Re: Herbal Medicines Pose Dangers to Public – Health Experts Cautions

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Herbal Medicine
Herbal Medicine

My attention was recently drawn to an article published in the Ghanaian Times (Saturday, 21st May 2022), which was attributed to one Dr. Adam Atiku, the Director of Medicine at the Tamale Teaching Hospital, warning the general public to desist from patronizing herbal medicines as they pose danger to the general public. Be it as it may, I found the headline by the Ghanaian Times misleading, as the substance of the story, did not match the headline it was given. 

Dr. Atiku asserted that some herbal medicines were not verified scientifically, and pose danger to the health of the people. This assertion, I understand. And as an objective scientist and researcher in Naturopathy, it is trite that some herbals are not verified scientifically.  I think Ghanaian Times could have done the public good with a more appropriate headline.  In an era of evidence-based medicine, we need to do away with the practice of “emotional medicine”.  I believe we need more Medical Journalists in Ghana to report on medical issues as the mainstream Journalists who have no medical background are reporting on scientific issues wrongly.  

We cannot survive as a species without herbs. Without plants, we would lose the human race as they aid our survival.  Plants protect us and preserve our mere existence.   Pharmaceutical industries largely depend on plants for the development of mainstream drugs.  A full 40 percent of the drugs behind the pharmacist’s counter in the Western world are derived from plants that people have used for centuries, including the top 20 best-selling prescription drugs in the United States today.

Vickers et al., (2001) note that many conventional drugs originate from plant sources. About a century ago, most of the few effective drugs were plant-based. Examples include aspirin (from willow bark), digoxin (from foxglove), quinine (from cinchona bark), and morphine (from the opium poppy). Find below a summary of drugs derived from plant sources (Taylor, Leslie. Plant-Based Drugs and Medicines. Square One Publishers, 2000, Garden City Park, N.Y)

