Role of medicinal plants in healthcare in Africa and related

issues: special emphasis to Ethiopia as an example.

M.I.Zuberi Ph.D (U.K), Professor of Environmental Science,

Ambo University, Ethiopia [zuberimi@yahoo.com]

Introduction

In all the developing countries, especially in the Continent of

Africa (Fig 1), the majority of the common people continue to

rely heavily on the use of medicinal plants as their primary

source of healthcare. About 70-80% of Africa’s population rely

on traditional medicine, for example, in Tanzania an estimated

30 000 - 40 000 traditional practitioners provide health service

in comparison with 600 modern medical doctors (Hedberg et al.,

1982; 1983); also in Malawi, there were an estimated 17 000

traditional practitioners and only 35 medical doctors (Anon.,

1987). The International Development Research Centre (IDRC) gave

one estimate which puts the number of Africans who routinely use

the traditional medicinal services for primary health care as

high as 85% in Sub-Saharan Africa.

The fact is use of medicinal plants was as old as human society,

in the written record, the study of herbs dates back over 5,000

years to the Sumerians, who created clay tablets with lists of

hundreds of medicinal plants.  In 1500 B.C., the Ancient

Egyptians wrote the Ebers Papyrus, which contains information on

over 850 plant medicines. In India, Ayurveda medicine has used

many plants possibly as early as 1900 BC as the earliest

Sanskrit writings such as the Rig Veda, and Atharva Veda are some

of the earliest available documents detailing the medical

knowledge that formed the basis of theAyurveda system later

described by ancient Indian herbalists such

as Charaka and Sushruta during the 1st millennium BC. The

Sushruta Samhita attributed to Sushruta in the 6th century BC

describes 700 medicinal plants. Also noted that the

first Chinese pharmacopoeia, the Shennong Ben Cao Jing lists 365

medicinal plants and their uses, while the succeeding generations

augmented on the Shennong Bencao Jing, as in the Yaoxing Lun (Treatise on

the Nature of Medicinal Herbs), a 7th-century Tang Dynasty treatise on

herbal medicine (eg Daly et al , 2000).

However, following the course of economic development, there has

been a shift from using traditional medicines to consulting

modern medical doctors, but with a very slow socio-economic and

cultural change taking place in Africa, this shift is mostly

confined to the urban areas. The vast rural populations, being

poor and having little access to modern medical system, still

rely on the medicinal plants used in the traditional system of

healthcare (Bannerman, 1983) . Even recent reports suggest

that 60%-80% of the people in Africa rely on traditional

remedies to treat themselves for various diseases (van Wyk,

2008), also a large percentage of the people in Africa use

traditional remedies to treat their animals for various diseases.

The African continent have a long history of use of plants

for curing diseases and ailments, and in some African

countries up to 90% of the population rely on medicinal plants as

a source of drugs (Hostettmann et al 2000). Traditional medicines

in Africa are generally not adequately researched, and are weakly

regulated (WHA 1988 ).  There is a lack of detailed

documentation of the traditional knowledge associated with the

use of medicinal plants, which is generally transferred orally

(WHO,2000). Also, there may be serious adverse effects 

resulting from misidentification or misuse of healing plants.

Now, all developing countries have begun to realize that the high

costs of modern health care systems and the technologies that are

required will be difficult to obtain for the majority of the

people, thus supporting Africa's dependence to traditional

medical system a positive aspect (WHO, 2001). Due to this,

interest has recently been expressed in integrating traditional

African medicine into the continent's national health care

systems (Farnsworth et al, 1985). For these reasons, there is a

need to document the plant resources, conserve and develop

traditional medical system incorporating it into the national

healthcare systems of all African countries through training and

evaluation of effective remedies and by documenting the knowledge

of plants utilized, giving recognition and proper emphasis on

their contribution to the primary healthcare (Akerele, 1987;

Anyinam, 1987; Good, 1987).

Only until recently, ethnobotanical studies are being carried

out throughout Africa confirming that native plants are the main

constituent of traditional African medicine; just a short

internet hunt of articles resulted in the following documents (

Table 1) . Ti is noted that in Africa publication of research on

medicinal plants began only in the early 1980s while in Ethiopia

it was during early 2000, but with time the emphasis on

documenting medicinal plants and its use has gained momentum. The

list, obviously is incomplete and excludes the use of plants for

ethno-veterinary uses, but it emphasizes the number of species

used , the highest being 330.

