Bioeconomy and ethnopharmacology - Translational perspective and sustainability of the bioresources of northeast region of India.

ETHNOPHARMACOLOGICAL RELEVANCE: The ecological environment of Northeast region of India (NER), with its high humidity, has resulted in greater speciation and genetic diversity of plant, animal, and microbial species. This region is not only rich in ethnic and cultural diversity, but it is also a major biodiversity hotspot. The sustainable use of these bioresources can contribute to the region's bioeconomic development. AIM OF THE STUDY: The review aimed to deliver various perspectives on the development of bioeconomy from NER bioresources under the tenets of sustainable utilization and socioeconomic expansion. MATERIALS AND METHODS: Relevant information related to prospects of the approaches and techniques pertaining to the sustainable use of ethnomedicine resources for the growth of the bioeconomy were retrieved from PubMed, ScienceDirect, Google Scholar, Scopus, and Springer from 1984 to 2023. All the appropriate abstracts, full-text articles and various book chapters on bioeconomy and ethnopharmacology were conferred. RESULT: As the population grows, so does the demand for basic necessities such as food, health, and energy resources, where insufficient resource utilization and unsustainable pattern of material consumption cause impediments to economic development. On the other hand, the bioeconomy concept leads to "the production of renewable biological resources and the conversion of these resources and waste streams into value-added products. CONCLUSIONS: In this context, major emphasis should be placed on strengthening the economy's backbone in order to ensure sustainable use of these resources and livelihood security; in other words, it can boost the bio-economy by empowering the local people in general.

Mapping prevalence and patterns of use of, and expenditure on, traditional, complementary and alternative medicine in New Zealand: a scoping review of qualitative and quantitative studies.

AIM: Traditional, complementary and alternative medicine (TCAM) is a popular healthcare choice worldwide. The extent of data available on TCAM, including prevalence and patterns of use in New Zealand, is unknown. This scoping review aims to map the existing research describing the use of TCAM (including prevalence, access, expenditure and concurrent use with conventional medicines) in New Zealand. METHOD: Research databases (MEDLINE, EMBASE, AMED, IPA (International Pharmaceutical Abstracts), CINAHL, PsycINFO and Scopus) and grey literature (Google Scholar and New Zealand government and relevant organisations' websites) were searched for studies published before 7 June 2019. Studies reporting on the prevalence and/or exploring aspects of TCAM use were included in this review. RESULTS: In total, 72 studies were reviewed. Available data suggest that TCAM use is widespread among New Zealanders, and some consumers pay large sums of money out-of-pocket. A wide range of TCAM practices and products is used by people of all ages and ethnicities and with various health conditions. There is some evidence of consumers using TCAM concurrently with conventional medicines. Studies were generally small, localised and conducted in sub-populations (e.g., specific age groups, health conditions). Different TCAM definitions, data collection tools, methods and prevalence measurement were used across studies, thereby limiting the comparability of data locally and internationally. CONCLUSION: A considerable number of studies/reports on TCAM use are available. Still, there is a lack of comprehensive, nationally representative data on prevalence and patterns of use of TCAM, including its use in relation to conventional medicine(s) in New Zealand.

Cost analysis in a Traditional, Complementary and Integrative Medicine unit in Brazil.

OBJECTIVE: To analyze the costs of a specialized service in Traditional Complementary and Integrative Medicines (TCIM) in Northeast Brazil to provide data on the cost linked to the implementation and maintenance of services of this nature and to identify the average cost per user for the Unified Health System. METHODS: This is a partial, descriptive, quantitative economic assessment, which used secondary data, later grouped in Microsoft Excel spreadsheets. The method used to analyze such costs was absorption costing, from which the service was divided into three costing centers: productive, administrative and auxiliary. RESULTS: After analyzing the data, the total cost of the service in 2014 was estimated at R$ 1,270,015.70, with a proportion of 79.69% of direct costs. The average cost per user in this period was R$ 36.79, considering the total of 34,521 users in individual and collective practices. CONCLUSIONS: The service has a cost per user compatible with a specialized service; however, TCIM offers a comprehensive and holistic approach, which can have a positive impact on quality of life.