                                                Drugs Derived from Plants
Drug/Chemical Action Plant Source
Acetyldigoxin Cardiotonic Digitalis lanata (Grecian foxglove, woolly foxglove)
Adoniside Cardiotonic Adonis vernalis (pheasant’s eye, red chamomile)
Aescin Anti-inflammatory Aesculus hippocastanum (horse chestnut)
Aesculetin Antidysentery Fraxinus rhychophylla
Agrimophol Anthelmintic Agrimonia supatoria
Ajmalicine Treatment for circulatory disorders Rauvolfia sepentina
Allantoin Vulnerary Several plants
Allyl isothiocyanate Rubefacient Brassica nigra (black mustard)
Anabesine Skeletal muscle relaxant Anabasis sphylla
Andrographolide Treatment for bacillary dysentery Andrographis paniculata
Anisodamine Anticholinergic Anisodus tanguticus
Anisodine Anticholinergic Anisodus tanguticus
Arecoline Anthelmintic Areca catechu (betel nut palm)
Asiaticoside Vulnerary Centella asiatica (gotu cola)
Atropine Anticholinergic Atropa belladonna (deadly nightshade)
Benzyl benzoate Scabicide Several plants
Berberine Treatment for bacillary dysentery Berberis vulgaris (common barberry)
Bergenin Antitussive Ardisia japonica (marlberry)
Betulinic acid Anticancerous Betula alba (common birch)
Borneol Antipyretic, analgesic, antiinflammatory Several plants
Bromelain Antiinflammatory, proteolytic Ananas comosus (pineapple)
Caffeine CNS stimulant Camellia sinensis (tea, also coffee, cocoa, and other plants)
Camphor Rubefacient Cinnamomum camphora (camphor tree)
Camptothecin Anticancerous Camptotheca acuminate
(+)-Catechin Hemostatic Potentilla fragarioides
Chymopapain Proteolytic, mucolytic Carica papaya (papaya)
Cissampeline Skeletal muscle relaxant Cissampelos pareira (velvet leaf)
Cocaine Local anesthetic Erythroxylum coca (coca plant)
Codeine Analgesic, antitussive Papaver somniferum (poppy)
Colchiceine amide Antitumor agent Colchicum autumnale (autumn crocus)
Colchicine Antitumor, antigout Colchicum autumnale (autumn crocus)
Convallatoxin Cardiotonic Convallaria majalis (lily-of-the-valley)
Curcumin Choleretic Curcuma longa (turmeric)
Cynarin Choleretic Cynara scolymus (artichoke)
Danthron Laxative Cassia species
Demecolcine Antitumor agent Colchicum autumnale (autumn crocus)
Deserpidine Antihypertensive, tranquilizer Rauvolfia canescens
Deslanoside Cardiotonic Digitalis lanata (Grecian foxglove, woolly foxglove)
L-Dopa Anti-parkinsonism Mucuna species (nescafe, cowage, velvetbean)
Digitalin Cardiotonic Digitalis purpurea (purple foxglove)
Digitoxin Cardiotonic Digitalis purpurea (purple foxglove)
Digoxin Cardiotonic Digitalis purpurea (purple or common foxglove)
Emetine Amoebicide, emetic Cephaelis ipecacuanha
Ephedrine Sympathomimetic, antihistamine Ephedra sinica (ephedra, ma huang)
Etoposide Antitumor agent Podophyllum peltatum (mayapple)
Galanthamine Cholinesterase inhibitor Lycoris squamigera (magic lily, resurrection lily, naked lady)
Gitalin Cardiotonic Digitalis purpurea (purple or common foxglove)
Glaucarubin Amoebicide Simarouba glauca (paradise tree)
Glaucine Antitussive Glaucium flavum (yellow horn poppy, horned poppy, sea poppy)
Glasiovine Antidepressant Octea glaziovii
Glycyrrhizin Sweetener, treatment for Addison’s disease Glycyrrhiza glabra (licorice)
Gossypol Male contraceptive Gossypium species (cotton)
Hemsleyadin Treatment for bacillary dysentery Hemsleya amabilis
Hesperidin Treatment for capillary fragility Citrus species (e.g., oranges)
Hydrastine Hemostatic, astringent Hydrastis canadensis (goldenseal)
Hyoscyamine Anticholinergic Hyoscyamus niger (black henbane, stinking nightshade, henpin)
Irinotecan Anticancer, antitumor agent Camptotheca acuminate
Kaibic acid Ascaricide Digenea simplex (wireweed)
Kawain Tranquilizer Piper methysticum (kava kava)
Kheltin Bronchodilator Ammi visage
Lanatosides A, B, C Cardiotonic Digitalis lanata (Grecian foxglove, woolly foxglove)
Lapachol Anticancer, antitumor Tabebuia species (trumpet tree)
a-Lobeline Smoking deterrent, respiratory stimulant Lobelia inflata (Indian tobacco)
Menthol Rubefacient Mentha species (mint)
Methyl salicylate Rubefacient Gaultheria procumbens (wintergreen)
Monocrotaline Topical antitumor agent Crotalaria sessiliflora
Morphine Analgesic Papaver somniferum (poppy)
Neoandrographolide Treatment of dysentery Andrographis paniculata
Nicotine Insecticide Nicotiana tabacum (tobacco)
Nordihydroguaiaretic acid Antioxidant Larrea divaricata (creosote bush)
Noscapine Antitussive Papaver somniferum (poppy)
Ouabain Cardiotonic Strophanthus gratus (ouabain tree)
Pachycarpine Oxytocic Sophora pschycarpa
Palmatine Antipyretic, detoxicant Coptis japonica (Chinese golden thread, goldthread, Huang-Lia)
Papain Proteolytic, mucolytic Carica papaya (papaya)
Papaverine Smooth muscle relaxant Papaver somniferum (opium poppy, common poppy)
Phyllodulcin Sweetener Hydrangea macrophylla (bigleaf hydrangea, French hydrangea)
Physostigmine Cholinesterase inhibitor Physostigma venenosum (Calabar bean)
Picrotoxin Analeptic Anamirta cocculus (fish berry)
Pilocarpine Parasympathomimetic Pilocarpus jaborandi (jaborandi, Indian hemp)
Pinitol Expectorant Several plants (e.g., bougainvillea)
Podophyllotoxin Antitumor, anticancer agent Podophyllum peltatum (mayapple)
Protoveratrines A, B Antihypertensives Veratrum album (white false hellebore)
Pseudoephedrine Sympathomimetic Ephedra sinica (ephedra, ma huang)
nor-pseudoephedrine Sympathomimetic Ephedra sinica (ephedra, ma huang)
Quinidine Antiarrhythmic Cinchona ledgeriana (quinine tree)
Quinine Antimalarial, antipyretic Cinchona ledgeriana (quinine tree)
Qulsqualic acid Anthelmintic Quisqualis indica (Rangoon creeper, drunken sailor)
Rescinnamine Antihypertensive, tranquilizer Rauvolfia serpentine
Reserpine Antihypertensive, tranquilizer Rauvolfia serpentine
Rhomitoxin Antihypertensive, tranquilizer Rhododendron molle (rhododendron)
Rorifone Antitussive Rorippa indica
Rotenone Piscicide, Insecticide Lonchocarpus nicou
Rotundine Analagesic, sedative, traquilizer Stephania sinica
Rutin Treatment for capillary fragility Citrus species (e.g., orange, grapefruit)
Salicin Analgesic Salix alba (white willow)
Sanguinarine Dental plaque inhibitor Sanguinaria canadensis (bloodroot)
Santonin Ascaricide Artemisia maritma (wormwood)
Scillarin A Cardiotonic Urginea maritima (squill)
Scopolamine Sedative Datura species (e.g., Jimsonweed)
Sennosides A, B Laxative Cassia species (cinnamon)
Silymarin Antihepatotoxic Silybum marianum (milk thistle)
Sparteine Oxytocic Cytisus scoparius (scotch broom)
Stevioside Sweetener Stevia rebaudiana (stevia)
Strychnine CNS stimulant Strychnos nux-vomica (poison nut tree)
Taxol Antitumor agent Taxus brevifolia (Pacific yew)
Teniposide Antitumor agent Podophyllum peltatum (mayapple or mandrake)
Tetrahydrocannabinol ( THC) Antiemetic, decreases ocular tension Cannabis sativa (marijuana)
Tetrahydropalmatine Analgesic, sedative, tranquilizer Corydalis ambigua
Tetrandrine Antihypertensive Stephania tetrandra
Theobromine Diuretic, vasodilator Theobroma cacao (cocoa)
Theophylline Diuretic, bronchodilator Theobroma cacao and others (cocoa, tea)
Thymol Topical antifungal Thymus vulgaris (thyme)
Topotecan Antitumor, anticancer agent Camptotheca acuminate
Trichosanthin Abortifacient Trichosanthes kirilowii (snake gourd)
Tubocurarine Skeletal muscle relaxant Chondodendron tomentosum (curare vine)
Valapotriates Sedative Valeriana officinalis (valerian)
Vasicine Cerebral stimulant Vinca minor (periwinkle)
Vinblastine Antitumor, Antileukemic agent Catharanthus roseus (Madagascar periwinkle)
Vincristine Antitumor, Antileukemic agent Catharanthus roseus (Madagascar periwinkle)
Yohimbine Aphrodisiac Pausinystalia yohimbe (Yohimbe)
Yuanhuacine Abortifacient Daphne genkwa (lilac)
Yuanhuadine Abortifacient Daphne genkwa (lilac)

