Friday, August 20, 2010

Evaluating traditional medicine research in Nigeria

...Effective legislation, national policy key for its integration in the nation’s healthcare

Taking a cursory look at Nigeria’s healthcare sector, the contribution of natural-based products to orthodox medicines cannot be overlooked. This is in view of the fact that African Traditional Medicine (ATM) has over time been the mainstay of primary healthcare for majority of Nigerians living in rural areas (over 50 percent of the nation’s population).
However, even as some African countries have put in place mechanisms for registration of traditional medicines legislation, regulatory framework and institutional instruments for developing ATM and locally producing commercial quantities of standardized African traditional medicines (ASTM) and subsequently integrating traditional medicine (TM) into the public health care systems, experts believe the integration of TM into Nigeria’s healthcare sector will do a long way in the nation meeting the Millellium Development Goals (MDGs) target.
In an interview with BusinessDay, Tamuno Okujagu, Director-General, Nigeria Natural Medicine Development Agency (NNMDA) said that the role of traditional medicine in healthcare delivery in the developing countries is well known. He noted that in view of the vast healthcare delivery and economic potential of traditional medicine, countries like China, India and Germany, who had developed their traditional health systems, had supported agencies and universities on researches into traditional medicine.
Okujagu disclosed that several research works on traditional medicine have been documented in line with procedures of the World Health Organisation (WHO) as well as with an African Union (AU) directive. He noted that the AU, in recognition of the vast potential of traditional medicine and its immense contribution to health and poverty alleviation, directed that research on African traditional medicine should be made a priority.
“African countries such as South Africa, Ghana, Egypt and Morocco had keyed into the initiatives and maintained specific institutional mandates to fast-track the co-ordination of research and development, promotion and documentation of traditional medicine. WHO acknowledges this growing need and potential of natural medicine and has continued to encourage and support its promotion, documentation, research and development through several initiatives,” the Director General revealed.
Lending his view, Tony Akhimen, former President Pharmaceutical Society of Nigeria (PSN), stated that even as the efficacy and potency of herbal medicines are being scientifically investigated, acknowledged and documented, the challenge for the Nigerian government is to work out policies that will regulate the herbal medicine sector.
According to him, “the overriding interest must be how to integrate herbal medicine into the mainstream of national healthcare system, intellectual property rights protection for traditional medicine practitioners, proper registration and certification of traditional medicine practitioners, speedy passage of traditional medicine bill and government's support for documentation, standardisation and protection of herbal plants from extinction due to human activities. No doubt, herbal medicine is the future of pharmacy. It is the source of raw materials for most pharmaceutical drugs,” he concluded.
It is worthy to note that traditional medicine to state that global market for traditional therapies stands at US$ 60 billion a year and is steadily growing even as China and India usually record between two to five billion dollars. In developed countries, like France, it is believed that about 75 percent of its population use complementary medicine at least once; in Germany, about 77 percent of pain clinics provide acupuncture; and in the United Kingdom, expenditure on complementary or alternative medicine stands at US$ 2300 million per year.
Giving the enormous economic and health opportunity which traditional medicine offers, a holistic step to ensure that effective legislation, goals and strategies are in place in order to incorporate traditional medicine into Nigeria’s healthcare system. Already, the WHO’s strategy on traditional medicine provides a framework for policy to assist countries to regulate traditional or complementary/alternative medicine (TM/CAM) to make its use safer, more accessible to their populations and sustainable.
For Olukemi Odukoya, Professor of Pharmacognosy at the University of Lagos, pharmacognosy is the vital link between traditional and orthodox systems of medicine and has its facts in traditional systems of medicine and traditional use of traditional plants.
“Efforts have been spent by Nigerian researchers on scientific evaluation and validation of Nigeria's medicinal aromatic plants, healing arts and systems hence, the inclusion of traditional medicine into the country’s MDGs as directed by the WHO and the African Union will go a long way in attaining health for all by 2015 otherwise could be elusive,” Odukoya stated.