Marcgrave and Piso's plants for sale: The presence of plant species and names from the Historia Naturalis Brasiliae (1648) in contemporary Brazilian markets.

ETHNOPHARMACOLOGICAL RELEVANCE: Parallelisms between current and historical medicinal practices as described in the seventeenth century treatise Historia Naturalis Brasiliae (HNB) provide us with an overview of traditional plant knowledge transformations. Local markets reflect the actual plant use in urban and rural surroundings, allowing us to trace cross-century similarities of ethnobotanical knowledge. AIMS OF THE STUDY: We aim to verify in how far the HNB, created in seventeenth-century northeastern Brazil, correlates with contemporary plant use in the country by comparing the plant knowledge therein with recent plant market surveys at national level. MATERIALS AND METHODS: We conducted a literature review on ethnobotanical market surveys in Brazil. We used the retrieved data on plant composition and vernacular names, together with our own fieldwork from the Ver-o-Peso market in Belém, to compare each market repertoire with the useful species in the HNB. We analyzed similarities among markets and the HNB with a Detrended Correspondence Analysis and by creating Venn diagrams. We analyzed the methods of the different markets to check whether they influenced our results. RESULTS: Out of the 24 markets reviewed, the greatest similarities with the HNB are seen in northern Brazilian markets, both in plant composition and vernacular names, followed by the northeast. The least overlap is found with markets in the central west and Rio de Janeiro. Most of the shared vernacular names with the HNB belonged to languages of the Tupi linguistic family. CONCLUSION: The similarity patterns in floristic composition among Brazilian markets and the HNB indicate the current wider distribution and trade of the species that Marcgrave and Piso described in 1648 in the northeast. Migration of indigenous groups, environmental changes, globalized and homogenous plant trade, and different market survey methods played a role in these results. The HNB is a reference point in time that captures a moment of colonial cultural transformations.

The transnational Sowa Rigpa industry in Asia: New perspectives on an emerging economy.

This article advances the hypothesis that "traditional" Asian pharmaceutical industries are rapidly growing in size and prominence in contemporary Asia, and identifies a lack of empirical data on the phenomenon. Addressing this gap, the article provides a quantitative outline and analysis of the Sowa Rigpa (Tibetan, Mongolian and Himalayan medicine) pharmaceutical industry in China, India, Mongolia and Bhutan. Using original data gathered through multi-sited ethnographic and textual research between 2014 and 2019, involving 232 industry representatives, policy makers, researchers, pharmacists and physicians, it assembles a bigger picture on this industry's structure, size and dynamics. Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations. The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.

Cost analysis in a traditional, complementary and integrative medicine unit in Brazil / Análise de custos em unidade de medicina tradicional, complementar e integrativa no Brasil

ABSTRACT OBJECTIVE To analyze the costs of a specialized service in Traditional Complementary and Integrative Medicines (TCIM) in Northeast Brazil to provide data on the cost linked to the implementation and maintenance of services of this nature and to identify the average cost per user for the Unified Health System. METHODS This is a partial, descriptive, quantitative economic assessment, which used secondary data, later grouped in Microsoft Excel spreadsheets. The method used to analyze such costs was absorption costing, from which the service was divided into three costing centers: productive, administrative and auxiliary. RESULTS After analyzing the data, the total cost of the service in 2014 was estimated at R$ 1,270,015.70, with a proportion of 79.69% of direct costs. The average cost per user in this period was R$ 36.79, considering the total of 34,521 users in individual and collective practices. CONCLUSIONS The service has a cost per user compatible with a specialized service; however, TCIM offers a comprehensive and holistic approach, which can have a positive impact on quality of life.