 

The development of drugs from plants continues, with pharmaceutical companies engaging in large-scale pharmacological screening of herbs. ​ Today, we hail India, China, and many other countries for their large investments and immense development in their Traditional Medicine sector, yet we as a nation are trying to destroy ours. Are we waiting for people from other countries to come and tell us the potentials we have before we develop our herbal and natural medicine sector? I can tell you on authority, that many medical professionals opt for herbal products in this country. The likes of Duffy Ohemaa Products making waves in this country and many others are doing extremely well in the herbal sector. All they need is just government support to compete globally. 

Today, India is promoting Ayush visas for tourists who want to visit their country to seek Traditional Medicines.  As a way to improve Ayush products, India will soon introduce the AYUSH mark, which will give authenticity to quality AYUSH products in the country. The mark will be given to products vetted using the latest technology. This will give confidence to people around the world that they are purchasing quality AYUSH products.

According to aihms.in (2021), India has over 3000 hospitals and 500 colleges committed to the spread of AYUSH practices, India has arisen as a world leader in this branch of medicine. Numerous wellness parks have also been established around the country that emphasize the significance of AYUSH practices.

AYUSH includes Ayurveda, yoga and naturopathy, Unani, Siddha, and homeopathy. The objective of AYUSH is to promote medical pluralism and to introduce strategies for mainstreaming the indigenous systems of medicine. In India, at the Union Government level, AYUSH activities are coordinated by the Department of AYUSH, under the Ministry of Health and Family Welfare.

These medicines are cost-effective as compared to other synthetic products. At present, India is also one of the top exporters of alternative medicines in the world. Major export destinations include the United States and European countries like Germany and France. The government of India is continuously supporting the industry with investments in scientific research in AYUSH, building the necessary infrastructure and regulatory framework to regulate this system of medicine.

A report by Mordor Intelligence (2022) found that AYUSH and the alternative medicine industry in India are expected to register a CAGR of 8.6% during the forecast period. In the context of COVID-19, the market for alternative medicines, like Ayurveda, has increased due to the increasing demand for various ayurvedic products to boost immunity. According to a report published in August 2020, beginning March 2020, the demand for honey went up 45%, chyawanprash by 85%, and turmeric by 40% in ayurvedic stores. The interest in these products was mostly fueled by the recommendations from the Ministry of AYUSH to fight COVID-19.

The Hindu (2022) also reported that the global market for herbal medicine was valued at $657.5 billion in 2020. It is expected to grow to $746.9 billion by the end of  2022. In China, the traditional medicine industry had total revenue of $37.41 billion in 2018, according to an IBISWorld report.

