Doctors and traditional health practitioners often treat the same patient without knowing what the other has prescribed. South Africa has recognised both healthcare systems in law, but it has not built the information infrastructure needed to help them work together safely.Every day across South Africa, doctors and traditional health practitioners treat some of the same patients without knowing what the other has already prescribed. South Africa has not built the information systems needed to share that information safely.Consider a common scenario. A patient consults a traditional health practitioner for a chronic condition before later presenting at a hospital with the same illness or a related complication. The doctor has no record of which traditional medicines the patient has already used. The traditional health practitioner may not know that the same patient has recently started antiretroviral therapy, chemotherapy or anticoagulants. Communication between the two systems depends largely on what the patient remembers and chooses to disclose.Patients should not be responsible for co-ordinating communication between two healthcare systems. Yet this is precisely the position many South Africans find themselves in every day.South Africa recognised traditional health practitioners in law nearly two decades ago. The Traditional Health Practitioners Act 22 of 2007 established a framework for regulating the profession, while the Protection, Promotion, Development and Management of Indigenous Knowledge Act 6 of 2019 recognised indigenous knowledge as a national asset and created mechanisms for its protection and management. The legislative framework exists. The information infrastructure needed to support it does not.In May 2026, parliament’s portfolio committee on health expressed concern about the operational challenges facing the Interim Traditional Health Practitioners Council of South Africa. The committee noted that the council is expected to regulate an estimated 300,000 practitioners while operating with a budget of about R6.7m in 2024, with less than R10m projected for subsequent years. Members also highlighted delays in operationalising the practitioner registration system envisaged by the act. These are implementation failures rather than legislative ones and they have direct consequences for patient safety.A common criticism is that traditional medicine lacks sufficient scientific evidence to justify closer collaboration with biomedical healthcare. Herb-drug interactions cannot be studied if clinicians do not know which traditional medicines their patients are using. Safety concerns cannot be identified consistently if adverse events are not reported. If the evidence base remains limited, it often reflects comparatively limited investment in documenting indigenous medicinal knowledge, investigating safety and studying interactions with conventional medicines.South Africa has invested considerably in documenting biodiversity. Herbaria preserve botanical specimens. Conservation programmes monitor threatened medicinal species. Universities continue to expand scientific knowledge of indigenous flora. What South Africa has not developed is an equivalent national reference documenting how medicinal plants are used in healthcare. A herbarium specimen identifies a species. It does not record indigenous names, preparation methods, documented contraindications, regional variation or the state of pharmacological evidence.A practical response would be the development of a national indigenous materia medica. Its initial scope should focus on medicinal species in common use, documented preparation methods, recognised contraindications, available pharmacological evidence and documented herb-drug interactions. If evidence remains uncertain, the register should identify those gaps clearly rather than presenting unsupported conclusions.Every doctor works from recognised clinical references. Every pharmacist relies on standard formularies. Traditional healthcare has no equivalent national reference designed to support safer clinical decision-making. Such a resource could help doctors respond appropriately when patients disclose traditional medicine use, help traditional health practitioners recognise safety concerns associated with conventional medicines, provide researchers with a stronger foundation for future investigation and strengthen pharmacovigilance through more consistent reporting.The register should not attempt to document every aspect of indigenous knowledge. Sacred, ceremonial and lineage-specific knowledge should remain outside its scope unless communities freely choose to share it. Prior informed consent, community participation and equitable benefit-sharing should underpin its governance. Its purpose is not to certify every traditional remedy as clinically effective but to reduce the information gap when traditional health practitioners and biomedical professionals are involved in the care of the same patient.South Africa has already recognised traditional healthcare in legislation and established a statutory regulator. Recognition is no longer the question. Implementation is. Building the information systems, administrative capacity and sustained investment needed to support that legislation would improve patient safety, strengthen research and help preserve indigenous medicinal knowledge. Until then, patients will continue to carry information between two healthcare systems that should already be communicating directly.• Katleho Nkamoheleng Mosese is a South African traditional health practitioner, indigenous knowledge researcher and founder of The Kitchen Alchemist.