RESUMO OBJETIVO Analisar os custos de um serviço especializado em Medicinas Tradicionais Complementares e Integrativas (MTCI) no Nordeste brasileiro, com o intuito de fornecer dados sobre o custo atrelado à implantação e manutenção de serviços dessa natureza e identificar o custo médio por usuário para o Sistema Único de Saúde. MÉTODOS Trata-se de uma avaliação econômica do tipo parcial, com caráter descritivo, de natureza quantitativa, que utilizou dados secundários, posteriormente agrupados em planilhas do Microsoft Excel. O método utilizado para analisar tais custos foi o de custeio por absorção, a partir do qual o serviço foi dividido em três centros de custeio: produtivo, administrativo e auxiliar. RESULTADOS Após a análise dos dados, o custo total do serviço em 2014 foi estimado em R$ 1.270.015,70, com proporção de 79,69% de custos diretos. O custo médio por usuário neste período foi R$ 36,79, considerando o total de 34.521 usuários em práticas individuais e coletivas. CONCLUSÕES O serviço apresenta um custo por usuário compatível com um serviço especializado, contudo, as MTCI oferecem abordagem compreensiva e holística, as quais podem impactar de forma positiva a qualidade de vida.

Introduction to the special issue: Saving plants, saving lives: Trade, sustainable harvest and conservation of traditional medicinals in Asia.

This "geographic and thematic" issue of the Journal of Ethnopharmacology focuses on the traditional medicines in trade in Asia on the 30th anniversary of the 1988 Chiang-Mai Declaration, an output of an historic meeting organized by WHO, IUCN and WWF. The emphasis on the Asian countries that represent the highest volume and value of medicinal plants trade in the world is deliberate. Not only because of the scale and speed of changes in traditional medicines trade in Asia, but also to highlight the conservation and sustainable use issues being faced today. In 1988, few studies had been done on the informal sector trade or on medicinal plant value-chains and even fewer studies on cross-border trade in medicinal plants or fungi. At that time, e-commerce in Traditional and Complementary Medicine (T&CM), so common today, did not even exist. And no comparitive, repeat studies of traditional medicines markets had been done at all. Thirty years later, this special issue illustrates how the traditional medicines trade has grown and changed. Links between medicinal plant conservation, scarcity and price on one hand and quality, safety and adulteration on the other are better understood. E-commerce in T&CM has grown exponentially, due to 51% of the world's population having internet access by 2017. Yet despite global policy goals for conservation and sustainable use, the challenges facing medicinal plants conservation are greater than ever before. Consequently, the need for co-operation between the health-care and conservation sectors recognised in 1988 is even greater today. And this is recognised in WHO's 2014-2023 strategy for traditional medicines, which identifies the need to raise awareness about issues of biodiversity and conservation as an important strategic action (WHO, 2013). This Special Issue is a small contribution towards that goal.

Evaluation of content and cost of traditional eye medication in a resource-poor country - Implications for eye care practice and policy.

BACKGROUND: Cataract, glaucoma, and conjunctivitis are common causes of ocular morbidity in Nigeria. A major obstacle in reducing the burden of ocular morbidity in rural areas is access to eye care services. Up to 80% of the population in developing countries use traditional medications for their primary healthcare needs because they are accessible, available, and affordable. The aim of this study is to evaluate the content and cost of commercialized traditional medications used in the treatment of common eye conditions in Nigeria. PATIENTS AND METHODS: All the registered traditional healers (THs) at an International Trade Fair in Enugu who treated eye problems were identified. Data on their location and scope of their practice were collected by the researchers. Proxy patients consulted THs in the trade fair with simulated cataract, glaucoma, and bacterial conjunctivitis, and treatment was sought. Medication for the treatment of the simulated disorders was paid for and procured. The mode of administration and the cost of the drugs were recorded by proxy patients. Each medication was labeled with a code and sent to the laboratories of the National Agency for Drug Administration and Control for analysis. Data were entered into a database on Microsoft Access and transferred to STATA V12.1 (StataCorp) for analysis. RESULTS: Cataract was treated by 87.5% of all the traditional eye healers interviewed. A total of 32 samples were collected and analyzed. These comprised mainly oral (53.1%) and topical traditional medications (43.8%). The pH of the topical samples ranged from 3.5 to 10, while the mean microbiological load per topical solution was 3.3 × 104 cfu/mL ± 0.96. The cost of treatment of cataract ranged from 4 to 70 USD. CONCLUSION: The content of the majority of the samples of traditional eye medications in this study had high extremes of pH and/or had a high microbial content. The practice of THs should be regulated.

