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2. Research Problem, Objectives and Conceptual Framework
3. Materials and Methods
4. What is Traditional Medicine?
4.1 Herbal Medicine
4.2 Traditional Herbal Medicine
5. Relevance of Medicinal Plants in the World
5.1 Traditional Medicine in Developing Countries
6. International Trade in Medicinal Plants
7. Medicinal Plants Policy in Ghana
8. Medicinal Plants and Health Delivery in Ghana
8.1 Health Care Delivery in Rural Ghana
8.2 Medicinal Plants and Health Care in Ghana
8.3 Farming Medicinal Plants in Ghana
9. Challenges Facing Medicinal Plants and their Use in Ghana
9.1 Deforestation and Medicinal Plants in Ghana
9.1.1 Deforestation and Changing Habitats of Diseases in Ghana
9.3 Mining Activities
9.4 Poor Farming Practices
9.5 Over Exploitation of Medicinal Plants
10. Strategies for Conservation and Sustainable Use of Medicinal Plants in Ghana
10.1 Combating Bush Fires
10.2 Re-afforestation of Lands Degraded by Mining Activities
10.3 Effective Education on Sustainable Faming Practices
10.4 Promotion of Medicinal Plant Farming
10.6 Capacity Building for Medicinal Plant Framers
10.7 Improving Research and Documentation of Medicinal Plants
10.8 Specific Policies and Guidelines for Conservation of Medicinal Plants
List of Tables
Table 1: Traditional Health vrs Modern Medical Practice
Table 2: 12 Leading Countries and their Average Imports and Exports from
List of Figures
Figure 1 : International Trade in Medicinal and Aromatic Plants (MAP)
Figure 2: Percentage Share of Total LDCs Exports Volume of Medicinal Plants,
by Major LDCs Exporters, Average 1998-2002
Figure 3: Bush Fire Destroying Plants in the Sefwi Wiawso District
Figure 4: Slash and Burn Method of Framing in Ghana
Annex 1: Terminology in Medicinal Plants (extracted from Nagpal & Karki, 2004)
Annex 2: List of Some Medicinal Plants and their Uses in Ghana
Annex 3 : Herbal Products from Centre for Scientific Research into Plant Medicine, Ghana
List of Boxes
Box 1: Traditional Medicinal Plants Policy of Ghana
Box 2: Cultivation of Medicinal Plants: The Case of Moringa
Box 3: Mampong Arboretum
Box 4: Mamfe Arboretum
Box 5: Ayikuma Arboretum
Box 6: Begoro Arboretum
Box 7: Tepa Arboretum
Box 8: Testimonies of Traditional Healers
The role of medicinal plants in traditional health care delivery in Ghana cannot be overemphasized. More than 250 indigenous trees and plants with healing properties have been scientifically catalogued in Ghana. Unfortunately, the very foundation upon which the medicinal plant species and the traditional health care system survive is threatened by deforestation. The rate of deforestation has increased by 50% over the last ten years, according to the UN Food and Agriculture Organization (FAO). The current area of intact forest is now estimated at between 10.9 and 11.8% of the original cover and 6.9% of the country’s total area. Deforestation is changing the habitats of disease-carrying insects and creating conditions that may help to spread malaria, river blindness and other devastating illnesses. Moreover, since the majority of the rural poor in Ghana depends on traditional medicine for their health care needs, the present high rate of deforestation will have a detrimental effect on the heath care delivery system in the country. Important plant species will be lost to deforestation unless urgent measures are taken. This paper examines the impact of deforestation on medicinal plants in Ghana.
Key Words: allopathic medicine, conservation, deforestation, diseases, domestication, endangered species, forests, health, medicinal plants, traditional
Since the pre-historic times, medicinal plants continue to play a vital role in human health care delivery (Abbiw et al., 2002; WHO, 2002). Medicinal plants ignored during some ages and even dismissed in others, have been waiting quietly and patiently for several thousand years for humanity to turn their eyes to them in order to know, to study, to use and to love them (Pamplona-Roger, 1998). They are indispensable for human health and provide a significant number of remedies required for good health care systems, particularly in the developing countries. It is estimated that 80% of the people worldwide depend on traditional medicine to meet their primary health care needs ( WHO 1999; WHO, 2003; Holley and Cherla, 1998; World Bank, 2001; FAO, 1998).
