22639 t \ Ethiopia: Traditional Medicine and the Bridge to Better Health ZIn Sub-Saharan Africa, thousands of centers and health posts, imported kilograms of medicinal plants and/ drug supplies and training of doctors or their parts are collected and used and nurses is of little value at the every day by mothers in the home, present time to the majority of the ru- _ traditional healers,' livestock owners ral population (in excess of 40 million and pastoralists. For more than 500 people). Medicinal plants and knowl- million people and hundreds of mil- edge of their use provide a vital contri- lions of livestock they are the only bution to human and livestock health readily available and affordable source care needs throughout the country. of human and livestock healthcare. The plants are generally readily avail- However, the loss of 5.5 million hect- able, have minimal side-effects and are ares of resource lands every year due free and/or affordable. They are an im- to deforestation, cultivation, over-graz- portant component of the agricultural ing, burning, erosion, etc. severely de- and environmental sectors and have creases this supply. Medicines, foods the potential to make major contribu- and other natural resource products tions to both macro and economic that have sustained rural people for growth and rural poverty reduction in No. 35 centuries are now seriously threatened the country. Environmental degrada- August 2001 and many potential medicinal plant species mav be lost forever. This in- IK Note8 reports periodicaUly on creasing scarcity of medicinal plant Indigenous Knowledge (1K) initiatives species represents a trend that should in Sub-Saharan Africa. It is published be immediately addressed. by the Africa Region's Knowledge and be immediately addressed. Learning Center as part of an evolving The majority of Ethiopians depend IK partnership between the World on medicinal plants as their only Bank, communities, NGOs, develop- ment institutions and multilateral >, ' source of health care, especially in ru- organizations. The views expressed in ral areas where access to villages is this article are those of the authors lacking due to the absence of vehicular and should not be attributed to the World Bank Group or its partners in roads. Modern health care through the this initiative. A webpage on IK is construction of new hospitals and up- available at //www.worldbank.org/afr/ grading of existing hospitals, health ik/default.htm 2 tion, deforestation, agricultural expansion, over-harvesting traditional health systems play in health care. Unfortunately, and population growth are principal threats to medicinal little has been done in recent decades to enhance and de- plants in the country. The loss from plant extinctions could velop the beneficial aspects of traditional medicine includ- result in significant socio-economic loss to Ethiopia and ing related research and its gradual integration into modern could be of global significance. medicine. Despite Ethiopia's commitment to the health sec- At present in Sub-Saharan Africa, there are no country- tor, its ability to provide increased resources for the study wvide quantitative data available on the supply of, or con- and sustainable use of medicinal plants has been limited. sumer demand for, medicinal plants and on economic ben- In most African countries, and Ethiopia is no exception, efits derived by the use of medicinal plants and their contri- there is a cadre of highly-trained professionals whose talents bution to health care. Similarly, most collectors/producers and expertise in the field of plant chemistry, pharmacognosy, and end users are unaware of the extent to which the expand- pharmacology, natural resource management, and the indus- ing demand in medicinal plants is threatening the survival of trial utilization of medicinal plant-based products are an increasing number of medicinal plant species. The prices underutilized. These professionals acknowledge their in- paid to collectors tend to be very low, and resources are fre- debtedness to traditional healers and birth attendants and quentlv open-access or common property. As a result, com- the need to work together to establish processes to manage mercial plant gatherers often "mine" the resources rather and validate traditional medicines. At present, both levels of than managing them. knowledge capital (traditional and scientifically-based) are The health and drug policies of the Ethiopian Ministry of underutilized. Health recognize the important role medicinal plants and The increasing demand by the industrial countries for herbal remedies has put increasing pressure on the supply of raw materials available in developing countries. Ethiopia is particularly conscious of the loss of its genetic resources, es- K K N o tes pecially in this case where such resources are the primary, if would be of interest to: not only source of healthcare for the rural and urban poor populations. By developing national Pharmacopoeia, govern- Name ments will initiate a process to formalize processes for the extraction, standardization, safety and efficacy, and dosage Institlition and formulation of phytomedicines. The formal integration of traditional and western medicine systems will build upon Address an ancient and acceptable cultural heritage, give strength to biodiversity conservation and management programs and provide a level of health care to all citizens that will be re- flected in future social and economic prosperity. After a somewhat circuitous development passage, the _-fi"(a<*,lifil^,l 6 - .6, ,0 - 6 S. . S l.nelit.].R_ Ethiopian government, wkith World Bank assistance, will soon start to implement the first conservation and sustainable use _ . _ - of medicinal plants project in Sub-Saharan Africa. The overall _i3 ;_S~ 6 -. objective of the project is to initiate support for conserva- * * -- .