Caracterización del sistema de salud de Honduras / Characterization of the Health System of Honduras

Este artículo describe el actual Sistema de Salud de Honduras, en los primeros párrafos trata sobre la demografía de la población del país, y se mencionan algunos indicadores básicos de salud, en la segunda parte se describe la estructura del sistema como es la conformación de las instituciones que la integran, la cobertura, sus recursos y el inanciamiento y por último se presentan las conclusiones de algunos retos que enfrenta el Sistema de Salud hondureño. Objetivo: caracterizar el sistema de salud de Honduras. Metodología: descriptivo retrospectivo y cualitativo, técnica: revisión documental. Este trabajo se realizó en la ciudad de Tegucigalpa, M.D.C., desde el mes de abril del 2016 a marzo del 2017, se hizo una búsqueda de la información actualizada en los portales de cada institución, como en algunas revistas médicas relacionadas al tema...(AU)

Traditional Knowledge of Gucchi, Morchella esculenta (Ascomycetes), in Doda District, Jammu and Kashmir, India.

The gucchi mushroom, Morchella esculenta, commonly known as the morel, is called thunthoo in the Bhaderwahi dialect spoken in District Doda of Jammu and Kashmir, India, and is an expensive food item that grows wild and is collected manually. Its nutritive and medicinal values are acknowledged. The farming community in the district traditionally collects the mushroom from forested areas through a well-managed community approach. Elders of families and communities have taught farmers how to identify the mushroom, recognize distribution patterns, and collect it. The knowledge and ability to differentiate M. esculenta from other poisonous wild mushrooms has also been inherited from the elders and community members. Women and children collect it from the outskirts of the forested areas and villages; men penetrate deeper into the dense forests in groups. It is either sold fresh to local shopkeepers or dried at home; the majority of gucchi collectors do the latter. Traditionally, the mushrooms are most commonly dried in the sun or the kitchen. The mushroom fetches a remunerative price and supplements the household incomes of the rural folk who collect it. Marketing gucchi has not been reported as a constraint. It has traditionally been used to overcome gastric problems and indigestion, as a tonic, to help heal wounds, and to reduce joint pain. Its medicinal uses are, however, restricted to only the hills and far-flung areas.

Patterns of change: The dynamics of medicinal plant trade in far-western Nepal.

