ROLE OF TRADITIONAL SYSTEMS OF MEDICINE IN NATIONAL HEALTH CARE SYSTEM:
The world wide interest in use of natural products and plant based remedies has led to different situations developing in different countries. Traditional medicine does not see only a single remedy or a single approach as being suitable for all people. Symptoms are seen only as an indication of a deeper malaise which is not necessarily considered to cause by physiological factors alone.
NATIONAL RECOGNITION FOR TRADITIONAL MEDICINE:
Government needs to recognize a system or practice therapies and drugs which been studied by professional evaluators for safety and efficacy to give legitimacy to what is considered appropriate for public use. Many traditional medicines are no different from food items like home made wines, jams, jellies, squashes, and syrup. They contain only natural ingredients and just as these are standards for food formularies and pharmacopoeias have been evolved to set standards for the preparation of many such traditional medicines. For assimilation into a health system, if the pharmacopoeial standards are adhered to if a licensing mechanism is in place and if there are ways of testing the product for the presence of the main ingredients and the absence of non permissible substances, the system is in place.
In India there are thousands of unani formulations licensed as medicines and sold ore the counter and included in the formularies of health departments both by the national and state governments. All such items sold as unani medicines and carry a license number together with the list of ingredients on the label.
India has also introduced GMP for traditional drugs which cover the requirements relating to qualification of employees, responsibility of Q.C managers, essential requirement of space, equipment, documentation of processing and packaging methods and need for self regulation.
Today research is done mainly to establish evidence of the efficacy of drug or therapy that is used. A few controlled trials or small randomized clinical trials do not inspire much confidence.
The Council of Research in unani medicine prepared formulations for the following areas: Bronchial Asthma, Filariasis, Infective hepatitis etc. WHO has recently finalized guidelines on research methodologies for traditional medicine.
WHY RAW MATERIAL AND STANDARDIZATION IS OF PARAMOUNT IMPORTANCE IN TRADITIONAL MEDICINE.
Traditional medicine relies almost 90% on use of medicinal plants supplemented by minerals, metals, animal and marine products like corals and shells. Health systems and administrators are involved in standardization of raw materials without this the quality of medicine can suffer, affecting the credibility of traditional remedies.
Medicinal plants comprising of 1000's of species of plants constitute a vast undocumented and over exploited resource. The growth and cultivation of such plants,
Their collection, storage, distribution, processing and marketing are now gaining importance as they all have impact on quality. In most countries where use of traditional medicine is strong cultivation is at present limited. Most natural products being collected by villagers and tribal people from waste land and forest. They may destroy whole plant instead of collecting just part to be used. Collection is not done during proper season. Now a days traders control collection of material. Industries have started cultivation of plants to be assured of standard quality and presence of active constituents. They have invested in recruiting botanist and standardization experts in order to access quality raw material. Some of these industries have their own R and D facilities where documentation is maintained and quality assured through HPTLC and TLC tests.
STANDARDIZATION A PREREQUISITE FOR QUALITY CONTROL OF TRADITIONAL MEDICINAL DRUGS:
Standardization of plant drugs is extremely difficult because very few Q.C tests are available in most countries using traditional medicine. In their absence, there are no methods to evaluate the contents and quantities as claimed on label.
Q.C is required at three stages namely.,
1. When raw material is used for confirming the process undergone by drug during manufacture and at finishing stage.
2. The shelf life or date of expiry need to be indicated.
3. Measures to test absence of pesticide residue, heavy metals and aflatoxin have to taken through proper regulation and testing.
For unani formulations a single medications has over 50 ingredients and certainly at least 6-10 ingredients in simplest medicine involving use of different parts of several plants. Scientists have given numerous suggestions about standards and q.c of drugs. Department of Indian systems of medicines have initiated schemes to help strengthen state pharmacies and labs to become models for proper formulation of quality medicine for use in public sector and government hospitals.
Traditional medicine can play a role in health system of country if system and its medicaments have been prepared in a manner that inspires confidence in quality and government supports the use of such systems with the needed controls.
Issues of quality have to be confronted squarely and national governments have to be made aware of what is acceptable across the world only then will traditional medicine be able to achieve its due position in health system.
References: Traditional medicines in Asia
Quality control of herbal products.
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