UK herbal medicines market stands at £240 million per year as an estimated 15 million people choose herbal remedies for everyday ailments. Figures for the global market top $60 billion per year and rising. But is demand for TM/CAM resulting in over-harvesting of the worlds most effective herbal medicines? Sam Burcher reports.
The World Health Organisation estimates that 75-80% of the worlds population use plant medicines either in part or entirely for health care . For many, plant medicines are a necessity, as costly pharmaceutical drugs are unaffordable; and for others, the desire to seek natural alternatives with few side effects is preferable to using conventional drugs. This dichotomy has led to important medicinal plants such as Goldenseal (Hydrastis canadensis), traditionally used for a range of immune deficiency disorders becoming the fifth most endangered species in the world. In Europe over 200 Medicinal and Aromatic Plants (MAPS) are on the endangered list .
Despite attempts by a number of conservation groups such as World Wildlife Fund, The World Conservation Union and Convention on Trade Endangered Species (CTES), further support is desperately needed to save plant species from becoming extinct .
David Bellamy, professor and celebrity naturalist, launched the Herbalert campaign in February 2003 for the Natural Medicines Society [See Box 1] at Neals Yard in London .
"I am delighted to help spearhead a campaign to put herbal medicine back where it deserves to be an important part of mainstream healing practice in the 21st Century," Bellamy said.
Clearly enthusiastic about the subject, he made an entertaining and impassioned plea to give herbal medicine its due accord. "Herbal Medicine has been the mainstay of healing across the world for over 6,000 years, the heritage of its success is manifest on the contents labels of many of todays mainstream medicines," he said. (See box 2) But he cautioned that over collection of plants from the wild, with no adequately regulated backup supplies from certified farms are threatening the diverse genetic base of many key plant species .
The Natural Medicines Society was established in 1985 to protect and develop the status of alternative medicines and works to defend consumers right to use CAM. Herbalert aims are as follows:
The World Conservation Union Medicinal Plant Specialist Group has assessed 270,000 plant species over a 20-year period and identified 33, 798 as being at risk of extinction. This is the first comprehensive listing of plants on a global scale. These are catalogued in the Red List of Threatened Plants (1997). Sadly 380 plant species are registered as extinct in the wild .
In response to continual demand for MAPs and the rapid depletion of forest resources, increasing numbers of cultivated plants may hold the key to protecting some wild stocks. Epidemiological surveys show preferences by certain practitioners and consumers for wild gathered species due to cultural reasons, such as the belief that wild plants are more medicinally powerful. And this is in part backed up by scientific studies suggesting secondary metabolites needed by plants in their natural habitats are not expressed in monoculture conditions .
However the trend is broadly moving towards a greater proportion of cultivated plants and this steady supply is endorsed by consumers, wholesalers and larger herb companies who approve the biodynamic/organic certification this method affords.
But commercialisation has an impact on rural people who depend on making money from harvesting wild plants. It is considered that up to 30% of village income can be generated through gathering MAPs. Whilst it may benefit the countrys "top" people or GDP when outsiders invest in largescale monoculture in rural parts for export, the ecology of the community is invariably disturbed.
A counterbalance to this is smallscale cultivation and home gardens. The benefits of these schemes are multitudinous. They provide a consistent income, require low economic imput, provide a response to local declining stocks and supply regional markets. Home gardens increasingly focus on medicinal plant propagation, which in turn rekindles the use of traditional remedies for common ailments.
Over nine tenths of MAPs used traditionally are gathered in Third World countries. Studies of Indian MAPS show that only 20 of 400 plant species used medicinally are not from wild stocks. In China, of the 5 000 medicinal plants identified and 1 000 to 2 000 commonly used, only 20% are cultivated. These countries are the biggest users and exporters of medicinal plants worldwide. Ginseng (panax) is revered in the east and popular in the west, but becoming increasingly rare.
If the majority of MAPS continue to be harvested from the wild, then measures must be applied to conserve them locally. There should be local monitoring of abundance and distribution, assessment of annual yields and records of harvest practices. The introduction of certification schemes, for example, and forest management, would encourage less wasteful harvesting techniques, and result in better prices for locals and allow recovery time of plants and trees for future harvests. Some scientific consultation would be needed, as well as a commitment to benefit- sharing and protection of sustainable indigenous traditions.
