Former acting Vice-Chancellor of the Obafemi Awolowo University, Ile-Ife, Anthony Elujoba, who is a professor of Pharmacognosis at the Pharmacy Department of the university, tells FEMI MAKINDE that the National Assembly should pass the Traditional Medicine Council Bill to make its practice a top-notch
You recently said Nigeria Centre for Disease Control and Presidential Task Force on COVID-19 should allow herbal medicine to manage willing victims of the virus. Is there an herbal cure for coronavirus now?
There is no cure for it yet as far as I know, but what we are talking about is the management of their symptoms. COVID-19 has never occurred before now, so, nobody can claim to have a cure for it. Herbal medicine could be used to manage COVID-19 symptoms like sneezing, cough, fever, respiratory troubles, diarrhoea and pains. There are herbs to treat these symptoms.
Is that not the same way they are using orthodox medicine to manage COVID-19 patients?
That is what I suppose they are doing but I am not part of the team, so I cannot say exactly. What I have read on some platforms which are not evidence-based is what you have said. They are also managing terrible symptoms like respiratory problems and giving the patient analgesic drugs, expectorants for cough, and adding some immune-stimulating drugs like vitamin C. I saw another one on social media talking about giving them ARV, anti-retroviral drugs which are being used for HIV/AIDS. You know that HIV is also a viral infection. That is the same principle herbal medicine can also use. There are anti-retroviral medicinal plants in literature and there are plants that can treat all of these symptoms as well.
Have these plants that can treat these symptoms been compounded into herbal mixture, tablets, or capsules?
Yes of course. The National Agency for Food and Drug Administration and Control has officially listed some medicinal plant drugs that can handle all of these symptoms. They are well prepared and well packaged and people have been using them since 1999 when the law establishing NAFDAC was made.
Are you saying these products have NAFDAC approval?
They have NAFDAC listing numbers. Listing means they are temporarily approved. I think it is renewed every two years if there are no problems. If they are now developed to the level of a clinical trial, NAFDAC can now be considering them for total approval like any orthodox medicine.
What has been preventing them from getting to the clinical trial stage?
Many things are responsible for this, but I can only talk about research and development of herbal medicine in the university. The major problem is finance. I will give you this example. In the 1990s and early 2000 when I was in the ‘Village Chemist,’ I had so many products even for people living with HIV/AIDS and all the symptoms we successfully treated in them were the same with symptoms associated with COVID-19 now. The commonest symptom in them was fever and each time you had a handshake with a person living with HIV, their palms are warm. This means their body temperature is always high. After the anti-retroviral drug, which could be given free of charge to people living with HIV came and we soft-pedalled and we were no longer treating people with HIV/AIDS. But when we were treating them, people got to know that the drugs were also useful to those who did not have HIV/AIDS. Everybody in Africa would have malaria and we started MSc and Ph.D. theses on all of these products and the very first one we did was for malaria which was common to everybody. We prepared the drugs, packaged them and we started selling them. We had three anti-malarial products. I transferred the Village Chemist to the university and the drugs have now been listed with NAFDAC. They became popular and people were buying them, so, we patented them. After patenting, we collaborated with our doctors at the Obafemi Awolowo University Teaching Hospital in Ife. They were also eager to join hands with us to write a proposal for a clinical trial. That proposal was accepted by the Ethical Research Board of the hospital for us to go ahead with the clinical trial on human beings. Now we applied for TETFund (Tertiary Education Trust Fund) grant for the clinical trial and of all the projects I was told were considered by TETFund, ours was not there.
What reason was given for excluding it?
I don’t know, but you can assist us to ask them. After that, we sought collaboration and applied to the West African Health Organisation because I am a consultant to them, Herbal Medicine Development for ECOWAS (Economic Community of West African States) and I have been attending meetings to make presentations on these drugs. After that, I was invited to submit a proposal for a clinical trial for the anti alarum herbal medicine. Immediately we realised that TETFund was not doing anything for us, we applied to the West African Health Organisation. At the point of signing the approval letter for the fund by the director-general of WAHO, this COVID-19 started and every fund was directed to that. We are still praying and expecting that that letter of approval before the DG will one day be signed when COVID-19 is gone. We are only waiting for external funding because the government here is not helping us.
Have you contacted the Federal Ministry of Health if there is anything they can do about it?
By their mandate, they don’t give fund, they can only support applications. It is not their mandate to fund research. The government has given TETFund the mandate to fund researchers.
But have you contacted the National Assembly which carries out oversight functions on this establishment to help push for the fund?
