The Pharmaceutical Journal
Vol 269 No 7229 p936
21/28 December 2002

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How to provide help for Africa

For many years the Commonwealth Secretariat has been undertaking seminars aimed at non-government organisations, herbal practitioners and farmers to help them set quality and conservation standards for herbs throughout the Commonwealth.

The purpose of these standards was initially to improve the quality of herbs to comply with the rigorous standards required by the European Union for herbs used in the manufacture of herbal medicines in the west and also to ensure that non-cultivatable herbs such as Devils Claw are not over harvested from the wild.

The initial focus on quality was to retain business in the EU and to provide cash crops for exports, which earn valuable foreign currency.

However this focus did not take into account the needs of the local populations of Africa, 80 per cent of whom rely on herbal medicines as their only source of medicine because the price of western pharmaceuticals is beyond their reach.

Most herbal practitioners work outside of the health services of most African countries. They collect their own herbs from the wild and usually dispense them as crude herbs. There is little or no regulation or control of either the practitioners or of the medicines they are dispensing. Incomes for the practitioners are low and depend on the ability of the patient to pay. The practitioner often gives medicine free of charge to patients who are unable to pay.

While lecturing on the quality standards of herbs in South Africa I invited questions, and a practitioner, who was also a qualified doctor, said she needed help. She told me that the day before she had examined a patient who was suffering from AIDS. The patient had walked 10km to be seen and she had sent the patient away with one month's supply of herbs, in this case a dried root weighing about 10kg, and had instructed the patient to boil a handful of the herbs for 20 minutes and drink the liquor every day.

She pointed out that the patient had to walk back home with the extra burden of the herbs and then had to find enough wood to boil the water to extract the active principles. Her question was how could she improve the situation for the patient.

On my return to the UK I discussed the matter in detail with the Commonwealth Secretariat and Centre for the Development of Enterprise. The Commonwealth Secretariat agreed to fund the training and the CDE agreed to fund the production of a handbook relating to the training. My company, Essential Nutrition, agreed to fund and produce a mobile pharmaceutical production unit.

For this unit a 40ft semi-trailer was purchased and the walls were lined with laminates and the floor covered in vinyl. Air handling was fitted and an electrically heated 100L extraction vessel installed. This was jacketed and used circulating oil for heat. A granulator, orbital mixer and a tray-drying oven were then added together with a 16-station Manesty tablet press and a 20L glass steam distillation apparatus.

After commissioning all the equipment and providing the ancillary equipment, such as balances, scales, scoops and overalls, the trailer was prepared for shipping and sent to Kenya.

Early in 2002 the trailer arrived in Nairobi and was taken to a hotel where 24 practitioners had been invited to attend a four-day course in herbal production techniques.

Three staff members from Essential Nutrition and two volunteers from South Africa showed each practitioner how to extract herbs and convert them into either powders, tablets or essential oils. The accent was on hands-on training but at the same time the major elements of good manufacturing practice were explained. When the training was completed, the trailer was moved to the School of Alternative Medicines and Technology in Nairobi, where it is in constant use.

The doctor who asked the original question attended the course and has now set up her own unit in Tanzania where she runs an American-funded AIDS programme. Her system has been adapted to burn wood because the other energy sources — electricity, oil and gas — are too expensive to buy.

The Commonwealth Secretariat and the CDE would welcome this type of assistance from any pharmacists who think that they have the technology and time to help develop a herbal processing system which would benefit more Africans.

I found the exercise to be hard work, but fun and satisfying. I would recommend other pharmacists to give it a try.