Medicinal Plants
and Phytomedicines:
Challenges and Opportunities
Introduction
Information relating to medicinal plants and traditional
medicine can be found in documents and databases aimed at readers in a wide
range of disciplines including botany, ecology, chemistry, medicine, veterinary
science, etc. However there are few publications reporting current work or
reviewing and analysing recent advances. Access to relevant information by the
public, decision makers and local communities is still very limited.
The Convention
on Biological Diversity, an international treaty that has been signed by more
than 160 member states of the United Nations provides an international legal
framework for the conservation of biological diversity including access to and
exchange of genetic materials. While many different approaches are being tried
to minimize the loss of biodiversity, the reduction of habitat loss and its
accompanying loss of biocultural diversity are still unfortunately some way
off.
The need for
internationally agreed methodologies for giving effect to the equity provisions
of the Convention on Biological Diversity (CBD) is now widely recognized. The
issue of benefit sharing has received considerable attention during the last
decade. Many developing countries are behind the rest of the world in the
development of national policies with respect to access to genetic resources
and trade in medicinal plants. Appropriate strategies to increase awareness of
policy makers and donors about the need for sustainable use and conservation
medicinal plants and traditional medicine, can complement research efforts
aimed to achieve this objective.
Article 15 of
CBD recognizes that "States have sovereign rights over their own
biological resources". It also recognizes "the close and traditional
dependence of many indigenous and local communities embodying traditional
lifestyles on biological resources, and the desirability of sharing equitably
benefits arising from the use of traditional knowledge, innovations and
practices relevant to the conservation of biological diversity and the
sustainable use of its components".
Article 8(j) of
the Convention on Biological Diversity (CBD) calls on the Contracting Parties
to respect, preserve and maintain the knowledge, innovations and practices of
indigenous and local communities embodying traditional lifestyles. It also
calls for the equitable sharing of benefits arising form the utilization of
such knowledge, innovations and practices. The issue of integrating equity
principles in benefit sharing arrangements has been under the consideration of
the Contracting Parties (COP) since the 3rd meeting of COP held at Buenos Aires
in 1966.
Traditional
medicine, in the estimate of the World Health Organization is used by up to 80%
of the population of most developing countries. These plant-based medicines are
used for primary health care needs.
Between 25-50% of modern drugs are derived from plants. Demand for
medicinal plants is increasing in both developing and developed countries. At
the same time, the bulk of the material traded still derives from
wild-harvesting. Only a very small number of species are cultivated.
Herbal medicines
and traditional healers are receiving attention from mainstream health
officials and international medical research and training institutions as
governments confront the high cost and inefficiencies of official health
programmes .
There is growing
recognition of the need for increased efforts to produce medicines from plants
in the South. A number of international organizations now support projects and
programmes in this area. There is still a need for substantial support at the
national level and regionally to promote medicinal plants, traditional medicine
and ethnopharmacology, and to assure that biological resources are being
harvested at a sustainable level.
Indigenous
Knowledge, Bioprospecting and Benefit Sharing:
The absence of
an internationally agreed methodology for sharing economic benefits from the
commercial exploitation of biodiversity with the primary conservers and holders
of traditional knowledge and information is leading to a growing number of
accusations of biopiracy committed by business and industry in developing
countries. Biodiversity in both developing and developed countries has been
accessed for a long time, for various purposes, by outside researchers, private
companies as well as local communities, with little or no returns to
conservation activities.
Bioprospecting
has been practised for many years in different forms but in more recent times
in particular with the development of CBD, the issue of sharing of benefits
arising from bio-prospecting has attained significance.
However, certain
critical issues remain unresolved, particularly in relation to how to go about
legalizing and formalizing the bio-prospecting process in a way which ensures
that there is full and prior informed consent of fair and equitable benefit
sharing with the originator of the knowledge and resource that enable the
bio-prospecting.
On the other
hand, traditionally, bioprospecting in developing countries has been the
preserve of field researchers in universities and botanical gardens. Indeed,
until recently, most bioprospectors in developing countries have been
individual professors or collectors who collected samples on contract with
foreign companies or sold samples left over from research expeditions. These
small-scale activities added little value to the biodiversity resource and in
any case, are now likely to be discouraged by national legislation implementing
the Biodiversity Convention.
