Traditional and Alternative Medicine: Research and Policy Perspectives

613 Pages·2009·27.62 MB·English

by  Tuley de Silva

TRADITIONAL AND
ALTERNATIVE MEDICINE
Research and Policy Perspectives

TRADITIONAL AND
ALTERNATIVE MEDICINE
Research and Policy Perspectives
- Editors
Tuley De Silva
Theeshan Bahorun
Manoranjan Sahu
Le Mai Huong
CENTRE FOR SCIENCE & TECHNOLOGY OF THE
NON-ALIGNED AND OTHER DEVELOPING COUNTRIES
(NAM S&T CENTRE)
2009
DAYA PUBLISHING HOUSE
Delhi -110 035
© 2009, All rights reserved with NAM S&T Centre
ISBN 81-7035-614-8
ISBN 978-81-7035-614-1
Despite every effort, there may still be chances for some errors and omissions to have crept in
inadvertently. No part of this book may either be copied or reproduced in any form or any manner
whatsoever without the prior written permission of the publishers.
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Foreword
This publication which contains the proceedings of the international workshop
on Herbal Medicinal Plants and Traditional Herbal Remedies is a timely one because
of the growing interest in herbal medicine. It has been thoughtful on the part of the
NAM S&T Centre, New Delhi and the Institute of Natural Products Chemistry,
Vietnam to have organized jointly this important workshop.
It is now clear that to achieve the goal of "Health for All" we have to promote a
blend of tradition medicine and modern drugs. Unfortunately much of the knowledge
on traditional medicine is getting lost and we can ill afford to remain silent spectators
of genetic erosion among medicinal plants. Both dying wisdom and vanishing crops
must be saved. This is why the World Health Organisation gave the slogan "save
medicinal plants to save lives".
The Herbal Drug Industry is growing. Unfortunately in many cases, there is an
expansion in the manufacture of drugs without concurrent efforts in improving the
production of the needed medicinal plants. This leads to many of the important
medicinal plants getting included in the Red Data books of conservation
organizations. Immediate steps are needed to achieve a paradigm shift in raw material
supply to drug companies, from collection to cultivation. This volume contains many
useful papers written by leading authorities on the subject. I hope that this kind of
interaction will foster greater south-south collaboration in the area of conservation,
sustainable use and equitable sharing of benefits from the herbal wealth of developing
nations. We owe a deep debt of gratitude to Dr. P. Pushpangadan, for this labour of
love.
Prof. (Dr.) M.S. Swaminathan
Member afParliament and
Chairman, M.S. Swaminathan Research Foundation
(MSSRF), Chennai, India
\
I
I
Preface
Plant resources have provided the basic needs of life such as food, feed, fibre,
fuel and shelter and will continue to provide these needs and much more on a
renewable basis. Plants have also been a valuable source of flavours, fragrances,
colourants, and phytochemicals for industries and pharmaceuticals. The rising
incidence of health related problems in both developing and developed countries
has prompted research in the development of drugs from leads identified from
traditional medical uses as an alternative approach to manage new deadly diseases
and those that have become resistant to aV<1.ilable drugs. There is also a resurgence of
interest on plant based medicines due to the undue side effects of modern therapeutic
agents and their inability to cure diseases, many of them being for the treatment of
symptoms. Herbal healthcare products could also help in uplifting the quality of life
of the ageing populations.
On the policy perspective, the Wodd Health Organisation has initiated global
efforts to urge governments to take steps to upgrade the traditional medical systems
and treatments of their respective countries through validation of their quality, safety
and efficacy. Guidelines have been developed by the WHO on standardisation, quality
control and analysis of herbal medicinal products. These initiatives have sparked
considerable interest in the international health-related scientific community to re
evaluate traditional therapies based predominantly on the use of medicinal plants.
Presently, research on the untapped plant resources and leads from traditional uses
that would hopefully identify useful bioactive compounds / extracts with therapeutic
relevance is being extensively carried out by scientists in developed and developing
countries. Additionally the role of plant based products as dietary/health
supplements, nutraceuticals, cosmecuticals and personal care products are being
investigated and many countries have recognised the need for such products. It is
clear from the high number of ongOing and completed studies in this research area
that plant derived pharmaceuticals and healthcare products can meaningfully
contribute towards the management of the biochemical and physiological functions
viii
