A professor of Pharmacognosy, Obafemi Awolowo University, Ile Ife, Osun State, Anthony Elujoba, talks about the place of herbs in orthodox medicine with KAYODE FALADE

Why are you interested in herbs despite your training as a pharmacist?

Due to my training as a pharmacist (an expert in matters of all medicines) I should be expected to have interest in medicinal herbs. At the bachelor degree level, the subjects that make up pharmacy have trained me to acquire skills that qualified me to become an expert in conventional drug matters, regarding formulation, production, dispensing, manufacture, importation, exportation, counselling and detailing. At postgraduate research levels (Masters/Ph.D), I chose to specialise in the subject of Pharmacognosy which is the study of drugs obtained and obtainable from natural sources namely, plants, animals and minerals; the other pharmacy subjects that never appealed to me at postgraduate level at that time (1973) included Pharmaceutics, Pharmacology and Pharmaceutical Chemistry. The subject of Pharmacognosy (my discipline) often leads the others on the journey of herbal drug research and development.

In fact, at a rudimentary stage of development, the subject for training of persons that prepared and dispensed medicines and their practice (under the apothecary scheme) was very close to what could have been referred to as pharmacognosy which has since grown to be called the pharmacy profession today. An appropriate pharmacy training in Africa must incorporate Herbal Pharmacy as a final year specialised option. This is a challenge to the Pharmacists’ Council of Nigeria and the deans of pharmacy in the country.

The use of herbs as medicine has been consistently criticised by health workers especially medical doctors and pharmacists. What is your take on this?

Permit me to infer from your question, that only the medical doctors have not liberally accepted our campaign that herbs also have utilisable therapeutic values and that herbs could bring both health and wealth to this nation like China and India. Some reasons for the doctors’ attitude and seemingly intellectual posture can be advanced: one, Traditional Medicine practice is often confused by many people with Herbal Medicine practice (which is the use of herbs to treat diseases and it represents only a small part of TM); HM (exploited through TM) had led to the discovery of many useful drugs such as quinine, aspirin, morphine, artemisinin and other important life-saving drugs in today’s orthodox medical practice. Secondly, doctors often strongly criticise and are not happy (genuinely too) with what we clearly consider to be the disadvantages of TM e.g. inexplicable aetiology of disease, imprecise diagnosis, intangible treatment modalities, etc. But, we can remove or reform the disadvantages of the practice.

Thirdly, we also feel that the doctors’ attitude might have been influenced by inaccessibility to correct information, hearsay or misguided information especially by the early colonial teachers of medicine and missionaries, who, in a genuine attempt to discourage the use of unproven and unwholesome practices of the early traditional healers, chose to almost effectively ban TM practices in Africa. Gladly however, on the individual platform, there are many doctors in this country today that agree with us about the potential of HM and even, a few doctors are practising HM or TM in this country. Gladly still, the acceptance level by doctors has been improved by the current sensitisation of the public through the visibility of several local and imported “official” NAFDAC-listed HM products in the Nigerian market. It is certainly heart-warming that future university training at B. Sc. Degree level for HM practitioners will remove all the demerits, unbelief and reservations facing our medical doctors; this is the experience of Ghana, with about five batches of trained B. Sc. HM graduates from the Kwame Nkruma University of Science and Technology, Kumasi who are presently serving as HM practitioners both in private and government establishments.

Indeed, they are already functioning together in parallel with the orthodox doctors in the same primary health care hospital outfits where an effective bilateral case referral system between the two forms is comfortably in place. On the other hand, no other category of health care providers would normally oppose the official development and recognition of HM. In fact, since 1980s, the Nigerian Schools of Pharmacy have incorporated Senate-approved HM modules into the training of pharmacists. Also, some nursing/midwifery schools have introduced some aspects of TM into the curriculum. We believe that Nigeria will get to the point when the two systems will collaborate for the good of their patients. My prayer is that the Minister of Health will complete what God has helped him to start as he plans to introduce the B.Sc Herbal Medicine programme (like in Ghana) into the medical schools of the Nigerian universities and also make the regular medical (MBBS) students have some basic knowledge of HM to make them benefit from and understand the collaboration.