The Indian Business Today (2021) also reported that the market size of the AYUSH sector grew by 17 percent between 2014 and 2020 to reach $18.1 billion, according to the Union Ayush Minister Sarbananda Sonowal.  Despite a slump in economic activity in 2020 due to the COVID-19 pandemic, the industry was projected to reach $20.6 billion in 2021 and $23.3 billion in 2022. In terms of the global share, India has grown faster in the AYUSH market as compared to the world and accounts for about 2.8 percent of the market, which it is likely to hold. Different product segments have grown at a much higher rate than the overall industry during the same time frame i.e., 2014 to 2020. Plant derivatives experienced 21 percent growth in the period 2014-2020 followed by nutraceuticals (20.5 percent), pharmaceuticals (15.8 percent), plant extracts 14.7 percent, and herbal plants (14.3 percent).

PharmaBiz.com (2022) also reported that the Indian Medicines Pharmaceutical Corporation Limited (IMPCL), the public sector manufacturing unit of the Ministry of Ayush recorded a turnover of Rs. 164.33 crore (tentative figure) for the financial year 2020 to 2021. This is the highest number achieved in the company’s history and an all-time high profit of approximately Rs 12 crore is reported for the year. In the previous year, 2019 to 2020, the best revenue figure of the company was Rs. 97 crores. This growth is reflective of the fast-growing adoption of Ayush products and services by the public in the wake of the Covid-19 pandemic.

In the case of China, in 1982, the Constitution of China gave full recognition to TCM. Since 2009, there has been continuous support for TCM in health policies. China has focused on developing quality infrastructure for TCM to co-exist with modern medicine under the same roof.

In November 2020, the AYUSH Ministry approved the manufacture of Astha-15, an Ayurvedic COVID-19 drug by Dalmia Healthcare. In May 2020, The AYUSH Ministry, in collaboration with the Health Ministry, launched the clinical trials of Ashwagandha, Yashtimadhu, Guduchi Pippali, and a polyherbal formulation (Ayush-64) Ayurvedic medicines for novel COVID-19 infection.

Regardless of why an individual uses it, traditional medicine provides an important health care service, whether people have physical or financial access to allopathic medicine, and it is a flourishing global commercial enterprise (Engebretson 2002Conboy et al., 2007Evans et al., 2007). In 1990, expenditure associated with “alternative” therapies in the United States was estimated to be US$13.7 billion. This had doubled by the year 1997, with herbal medicines growing faster than any other alternative therapy (Eisenberg et al. 1998). In Australia, Canada, and the United Kingdom, annual expenditure on traditional medicine is estimated to be US$80 million, US$1 billion, and US$2.3 billion, respectively. These figures reflect the incorporation of herbal and other forms of traditional medicine into many health care systems and its inclusion in the medical training of doctors in many parts of the developed world.

The total commercial value of the ethnobotanicals market cannot be ignored. In 1995, the total turnover of nonprescription-bound herbal medicines in pharmacies was equal to almost 30% of the total turnover of nonprescription-bound medicines in Germany, and in the United States, the annual retail sales of herbal products were estimated to be US$5.1 billion. In India, the use of herbal medicine is a common practice, and about 960 plant species are used by the Indian herbal industry, of which 178 are of a high volume, exceeding 100 metric tons per year (Sahoo, 2010). In China, the total value of herbal medicine manufactured in 1995 reached 17.6 billion Chinese yuan (approximately US$2.5 billion; Eisenberg et al., 1998WHO, 2001). This trend has continued, and annual revenues in Western Europe reached US$5 billion in 2003-2004 (De Smet, 2005). In China, sales of herbal products totaled US$14 billion in 2005, and revenue from herbal medicines in Brazil was US$160 million in 2007 (World Health Organization; http://www.who.int/topics/traditional_medicine/en/). It is estimated that the annual worldwide market for these products approached US$60 billion (Tilburt and Kaptchuk 2008).

We cannot demean our Traditional Medicines and hide in our bedrooms and use them privately.  I believe, Natural Medicines in Ghana could be another ‘e-levy’ to generate funds for the government if we pay attention to developing the herbal industry.  

Nobody is immune from herbs. We use them daily and they are in our kitchens. It is time we do away with academic arrogance in the medical sector as well and let us raise little “David” high enough to challenge “Goliath” as India and others have done. Let us do away with the “old wine” mentality and embrace new wine ideals in the health sector. 

In conclusion, Paul said, “One man’s faith allows him to eat everything, but another man, whose faith is weak, eats only vegetables or herbs” (Romans 14:2 NIV). This is a myopic scruple that Paul was dealing with.

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