There has been a
recent growth of interest in traditional medicine from the international
pharmaceutical industry, as well as from the national product industry in
Europe and America. Traditional medicine has become to be viewed by the
pharmaceutical industry as a source of "qualified leads" in the
identification of bioactive agents for use in the production of synthetic
modern drugs.
Bioprospectors
express optimism that they can help to implement the 1992 Convention on
Biological Diversity by encouraging biodiversity, conservation and stimulating
capacity building in developing countries. Many indigenous people and local
communities however, are sceptical of existing bioprospecting agreements.
Those concerned
with the development of bio-resources for human health recognise that when
local custodians of biodiversity benefit from their sustainable use by others,
conservation opportunities increase. The CBD codifies this benefit-sharing
principle, but the absence of applicable instruments to equitably compensate
all stakeholders within a country leaves it largely untested.
Currently this
aspect of the debate on access and benefit sharing has not received much
attention, as the focus has been on the development and establishment of
policies and legislation. It is clear that many local and indigenous
communities will not be able to go through this process alone and would need
assistance and capacity development.
Many legal and
practical problems relating to protection of IPR remain yet to be fully
understood and addressed: the collective ownership/custodianship of traditional
medicine; the problem of ownership and exercise of rights in traditional
medicinal knowledge which exists across different countries in a region;
practical means for the exercise and management of rights; mechanisms for
application of customary law to protection of traditional medicine; and the
need for comprehensive documentation standards, for traditional medicine.
In order to
achieve better understanding and wider consensus of these issues it is
necessary to address basic conceptual problems and test practical solutions to
the protection of traditional medicine. There is a need to continue debate with
true stakeholders-practitioners of traditional medicine, representatives of the
medical community, the pharmaceutical and biotechnology industries,
intergovernmental organizations, etc. Lasting solutions can only be found if
all stakeholders work together in good faith and bring their specific expertise
and experience towards a common understanding and solution of the problems.
Constraints in
developing traditional medicine:
A large portion
of the population in a number of developing countries still relies mainly on
traditional practitioners, including traditional birth attendants, herbalists
and bone-setters, and local medicinal plants to satisfy their primary health
care needs. Practices involving use of traditional medicine vary greatly form
country to country and from region to region as they are influenced by factors
such as culture, mentality and philosophy.
Despite its
existence over many centuries and its expansive use during the last decade, in
most countries, traditional medicine, including herbal medicines has not yet
been officially recognized, and in most countries the regulations and
registration of herbal medicines have not been well established.
Furthermore
research and training activities for traditional medicine has not received due
support and attention. As a result, the quantity and quality of safety and
efficacy data are far from sufficient to meet the demands for the use of
traditional medicine in the world. Safety and efficacy data exist only in
respect of much smaller number of plants and their extracts and active
ingredients, as well as preparations containing them.
Reasons for the
lack of research data involve not only policy problems, but also the research
methodology for evaluating traditional medicine. There is literature and data
on the research of traditional medicine in various countries, but all
scientists may not accept them. There is a need for validation and
standardization of phytomedicines and traditional medical practices so that
this sector can be accorded its rightful place in the health care system.
As the
characteristics and applications of traditional medicine are quite different
form western medicine, how to evaluate traditional medicine and what kind of
academic research approaches and methods may be used to evaluate the safety and
efficacy of traditional medicine are new challenges which have emerged in
recent years.
Along with
increased interest in medicine is an increased interest in the safety aspects
of the practice of herbal medicine. Private sector involved in the business of
herbal drugs should take responsibility and ensure the safety and efficacy of
the preparations that they put on the market.
The Role of the
Private Sector:
The private
sector (e.g. biotechnology industry) plays a crucial role in developing
economic activities relating to herbal bioprospecting, using the skills and
knowledge of local peoples and compensating them for their knowledge.
Governments can promote such involvement, by improving co-operation between
public organizations and companies established to improve biotechnology
research and training, providing incentives for private companies to contribute
to biodiverstity, and establishing policies, which promote the involvement of
the private sector in biodiversity conservation.