Table 1 Summary of research publications on medicinal plantuse in Ethiopia and some African countries

Author /associates

Countries No Species

Year

Adjanohoun et al

Niger, Gabon, Mali,Togo, Congo

--

1980, 1984,

Ake Assi et al Côte d’Ivoire, Cenl. African Rep

--

1988

Hedberg, et al Tanzania, --

1982,1983,1985,

Good, et Kenya --

1980, 1987

Betti Jean l Cameroon (dja biosphere)

102

2004

Giday, M Ethiopia (zay -- 2001

people)

Giday et al. Ethiopia (lake Ziway area)

33 2003

Balemie, et al Ethipopia(East Shoa)

---

2004

Kebu et al Ethiopia, East Shoa)

-- 2004

Ermias Lulekal& Haile Yineger

Ethiopia (SE, Bale Mountain)

337

2005

Haile Y Ethiopia (Balemountain)

-- 2005

Debela Hunde etal

Ethiopia (Oromia) 52 2006

Wondimu et al.

Ethiopia ( Arsi, Oromia)

83 2007

Yineger & Yewhalaw.

Ethiopia (southwestern)

-- 2007

Giday Mirutse Ethiopia (SWest) 124

2007

Endalew Amenu Ethiopia (West Shoa)

89 2007

Teklehaymanot &Giday

Ethiopia (Northwestern)

-- 2007

Regassa Ethiopia (southern)

-- 2013

Yineger et al. Ethiopia (southwestern)

67 2008

Lulekal et al. Ethiopia 23 2008

(southeastern) 0

Bekalo et al. Ethiopia (southern)

120

2009

Mesfin et al. Ethiopia (Southern)

65 2009

Ragunathan and Abay

Ethiopia (Northwestern)

27 2009

Awas et al Ethiopia (Southwestern)

-- 2009

Gidey Yirga Ethiopia (Northern) 16 2010

Wabent etal

Ethiopia (Southeast)

40 2011

Mohammed Adefa and Berhanu Abraha

Ethiopia (South Wollow)

-- 2011

Anteneh Belayneet al

Ethiopia (eastern) 51 2012

Fisseha Mesfin et al

Ethiopia(SNNPR) 66 2012

Zerabruk, & G. Yirga.

Ethiopia (Western) -- 2012

Kalayu Mesfin etal

Ethiopia (Northern)

31 2013

Mohammed &Aydagnehum

Ethiopia (Gamo Gofa)

89 2013

Ketema Tolossa Ethiopia (SNNPR) 91 2013

et al

Zewdu Birhanu Ethiopia(Northwestern)

41 2013

Fisseha Mesfinet al

Ethiopia (SNNPR) 56 2014

Balcha Abera Ethiopia (Southwest)

49 2014

Mesfin, Fissehaet al

Ethiopia (Amaro) 56 2014

Now, with 70-80% of Africa’s population relying on traditional

medicines, the importance of the role of medicinal plants in the

healthcare system being enormous, also Africa is endowed with

many plants that can be used for medicinal purposes in the future

. In fact, out of the approximated 6400 plant species in tropical

Africa, more than 4000 are used as medicinal plants (WHO, 2007).

As most of the modern drugs have been developed from knowledge

and materials from medicinal plants use, serious attention has

now been given on this sector, as is evidenced by the

recommendation of the World Health Organization in 1970

(Wondergem et al., 1989) . As a result, proven traditional

remedies are being incorporated within national drug policies,

some moves towards a greater professionalism within African

medicine are being initiated (Last and Chavunduka, 1986). Little

attention however, has so far been paid to the socio-economic and

conservation aspects of medicinal plant resources, probably due

to lack of resources and the relatively scattered nature and

small volumes involved, also the specialist nature of the

informal trade is there. Although the high rate of population

growth, wide degradation of forests and rapid urbanization have

generated a heavy pressure on the plant-based raw materials with

wide and intensive collection and marketing with the trade

networks expanding from rural to urban to international levels.

This shift from the collection of raw plant materials from the

traditional experts to commercial exploiters with purely

commercial and short term interest has resulted in a disregard

for traditional conservation practice and a breakdown of taboos

and customs in the matter. This, in addition to a very rapid and

substantial decline in the area of natural vegetation and

forest , the natural home for medicinal plants, has exacerbated

the crisis.

Medicinal plants use in Ethiopia

A country with a wide range of climatic and ecological

conditions supporting an enormous diversity of fauna and flora,

(Pankhurst, 2001), Ethiopia, possesses a wide range of

potentially useful medicinal plants (Fig 2). Ethiopia is

believed to be home for about 6500 species of higher plants,

with approximately 12% of these endemic (UNEP 1995).

