Contribution to a global proposal supporting the use of medicinal plants by developing countries: The case of Guatemala

ARMANDO CACERES

San Carlos University of Guatemala, Guatemala

Introduction

The genetic and cultural wealth of Guatemala expresses itself on a traditional medicine based on the use of medicinal plants. The experiences of the last decade indicate that the issue of the medicinal plants is of interest from all points of view and it might contribute to the development of the people by means of its systematic study in a multidisciplinary approach. The present paper summarises the Guatemalan experiences in recognising, organizing, coordinating and implementing institutional and national projects in order to fully validate the use of medicinal plants and to support its application by the national health systems.

Research and development strategy

The fact that Guatemala is placed in the junction of the North and the South, the Atlantic and the Pacific, brings about the result that the country has an outstanding biological diversity, in spite of the threatening decay seen in its national heritage. The cultural legacy of the Mayas' forefathers is rich in the wise use of the resources produced by nature, out of which a deeply rooted traditional medicine has been formed. However, it lacks systematization and has not achieved full acceptance as part of the national legal medical system. The social decadence and the financial "bankruptcy" generalized in many countries, to the health problems, the growing incapacity to purchase of imported drugs and the lack of supplies of pharmaceutical products in the the local markets, create the need to look into a therapeutic system which is part of the national heritage. In an effort to contribute to the reconstruction of Guatemala after the earthquake of 1976, Meso-American Centre for Studies on Appropriate Technology (CEMAT) was created as a non-governmental organization, projecting itself towards the adaptation and integration of appropriate technologies for development within the framework of the organization of rural micro-enterpreneurial groups. The areas covered have been: energy (timber, biogas, gasification); sanitation (latrines, digestors, water purification); agriculture and primary health care (phytotherapy, acupuncture promoters); building materials (puzzalana, fibercreto covers), mini-animal husbandry (bees, rabbits, fishes, swine) and information (information center with 250,000 specialized documents, bulletin in two languages sent to 76 countries, translations, organization of national and international events). With the experience attained by means of the joint research with the groups, a methodology of workshops was developed to train and up-grade the rural personnel in construction, monitoring use of the appropriate technology introduced, as well as in the micro-enterprise organization of these community groups.

An area which received particular attention was the project under the title: "Rural Enterprise of Medicinal Plants" which carried out activities during 1979-89 in six fields, namely: ethnobotany, agronomy, pharmacology, industrialization, training and information. The findings have been published in national and international bulletins. At present the Programme of Medicinal Plants of CEMAT is financing four research projects namely: a Producers' Commodity network, Industrialization, Commercialization, and Information and Training.

The ever growing demands to work on medicinal plants on a comprehensive way led to the formation of a multi-disciplinary and inter-institutional group to coordinate the activities for the optimal use of the natural and ethnomedical resources, especially the use of medicinal plants. In 1984 a Committee, CONAPLAMED, was formed, which in 1988, was transformed into a Commission which is now awaiting legalization. CONAPLAMED is made up of 12 public and private institutions. Its organizational structure is based on three national groups: Ethnobotany-Agronomy, which deals with projects related to botanical and agronomical studies; Phytochemistry- Pharmacology whose objective is to conduct scientific studies lending to the validation of the use of medicinal plants, and Industrialization-Commercialization, which deals with industrialization and commercialization of medicinal plants and by- products. The Commission organizes annual National Seminars on Traditional Medicine in which the research information from the national groups is disseminated. In this way the research findings have been disseminated at national level, but coordination at an international level is underway to achieve some international exchange of information. Since 1982 there is an active participation in the TRAMIL workshops for the creation of a Caribbean Pharmacopoeia under the coordination of ENDA-Caribbean in the Dominican Republic which will take place in Guatemala in November, 1990. In 1987 the First Meso-American Seminar of Ethno- Pharmacology was organized with 150 participants from 10 countries. 20 scientific papers were presented and published. The Second Meso-American Seminar of Ethno-Pharmacology took place in San Jose, Costa Rica, in December 1989.

Objectives

General

To scientifically validate the use of traditional medicine as an integral part of the national systems of health care; to strengthen the acceptance of traditional medicine by the people as part of their cultural heritage.

Specific

· To compile existing ethnobotanical information according to practising ethnic groups.

· To encourage the cultivation of medicinal plants as part of the conservation strategy.

· To develop non-sophisticated technology for the utilization of indigenous and exotic medicinal plants.

· To conduct chemical and pharmacological studies in order to validate the efficacy of popularly used medicinal plants.

· To disseminate important scientific information on medicinal plants.

· To compile national and regional pharmacopoeia of medicinal plants.

· To promote the production of plant - derived pharmaceuticals based on the available indigenous medical flora.

· To create an awareness at all decision making levels, on the importance of traditional medicine as a priority in formulating health policies.

· To provide financial support to all initiatives working towards promoting the utilization of medicinal plants and phytopharmaceutical products.

Methodology

In order to achieve these objectives, there is a need to form a multidisciplinary and inter-institutional research team representing various research institutions to effect the following:

· Carrying out countrywide ethnobotanical surveys to assess the medicinal potential of the indigenous flora. The collected voucher plant specimens should enrich our national herbaria for retrieval and exchange purposes.

· To encourage planting of the most commonly used medicinal plants by the farmers and family communities. Further the work of preserving native species would be promoted through the integration of these plants in silviculture and agroforestry programmes.

· To establish medicinal plant farms for those plants with known chemical composition and efficacy. However, experimentation to determine the agronomical parameters of indigenous medicinal plants should be conducted prior to large scale cultivation.

