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Introduction

Gerard C. Bodeker

Global Initiative For Traditional Systems (GIFTS) of Health.
Health Services Research Unit
Institute of Health Sciences, University of Oxford, UK
fax:++44 1865 226711 Email:gree0179@ermine.ox.ac.uk




FAO's Non-Wood Forest Products Series addresses the use of forest resources by local communities in the context of conserving biodiversity and promoting local economic self-sufficiency.

This volume on medicinal plants links together the physical environments of local communities and their use of plants in promoting and maintaining their health.

Medicinal plants form the basis of traditional or indigenous health systems used, in the estimate of the World Health Organization, by the majority of the population of most developing countries.

It is a feature of traditional health systems that they span a divers range of policy areas that extend beyond the immediate domain of health. For example, prospects for the future supply of medicinal plants impact the long term viability of traditional health systems. Training of practitioners and preservation of traditional ecological and medical knowledge lie at the core of future prospects for ancient but challenged traditions. In many traditional societies, women are the primary herb gatherers and also the herbalists. Societal changes in work and family patterns also have an impact on the nature of the traditional health sector and the services it plays in providing everyday health care to the majority of the population of most countries in the South.

In recent years, there has been a growth of interest in traditional medicine, in part driven by the interest in complementary medicine in industrial countries and in part resulting from the interests of the international pharmaceutical industry. Demand for herbal medicines in the North has led to significant changes in traditional patterns of medicinal plant harvesting and, as in the case of Prunus africana in Cameroon, has placed some species under threat.

Accordingly, the papers in this volume also addresses the expanded demand for medicinal plants in national and international health care and the associated pressures that this demand is placing on wild sources of plants.

A number of papers report that herbalists now report having to walk increasingly greater distances for herbs that once grew almost outside their door. As habitats for plants disappear and overharvesting for commercial uses reduces stocks of wild medicinal plant material, there is a corresponding drop in the availability of the plants used as the first and last resort for health care by many rural populations.

The pharmaceutical interest in plants as a source of medicines is less likely to raise issues of concern about sustainability of harvesting, as relatively small amounts of plant material are needed to conduct the screening for bioactivity that is the basis of many contemporary drug development strategies. However, issues of intellectual and cultural property rights have emerged as significant factors in this field.

The Kari-Oca Declaration, adopted by the Kari-Oca Conference of Indigenous Peoples at UNCED in 1992 emphasized among other points:

  • that indigenous wisdom must be recognized and encouraged
  • that the traditional knowledge of herbs and plants must be protected and passed on to future generations
  • that traditions cannot be separated from land, territory or science
  • that indigenous communities require that their right to intellectual and cultural properties be guaranteed and must include the right over genetic resources, gene banks, biotechnology and knowledge of biodiversity programmes.

  • Several years earlier, the Chiang Mai Declaration had noted that, since medicinal plants form the basis of medicines used by the majority of the population of most developing countries, the loss of certain medicinal plant species and reduced supply of other important plants would have a direct impact on human health and well being. The Chaing Mai Declaration drew attention to the urgent need for international cooperation and coordination to establish medicinal plant conservation programs in order to ensure that adequate supplies are available to future generations (Akerele, Heywood, and Synge, 1991). These issues are even more pressing today, after a decade of policy inertia and development oversight.

    Several papers in this volume offer examples and arguments to extend and refine the debate associated with these recent trends, including Graham Dutfield's analysis of the widely publicized Costa Rican model.

    Both bioprospecting - as the search for new drugs from medicinal plants and the use of traditional medical knowledge as a source of leads has come to be called - and the overharvesting of medicinal plants to serve national and international markets, raise the need for new policies which integrate health, environmental and economic perspectives.

    Investments are needed for the development of appropriate conservation, cultivation and harvesting strategies which will simultaneously meet the demand for low-cost and locally-available medicines. At the same time, there must be immediate effort to ensure the conservation of diverse biological resources and the preservation and application of local cultural knowledge on the use of these resources. The important work of the Foundation for Revitalization of Local Health Traditions in India is a valuable reference point in this respect and is elucidated in Darshan Shankars' paper in this volume. The essence of a viable strategy as Shankar notes, is the full participation of local community members as stakeholders, conservers, students, educators, and beneficiaries.

    Even then, as Cunningham, He and Kuipers point out in their respective articles, cultivation is difficult to establish when prices for wild-sourced material are so low that there is little incentive for investment in horticultural programmes. Market conditions here seem to be working against environmental need. De Silva identifies essential oil production and local processing of medicinal plants as an additional source of revenue generation and a potential means for making mixed horticulture programmes economically viable.

    The papers in this volume address research, policy and programmatic perspectives. Most resulted from a series of international meetings organized by the Global Initiative For Traditional Systems (GIFTS) of Health (Bodeker, 1996). Other papers have been prepared specifically to round out this collection of articles addressing the diverse perspectives associated with the supply, use, conservation and trade in plants for human health care.

    A clear understanding of both the supply-side issues and the factors driving the demand and size of the medicinal plant market is a vital step towards planning for both the conservation and sustainable use of the habitats of these plants as well as for ensuring continued availability of the basic ingredients used to address the health needs of the majority of the worlds' population.

    Kuipers, Duke and Cunningham both address the impact of the international herb trade on local stocks of medicinal plants. As international trade in medicinal plants grows to a multi-billion dollar industry, local harvesting patterns shift from sustainable local harvesting to commercial gathering without regard to the regeneration of species for future yields. Asia's herbs feed Europe's need for herbal medicines while America's stocks of native ginseng are dwindling due to demand in Asia. There is a vast, secretive and largely unregulated trade in medicinal plants, sourced mainly from the wild, which continues to grow dramatically in the absence of serious policy attention or environmental planning.

    The papers in this volume join an emerging literature - including the two recent World Bank discussion papers on medicinal plants (1996, 1997), Balick, Elisabetsky and Laird's important volume "Medicinal Resources of the Tropical Forest" (1996) and the earlier pioneer work containing the Chiang Mai Declaration on the conservation of medicinal plants "Conservation of Medicinal Plants" by Akerele et al. (1991). This volume is presented as a contribution to clarifying the many policy issues associated with the conservation, use and production of medicinal plants.

    The key themes of the emerging debate surrounding the status and future of medicinal plants is the recognition that medicinal plants constitute a vast, undocumented and overexploited economic resource and that they are the principle health care resource for the majority of the world's population. It is through serious analysis, such as that offered in the papers in this volume, that future policy and practice can work to ensure that the health needs of 8-9 billion people in the world will be able to met in part by the plants that have served their societies and families throughout the history of mankind. This is work that cannot not be done.

    REFERENCES

    Akerele, O, Heywood, V, and Synge, H, (eds), 1991, Conservation of Medicinal Plants. Cambridge University Press.

    Balick MJ, Elisabetsky E, Laird SE, (eds). Medicinal Resources of the Tropical Forest: Biodiversity and its Importance to Human Health. New York, Columbia University Press, 1996.

    Bodeker G, (ed) 1996. The GIFTS of Health Reports. A special issue of the Journal of Alternative and Complementary Medicine, 2,3, 319-458.

    Srivastava J, Lambert J, Vietmeyer N, 1996. Medicinal Plants: An Expanding Role in Development. World Bank Technical Paper Number 320.

    Lambert J, Srivastava J, Vietmeyer N, 1997. Medicinal Plants: Rescuing a Global Heritage. World Bank Technical Paper.



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