Traditional medicinal practices are common in Ethiopia,

about 80% of the population in the country use plant based

traditional medicine for primary health care (Dawit , 2001).

It has been estimated that 95% of traditional medical

preparations in Ethiopia are of plant origin (Dawit, 1986), there

is a rich reservoir of local indigenous knowledge on medicinal

plant use. Medicinal plants used by the Ethiopian were estimated

to be over 700 species, but later were revised to about 1000

(Edwards, 2001), more than 300 of which are frequently

mentioned in many sources ( Edwards, 2001; Giday et al, 2010 and

in table 1).

The knowledge on medicinal plants is largely oral, however,

Ethiopia’s ancient church practices have documented some of the

knowledge as inscribed in Parchments which partly characterize

the traditional medical system usually described as medico

religious written in Geez manuscripts of the 15th century

(Gelahun Abate, 1989; Dawit Abebe and Ahadu Ayehu, 1993). Many

cultural groups in the country have their own written or oral

traditions that could be associated with individual clans or

groups as partly stated by Amare Getahun (1976) and Abbink

(1995). The greater concentration of medicinal plants are found

in the south and south western Ethiopian parts of the country

following the concentration of biological and cultural diversity

(Edwards, 2001; Belayneh et al.2012 ). For a very long time, 80%

of the human population and 90% of livestock in Ethiopia rely

on traditional medicine, as most plants species have shown

very effective medicinal value for some ailments of human beings

and domestic animals (Abebe 2001). Formal recognition to

traditional medicine in Ethiopia was given in 1942 where the

legality of the practice is acknowledged as long as it does not

have negative impact on health, this was reaffirmed in the 1943

and 1948 in Medical Registration Proclamations. The Ethiopian

Penal Code (512/1957) and the Civil Code (8/1967) provide

guidelines for the practice of traditional medicine, there was no

stipulation of any requirement for registration. Although

registration and licensing was introduced in 1950 (Ministry of

Health, 1984), yet this is not in practice.

Impact of utilization of medicinal plants

In Africa and particularly in Ethiopia, most of the raw materials

used come from the wild ( Table 2) and there are many

implications of this.

Table 2 Status of medicinal plants in Ethiopia [Source: ref. inTable 1]

State of existence Number of species %

Wild 357 40.2Cultivated 89 10 Weed 52 5.9Undetermined 389 43.9

According to the UNCTADD/GATT International Trade Centre, the

total value of imports of medicinal plants for OECD countries,

Japan and the USA increased from US$ 335 million in 1976 to US$

551 million in 1980. Of the 200 tons of Harpagophytum procumbens

and H. zeyheri tubers exported annually from Namibia, Germany

imported 80.4%, with the remaining sold to France, Italy, USA,

Belgium and to South Africa (Nott, 1986). There are numerous

examples, eg. Maytenus buchananii, around 27.2 tons of plant

material were collected by the American National Cancer Institute

(NCI) from a conservation area in the Shimba Hills of Kenya for

screening purposes as a potential treatment for pancreatic

cancer, but when additional material was required four years

after the first harvesting in 1972, regeneration was so poor that

collectors struggled to obtain the additional material needed.

Others like 75-80 t of Griffonia simplicifolia seed exported each year

to Germany from Ghana (Abbiw, 1990) or the medicinal plant

material exported from Cameroon to France (Voacanga africana seed

(575 tons); Prunus Africana bark (220tons), Pausinystalia johimbe

bark (15 t) (United Republic of Cameroon, 1989) all testify how

the raw materials are harvested from nature. Also alarming that

no useful survey or research are known on the social or

environmental consequences of this harvesting, especially when

the harvesting process remains very destructive like cutting or

uprooting the plants for collecting fruits/seeds or bulbs (Rifai

and Kartawinata, 1991) as the trading agent or pharmaceutical

company are willing to pay a high price for a very large

amounts. There also are numerous records how many species of

medicinal plants became endangered or even extinct because for

uncontrolled harvest of important parts like root, fruits, seeds

or bark . As listed in Table 3, high proportions of the parts

used have been roots, whole plants, fruits, bark stem and seeds ,

collection of these affected the number, survival and

reproduction of the species.

