CaHMRI News CARIBBEAN HERBAL MEDICINE RESEARCH INSTITUTE September, 2010
Volume 2, Issue:4
Concerning the responsible use of herbal medicinal products The “greening” of modern medicine has been supported globally with serious scientific study which is being undertaken to promote the responsible use of herbal medicinal products (HMPs). Initiatives in this field include the work of TRAMIL in the Caribbean region: and TRAMIL is the acronym for Traditional Medicine In Lands bordering the Caribbean sea. It is an applied, non-profit scientific research programme on the medicinal plants, which was started in 1984 in the Dominican Republic, but which remains far too sparsely supported financially. TRAMIL aims “to stimulate actionoriented research that has the potential to educate physicians, pharmacologists, health personnel, and those involved in primary healthcare programs”. Over the years, the research team in TRAMIL has included over two hundred specialists in the areas of botany, ethnobotany, chemistry, pharmacology and medicine, working in cooperation with social workers. Through their academic units and professors, over thirty-five institutions from around the world have been involved in the TRAMIL program.. Under the leadership of Lionel Robineau M.D., the research team has been regularly carrying out ethnopharmacological disease-based field surveys on the traditional medicinal uses of plants by people in the Caribbean territories. The main interest lies in the folk knowledge of the population at large rather than the knowl-
edge and experiences of the traditional healers. The TRAMIL survey method uses a special questionnaire, and the focus has been on non-life threatening ailments in the region. TRAMIL surveys have been conducted over the period 1984 through 2003 at separate times in the field at the following locations, Antigua, Barbados, Belize, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, French Guiana, Grenada, Guadeloupe, Haiti, Honduras, Marie Galante, Lantana camara - wild sage Martinique, Mexico, Nicaragua, Panama, Puerto Rico, St. Lucia, St. Vincent, Tobago and Venezuela. In the TRAMIL surveys, those uses of plants which are identified by the interviewees as their first resource, and which account for 20% or more of the reported uses, for the given health problem are deemed to be “significant uses”. Those medicinal uses which are found to be “significant” are then subjected to scientific laboratory evaluation, and to critical review of the chemistry and pharmacology and toxicology of the particular plants. However, TRAMIL is not involved in the conduct of clinical trials with these traditional remedies.
Inside this issue: CONCERNING THE RESPON- 1 SIBLE USE OF HERBAL MEDICINAL PRODUCTS
CENTERS OF THE NIH
WHAT DO HERBAL PHARMA- 4 COPOEIAS DO?
CaHMRI News From page 1 Detailed discussions are held (usually biennially) in face-to-face meetings held in an international setting, rotated from one country to another, at which the significant uses for each plant are evaluated for classification as either REC (recommended), or TOX (toxic, not recommended for further use).
“UNDER NO CIRCUMSTANCES IS THIS INFORMATION INTENDED TO BE USED AS A BASIS FOR CONDUCTING MEDICAL DIAGNOSES, CLINICAL OR SURGICAL PROCEDURES OR
(MEDICAL) LAB. TESTS.”
Those significant uses that have not yet been adequately studied are classified as INV (under investigation) by TRAMIL. By this means, and with the knowledge of the health authorities, TRAMIL seeks to provide communities and healthcare professionals with practical information on the treatment of certain ailments using medicinal plants, at minimal cost and in harmony with popular tradition. In 2007, TRAMIL published its second edition of “Caribbean Herbal Pharmacopoeia” as a CD-ROM or e-book (Copyright 2007: TRAMIL, Apdo. 3370, Santo Domingo, Dominican Republic: email email@example.com ). It includes three hundred and twentyone “significant uses” for the medicinal plant parts of ninety-nine Caribbean species. Specific dosages are included for 185 out of the 321 significant uses of these plants. The majority of the medicinal plant parts have been classified as REC, and at least six as TOX. Listed among the harmful plant species are Lantana camara (“kayakeet” or “wild sage”), Nicotiana tabacum (“tobacco”) and Thevetia peruviana (“lucky nut” or “yellow oleander”), as well as Argemone mexicana, Datura stramonium, Jatropha Page 2
curcas, Piper auritum and Pouteria sapota. This publication is intended to guide the reader or consumer to use traditional herbal remedies in a responsible way, since self-medication has persisted throughout the years. It declares that: “Under no circumstances is this information intended to be used as a basis for conducting medical diagnoses, clinical or surgical procedures or (medical) lab. tests.” Further information might be obtained from the review of this e-book, as reported on pages 73 and 74 by D.D. Soejarto Ph.D., in the May-July 2010 issue of volume 86 of HerbalGram (The Journal of the American Botanical Council).
