OPTIMUM STRATEGIES FOR THE DEVELOPMENT OF MEDICINAL PLANTS AND TRADITIONAL MEDICINES RESEARCH IN MALAWI WITH SPECIAL EMPHASIS ON THE INTERNATIONAL TRADITIONAL MEDICINE COUNCIL OF MALAWI (ITMCM)

OPTIMUM STRATEGIES FOR THE DEVELOPMENT OF MEDICINAL PLANTS AND TRADITIONAL MEDICINES RESEARCH IN MALAWI WITH SPECIAL EMPHASIS ON THE

INTERNATIONAL TRADITIONAL MEDICINE
COUNCIL OF MALAWI (ITMCM)

Yesetsani Kambewankako
Director (ITMCM)
P.O. BOX 713
BLANTYRE
MALAWI

TABLE OF CONTENTS

1.0 Introduction
2.0 Background Information

2.1 Socio-economic Status of Malawi

2.2 The Historical Background of the International Traditional Medicines Council of Malawi (ITMCM)
2.3 Activities to Date of the ITMCM
2.4 Activities of other related Institutions
3.0 Major Constraints in the Development of Traditional Medicine and Research in Malawi
4.0 Recommended Strategies
5.0 After Cape Town - Which Way Forward

Proposed Institutional and Organization Chart
References.

1.0 INTRODUCTION
It is generally accepted that an estimated 85% of rural population in Malawi use traditional medicines for curing diseases due to high costs of drugs from hospitals and pharmacies as well as very low levels of availability of curative drugs. The influx of traditional healers on forests in oder to get traditional medicinal plants cause environmental degradation and rapid depletion of indigenous medicinal plants. Lack of knowledge of right medicinal plants for curing different diseases, lack of high value medicinal plants, raw materials for expanding the export base of traditional medicinal plants, feature highly amongst the reasons why medicinal plants and traditional medicine research should be developed in Malawi. Furthermore, the current global initiatives to develop traditional medicine relevant research is providing the best enabling environment so far to link any research activity to national, regional and global perspectives.
This paper is an extended and revised version of the one that was presented to a workshop on the Industrial Cultivation of Aromatic and Medicinal plants, convened by the Malawi Industrial Research and Technology Development Centre, in April; 1997 at Sun and Sands Holiday Resort, Mangochi, Malawi. The Workshop was sponsored by the United Nations Development Programme, UNDP.

This paper focuses on the development of Traditional Medicines Research as a tool inter alia for attaining sustainable development in Malawi and highlights relevant proposed optimum strategies that may be useful in order for the project to succeed.

This paper has been extended and revised in order to make use of this multi-sectoral forum of about 50 participants to share and improve on the issues that have been highlighted for the betterment and promotion of Traditional Medicine within the perspective of Research and Development on national, regional and entire Africa level.

2.3 BACKGROUND INFORMATION
The relevant background information necessary to bring a successful and useful linkage to Traditional Medicinal Plant Research in Malawi, the historical background of the oldest Traditional Medicine Association now the ITMCM and activities of the related institutions. The background information is as follows:

2.1 The Socio-economic Status of Malawi
Malawi belong to the least developed countries with an estimated GNP per capita in 1991 of $230 and three-quarters of the population, was sustained in 1991 by small scale agriculture (smallholder Farming).

(1)Malawi's population was estimated at about 10 million people and grew at a rate of 3.3% per annum in 1994 and a population density of 85 persons per sq.km in 1987.

(2) Over half of smallholder farmers cultivated less than one hectare of land which was insufficient to satisfy the food requirements of the household, due to increased pressure on land.
Currently the Government's strategy among others in order to attain sustainable development is the introduction of the Poverty Alleviation Programme and Free Primary School Education.

