Speech by Dr. G. L. Monekosso, World Health Organisation

Mr. President of the United Republic of Tanzania,
Honourable Ministers,
Your Excellencies,
Representatives of International Organizations,
Distinguished Delegates,
Ladies and Gentlemen

May I first of all, Mr. President, thank you most sincerely for the great honour you have done us by gracing, with your presence, the formal opening of this International Conference of the Countries of the South on Medicinal Plants, so generously hosted in Arusha, following the kind invitation of your government. We are well aware of the great efforts that you, as President of the United Republic of Tanzania, and the Director-General of the World Health Organization have made to ensure the success of this historic meeting of donor and recipient countries.

We are, therefore, happy to voice to your government, in the presence of this august Assembly, our thanks and deep gratitude for all that you have done to achieve health for all Tanzanians by the year 2000, which is our common social objective. Similarly, we salute the decisive action taken by your government, and especially by the Ministry of Health and Tanzanian communities to control disease, postpone death, promote health, and reserve our common community health.

Finally, Mr. President, may I assure you that I am extremely happy to be here, once again, in the United Republic of Tanzania, to which I consider home and which harbours many happy memories; and I would like also to express to you my deep satisfaction at the excellent cooperative relations that exist between the United Republic of Tanzania and the World Health Organization.

Honourable Ministers,
Your Excellencies,
Representatives of International Organizations,

Your presence today at this ceremonial opening is particularly comforting, since it shows very clearly as we are all now aware, in these difficult times, that the effective solution of problems of international cooperation can only be achieved through concerted approaches to socioeconomic development. That progress and development can only result from a collective will to make positive changes in mental attitudes and living conditions. That is why it is desirable, despite significant improvements in coordination in recent years, that additional efforts must be made to clear away the final obstacles to progress in international health cooperation in traditional medicinal plants.

Our organization has already charted our course, the path to our common objectives. This may be found in the resolutions of the World Health Assembly adopted during the past three years (WHA 40th, 33, WHA 41th, 19th and WHA 42nd, 43). In the African Region Assembly, Resolution AFR/RC28/R3 invited member states of the region "to take appropriate steps to ensure the use of essential drugs and traditional medicinal plants so as to meet the basic needs of communities and promote the development of African pharmaceutical industry", while Resolution AFR/RC34TH/R8 1984 invited member states to "prepare specific legislation governing the practice of traditional medicine within the framework of national health legislation and ensure an adequate budget appropriation to allow the effective launching or development of a programme of traditional medicine". I also recall that in February 1976 my predecessor convened the experts of the region to consider the following terms of reference:

(i) To assess the present situation of traditional medicine in the region.

(ii) To identify ways and means of fostering collaboration between traditional and modern medicine.

(iii) To propose material for the working paper of the technical discussions of the twenty sixth session of the regional committee for Africa of WHO.

In November 1979 we organized a workshop in Bamako, Mali, for French-speaking countries on "The Role of Traditional Medicine in the Development of Health Services". In August 1980 a similar workshop was held at Accra, Ghana, for English-speaking countries. The objectives of those two workshops were:

(i) To analyse the experiences of collaboration between practitioners of the two systems of medicine in some African countries.

(ii) To formulate a realistic approach for collaboration between the two systems in order to improve health coverage of the population.

Between 1981 and 1985 five collaborative centres were set up: one in Ghana, another in Mali and two in Nigeria. Their number was increased to five in 1985 with the one in Madagascar. The main responsibilities are:

(i) To compile an inventory of medicinal plants with recommended uses.

(ii) To verify the therapeutic actions attributed to the listed plants, together with their possible undesirable or toxic effects.

(iii) To carry out studies with a view to improving and standardizing of the form and presentation of traditional medicines.

(iv) To collaborate in training research workers desiring to study traditional medicine and in the improvement of the practices of traditional practitioners.

(v) To carry out studies on the rote of traditional practitioners in primary health care.

In July 1984, we organized a consultation on the coordination of activities relating to traditional medicine in the African region, with the various international and regional organizations and agencies concerned. The objectives of that consultation were:

(i) To evaluate activities related to traditional medicine in the African region.

(ii) To propose mechanisms for coordinating work in traditional medicine in the African region, bearing in mind the allocation of responsibilities to the various agencies.

In 1987 the Regional programme created a unit for traditional medicine in Africa. In February 1989, the first meeting of WHO collaborating centres for traditional medicine in the African region was held in Niamey, Niger, with the following objectives:

(i) To identify the priorities of the African region after assessing the current situation in various countries.

(ii) To establish guiding principles of a regional strategy for the use of traditional health technologies in the national primary health care policy.

Finally, it is planned this year to examine the programme on traditional medicine in the course of the fortieth session of the regional committee for Africa.

It may be said that this conference comes at the right time, when we are putting all our strength into the battle to promote primary health care. Our meeting today is a clear indication of our determination to make better use of local resources and recover our freedom and identity through self- sufficiency in matters of health. It is also a way of reaffirming our cultural values. I believe very sincerely in international cooperation, but it has its limits. We should, in future, make use of our own raw materials and our capacities, for local production. But we should also be aware that realism requires us to keep a proper balance between folklore and scientism. Folklore, far from serving the objective that we are pursuing, will give the sceptics a pretext for continuing to doubt the values of our civilization. Scientism has far too long been used as a comforting alibi for a stagnation.

The scenario for African health development adopted by the ministers of health, provides a dynamic framework for the rapid and effective implementation of the primary health care approach, especially two of its components: traditional medicine and medicinal plants. The aim in regard to these plants is not to seek systematically to replace all modern drugs, and still less to bring two types of therapy into opposition, but rather to avoid duplication of efforts in order to make optimal use of available resources, and thus meet the need for accessibility of pharmaceuticals, both from the geographical and financial point of view.

To that end the following themes have been chosen:

(i) Ways and means of cooperation to establish a systematic inventory of plants with their uses and comparative analyses.

(ii) Promotion of plant culture and processing with a view to obtaining stable and standardized galenical preparations that are recognised to be harmless yet effective, while not overlooking the marketing aspects.

(iii) Problems related to ethnobotany and conservation of medicinal plants.

(iv) Resources for implementation, financing, technical and institutional structures and an appropriate legal framework. That is the arsenal without which nothing cam be done.

These are issues that reflect our concerns at the regional office.

This means that you have our full encouragement and support in your difficult but noble duty. I have no doubt of the results of this forum and I am sure that with the cooperation of so many experts we shall be able to meet the challenge.

We are putting our trust in your skills, your devotion to duty and above all your commitment to work for our common objective: "The achievement of health for all by the year 2000".

Your Excellency, Mr. President, I have taken up much of your valuable time in this somewhat extended address, because great things are at stake, and because I know that your hearts lie in self-reliance development. Our approach to health development in the African region follows the same path, and that is what I have tried to show.

I wish the conference on medicinal plants every success. Thank you for your kind attention.