ETHNOPHARMACOLOGICAL RELEVANCE: Combined quantitative and qualitative environmental product trade studies, undertaken in the same location over time, are instrumental in identifying plant species with commercial demand and explaining what drives temporal changes. Yet such dynamic studies are rare, including for Himalayan medicinal plants that have been large-scale traded for millennia. AIM OF THE STUDY: To (i) investigate changes in medicinal plant trade in the past 17 years, and (ii) identify the main factors driving changes, using a study of Darchula District in far-western Nepal. MATERIALS AND METHODS: Medicinal plant production network data were collected from March to August 2016, for the fiscal year 2014-15, for Darchula District in far-western Nepal through 167 quantitative (58 harvesters, 38 sub-local traders, 25 local traders, 25 central wholesalers, and 21 regional wholesalers), 61 qualitative (15 sub-local traders, 19 local traders, 15 central wholesalers, and 12 regional wholesalers) interviews, and four focus group discussions. Results were compared to previously unpublished similar data for Darchula District for the year 1997-98, using quantitative and qualitative interviews with 10 local traders, 20 central wholesalers, and 53 regional wholesalers. Data analysis was guided by an analytical framework derived from Global Production Network theory. Quantitative data were used to estimate changes in 12 indicators while the qualitative information allowed identification of the factors driving observed changes in the indicators. RESULTS: The volume of medicinal plants traded from Darchula District in the fiscal year 2014-15 was 401 t with a harvester value of USD 5.5 million, representing a 2.3 fold increase in volume and 17.2 fold increase in value compared to 1997-98. Trade in the two observation years comprised 30 air-dried plant products (from 28 identified species as well as lichens and a mineral substance); 12 products were traded in both periods, while seven disappeared, and 11 new products entered the trade. The number of traders increased from 10 to 63, mainly due to the emergence of a single high value product yarsagumba (Ophiocordyceps sinensis), a fungus-caterpillar complex which alone contributed 85% of total trade value. Over the observed time period, harvesters and traders increased their margins at the cost of central wholesalers, indicating that market changes favoured lower tier actors, eroding the previously identified passive central wholesaler oligopsony in Nepal. Important drivers of market changes are: (i) rising incomes in China and India, expressed through demand for new products and increasing per unit prices for a range of products, (ii) expanding infrastructure (roads and telecommunications) towards and into harvesting sites, reducing transport costs and increasing market efficiency, and (iii) government interventions, causing disappearance of some species from trade. These market changes also led to increased cultivation at lower altitudes, and a sharp increase in the number of processor industries in Nepal. CONCLUSION: Trade in medicinal plant products in far-western Nepal in the past two decades has increased substantially, doubling in volume and increasing 17 fold in value. There is a backbone of constantly traded species but also species that disappear from trade and new species that enter. Changes favour harvesters and traders at the benefit of central wholesalers whose previous passive oligopsony is disappearing. The three main drivers of change are rising incomes in China and India, expanding infrastructure, and government interventions in Nepal. Commercial medicinal plant resources are a substantial asset that appears to offer opportunities for economic development in far-western Nepal. The trade, however, may pose sustainability threats that are best understood by combining species-level biophysical, trade, and consumer studies.

Twists, turns and trade: A new look at the Indian Screw tree (Helicteres isora).

ETHNOPHARMACOLOGICAL RELEVANCE: This is the first study of global trade in fruits of the widely used traditional medicine, Helicteres isora L. It is used in Ayurvedic, Siddha, Unani medical systems and/or local folk traditional medicines in Bangladesh, India and Pakistan. The roots are used in Traditional Chinese Medicines in China and the fruits in jamu products in Indonesia, Malaysia and Thailand. In addition, H. isora fruits are also used in "traditional" medical systems far beyond the natural distribution of this species, for example in Zulu herbal medicine (South Africa) and Kurdish herbal medicines (Iraq). AIMS OF THE STUDY: This study had three aims: (i) to assess the global trade in H. isora fruits; (ii) to study the H. isora trade from West Timor to Java in terms of actors and prices along the value chain and (iii) to get a better understanding of the potential of this species to improve household income in eastern Indonesia. MATERIALS AND METHODS: This study uses historical records, a contemporary analysis of global trade data (2014-2016) and field assessments of value chains and the biological factors influencing H. isora fruit production. RESULTS: Globally, the major exporter of H. isora fruits is India, which exports H. isora fruits to 19 countries, far beyond the natural geographical distribution of this species. Over a 36-month period (January 2014-December 2016), India exported 392 t of H. isora fruits, with a Free-On-Board (FOB) value of Indian rupiah (INR) 18,337,000 (US$ 274,055). This represents an average annual export quantity of about 130,526 kg/year. Over this three year period, most of these exports (85.5%) were to Indonesia (346.58 t), followed by Thailand (6.85%). Indian H. isora exports are also used in many other medical systems, including Kurdish and Zulu "traditional" medicines in Iraq and South Africa. Formation of an Indian diaspora in Bahrain, Mauritius, South Africa, Tanzania and Trinidad and Tobago over the past 130 years is one of the drivers of H. isora fruit trade outside the natural geographic distribution of the species. In Indonesia, demand for H. isora fruits is supplemented by an intra-island trade in Java and an inter-island trade from East Nusa Tenggara. West Timor, for example, exports around 31-37 t of air-dried H. isora fruits per year to Java. At the farm gate, local harvesters in West Timor get 4000 IDR (c. 0.3 US$) per kg, with businesses in Java paying 25,000 IDR (c.US$2) per kg for H. isora fruits. This is similar to the price paid for H. isora fruits imported from India to Java. CONCLUSIONS: India is the major exporter of whole dried H. isora fruits, including to countries where this species has never been in traditional use. In Indonesia, H. isora fruit extracts are used in the cosmetic industry as well as in jamu herbal medicines, including "Tolak Angin", the country's most popular commercial "jamu" preparation. Indonesia also is the major importer of H. isora fruits from India. In eastern Indonesia, improved income to local villagers from the H. isora fruit trade could come from improved H. isora fruit quality due to better drying techniques. This would also reduce health risks along the supply chain from to mycotoxins that have been recorded on poorly dried H. isora fruits. There also is an opportunity for cultivation of H. isora in small-holder teak plantations in Indonesia, with harvest of H. isora fruits as well as the medicinal bark.