In the last few
years developing countries have felt the increasing pressure of what has now
become known as bioprospecting and biopiracy. The pressure has come especially
in the sector of traditional medicine. Given the fact that in most countries,
very little legislation is in place, civil society groups and governments have
reacted increasingly strongly. Communities are looking for concrete short-term
benefits and, in most cases, monetary benefits. Therefore they would not be interested
in long drawn out access and benefit agreements. There is a need for funding
agencies and bioprospectors to start funding the communities or the service
providers to communities to work through the process of value addition to both
potential and existing products, through a bottom up approach.
Research:
There are still gaps in
knowledge of how traditional knowledge systems of health work, their
limitations and prospects. There is lack of understanding of cosmovisions of
traditional healers and of the links between spiritual and traditional healing.
Successful experiences and approaches on conservation and sustainable use of
medicinal plants are still rare.
With regard to research aspects
pertaining to medicinal plants, traditional medicine and local communities; a
number of questions are still unanswered: Which traditional remedies work,
which have been tested and how? How should traditional medicine knowledge,
practices and preparations be validated at the community level, using what
methods and facilities? How should
traditional medicines be standardized at local and traditional healer levels,
using what methods and facilities? Under which conditions does traditional
medicine work best? Who uses it and
under which conditions? To what extent
do local communities accept traditional medicine practices? What has been done to promote mutual
understanding and professional respect between western doctors and traditional
doctors? Which aspects of traditional
medicine can be combined with western style medicine and how? Have all major
medicinal plants been identified and documented? What has been lost? What is remaining? Are traditional knowledge systems relating to
sustainable use and conservation of medicinal plants clearly understood? Are gender issues properly taken into
consideration? How can traditional
methods be incorporated in research agenda?
How should local and traditional knowledge contribute to the propagation and sustainable use and conservation of medicinal
plants? What are the limitations and
potentials of spiritual beliefs relating to traditional healing systems? What are
cultural practices and beliefs that are supportive of the conservation
and sustainable utilization of medicinal plants? What effective agro-ecological methods that
enhance propagation and cultivation of specific medicinal plants?
A coherent
research agenda will need to address:
Health
- Safety and
efficacy of traditional remedies.
- Appropriate
research methodology, standardization of herbal medicines.
- Utilization of
traditional medicine - reasons, demographics, economics, etc.
- Who uses it
and under which conditions? medicinal practices?
-Promotion of
mutual understanding and professional collaboration between modern and
traditional doctors?
- Basis for
integration of services.
Biodiversity
Ethnobotanical surveys and Red Data Book
status of medicinal plants.
Studies of indigenous conservation and use of
medicinal plants.
Effective agro-ecological methods that enhance
propagation and cultivation
of
specific medicinal plants.
Social
dimension:
Gender issues in medicinal plant use,
conservation and cultivation.
The role of spiritual beliefs in traditional
healing systems.
Priority Issues that need special attention
include:
a) The place and
contribution of traditional medicine in primary health care, with particular
attention to priority diseases such as malaria, HIV/AIDS, TB; e.g. gaps between
the finality of current research with regard to public health concerns and
local communities needs and priorities.
b) The global
context (bioprospecting, IPR, TRIPs, CBD, etc): Implications for promotion of
the sector; e. g protection of traditional knowledge and practices relating to
the uses of medicinal plants and traditional medicines.
c) Sustainable
use and conservation of medicinal plants:
The contribution of forests in community health care (e.g. linkages
between forestry and health, destruction of forest and its impacts and
consequences to the health of people, various ways in which the health of
people is affected through the destruction of forests, etc.);
d) Propagation
and domestication of medicinal plants
(e.g. successful experiences at the village level), over harvesting and
controlled harvesting, resource management;
e) Economic and
policy incentives and legal tools for conservation and sustainable use (e.g.
encouraging private sector, researchers and local communities);
f)
Commercialisation and economic value of medicinal plants at the community
level: The economics and prospects of small scale derived drug industry (status of medicinal plants production,
marketing, markets and value-added processing);
g) Strategies to
enhance income generation and benefit sharing from medicinal plants and
traditional medicine;
h) Integration
of traditional medicine and public health programmes and systems;
i). Spiritual
and cultural values that are supportive to medicinal plants conservation,
traditional healing and practices;
j) Tools,
mechanisms and strategies to enhance information exchange, co-operation and
collaboration.
