The value of biodiversity as a source of pharmaceutically active substances has been the subject of a number of studies, for example Pearce and Puroshothaman (this volume), McNeely (1988), Farnsworth and Soejarto (1985) and Principe (1991). This value is now being cited as one of the many arguments for conserving natural habitats and, in particular, tropical forests which contain the largest number of plant species. These analyses, however, ignore the additional role of these as sources of medicines in the form of herbal treatments used by the majority of people in developing countries. Furthermore, this direct local use of plant resources contributes to the preservation of species and habitats, and can be used as the basis for conservation policies centred on indigenous management regimes and utilisation. The success of such policies depends on the allocation of property rights and the cultural status of herbal medicine which could be an important component of primary health care in developing countries, as advocated by the World Health Organization.
Recent attempts to value non-timber forest products and in particular medicinal plants (Balick and Mendelsohn, 1992) have examined only the current local market value of these products and have not attempted any in-depth evaluation of the benefits to rural communities of traditional health strategies. In addition, no studies have attempted to place a value on the health care provided by traditional healers and traditional plant medicines in terms of the costs of their modern equivalents.
It seems likely that up to 80% of the world's population rely chiefly on so-called 'traditional' medicine for primary health care; in many developing countries the majority of the population depend on traditional remedies. This is partly through poverty, but also occurs because traditional systems are more culturally acceptable, and are able to meet psychological needs in a way Western medicine does not (Prescott-Allen and Prescott-Allen, 1982).
Medicinal plants, therefore, play an important role in health care systems of developing countries. In many countries there is an increasing emphasis on primary health care: basic health care which is not only effective, but affordable by underequipped and underfinanced countries, and by poor communities within those countries. Many governments have adopted policies of greater self-reliance in essential drugs, and traditional medicines are often cheap, readily accepted by consumers and locally available. For example, both China and Mongolia are pursuing health care systems founded on the practice of traditional medicine. In China, health care professionals use medicinal plants to treat 40% of patients requiring primary health care. The State owned Chinese Drugs Company has plantations covering three million hectares to assure supplies of drugs. Similarly, in Sri Lanka the government recognises the importance of traditional medicine and encourages its practice. The University of Colombo's Ayurveda College trains students in traditional medicine and a special medical council is responsible for registering and licensing practitioners. There are now some 12000 registered practitioners in the country (Bird, 1991). In many African countries the significance of traditional medical practitioners is now recognised. African healers were given professional status first in Ghana, in 1969 on the initiative of Kwame Nkrumah, the first President (Maclean and Fyfe, 1987). In some of these developing countries attempts are underway to integrate Western and indigenous medicine. This requires the scientific evaluation of traditional medicines, larger scale manufacture with better quality control, and training in the use of herbal remedies.
In Asia the study of the traditional uses of medicinal plants has long enjoyed a respected role. Ethnobotanical information is preserved not only orally by folk practitioners, but also in the texts of the Ayurvedic medical traditions of the Indian subcontinent and in traditional Chinese medicine, both of which are widely practised. Such systems were not significantly disrupted by the colonial era, and continue to be studied in herbariums and universities. Limited interest in the developed countries centres mainly on the biomedical application of plant medicines and the cultural context of medicine as regards the acceptance of Western medicine in developing countries (see Romanucci-Ross et al., 1983).
This chapter addresses two issues concerning the use and conservation of medical plants. First, their utilisation in traditional medicine and the scope for integration in primary health care, and second, their role in the conservation of biodiversity through locally-based extraction and trade.
There are strong economic arguments for developing and developed countries to invest in research and development of traditional remedies and medicinal plants, and to ensure that medicinal plants and a knowledge of their properties and use are conserved. This is currently under threat as a result of the rapid loss of habitat, aided in some cases by overexploitation. This chapter addresses these issues by examining the management, use and trade of medicinal plant resources in Ghana. Some policy measures which could allow local communities to benefit from the trade in these resources, as well as facilitate conservation of their habitats, are discussed.
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