Traditional Medicine Practitioners And Researchers Undergo Intensive Training On Medicinal Plant Cultivation And Good Manufacturing Practices In Herbal Medicine Production In Vietnam

A team of Traditional medicine Practitioners and Plant medicine researchers from Ghana, through the support of the German corporation For International Cooperation (GIZ), have embarked on a two week intensive training in Vietnam, from the 6^th to 20^th May 2018, on Good agriculture and collection practices (GACP), and Good manufacturing practices (GMP) for production of herbal medicine. The intention of the study tour was also to obtain first-hand information of the success story of the full integration of allopathic care and Traditional herbal medicine in the country for a possible replication in Ghana.

The participants who were hosted by the Ha Noi University of Pharmacy (HUP), in Vietnam, comprised of four members of the Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM); Dr Bernard Kofi Turkson (Medical Herbalist, GHS), Dr Annabella Adade (Medical Herbalist), Mr Joseph Kofi Takyi (Regional Chairman, GHAFTRAM, Ashanti region), and Dr Mohammed Kweku Edu (CEO Edu Herbal, Advisor, GHAFTRAM Central Region), together with Dr Isaac Kingsley Amponsah, a Senior lecturer and Plant medicine researcher with the Department of Herbal Medicine, KNUST, .

With cultivation of medicinal plants key to sustainability of safe herbal medicine production in Ghana, the participants were taken through teaching sessions and field work to W.H.O accredited medicinal plants cultivation sites for Good agriculture and collection practices, by Ha Noi University of Pharmacy (HUP) experts. Participants also made Visits to community owned herbal manufacturing industries as well as private manufacturers, (all of whom are GMP compliant) where they were taken through Good manufacturing practices prescribed by the World Health Organization (W.H.O)

A picture of one of the W. H. O accredited cultivation sites in Vietnam

The team also visited the National Traditional Medicine hospital of Vietnam, to obtain first-hand information on the Vietnamese version of a successful integration of herbal and conventional medicine, achieved since 1952. The hospital, fully equipped with modern diagnostic machines comparable to Korle Bu or Komfo Anokye Teaching Hospitals of Ghana, make use of herbal medicines mainly for treatment, although the conventional diagnostic methods are employed in diagnosis. Participants witnessed machines designed for dispensing of preparations in suitable dosage forms, to facilitate patient compliance, a technology the leadership of GHAFTRAM look forward to replicating in Ghana, with support from government and other funding agencies.

Participants noted that, contrary to the training of Medical Herbalist in Ghana by KNUST, the Traditional medicine doctors in Vietnam were trained in the Medical schools, observing similar curriculum as conventional/orthodox medical practitioners. This has resulted in the acceptance of traditional medicine practitioners by practitioners of conventional medicine as fellow competent colleagues, and not competitors in Vietnam.

Delivering a lecture during the course of the visitation, former Deputy director of Traditional Medicine of the Ministry of Health of Vietnam, Prof. Dr. Tran Thi Hong Phuong, intimated that wholesalers of medicinal plant materials make sales of around $20 to 30 thousand dollars averagely per month. According to her, Vietnam is only able to meet 20% of the medicinal plant material need through cultivation and harvest from the wild, as such tonnes of medicinal plant materials are imported from East Asia, especially China annually. She however disclosed that the government of Vietnam have encouraged cultivation of medicinal plants by the locals through several ways of which included; The manufacturing industries made to pay five times for the raw herbal materials than income earned from rice cultivation, Introduction of the one community one herbal product project (OCOP), and the offering of shareholding positions for cultivators of medicinal plants at the community level in addition to payment for supply of the raw materials grown.

Dr Isaac Amponsah, a lecturer with the Department of Herbal medicine of the Kwame Nkrumah University of Science and Technology (KNUST), disclosed that the study tour has opened up areas of research he believes academia should engage in order to support the growth of the herbal medicine industry, as well as train effectively Medical Herbalists at the undergraduate level. According to him, the commitment of Ha Noi University of Pharmacy Faculty members (Vietnam) to national development through community based herbal medicine research, is worth emulating. He stressed that implementation of findings and exposure from the study If considered in Ghana, will not only ensure supply of authentic and safe raw materials to feed Ghanaian Herbal medicine industries, but will also create jobs for many, including the marginalized in the rural areas.

The leadership of GHAFTRAM are thankful to the German government, through GIZ, for the invaluable support to embark on the study tour. They are also Appreciative to the Government of Ghana, the Honorable minister of health, and the Traditional Medicine Directorate of the ministry of health (MOH), for the support shown the herbal medicine sector this far.

Background
An international workshop on Herbal medicines regulation under the Cross-Sector Cooperation Fund (Prolifund) project with the theme; Access to high quality and affordable medicines in Africa and South East Asia was organized by the Ghana Food and Drugs Authority from 7th-9th March 2018. Experts from Thailand and Vietnam shared some experiences at the workshop, which sought to address the peculiar challenges Ghana is encountering in relation to Cultivation of Herbal Farms, Good Manufacturing Practices, and achievement of complete integration of Traditional medicine with mainstream orthodox/allopathic medicine.

Ghana has seen considerable growth of the herbal medicine industry, enjoying an enviable position in the sub region and Africa as the only country to attempt integration of herbal medicine with allopathic medicine. However there are challenges in the selection of medicines for the national essential herbal medicine list due to concerns of noncompliance to Good Manufacturing Practices (GMP) among others. The situation is compounded by a half-baked integration of conventional and traditional herbal medicine in various hospitals in the ten regions of Ghana, under the ministry of health, in a pilot project since 2012. The lack of a national essential herbal medicine list has hindered coverage of herbal medicines by the National Health Insurance Scheme (NHIS), and as such patronage of herbal medicine services at the various herbal medicine units/clinics pilot centres, whose outcome is expected to help policy makers achieve full integration of herbal medicine with orthodox medicine, has not been the best. The anticipated national essential medicine list is expected to also ensure access to herbal medicines under NHIS from accredited Pharmacies, Herbal Shops, and Private Herbal Clinics/hospitals.

The Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM) and other stakeholders, also has concerns with sustainability of herbal medicine manufacturing due to rapid depletion of forest resources, as majority of practitioners harvest medicinal plants from the wild.