k) Benefit
sharing and development of and collaboration with indigenous peoples and local communities (mechanisms, models and
case studies);
l) Options for
national policies and legislation to access genetic resources and legal and
financial aspects related to benefit sharing;
m) Prospects for
private sector participation in Biodiversity Prospecting in developing
countries.
n) Options for
legislation, policies and incentives to add value to medicinal plant genetic
resources and increase capacity in bioprospecting;
o) Improvement
of the multidisciplinary information on medicinal plants needed for
conservation, agriculture, primary health-care and manufacturing activities;
p) The economic
significance of traditional medicinal knowledge and systems;
q) The
enhancement of medicinal plant usage through intellectual property rights,
capacity building and information technology and transfer;
r) Developing
and using indigenous and traditional knowledge for promoting bioprospecting for
the benefit of all stakeholders involved;
s) Mechanism,
strategies, partnership and co-operation for encouraging bioprospecting-based
business in medicinal plants and phytomedicines;
Policy, planning
and legislation:
A coherent
national programme on Medicinal Plants should include the following
institutions:
·
Ministry of Health:
Formulation of national policy, legislation, regulation and
licensing, collection, analysis and dissemination of information on medicinal
plants, approval of selected plant remedies for use by health services.
·
Ministry of Agriculture:
Cultivation of medicinal plants (small and large-scale
production), protection of endangered species.
·
Universities:
Pharmacy:
Inventory of indigenous medicinal plants and natural products,
identification of constituents of traditional remedies, pharmacological
evaluation of medicinal plants and natural products, identification of active
substances, their extraction and toxicity testing, dosage and formulation.
·
Clinical Medicine: Clinical trials and field
testing
·
Public Health: Studies on indigenous remedies and
their uses (ethno-medicine), training of health personnel (manuals).
·
Botany: Cultivation of medicinal plants, Cloning
and cell culture, Taxonomy identification, studies on ethnobotany.
·
Pharmaceutical industry (government and private):
pharmaceutical development, processing and pilot production, trial marketing,
full-scale production.
·
Ministry of Trade: Assessment of local trade in
medicinal plants, exports and imports.
A National Strategy on Medicinal Plants should highlight the
following:
·
Assessment of the importance of traditional
medicine in the country;
·
Current status of medicinal plants and
traditional medicine at the national level;
·
Activities and institutional framework;
·
Co-ordinating and implementing agencies; support
of R&D;
·
Role of NGO's and traditional healers
associations;
·
Respective roles of public and private sectors;
·
Actions and strategies to promote traditional
medicine and medicinal plants - list of
most common medicinal plants and their uses;
·
Efforts to integrate traditional medicine in
official public health systems:
Advantages, disadvantages, implications, obstacles, policy options and
key players.
·
Lessons learnt and new perspectives:
·
Limitations and potentials
·
Future directions:
- Research priorities, Technology transfer and capacity
building;
- Planning & Development, Policy options;
- Information exchange and management;
- Co-operative strategies and mechanisms;
VI. REFERENCES
-
Cunningham, A.B. 1993. African Medicinal Plants: setting priorities at the interface between conservation and primary health care. Working paper 1. UNESCO, Paris
.
-
LeBeau,
D, 1998. Urban patients' utilisation of traditional medicine: upholding culture
and
Tradition, University of
Namibia, Sociology Department Windhoek, Namibia.
-
Marshall, N.T., 1998. Searching for a Cure: Conservation of Medicinal Wildlife
Resources in East and Southern Africa. TRAFFIC International.
-
Nshimo C. 1888. Utilization and conservation
of medicinal plants in Africa, Faculty
of Pharmacy, Muhimbili University College of Health Sciences, Dar es Salaam,
Tanzania.
-
Myles
Mander, 1998. The marketing of indigenous medicinal plants in south Africa: a
case study in Kwazulu-Natal, Institute of Natural Resources, Natural Resource
Management Programme,
South Africa.
-
Wambebe C, 1998. Development
and production of standardised phytomedicines, National Institute for
Pharmaceutical, Abuja, Nigeria.
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