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Traditional medicine development for medical and dental primary health care delivery system in Africa.
African Journal of Traditional, Complementary and Alternative Medicines. 2005; 2(1):46-61.Traditional African Medicine (TAM) is our socio-economic and socio-cultural heritage, servicing over 80% of the populations in Africa. Although, it has come a long way from the times of our ancestors, not much significant progress on its development and utilization had taken place due to colonial suppression on one hand, foreign religions in particular, absolute lack of patriotism and political will of our Governments, and then on the other hand, the carefree attitudes of most African medical scientists of all categories. It is incontrovertible that TAM exhibits far more merits than demerits and its values can be exploited provided the Africans themselves can approach it with an open mind and scientific mentality. The degree of sensitization and mobilization by the World Health Organization (WHO) has encouraged some African countries to commence serious development on TAM. The African Regional Director of the WHO has outlined a few guidelines on the responsibilities of all African nations for the realistic development of TAM, in order to sustain our health agenda and perpetuate our culture. The gradual extinction of the forests and the inevitable disappearance of the aged Traditional Medical Practitioner should pose an impending deadline for us to learn, acquire and document our medical cultural endowment for the benefit of all Africans and indeed the entire mankind. (author's)
ESSENTIAL DRUGS MONITOR. 1991; (11):15-7.The WHO Programme on Traditional Medicine has joined WHO's global program on drug management and policies because there is a need for recognition that an adequate technological infrastructure must be in place to maximize plants for their medicinal value, especially in the context of primary health care (PHC). PHC places traditional medicine high on its list of priorities and emphasizes the availability and use of appropriate drugs. For example, countries should distribute seeds or plants to be cultivated in home or community gardens and taken as infusions. Scientists have not studied most medicinal plants which can be a rich potential resource for developing countries. Countries should apply known and effective technologies to meet health needs in a culturally acceptable manner and to promote self reliance. They must 1st strengthen data gathering and analysis capabilities needed for economic mapping of medicinal flora, then develop data centers on medicinal plants and plant derived products, such as the WHO Collaborating Center in Chicago. Clinical research should focus on the safety and efficacy of herbal medicines used by traditional health practitioners and on developing antiinfective agents. For example, 2 WHO agencies are collaborating on identifying, preparing, and testing extracts for medicinal plants for antiHIV capabilities. WHO favors developing the knowledge and skills of traditional health practitioners within the framework of PHC. Further, interregional workshops promote selection and use of traditional medicine in national PHC programs. Since there continue to be much public interest in medicinal plants, accurate information must be disseminated to the public and health professionals so they can know both the potential benefits and harmful effects of these remedies.
In: Future aspects in contraception. Proceedings of an International Symposium held in Heidelberg, 5-8 September 1984. Part 1. Male contraception. Boston, Massachusetts, MTP Press, 1985. 205-18.It is clear that there is now, and will continue to be, a need for safe, effective, affordable, and acceptable fertility-regulating agents for use by men as well as women. This need will be especially apparent in many developing countries of the world. Since plants are an abundant natural resource in most developing countries, it seems logical and prudent to initiate meaningful research programs designed to study the flora of such countries for useful drugs, including effective agents for fertility regulation. A brief resume is presented showing that obvious problems surround research involving the development of effective fertility-regulating agents from plants. Many of the problems can be overcome with assistance from organizations such as the Special Programme of Research, Development and Research Training in Human Reproduction of the World Health Organization. An ongoing activity of the WHO Special Programme, in the form of its Task Force on Plants for Fertility Regulation, has recently been established. This activity is target-oriented in having for its goal the development of safe, orally effective, plant-derived fertility regulating agents for use by the male and by the female as well. In establishing a network of collaborating