2.2 Historical Background of the International Traditional Medicines Council of Malawi (ITMCM)
Up to 1963 the practice of traditional medicines in Malawi was not organized. It was only in 1963 that a national conference for Orthodox medicinal doctors was organised at Kwacha Conference Centre by the Ministry of Health in order to discuss dangerous effects of the practice of traditional medicine in Malawi. The Malawi government encouraged, however, well known traditional doctors of that time to attend and present views of traditional medicines practitioners. Traditional doctors Grant William Chipangula (The current Chairman of the ITMCM) and the late Symon Nkhoma attended this conference. These representatives suggested that instead of discouraging traditional medicine practice they would look into an alternative approach of providing a solution to the problem. They recommended that traditional healers be organised and registration of practicing healers be encouraged, so as to create a means for institutionalizing the practice and create a channel for communication whereby from time to time issues and messages relating to ethics and professional conduct may be disseminated. In order to implement this, some consultations were made with traditional doctor Green Ntopa who was a Malawian leaving and practicing at that time in Zimbabwe. Following these consultations, the first Traditional Medicines Association was formed and was called African Traditional Mediciner's Association of Central Africa. Founder was Symon Nkhoma while Green Ntopa was Chairman and Grant William Chipangula was the Director.
This set up was short lived as there rose a political conflict between Green Ntopa and the then Malawi Government. He thus migrated to Zimbabwe for fear of being detained. The late Green Ntopa left Traditional Dr. Grant Chipangula to run the association.
In 1974, it was decided at a board meeting that it was necessary to expand internationally the activities of the organization. Consequently the Association of Malawi changed to African International Traditional Mediciner's Association and established contacts with organizations of similar objectives internationally, which included.
- South African Traditional Healers Council (SATHC)
- International Organization of Traditional Healers and Medical practitioners and Researchers whose Headquarters is in Bulawayo, Zimbabwe.
- The Australian Traditional Medicines Society and
- The Zambian Association.

In 1995, the Association changed its name to International Traditional Medicines Council of Malawi (ITMCM) in order to satisfy the need for having one board that can coordinate registration and overall activities of traditional medicine related associations in Malawi and serve as a mandated link between the Government and the Traditional Healers.

2.3 Activities to Date of the ITMCM
* It has already been mentioned above that some kind of dialogue between the Orthodox Medicine practitioners and he traditional medicine practitioners towards the direction of developing traditional medicine Research in Malawi, started in 1963. This was at Kwacha Conference Centre meeting which gave birth to the identification of the need to institutionalize traditional medicine practice, through formation of association such as the now International Traditional Medicines Council of Malawi (ITMCM). The council's one of the objectives is to promote development of traditional medicines in Malawi (including research and preservation of medicinal plants).
* Leading international affiliations included the first meeting of the Delegates of the Traditional Healers Councils of Malawi and South Africa that discussed International cooperation in Johannesburg on 15th January 1988.
* In 1993 following a Zambian similar cooperation agreement, 16 traditional medicines doctors (10 men and 6 women) represented the International Traditional Medicines Council of Malawi at an International Aids Conference for Traditional Healers at Evelyn Home College, Lusaka.
* ITMCM is a founding member of the International Organization of Traditional and Medical Practitioners and Researchers which has its secretariats currently in Bulawayo, Zimbabwe.
* Since 1990, ITMCM has also signed a Cooperation with Ghana's Traditional Healers' Association to such an extent that the council had up to 1997 a guest trainee from Ghana, who was trained up to the Councils diploma level with Dr. Chipangula in Blantyre.
* One of the important activities attributed to ITMCM is the participation of the Council in 1996 in the preparation of the first list of 100 plants for the Malawi Medicinal
* Plant Pharmacopoeia Project in conjunction with the Malawi Industrial Research and Technology Development Centre which was coordinated by the National Research Office at the University Offices, Zambia, Malawi.
* The ITMCM was formed in 1995 and launched in 1996, its activities and the establishment of Medicinal Botanic Garden network. The launching was performed by the Minister of Health and Population at the ITMCM's first Medicinal Botanic Garden and the Council intends to establish more medicinal botanic gardens throughout the country.
* The ITMCM is involved in the Industrial Cultivation of Medicinal and Aromatic Plants currently being coordinated by the Malawi Industrial Research and Technology Development Centre (MIRTDC). The ITMCM participated in a relevant workshop sponsored by UNDP in 1997 where ITMCM presented a paper. The ITMCM participates also in dissemination of health related messages e.g. Aids prevention etc.
* The ITMCM attended the Traditional Medicine Research Workshop organised by the Chancellor College's Chemistry Department, 24-27 March, 1997 and funded by IDRC
2.4 ACTIVITIES OF OTHER RELATED INSTITUTIONS
2.4.1 The University of Malawi, Chancellor college - Chemistry Department
The University of Malawi Chancellor College's Chemistry Department has since early 1980s actively been involved in research activities relevant to development of traditional medicine practice at different levels. Since May, 1997 the department has been involved in a comprehensive research focusing on the situation analysis of the status of traditional medicine research and relevant works in Malawi which the Council (ITMCM) feels has been successfully performed by the department.

