Microsoft word - medicinalplanthealthcare.doc
Prim ary health care often relies on m edicinal plants
For thousands of years hum anity has know n and exploited the curative and therapeutic effects of m any plant species and they have been used to m anufacture m edicines. D espite enorm ous progress in synthetic chem istry and biotechnology, pharm acy is still prevailingly based on plant substances. A lthough hom eopathy and sim ilar practices have enjoyed a certain renaissance in w estern countries, the use of plant raw m aterials in m edicine has receded in recent decades. N evertheless, plant rem edies are still the basis for the prim ary health care of m ost people of this w orld. The m edical sciences tap thousands ofplant species w hich have a healing effect on the hum an body, and m any are regularly used to prevent or cure diseases. A ccording to the W orld H ealth O rganisation (W H O ), 80 percent of the w orld'
s population rely on traditional m edicine. In China alone, plant-based m edicines are the backbone of prim ary
health care for a billion people. W orld-wide, at least 35,000 plant species are used for medicinal purposes - and not just those w hose effect on the hum an body has been proven scientifically, but also those w hich are know n to have a generally positive effect, i.e. are regularly used to treat diseases, but w hose effects have not yet been scientifically investigated or proven. M edicinal plants are used for the industrial scale m anufacture of m edicines and for herbal treatm ents. Several of the relatively few species used in industrial m anufacturing are cultivated as field crops, because this is the only w ay to ensure a steady supply and m aintain continuous quality standards. Cultivated m edicinal plants have been selected and bred to contain a higher content of biologically active ingredients than their w ild form s. H erbal treatm ents, how ever, frequently use different species from w ild collections. H erbal treatm ents are typical,e.g. for the Indian A yurvedic m edicine and Traditional Chinese M edicine (TCM ).
A ccording to U N CTA D statistics from the beginning of the 90ies, world trade in plant-based drugs valued m ore than US$ 800 million per year. China is the world's largest exporter. More than 120,000 tons of plant-based drugs are traded each year, a figure four-fold that of India and ten-fold that of G erm any, the countries second and third on the list. O ther leading export countries are Singapore, Egypt, Chile and the U SA . H ong K ong is the greatest im porter of plant-based drugs (77,000 tons per year), followed by Japan and Germany. The USA, Korea, France and Pakistan also im port large quantities. D eveloping econom ies are therefore not just suppliers of raw m aterials, just as industrialised countries are not the m ain consum ers. Indeed, industrialised nations such as G erm any, U SA and Singapore are m ajor exporters.
Collecting w ild m edicinal plants bears the danger of over-exploiting this bio-resource - species m ay recede or even disappear. Realising that collecting w ild species w as a threat to m edicinal plants, the Chiang M ai D eclaration, draw n up by the W W F, the IU CN and the W H O , was adopted in 1989. The Declaration's motto is "Health for all by the year 2000". It underlines the immense importance of medicinal plants and denounces their often ruthless exploitation. The Chiang M ai D eclaration calls for international co-operation to protect m edicinal plants and thus ensure health care for future generations. Local users are rarely a threat to any variety, but large scale collection for export, i.e. international trade, is. Tw o internationally-binding agreem ents are relevant to the protection of m edicinal plants: The Convention on Biological D iversity and the Convention on International Trade in Endangered Species of W ild Fauna and Flora (CITES). The Biodiversity Convention focuses on the sustainable use of the elem ents of biodiversity and the establishing of econom ic incentives to conserve nature. For m edicinal plants this m eans giving preference to a com patible level of collecting w ild plants, rather than cropping them on a large scale. If m edicinal plants are only cultivated as field crops, there is no econom ic incentive to retain their natural habitat. The Convention therefore opposes the opinion w idely held by traditional ecologists that rare m edicinal plants should be cultivated, so that collecting w ild populations w ill cease. W hether to prom ote w ild collection or cultivated production has to be w eighed up in each case. The Y atam ansi root native to N epali highlands is an exam ple: It is frequently used in A yurvedic m edicine, and large quantities are exported to India. A s it becam e im possible to cover the dem and by collecting w ild grow ing plants, it seem ed justified to cultivate the crop in order to cover dem and yet retain the species - and this approach is show ing success. The CITES Convention developed a m onitoring system for international trade in endangered species of fauna and flora. A s soon as a species listed on the annex to the Convention is im ported into another m em ber state, a certificate of origin has to be brought forw ard certifying that the species in question is not endangered there. International trade can also be com pletely prohibited if necessary.