centers, primarily located in developing countries, to carry out the research required to accomplish this objective, a major effort has been made to strengthen research capabilities related to fertility regulation. Evidence is presented that plants do contain substances that are capable of affecting fertility, but further research and development is required and many questions remain to be answered. Successful research and development programs, whether situated in developed or developing countries and regardless of the type of biological activity being pursued, somehow seem to lack the understanding and support of decision makers who can adequately fund such programs. Natural products research capability is a strength in most of the developing countries that is largely unnurtured, and encouragement, assistance, and support must be provided when a need is demonstrated. However, the majority of developing countries do not have the financial resources single-handedly to initiate and sustain meaningful research programs in the search for useful and effective plant-derived fertility-regulating agents that could improve health care in these countries. An attempt is made to illustrate that, on a global basis, plants historically and currently are a major source of drugs used to alleviate human suffering and improve health care. They represent an untapped reservoir of biodynamic agents. A WHO program for research on plants to discover useful fertility-regulating agents is described that must be characterized as limited, but can point to measurable successes. It can also serve as a model for the planning, organization, and implementation of similar programs in other developing countries. Development of practical fertility-regulating agents from plants is a high-risk and expensive venture that, even with a modest international investment, has turned a great deal of attention to an untapped resource that could eventually produce great benefits. (author's)
In: Chang CF, Griffin D, Woolman A, ed. Recent advances in fertility regulation: proceedings of a Symposium organized by the Ministry of Public Health of the People's Republic of China, and the World Health Organization's Special Programme of Research Development and Research Training in Human Reproduction, Beijing, 2-5 September, 1980. Geneva, Atar, 1981. 330-64.The development of safe, orally effective, fertility-regulating agents from higher plants for use in human beings is an old idea, but limited short-term research programs in this area have been unsuccessful in their efforts to find useful compounds. At this time more than 800 scientific articles can be cited that report 1 or more types of pharmacologic activity exhibited by extracts of plants and by substances of known structure derived from plants that bear some relevance to the topic of fertility regulation. Despite this body of information, a majority of the world scientific community continues to discount plants as a source of useful agents to regulate human fertility. This review presents the current status of world interest in plant-derived fertility-regulating agents. The attempt is made to clarify some of the undeserved negative options voided by many. An account is included of a unique interdisciplinary approach to the solution of problems in this area that has been organized by the Special Program of Research, Development and Research Training in Human Reproduction of the World Health Organization (WHO). The review covers the following: plants as a source of useful drugs; reliability of published experimental data on fertility-regulating plants; past work in the field of fertility-regulating plants; the WHO Task Force on indigenous plants for fertility regulation; and future prospects. It is generally recognized that the pharmaceutical industry in developed countries lacks interest in looking for new drugs in plants. Most scientists in developing countries whose interests are in the area of natural products have traditionally restricted their studies to indigenous flora. More than 1800 articles were found that presented information pertinent to fertility-regulating plants, but much of the data in these articles relates only indirectly, if at all, to practical human fertility regulation. The most important category of potentially useful information derived from the literature, aside from the vast amount of ethnomedical data, concerns reports that certain plant extracts elicit anti-implantation activity following oral or parenteral administration in a variety of laboratory species. It is unfortunate that most of the data seem to have limited credibility. It appears from the preliminary data that NAPRALERT computer analysis has been able to identify many promising fertility-regulating plants. 8 plants seem to have reproducible post-midcycle fertility-regulating activity following oral administration in a bioassay developed by the WHO Task Force.
