuinely “stand with science”, we must ask: whose science counts?

Historically, science in South Africa has been framed through a narrow, colonial lens that systematically marginalised African systems of knowledge, particularly in health, often dismissing them as informal or unscientific. This exclusion continues to affect cultural recognition, as well as the inclusivity and effectiveness of health and science interventions. To genuinely “stand with science”, we must ask: whose science counts?

Africanisation offers a necessary corrective. It does not reject global scientific methods but calls for a more inclusive, context-sensitive approach that values diverse ways of knowing. African indigenous knowledge systems, developed over generations through observation, experience and adaptation, hold important insights into health, medicine, agriculture and environmental health. From plant-based remedies to holistic approaches, these systems have long sustained communities. Recognising indigenous knowledge as part of science is not a departure from science; it is an expansion of it.

In many rural and underserved communities, traditional healers remain the first point of care. Ignoring this reality can undermine public health efforts and alienate the very communities policies aim to serve. Health laws and policies should therefore create space for meaningful integration — ensuring that indigenous practices are respected, appropriately regulated and supported through research and collaboration.

Such integration requires care. Processes of scientific validation should engage indigenous knowledge holders as partners, not subjects. This is where ubuntu becomes essential. The African philosophy of ubuntu — “I am because we are” — reminds us that health, science and human progress are not individual achievements but collective responsibilities. Advancing health technologies, scientific knowledge and equitable access depends on recognising our interdependence: no person or community can thrive alone. Ubuntu calls us to build systems where all South Africans, rural and urban, rich and poor, can contribute to and benefit from scientific progress.

Positioning health and science as human rights also highlights equity. Access to health care, technologies and scientific advancements remains uneven, reflecting broader socioeconomic disparities. Africanisation is therefore not only about knowledge but also about redistribution, inclusion and empowerment. Marginalised communities must be active participants in shaping scientific progress, not merely its recipients. Ensuring broad participation is essential if the benefits of science and technology are to be shared fairly.

This approach can also strengthen the fight against misinformation in health and science. Distrust in formal science often stems from historical exclusion and exploitation. Valuing indigenous knowledge can help rebuild trust and create bridges between communities and formal health systems.

This World Health Day, “Together for Health: Stand with Science” should mean standing with all knowledge systems that advance human wellbeing. In South Africa, this requires confronting historical exclusions, embracing Africanisation, embedding indigenous knowledge within health and science, and living the principles of ubuntu in practice — acknowledging that our collective health depends on the dignity, participation and wellbeing of every person.

By recognising health and science as human rights, grounded in both global evidence and local knowledge, South Africa can lead by example — demonstrating that justice, inclusivity and innovation are mutually reinforcing. On this day, we should reaffirm that health is not only protected but truly shared, rooted in the wisdom, cultures and collective strength of all South Africans.

• Mthembu is a lecturer at the University of KwaZulu-Natal. She holds an LLB and LLM in medical law, and is pursuing a PhD in medical law at UKZN. Her research interests include medical law, indigenous knowledge systems, health competition law, emerging reproductive health technologies, constitutional law, and access to fertility treatments