Table 3 Plant parts used for the preparation of traditional

remedies in Ethiopia [Source: Dawit Abebe and Ahadu Ayehu (1993)

and ref from Table 1]

Plant part used Number of plant species%

Roots 378 58.3 Leaves 209 32.2 Whole plant 76 11.7 Fruits 76 11.7 Flowers 66 10.2 Bark 58 8.9 Stems 37 5.7 Seeds 35 5.4 Above ground 18 2.7 Latex 15 2.3 Resin 10 1.5 Sap 5 0.8 Gum 5 0.8 Rhizomes 2 0.3 Young shoot 1 0.15 Twig 1 0.15

For example, in South Africa, prior to 1898, local extermination

of Mondia whitei had been recorded in the Durban area due to

collection of its roots; by 1900, Siphonochilus natalensis (an endemic

species had disappeared from its only known habitats due to

trade. In Côte d’Ivoire, Garcinia afzeliiis considered threatened due

to harvesting (Ake Assi, 1988), destructive harvesting of

Griffonia simplicifolia, Voacanga thuoarsii and Voacanga Africana fruits for

the international pharmaceutical market is also of high concern;

in Nigeria, despite traditional restrictions the Okoubaka

aubrevillei trees (a very rare species in West Africa) were being

harvested . There appears to be nothing published on the

current status of many of these species. Some other examples are

Prunus Africana , Pausinystalia johimbe bark harvesting in Cameroon and

Madagascar, fruit harvesting of Griffonia simplicifolia, Voacanga thuoarsii

and Voacanga africana for the international pharmaceutical market.

Taverniera abyssinica whose slender roots are marketed is a

popular traditional medicine but the species is labeled as

critically endangered in the Red List of Endemic Trees and Shrubs

of Ethiopia (Vivero et al., 2003).

There are many reasons for the lack of management of these

resources, one major issue is the low prices paid for the raw

materials do not cover the costs of replacement or resource

management , and there is no such attempts in field. Instead,

the major traders/ importers especially from the developed

countries continue to demand high volumes of plant material

contributing to the decline of medicinal plant species in Africa.

Fortunately, in most of the African countries having high rural

population and low urbanization, collection of raw materials

for ordinary species is often on the small scale, still keeping

some wild populations going. But where a species is popular and

the demand is high but supplies are low and specially if the

species is already rare due to habitat destruction and

agricultural expansion, the damage to the population will be very

rapid and high, needing quick attention. Also important is the

part used, the common sale and use of medicinal plant leaves as a

source of medicine in many countries (like Côte d’Ivoire) leaves

less pressure on the plants; which differs markedly from the

high frequency of roots, bark or bulbs, fruits and seeds at

markets (Table 3). Throughout Lesotho, Malawi, Mozambique,

Swaziland, Zambia, Zimbabwe, and particularly South Africa,

herbal material that is dried (roots or bark), or has a long

shelf-life (bulbs ,seeds and fruits) dominates herbal medicine

markets.

Although there is very limited information on the population

biology of medicinal plants, it is possible to classify target

plant species according to demand, plant life-form, part used,

distribution and abundance (Cunningham, 1990). From a

conservation viewpoint, African medicinal plants can be divided

into two categories that are of concern:

(1) Species with slow growth/reproduction with a limited

distribution but high in demand for commercial gathering

where demand exceeds supply ( eg. Warburgia salutaris in east

and Southern Africa and Siphonochilus aethiopicus in Swaziland

and South Africa.

(2) Popular species which are not endangered because they

have a wide distribution, but where habitat change and

intense commercial harvesting (eg. Trichilia emetica and Albizia

adianthifolia in southern Africa ).

Research, documentation and dissemination

As emphasized above, tropical and subtropical Africa contains

more than 40,000 species of plant with a potential for

development and out of which only 5000 species are used

medicinally and , in spite of this huge potential and

diversity, the African continent has only contributed 83 of

the 1100 blockbuster drugs globally (Rukangira, 2004). A few

plant species that provide medicinal herbs have been

scientifically evaluated for their possible medical

applications. Some plants used in traditional medicines, such

as taenicides, are widely known to be toxic. For example,

blindness and changes in central nervous system function have

repeatedly been found in people who took over dosage of

Hagenia abyssinica (Rokos, 1969). Many cases

of Podophyllum poisoning have been reported from Hong Kong

following the inadvertent use of the roots because of

similarity in the morphology of roots. Also cases of

cardiotoxicity resulting from the ingestion of Aconitum species

used in complementary medicine for acute infections and panic

attacks have been reported also from Hong Kong (WHO, 2004).

There are increasing number of reports of patients

experiencing negative health consequences caused by the use of

herbal medicines. Among many, one of the major cause of

diverse effects is directly linked to the poor quality of

herbal medicines, including raw medicinal plant materials, and

to the wrong identification of plant species. Cultivating,

collecting and classifying plants correctly are therefore of

the utmost importance for the quality and safety of products.