I don’t agitate too much about things. I wait for God to do whatever he can do about it. The WAHO invitation came miraculously, so, I believe God can do it. I do go round to meet people, I am always in my laboratory working in my way to make the country great by what I do. If the government calls me, I am ready, they use me a lot and anytime they call me, I don’t object but I don’t go about pressing buttons.
Have you made your suggestions about the management of COVID-19 cases known to NCDC and the Presidential Task Force?
I have no access to NCDC or PTF. I am only used to some officials at the Federal Ministry of Health because they have put me in some committees. I have made some moves towards that. Until now, there was no response and I can understand because herbal medicine is not yet at a stage that everybody accepts because of the disadvantages of herbal preparations. There are advantages and there are disadvantages. The knowledge of herbal medicine now is beyond the level it used to be. We cannot run away from herbal medicine because of some disadvantages. Many of them have been resolved scientifically, but many people don’t know.
Disadvantages like what?
There are a number of them already raised like it is not scientific, unhinge nix preparation, adverse effects which could come up and occultism. But science has answers to these disadvantages if I explain them one after the other. Except for occultism that is everywhere in Africa, it is in every trade and even in journalism, so, nobody can say it is restricted to herbal medicine practice. So, nobody can say they would shun herbal medicine because of occultism. We should all be prayerful and I am saying this because of my experience. When I became the acting vice-chancellor, I introduced the second stanza of our anthem as the national prayer before all official meetings.
Are you also collaborating with virologists to achieve your goal?
Virology and other branches of science have a role to play in herbal medicine, including anthropology. We can collaborate with anybody. If virology and pharmacognosy had collaborated before, perhaps we will not be looking for an answer now. We would have had the answers to these emerging diseases like the Ebola virus, SARS and others. I used to know a virology laboratory in the University College Hospital (Ibadan) and I sent an email to the head of that laboratory. The email was never responded to, maybe the man never received it, but I didn’t follow up. I am saying this now because we are eager to collaborate, we need somebody who is a virologist, who is ready to work with herbal medicine to use herbal medicine to see whether we can control these emerging diseases. That is what I want the government to try and facilitate.
Since there is no known cure for COVID-19 and you believe that there are herbal products that can manage the cases, will you be willing to try the herbal drugs on infected monkeys to show their efficacy?
That question should be posed to knowledgeable virologists we have in the country and there are many of them. If we want to do that, we require the collaboration of virologists. There are many products apart from mine that have been listed by NAFDAC.
Are you saying if there are willing virologists, you are ready to test the products on monkeys?
That should be possible. We had tried our malaria products on animals here before we asked people to take them. If any virologist is ready to do that, we are ready. The plants are there and we can supply the extracts.
Is it true that bitter kola can be used to prevent coronavirus?
Although bitter kola is known to possess some antiviral activities and I know it is reported as a good anti-hepatitis, I am yet to find in the literature that it has been successfully used to treat COVID-19 or Ebola virus in an evidence-based clinical trial. When faced with the need, I used to include bitter kola in my treatment of respiratory health issues in the Village Chemist. In general, I do believe (within the limit of my literature up-date) that bitter kola also carries the same chances as all other known antiviral herbs in the books, to treat or prevent emerging diseases such as COVID-19, Ebola virus or others if subjected to the test.
The Ooni of Ife, Oba Adeyeye Ogunwusi, has said that herbal cure would soon be found for coronavirus. Are you working together on this?
No. But fortunately, the Ooni is my father. Mine is to go to the laboratory and make known what I found out there.
Do you think you need legislation to push herbal medicine practice to a greater height in Nigeria?
The WHO/Afro Office has done a lot. The office has given a lot to every developing country in Africa to certify traditional medicine and to institutionalise traditional medicine practice. Traditional medicine should be approved the same way orthodox medicine is approved. Some countries had perfected this. The late Prof Dora Akunyili came and implemented the law which we commended in 1999. I was a member of the committee that proposed the law. When she came and said herbal medicine could then be approved by NAFDAC, I was very happy. That was when herbal medicine started gaining recognition in this country. The government also supported the formulation of herbal pharmacopeia. It contains medicine plants that have been approved not to be toxic, to be safe to use, and with little properties scientifically proven in the form of a crop under each of those medicinal plants. Any plant that appears in that pharmacopeia has become an official drug in that country. The edition of that book, Herbal Pharmacopeia, was inaugurated in 2008. Another committee has been inaugurated to review that book. That is one of the recommendations of the WHO Afro office towards ensuring total integration of traditional medicine. The most important one remaining now is the bill at the National Assembly.
What is the bill all about?
