The WHO strategy for traditional medicines. Application in developing countries ?

Many herbal preparations are commonly used worldwide, whether for primary health care or as complementary and alternative medicine. The WHO now recognizes the contributions that traditional and complementary medicine (T & CM) can bring to the welfare of individuals but more especially their impact in developing countries health systems. In China, Korea, India, Vietnam, certain types of T & CM are already fully integrated into national health systems. By contrast, in most other countries, the T & CM are only partially, if at all, integrated, resulting in uncontrolled practices that cause problems to public health. In order to properly integrate the T & CM services in their health systems, many countries need to acquire knowledge and experience in the field to enable them to ensure the quality, safety and effectiveness of T & CM and regulate practices and practitioners. The major challenges and problems associated with the integration of traditional medicines, the procedures recommended by the WHO and the means of their practical application will be illustrated through the pilot project PhytoKat, a Congolese-Belgian development project being implemented in Katanga, D.R. Congo to train young scientists to investigate: (i) the conditions for the introduction of traditional practices in modern medicine (quality of the traditional praticians and diagnostics; quality, efficiency, safety of their treatments); (ii) the documentation of herbal medicines used, considering the ethnomedical, botanical, chemical and biological aspects; (iii) the possibilities of conservation and local production, in a context of regional erosion of plant diversity and excessive harvesting of some vulnerable medicinal species; (iv) a possible local definition of 'well-established' and 'traditional' uses. Acknowledgements: The ARES (Academie de Recherche et de l'Enseignement Supérieur) is gratefully acknowledged for financial supportConditions pour l'intégration de la médecine traditionnelle aux soins de santé modernes. - Fédération Wallonie Bruxelle

La stratégie de l'OMS pour les médecines traditionnelles. Application dans les pays en développement : le projet PhytoKat en R.D. Congo

Conditions pour l'intégration de la médecine traditionnelle aux soins de santé modernes. - Fédération Wallonie Bruxelle

Extension of the EU 'Traditional Herbal Medicine' concept to an oral transmission context: the case of the 5 anti-infectious medicinal plants most widely used in Burundi

peer reviewedIntroduction: In Burundi, five plants, namely Urtica massaica Mildbr., Mikania natalensis DC., Senecio maranguensis O. Hoffm., Justicia nyassana Lindau and Helichrysum congolanum Schltr. & O. Foffm., are widely cited for the treatment of "diseases compatible with a microbial infection" i.e. probably infectious diseases. In view to derive a regional concept of plausible activity and safety, akin to the European Union notion of "Traditional Herbal Medicine", the present work aims to compare the local knowledge and uses of these five popular anti-infectious plants, including eventual recommendations and interdicts. Materials and Methods: A survey was carried out among 43 traditional healers from different regions of Burundi, including the city of Bujumbura, to fully repertory the uses of these five medicinal plants and define consensus in their uses through their fidelity levels and use values for each cited disease. Phytochemical analyses of these plants allowed to identify their main classes of secondary metabolites. Results: From their fidelity levels, the studied plants appear extensively reported for infectious diseases, except for U. massaica, that is mainly used in inflammatory conditions. M. natalensis has the highest use value for the treatment of skin diseases (use value, 1.65), digestive tract disorders (1.07) and gastrointestinal infections (0.51); U. massaica for inflammation (1.07), digestive tract (0.51) and metabolic disorders (0.42); J. nyassana for gastrointestinal infections (2.00), skin diseases (0.81) and circulatory system disorders (0.51); S. maranguensis (2.60) and H. congolanum (2.49) for skin diseases. Conclusions: Interviews are a quite interesting survey method to apprehend usages of herbal drugs, but the information on their efficacy, side effects and interdicts is particularly difficult to obtain. In the absence of clinical trial data, the marked convergence of some usages nevertheless indicates a plausibility of efficacy and safety, coherent with the EU concept of "Traditional Herbal Medicine", which point to possible rational recommendations of treatments. There however remains a need for a strategy to obtain reliable safety information and to legally define whether a given use can be considered as "traditional".3. Good health and well-bein

An alternative and simplified approach to identification and test for minimum content of TCM herbal drugs.