In the United States, medicinal plants are under siege, losing over 2 400 acres of native habitat every day. As many as 29% of the most important plants discovered and harvested ceremoniously by the indigenous dwellers of North America are threatened with extinction. Currently more than 60 million Goldenseal (hydrastis canadensis) roots are harvested or wildcrafted annually, pulling it closer to extinction. The yellow roots became commercial produce in the 1850s, and signs of over-harvesting were apparent as early as 1905 . Three quarters of commercial harvesting takes place in the Appalachian mountain range where a number of native plants are considered "at risk". American ginseng (panax quinquifoloium), Black Cohosh (cimicifuga racemosa) and Blue Cohosh (caulophyllum thalictroides) Slippery Elm (ulmus fulva) and Echinacea (augustifolia) are all over-harvested to supply an increasing home market as well as export demands .
The UK is in the bottom group for importing MAPs and a study to investigate commercial uses of wild and traditionally managed wild plants in England and Scotland provides encouraging results. Wetlands and woodlands are harvested more extensively than heathlands, moorlands, and coastline habitats and both areas continue to be an important form of traditional land management, making a modest and sustainable contribution to rural livelihoods .
The National Institute of Medicinal Herbalists and Middlesex University degree courses in Medicinal Herbalism teach students to cultivate MAPS as part of their degree course in the universitys own gardens. The course also runs a public clinic adjoining the campus for qualified practictioners who select cultivated organic MAPs from within UK for their patients. .
Ongoing implementation of European Parliament Directives on Traditional Herbal Medicines and improvements of regulation and legislation of all herbal remedies will also be addressed by Herbalert. David Tredinnick MP and co-chair of the Parliamentary Group for Integrated and Complementary Health said: "Herbalert can play a valuable role in providing independent information to assist consumers in choosing safe and effective herbal products and can help ensure future generations have access to appropriately regulated herbal medicines." 
The Directive on Traditional Herbal Medicinal Products came from the need to market herbal medicines throughout the EU without meeting stringent and costly licensing requirements for conventional pharmaceutical drugs. For years the sale of herbs making no claims and available in unprocessed forms were exempt from licensing. This was in accordance with the 1968 Medicines Act sanctioning the sale of herbs either in their dried state or in pill or powdered forms.
In 1965 the UK signed up to the EC Directive which called for the harmonisation of all medicines sold within the European community. Had this directive been implemented to the letter it would have effectively abolished these exemptions.
The new proposal for a Directive on Traditional Herbal Medicinal Products is widely supported by the majority of herbal interest groups. In practical terms the proposal is the culmination of a hard fought battle to retain the right for the continued availability of herbs throughout Europe that have proved their efficacy and safety over 30 years to be exempt from trials. Herbs from outside Europe are to demonstrate 15 years of safe use in their country of origin and a further fifteen years safe use within the EU, although there are moves to reduce this to 10 years through an amendment. Prescriptions resulting from one-to-one consultation with herbal practitioners meeting the above criteria for safety should also be exempt. Finally, herbal medicines must be produced according to Good Manufacturing Practice (GMP) which entails labelling, dosage instruction and warnings of contraindications.
To date there are few policies in place to monitor harvest and trade of medicinal plant species. By far the most important implementations of international legislation are the inclusion of MAPs to CITES and the entry into force of the Convention of Biological Diversity (CBD) agreed at the World Summit in Rio 1992.
The Global Summit on Medicinal Plants takes place on Mauritius in September 2003 where "Recent Trends in Phytomedicine (herbal medicine) and Other Alternative Therapies for Human Welfare" is the central theme. Here scientists, researchers and policy makers will gather to discuss key conservation plans for MAPs comprising the mainstay of traditional healthcare, alternative therapies and a quarter of conventional medicines. 
The Herbalert campaign includes making representations to the European Parliament on behalf of consumers to ensure availability of good quality, sustainable, herbal remedies and the right of practitioners to prescribe as appropriate to their patients. Herbalert is also working for an amendment to the Directive for an inclusion within the proposal relating to 'sustainable use' of herbs as laid out in the aims of the Convention on Biological Diversity as this is an important, but much overlooked, factor for the future of herbal medicine.
Here are some examples of medicinal plants contributing to pharmaceutical medicine:
 Scientists have successfully synthesized some plants medicines such as Aspirin, but cases such as the rosy periwinkle* are impossible to synthesize, which means the plant is the only source of the medicine.
Article first published 25/03/03
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