The commercialization of traditional medicine in modern Cambodia.

Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients' financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine's popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country.

USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.

Ayurvedic medicine in Mauritius: Profile of Ayurvedic outlet, use, sale, distribution, regulation and importation.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurvedic medicine (AM) is a legalised alternative traditional medical system in the multicultural tropical island of Mauritius. A panoply of Ayurvedic specialised shops/centres involved in the provision of Ayurvedic services hereafter termed as 'outlets' operates in different regions of the island and is extensively exploited by a significant number of Mauritians. Nonetheless, there is currently no study geared towards studying the status of AM and profile of Ayurvedic outlets in Mauritius and there is undoubtedly a dearth of standardized regulatory framework governing the practice of AM in Mauritius. The present study attempts to study the profile of Ayurvedic outlets, sale, distribution, regulation and importation of AM in Mauritius. AIM OF STUDY: To evaluate the characteristics profile of Ayurvedic shops/clinics/pharmacies/centres, to document common Ayurvedic products used in the treatment and management of diseases, and to analyse existing regulatory control of AM in Mauritius. MATERIAL AND METHODS: Ayurvedic outlets were identified using a random approach. Once permission granted, outlets were visited where face-to-face interviews with Ayurvedic practitioners/directors/dispensers were undertaken using a semi-structured questionnaire. The characteristics of the outlets with respect to the type of business registration, procurement and dispensing of products, registration and qualification of personnels employed amongst others were studied. The International Classification of Diseases (ICD) 10 was used to classify common AM dispensed to patients. Additionally, information was sought from local authorities pertaining to existing legislation governing the importation and regulation of AM in Mauritius. RESULTS: A total of 16 Ayurvedic outlets ('pharmacies' (n=3), clinics (n=2), shops (n=5) and centres (n=6)) was surveyed. Six outlets dispensed AM strictly on prescription only after consultation with an onsite full-time employed registered Ayurvedic practitioner. Seven outlets offered AM both on prescription and over-the-counter where consultation was not mandatory. The remaining three outlets, where no Ayurvedic practitioner was employed, did not offer consultation at any time and dispensed the medicines over-the-counter most of the time. There is currently no such legal framework that acknowledges the existence of an Ayurvedic pharmacy in Mauritius and no trained Ayurvedic pharmacist was recruited in any of the outlets. It was also found that no specific requirements were in place to establish an Ayurvedic outlet in Mauritius. A wide variety of Ayurvedic formulated and single herb products were recorded to be in use against common diseases. Ayurvedic products were imported from India (n=10), purchased from local suppliers (n=6) or locally manufactured (n=1). The Traditional Medicine Board under the aegis of the pharmacy board is a regulatory body which requires Ayurvedic practitioners to be registered so as to practice AM in Mauritius. Additionally, the government has an Ayurvedic committee, under the aegis of the Pharmacy board in the Ministry of Health and Quality of Life to monitor the importation of AM. However, no legal framework has been enacted to regulate the sale of AM under prescription or under the supervision of an Ayurvedic practitioner. CONCLUSION: The current regulatory framework is such that the sale/use/distribution of AM is not strictly controlled unlike its importation. This has led to a certain form of unregulated practice in the private sector whereby the dispensing and sale of AM are being done over-the-counter without professional recommendations. It is recommended that authorities need to regulate the Ayurvedic medical system in Mauritius by amending stringent laws to ensure safety of patients.