2.4.2 Malawi Industrial Research and Technology Development Centre (MIRTDC)
Among other objectives the relevant main objective of the MIRTDC is to stimulate and facilitate linkages between the activities of various sectors, in the development and utilization of medicinal and aromatic plants. The centre has plans in this connection to set up pilot scale processing facilities for the development and testing of technologies and processes for extracting plant materials into standardized and safe products for use as medicines. It intends also to maintain a data base for preservation of information on medicinal plants.
The Centre convened in April, 1997 a workshop on utilization of medicinal and aromatic plants in Malawi. The workshop was sponsored by the United Nations Development (UNDP). Main objectives of the workshop included.

(a) to sensitize key role players in the area of Medicinal and Aromatic Plants, of the need to preserve and grow medicinal and Aromatic plant species.
(b) to discuss the needs and to formulate strategies for the preparation of standardized herbal formulations that will protect the public from toxic plant materials and herbal medicine over-doses:
(c) to discuss the need and to formulate strategies for developing technologies for the processing of Medicinal and aromatic plants in order to stimulate planned cultivation and preservation of plants.
2.3 National Herbarium and Botanic Gardens (NHBG)

National Herbarium intends to focus on the role of the Herbarium in Traditional Medicine and will document valuable plants in traditional medicine and encourage cooperation between herbalists herbarium and chemists. Further the herbarium will assist in plant identification, phenological studies, plant distribution and conservation of the medicinal plants.
(a) The Ministry of Health and Population
The Malawi Government's Ministry of Health has made some deliberate efforts to initiate and support development of traditional medicine and traditional medicine research.
Conference and workshops include:
* the first conference that led to the birth of the first traditional medicine association;
* in 1987 the University organized the first National Seminar on Traditional and Modern Medicinal practices; and
* In 1995 the Ministry initiated multi-sectoral meeting where participants nominated the MIRTDC to take a leading role in the development of a National Pharmacopoeia of Medicinal Plants of plants of Malawi. The Centre has since that time being working together with the traditional medicine practitioners and the University of Malawi in the area.
3. MAJOR CONSTRAINTS IN THE DEVELOPMENT OF TRADITIONAL MEDICINE AND PLANT RESEARCH IN MALAWI
3.1 Traditional Healers Related
3.1.1 One of the major constraints to achieve a meaningful technical and policy research in development of traditional medicine in Malawi is the lack of knowledge of who the traditional healers are? Where they are? What they do and how they perform. Knowledge of these issues will make any further research works and dissemination of results to be more targeted to the user.
3.1.2 Lack of well informed and organized traditional medicine related associations. Most of the traditional medicine associations for traditional healers suffer from lack of good governance, democratic practices, lack of creativeness in their developmental programmes which are pronounced e.g through copying of names and activities of already registered associations and not being able to refer patients to specialists of particular ailments. They lack know how transfer strategies and exposure to international standards.
3.1.3 Very High Rate of Illiteracy
The level of illiteracy amongst traditional healers is very high. This is one of the major constraints because the society they are interacting with today is a learned and sophisticated society. Mutual understanding between the traditional healers and the other stakeholders such as traditional medicine researchers will only be strengthened if the illiteracy rate amongst the traditional healers would drop. This would further facilitate confidence amongst the traditional healers as well as increase possibility of getting information through reading. Thus increasing the ir mode of communication.
3.1.4 Lack of proper control and coordination of Traditional Medicine Research, practice and development issues.
3.1.5 The major constraint that is reflected from all the issues raised above is very weak institutions.
3.1.6 Poverty is also one of the major constraints for Traditional Medicine Development. Many Traditional Medicine practitioners perform below standards of professional ethics due to poverty.
3.2 Government Institutions Related
3.2.1 For many years now the Government has pronounced commitment through initiation of related workshops and seminars but the government has failed to institute deliberate instruments to support their commitment. Institution to institute deliberate instruments to support their commitment. institution of these instruments would enable the Government to disseminate easier and efficiently any new levels of understanding of the issues that relate to traditional medicine practice, Research and Development both within the Government institutions and outside.