** , tion, management and sustainable use of medicinal plants for - * 31 SEIEE human and livestock health care. The project's specific ob- - S =_ S S 65. 5 5jectives are to: (i) strengthen institutional capacity; (ii) con- firm and document selected commonly-used medicinal 3 Ethiopia conservation and sustainable use of medicinal plants lead agency and contributing institutes, agencies and communities Lead agency IBCR Board Chair: Deputy Institute of Biodiversity and Conservation Research (IBCR) Prime Minister Conservation Cultivation l Scientific validation In situ & Human healthcare sustainable use Methods IBCR & * School of Pharmacy, communities * Biology Dept, MU AAU * EARO, MOA * Department of Drug * EORC Research (DDR), MOH Communities * Healers/Birth Attendants Socio-economic survey IDR, AAU Livestock healthcare * Faculty of Veterinary Medicine, AAU. Intellectual property rights . Pastoralists Database Ethiopian Science and Technology National Herbarium, AAU Commission Goals * Improved human and livestock healthcare * Globally significant biological resources secured plants for the treatment of three major human diseases and livestock healthcare on a national level; (v) develop a (tapeworm infections, bronchopneumonia, hypertension) national medicinal plant database; and (vi) support in situ and three livestock diseases (tapeworm infections, mastitis, conservation and management and initiate ex situ cultivation dermatophilosis); (iii) initiate studies for the safe utilization of medicinal plants in the Bale Mountains National Park area. of effective medicinal plant remedies for these three major Project funding will be both credit and grant. The credit human diseases and three livestock diseases; (iv) assess the will support: development of a national database of medici- economic benefits derived from medicinal plants in human nal plants; assessment of current levels of usage and eco- 4 nomic benefits derived in the country from the use of me- ing a new synthetic drug. Testing requirements formulated dicinal plants; training and institutional strengthening; de- by regulatory authorities to ensure safety of "new" drugs are velopment of Intellectual Property rights guidelines for shar- not necessarily applicable to traditional remedies. A more ing traditional medicinal knowledge; determining safety and limited range of pre-clinical toxicological tests may be ad- efficacy of plant remedies used to treat three major human equate. diseases and three major livestock diseases; initiating stud- Medicinal plants and knowledge of their use are a thread ies of propagation and cultivation methods for selected me- that links education and knowledge institutions, health and dicinal plants; and project implementation, monitoring and population issues, sustainable development, environmental evaluation. Grant funds will support biodiversity conserva- and cultural issues, gender, and rural, urban and private sec- tion and sustainable management of in situ medicinal plant tor strategies. Consequently, this project should be moni- resources in and around the Bale Mountains National Park as tored carefully by the concerned departments both in the a means of reducing harvesting pressure on wild plants. The WWorld Bank and other development organizations to see how grant will also cover the costs of education and mass aware- it can be effectively integrated for the benefit of the poor. ness campaigns, local training, and pilot farmer-based culti- WA1hile not the panacea, they are basic to poverty alleviation vation trials of selected threatened medicinal plants in home and development effectiveness and should be viewed within and community gardens and boundary and buffer zones of the the long-term holistic and strategic framework. national park. The lead agency and collaborating agencies, institutes and communities are identified in Figure 1. Recommendations for using traditional plant-based rem- edies in primary health care programs will carry weight only through studies that establish their credibility and illustrate __- their safety The use of such remedies over a long period of time may provide important information on pharmacological 1 Traditional healers in this context only include herbalists, bone setters, time may provide important ~~~~~~~psychic healers and traditional birth attendants. Faith healers, diviners effects in humans and livestock of particular groups of chemi- and spiritualists also use medicinal plants, but not as the primary source of healing. cal compounds - information not usually available wvhen test- For more iformation, pLease e-maWl ambert@wrldbankorg