One of the criticisms against the use of herbs is its lack of regulated and generally accepted dosage. How true is this?

Yes, contrary to some critics, Traditional Medicine has dosage but certainly not clinically evidence-based and obviously in many instances, such dosages cannot be acceptable to any health care provider including me. This is one of the numerous demerits of TM which can easily be perfected by pharmaceutical science and by training the practitioners at B. Sc degree level.

Is there any collaboration between herbs and orthodox medicine?

Right now, the long-awaited professional collaboration is non-existent in Nigeria, unlike in China and India while it has just successfully taken-off in Ghana. In 12 local government areas in Ghana, each primary healthcare hospital houses a herbal department, operating with effective procedural and bi-lateral referral system, patients are free to choose their preferred mode of therapy (whether from herbal or orthodox department) right from their arrival at the OPD (documentation/card) room. This collaboration success will also feature in Nigeria when the B. Sc Herbal Medicine graduate programme begins to mature.

What is the place of herbs in modern pharmacology?

Simply, in any Faculty of Herbal Medicine (India, China, Ghana, etc.), there is a subject called Herbal Pharmacology to which the same principle of “modern” pharmacology i.e. of orthodox drugs is applicable. In other words, the pharmacology of herbs takes origin from basic orthodox pharmacology except that the study deals solely with the actions of herbs (not drugs) in human and animal systems. Herbal medicines are tested first on animal systems under Herbal Pharmacology and in the human body under Clinical Pharmacology.

Is there an ailment which herbs cannot treat or cure?

I am sorry, this question is rather unscientific in my view for only a minute proportion of available herbs has been studied on a limited number of ailments; then, how can I or any mortal person know without researching into the whole forest if there is any ailment that cannot be treated with herbs? In any case, I will try to answer the question scientifically by saying that there is no ailment whose management/cure cannot be investigated with herbs. Allow me to substantiate and strengthen this statement by agreeing with the traditional medicine practitioners who believe that there is no disease whose cure cannot be found in the forest. Since there are thousands of medicinal plants yet un-investigated for human or animal ailments, I personally believe that it is surer and wiser to find herbal treatment in the forest for a new ailment through research than by investigating synthetic chemical drugs in the test-tube. When the plants’ chemical molecules responsible for the biological activity are known, then the synthetic test-tube production can take over on a large-scale.

Can herbs treat or cure the Ebola Virus Disease?

I will not answer it in a yes-or-no manner. However, as can be inferred from above, the chances are high that herbs to fight Ebola could be more easily found through herbal research and development effort on our forest.

Recently in an Internet knowledge-sharing debate among the TM experts in Africa on Ebola, initiated by the World Health Organisation in Africa (WHO/AFRO) based in Brazzaville, a contributor challenged us to search for the cure of Ebola. This statement must have premised from the fact that there are numerous well-known antiviral plants and those that can cheaply relieve the symptoms of Ebola in the African forest that we should have investigated for the cure of Ebola at least outside the human body. Like many other African nations, Nigeria is lucky to have an Institute of Virology and universities with identifiable virology laboratories that could be engaged in serious herbal research.

There are also Faculties of Pharmacy with herbal outfits for teaching, research and herbal clinical services that can suggest candidate herbs for EVD screening. I suggest that they should be called to action now because it appears to me that other smaller ECOWAS countries are already expecting Nigeria to help find an emergency breakthrough therapy for the ebola epidemic by research. We must begin now from somewhere by urging Africa to wake-up while Nigeria strives to take the lead.

What is your take on the assumption by some that bitter kola can be used to fight the Ebola virus?

Even though it is in the literature that bitter kola possesses antiviral activities, even though, I’m yet to find in the literature that it has been successfully used to treat EVD in an evidence-based trial.