Saturday, August 22, 2015

Herbal medicine: the other half of healthcare in the Philippines

(Published in Enrich magazine, 2010)

FILIPINOS ARE AVID PATRONS of herbal medicine: they spend anywhere from P75-90 billion on herbal medicines annually, according to the government. That’s about half the total amount spent by Filipinos on medicine (both synthetic and natural) every year.

It’s a massive amount that indicates a huge pent up demand for herbal medicines, which have been a basic remedy in many Filipino homes since the time of their “lolos” and “lolas” mostly because they’re cheaper than synthetics. Today, some 60 legitimate manufacturers (mostly small and medium-scale Filipino companies), small independent producers, multinational companies and a growing list of importers (legitimate and otherwise) cater to this rise in demand for traditional medicine.

Herbal medicines are defined as those that use natural herbs and plants for the treatment or prevention of diseases and disorders, and for promoting good health. The penchant for herbals is not peculiar to Filipinos, however. The World Health Organization (WHO) estimates that 80% of the world's population presently uses herbal medicine as part of their primary health care. WHO also revealed that 25% of modern drugs used in the United States are derived from plants. Over 7,000 medical compounds in the modern pharmacopoeia also come from plants, while some 35,000 plant species are estimated to have medicinal value.

The Department of Health (DOH) classifies herbal medicines as either food or herbal supplements, emphasizing these are not meant as alternatives to synthetic pharmaceuticals. Hence, the disclaimer, “No Approved Therapeutic Claims,” all herbal medicines carry on their packaging. This government concern also explains its warnings to the public to always check whether the herbal products they buy are approved by the Food and Drug Administration (FDA) and carry the FDA seal of approval.

Our government’s emphasis on product safety and efficacy is matched by the natural health products industry whose members have banded together as the Chamber of Herbal Industries of the Philippines, Inc. (CHIPI). A self-regulating industry group, CHIPI consists of 60 of the leading FDA-registered companies engaged in the research and development, production, domestic and export marketing of various natural health products including herbal medicine, food supplements, cosmetics and home care products.

Beginning in the 1990s, a renewed interest in traditional medicine has taken hold in the Philippines. The government recognizes the importance of traditional medicine in providing essential health care. It notes the practice of traditional medicine (passed on from generation to generation) has gained a deep significance in health delivery since most Filipinos still cannot afford expensive western medical treatment.

A legitimate industry
Lito Abelarde, CHIPI chairman, said herbal products registered with the FDA as herbal medicine or food supplements, like products of CHIPI members, are not advertised as "miraculous" or "cure-alls.” CHIPI has taken the position that advertising any herbal product as "miraculous" and with "cure-all" claims is improper, deceptive and against FDA regulations.

“All advertising copy of CHIPI member companies are closely scrutinized and pre-approved by the Advertising Standards Council (ASC) which strictly follows the guidelines of the FDA on allowable product claims. Members of CHIPI strictly follow CHIPI's Code of Ethics that includes truth in advertising,” he explained.

Abelarde said a few "bad eggs" that operate outside of proper industry practices have managed to escape FDA supervision, creating a bad image for the legitimate herbal companies and products that adhere to FDA regulations.

He noted the natural health products industry is a legitimate industry whose growth is due to, and is regulated by a law, the Traditional and Alternative Medicine Act (TAMA) of 1997. TAMA declares it a policy of the Philippines to improve the quality and delivery of health care services to Filipinos through the development of traditional and alternative health care, and its integration into the national health care delivery system. It also provides the legal framework that supports the natural health products industry.

TAMA or Republic Act No. 8423 created the Philippine Institute of Traditional and Alternative Health Care (PITAHC) to accelerate the development of traditional and alternative health care in the Philippines. PITAHC’s ex-officio chairman is Secretary of Health Dr. Esperanza Cabral.

