Going back to the roots: State acts to save healing herbs

Adaptogen health food selection with herbs and spices. [Courtesy/iStock] Under colonial rule, traditional medicine and its practitioners were outlawed. Even after independence, medical professionals did little to counter the widespread belief that traditional healing was unscientific and irrelevant to national healthcare systems. Today, however, attitudes are slowly changing. "First, the sources of medicinal plants-an important component of Kenya's biodiversity-are primarily from the wild and are increasingly under threat," says Prof Richard Muga, former Director of Medical Services. "The threats include population pressure, expanding agriculture, deforestation, overgrazing, climate change and wildfires." He adds, "Second, there is no robust regulatory framework in place to protect the public from unsafe products or unqualified practitioners. Third, global demand for herbal products and raw medicinal materials is growing dramatically." Prof Muga was speaking at a workshop in Nairobi under the theme, "Government Sets Agenda on the Use of Herbal Medicine in Kenya", which brought together traditional healers, herbal practitioners and conventional medical professionals. Raw materials The World Health Organisation (WHO) estimates that global herbal medicine sales exceed US$95 billion annually. Yet, there's little data on the exact quantity of raw materials used-likely more than 4 million metric tonnes. Prof Muga advocates moving the oversight of traditional healers and herbal medicine from the Ministry of Sports and Culture to the Ministry of Health. "This will enable the testing of their products in certified laboratories to verify efficacy, safety and quality," he explains. Clearly, traditional medicine forms a huge economic activity. It supports livelihoods for collectors, transporters, vendors, healers and international processors of raw materials-although the latter takes away local job opportunities and revenue. Kenya's Ministry of Environment, tasked with managing natural resources, has long overlooked medicinal plants. Historically, traditional healers harvested their ingredients from the wild or home gardens. However, as Dr Willis Wanjala, Chief Executive Officer of Makini Herbal Clinic, notes, "This resource base has been shrinking, posing a serious challenge to collectors and users alike-especially women, who rely on herbal trade as their sole source of income." He emphasises the importance of re-establishing Kenya's native plant biodiversity. "Policies and sustainable management practices should involve local communities. Guidelines for sustainable harvesting are crucial, especially for species that cannot be easily cultivated." Viable alternatives To reduce pressure on wild sources, agriculture offers viable alternatives. "Since many rural healers are also farmers, they are well-placed to adopt sustainable cultivation methods," says Prof Muga, who also formerly led the National Population Council. He calls for the Ministry of Agriculture to integrate traditional knowledge with modern agricultural practices. Together, the environment and agriculture sectors play a key role in supporting the raw material supply chain for herbal medicine, which many Kenyans-especially the rural and urban poor-depend on. "Herbal treatments often serve as the only affordable option for millions, given the limited reach and cost of modern healthcare," Dr Wanjala adds. Although the Ministry of Health has taken steps to integrate traditional medicine into the formal system, many gaps remain. Few African herbal products have been scientifically validated, and fewer still are used in public health facilities. Kenya has an opportunity to lead in building a local pharmaceutical industry rooted in indigenous plants, traditional knowledge and modern science. "ICIPE, for example, has developed phytomedicines like Naturb from Ocimum and Mondia Tonic from Mondia. But have these been tested under WHO guidelines?" Prof Muga asks. "If not, these should be a starting point for the Ministry of Health's regulatory efforts." From Kitui, traditional healer Joseph Kivuludi shares a cautionary tale. Kenya was once the world's top producer of pyrethrum-28,000 tonnes in 1992/93-but production fell to 12,000 tonnes despite the crop's profitability. He blames poor farmer support, high administrative costs and lack of fair market access. "We must not repeat these mistakes with medicinal plant cultivation," he warns. According to Kivuludi, realising the full socio-economic potential of traditional medicine requires coordinated collaboration across ministries, traditional healer associations, commercial enterprises and the public. "Efforts must be both vertical and horizontal," he says. Indigenous knowledge Involving rural communities in sustainable harvesting and commercial production could significantly raise their incomes. "An extra Sh600 (about $5) a week could dramatically increase rural purchasing power," he explains. Urban communities, too, could benefit through processing and distribution jobs. The Ministry of Health began laying the groundwork for a multi-sectoral action plan nearly four decades ago. While implementation remains a challenge, there is much to gain from collaboration. Demonstrating the value of biodiversity in healthcare could strengthen the Ministry of Environment's bargaining power with the Treasury. Similarly, by helping farmers adopt propagation methods, the Ministry of Agriculture could boost rural income and strengthen the foundation for a self-sufficient pharmaceutical industry. If Africa could claim even US$10 billion of the estimated US$75 billion global herbal market, this could double or triple the region's current health spending. Kenya and Africa stand to gain by formally embracing traditional medicine and its practitioners. Failure to protect the plant resource base and indigenous knowledge could result in irreversible losses. While no official figures exist on the economic contribution of traditional medicine to Kenya's GDP, its value is undeniable. "If we fail to protect it, we will all feel the loss," Muga says. "The government must take charge of setting an agenda for the regulation and growth of the herbal medicine sector. This is a multibillion-shilling industry waiting to be tapped." Not sidelined Two decades ago, Kenya pledged to integrate traditional medicine with conventional healthcare. This move aligned with World Bank and World Health Organisation (WHO) recommendations, which asserted that herbal remedies are as effective as modern pharmaceuticals-if not more so. This development aimed to bridge the long-standing divide between biomedical professionals and herbalists. For years, conventional doctors dismissed herbalists as sorcerers-a colonial-era view. But United Nations agencies reminded governments that more than 95 per cent of conventional drugs are derived from plants, and herbalists should not be sidelined. Some of the world's most effective anti-malarials, for instance, are derived from herbs found in Chinese forests. Recognising this, international NGOs have begun funding policy development and implementation efforts to harmonize traditional and conventional medicine. Experts argue that since governments often fail to deliver adequate healthcare, they lack the moral authority to restrict qualified traditional healers from serving the poor. Kenya finally gave in to mounting pressure in 2004. Until then, the Directorate of Medical Services had resisted efforts to formalize guidelines for integration. The conventional medics have all along viewed herbalists as black magicians and sorcerers, a perception advanced and perfected during the colonial era. The UN agencies, however, intervened at the right time by reminding the government that more 95 percent of conventional remedies are indeed herbal derivatives and that herbalists should not be ignored as alternative providers of crucial health services. In fact the most effective anti-malaria drugs are made from the natural herbs harvested from Chinese forests. It is important that in recognition of the significance of herbal medicine, international non-governmental organisations (NGOs) of unlimited means are funding and financing the development and implementation of policies that are enhancing the merger of traditional medicine and conventional medicine. "We're now monitoring herbalists' operations in both urban and rural areas," Muga says. "The differences are stark. The government must step in to help citizens distinguish between genuine practitioners and imposters." He underscores the need for regulation to weed out quacks who might exploit legalization for profit. "The credibility of this ancient practice depends on our ability to ensure it meets modern standards."

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