Doctors' strike; when will this impasse end?
Alexander Chiejina
The outpatient ward at the Lagos State University Teaching Hospital (LASUTH) is filled; scores of people waiting to be attended to. The same is the case at the paediatric ward where medical staffs are seen going to and fro, trying to cope with the pressure associated with influx of patients. This scenario is the same at Gbagada, Isolo and other state-owned general hospitals in Lagos state. Interestingly, patients are waiting anxiously for medical doctors and the government to settle their current differences which has impacted negatively on health services.
Intriguingly, apart from nurses, ward aides, cleaners and few non-medical staff, doctors who are acknowledged as leaders of the medical team were conspicuously missing. This development has played itself out several times over in some state-owned hospitals in the Federation including Lagos since last week. No doubt, this has necessitated affected health institutions to develop strategies on how to cope by offering skeletal healthcare services even without doctors at their duty posts.
Taking a brief look from January 2010 to date, the health sector has witnessed several setback following incessant strikes by Nigerian doctors. It is even more surprising if it is considered that embarking on strike is equivalent to refusal to perform the most basic function of a medical doctor, that is, to save lives first and foremost, an act contrary to the medical profession’s famous Hippocratic Oath which one swears to uphold.
Observers note that the impact of the series of strikes may not only deepened the problems of poor infrastructures in the health system, but worsened the collapse of the far less impressive primary and secondary health care delivery systems in the country if nothing urgent is done to check the trend.
Worse still, tongues have continued to wag that when many innocent Nigerians lose their lives unnecessarily during these strikes, no one bears the repercussions. Indeed, who asks questions when there is no respect for the noble call to save lives?
As stated by a section of the public during a recent debate, although doctors command much respect within medical circles and society at large, their penchant to frequently utilise strike as a weapon whenever there is disagreement with their employers, notably government, is fast eroding the level of confidence and trust that their clients have for them and their profession.
As some of the most respected professionals in the world, medical doctors are expected to toe the path of dialogue and to exhaust all avenues for the sake of their patients. Just like the traditional old sayings, “When two elephants fight the grass suffers” The Nigerian masses have been at the receiving end since the emergence of strike in all hospitals across the nation.
It is no longer secret that the latest strike was sparked off by the recent Consolidated Medical Salary Structure (CONMESS) approved by the Federal Government for doctors under their employment. Since the approval, controversy has trailed the salary structure as doctors in all the states have been agitating that the scale be reflected in their own states.
For Lagos state, the Medical Guild, the representative organ of all doctors in the service of Lagos state and made of affiliate bodies that includes the Association of Resident Doctors LASUTH, the medical and dental Consultant Association of LASUTH and General Hospitals embarked on a strike action last week Thursday over what it called insensitivity by the state Government towards the implementation of CONMESS among other sundry issues.
For Ayobode Williams, Chairman, Medical Guild, Lagos state, “the congress decided to withdraw its services in all Lagos state Government hospitals until CONMESS is paid to all doctors in Lagos State Government Service, all arrears from January 2010 are paid immediately, all court processes against the Medical Guild be withdrawn and that no single member of the association be victimized consequent to the industrial action.”
At the other divide, the National Industrial Court enjoined the National Association of Resident Doctors and the Medical Guild to call off their strike action as a matter of urgency just as it also directed the Lagos State government to hold a meeting with representatives of the striking doctors within the week with a view to resolving the issues in dispute.
Jide Lawal, Public Relations Officer (PRO), Lagos State Ministry of Health, explained that the directive was pursuant to the provisions of Section 20 of the NIC Act in the suits number NIC/LA/28/2010 and NIC/LA/29/2010 between the Attorney General of Lagos State and the Association of Residents Doctors on one hand and the Medical Guild on the other hand.
Lawal disclosed that the court urged government not to penalize or victimize any of the doctors for their participation in the strike action but urged the striking doctors to avail themselves of the window provided by the Court's directives to both parties and embrace the path of dialogue, allow a sense of fairness, good judgment and peace to prevail in order to find an amicable solution to the present crisis.
Notable amongst these agitators are the Oyo, Ogun, and Katsina states where the doctors are currently on strike. The affected State governments have at separate forum stated that as much as they would want to meet the demands of the doctors, they cannot afford to pay the huge wage bill that the new salary scale would amount to.
As the situation currently reflects, many states may be unable to meet up with the new scale. Sadly as the strike action continues, the loser in the whole affair is the patient.
Concerned stakeholders and close observers of the health industry are now of the opinion that the State governments and Nigerian doctors are playing politics with the lives of helpless Nigerians who depend on the services of the government owned hospitals for their health needs, and whose tax is the source of the doctors’ salaries. Even as it is, a fundamental question remains unanswered. Where lies the opinion of the Nigerian masses in all these?


By Alexander Chiejina

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