CONNOR DAVIS: Cannabis in South Africa - Bridging the gap between perception and reality

Since the South African Constitutional Court’s landmark ruling in 2018 that decriminalised the use of cannabis, the country’s cannabis industry has grown significantly.

In 2024 alone, cannabis revenue is expected to be around R5.5 billion. Despite this, the growth rate in South Africa is still slower when compared to other global markets such as North America and Europe.

One major reason for this may be the stigma that remains around the perception of cannabis as being a counterproductive or even dangerous habit.

While a growing distrust of big pharmaceutical corporations has seen a strong move by consumers towards more alternative healing modalities such as nootropics, functional mushrooms and other plant medicines, this negative perception around cannabis remains – particularly among older generations, who perhaps have the most to gain from medical cannabis.

“Because cannabis was criminalised in the past, many potential patients may be reluctant to use it to treat medical conditions,” said Anton Ofield-Kerr, co-founder of AKOS BIO, an online pharmacy that is pioneering the dispensing of high-grade medical cannabis in South Africa.

“This mistrust is mainly due to a lack of consumer awareness about the efficacy of medical cannabis in treating a range of medical conditions. “

Ofield-Kerr is no stranger to advocacy in the health space, having previously worked to set up and expand some of South Africa’s first HIV clinics and advocating for access to antiretrovirals and other life-changing medicines across Africa.

A general lack of knowledge about the sometimes life-changing benefits of cannabis therapy means potential patients don’t know what type or formulation of cannabis will best help them. As a result, their experience can be a negative one and they may not want to try it again.

In a medical context, patients in South Africa are legally able to access cannabis therapies if they have a valid prescription from a doctor, under a section 21 application granted by the South African Health Products Regulatory Authority (SAHPRA); which is a licence to prescribe an unregistered compound.

However, since the Constitutional Court ruling, there has been no robust regulatory framework in place for the manufacture of medical cannabis.

The regulatory framework for manufacturing is very robust. It’s the lack of access to SA manufactured products which are all exported that AKOS BIO pharmacy has worked to address.

While cannabis is being used intentionally to treat medical conditions – such as the relief of chronic pain, muscle spasms, manage the side effects of chemotherapy, social anxiety or sleep disorders – the lack of education and access to regulated medical cannabis products mean consumers don’t know enough about the cannabis they are accessing which is unregulated.

The inspiration driving AKOS BIO was to provide access to safe, quality assured and locally sourced medical cannabis therapies. Up until now, almost all high-quality medical cannabis products produced in South Africa were exported into the medical sector in the UK, Europe, Australia and North America.

AKOS BIO is one of the first businesses in South Africa to fully comply with South Africa's stringent regulatory framework, which means that South Africans are now able to access locally sourced, fully regulated, high-quality GMP-certified medical cannabis.

Another factor in the relatively slow growth of the cannabis industry in South Africa may be that local doctors – the usual trusted source of health information – aren’t generally trained in the responsible prescribing of medical cannabis, and so aren’t able to use the significant benefits they offer.

There is also a lack of formal research into the benefits of cannabis. Following the United States’ “War on Drugs” in the 1960s, the United Nations Office on Drugs and Crime established a treaty in 1961 that criminalised drugs such as medical cannabis, LSD and psilocybin. As a result, medical research on those compounds was halted and has only recently been restarted.

While the tide is now turning in terms of research being done, many doctors still consider cannabis to be a fringe topic and are hesitant to prescribe it.

The irony, says Ofield-Kerr, is that it has far fewer side effects and is cleaner, safer and healthier than many drugs routinely prescribed such as opioids, antispasmodics and antidepressants.

For pharmacies like AKOS BIO, the challenge is to provide new treatment options for chronic and acute conditions, which involves overcoming the perception of medical cannabis as being not just illegal but not a legitimate medical treatment.

This requires concerted efforts across industries, from healthcare providers advocating for evidence-based treatments to businesses prioritising transparency and quality in their offerings.

If done successfully over the coming years, South Africa’s cannabis industry has the potential to grow at an exponential rate.

This will not just boost the overall economy, but also promote more widespread adoption of natural healing substances that can help and heal, especially when the benefits can be life-changing for many patients.