Case Study 28
Medicinal Plants vs. Pharmaceuticals for
Tropical Rural Health Care
Thomas J. Carlson,
Department of Integrative Biology,
University of California, Berkeley, CA 94720-3050
Keywords:Medicinal plants, pharmaceuticals, biodiversity, ethnolinguistic
diversity, tropical countries, USA, Europe
Tropical rural communities may receive treatment from locally available traditional
botanical medicines and/or modern pharmaceuticals. Assessment of these two medical
systems generates interesting comparisons when evaluating local indigenous versus
external control, access, availability, affordability, long term sustainability
and ability to safely and effectively use each medical system. Each medical
system maintains a characteristic capital flow between North and South and rural
and urban. Traditional botanical medicine is based on local indigenous resources
and knowledge. Climate change and ecosystem damage diminish the local biological
resources available to tropical rural communities to contribute to their health
While pharmaceutical companies conduct advertising campaigns in tropical countries
to increase consumption of pharmaceuticals in urban areas, most people living
in rural areas have limited access to or can not afford these drugs. The World
Health Organisation (WHO) estimated that 80% of people in the world use medicinal
plants as their primary health care medicines. Research on the bioactivity of
tropical medicinal plants has demonstrated that most are safe and effective
therapies. Unfortunately, tropical public health programmes do not usually recognise
the therapeutic value of traditional medicine and instead encourage widespread
use of pharmaceuticals to treat diseases already adequately managed by locally
available traditional botanical medicines.
Due to the research, development, formulation, packaging, distribution, and
refrigeration costs, pharmaceuticals are capital and energy intensive forms
of medicine that are under external urban and/or Northern control resulting
in capital flow from rural to urban and South to North. These capital and energy
inputs make the cost of pharmaceuticals high and reduce access for tropical
rural communities. If pharmaceuticals reach these communities there is often
not a continuous supply or available refrigeration. If refrigeration is available
it requires a high capital input and energy consumption. Many donated pharmaceuticals
have exceeded their expiration date and are often for ailments that are rare
or not present in the recipient communities. When pharmaceuticals are used by
rural populations, they are often given inappropriately (wrong dose and/or for
wrong disease) because modern medical professionals are seldom present to correctly
administer these medicines.
Locally available medicinal plants can contribute to health care needs and generate
economic benefits for tropical rural communities. The WHO Traditional Medicine
Programme and other research programmes have conducted research on tropical
medicinal plants that have demonstrated safety and efficacy for the treatment
of common tropical diseases including malaria and infections of the skin, lungs,
and gastrointestinal tract.
Collaborative agreements may be established that enable tropical rural communities
to harvest botanical medicines from their local ecosystems and sell them to
northern or tropical urban areas as herbal medicines or for the extraction of
pharmaceuticals. Twenty five per cent of modern medical drug prescriptions written
in the United States are pharmaceuticals derived from plant species. In compliance
with the Convention on Biological Diversity, these collaborative relationships
between rural communities and research institutions can include agreements that
will entitle communities to receive long term benefits if marketable pharmaceuticals
or herbal medicines are derived from their botanical resources.
Impacts (Achieved Benefits)
Tropical rural traditional medicines under local indigenous control are more
affordable, available, and sustainable forms of medicine because they do not
require the capital and energy inputs needed for pharmaceuticals. These botanical
medicines are typically more therapeutic and safe because the medicine source
is locally harvested and knowledge of its medicinal use is known by the local
ethnolinguistic group. Use of ethnobotanical knowledge can also generate economic
benefits that result in capital flow from urban to rural and North to South
enabling local communities to use these resources to establish land demarcation,
community-based medicinal plant reserves, traditional medicine hospitals, infrastructure
support for a traditional healers' union, supplies for schools, and clean water
systems. These health care and economic benefits derived from ethnobotanical
knowledge generate incentives for tropical rural communities to conserve their
biological and ethnolinguistic diversity.
|Table 16.1 Tropical Botanical Medicines
|Long-term sustainability for indigenous community
|Ability of indigenous community to use medicine appropriately
|Cost of medicine
|Commodity produced & sold by indigenous community
|Capital flow South to /North
|Capital flow North to South
|Capital flow rural to urban
|Capital flow urban to rural
First, as demonstrated in Table 16.1, many barriers exist to safe, effective,
affordable, and sustainable use of modern medicines in tropical rural communities.
Tropical botanical medicines under local rural indigenous control are more affordable,
available, therapeutically beneficial, and sustainable for these communities.
Second, modern medical health care programmes should work to complement rather
than replace the local traditional botanical medical systems. The use of modern
pharmaceuticals at the local rural level should be reserved to only treat those
diseases not well managed by the local botanical medicines. When pharmaceuticals
are used for specific ailments, there should be careful monitoring of the treatment
by modern medical professionals to make sure the correct dose is given and the
appropriate disease is being treated.
Third, the local traditional medical systems should be included as integral
components of tropical health care programmes.
Fourth, use of ethnobotanical knowledge and harvesting of non-timber medicinal
plant products from their local ecosystems can generate economic benefits for
Fifth, the health and economic benefits of botanical medicines can establish
incentives for rural tropical peoples to conserve their ecosystems, ethnobotanical
knowledge, and languages.
Sixth, and perhaps most relevant to the climate change issue, all of these
efforts to encourage the use of indigenous, ethnobotanical and local resources
can help to preserve these areas, and thereby contribute to the mitigation of
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Guo, 1985. Medicinal Plants in Therapy. Bulletin of the World Health Organization,
63 (6), 965-81.
WHO, 1992: The Use of Essential Drugs: Model List of Essential Drugs:
Fifth Report of the WHO Expert Committee, 1992. World Health Organization Technical
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