Globally, the use of traditional medicine has received a renewed attention during the decade of 1990 (WHO, 2002; Ravi et al., 2006). In the developed countries, traditional, complementary and alternative medicines are becoming more popular. For example, the percentage of the population that has used such medicines at least once is 48% in Australia, 31% in Belgium, 70% in Canada, 49% in France and 42% in the United States of America (WHO, 2002). In tropical Africa, more than 4,000 plant species are used for medicinal purposes, and 50,000 tons of medicinal plants are consumed annually in the region (Karki, 2007). Interest in medicinal plants is becoming more and more recognised in health care delivery, particularly in developing countries because they are affordable, readily accepted by consumers and locally available (WHO, 2003; Falconer, 1994; Abbiw et al., 2002; Brown, 1992).
Worldwide, about 50,000 known species of plants are used in traditional and modern medicine systems (Schippmann et al., 2002; Lange et al., 1997). After a period of brilliant scientific developments in which science of healing has built all its hopes on the basis of sophisticated laboratories and highly technological devices, the interest in nature’s simple remedies is quickly growing (Pamplona-Roger, 1998). The World Health Organization (WHO, 2002) has estimated that the present demand for medicinal plants is approximately US $14 billion per year and is growing at the rate of 15 to 25% annually. The demand for medicinal plants is likely to increase by more than US $5 trillion in 2050 (Chandra et al., 2006) . In many developed countries popular use of traditional medicine is fuelled by the concern about the adverse effects of chemical drugs, questioning of the approaches and assumptions of allopathic medicine, and greater public access to health information (WHO, 2002).
Many governments around the world have adopted policies on traditional medicines. For example, both China and Mongolia are pursuing health care systems based on the practice of traditional medicine. In many African countries, the significance of traditional medical practitioners is now recognised and attempts are being made to integrate western and indigenous medicine (Brown, 1992). In Ghana for instance, successive governments have recognised the importance of medicinal plants. About 75% of the population, in both the urban and the rural areas, depend on medicinal plants for their everyday health-care needs (Abbiw et al., 2002).
An estimated 4,000 to 10,000 species of medicinal plants in the world face potential local, national, regional or global extinction, with subsequent serious consequences for livelihoods, economies and health care systems (Hamilton, 2004; Maundu et al., 2004). It is estimated that 95 % of Medicinal and Aromatic Plants (MAPS) in developing countries are harvested and collected in wild (Karki, 2007). In Ghana, despite the increasing use of medicinal plants and the growing understanding of their importance in health care delivery system, their future is being threatened by extinction. Medicinal plants are increasingly threatened by various environmental, socio-economic and institutional problems. At the same time traditional and indigenous knowledge about these plants is weakening and, in some cases, vanishing altogether. It is estimated that 117 species of medicinal plants are threatened by extinction in Ghana (IUCN, 2005; MES, 2002). Food and Agriculture Organization (FAO, 2005), has also estimates that the rate of deforestation in Ghana has also increased by 50% over the last ten years. The phenomenon is threatening the medicinal plants and traditional health care systems in Ghana. It is also changing the habitats of disease-carrying insects and creating conditions that may help to spread malaria, river blindness and other devastating illnesses.
This paper therefore seeks to: 1) examine the role of medicinal plants in health care delivery in Ghana, 2) critically examine the threats and causes of medicinal plants depletion in the country, and 3) suggest strategies for conserving and ensuring a sustainable use of medicinal plants. Assessing the effectiveness of the vast range of medicines and healing practices in Ghana is beyond the scope of this study. It is important to note that scientific research institutions such as Centre for Scientific Research into Plant Medicine in Ghana, in collaboration with traditional healers, have endorsed a number of plant medicines for the treatment of various diseases in the country (See Annexes 2 and 3).
