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Medicinal and Aromatic

THE AMERICAS

Mahabir P. Gupta

Sukhdev Swami Handa

Gennaro Longo

Dev Dutt Rakesh Editors

Mahabir P. Gupta, Profesor Titular de Farmacognosia y Director de Centro de Investigaciones Farmacognósticas de la Flora Panameña, Facultad de Farmacia, Universidad de Panama, Panama, Republica de Panama

Sukhdev Swami Handa, International Consultant, Industrial Utilization of Medicinal and Aromatic Plants, Environment, ICS; Scientific Adviser Emami Group of Companies, Health Care Products Division, Kolkata, India

Gennaro Longo, Chief of Environment Area, Special Adviser on Technology Development, ICS

Dev Dutt Rakesh, International Consultant, Industrial Utilization of Medicinal and Aromatic Plants, Environment, ICS Acknowledgments

Special thanks to the work done by Mr. Mohd Shahidan Mohamad Arshad, ICS Fellow during 2011, for his constant support in updating and reviewing the information received by the authors and by the experts contacted in the different countries, as well as to Ms. Elisa Maria Sarti, staff of ICS, who followed the compilation, preparation and editorial work of the volume.

We acknowledge, with thanks, the help received from the following persons in reviewing and updating the compiled information on the medicinal and aromatic plants of their respective countries.

South America

Ms. Susana Zacchino, Universidad Nacional de Rosario, Rosario, (Argentina) – [email protected]

Mr. Alberto Giménez, Universidad Mayor de San Andrés, La Paz, (Bolivia) – [email protected]

Ms. Thereza Christina Monteiro de Lima, ICS MAPs National Focal Point, Department of Pharmacology, Federal University of Santa Catarina, Florianopolis (Brazil) – [email protected]

Ms. Gloria Montenegro, ICS MAPs National Focal Point, Facultad de Agronomía e Ingeniería Forestal, Pontificia Universidad Católica de , Santiago (Chile) – [email protected]

Mr. Gabriel Jaime Arango, Universidad de Antioquia, Medellin (Colombia) - [email protected]; [email protected]

Mr. Esteban Ferro, Universidad Nacional de Asunción, Asuncion (Paraguay) – [email protected]

Ms. Olga Lock, Pontificia Universidad Católica de Perú, Lima (Peru) – [email protected]

Mr. Stephen Tillett, Herbario “Ovalles” (MYF), Facultad de Farmacia, Universidad Central de Venezuela, Caracas (Venezuela) – [email protected]

3 North and

Ms. Alice Pérez, ICS MAPs National Focal Point, Natural Products Research Centre, CIPRONA, San Jose (Costa Rica) – [email protected]

Ms. Marlene Porto and Mr. René Delgado, National Center for Drug Research and Development, CIDEM, Havana, (Cuba) – [email protected]; [email protected]

Mr. Manuel Antonio Vázquez Tineo, Mr. César Lozano (Puerto Rico) – (Dominican Republic) – [email protected]; [email protected]

Mr. Armando Cáceres, Universidad de San Carlos, y Farmaya. S.A., (El Salvador, Guatemala y Honduras) – [email protected]

Mr. Robert Weniger, Universidad de Strasbourg, Strasbourg, France (Haiti) – [email protected]; [email protected]

Mr. Mahabir Gupta, ICS MAPs National Focal Point, Centro de Investigaciones Farmacognósticas de la Flora Panameña, Facultad de Farmacia, Universidad de Panama, Panama (Panama) – [email protected]

Mr. César Lozano, Universidad de Puerto Rico (Puerto Rico) – [email protected]

Ms. Angela Margaret Ishmael-Severin, Forestry Department, Ministry of Agriculture, Forestry and Fisheries, Dept. Castries (Saint Lucia) – [email protected]

Mr. Compton Seaforth, The Caribbean Herbal Medicine Research Institute, The University of Trinidad & Tobago, Waterloo Research Centre, Trinidad (Trinidad and Tobago) – [email protected]

The Compendium of Medicinal and Aromatic Plants provides policy-makers, the scientific community and entrepreneurs with comprehensive information on the medicinal and aromatic sector on a continental basis. It has been divided into four volumes: Africa, Asia, Europe and The Americas. The information compiled will encourage strategic partnerships in scientific research and business alliances.

