Biopiracy versus One-World Medicine-From colonial relicts to global collaborative concepts.

BACKGROUND: Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism. HYPOTHESIS: The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe. STUDY DESIGN: Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine. CONCLUSION: To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients.

Screening of Plants Used as Traditional Anticancer Remedies in Mkuranga and Same Districts, Tanzania, Using Brine Shrimp Toxicity Bioassay.

BACKGROUND: Inadequate specialized cancer hospitals and high costs are contributing factors that delay cancer patients from accessing health care services in Tanzania. Consequently, majority of patients are first seen by Traditional Health Practitioners (THPs) before they access specialized services. This study presents ethnomedical information and preliminary evaluation of 25 plant species claimed by THPs in Mkuranga and Same districts of Tanzania on use for treatment of cancer. Literature search and laboratory investigation results are presented to support evaluation. METHODS THIS STUDY WAS A SINGLE DISEASE ETHNOMEDICAL ENQUIRY FOCUSING ON PLANTS BEING USED FOR CANCER TREATMENT: Face-to-face interviews and questionnaires were administered to eight (8) THPs in Mkuranga and Same districts on the claimed plants and their use for management of cancer. Plants were selected based on being frequently mentioned and emphasis given by THPs. Literature search and brine shrimp toxicity (BST) of methanol : dichloromethane (1:1) extracts was used as surrogates to evaluate strength of the claims. RESULTS: This study reports 25 plant species used by the THPs in two districts of Tanzania. Eight plants (32%) have been reported in the literature to have activity against cancer cells. BST results revealed, 14 (56%) plants exhibited high toxicity against brine shrimps. The most active plants included Croton pseudopulchellus Pax (LC50 4.2 µg/ml), Dalbergia melanoxylon Guill. & Perr. (LC50 6.8 µg/ml), Loranthus micranthus Linn (LC50 4.0 µg/ml), Ochna mossambicensis Klotzsch (LC50 3.3 µg/ml), and Spirostachys africana Sond. (LC50 4.4 µg/ml); their toxicity was comparable to that of Catharanthus roseus (L) G. Don. (LC50 6.7 µg/ml), an established source of anticancer compounds. Nine other plants had LC50 values between (19.8 and 71.6) µg/ml, indicating also potential to yield anticancer. CONCLUSION: Literature search and BST results provide a strong support of the potential of the claimed plants to yield active anticancer compounds.

Biopiracy of natural products and good bioprospecting practice.

BACKGROUND: Biopiracy mainly focuses on the use of biological resources and/or knowledge of indigenous tribes or communities without allowing them to share the revenues generated out of economic exploitation or other non-monetary incentives associated with the resource/knowledge. METHODS: Based on collaborations of scientists from five continents, we have created a communication platform to discuss not only scientific topics, but also more general issues with social relevance. This platform was termed 'PhytCancer -Phytotherapy to Fight Cancer' (www.phyt-cancer.uni-mainz.de). As a starting point, we have chosen the topic "biopiracy", since we feel this is of pragmatic significance for scientists working with medicinal plants. RESULTS: It was argued that the patenting of herbs or natural products by pharmaceutical corporations disregarded the ownership of the knowledge possessed by the indigenous communities on how these substances worked. Despite numerous court decisions in U.S.A. and Europe, several international treaties, (e.g. from United Nations, World Health Organization, World Trade Organization, the African Unity and others), sharing of a rational set of benefits amongst producers (mainly pharmaceutical companies) and indigenous communities is yet a distant reality. In this paper, we present an overview of the legal frameworks, discuss some exemplary cases of biopiracy and bioprospecting as excellent forms of utilization of natural resources. CONCLUSIONS: We suggest certain perspectives, by which we as scientists, may contribute towards prevention of biopiracy and also to foster the fair utilization of natural resources. We discuss ways, in which the interests of indigenous people especially from developing countries can be secured.

Clinical pharmacy to meet the health needs of Tanzanians: education reform through partnership across continents (2008-2011).