of a wide range of disorders. However in many cases, the issue of mechanism of
action and pharmacodynamics is a major concern and it is necessary to conduct
research extensively focused on molecular level activities and clinical trials that will
contribute to our understanding of the efficacy and safety of many extracts with
therapeutic potential.
There are clear trends that the mainstream pharmaceutical research is moving
away from single molecule or single target approach to combinations and multiple
target approaches. Plant extracts containing several multiple pharmacological
compounds have been reported to act on multiple molecular and cellular targets and
such approach is gaining support in the development of drug combinations/ extracts
to fight diseases. There is growing evidence in support of the potential uses of medicinal
plant derivatives and extracts as healthcare products that reduce the visits to
physicians for minor ailments and as immunostimulants, anti-ageing products and
rejuvenative agents that contribute to quality of life of the elderly.
The focus of this book "Traditional and Alternative Medicine: Research and
Policy Perspectives" prominently encompasses the importance of traditional medicine
in our modern health systems and discusses the potential applications of
phytochemicals to assist biomolecular mechanisms and hence offer realistic and
therapeutic possibilities. It includes review papers on production strategies, projection
trends, regulatory status and IPR issues. Further reports are centred on the
characterization and isolation of useful medicinal plant phytochemicals, clinical
and bioactivity studies comprising antifungal, anticancer, antioxidant, enzyme
inhibitory, hepato-protective and acetylcholinesterase assays amongst others. Finally,
a series of comprehensive country reports provide an evaluation of the use of
traditional heath care systems and related research output in Nigeria, Turkey, India,
Laos, Vietnam, Mauritius, Myanmar, Nepal, South Africa, Indonesia, Brunei, Bhutan,
Sri Lanka and Mongolia.
It was with thi~ background that the NAM S& T Centre organised the International
Workshop on Herbal Medicinal Plants and Traditional Herb Remedies in September
2007 in Hanoi, Vietnam. NAM S&T Centre continues to promote the fullest possible
and mutually beneficial collaboration among scientists and technologists and
scientific organizations from non-aligned and other developing countries. This book
is reflective of the dedication ofNAM S&T Centre to such aventure. We hope that this
timely publication will contribute to an understanding of the status of research,
policies and regulatory status of medicinal plants and their products in developing
countries.
Tuley De Silva
Theeshan Bahorun
Manoranjan Sahu
LeMaiHuong
Introduction
Herbs and traditional medicines are being extensively used for healthcare in
almost all the countries since times immemorial. Ancient religious texts are replete
with references on the use of natural products with medicinal properties. Because of
local beliefs and practices and also from cost considerations herbal medicines remain
a popular mode of treatment in the developing countries. Even in the industrialised
society the rising cost of prescription drugs and ensuing side effects of the treatment
make it highly attractive to use the traditional medicine particularly for minor ailments.
Modem system of medicine is based on sound experimental data, toxicity studies
and human clinical studies, but in case of herbal medicine, on the contrary, the
pharmacopoeia on herbal products is usually not available, standardization and
quality control parameters for the raw material as well as finished products are
virtually non-existent, and herbal industry lacks good manufacturing practices. Even
the barest minimum standards of the medicinal plant products are not maintained or
regulated and the quality of finished herbal products is often not monitored or is not
up to the mark.
In addition, even though almost all the developing countries, specifically those
sitting in the tropical belt, are a rich and abundant source of flora and
phytopharmaceuticals, many medicinal plants are either getting scarce or are on the
verge of extinction resulting into genetic erosion due to a huge public demand and
also because a large number of modem drugs are extracted and developed from the
plants. If this trend continues, the human race will lose some of the most important
sources of future drugs, which will be lost by the mankind forever.
As such, there is an urgent need for the developing coUntries to take a fresh look
at the status of medicinal plants, take up sustainable harvesting by balancing the
commercial demand with the conservation of the valuable plants and their contribution
to biodiversity and initiate extensive activity for the preservation of germplasm. In
addition, they should develop their own technologies for processing of the crude