This volume presents an overview of qualitative and quantitative data on medicinal and aromatic plant resources, the status of their use in traditional systems of medicine and R&D activities in thirty-seven American countries. 4 Preface

The Americas are the lands of the Western hemisphere or New World, consisting of the continents of North America and South America with their islands and regions. The Americas cover 8.3% of the Earth’s total surface area and contain about 14% of the human population.

International and national trade in alternative medicine including herbal products is nearly USD 70 billion. The estimated global trade in medicinal and aromatic plants and their products wasUSD250 billion in 2000, and is expected to reach USD 5trillion by 2050 according to the World Bank report. China, France, Germany, Italy, Spain, the United Kingdom, and United States of America are the important global market for MAPs.

An enhanced global interest in the use of MAPs and the increasing demand of the raw materials by pharmaceutical, nutrition, cosmetic and perfumery industries have resulted in a vast and expanding market in the last two decades. Estimates suggest that, in the US and Europe, the trade has typically been growing at the average of 10% per year, driven by the popularity of MAPs based products and the increasing official recognition of the benefits of traditional medical systems involving herbal preparations.

The American flora represents one of the world’s wealthiest sources of material with pharmacological activity. Historical records demonstrate that Americans have used several medicinal plant species for thousands of years. The Spanish and the Portuguese introduced several American plant species to other part of the world and, also transported them in great quantities to Europe.

In spite of the very rich natural resources, the American countries have not used their rich biodiversity in a proper way to benefit their own development. Furthermore, because of the uncontrolled exploitation, most of the relevant areas of these countries biodiversity are being reduced rapidly, and important plant species are disappearing. Despite the many individual efforts of the governments to preserve the biodiversity for future generations, the traditional knowledge, especially that derived from traditional medicine is fast disappearing in the rural American communities.

There are considerable differences in the kinds of policies and regulations that have been developed. Many countries have regulation and registrations systems for herbal medicines, yet a number of countries still developing similar laws, regulations or national policies on TM/CAM. However, the number of countries having expert groups, national research institutes and national offices is much higher, indicating such policies and regulations are being developed, or will be developed in the near future. The MAPs pharmaceutical industry is in the early stages in many of the Americas countries. Due to

5 lack of reliable information on the trade statistics, it is very difficult to estimate the American market of MAPs and their products.

A number of international organization such as the Food and Agriculture Organization (FAO), the United Nations Industrial Development Organization (UNIDO), The World Health Organization (WHO), the International Development Research Centre (IDRC), among others, have been addressing the issues concerning medicinal and aromatic plants through support for research, networking and coordination. Some American nations are now developing national policies on traditional medicines to cover quality and safety. Furthermore, many countries have also ceased collection from natural sources. However, despite these efforts, commercial exploitation, unsustainable use, cultural changes, and lack of the institutional support have threatened the existing MAPs resources and traditional knowledge. Also, in depth biodiversity studies have yet to be completed in many countries and coordination among the various institutes working on medicinal plants and traditional medicines is still lacking. These are necessary to sustainably exploit MAPs resources for commercial use.

The International Centre for Science and High Technology (ICS-UNIDO) has prepared this Compendium of Medicinal and Aromatic Plants of the Americas to present the status of the medicinal and aromatic plants in each American country. It provides valuable information on traditional systems of medicine, government efforts to promote them, medicinal and aromatic plant resources, research and development activities, trade, and the major challenges faced by sustainable commercial exploitation.

This document should help these nations to improve the health and living standards of individuals using these resources and assist those who promote traditional systems of medicine.

6 Contents

Introduction

1. The Status of Medicinal and Aromatic Plants in South America

Argentina...... 35 - 45 Bolivia...... 46 - 53 Brazil...... 54 - 70 Chile...... 71 - 93 Colombia...... 94 - 102 Ecuador...... 103 - 125 Guyana...... 126 - 128 Paraguay...... 129 - 150 Peru...... 151 - 169 Suriname...... 170 - 175 Uruguay...... 176 - 184 Venezuela...... 185 - 197

