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BRAZIL: Public Health Embraces Herbal Medicines

Fabiana Frayssinet

RIO DE JANEIRO, Jun 1 2009 (IPS) - Handed down from generation to generation, traditional knowledge about medicinal plants has reached state laboratories in Brazil through a programme that has already identified 71 native and exotic species for producing herbal medicines.

The National Programme of Medicinal Plants and Phytotherapeutics was created around the time when the World Health Organisation (WHO), in 1978, recognised the use of medicinal plants for prophylactic, curative, palliative and diagnostic purposes, and recommended that public health policies include them.

According to the Health Ministry, Brazil is the country with the greatest plant genetic diversity in the world, with close to 55,000 classified species out of an estimated total of between 350,000 and 550,000. It also has a deep-rooted culture of the use of medicinal plants, linked to traditional folk wisdom.

Now the home remedies that grandmothers often prepare, are recommended by a friendly neighbour or are in common use in indigenous and Afro-descendant communities will be available in the public health system.

Using the list of 71 plants, experts will carry out research studies to prepare new medicines. At present Brazil's public health system only offers remedies derived from "espinheira-santa" (Maytenus ilicifolia), for gastritis, ulcers and other illnesses, and from "guaco" (Mikania guaco), a soothing expectorant for coughs.

The aim is to recover and promote folk practices in traditional medicine, but also to foment the study and economic development of the various Brazilian ecosystems, Sandra Magalhaes, a biologist at the Oswaldo Cruz Foundation (FIOCRUZ), linked to the Health Ministry, told IPS.

Magalhaes, who studies medicinal plants in the experimental field station at the FIOCRUZ Atlantic Forest Campus in Rio de Janeiro, said the programme also has economic goals.

One is to stimulate production of medicinal plants as a source of income for small farmers and national laboratories. Another aspect is that "this medicine has proved to be cheaper than synthetic or allopathic medicines." According to the biologist, municipal programmes already using phytotherapeutics have significantly reduced their costs.

The FIOCRUZ experimental station is an aromatic patchwork of the more than 126 native and exotic species cultivated in its fields. It is like an open-air pharmacy holding out the promise of healing for all kinds of health problems.

The range of plants grown here goes from "assa peixe" (Vernonia ruficoma or Vernonia polyanthes) which is frequently used in syrups to treat flu, bronchitis and coughs, to "carqueja" (Baccharis trimera), used for healing wounds and for the stomach.

The Health Ministry's list of plants, whose effectiveness has been "scientifically demonstrated," according to Magalhaes, also includes "babosa" (Aloe vera), which has antiseptic and wound healing properties, and can be used to combat dandruff and hair loss.

The programme is intended to serve as a platform for expanding the number of herb-based medicinal compounds financed by the government. The only two preparations now available are the ones based on "guaco" and "espinheira-santa."

According to spokespersons at the Ministry, the priority was to select plants that would be useful for treating the most common ailments.

Décio Luiz Alves, a member of the board of the Brazilian Society of Phytomedicine (SOBRAFITO) and head of its Rio de Janeiro section, is an ardent advocate of herbal medicines, which he says can be used in all manner of common maladies.

In an interview with IPS, Alves said that the natural substances in plant medicines are "more easily recognised by the human body" than synthetic ones, and therefore are "better accepted" by the body and have a "gentler" action.

Alves described the effects of a synthetic anti-inflammatory, prescribed for example for joint pain, "which causes gastritis," which then has to be treated with an antacid, "which then causes constipation problems."

"An herb-based medicine, on the other hand, treats the joint pain and at the same time protects the stomach lining, because it is gentler and prevents the gastritis that can be caused by an ordinary anti-inflammatory," he said.

But like other experts, Alves warned that without medical advice, plant medicines can cause problems.

"They are medicines, and as such they have disadvantages and side effects if they are not taken correctly," he said. For the same reason, he said the strict Brazilian laws on phytotherapeutics are entirely justified.

Magalhaes warned about other potential risks of herb-based medicines, right from the moment the plants are grown. In fact, the goal of the government programme is to ensure safety, quality and effectiveness in the phytochemical production process from the cultivation stage, she said.

The FIOCRUZ biologists teach the farmers involved to be careful when choosing the soil where they grow their plants – for instance, it should not contain heavy metals – and to replace toxic pesticides and herbicides with natural ones, as well as paying attention to the timing of planting and harvesting.

Producers also learn to handle the medicinal plants without contaminating them. And at the point of use, experts recommend care over the dosage and contraindications.

"We are talking about medicinal plants and phytotherapeutics, but also about health products. So although they may be viewed as simpler medicines, a doctor's indications are always necessary," Magalhaes said.

The FIOCRUZ biologist said it was important to learn what part of the plant – stem, root, leaf or flower – should be used for different ailments.

"It's important to know exactly what part of the plant has the highest concentration of the molecule or active principle that has a biological effect in a particular disease. Otherwise, the remedy may have no influence, or even the opposite effect to what is desired," she said.

Leonardo Lucchetti, research manager at Farmanguinhos, FIOCRUZ's government laboratory, said that the idea that natural medicine "does not have side-effects is a popular myth."

"Many people believe that the remedies they prepare at home can't harm them. But it's essential to know what dose to use, what the appropriate concentration of the active principle is, whether the patient is taking other medicines at the same time, and the effect of interactions with their diet, too," Lucchetti told IPS.

The Laboratory for Chemistry of Natural Products at Farmanguinhos is devoted to research into these active principles.

"We screen the chemical substances present in plant extracts, to identify candidates for the active phytotherapeutics of tomorrow," Lucchetti said.

The laboratory studies the plants to be used in the public health system, in order to determine their effectiveness and risks, and probe the scientific legitimacy of the benefits ascribed to them by traditional wisdom.

"In the case of synthetic or allopathic medicines, their molecules have already been isolated, their structures are known and their side effects have been described. But in the case of medicinal plants, we are talking about a living organism that is composed of thousands of molecules," Magalhaes said.

That is why biologists regard it as important that government programmes guarantee the safety and effectiveness of the plant-based medicines to be included in public health policy.

"Medicines are intended for use in the cure or prevention of disease, and therefore we cannot treat them lightly or negligently, without taking into account all the scientific information and safety issues involved," Lucchetti said.

He said medicinal plants are not necessarily dangerous, but that risks can arise if they are inadequately cultivated, prepared in laboratories, tested or prescribed, or consumed recklessly.