Advances in Steroid Biochemistry and Pharmacology. 1979; 7:1-8.Due to the numerous adverse side effects of steroidal contraceptives which continuously arise and result in potential decreases in the benefit-to-risk ratio, new chemical and biologic strategies need to be designed and implemented to assure continued success in the contraceptive area. Novel contraceptive stragegies include both new chemical classes and their receptive biologic targets. 4 basic pharmacologic approaches subserve female contraception: inhibition of ovulation; inhibition of fertilization; inhibition of implantation; and interruption of established implantation. Many diverse compounds have been evaluated in regard to a male contraceptive, but problems of toxicity and loss of libido have made the search difficult. The problem is further complicated by the task of trying to eliminate the hundreds of millions of sperm that are constantly being produced and which are in different stages of the spermatogenic cycle. This task calls for chronic dosing and the accompanying problem of eventual liver involvement and hypertrophy of the secondary accessory sex organs. An interesting area supported by the World Health Organization is the identification of plants and the isolation of their active principles for fertility regulating purposes. The United States National Institute of Health supports 3 major and separate programs related to contraception: 1) synthesis and testing of anti-ovulatory agents; 2) synthesis and testing of male contraceptive agents; and 3) peptide antagonists of LH-RH (luteinizing hormone-releasing hormone) as ovulation inhibitors. The following categories represent areas of research that might prove fruitful: LH-RH agonists; LH-RH antagonists; non-natural synthetic products; inhibin; and plant extracts. These categories are reviewed.
Bulletin of the World Health Organization. 1978; 56(3):343-52.The WHO Special Programme of Research, Development and Research Training in Human Reproduction has established a 6-center program to investigate new fertility regulating agents from plants for use in humans. Establishment of the project was preceded by a comprehensive search of the literature, including the following sources: 1) articles on medical botany; 2) reports of testing crude plant extracts for fertility regulating purposes; 3) reports of in vitro effects of plant extracts; and 4) reports of a limited number of experimental studies in human subjects. The limitations of these sources of data are discussed. Information on 3000 plants was collected and computerized, using a weighting system, in order to assign priorities on the plant substances most promising for further study. The 6 centers will then procede to initiate pharmacological and chemical studies on the priority substances. Both male and female antifertility agents are included in the study. (Summary in FRE)
[Status of research in the field of developing modern methods of birth rate regulation (based on data of the WHO enlarged program of human reproduction in 1977)] o sostoianii nauchnykh issledovani: i v oblasti razrabotki sovremennykh metodov reguliatsii rozhdaemosti (po dannym rasshirenno: i programmy VOZ poreproduktsii cheloveka za 1977.
AKUSHERSTVO I GINEKOLOGIIA. 1979; 2:3-5.The problem of human reproduction, especially of birth rate regulation has received much attention in the last decade. The main goal of the enlarged program of research undertaken by WHO in 1977 is to find modern, safe, convenient, and effective methods of contraception which are helpful for family planning. The basic topics under study are oral contraceptives, hormonal medications with prolonged effectiveness, intrauterine contraception, intravaginal and intercervical contraception, contraceptives from plants, biochemical methods of determining ovulation and others. Promising methods under study are the immunological approach based on the search for vaccines with the ability to inhibit sperm locomotion, development of zygote or implantation of the ovum and new methods for male fertility contraception (e.g., intranasal introduction of steroids). Definite attention is paid to methods of surgical sterilization of men and women. Problems of the postabortion period and treatment of infertility are also under intensive investigation in many countries participating in the WHO enlarged program on human reproduction.
American Pharmacy. 1979 Sep; 19(10):23-4.Pharmaceutical scientists and botanists from all over the world met at the University of Illinois to map a 3-year program for collecting and testing plants which may be effective in regulating fertility. Launched in July, 1979, the project will continue through May, 1982. The study is sponsored by the World Health Organization. More than 100 pounds of each plant sample are needed for the pharmacological and phytochemical tests. 300 plant species will be studied, which represents only a fraction of the almost 4000 species for which fertility-regulating information has been gathered. In 1974 Americans paid about $3 billion for prescriptions of plant-extracted drugs. In the same year the pharmaceutical companies devoted only $200,000 of a $1 million research effort to the study of plant extracts. The plant data are being analyzed and stored with the help of a computer system developed at the Illinois College of Pharmacy. The Natural Products Alert (NAPRALERT) system considers whether or not a plant is poisonous or has adverse side effects. An estimated 5000 scientific periodicals are computerized per year. Some 4000 plants are listed, but another 4000 with fertility regulation potential are expected to be recorded. Some 750,000 species of flowering plants grow on earth.