Not only patient safety issues, there is a huge risk that a

growing herbal market and its great commercial benefit might

pose a threat to biodiversity through over-harvesting of the

raw materials for herbal medicines and other natural health

care products. If not controlled, these practices may lead to

the extinction of endangered species and the destruction of

natural habitats and resources. The WHO guidelines on good

agricultural and collection practices (GACP) for medicinal

plants are an important initial step to ensure good quality,

safe herbal medicines and ecologically sound cultivation

practices for future generations (WHO,2004). In an easy-to-

understand style they cover the spectrum of cultivation and

collection activities, including site selection, climate and

soil considerations and identification of seeds and plants.

Guidance is also given on the main post-harvest operations and

includes legal components such as national and regional laws

on quality standards, patent status and benefits sharing.

The safety and efficacy data are available for even fewer herbs,

their extracts and active ingredients and the preparation

containing them. Also in most African countries, the herbal

medicines market is poorly regulated and herbal products are

often neither registered nor controlled. So, the assurance of

safety, quality and efficacy of medicinal plants and plant

products has now become the key issue among the users in urban

areas and in other developed/ developing countries. For

ensuring the efficacy of traditional medicine, both the general

consumer and health care professionals need reliable, up to date

and authoritative information on the safety and efficacy of the

medicinal plant products.

Research and documentation are important for allowing reliable

information exchange between the sources and users of the

medicinal plants. Without well documented reliable information

on the safety, efficacy and phytochemical characteristics of

different constituent/products, it is difficult for users and

buyers to assess the utility or value of the raw materials and

extracts of African origin. Consequently, the level of use and

world trade in Indian and Chinese medicinal plants and extracts

are far more extensive than those of the African Region.

Although, in recent years there has been an upsurge in research

and development in African universities and research centres on

ethnobotany and medicinal products ( eg Table 1), only a few

plant products have been commercialized and still much of the

basic scientific information is not available (Newmann,2005;

AAMPS, 2010).

Also, much of valuable information on reproductive system,

seed/seedling survival and population dynamics are not available

for decision making in management, so is on the quantities of

traditional medicines being harvested or sold, whether for the

local use, trade or for export and the extraction of active

ingredients. For example, in South Africa, harvesting from wild

populations of certain species is on a scale that cause concern

amongst conservation organizations and rural herbalists, and a

listing of priority species is available (Cunningham, 2001).

Studies and research information which identify threatened

medicinal plants should

be circulated through the International Board for Plant Genetic

Resources (IBPGR) to regional gene banks and IUCN, also

information should be disseminated to rural communities on

appropriate conservation / cultivation methods for medicinal

plants which are in local demand. Very little goes unnoticed in

communally owned areas so that if problems arise regarding the

depletion of valued local resources, the traditional medicinal

groups / associations or community leaders are likely to be

effective for immediate action. Information relating to adverse

toxic properties in medicinal plants should also be circulated

particularly to practitioners/traders and in Primary healthcare

training (Akerele, 1987; Anyinam, 1987; Good, 1987).

Market related research and information sharing should also be

emphasized, a rapid development of alternative supply sources

through buffer stock/cultivation in large quantities and at a

low price to compete with prices obtained by gatherers of wild

stocks can reduce the pressure on wild resource base. This will

satisfy market demands, result in more secure jobs and provide

fewer incentives to gather from the wild. If this does not occur,

key species will disappear from the wild, thereby undermining the

local medicinal resource base. Also important are in information

on plant biology and reproduction, as many of the vulnerable

category of species, by their very nature, may not be grown

profitably due to their slow growth rates or especial habitat

requirements, especially as the land which is most likely to be

available for medicinal plant cultivation is likely to be less

productive.

Information and codes on effectiveness, precision and standards

are important too. In Ethiopia, Amare Getahun (1976), Sofowora

(1982), and Dawit Abebe (1986) discussed the lack of

precision and standardization as one drawback for the

recognition of the traditional health care system. One of

the constraints which are hindering proper development and use

of medicinal plants is the lack of suitable technical

specifications and quality control standards for African

medicinal plants and extracts. This makes it extremely difficult

for users and buyers whether local or overseas to compare batches

of products from different places or years. Lack of trading

standards also implies that Good Agricultural and Collecting

Practices (WHO, 2003) and Good Manufacturing Practices (WHO,

2007) are not adhered to. This is in marked contrast with

countries such as China and India where traditional formulations

have not only been recorded but are evaluated both at the local

and national level and used in their health centres.