Abelarde said CHIPI is encouraged that serious efforts are now being undertaken to align FDA regulations for natural health products with the new national health policy as established by TAMA. PITAHC recently commissioned a group of PhDs in Pharmacy belonging to the National Institute of Health of UP-Manila to act as its Technical Working Group in reviewing FDA regulations on natural and herbal health products. The group will also propose for PITAHC's approval a revised set of regulations in harmony with TAMA's objectives. 

“Hopefully once approved by PITAHC, the FDA will then adopt these revisions,” Abelarde said. He expects the proposed revisions will set in place new product categories and processes by which companies producing natural and herbal health products can validate their products' therapeutic values and be allowed to make appropriate therapeutic claims. 

This then will lead to the phasing out of the disclaimer," No Approved Therapeutic Claims," the FDA requires as mandatory in labels of all food supplement products. Abelarde noted this practice prevents companies from saying what their products are for and deprives the public of the adequate information needed to make informed decisions.

Approved herbal plants
It will help consumers to know that DOH advocates the use of 10 herbal plants that have passed its "Traditional Health Program.” DOH said these 10 herbs were rigorously tested and are clinically proven to have medicinal value in the relief and treatment of various aliments. You can use the acronym “TANAY BULBS” so you can easily remember the following 10 herbs:

Tsaang Gubat. Effective against diarrhea and stomach ache. Boil the leaves in water and let the patient drink it like a tea. Remember to cool and strain the decoction before drinking. Scientific name: Carmona retusa.

Akapulko. Anti-fungal treatment for ringworm, athlete’s foot, tinea flava and scabies. Scientific name: Cassia alata L. English name: ringworm bush. Other name: Bayas bayabasan.

Niyug-niyogan. Anti-helmintic (anti-parasite) whose seeds are effective in eliminating intestinal worms. Dosage depends on the age: 5-7 seeds for children and 8-10 seeds for adults. Not to be given to children under the age of 4, however. Scientific name: Quisqualis indica L. English name: Chinese honeysuckle.

Ampalaya. Treatment for diabetes (mild non-insulin dependent). Ampalaya leaves may be boiled or blanched, or steamed and eaten. Ampalaya in pill and tablet forms are also available. Scientific name: Mamordica charantia. English name: Bitter gourd, balsam pear or balsam apple.

Yerba Buena. Used to treat nausea and fainting (apply crushed leaves to nostrils), insect bites (apply juice to affected body part) and as an analgesic for aches and pains (use as a decoction).

Bawang. Known to lower blood pressure and cholesterol levels in the blood. Crush a small piece and apply to an aching tooth. Scientific name: Allium sativum. English name: Garlic.

Ulasimang Bato. Used to lower uric acid, and useful for patients with rheumatism and gout. Prepared as a decoction. May also be eaten as a salad. Scientific name: Peperonica pellucida. Other name: Pansit pansitan.

Lagundi. Commonly used to treat asthma, cough and fever. May also be used as an aromatic bath for sick persons. Scientific name: Vitex negundo. English name: Five-leaved chaste tree.

Bayabas. Pounded leaves can be used to ease a toothache. A decoction made from boiling its leaves can be used as a mouthwash. Can also treat diarrhea and as an antiseptic disinfectant for cleaning wounds. Scientific name: Psidium guajava L. English name: Guava.

Sambong. Primarily for anti-edema and a diuretic (it increases the excretion of urine). Also known to prevent kidney stones. Scientific name: Blumea Balsifera; English name: Haliban/Camphor.

A word of caution: consult with a doctor knowledgeable in herbal medicine or Philippine medicinal plants before taking or mixing any herb with prescription and non-prescription drugs. Some herbal medicines can have adverse reaction when mixed with other drugs.

In the United States, most herbal remedies are regulated as dietary supplements. Manufacturers of products in this category are not required to prove the safety or efficacy of their product. The U.S. FDA, however, may withdraw a product from sale should it prove harmful. In the European Union, herbal medicines are regulated under the European Directive on Traditional Herbal Medicinal Products.