The annexes to the CITES Convention contain more than 100 plant species used at least occasionally for medicinal purposes. A dozen of these are traded on a significant international scale, including agarw ood (Aquilaria m alaccensis) from India and other A sian countries, am erican ginseng (Panax quinquefolius)from the U SA and Canada and the A loe (Aloe ferox) from Southern A frica.
K now ledge of w hich m edicinal plant to use w hen, is often passed dow n over m any generations. Traditional healers have recourse to a w ide range of different m edicinal plants. Their exclusive know ledge on w hen to use w hat gives them high social esteem . Traditional m edicine often m ixes real rem edies, as w e know in W estern science, w ith others w hich just have a placebo effect. Representative ethno-botanical surveys are aim ing to m ake traditional know ledge available beyond its original locality. Traditional healers, m edicine-m en and herbal w om en, etc. are interview ed and inventories draw n up of the m edicinal plants they use. Experience now show s that only those plants that are used significantly by different groups of people do in fact contain biologically active ingredients. The potential of local know ledge and the possibility of m anufacturing new m edicines is often over-estim ated. H igh-input ethno-botanical surveys over m any years have not yet yielded approaches that can be used on industrial scale. The anticipation that the benefits resulting from indigenous know ledge can be returned to the original resource carriers in a benefit-sharing process m ay take decades to m aterialise and in the final instance even be a com plete failure because no m onetary value can be put on the results obtained. Ethno-botanical surveys nevertheless do regularly lead to the discovery of new agents to com bat w idespread diseases and ailm ents such as diarrhoea, infections, stom ach pains, m alaria, etc. A part from the fact that they are locally available, how ever, these discoveries are seldom m ore effective than active ingredients already know n.
Strategies to dissem inate the use of m edicinal plants
W hereas biodiversity in general has a high potential for finding new m edically active ingredients, enhancing the need to protect biodiversity, this is rarely an issue of prim ary significance for practical developm ent co-operation projects. H ere, a m ore prom ising approach is to confirm the resources of plants w ith an already know n m edicinal effect and to investigate and prom ote their use potential and m arketing opportunities. H igh inputs and expertise are required to verify the effectiveness of m edicinal plants, m any of w hich generate a subjective healing process although the therapeutic im pact cannot be objectively verified or transferred to other patients. To prom ote the use of m edicinal plants in m edicine, the effectiveness of each species and each application has to be verified and, as w ith any other m edicine, quality and safety aspects m ust be exam ined (side effects!). A G TZ assisted project in Indonesia (on im proving the use of traditional m edicinal plant preparations) developed a strategy to incorporate the w ide-spread therapeutic use of m edicinal plants into the country'
ensuring that specific quality criteria are adhered to (in Indonesia about 70 percent of all diseases are treated with traditional rem edies). In the scope of existing structures some 50 to 70 plant species are processed and undergo a medical-pharm aceutical evaluation each year. The costs per plant range from DM 3,000 to 5,000. Monographs were drafted for a pharm acopoeia, the basis for any pharm aceutical applications. Five varieties of m edicinal plant w ere processed in the project, to develop a pattern for further procedure; one of these, the Andrograhis paniculata w as identified as a prom ising anti-m alaria agent. M ax Kasparek w orks for the G TZ project "Im plem enting the Biodiversity Convention". H e is a m em ber of the "IU CN -Special Survival Com m ission" and co-author of the book "D irectory for M edicinal Plants Conservation" (Bonn,1996).
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