Problems with medicinal plant use: Management for safe &

sustainable use

With the progress in modern science, concerns on the safety

and quality of raw plant materials and finished products from

medicinal plants became a major issue (WHO, 2001, 2007). The

quality of plant products not only depend on genetic or on

environment of the plant, but also on collection methods,

cultivation, harvest, post-harvest processing, transport and

storage practices. There remains a high probability of

contamination by microbial or chemical agents during any of

the production stages resulting in deterioration in safety and

quality. Most of the medicinal plants being collected from the

wild may be contaminated by other species or plant parts

through misidentification, accidental contamination or

intentional adulteration, all of which may have unsafe

consequences.

Also important are the interaction between medicinal plant use

and modern medicines among the urban and immigrant

populations. The Ethiopian immigrant population is more

diffuse in the USA and other developed countries and often

without access to traditional medicinal practitioners, often

use herbal remedies (Hodes, 1997). In many cases Ethiopian

patients in urban and foreign areas use traditional remedies

in combination with prescribed modern medications for related

or unrelated health conditions without informing their

physician (Fullas,2001). Ethiopian patients who use

traditional medicine and do not inform their health care

providers may do this for several reasons including cultural

differences ( Jackson,2008) . Many herbal substances that are

used in Ethiopian traditional medicine are also used as

ingredients and spices in Ethiopian food (Fullas, 2003; Zuberi

et al , 2014). Consumption of these herbs and spices as part

of a normal diet is not likely to cause adverse herb-drug

interactions as consumed in relatively small quantities but

when utilized for medicinal purposes there may be an

increased likelihood of adverse interactions with modern

medicines (Jackson, 2008).

Therefore, the management of traditional medicinal plant

resources is probably the most complex African resource

management issue facing conservation agencies, healthcare

professionals and resource users. As pressure is increasing on

diminishing medicinal plant supplies, constructive resource

management and conservation actions must be identified, based

upon a clear understanding of the surrounding medicinal plant

use. Among others, three central issues to be considered: (1)

What are the causes behind the depletion of wild populations of

medicinal plant species in Africa? (2) Which species are of

particular concern and should be given priority for positive

action? (3) What can be done to ensure the effective conservation

of all medicinal plant species? As medicinal plant resource

management problems exist not in these areas alone but also in

the processing, standardization, quality control, marketing and

consumption not only the rural areas but in densely populated and

rapidly urbanizing regions, efficient management and control

reaching a balance between human needs and medicinal plant

resources is most urgent.

Giving emphasis to the plant resources, identification of habitat

with a high density of endemic families, genera and species with

medicinal properties; management effort around core conservation

areas through interaction with resource users and provision of

alternatives to wild populations of threatened species are

important. For those which are nearly extinct or seriously

endangered, seed and gene banks should be maintained as

precaution and backup against extinction. It is important for the

gene bank to collect information on uses and efficacy of

medicinal plants than collect material for ex-situ conservation.

Where the local habitats of these medicinal plants are

threatened there is the need to be established in field gene

banks until technology is available for reestablishing the

indigenous habitat. But ultimate goal of the conservation process

is certainly to preserve the natural habitats of vulnerable

medicinal plant species and to achieve sustainable exploitation

in less vulnerable areas. So, permanent forest areas/ large plots

should be set up in selected sites to monitor the status of the

endangered species like Warburgia salutaris, Garcinia afzeliiand Okoubaka

aubrevillei in Africa. Also, collections for seed and gene banks

should be undertaken according to the principles of conservation

biology and population genetics, the sample size , population

size and distribution, genetic diversity and reproductive biology

should be kept in mind for future stability, medicinal property

and evolutionary changes. Also attention be given in order to

select for commercially beneficial properties such as growth

rate, adaptation to different habitats and highest levels of

active ingredients for pharmaceutical use. Moreover,

establishment of ex-situ populations of threatened and endangered

species in more than one locations, botanical gardens under the

existing framework of the IUCN Botanical Gardens Programme should

be considered. The

potential for the clonal production of medicinal plants with

desired qualities or known toxicities. Are good options. The

conservation of medicinal plants is by necessity a long term

project requiring the development of traditional medicinal

practitioner groups/associations, trained technical staff

supported by organizations/universities and a general public that

is aware of

the issues at stake. Improvement in national education standards

especially in the fields of natural resource management is a key

factor in the conservation issue which will come about only as a

result of economic development in the African nations.