Volume 2, Issue:4 Botanical Research Centers of the NIH .Herbal medicinal products (HMPs) remain as popular as ever and their use continues to be on the rise. It is forecast that in the USA, sales of HMPs will increase by about nineteen percent over the next five years; over fifteen billion dollars in sales were recorded in 2007. The HMPs are known also as “botanicals”. (Every botanical or HMP is usually a highly complex mixture containing a number of
the current best selling HMPs in the U.S.A. These include garlic and licorice, and others which are not Caribbean traditional remedies, such as St. John’s Wort (Hypericum perforatum) and black cohosh (Actaea racemosa). The results from the work of these research centers will provide healthcare professionals with the information needed to counsel people concerning the responsible use of herbal medicinal products. More information can be gleaned by contacting either:- NCCAM Press Office 301 -496-7790 firstname.lastname@example.org, or ODS Media 301-4352920 ODSmedia@mail.nih.gov DESPITE THEIR WIDESPREAD USE, THE VAST MAJORITY OF HMPS HAVE HARDLY
BEEN STUDIED SCIENTIFICALLY FOR
bio-active chemical constituents; and special approaches are required in its chemical analysis).
THEIR SAFETY AND EFFICACY IN HUMANS.
Despite their widespread use, the vast majority of HMPs have hardly been studied scientifically for their safety and efficacy in humans. In 1999 the National Institutes of Health (NIH) started to provide funding in a systematic manner to develop a “botanical research initiative” in the U.S.A., “to study the safety, effectiveness and biological action” of botanicals. This year, on the 31st August the NIH announced further funding, for the third five-year period, of millions of dollars for five “botanical research centers”. The particular “botanicals” proposed for study by these research centers are found amongst Page 3
Volume 2, Issue:4 What do herbal pharmacopoeias do? Letâ€™s start by describing a pharmacopoeia as a book containing directions for the identification and preparation of medicinal agents, which is published by the authority of a government or of a medical or pharmaceutical society. In one of the articles above, reference was made to a new Caribbean herbal pharmacopoeia. This one is a relatively preliminary publication, when compared with much more comprehensive works such as the Indian herbal pharmacopoeia (since the 1960â€™s), the British herbal pharmacopoeia of the 1990â€™s, and since 1995 the American herbal pharmacopoeia. But in each case, the mission is the same, namely to promote the responsible use of herbal medicinal products in the particular country or region. Each herbal pharmacopoeia publishes critically reviewed documents called monographs on medicinal plants and botanicals, selected from among those most frequently used in the particular country. The data for the content of each herbal pharmacopoeia largely depends on the results of scientific evaluation of the selected herbal medicinal products. But such data today still remains severely lacking, relative to the safety and effectiveness, safe clinical use, and the potential for harmful interactions of the HMPs with conventional (chemical) medicines, to safeguard the public health. This factor restricts the good that a herbal pharmacopoeia can actually do at the present time.
FUTURE ISSUES will include: *Counting all the known phytochemicals on Earth *Harmful herbs *Ethnomedicines, phytomedicines, nutraceuticals etc. *Worm grass in Chemopodium ambrosioides
To send us your comments about this newsletter, please contact;The Herbal Institute at UTT at Tel: 1 (868) 673 0029 / 673 2654 email@example.com or firstname.lastname@example.org
CaHMRI Newsletter - Issue 6