While this work remains chiefly a product of critical literature review of articles in international and national journals, reports and publications of international development agencies such as the World Health Organisation (WHO), it is spiced with data from consultations and semi-structured interviews with selected health professionals, botanists, foresters, farmers, policy-makers, researchers, traditional healers and testimonies from patients who have used medicinal plants and or are using.
WHO (2003) defines traditional medicine as health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. “Traditional medicine”(TM) is also called botanical medicine or phytomedicine. It is defined as the use whole plants or part of plants to prevent or treat illness (Lee, 2004; Lengkeek, 2004; WHO, 2002). A medicinal plant is any plant which provides health-promoting characteristics or curative properties. Plant parts used include seeds, berries, roots, leaves, bark, or flowers. TM is also a comprehensive term used to refer to both traditional medicine systems such as traditional Chinese medicine, Indian ayurveda and Arabic unani medicine, and various forms of indigenous medicine (Karki, 2007;WHO, 2002). In countries where the dominant health care system is based on scientifically-based-medicine, or where TM has not been incorporated into the national health care system, TM is often termed “complementary”, “alternative” or “non-conventional” medicine (WHO, 2002).
Herbal medicine refers to medicinal products whose active ingredients are derived from aerial or underground parts of plants or other plant material or combination of them, whether in crude state or as plant preparation. Plant material includes such substances as juice, gums, oils, etc. Herbal medicines may also contain plant materials other than the active ingredients and may even contain other non-plant organic or inorganic active ingredients (Sekagyaet et al., 2006).
Traditional herbal medicine refers to the therapeutic values of herbal medicine beyond the medication’s active ingredients, in which the herbal medicine is considered to be active only when it is imbued with an invisible life force (Sekagyaet et al., 2006). It is the oldest known type of medical treatment and has been practised in virtually every culture worldwide. It relies on an understanding of treatment as something more than what can be perceived by physical senses of vision, taste, touch, feeling, and smell. Traditional medicine addresses the individual as an interlinked whole, body, emotions, mind, relationships, and spirit (Sekagya et al., 2006).
The use of plants as medicines to treat illness has a long and venerable history. Over the centuries, the indigenous peoples of the world have developed sophisticated social systems and their traditional healers through oral tradition and empirical means (WHO, 2002; Lee, 2004). The use of plants was an integral part of the development of modern civilization. Primitive man observed and appreciated the great diversity of plants available to him. Much of the pharmacopoeia of scientific medicine in modern times was derived from the herbal lore of native peoples’ acquired and compiled knowledge systems which have been disseminated from generation to generation (WHO, 2002; Poonam et al., 2006).
The use of plants for medicines is by far the biggest use of plants in terms of the number of species specifically targeted (Plant Europa, 2006). Today, more than 50,000 plant species are being used in various human cultures around the world for medical purposes and many of them are subjected to uncontrolled local and external trade (Lange et al., 1997; Schipmann et al., 2002; Lewington, 1993). WHO notes that at least 7,000 medical compounds in the modern pharmacopoeia are derived from plants. About 25 percent of the prescription drugs dispensed in the United States contain at least one active ingredient derived from plant material (WHO, 2002). Many conventional drugs originate from plant sources; some of the most effective drugs are plant based such as aspirin derived from bark of willow, digoxin derived from foxglove, quinine derived from the bark of cinchona, and morphine derived from the opium poppy (Lee, 2004). Scientific interest in medicinal plants has burgeoned due to increased efficiency of new plant-derived drugs, growing interest in natural products and rising concerns about the side effects of conventional medicine (Lee, 2004).
TM continues to play an important role in the health care systems of developing countries. In many parts of this region, it is the preferred form of health care due to its accessibility and affordability (WHO, 2002; Cunningham, 1993; Twarog et al., 2004). One-third of the world’s population still lacks regular access to essential drugs, with the figure rising to over 50% in the poorest parts of Africa and Asia. TM therefore offers a major and accessible source of health care (WHO, 2002). It is estimated that in developing countries such as Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home (WHO, 2002).
