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West African Herbal Pharmacopoeia West African Health Organisation (Waho) WEST AFRICAN HEALTH ORGANISATION (WAHO) WEST AFRICAN HERBAL PHARMACOPOEIA WEST AFRICAN HEALTH ORGANISATION (WAHO) WEST AFRICAN HERBAL PHARMACOPOEIA @2020 WAHO WEST AFRICAN HEALTH ORGANISATION (WAHO) BOBO-DIOULASSO (BURKINA FASO) Tel. (226) 20 97 57 75/Fax (226) 20 97 57 72 E-mail : [email protected] Web Site : www.wahooas.org All rights reserved: No part of this publication is to be reproduced or used in any form or by any means – graphic, electronic or mechanical, including photocopying, recording, taping or information storage or retrieval systems, without written permission of the Director General, West African Health organization. WEST AFRICAN HERBAL PHARMACOPOEIA WAHP 2020 TABLE OF CONTENTS CONTENTS III FOREWORD IV PREFACE VI INTRODUCTION VIII MONOGRAPHS 1 ABRUS PRECATORIOUS 2 ACANTHOSPERMUM HISPIDUM 11 ANACAARDIUM OCCIDENTALE 21 ANNONA SENEGALENSIS 34 CALOTROPIS PROCERA 45 CASSIA SIEBERIANA 60 CHROMOLAENA ODORATA 69 CHRYSANTHELLUM INDICUM 79 CITRUS PARADISI 88 COCHLOSPERMUM TINCTORIUM 100 COMBRETUM GLUTINOSUM 110 DANIELLIA OLIVERI 119 EUPHORBIA POISONII 128 FLUEGGEA VIROSA 136 GARDENIA TERNIFOLIA 146 GUIERA SENEGALENSIS 155 JATROPHA GOSSYPIFOLIA 166 NEWBOULDIA LAEVIS 177 OLAX SUBSCORPIOIDEA 186 PAVETTA OWARIENSIS 197 PILIOSTIGMA THONNINGII 204 PLUMBAGO ZEYLANICA 213 POLYALTHIA LONGIFOLIA 222 SANSEVIERA LIBERICA 231 STROPHANTHUS GRATUS 240 TERMINALIA MACROPTERA 248 THEVETIA PERUVIANA 258 VISMIA GUINEENSIS 266 VITEX DONIANA 274 XIMENIA AMERICANA 283 ANNEXE 292 WAHO III WEST AFRICAN HERBAL PHARMACOPOEIA WAHP 2020 FOREWORD Globally, the use of traditional medicine (TM), particularly herbal medicines, has surged over the past two decades, with many people now resorting to it for treatment of various health conditions. For example, in Europe, the use of TM ranges from 42% in Belgium to 90% in the United Kingdom; and from 42% in the USA in adults and 70% in Canada. In Africa, TM usage ranges from 60% in Uganda and the United Republic of Tanzania; 70% in Ghana and Rwanda; to 80% in Benin and 90% in Burundi and Ethiopia. The fast-growing demand for TM worldwide therefore calls for harmonized monographic standards to safe- guard the safety and quality of the products, to foster consumer confidence and to improve access to es- sential medicines. In 1978, the World Health Assembly adopted resolution WHA31.33 on Medicinal Plants, which called upon WHO to coordinate the efforts of Member States to develop and apply scientific criteria and methods for proof of safety and efficacy of medicinal plant products, and develop appropriate international standards and specifications, especially for galenicals and manufacturing practices. In pursuance of this policy di- rective, WHO published guidelines for registration of TM products and monographs on selected medicinal plants. WHO monographs, however, are not pharmacopoeia monographs; rather they are comprehensive scientific references, which aim to: (a) provide scientific information on the safety, efficacy, and quality control of widely used medicinal plants; (b) provide models to assist Member States in developing their own monographs or formularies for these and other herbal medicines; and (c) facilitate information exchange among countries. In 2013, the West African Health Organisation (WAHO) published the First Volume of the West African Her- bal Pharmacopoeia (WAHP), a legally-binding collection of standards and quality specifications for medi- cines used in the Economic Community of West African States (ECOWAS). The First Volume of the WAHP contains 55 monographs of medicinal plants commonly used in the region for treating the six WHO desi- gnated priority diseases (HIV/AIDS, tuberculosis, hypertension, diabetes, malaria and sickle cell anaemia). Interestingly, unlike the First Volume, the Second Volume contains 30 monographs, primarily focused on medicinal plants with antiviral potential against some of the most deadly viral infections of the modern era. For example, the medicinal plants: Euphorbia poissonii, Fluggea virosa and Piliostigma thonningii have been shown to have the ability to treat opportunistic infections related to HIV/AIDS. Nevertheless, there appears to be no research studies on the therapeutic potential of any of the plants featured in the Second Volume of the WAHP for treating emerging or re-emerging diseases. But, since a number of these plants have chemical constituents that are antiviral, it is likely that a well formulated com- position containing some of them may prove useful in the treatment of emerging and re-emerging diseases. As part of WHO’s response to the novel coronavirus outbreak, the WHO Blueprint for R&D has been ac- tivated to accelerate the development of diagnostics, vaccines and