ARSO’s Opinion on COVID-19 and African Traditional Medicine
THE WTO ALMA-ATA’ DECLARATION OF 1978 AND WHO TRADITIONAL MEDICINE STRATEGY 2014–2023: ARTAMISIA COVID-ORGANICS (COVID-19 “TRADITIONAL CURE”) – COULD THE TRADITIONAL MEDICINE HOLD KEY TO HUMAN PHARMACEUTICAL NEEDS, AFRICA IN PARTICULAR? – FOCUSING ON THE ARSO TC 13, ISO 249 AND THE WTO DIRECTIVES OF ON TRADITIONAL MEDICINE AND THE RELATED REGULATORY FRAMWORKS (STANDARDS AND CONFORMITY ASSESMENT).
As the World Health Organization (WHO) confirms that there is no proof of a cure for Covid-19, Madagascar’s President (left), on 8th April 2020, launched a traditional herbal remedy for the COVID-19, putting in light the question “Could traditional African medicine change the course of history”. Baptised Covid-Organics, the tonic is derived from Artemisia, the most powerful antiviral plants grown in Madagascar, and currently typically consumed as an infusion, when it comes to treating COVID-19, is a plant with proven efficacy in treating malaria as well as other indigenous herbs. Dr Charles Andrianjara, Malagasy Institute of Applied Research (Imra), which developed the tonic, agreed that Covid-Organics should be used for prevention. But what are the potential benefits of this plant, scientific studies and tests needs to be undertaken to prove its efficacy. According to Catherine Hill, an epidemiologist and former department head at the Institut Gustave Roussy in Villejuif, France: “The fact that artemisia has effects on viruses similar to the novel coronavirus makes a strong case for initiating studies. The renowned Max Planck Institute in Germany, which has received 18 Nobel prizes since 1948 and publishes 15,000 papers each year, launched an in vitro trial on 8 April, in collaboration with the US Company ArtemiLife and Danish researchers. According to Cornet-Vernet, around 10 African countries have already agreed in principle to perform clinical trials focused on artemisia, including Benin, Central African Republic, Côte d’Ivoire, Democratic Republic of Congo, Madagascar and Rwanda (https://www.theafricareport.com/26599/coronavirus-the-miracle-remedy-touted-by-madagasars-rajoelina/). What ever the remedy, whether Traditional Medicine (TM) or Conventional medicine, the priority is the same: to protect and save as many lives as possible and offer people the guarantee of a new tomorrow.”
Given that for a millennia, Africa has a tradition of using herbal medicine to heal the sick with herbal or animal-derived remedies, handed down through generations and given that 80% – 90 % of Africa’s population depending on TM for their primary healthcare, and with a global trade estimated at US$ 83 billion dominated mainly by western herbal medicine, Traditional Chinese Medicine (TCM) and Ayurveda, while African share being insignificant yet its wealth in biodiversity makes it a bio-prospecting hotspot (WHO 2003), therefore making traditional medicine truly mainstream incorporating its knowledge into modern healthcare and ensuring it meets modern safety and efficacy standards is a subject of global priority. Developing Standards for TCM is therefore key, and of upmost importance, to:
- Ensure the quality and safety of TCM products and/or services
- Improve patient safety and satisfy their expectations and requirements
- Facilitate the use of TCM in a more scientific, safer and efficient manner
- Comply with relevant legislation
- Boost TCM enterprises and the countryʼs economic growth
This brings into sharp focus the role of ARSO TC 13 on African Traditional Medicine and the ISO/TC 249 Traditional Chinese medicine (with 50 published standards and 40 under development) FOCUSING on quality and safety of raw materials, manufactured products and medical devices and of informatics, including service standards limited to involving the safe use and delivery of devices & medicine. The WHO has already given the directives and acceptance. The WTO Alma-Ata’ Declaration of 1978 and the WHO Traditional Medicine Strategy 2014–2023. The WTO Alma-Ata’ Declaration of 1978 AND resolved to in cooperate the TM in the health care systems in developing countries if the objective of the “Health for All by the Year 2000” was to be realized. Subsequently, the OAU (African Union) Heads of State and Government declared the period 2000 – 2010 as the African Decade on African Traditional Medicine. In 2013, WHO developed and lunched ‘WHO Traditional Medicine Strategy 2014–2023 that aims at building the knowledge base and formulating national policies; strengthening safety, proven quality and effectiveness through regulation; and, promoting universal health coverage by integrating T&CM services and self-health care into national health systems. The WHO Regional Office for Africa has developed model guidelines that the Member States can adapt or adopt, as basis for the incorporation of African traditional medicine in their Healthcare systems. The Office also declared 31st August every year as African Traditional Medicine Day to affirm the continent’s shared commitment to promoting rational Traditional Medicine practices. The date coincides with 31 August 2000 when the Ministers of Health adopted the relevant resolution at the 50th session of the World Health Organisation (WHO) Regional Committee for Africa in Ouagadougou, Burkina Faso.
ARSO THC 13 aims to address:
- Quality issues: Adulteration, misidentification of plant, faulty collection and preparation, incorrect formulation process thus affecting quality and purity of herbal medicines
- Processing and harvesting issues: Indiscriminate harvesting, poor agriculture and propagation method, poor pre and post-harvest practices, and lack of processing techniques – hence substandard quality of herbal drugs.
- Quality control related issues: Standardization, poor quality control procedure and lack of Good Manufacturing Practices (GMP). Lack of awareness regarding the guideline among growers and manufacturers, lack of implementation and regulation of the guideline are also frequent in small and medium scale industries.
- Administrative issues: Lack of regulation and controlling authority in herbal sector, lack of proper monitoring and controlling.
- Infrastructure related issue: Lack of processing technique, trained personal, sophisticated instrument, utilization of modern techniques, facility to fabricate instrument locally are the major problems.
- Pharmacogivilane: Proper pharmacogivilane in herbal sector is the need of time to find the toxicological data and adverse drug reaction of herbal drugs. Adverse reactions, contraindications, interactions with other drug, food and existing orthodox pharmaceuticals need to be monitored properly.
- Clinical trial: Since the safety continues to be a foremost issue with the use of herbal remedies therefore, clinical trials are necessary to understand the safety and efficacy of these drugs before introduced them in global market.