Popular Medicine and Empirics in Greece, 1900-1950: An Oral History Approach.

Western literature has focused on medical plurality but also on the pervasive existence of quacks who managed to survive from at least the eighteenth to the twentieth century. Focal points of their practices have been their efforts at enrichment and their extensive advertising. In Greece, empirical, untrained healers in the first half of the twentieth century do not fit in with this picture. They did not ask for payment, although they did accept 'gifts'; they did not advertise their practice; and they had fixed places of residence. Licensed physicians did not undertake a concerted attack against them, as happened in the West against the quacks, and neither did the state. In this paper, it is argued that both the protection offered by their localities to resident popular healers and the healers' lack of demand for monetary payment were jointly responsible for the lack of prosecutions of popular healers. Moreover, the linking of popular medicine with ancient traditions, as put forward by influential folklore studies, also reduced the likelihood of an aggressive discourse against the popular healers. Although the Greek situation in the early twentieth century contrasts with the historiography on quacks, it is much more in line with that on wise women and cunning-folk. It is thus the identification of these groups of healers in Greece and elsewhere, mostly through the use of oral histories but also through folklore studies, that reveals a different story from that of the aggressive discourse of medical men against quacks.

Current Perspective in the International Trade of Medicinal Plants Material: An Update.

BACKGROUND: The recent years have seen an increased interest in medicinal plants together with the therapeutic use of phytochemicals. Medicinal plants are utilized by the industry for the production of extracts, phytopharmaceuticals, nutraceuticals and cosmeceuticals and their use is expected to grow faster than the conventional drugs. The enormous demand of medicinal plant material has resulted in huge trade both at domestic and international levels. METHODS: The trade data of medicinal plant material with commodity code HS 1211 (SITC.4, code 292.4) and their derived/related products which are traded under different commodity codes has been acquired from COMTRADE, Trade Map, country reports, technical documents etc for the period 2001 to 2014. The data was analyzed using statistical tools to draw conclusions. RESULTS: The significant features of the global trade; the leading source, consumer, import and export countries; and the striking trends are presented. The trade of the ten key countries and the selected important items is also discussed in detail. The conservative figure of trade of medicinal plants materials and their derived/related products including extracts, essential oils, phytopharmaceuticals, gums, spices used in medicine, tannins for pharmaceutical use, ingredients for cosmetics etc. as calculated from the global export data for the year 2014 is estimated at USD 33 billion. The average global export in medicinal plants under HS 1211 for the fourteen year period was USD 1.92 billion for 601,357 tons per annum and for the year 2014 it stood at 702,813 tons valued at USD 3.60 billion. CONCLUSION: For the studied period, an annual average growth rate (AAGR) of 2.4% in volumes and 9.2% in values of export was observed. Nearly 30% of the global trade is made up by top two countries of the import and export. China and India from Asia; Egypt and Morocco from Africa; Poland, Bulgaria and Albania from Europe; Chile and Peru from South America are important supply sources. The USA, Japan and Europe are the major consumers of the world.

Bioactive Compounds from Plants Used in Peruvian Traditional Medicine.

It is estimated that there are as many as 1400 plant species currently used in traditional Peruvian medicine; however, only a few have undergone scientific investigation. In this paper, we make a review of the botanical, chemical, pharmacological and clinical propierties of the most investigated Peruvian medicinal plants. The plant species selected for this review are: Smallanthus sonchifolius (yacon), Croton lechleri (sangre de grado), Uncaria tomentosa/U. guianensis (uña de gato), Lepidium meyenii (maca), Physalis peruviana (aguaymanto), Minthostachys mollis (muña), Notholaena nivea (cuti-cuti), Maytenus macrocarpa (chuchuhuasi), Dracontium loretense (jergon sacha), Gentianella nitida (hercampuri), Plukenetia volubilis (sacha inchi) and Zea mays (maiz morado). For each of these plants, information about their traditional uses and current commercialization is also included.