In 2009, the Muhimbili University of Health and Allied Sciences (MUHAS) School of Pharmacy began to revise its BPharm curriculum for students entering in 2011. Its goal was to assure these pioneer students and their successors would be prepared to lead pharmacy practice to improve patient care and health outcomes in Tanzania. Building on its own experience and recommendations from other parts of the world, MUHAS actively engaged counterparts from the University of California San Francisco School of Pharmacy. MUHAS's vision was to create a curriculum to educate students to become 'clinical pharmacists' with a more direct patient-care focus. This means a major expansion in activities undertaken by newly graduating pharmacists - beyond preparing and dispensing medications. With the transformation from a traditional curriculum (knowledge-based) and teaching (lectures), the new approach emphasizes interprofessional team care, clinical science content (treatment and prevention of diseases), and experiential learning opportunities from classrooms to patient-care settings. Assessments of strengths and weaknesses of previous graduates' performance in their early employment informed curricular revision; evaluation of the competence of students and of new graduates will guide further revisions to assure preparation of effective pharmacists to lead practice in Tanzania.

Curricular transformation of health professions education in Tanzania: the process at Muhimbili University of Health and Allied Sciences (2008-2011).

Tanzania requires more health professionals equipped to tackle its serious health challenges. When it became an independent university in 2007, Muhimbili University of Health and Allied Sciences (MUHAS) decided to transform its educational offerings to ensure its students practice competently and contribute to improving population health. In 2008, in collaboration with the University of California San Francisco (UCSF), all MUHAS's schools (dentistry, medicine, nursing, pharmacy, and public health and social sciences) and institutes (traditional medicine and allied health sciences) began a university-wide process to revise curricula. Adopting university-wide committee structures, procedures, and a common schedule, MUHAS faculty set out to: (i) identify specific competencies for students to achieve by graduation (in eight domains, six that are inter-professional, hence consistent across schools); (ii) engage stakeholders to understand adequacies and inadequacies of current curricula; and (iii) restructure and revise curricula introducing competencies. The Tanzania Commission for Universities accredited the curricula in September 2011, and faculty started implementation with first-year students in October 2011. We learned that curricular revision of this magnitude requires: a compelling directive for change, designated leadership, resource mobilization inclusion of all stakeholders, clear guiding principles, an iterative plan linking flexible timetables to phases for curriculum development, engagement in skills training for the cultivation of future leaders, and extensive communication.

Screening of some Tanzanian medicinal plants from Bunda district for antibacterial, antifungal and antiviral activities.

Extracts from 50 plant parts obtained from 39 different plants belonging to 22 families used to treat infectious diseases in Bunda district, Tanzania, were screened against twelve microorganisms, including the bacteria Bacillus cereus, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Salmonella typhimurium, the fungi Aspergillus niger, Candida albicans, and the viruses Herpes Simplex Virus type 1, Vesicular Stomatitis Virus T2, Coxsackie B2 and Semliki Forest A7. The highest activity was obtained for the n-hexane extract of Elaeodendron schlechteranum root bark against the Gram-positive bacteria Bacillus cereus (MIC 0.97 microg/ml and MBC 1.95 microg/ml) and Staphylococcus aureus (MIC 3.90 microg/ml and MBC 31.25 microg/ml). Gram-negative bacteria were less sensitive. Only Balanites aegyptiaca stem bark exhibited a high antifungal activity against Candida albicans (MIC 125 microg/ml and MFC 250 microg/ml). Extracts from four plants; Lannea schweinfurthii, Combretum adenogonium, Ficus sycomorus and Terminalia mollis showed strong antiviral activity with RF values of 10(3) and 10(4) against Herpes Simplex Virus type 1 at various concentrations. Our results support, at least in part, the use of most plants as claimed by traditional healers/informants especially against the Gram-positive bacteria Bacillus cereus and Staphylococcus aureus.

Ethnopharmacological survey of the Bunda district, Tanzania: plants used to treat infectious diseases.