Table 1: Traditional Health vrs Modern Medical Practice
illustration not visible in this excerpt
Source: WHO, 2003
Table 1 reveals the ratio of traditional health practitioners and medical doctor to population in selected countries in Africa. It is clear from the radio of the traditional medicine practitioners and western trained doctors that traditional medicine practitioners play a very crucial role in health care delivery in Africa. Recognising this important role, WHO in 1977 called for recognition of traditional healers (WHO, 1978a), and in 1978 declared at Alma Ata that African traditional healers should be part of primary health care team (WHO, 1978a). Also, the resolution on “Promoting the Role of Traditional Medicine in Health Systems: A Strategy for the African Region”, adopted by the fiftieth meeting of WHO’s Regional Committee for Africa in August 2000, states that the African Member States are aware that about 80 per cent of the region’s population depends on traditional medicine for its health care needs (WHO, 2000)
Traditional healers are important and an under-utilised national health care resource in developing countries, where they are more available than western-trained doctors (Sekagyaet et al., 2006). The African Regional Strategy on Traditional Medicine was also adopted in 2000 to institutionalize and integrate TM into conventional medicine with the aim of delivering health for all through optimization of the use of traditional medicine. It emphasizes the importance of collaboration, communication, harmonization and partnership building between conventional and traditional systems of medicine, while ensuring intellectual property rights (IPRs) and protection of traditional medical knowledge (TMK) (WHO, 2003).
Sustainable management of medicinal plant resources is therefore important not only because of their value as a potential source of new drugs, but the large reliance on traditional medicinal plants, particularly in the developing world. WHO (2003) noted that the provision of safe and effective use of medicinal plants therapies could become a critical tool for increasing access to health care in developing countries. As health care gets increasingly expensive and ineffective in many African countries, a growing number of people are turning to traditional medicine. Kala et al. (2006) noted that the growing recognition of medicinal plants is also due to several reasons, including escalating faith in herbal medicine. Allopathic medicine may cure a wide range of diseases; however, its high prices and side-effects are causing many people to turn to herbal medicines which are less expensive and have fewer side effects (Kala C.P, 2005; Kala et al., 206).
TM is particularly relevant for the poor, many of whom can neither access nor afford the cost of allopathic or ‘conventional medicines’ (Lengkeek, 2004). In most developing countries, health-enhancing anti-retroviral medicines for HIV/AIDS patients are prohibitive, either because they are not available, or because they are away out of range in terms of cost. HIV/AIDS amplifies other poverty dimensions and has itself become a poverty disease, thereby increasing the need for traditional medicine (Lengkeek, 2004). Two thirds of the population of most HIV/AIDS affected countries live in rural areas and in remote locations where modern medical facilities are not available. In these areas, TM is often the only alternative medicine for treating opportunistic infections.
While the global market for medicinal and aromatic plants can be estimated to be at least US$60 billion (WHO, 2003; Craker, 2007) and expanding at 20% annually in India (Hamilton, 2003;Subrat, 2002), the exact market figures and trends are difficult to estimate accurately because much of the trade is either unrecorded or poorly classified and the number of small and medium-sized companies in the industry are hesitant to share data (Laird, 1999; Iqbal, 1993; FAO, 2005; Craker, 2007)). (Laird 1999). Also, medicinal plants are used in non-medicinal end-uses and not reported separately (FAO, 2005). China is the biggest producer and exporter of medicinal plants, accounting for 30% of total world trade (Iqbal, 1993; Lange, 2006). Others include France, Germany, Italy, Japan, Spain, the UK and the US (Laird, 1999). Factors contributing to the growth in demand for medicinal plants include the increasing human population; the high cost of western medicine and the inability of countries, particularly developing countries, to meet the increasing demand for health personnel.
Table 2: 12 Leading Countries and their Average Imports and Exports from 1991-2003
illustration not visible in this excerpt
Source: COMTRADE Data base, 1991-2003, United Nations Statistics Division, New York.
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