East London-based Dr Shiksha Gallow is well-known in South Africa for her medical cannabis research and is now finding that her expertise has international appeal. 

She presented at the Society Of Cannabis Clinicians (SCC) Conferencein Baltimore USA in October 2024, then opened up a Holistic Healing branch in Costa  Rica, visited Thailand and the Phillipines during December 2024 as a keynote speaker to share her South African research and experience. In the Phillipinnes she supported a workshop calling for the legalization of medical cannabis and urged the Manila government to recognize the therapeutic benefits medical cannabis could bring to its population of 117 million.

In January this year she joined forces with GET Pharmaceuticals, a Gauteng based GMP extraction and pharmaceutical cannabis processing facility which has geared itself up to be a major cannabis processor and exporter. 

As their new Medical Director she is off to Australia where she will present two sessions at the UIC 2025 Australian Medical Cannabis Symposium in Brisbane on 21 to 23 February 2025.

• The role of cannabis in prostate cancer treatment, and

• The medical cannabis landscape in South Africa.

Her new role as GET’s Medical Director will be to provide clinical and scientific leadership by guiding formulation development with clinical insight and leverage her expertise and international network to look for global partnerships.

Meanwhile the results of Dr Gallow’s study, which concluded on 30 August 2024, are under review by the South African Medical Journal.  It took Dr Gallow two years of hard work to secure the necessary ethical approval from SAHPRA and SAMRC before the trials began in 2022. The primary objective was to ‘investigate the potential of medical cannabis as a replacement for opioids in pain management within the South African population’.

Cannabiz Africa publisher Brett Hilton-Barber spoke to Dr Gallow about the groundbreaking study, her growing international profile and her views on the controversial Section 21 medical cannabis patient being the only way to legalize cannabis in South Africa.

BHB: As I understand, the study monitored the condition of people who were taking opioids for chronic pain to see whether there was any improvement if their medication was switched to cannabis?

SG: Yes, a total of 447 patients were recruited, with 302 meeting the criteria for inclusion in the study. The trial was sponsored by the Cannabis Research Institute, the Cannabis Research Council and Releaf Pharmaceuticals. Patients received both cannabis flower and oil at no cost for a period of one year”

BHB: I know you are waiting for the review of your results to come out, but internationally, the general literature suggests that cannabis has been effective in replacing opioids in pain management. Were there any surprises for you emerging in the results?

SG: By month six, 93% of patients had successfully transitioned off opioids, which is an incredible result. Additionally, many patients reported an improved quality of life, particularly in sleep patterns.

One surprising finding for the investigators was a temporary rise in anxiety during the first two months of cannabis use. However, from month three onward, anxiety levels dropped significantly. Upon reviewing patient notes, we identified that this initial spike was due to opioid withdrawal effects.

Patients with multiple sclerosis showed remarkable improvements in mobility, reduced blurred vision, and significant pain relief. Cancer patients experienced increased appetite and reduced anxiety. Notably, two patients with traumatic brain injuries reported dreaming for the first time since starting cannabis treatment.

BHB: Where does your research take you next?

SG: We will be conducting Phase 2 and 3 of the trials in Costa Rica. We will be working with a top medical school in Costa Rica where we have been conducting clinical trials for cancer.  We will be testing the safety and efficacy of the drug formula as well as monitoring how the drug is metabolised.  The Phase 3 will be conducted at multiple centres in Costa Rica with several patients, these will be  randomised and blinded.

BHB: You have been invited as a guest speaker to many countries to share your expertise. What about training?.

I am also training doctors globally on medical cannabis and in South Africa. My training is accredited  by the HPCSA by UCT  for 25 CPD points for all medical doctors. I trained 40  doctors in the Philippines an many in other countries. Last year I was appointed by the Tshwane University of Technology as the clinical research associate for medical cannabis. An additional appointment was by the University of Pretoria as the Principal Investigator for any cancer and cannabis clinical research

BHB: You have had wide exposure to a broad number of medical cannabis regimes across the world. How does South Africa rate in your opinion in the way medical cannabis is being approached.

SG:  South Africa has a relatively strong base of expertise when it comes to cannabis, with knowledgeable professionals in cultivation, medicinal applications, and policy. However, the lack of clear regulations and enforcement has led to a proliferation of illicit cannabis shops, which poses significant challenges. These unregulated outlets operate without quality control, potentially exposing consumers to unsafe products while undermining legitimate businesses and tax revenue. Additionally, the absence of a well-defined legal framework creates uncertainty for investors and slows the growth of a formal cannabis industry. Addressing these regulatory gaps is essential for ensuring product safety, economic benefits and the responsible development of the cannabis sector in South Africa.

BHB: Section 21 of the Medicines Act is the only legal way to buy cannabis in South Africa, and SAHPRA is concerned that ‘medical’ prescriptions are really being used for ‘rec’. What do you think of Section 21, and is it actually helping the cause of medical cannabis?:

SG: Honestly, I believe Section 21 is being misused, with only a few patients truly benefiting from it. The process, which is intended to provide access to unregistered medicines for patients in need, often seems to be exploited, either by bureaucratic inefficiencies or commercial interests. In my experience, very few patients receive tangible benefits, while many others who could genuinely benefit are left without proper access”

BHB: So what needs to happen?

SG: There needs to be greater oversight, transparency, and a patient-centred approach to ensure that Section 21 serves its intended purpose – providing critical treatment to those who need it most.

BHB: Everyone has some kind of ‘moment’ of profundity or craziness on their cannabis journey. What was yours?

SG: For me, the most profound experience was witnessing some patients with Stage 4 cancer achieve remission just three months after starting our protocol. I had never seen anything like it before – it as truly remarkable! 

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