An ethnobotanical study was carried out in six villages in the Bunda district, Mara Region, Tanzania, where the use of plants still has a special meaning to the society, in the treatment of various diseases. Information was obtained from the traditional healers and other experienced persons, having some knowledge on medicinal plants. Fifty-two plants were reported for use in the treatment of various infectious diseases. These plants belong to 29 families, with Papilionaceae being the most represented. Leaves ranked the highest, especially for use in topical preparations. Oral administration was the most frequently used route of administration. Twenty-one percent of the recorded plants were reported for treating venereal diseases, with syphilis and gonorrhea being the most commonly mentioned. Information providers requested feedback with regard to the plants proven scientifically to be toxic in order to avoid risks while offering their services. From this work it was found out that, people in this area commonly use medicinal plants with trust they have built on the curative outcome witnessed. As the first ethnobotanical study in Bunda district recording 52 plants in a small area covered, publication of this work is expected to open up more studies to record many useful medicinal plants unfolded.

Screening of Tanzanian medicinal plants for anti-Candida activity.

BACKGROUND: Candida albicans has become resistant to the already limited, toxic and expensive anti-Candida agents available in the market. These factors necessitate the search for new anti-fungal agents. METHODS: Sixty-three plant extracts, from 56 Tanzanian plant species obtained through the literature and interviews with traditional healers, were evaluated for anti-Candida activity. Aqueous methanolic extracts were screened for anti-Candida activity by bioautography agar overlay method, using a standard strain of Candida albicans (ATCC 90028). RESULTS: Twenty- seven (48%) out of the 56 plants were found to be active. Extracts of the root barks of Albizia anthelmintica and Balanites aegyptiaca, and roots of Plectranthus barbatus showed strong activity. CONCLUSION: The extracts that showed strong anti-Candida activity are worth of further investigation in order to isolate and identify the active compounds.

Chemical composition and in vitro antimicrobial activity of the essential oils of two Helichrysum species from Tanzania.

The chemical composition of the essential oils obtained from the aerial parts of Helichrysum cymosum and H. fulgidum, from Tanzania, were analyzed by GC and GC/MS. A total of sixty-five compounds, representing 92.4% and 88.2% of the two oils, respectively, were identified. trans-Caryophyllene, caryophyllene oxide, beta-pinene, p-cymene, spathulenol and beta-bourbonene were found to be the main components. Furthermore, the oils were tested against six gram (+/-) bacteria and three pathogenic fungi. It was found that the oil of H. fulgidum exhibited significant antimicrobial activity, while the oil of H. cymosum was not active at all.

Evaluation of the potential cancer chemotherapeutic efficacy of natural product isolates employing in vivo hollow fiber tests.

The hollow fiber test has been developed for the preliminary in vivo assessment of cancer chemotherapeutic efficacy of selected natural products. Using this model, we have established growth conditions for HL-60, HUVEC, Ishikawa, KB, KB-V1, LNCaP, Lu1, MCF-7, Mel2, P-388, and SW626 cells implanted at the intraperitoneal (i.p.) and subcutaneous (s.c.) compartments of athymic mice. Five cytotoxic natural product isolates (2-6) were tested in this model, along with paclitaxel (taxol) (1). Among the compounds tested, dioscin (2) and 13-methoxy-15-oxozoapatlin (3) were found to be active, indicating their potential to function as cancer chemotherapeutic agents. On the other hand, ochraceolide A (4), alpha-lapachone (5), and 2-(1-hydroxyethyl)naphtha[2,3-b]furan-4,9-quinone (6), all of which were significantly cytotoxic to cultured mammalian cells, did not mediate significant responses with the hollow fiber model. In further xenograft studies using KB cells implanted at the subcutaneous site, compound 3 mediated a statistically significant response which was consistent with the response observed at the subcutaneous compartment in the hollow fiber tests. In sum, these studies illustrate the usefulness of the hollow fiber model in natural product drug discovery programs. Preliminary indications of potential therapeutic efficacy can be provided quickly at relatively low expense. Agents capable of mediating a response at the subcutaneous site would appear to warrant greatest attention.