WHO Chronicle 33:58-59. February 1979.6 centers have been designated to conduct research aimed at finding new and effective fertility regulating agents from plants. The centers are part of the WHO Special Program of Research, Development and Research Training in Human Reproduction. Information concerning about 3000 plants has already been computerized. The sources of this information are many and varied. Some of the reports are scientifically based. Some contain vague or hearsay evidence, and others use terminology which raises questions about the authors' awareness of some of the terms they used. Thus, currently, the amount of detail available regarding the administration of these plants for fertility regulation often provides an inadequate basis for assessing the possible mechanism of action. For the purposes of the WHO program, in which a Task Force has been established in this subject, only certain types of fertility regulating agents are being considered. Each is being assigned to a specific category, according to its use. The compuer is fed all the available weighted data concerning fertility regulation for each plant and for each category of fertility regulating agent. On this basis, the computer then provides a priority rank-ordered list of plants to assist in the selection of the most appropriate plants for experimental investigation by the 6 centers in the program. Each of the 6 centers will be assigned plants from the rank-ordered priority list, those indigenous to the country where the center is located being assigned there if possible. A few parallel studies will continue to be supported by WHO, based on the needs of the program and the merits of each study.
WHO Chronicle 33:56-57. February 1979.In May 1978 the 31st World Health Assembly urged the World Health Organization (WHO) to compile an inventory of medicinal plants with standardized botanical nomenclature of those most widely used and to compile and periodically update a therapeutic classification of the plants. WHO was also asked to review the available scientific data relating to the efficacy of medicinal plants and their products in the treatment of specific conditions and diseases and to make available the results of such reviews. In response, WHO has compiled an inventory of plants known to be used for therapeutic purposes thorughout the world. WHO will extract from the inventory a list of the plants which really do exert some pharmacological effect and which are most widely used. The initial list will consist of 228 plants. To draw up this preferential list of most used medicinal plants, a classification into 3 categories will be made: 1) plants that are used directly in therapy; 2) plants that constitute the raw mateiral for galenicals; and 3) plants that constitute the raw material for industrial processing and which are used either for the extraction and purification of their active principles or used as starting materials or intermediates for synthetic preparations. A code of specifications for vegetable drugs belonging to the 3 categories already classified in also planned. Much work needs to be done on medicinal plants used in traditional medicine and those whose reputed therapeutic properties have not yet been scientifically assessed.
World Health. 1978 Aug-Sept; 16-19.Although no plant has yet been scientifically shown to have fertility-regulating effects in humans, peripheral evidence warrants an organized effort in this area. And although large numbers of people in the world use plants as drugs, most notably in China, at present the only plant principles found useful in humans for conditions relating to fertility regulation - the alkaloids sparteine and pachycarpine - cannot be used in a practical way. Perhaps the most interesting agent in plants which has been extensively studied in humans is m-xylohydroquinone, isolated from the common pea. Its antifertility activity was studied in Indian women, but found to be only 60% effective. A thorough reevaluation of this agent might prove useful. The Task Force on Indigenous Plants for Fertility Regulation at WHO has initiated a collaborative effort to conduct laboratory tests on plants alleged to have fertility-regulating properties. The testing procedures are complicated, and although it is too soon to determine results, the untapped potential for development of a plant-derived, safe and inexpensive fertility-regulating agent, is significant.
IPPF News 2(5): 3. September-October 1977.The International Planned Parenthood Federation finances more than $100,000 in biomedical research grants annually. The grants, given to scientists around the world, are to finance research into better maternal and child health programs and safer and more effective contraceptives. Examples of current projects are cited, e.g., nutrition, IUD mode of action, contraceptive properties of plants, and child spacing.