· To establish adequate research infrastructure, including expertise and well equipped laboratories, to conduct chemical and pharmacological studies including in-vitro, in-vivo studies and clinical evaluation of our medicinal plants and pharmaceutical products.

· To exchange research information by means of networks so as to have access to the information in research centers from other countries. Although specialized information networks on medicinal plants do exist, the researchers have a limited access to the information due to either financial or technological reasons.

· To compile a national pharmacopoeia. The proceedings of the TRAMIL workshop illustrates the way to attain this important objective. It is based on information obtained from regional field ethnobotanical surveys and recommendations emanating from scientific workshops.

· To produce laboratory or pilot-plant scale extracts of active principles or phytotherapeutical products at a sustainable level, with the agricultural production capacity. The goal would be to substitute a percentage of the imported drugs and to subsidize these operations until they become competitive with the market of the multinationals.

· To promote and consolidate the use and transmission of the concepts and practices of traditional medicine, as well as to convince the modern medical system on the qualities of these traditional therapeutic practices.

· To establish an international network of institutions working on the validation of traditional medicine. Perhaps the identification work of the institutions and the working plan might require some time but once consolidated it could favour all the member states. The role of the modern medical system is very important but we have to acknowledge the need for a change in the mentality and policies of the entire health systems. The financial support of both the government and donor agencies should put emphasis in strengthening the local research capability to implement the required projects. Where such research capability is not sufficient, joint projects could be implemented by specialized centers in developing countries.

Remarks

Given the political will in the developing countries, the financial backing from friendly countries, the technical cooperation of international agencies, and the commitment on the part of the national groups, then it would be possible to create working teams to achieve the following:

· The creation of resource teams, technically skilled, which, given the proper material and financial resources, would significantly contribute to the multidisciplinary validation of traditional medicine and to its use in legal health systems, in particular, medicinal plants.

· The cooperation among centres from developing and developed countries to carry out joint projects which will facilitate the proper documentation of what has been done on the validation of medicinal plants, of interest to countries which might benefit from it.

· The production of national or regional pharmacopoeia that will facilitate the utilization of medicinal plants as safe therapeutical alternatives to modern drugs.

· The development of phytopharmaceutical products, which might partially substitute some of the conventional medications demanding imported raw materials, and which could be produced by pharmaceutical industries based in developing countries through joint projects.

· The institutionalization of traditional medicine in all those countries having the necessary conditions to incorporate these beliefs and practices to their national health systems. It is encouraging that in China, India and other countries, traditional medicine has been integrated in primary health care and at present it is in the hands of the population.

· The regaining of self-confidence in combating diseases, promoting the strengthening of national identity, providing alternative choices to the country regarding importation of medications, and comprehensively improving the doctor-patient relationship which lacks in the modern medical system.

References

CEMAT (1980). Report from the First Workshop on Medicinal Botany from Guatemala. CEMAT and Mexican Institute of Research in Medicinal Plants, Guatemala: 51 p.

Caceres, A., L. M. Giron, and M. E. Juarez. (1983). Cooperation studies and technical transference on medicinal plants between USAC/CEMAT. Perspective 2: 160-165.

Caceres. A. and I.M. Giron. (1984). A system for revalidating, researching and commercialization of medicinal plants in Guatemala. In: E.M. Villatoro (Ed.) Ethnomedicine in Guatemala. Centre for Folkloric Studies, Guatemala: 283-316.

Caceres, A., L. M. Giron, and S R Alvarado. (1986). Antibacterial action of Plants with a Medicinal Use in Guatemala. Memoire. Ill Nat. Congress of Microbiology, Guatemala: 89-96.

Fletes, L., L. Aguilar, N. Ayala, B. Lopez, and A. Caceres. (1987). Activity against entero-bacteria by maceration of some vegetables. Memoires. I Meso-American Seminr of Ethnopharmacology and III National Congress on Traditional Medicine, Guatemala: 151-152.

Caceres, A., L. M, Giron, A. M. Martine. (1988). Screening of the diuretic activity of plants used in Guatamala against urinary maladies. Revista Anuario Associacion Guatemalteca de Cardiologia 4: 45-49.

Caceres, A., H. Logemann, M. A. Giron, and B. R. Lopez. (1989). Anti-fungi activity of plants used in Guatemala for the treatment of dermatophytosis. Memorires. Ill Scientific Week of the Faculty CCQQ and Pharmacy, Guatemala: B4-B7.

Caceres, A. and D. Sapper. (1977). Diuretic activity of plants used for the treatment of urinary ailments in Guatemala. Journal of Ethnopharmacology 19: 233-245.

Caceres, A. I.L. M. Giron, Sr. Alvarado, and M. F. Torres. (1987). Screening of antimicrobial activity for plants popularly used in Guatemala for the treatment of dermato-mucosal diseases. Journal of Ethnopharmacology 20: 223-237.

Giron, L. M. (1988). Guatemala's medicinal plants project. Woman of Power 11: 33.

Giron, L. M., G. A. Aguilar, A. Caceres and G. L. Arroyo. (1988). Anticandidal activity of plants used for the treatment of vaginitis in Guatemala and clinical trial of a Solanum digrescenss preparation. Journal of Ethnopharmacology 22: 307-313

Giron, L. M., V. Freire, A. Caceres and A. Alonzo. (1988). Ethnobotanical study of the Caribbean area in Guatemala. Presented at TRAMIL 3 Workshop, Havana: 25

Womiger, L. and L. Robineau. (1988). Elements for a Caribbean Pharmacopoeia, Santo Domingo, ENDA-Caribbean: 318pp.

Memoires. I Meso-American Seminar on Ethnopharmacology and III National Congress on Traditional Medicine, Guatemala, 1.