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Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania.
Tanzania Health Research Bulletin. 2007 May; 9(2):115-120.Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania. (author's)
Lancet Infectious Diseases. 2007 May; 7(5):313.In Zambia, widespread promotion of claims that herbal remedies can cure HIV/AIDS have been making individuals with HIV/AIDS abandon their antiretroviral therapy for ineffective drugs, the Network of Zambian People Living with HIV and AIDS has warned. Miriam Banda of the Network told journalists that both print and electronic media in the country have been persistently carrying advertisements and news stories that bring false hope to people living with HIV/AIDS. It is unclear how many people have been leaving antiretroviral programmes in the country as a result of these claims. At least 1.1 million people of Zambia's 11.6 million population have HIV/AIDS, which has devastated the economy and decreased life expectancy at birth to less than 40 years. (excerpt)
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)
WORLD HEALTH FORUM. 1993; 14(4):390-5.About 80% of the world's people depend largely on traditional plant-derived drugs for their primary health care (PHC). Medicinal plants serve as sources of direct therapeutic agents and raw materials for the manufacture of more complex compounds, as models for new synthetic products, and as taxonomic markers. Some essential plant-derived drugs are atropine, codeine, morphine, digitoxin/digoxin, and quinine/artemisinin. Use of indigenous medicinal plants reduces developing countries' reliance on drug imports. Costa Rica has set aside 25% of its land to preserve the forests, in part to provide plants and other materials for possible pharmaceutical and agricultural applications. The Napralert database at the University of Illinois establishes ethnomedical uses for about 9200 of 33,000 species of monocotyledons, dicotyledons, gymnosperms, lichens, pteridophytes, and bryophytes. Sales of crude plant drugs during 1985 in China equaled US$1400 million. Even though many people use medicinal plants, pharmaceutical firms in industrialized nations do not want to explore plants as sources of new drugs. Scientists in China, Germany, and Japan are doing so, however. Screening, chemical analysis, clinical trials, and regulatory measures are needed to ensure safety of herbal medicines. WHO has hosted interregional workshops to address methodologies for the selection and use of traditional medicines in national PHC programs. WHO, the International Union for the Conservation of Nature and Natural Resources, and the World Wide Fund for Nature developed guidelines for conservation of medicinal plants. Their 2-pronged strategy includes prevention of the disappearance of forests and associated species and the establishment of botanical gardens. WHO's Traditional Medicine Programme hopes that people will apply known and effective agroindustrial technologies to the cultivation and processing of medicinal plants and the production of herbal medicines and the creation of large-scale networks for the distribution of seeds and plants.
MEDICAL ANTHROPOLOGY QUARTERLY. 1992 Jun; 6(2):99-113.In drug development and marketing, multinational companies tend to patronize developing countries and even raise health risks by distributing products of questionable utility. The World Health Organization has pushed for standardization and quality assurance of drugs to compel companies to fully disclose adverse reactions. Clinical trials use small and unrepresentative samples, thus longterm side effects are not taken into consideration such as steroid-induced hypertension in asthma patients. Unintended side effects are true side effects in the view of some (hair loss and lacrimation in anticoagulant therapy). Reactions that encompass primary and secondary effects include allergic reactions, hypersensitivity, and the corollaries of differential drug metabolism (serum albumin polymorphisms, G6PD deficiency, hemoglobinopathies, and hepatic enzyme irregularities). Primary action and side effects are subject to interpretations, as the antihistamine Benadryl causes drowsiness when used for allergies, but as a sedative its ability to induce drowsiness is the primary action. Minoxidil promotes hair growth, but it was originally developed as an oral hypotensive, and it also could treat impotence. RU-486 or mifepristone, the abortion pill, has been used for glaucoma and brain tumor treatment. The Hausa of Nigeria use both indigenous plant medicines and drugs, but their cultural interpretation of drug effects can lead to confusion: bitter plants have been used as abortifacients and the bitter drugs chloroquine, penicillin, and chloramphenicol have also been endowed with such qualities. Stomach aliments are treated with chile pepper, coffee senna, and balsam apple along with erythromycin and salicylates to induce purging. The tooth discoloration caused by tetracycline therapy is imputed to witchcraft. A more relativistic approach concerning the side effects of drugs is needed as their perception in many cultures is conceptually different.
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)
Geneva, Switzerland, WHO, 1978. 41 p. (Technical Report Series No. 622)A WHO meeting to study the promotion and development of traditional medicine was held in late 1977. Traditional medicine concepts and its place in health care are discussed. The fact that traditional medicine consists of a great deal more than the use of medicinal plants is illustrated with discussions of indigenous medical systems from various countries. Much of traditional medicine has been shown to have intrinsic value. It should be evaluated and its efficacy, safety, and availability improved. This should be done because the use of traditional medicine is the surest means of achieving total health care coverage of the world population, using safe, acceptable, and economical means, by the year 2000. The meeting discussed methods of integrating traditional medicine and traditional medical practitioners into the national health care systems of developing nations. Examples of such integration from various countries are cited. Manpower in this area can best be developed by utilizing and retraining, if necessary, existing personnel, including TBAs (traditional birth attendants). Research priorities in the field will vary with cultural settings. The various possible research approaches are illustrated with case studies.