The need in Africa for institution building, organizing the

stakeholder groups and better staffing and funding of traditional

medical institutions, herbaria, research and evaluation centers,

chemical analytical facilities, drug testing are well known

(Hedberg et al, 1982;1983). Along with medicinal plant

conservation, there should be expansion of cultivation of

medicinal plants especially those with high demand, the rural

communities, commercial growers, government decision-makers,

pharmaceutical companies should come forward.

Traditional medicinal practitioners in most cases are working in

isolation and neglect, though are very aware of the conservation

status and needs of the local medicinal plants can do very

little. It is true, they can be influential in changing local

opinion so as to limit over-exploitation and in conservation only

if they are organized and supported. It is recommended that

support is given to the formation of rural traditional medical

practitioners’ associations which might be easily possible

through local health services providing system of the country

with the support of the national governments and WHO.

Realizing the needs of institutions, as early as in 1979, the

Office for the Coordination of Traditional Medicine was

established in Ethiopia which arranged meetings, workshops and

conducted chemical assays and biomedical studies of some herbal

medicines and a total of 6,000 traditional practitioners were

registered and a monograph describing 260 medicinal plants was

prepared (Ministry of Health, 1984, GoE, 1993; Beshaw, 1991).

There were targets of the drug policy include conducting

coordinated research on traditional medicines and for development

into pharmaceutical drugs, general strategies for strengthening

the health sector through research and development, creating

favorable conditions for the development of safe and effective

drugs and involving private providers ( Ministry of Health,

1993; GoE, 1993). Laws and regulations on traditional medicine

were issued , the national drug program was formulated through

Drug Administration and Control Authority (DACA) but little

progress could be obtained till 2006 (Kebede Deribe Kassaye et

al, 2006).

Cultivation of medicinal plants: an alternative

As the demand on medicinal plants multiply with expansion of the

pharmaceutical industries, cultivation as an alternative to

overexploitation of scarce traditional medicinal plants was

suggested over 50 years ago in South Africa for scarce and

effective species such as Alepidea amatymbica and Warburgia salutaris.

But even just few years ago, no large scale cultivation had

taken place. There are two main reasons for this, and both apply

elsewhere in Africa:

(1) lack of institutional support for production and

dissemination of key species for cultivation;

(2) the low prices paid for traditional medicinal plants by

herbal medicine traders and urban herbalists.

At present, cultivation of medicinal plants is chiefly

restricted to temperate areas and with the exception of India

and Nepal, few tropical countries have investigated the potential

of cultivating medicinal plants on a commercial scale. As

commercial cultivation depends on many aspects especially the

price of the raw materials, cost of cultivation, market stability

and the price for favoured species , all determining whether

cultivation is a viable option, under uncontrolled market when

the supply exceeds demand, then price falls.

In spite of the above constraints, cultivation has replaced

wild collection for the supply of some essential drugs used in

modern medicine, eg. the Madagascar rosy periwinkle,

Catharanthus roseus, which is widely cultivated in Spain and the

United States for its properties in treating childhood

leukaemia and Hodgkin’s disease. Another traditional medicine

for which demand is greater than the potential for supply is

the African tree Pygeum  (Prunus africana), bark being very

popular as natural remedy for prostate disorders in some

European countries. As it is harvested from wild trees growing

in the mountain forests of Africa and in Madagascar which is

unsustainable under current practices, so the International

Centre for Research in Agroforestry (ICRAF) and others are

working to establish sustainable sources of Prunus

africana through conservation of wild tree populations and

assistance to smallholders to grow the tree also helping

increasing farmers’ incomes. Another example, is Devil’s

Claw, Harpagophytum procumbens, a popular medicinal plant used

as a tonic, a treatment for arthritis and rheumatism, to

reduce fever, ease sore muscles, reduce cholesterol, and

externally the ointment is used to treat sores, boils, and

ulcers has been unsustainably harvested and may become extinct

in the wild under current practices. Now Devil’s Claw is

produced in southern Africa and Namibia providing local

people with a sustainable product at a guaranteed and fair

price.

Though ethnobotanical studies conducted in Ethiopia (Table 1)

indicated that most medicinal plant species used to treat human

ailment were wild, implies that the majority of plants of

medical importance were not yet identified and describe,

to be under cultivation will require important information about

their biology, reproduction and management. Although some of

these species are threatened in the wild (e.g. Garcinia afzelii and

Warburgia salutaris), low prices provided by the traders/exporters

fails to ensure that they can be profitably cultivated without

well coordinated, well supported and organized program.

