This article examines Indigenous Peoples' Rights and Customary Land in East African Legal Frameworks: Decolonial Reflections with a focused emphasis on Malawi within the field of Medicine. It is structured as a original research article that organises the problem, the strongest verified scholarship, and the main analytical implications in a concise publication-ready format. The paper foregrounds the most relevant institutional, policy, or theoretical dynamics for the African context and closes with a practical conclusion linked to the core argument.