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Perceptions and use of traditional African medicine in Lubumbashi, Haut-Katanga province (DR Congo): A cross-sectional study.

peer reviewedIn the Democratic Republic of Congo, the desire of the Ministry of Health to integrate Traditional African Medicine into the Official Health System remains limited by the lack of reliable data on several aspects of this medicine. This study aims to determine the perceptions of the Lubumbashi population towards Traditional African Medicine and the contexts of recourse to these therapeutic modalities. We conducted semi-structured interviews of population samples in each of the 7 Lubumbashi municipalities, which were semi-randomly selected in proportions to each population size, from January to June 2017 and from February to July 2018. A total of 4278 people (average age, 32.1 ± 10.4 years; 36.5% of women) have been surveyed. Among them, 75.8% define "Traditional African Medicine" as "herbal-based treatments"; 79.4% have resorted to traditional medicine, for several pathologies and social problems. This medicine was preferred for efficiency, speed of healing and low cost, as well as the presence of the diseases against which it would be the only one used. Most, (52.1%) have started with Conventional Medicine, then resorted to Traditional African Medicine, 34.7% started directly with Traditional African Medicine, while 13.2% combined these two medicines. From those who have resorted to Traditional African Medicine (n = 3396), 55% declare no concern towards traditional medicine, while 42.5% fear looseness, overdose, intoxication, and lack of hygiene; from those who have not resorted to Traditional African Medicine (n = 882), 78% are fearful of fear looseness, witchcraft, and fetishism. Traditional African Medicine remains an important health care resource for the Lubumbashi people. It is essential that decision-makers consider the importance of this health sector for the population, but also the reported fears and hindrances, and work towards the regulation, sanitization, and control of this medicine to ensure its safe use.3371 - PhytoKat ARES CCD PRD 2016 duez - Conditions pour l'intégration de la médecine traditionnelle aux soins de santé modernes. - Fédération Wallonie Bruxelles12. Responsible consumption and production3. Good health and well-bein

The PhytoKat project in Katanga DR Congo: a multidisciplinary approach for solving environmental and societal problems

As is the case in most African countries, DR Congo faces multiple health problems, notably a limited access to conventional medicine. For most people, traditional medicine (TM) is the primary, and often the only, accessible source of care; TM covers the primary health needs of 80% of rural and urban populations who mainly rely on plants as sources of drugs. Considering the rapid population growth (3.5%/year in RDC), the demand for medicinal plants implies a risk of extinction for several species, which requires to supplement supply by agriculture, possibly family farming. The WHO advocates the modernization of TM in developing countries for primary health care to face health challenges such as malaria or infectious diseases. The PhytoKat pilot project aims to establish the necessary foundation for progress in this direction in Katanga by (i) evaluating the conditions for integrating traditional practices in modern medicine; (ii) deepening the botanical, agronomical, pharmacological and chemical studies of interesting plants; and (iii) developing, in the context of a regional erosion in plant diversity, an urgent inventory of medicinal species current distribution for a reasoned conservation strategy. Through a multidisciplinary team including agronomists, chemists, pharmacists and veterinarians, the project aims at correcting the gaps identified by the recent Joint Context Analysis, performed in DR Congo at Belgian government initiative, for the domains environment / natural resources: 'Lack of information, knowledge and awareness among decision makers and local communities on the benefits of biodiversity-related development'

Linear regression analysis of silychristin A, silybin A and silybin B contents in Silybum marianum

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Organocatalysis paradigm revisited : are metal-free catalysts really harmless ?

peer reviewedCatalysts are commonly used in polymer synthesis. Traditionally, catalysts used to be metallic compounds but some studies have pointed out their toxicity for human health and environment, and the removal of metal impurities from synthetic polymer is quite expensive. Organocatalysts have been intensively synthesized and are now widely used in ring-opening polymerization (ROP) reactions to address these issues. However, for most of them, there is not any evidence of their safety. The present study attempts to assess whether well-established organo-based ROP catalysts used for the preparation of FDA-approved polyesters may present a certain level of cytotoxicity. In vitro toxicity is evaluated using a methyl-thiazol-tetrazolium cytotoxicity assay on two cell models (FHs74Int and HepaRG). Among the investigated organocatalysts, only functionalized thiourea shows an important cytotoxicity on both cell models. 4-Dimethylaminopyridine (DMAP), 1,5,7-triazabicyclo[4.4.0]dec-5-ene (TBD), and meta-(trimethylammonio)phenolate betaine (m-BE) show cytotoxicity against HepaRG cell line only at a high concentration