An interesting model is provided in Thailand where a project for

cultivation of medicinal plant of known efficacy has been

initiated in about 1000 villages and traditional household

remedies, with improved formulae, are produced as compressed

tablets packed in foil and distributed to “drug co-operatives”

set up through a Drug and Medical Project Fund in more than 45

000 villages as well as in community hospitals ( Wondergem et al.

1989; WHO, 1977) have already drawn on the Thailand experience in

making recommendations regarding primary healthcare in Ghana.

WHO’s efforts toward sustainable medicinal plant use

The importance of medicinal plants in the health care systems in

many developing countries including those of Africa has been

underscored by various resolutions of the World Health Assembly

and WHO Regional Committees. The Resolution WHA41.19 of 1988 on

Traditional medicine and medicinal plants (WHA, 1988) urged

Member States to examine the situation with regard to their

indigenous medicinal plants and to take effective measures to

ensure their conservation and encourage their sustainable

utilization. That resolution requested WHO to promote inter-

country meetings for the dissemination of knowledge and the

exchange of experience on the subject; and to collaborate with

Member States in the design and implementation of programs for

the conservation and sustainable utilization of medicinal plants.

The resolution AFR/RC 50/ R5 of 1999 on Essential drugs in the

WHO African Region situation and trends analysis (WHO, 2000)

requested WHO to support the African member states to carrying

out research on medicinal plants and promoting their use in

health care systems; while resolution AFR/RC 5//R3 of 2000 was on

promoting the traditional medicine in health systems. A Strategy

for the African Region (WHO,2001) urged Member States to actively

promote, in collaboration with all other partners, the

conservation of medicinal plants and requested WHO to strengthen

WHO Collaborating Centres and other research institutions to

carry out research and develop monographs of medicinal plants and

disseminate results on safety and efficacy of traditional

medicines. Following these efforts, many countries including

Benin, Burkina Faso, Cameroon, Cote d’Ivoire, Ghana, Guinea,

Madagascar, Mali, Mauritius, Nigeria, Senegal, Seychelles and

South Africa have developed monographs of medicinal plants,

while Benin, Cameroon, Chad, Cote d’Ivoire have developed

inventories of medicinal plants and documented traditional

medical drugs. WHO also helped in developing monographs on some

commonly used medicinal plants (WHO, 1999-2000). Also some

countries like Ghana and Nigeria have published national herbal

pharmacopoeias, other countries have been conducting research on

traditional medicines used for the treatment of priority

diseases. The WHO has released guidelines for good agricultural

and collection practices for medicinal plants - an industry

estimated worth more than US$ 60 billion (WHO,2004). The

guidelines are intended for national governments to ensure

production of herbal medicines is of good quality, safe,

sustainable and poses no threat to either people or the

environment.

Following WHO’s initiatives (WHO,2005), the Ethiopian authorities

also undertook attempts to regularize this sector. Laws and

regulations on traditional medicine under the Drug Administration

and Control Proclamation No. 176/99 was introduced, national

drug program was adopted, one of the responsibilities of the Drug

Administration and Control Authority (DACA) which was to prepare

standards of safety, efficacy and quality of traditional

medicine, and evaluate laboratory and clinical studies and

giving license for the use of traditional medicine in the

official health services. But even in 2006, there was no

registered traditional practitioner and way of registration in

the Federal Ministry of Health but numerous herbal medicines

being sold on the streets with medical claims (Kebede Deribe

Kassayeet al, 2006). Also, no regulatory requirements exist for

the manufacturing or safety assessment of traditional medicines

and herbal medicines are not included in the essential medicines

list, there being neither a post market surveillance system, a

restriction on the sale of herbal medicines nor a guideline for

clinical trials using traditional medicines. By early 2006 DACA

had not yet carried out any activity on traditional medicines and

no traditional drug was registered and licensed although

guidelines are being prepared (Kebede Deribe Kassayeet al, 2006).

Conclusion

It is indicated from the above discussion that to sustain the

use of medicinal plants in Ethiopia but also in all other

developing countries like India, China and South Africa, it is

important to create a long term relationship and collaboration

among all the stakeholders of the traditional medicine system

and with the modern medicine system including the pharmaceutical

industry, aiming at the wellbeing of the common people. To do

this, it is required that the national governments and the

international organizations like the WHO should take very

concrete steps keeping all the actors of the traditional medicine

in the fore.

Fig 1. AFRICA POLITICAL MAP [http://www.worldatlas.com/]

Fig 2 Ethiopia showing natural areas [https://www.google.com.et/]

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