Envisaging challenges for the emerging medicinal Cannabis sector in Lesotho | Journal of Cannabis Research

Cannabis

The most common Cannabis species grown around the world, including in Africa, and of course in Lesotho is Cannabis sativa, which can be traced to Asia (Government of Canada 2023). Cannabis sativa contains a complex mix of approximately 60 unique cannabinoids along with various chemical compounds (Western Cape Tourism, Trade and Investment Promotion Agency (Wessgro), (2021). The main active ingredient responsible for the production of Cannabis is delta-9-tetrahydrocannabinol (THC) (Wessgro), (2021). The National Institute on Drug Abuse (NIDA) (2019) also reported that the most commonly used parts of Cannabis sativa are dried leaves, flowers, stems and seeds and contain the mind-altering chemical THC and other similar compounds.

Medical Cannabis product

The name Medical Cannabis relates to the therapeutic activity of herbal Cannabis and its constituents (Whiting et al. 2015). For Wessgro (2021), medicinal Cannabis is a legal, high-quality and standardised product made from crude Cannabis. Having started in China, Asia, then the Middle East, and Africa, the use of Cannabis for medicinal purposes spread to the rest of the world (Lafaye et al. 2017). As Bridgeman and Abazia (2017) pointed out, the Cannabis plant contains more than 100 different chemicals, known as cannabinoids, while Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the main relevant chemicals used in medicine. The authors further argued that THC makes an individual euphoric when smoking Cannabis or eating foodstuffs with cannabis contents. For the purpose of this research, medicinal Cannabis refers to plant-derived Cannabis products prescribed by medical practitioners for treating specific conditions as in epilepsy and pain (Bridgeman & Abazia 2017).

Cannabis can include high CBD and low THC products, although CBD products also appear as consumer goods. Medical Cannabis products are currently prepared as plant materials, oils, tinctures, edibles or capsules (Prohibition Partners, 2019). Medicinal Cannabis is administered with the intention of alleviating pains caused by diseases and illnesses, such as, Multiple Sclerosis (MS), depression, anxiety, Human Immunodeficiency Virus (HIV), nausea and vomiting, associated with chemotherapy, Posttraumatic Stress Disorder (PTSD), epilepsy or opioid addiction (National Academies of Sciences, Engineering, and Medicine (NASEM), 2017). However, medicinal Cannabis-related matters could be complicated in that, Cannabis is still an illegal drug and is legally constrained at the national and international levels in many countries (Mpela 2021). With some significant improvements in terms of legal imperatives by the industry, many challenges seem to lie ahead. Also noticeable worldwide is the increasing number of the Cannabis companies, making the industry highly competitive, something which has posed challenges for this particular industry. Doing business, coupled with observing the pertinent legal frameworks, using, distributing and growing Cannabis in such a legally multifaceted landscape, the Cannabis companies have encountered some difficulties (Matthew 2023).

The challenges facing the Cannabis sector

The complex legal landscape

The medicinal Cannabis industry has been inhibited by regulatory restrictions for a long time. However, the legal market has emerged rapidly as many governments have started to legalise the production and use of medical Cannabis. For instance, many jurisdictions, especially in Europe, North America and South America, have liberalised control measures on Cannabis by decriminalising some instances of production, sales, possession and use. Some African countries, including Lesotho, have not been any exception to such a worldwide surge. Included in this industry are various activities, involving different professionals with direct, ancillary or tangential roles in the legal production, extraction, transport, sale and consumption or use of medical Cannabis, recreational Cannabis and any other related by-products (Duvall 2019). Further involve in cannabis industry are medical personnel, legal professionals, policy makers, dispensary owners and employees, cultivators and farmers, transport and handling personnel, and individuals as well as company manufacturing products as in oils and seeds for health and beauty products (Pacula and Smart 2017). However, with the industry being widely known for enforcing laws, some of which being clouded by ambiguous and contradictory regulations, Cannabis companies would end up operating with limited success (Bodwitch et al., 2019; Gianotti et al., 2017).

Cannabis cultivation methods

Medicinal Cannabis may grow either outdoors or indoors, thus differing from species to species as well as distinctive forms of produce, depending on different geographical situations. Outdoor cultivation is the traditional and original method of Cannabis cultivation that has been used for so long, mainly in African countries. Growing Cannabis outdoors exposes a crop to the elements, offering natural light and significantly reducing costs for growers. Nonetheless, the challenge is that Cannabis is exposed to harsh environmental conditions that may hinder an outdoor crop. For instance, prolonged heavy rains, insects and aggressive plants, such as, thistles, animals and extreme weather conditions are all potential crop killers. Improper soil and water resource management and pest control may also induce critical environmental hazards (Zheng et al. 2021). As a result, outdoor Cannabis growing could limit the growers’ control over environmental crossover from neighbouring fields.