In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 184-93.It has been estimated that from 25 to 75 thousand species of higher (flowering) plants exist on earth. Of these only about 1% are acknowledged through scientific studies to have real therapeutic value when used in extract form by humans. A computerized data base on the chemistry and pharmacology of natural products is available. The data base is maintained in the Department of Pharmacognosy and Pharmacology, College of Pharmacy, University of Illinois, at the Medical Center, and has been given the acronym NAPRALERT (Natural Products ALERT). A systematic surveillance of the world literature on the chemistry and pharmacology of natural products has been in progress since 1975. In addition, a substantial amount of retrospective information has been acquired and computerized on selected genera of plants and on the pharmacological activities of natural products. These retrospective searches extend back into the mid 1700s. The major fields covered in the NAPRALERT system are 1) the organism record; 2) work types; 3) compound record; 4) pharmacology record; and 5) demographic record. There are 2 major areas in which traditional medicine can be served through the use of NAPRALERT: data retrieval and problem solving. Since most problems in traditional medicine are regional ones, it is possible to program the NAPRALERT data base to respond primarily to questions concerning plants of a specific country, or within a given continent. Recently the NAPRALERT base has been made available to individuals, industrial firms, academic institutions and government agencies with a modest fee calculated on the basis of actual computer time required to generate data output, the cost of copying the material and the mailing costs. In the near future, NAPRALERT will be approaching international funding agencies to enlist their cooperation in financing a 10 year program that will allow them to computerize all of the world literature on natural products as far back as 1900. This will be an enormous effort, which cannot be effectively accomplished without direct cooperation from interested scientists and institutions in developing countries. A plan for obtaining that objective is outlined.
In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 194-206.There is a genuine interest now being taken in phytotherapy and medicinal plants throughout the world. In industrialized countries there is a trend of going back to nature or wanting to combat the chemical pollution of the body provoked by inopportune chemotherapy or by the misuse of convenience drugs of chemical origin; third world countries are primarily concerned with providing their peoples with adequate coverage of their essential drug needs. A new type phytotherapy is proposed, to produce phytotherapeutic preparations for use in modern medical practice from the resources of traditional medication. In view of difficulties experienced by developing countries in meeting their needs for essential drugs, 4 measures might be taken to encourage utilization for primary health care of their vast local resources: 1) a real health policy option at national and regional level; 2) determination of priorities regarding health problems and definition of possible solutions; 3) goal-oriented applied scientific research on medicinal plants, incorporating properly planned programs; 4) effective implementation of these programs with regard to technical and financial resources and appropriate personnel. Cooperation among developing countries, with the industrialized countries and with organizations of the United Nations system is recommended. A table illustrates integrated overall organization.
In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 236-78.The various systems of traditional medicine in the countries of the Western Pacific Regions have several characteristics, including a long history, usually dating back many centuries. The resources in medicinal plants are rich, especially in the subtropical and tropical zones, although their development in different countries is unequal. While accepted by the general population, particularly among rural inhabitants, traditional medicine is often rejected or ignored by modern medical practitioners and by the more affluent and educated classes in some countries. Practices observed in the region follow 1 of 2 patterns. 1 model is highly institutionalized, with formal academic training in a variety of disciplines in recognized schools, professional associations, and official recognition. The Chinese system and Hindu medicine practiced in Malaysia, Singapore, Fiji, and Australia follow this pattern. The 2nd pattern is less well defined and institutionalized but nevertheless deeply rooted in the culture of the particular community in which it is practiced. The role of traditional healers in the region; the Chinese system of traditional medicine; traditional medicine in China today including the practice of acupuncture; research in herbal drugs; traditional Chinese medicine in other countries including Vietnam, Malaysia, the Republic of Korea, and Japan; and folk and tribal medicines in the Philippines and rural Malaysia and South Pacific countries such as Papua New Guinea, Kiribati, and Fiji are discussed. WHO stimulates the development of traditional medicine in the region by supporting research, training traditional practitioners and encouraging their integration into health care systems as well as their participation in information sharing publications and activities.
Evaluation of the work of the Task Force on Indigenous Plants for Fertility Regulation of the Special Programme of Research in Human Reproduction.
In: Assessment of the WHO Special Programme of Research, Development and Research Training in Human Reproduction [HRP]. II. Task Force reports. Country reports, [compiled by] Sweden. Swedish Agency for Research Cooperation with Developing Countries [SAREC]. Stockholm, Sweden, SAREC, 1983 Apr.  p..This report describes and evaluates the work of the Task Force on Indigenous Plants for Fertility Regulation of the Special Programme of Research in Human Reproduction at WHO. The goal of the project is to set up a network of collaborating centers to train personnel, design bioassays, isolate and test plant substances that are safe and effective by oral route for "morning after" pills or anti-implantation agents or male contraceptives. Plants chosen for assay were selected by a literature search including ethnomedical sources. All data were computerized, weighted and rank ordered. 300 of the 4500 species fell into the high priority group. 4 research centers now participate: Chinese University of Hong Kong, Seoul National University, University of Peradeniya, Sri Lanka and University of Illinois. In 1980-1981 the literature surveillance component of the Task Force provided bi-annual literature updates on the assigned plants. Primate studies are planned for 1982 and phase I human trials are anticipated in 1985 for the 1st compound. Zoapatle (Montanoa tomentosa) is a plant used for centuries in Mexico to terminate early pregnancy. An active compound, zoapatanol, and another more stable analogue are in pre-phase I trials. 4 plants from India are being examined for sperm agglutination activity, the spermatogenesis inhibiting effect of Koenchai (Chinese celery) and the mechanism of action of gossypol are being researched.