Indigenous knowledge systems and pandemic health resilience.

Introduction: Indigenous Knowledge Systems (IKS) have played important roles in community-based health responses across the Global South, yet they remain marginalized in formal health policy during global health crises. This study examined how IKS were mobilized to support respiratory and immune health during the COVID-19 pandemic across BRICS (Brazil, Russia, India, China, South Africa) and Southern African Development Community (SADC) countries. Methods: A qualitative exploratory research design was employed across Zimbabwe, South Africa, and China involving 38 participants. Data were collected through semi-structured interviews (n = 22), digital questionnaires (n = 10), and WhatsApp voice narratives (n = 6). Purposive and criterion-based sampling ensured representation across age, gender, geography, and familiarity with IKS. Data were analysed using Braun and Clarke's six-phase thematic analysis with inter-rater reliability verification (Cohen's κ = 0.82). Member checking was conducted through community advisory boards, and ethical approval was obtained from institutional review boards in each participating country. Results: Participants reported using 27 distinct herbal remedies, primarily derived from locally available plants, including Discussion: The findings suggest that IKS can complement biomedical approaches in strengthening health system resilience during public health emergencies. Integrating IKS into pandemic preparedness and response requires policies that recognize epistemological diversity, protect intellectual property, promote equitable benefit-sharing, and strengthen community knowledge sovereignty within planetary health frameworks.