In addition, medicinal Cannabis is mostly grown in green houses, mostly in developed countries. Joost (2019) reported that the intention is to mimic the elements of the outdoors that facilitate plant growth while maintaining full control over environmental parameters. The positive side of growing Cannabis in greenhouses is that the grower can detect how much carbon dioxide is in the air; how much moisture the plant needs; and even how well the soil conducts electricity (Bahji and Stephenson 2019). However, high upfront costs, including the building structures, equipment, water, electricity and other utilities, are the major downside of growing Cannabis indoors. Vaughan et al. (2021) argue that the light used indoors often reaches beyond greenhouses, causing some dissatisfaction on the part of the local communities and potentially disturbing ecosystem processes (Rich et al., 2020). Nonetheless, in 2019 and 2020, it was reported that growth in indoor Cannabis cultivation appeared to have overtaken growth in outdoor cultivation at the global level, with the overall net number of countries recording improved indoor cultivation being three times the net number of countries reporting a moribund outdoor cultivation (UNODC, 2022).

Competition

The common place increasing competition from Cannabis companies entering into the space is justifiably a major concern. The more countries legalise the medicinal Cannabis, the more companies enter into the Cannabis industry. For instance, on the African continent, Lesotho, Uganda, Malawi, Rwanda, Eswatini, Zimbabwe, Morocco and South Africa have already legalised the medicinal Cannabis. Such a series of legal frameworks in the Cannabis industry by the African countries may lead to a stiff competition among the Cannabis companies and across the African countries. A high competition may also threaten and push SMMEs Cannabis out of the emerging legal Cannabis industry (David et al. 2020).

Start-up costs

The Cannabis industry start-ups differ from traditional businesses with regard to the initial upfront costs. These are the expenses that Cannabis companies incur in the process of starting a new business venture. In many African countries, the expenses incurred include acquiring a licence fee for Cannabis production. The case in point is Lesotho where a licence fee for Cannabis production is approximately $350 000. In South Africa and Malawi, the production licence fee is approximately $1,465 and $10,000 respectively. In addition to the licence fee, setting up a medicinal Cannabis facility in South Africa, which cannot be afforded by many SMME Cannabis growers is estimated at $182,000 to $304 000. Adinoff and Reiman (2019) also argue that in the United States, economically disadvantaged individuals cannot participate in the legalised Cannabis market due to its high costs. In this view of this state of affairs, some researchers observe the participation of SMMEs Cannabis in the industry as crucial with potentially positive impact on the economy and citizens’ livelihoods in any given countries. This view is supported by Rusenga et al. (2022), who argue that legalising Cannabis production for medical purposes is extremely good. However, guaranteeing the involvement of ordinary citizens, SMMEs and local producers in the industry has to date proved challenging for many African countries.

The research capacity

In order to successfully inform health care decisions for a public policy, the research capacity of the Cannabis industry should be strengthened. Such policy-making decisions would require input from many stakeholders. These include clinical and public health Cannabis researchers; research methodologists; representatives from working groups who have developed research reporting guidelines; organisations engaged in standard development; representatives from scientific publications; and government agencies, with direct or indirect involvement in the research process (NASEM, 2017). In particular, institutions of higher learning should also come on board in advancing Cannabis research and offering courses geared towards the Cannabis industry.

Igiri et al. (2021) indicated that institutions of higher learning should offer courses, whose foci range from the business side of operations to growing and cultivating plants. Such courses could equip students with Cannabis consultancy, growing, technical extraction and dispensary operator skills. Establishing industry-focused universities for Cannabis research should be prioritised for the benefit of the country concerned. Besides, higher-learning institutions, particularly in Southern Africa, should be given funding for research, something has to date been a major barrier. Therefore, without adequate financial support, Cannabis research would hardly inform the health care and public health practice; nor would any initiatives for keeping pace with changes in Cannabis policy and patterns of Cannabis use make any headway. Supporting this view, Egbetokun et al. (2022) attribute low research output to poor funding and non-conducive and weak organisational climate in Africa. Some universities on the continent have few postgraduate programmes that further adversely affect their research output. Apart from lack of financial support for research and appropriate infrastructure, including laboratory facilities and equipment, the internet bandwidth required for collaboration with the global scholarly community, hence accessing more knowledge resources has been wanting (Igiri et al. 2021).