Integration Of Herbal Medicine In Ghana’s Healthcare Program (part 1)

National policies are the basis for defining the role of traditional medicines(herbal medicine) in national health care programs, ensuring that the necessary regulatory and legal mechanisms are established for promoting and maintaining good practice, assuring the authenticity, safety, and efficacy of traditional medicines and therapies, and providing equitable access to health care resources and their resource information (WHO 2005). Another fundamental requirement is harmonization of the market for herbal medicines for industry, health professionals, and consumers.

According to the WHO, Traditional medicine(TM) is “the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness”. There are many different systems of traditional medicine, and the philosophy and practices of each are influenced by the prevailing conditions, environment, and geographic area within which it first evolved, however, a common philosophy is a holistic approach to life, equilibrium of the mind, body, and the environment, and an emphasis on health rather than on disease. Generally, the focus is on the overall condition of the individual, rather than on the particular ailment or disease from which the patient is suffering, and the use of herbs is a core part of all systems of traditional medicine.

In Africa up to 90% and in India 70% of the population depend on traditional medicine to help meet their health care needs. In China, traditional medicine accounts for around 40% of all health care delivered and more than 90% of general hospitals in China have units for traditional medicine. However, use of traditional medicine is not limited to developing countries, and during the past two decades public interest in natural therapies has increased greatly in industrialized countries, with expanding use of ethnobotanicals. In Ghana, integration of herbal medicine units into the national healthcare delivery system has been as slow as molasses in January. Today, the Traditional Medicine Policy (TMP) whose object is to provide a general policy direction or framework within which government’s short to long term plans on TM would be based has been gathering dust ever since it was written. According to the TMP, Traditional Medicine Practitioners (TMPs) and Orthodox Medicine Practitioners (OMPs) who are operating separately have mistrust amongst them. This was attributed to ignorance as both TMPs and OMPs lack information and education on the roles of each practice. Thus, there is a very loose co-operation between OMPs and TMPs. Also, there is this general feeling among TMPs that they are not being accorded the needed recognition by their counterpart OMPs. Thus, there is resistance to integration of herbal medicine practice with the national healthcare system which is skewed towards allopathic practice.

Over the past 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the word. However, large sections of the population in developing countries still rely on traditional practitioners and herbal medicines for their primary care. According to a survey by the National Center for Complementary and Alternative Medicine, herbal therapy or the usage of natural products other than vitamins and minerals was the most commonly used alternative medicine (18.9%) when all use of prayer was excluded. A survey conducted in Hong Kong in 2003 reported that 40% of the subjects surveyed showed marked faith in TCM compared with Western medicine. The most common reasons for using traditional medicine are that it is more affordable, more closely corresponds to the patient’s ideology, allays concerns about the adverse effects of chemical (synthetic) medicines, satisfies a desire for more personalized health care, and allows greater public access to health information. The major use of herbal medicines is for health promotion and therapy for chronic, as opposed to life-threatening, conditions. However, usage of traditional remedies increases when conventional medicine is ineffective in the treatment of disease, such as in advanced cancer and in the face of new infectious diseases. Furthermore, traditional medicines are widely perceived as natural and safe, that is, not toxic. This is not necessarily true, especially when herbs are taken with prescription drugs, over-the-counter medications, or other herbs, as is very common and can result in adverse drug reactions.

In China, in 2003, traditional herbal medicines played a prominent role in the strategy to contain and treat severe acute respiratory syndrome (SARS), and in Africa, a traditional herbal medicine, the Africa flower, has been used for decades to treat wasting symptoms associated with HIV. 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, 2 WHO agencies are collaborating on identifying, preparing, and testing extracts for medicinal plants for antiHIV capabilities. WHO favours 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.

The prospects of fully integrating herbal medicine practice into the mainstream national healthcare system in line with happenings in China, Cuba and India are many. One of which is to do away with the charlatans or quacks in the system since their source of clientele will be hampered significantly. On the whole western-trained physicians appear unwilling to allow TM and their practitioners in the official medical system in most African countries. This is an indication that not much is done in medical schools to encourage the teaching of TM as they keep unfolding in some parts of the world. In fact, TM is taught as part of curriculum in medical schools in USA and Cuba, although passionate ambivalence towards TM has been noted in Ghana, about 70% of the population still depends on TM for the PHC.

By MH/Dr Ernest Aggrey, 0543999776/[email protected]

Reference:
Benzie, I.F. and Wachtel-Galor, S. (2011).Herbal medicine: Bimolecular and Clinical Aspects, Herbal Medicine; An Introduction to Its History, Usage, Regulation, Current Trends, and Research Needs. Second Edition; CRC Press. Pg 5-8,453-454