That is what we call Traditional Medicine Council Bill. It states that there must be a council regulating the practice of traditional medicine in Nigeria, just like we have Medical and Dental Council of Nigeria; Pharmacists Council of Nigeria; Nursing and Midwifery Council of Nigeria. That is the one that will guide and regulate the practice of herbal medicine for people that want to open clinics and traditional medicine hospitals. Already, NAFDAC is the institution regulating the products, including herbal drugs, but NAFDAC does not have the mandate to regulate the practice. NAFDAC is just to regulate that the products are good, safe, and efficacious.
What stage is the bill now?
About 12 years ago, the bill reached the National Assembly and I think it passed either the first or the second reading and it died. The bill has now been reviewed by the Federal Ministry of Health and they have passed it through the Ministry of Justice and I was told that the bill is now going to be re-sent to the National Assembly. I am not sure if it had been sent or it is about to be returned to the National Assembly. So, those are the two journeys that the bill is making.
Madagascar is claiming to have found an herbal cure for COVID-19. Will herbal medicine practitioners in Nigeria be willing to collaborate with your colleagues in that country?
We do not have to collaborate with any country in Africa on anti-malaria plants, every country has its own. The inducement for people looking for anti-malarial plant stems from the fact that chloroquine has been mentioned even by the United States President, Donald Trump. What we, herbal scientists, thought immediately was using medicinal plants with anti-malarial properties because of various advantages of herbal medicine. It is available with us, we don’t need to import it. It is affordable and readily acceptable by our people. We are thinking that if chloroquine does it because chloroquine is being considered to do it, then we will use our medicinal plants to do it. We are sure that our people will accept it than chloroquine. The first symptom of COVID-19 is fever and I guess that is why Madagascar went straightaway to investigate their medicinal plants with anti-malarial properties and they got it. If Nigeria had allowed us to do it at the time we were agitating for it, we would have been the first.
What is now your recommendation again on this?
I will suggest that there should be parallel treatment centres across the country where herbal preparations will be used. Only COVID-19 patients that opt for herbal management should be admitted there. There should be informed consent and the patients would be told in the form what the management is all about, the medicinal plants that are inside and they should be told it may work and it may not work. So, the patient will think about it and decide whether they want it or they don’t want it. Those that want it will take responsibility for whatever happens, then experts will be stationed at such centres because they have to supervise it if they prepared the products. But nobody can say they have herbal medicine that cures COVID-19 now because it is a new disease.
Is there any ailment that herbs cannot manage or cure?
I am aware that just a small proportion of known herbs had been investigated pharmacologically. Many known diseases have not been subjected to phytomedical investigation, for example, COVID-19. There are still many more plants yet un-investigated and it is impossible to know whether such plants will cure emerging diseases without any pharmacological experiments. Traditional medicine practitioners believe that there is no disease whose cure cannot be found in the forest. There is a spiritual faith-evidence that God has divinely provided a cure for every ailment in the same environment where He has allowed the corresponding ailment (Ez. 47:12; Rev. 22:2). Since there are thousands of medicinal plants yet un-investigated for human or animal ailments, I believe that it is surer and wiser to seek an herbal solution for a new disease like COVID-19 by research than by synthetic investigation for chemical drugs.
I strongly suspect that, among the Chinese-donated material consignments of COVID-19 supports, their government would have included a lot of traditional Chinese medicines whose compositions and safety we, or even NAFDAC, did know little about. The Chinese herbal preparations will most probably not “cure” but be immune-boosting and/or for COVID-19 symptoms. Can we not also use some of the NAFDAC-listed immune boosters? We can also be innovators in Nigeria of what the whole world will buy.
Apart from making herbal medicine to cure malaria and manage other ailments, is there anyone for cancer that is ravaging the world?
That is not my area, but I know a colleague within the field of pharmacognosy who is doing that. I have never worked on anti-cancer herbal medicine.
Do you have the one that can cure sickle cell?
That is where I started from and there is a product now that has been patented and all that we used is pawpaw.
Does the product cure sickle cell?
It doesn’t cure it but it manages it. It prevents crisis and it can reduce crisis if it comes.
Has that one also been listed by NAFDAC?
No. It has not been listed by NAFDAC because the university has not provided all that is required by NAFDAC. There must be a place where you prepare it in a hygienic form with a good manufacturing practice. It must look like a mini-industry. I guess the university is handicapped by the fund.
Can herbal products cure the mental problem and bone issues?
There are bone setters and for psychiatry, we call them traditional psychiatrists. The two areas of herbal practice have been recognised by the World Health Organisation a long time ago. The WHO recognises that they have enough skills to be exploited by primary healthcare. Some of the renowned psychiatrists we have like our former Vice-Chancellor, Prof Roger Makanjuola, have collaborated with traditional psychiatrists before.