Thursday, April 12, 2007
Integrating traditional/herbal medicine into orthodox medicine
By: G.D. ZANEY
BEFORE the colonization of the African continent, traditional medicine was the backbone of healthcare delivery and had sustained generations, but with the advent of western education, Christianity and western medicine, it tended to be frowned upon.
Currently, however, the annual global market for traditional and alternative medicine is estimated to be about US$ 60 billion as a result of resurgence to that which became frowned upon. Indeed, this resurgence, which is global, has seen the USA, for example, liberalizing the use of such therapies and endorsing their subjection to critical examination under massively- funded research programmes so as to maintain quality health standards.
Today in Canada, the United Kingdom, Germany, Australia, China, Korea and India, more alternative therapy outlets exist than in any other African country. And one may pause to ask why Bill Clinton, ex-President of the USA, had once indicated great expectations about Africa contribution to solving the HIV/ AIDS pandemic.
What about the Federation for Integrated Health (FIH), set up by Prince Charles, the Prince of Wales, which, for the past eleven years, has been leading the crusade of an integrated approach to the art of healing?
In recent years, research has established that 80 per cent of general practitioners are referring some conditions to complimentary practitioners and 75 percent of patients have indicated that they would prefer to have available both western orthodox and complimentary approaches to enable them to access the benefits of each system.
In China, traditional Chinese medicine accounts for 20 per cent of the total health delivery system, which, however, generates 55 per cent of total health infrastructure and equipment.
In Ghana, plant medicine abounds in generous quantities and, in many instances, the only treatment option available. Indeed, about 1,000 medicinal plants are known to exist in Ghana, 80 per cent of which have been identified by baseline studies.
The studies have also shown that about 3,000 herbal formulations have been documented as being efficacious for specific conditions, out of which over 600 are circulating as herbal medicine products and 60 of which have undergone preliminary phyto-chemical analysis and safety tests at the Centre for Scientific Research into Plant Medicine and through M. Sc Project works.
Again, it is worthy of note, three hundred of these herbal products have also been given market authorization by the Food and Drugs Board / Sight cannot also be lost of the fact that some 200 herbal products, ranging from food supplements and non-hormonal contraceptives to bone- healing, immune and body-energy enhancers and anti- snake venom products, are also imported from the USA, China, Germany and the United Kingdom.
For various reasons, including affordability, accessibility and effectiveness, many Ghanaians depend on plant medicines for their health care needs. Evidence abounds that certain health problems, particularly communicable and chronic diseases have defied modern orthodox medicine and that where orthodox medicine fails or when it is unable to provide the needed therapy, patients are told to prepare for death.
In point of fact, traditional/herbal or complimentary/alternative medicine cannot lay claims to being a solution or the best therapy for every ailment. What is agreed, instead, is that no particular health care system is a panacea to all health problems.
It is, however, significant to note that the World Health Organisation (WHO) has recognized traditional medicine, particularly plant medicine as an important alternative health care system for most of the world’s population, for which reason it has advocated the use of scientifically proven, safer, effective and quality medicine.
It is also the medium-term policy of the Ministry of Health to facilitate research into and the development of medicines with specific reference to safety, efficiency and quality issues, while Act 575 requires the establishment of a Traditional Medicine Practice Council to regulate traditional and herbal medicine in the country.
In response to the WHO requirement and the Ministry of Health’s medicine policy, therefore, the need arose to harmonize ideas and efforts at pursuing a plant medicine/complementary medicines research agenda. In other words, the Ministry of Health is making every effort to promote plant medicines that are efficacious, safe and of good quality as part of the health care delivery system in Ghana.
This is to say that plant medicines produced and used in all WHO member countries are required to be scientifically assessed for safety, efficacy and quality. To ensure that all therapeutic procedures and agents in Ghana, including plant medicines are ascertained for their safety, efficacy and quality through scientific testing, the Board (FDB) Law (PNDC Law 305 B) was enacted in 1992.
This Law (PNDC Law 305 B) Mandates the FDB to implement regulatory measures aimed at achieving high standards of safety, efficacy and quality of foods and drugs, including herbal medicine in Ghana.
The FDBrequires evidence of safety, efficacy and quality in order to approve and register plant medicines in the country, but lacks the requisite financial backing to undertake any survey to access centers in the country that can conduct the testing of plant medicines.
Fortunately, the Danish International Development Agency (DANIDA) intervened by sponsoring the Traditional and Alternative Medicines Directorate (TAMD) of the Ministry of Health to conduct such a survey.
The report of the DANIDA/TAMD sponsored Institutional Capacity survey identified various needs, including the need for harmonizing procedures and methods used by the research testing laboratories. The result was the need to produce a manual of hamonised country specific valid procedures which take into consideration the validity of the test procedure as well as available equipment in Ghana.
The Ghana National Drugs Programme (GNDP), in collaboration with the TAMD, responded to the need and, accordingly, developed a Manual of Harmonised procedures for assessing the safety, efficacy and quality of plant medicines in Ghana. The Manual provides guidelines to ensure aniform approach for assessing herbal medicines in Ghana. It outlined the types of tests/experiments that are needed to assess the safety of plant medicines and the methods for the standardization and assessment of the quality of plant medicines. The Manual also provides recommended models and procedures for local scientists.
At the launch of the manual in Accra last year, Togbega Dabra V1, president of Traditional Medicine Practitioners, called for the appointment of a Deputy Minister to be responsible solely for traditional and alternative medicine, while as a matter of urgency, herbal units should be established in all the ten regional hospitals to absorb the herbal doctors being trained at the Kwame Nkrumah University of Science and Technology, Kumasi.
Togbega Dabra added that Government, NGOs development partners and all other stakeholders should absorb the cost of tests conducted on and the registration of herbal remedies, in the interest of public health, and enjoined traditional medicine practitioners to co-operate with the TAMD, NGOs and other stakeholders in order to move the strategic plan of Traditional and Alternatives Medicine development forward, in line with the provisions of the African Union’s Decade for Traditional Medicine(2001-2010).
One major challenge facing traditional/herbal or alternative/ complementary medicine is the HIV/AIDS pandemic, for which there is the need for a policy document on involving traditional health centers fully in the fight against it. There is also the need to increase the production and development of medicinal plants through medicinal plant nurseries and subsequent cultivation.
Then also arises the need for the establishment of a Traditional Medicine Practice Council and the development and designation of referral forms to be used by traditional healers who should also be given more training in the hospital setting to observe clinical procedures. And, indeed, without the establishment of hospital/health care centers for both orthodox and traditional medical practitioners in order for them to work hand in hand, the goal of integrating traditional/herbal medicine into orthodox medicine will be defeated.
The Ghanaian Times - Thursday, April 12, 2007 Page: 9