3.2.2 Related to Relevant Institutions e.g. Related Parastatal Bodies
Parastatal bodies have sometimes sidelined traditional healers in planning and implementing of traditional medicine research work or studies. This practice encourages the traditional healers to loose confidence in these otherwise useful partners.
3.3 Donor Related
3.3.1 The failure of one Traditional Healers Association to manage the organization prudently due to lack of good governance, transparency and good practice, has usually blocked support for other new associations that have a potential for being properly organised and prepared for a positive change for betterment of Traditional Medicine and Medicinal plant Research in Malawi. This is one of the major constraints for the development of the associations, particularly their well organised institutions are the ones who have the potential for a successful and sustainable membership development.
4.0 RECOMMENDED STRATEGIES
4.1 Institutional Development
* It is highly and urgently recommended that Traditional Medicine Related Associations in Malawi should be financially and technically supported to in order to establish and build capacity for their institutions. This will facilitate better fulfillment of their programmes and objectives. Donors are requested to disregard unbecoming experiences they made with certain Traditional Medicine Associations. It should be noted that these practices were encouraged by the undemocratic environment of that time.
* Volunteer attachment to each of the associations would be as one of the necessary milestones to know how transfer and better international collaborations. Therefore this should become and part and parcel of the financial support programme.
4.2 National Coordination and Control
There is need to establish a National Coordination and Control Unit through creation of a new council, Traditional Medicine Control and Coordination commission or improving the status of the already existing and registered International Traditional Medicines Council of Malawi.
4.3 Improved Cooperation with Related and Reference Institutions
There are major relevant institutions in Malawi, (apart from the Malawi Governments Ministry of Health), that are involved in activities that relate to Traditional Medicine Practice, Research and Development. These are:
* National Herbarium and Botanic Gardens,
* Chancellor College's Chemistry - Department, of the university of Malawi, and
* The Malawi Industrial Research and Technology Development Centre (MIRTDC)
There is need to develop in Malawi deliberate strategies that should encourage positive collaboration between the ITMCM (including other Traditional Medicine Related Associations) and the above named organizations. The recommended approach is as follows:
4.3.1 National Herbarium and Botanic Gardens to be the reference point for plant identification, Medicinal Botanic Gardens and Plant Conservation including preservation as well as taxonomical and phenogical studies;
4.3.3 Malawi industrial Research and Technology Development Centre to be the reference unit for Industrial Cultivation of Medicinal and Aromatic Plants, development and transfer of related technologies and entrepreneurship development.
5. The strategies are recommended as follows:
5.1 Creation of an Africa Region Centre.
The Centre's activities to concentrate on:
* Traditional Medicine Systems Research and Development;
* Industrial Cultivation of Medicine and Aromatic plants;
* Plant Conservation and Preservation;
* Institutional and Capacity Building support for Traditional Medicine Related Associations.
The Centre's activities to be linked to National Traditional Medicines Control commissions or councils who in turn will be linked to the Traditional Medicines Associations who will use a reference points related institutions of respective countries to implement the programmes. This will be in consultation and collaboration with the National commission or council, that will report and get instructions from the Africa-Region Centre. All involved small scale entrepreneurs, Medicinal and Aromatic plants farmers as well as the Traditional Medicines practitioners and healers will be organised members of the traditional Medicines Associations.

REFERENCES
1. Report on the workshop on the Development of and Utilization of Medicinal and Aromatic Plants, MIRTDC Blantyre 1997;
2. Country strategies for Social Development - The Experience of Malawi - UNDP series on sustainable Human Development;
3. United Nations Populations Fund in Malawi - safeguarding the future;
4. Information background to the Regional workshop on Medicinal Plants and Traditional Medicines in Africa, Cape Town, 14-18 April, 1998.