therapeutics. The Blueprint also reco- gnizes behavioural change interventions, and initiatives to fill critical gaps in scientific knowledge, to allow the design of better disease control measures. This therefore provides an opportunity for West African TM research scientists to pursue rigorous R&D activities aimed at contributing to the search for effective remedies for treating emerging diseases, such as Nipah virus, Crimean-Congo haemorrhagic fever, avian influenza A (‎H5N1)‎, Ebola virus disease, Marburg, Lassa fever, Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), and Rift Valley fever. IV WAHO WEST AFRICAN HERBAL PHARMACOPOEIA WAHP 2020 The first and Second Volumes of the WAHP are useful additions to the Herbal Pharmacopoeias available in West Africa, developed by national governments of Ghana (1992, 2007 and 2015), Nigeria (2008) and Cote d’Ivoire (2019), as well as a Multilingual Dictionary and Monographs of African medicinal plants for eight West African Member States (2012). Preparing the Second Volume of the WAHP involved a fourteen-member Pharmacopoeia Development Committee selected from the ECOWAS Member States. The members of this Committee comprised of experts in Anthropology/Sociology; Botany/Ethnobotany; Communication Experts; Information Technology Specialists; Pharmacognosy; Pharmacology; Public Health; Research; Toxicology; as well as Traditional Medicine Practitioners and Medical Herbalists. They were assisted by eight ex-officio members including staff from WHO/AFRO. It is my hope that other RECs will follow the footsteps of ECOWAS to develop herbal pharmacopoeias for ensuring the identity, purity, and quality of medicinal plants in their sub-regions. I recommend that the ECOWAS Member States use the monographs of the Second Volume of the WAHP for quality control, trai- ning and local manufacturing of TM products. This will contribute to improving access to essential medicines in accordance with one of the objectives of UHC which is now more urgent than before, given the frequent pandemic of emerging infectious diseases. Dr Matshidiso Rebecca Moeti WHO Regional Director for Africa WAHO V WEST AFRICAN HERBAL PHARMACOPOEIA WAHP 2020 PREFACE In its 2014-2023 Traditional Medicine Strategic Document, the World Health Organization (WHO) sets out two major objectives - to support countries seeking to harness the contribution of traditional medicine to health and wellbeing, and to promote the safe and effective use of traditional medicine through regulation. Since 2010 however, the West African Health Organisation (WAHO) has championed the recognition and promotion of rational traditional medicine practices by Member States of the Economic Community of West African States (ECOWAS). Member States are encouraged and supported to document, validate and regu- late the use of plant and herbal medicines in the region. Traditional medicine is now included as a module in the training curriculum of many medical schools in the region, and a dedicated traditional medicine day is celebrated annually in each country. This deliberate policy is a reflection of the political determination of ECOWAS Heads of State and Govern- ment to improve access in the region to quality medicinal plants with established therapeutic benefits. As part of the policy, WAHO published in 2013 the first West Africa Pharmacopoeia of Herbal Medicines which was adopted in April 2014 by the 15th Ordinary Session of the Assembly of ECOWAS Health Ministers in Monrovia, Liberia. It identifies several traditional herbs and plants of medicinal efficacy in the region and specifies the criteria and methods of analysis to be used to guarantee the quality, safety and potency of the medicinal plants. The second volume of the West African Pharmacopoeia of Herbal Medicines is now available. And conti- nuing the practice with the first, this second volume was again prepared by a multidisciplinary team of pro- fessionals that included traditional medicine practitioners, herbalists, experts in pharmacognosy, pharmaco- logists, toxicologists, botanists, ethno-botanists, anthropologists, sociologists and public health physicians. The team was supported by IT and communication specialists. Specific objectives were set for the multi- disciplinary team of experts, in line with the instruction of ECOWAS Ministers of Health that WAHO should regularly produce monographs of plants for treating common and newly-emerging diseases in the region. Preparation of the Pharmacopoeia therefore involved documentation of emerging and re-emerging public health diseases in West Africa, a review of the socio-anthropological studies on the uses of medicinal plants for treating such diseases, and a literature survey of all available data on the selected medicinal herbs and plants. A detailed
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