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. Centre for Science and Technology of the Non-Aligned and Other Developing Countries (NAM S&T Centre) Core-6A, 2nd Floor, India Habitat Centre, Lodhi Road, New Delhi-110 003 (India) Phone: +91-11-24644974,24645134, Fax: +91-11-24644973 E-mail: [email protected] Website: www.namstct.org Published by : Daya Publishing House 1'123/74, Deva Ram Park, Tri Nagar, Delhi -110 035 Phone: 27383999, Fax: (011)23260116 e-mail: [email protected] website: www.dayabooks.com Showroom: 4760-61/23, Ansari Road, Darya Ganj New Delhi -110 002 Phone: 23245578, 23244987 Laser Typesetting : Classic Computer Services Delhi -110035 Printed at : Ch awl a Offset Printers Delhi -110052 Printed in India 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