2. The Status of Medicinal and Aromatic Plants in North and Central America

Antigua and Barbuda...... 198 - 202 Bahamas...... 203 - 206 Barbados...... 207 - 211 ...... 212 - 216 Canada...... 217 - 226 Costa Rica...... 227 - 237 Cuba...... 238 - 259 Dominica...... 260 - 264 Dominican Republic...... 265 - 275 El Salvador...... 276 - 279 Grenada...... 280 - 282 Guatemala...... 283 - 292 Haiti...... 293 - 297 Honduras...... 298 - 308 Jamaica...... 309 - 315 ...... 316 - 322 Nicaragua...... 323 - 326 Panama...... 327 - 360

7 Puerto Rico...... 361 - 365 Saint Kitts and Nevis...... 366 - 369 Saint Lucia...... 370 - 375 Saint Vincent and the Grenadines...... 376 - 379 Trinidad and Tobago...... 380 - 385 United States of America...... 386 - 397 United States Virgin Islands...... 398 - 400 References...... 401 - 411

8 Introduction

The Americas are the lands of the Western hemisphere or New World, consisting of the continents of North America and South America with their associated islands and regions. The Americas cover 8.3% of the Earth’s total surface area (28.4% of its land area) and contain about 14% of the human population (about 900 million people).

North America, Central America and the Caribbean together contain about 549 million hectares of , corresponding to 14% of the world with 1.1 hectares of forest per capita, which is above the world average. Some 86% of the region’s forests are in Canada and the United States. South America contains about 885 million hectares of forests which corresponds to 23% of the world forests. South American forests amount to 2.6 hectares per capita, which is considerably above the world average. Almost all forests are located in the tropical ecological domain and South America has about 54% of all tropical rain forests and the proportion of forest cover in the tropical rain forest zone is 82%. Forest plantations represent just 1% of the total forest cover.

The forest has important symbolic and cultural value with certain sites having particular spiritual or cultural significance besides various products are harvested from these forests including plants for food and medicinal uses. Throughout the Americas there is increasing commercial demand for non‐wood forest products including MAPs (FAO, 2000).

The use of medicinal plants as drugs is widespread in the Americas and in some countries of South America this may amount to about 70% of the population (Gupta and Caceres, 2003) using medicinal plants and their products.

The American flora represents one of the world’s wealthiest sources of material with pharmacological activity. Historical records demonstrate that Amerindians used several species of plants such as avocado (Persea americana Mill.), potatoes (Ipomoea batatas (L.) Lam), mate (Ilex paraguariensis A. St.‐Hil.) and cacao (Theobroma cacao L.) thousands of years ago. The Spanish and the Portuguese introduced several American plant species to other parts of the world and, according to historical records, plants were also transported to Europe in large quantities since 16th century (Brandao, et al., 2008).

In North America, forest harvested plants used for their therapeutic value are marketed either as medicines or as dietary supplements. Plants that have been tested for safety and efficacy and meet US‐FDA standards are marketed as drugs. Some well-known examples of plant derived medicines include digitalis from Digitalis purpurea L. (foxglove), lobeline from Lobelia inflata L. (Indian‐tobacco) and taxol from Taxus canadensis Marshall

9 (Pacific yew). More than 25 tree species, 65 herbaceous plants, and 29 that have been listed by the United States Pharmacopoeia. Table 1 lists some well‐known species marketed as dietary supplements in this country (Chamberlain et al., 1998).

Traditional Medicines in North, Central and South America

At the time of America’s discovery, Europe was still in the throws of barbarous middle Ages, whilst the Aztec civilization that the Spaniards encountered was at its flourishing height. The Aztecs and Maya not only knew and used many different kinds of healing plants but also had various types of medical practitioners who specialized in different kinds of illnesses. There were hospitals where the sick could be isolated from the rest of the community and given specialist’s care and attention.

In the Americas the knowledge and practice of traditional medicine is as diverse as its cultural heritage and botanical diversity. The region is rich not only in the diversity of plants resources, but is equally rich in cultural diversity. The number of plants used for medicines in different ways by different people is endless. Traditional curanderos or yerbaristes are often found selling their wares at market stalls. Many forest workers, such as the chicleros, still rely heavily on the plants they find in the forest, for medicine, for food and for other needs. In rural areas poverty and the remoteness of the communities have been contributing factors in preserving traditional plant knowledge that is quite ancient and was well developed by the first European settlers in the Americas (Morgenstern, 2001).

In the US, during most of the 20th century, herbs or botanicals have been regarded with skepticism and the practice of herbal medicine went into decline. Plants were viewed mainly as a potential source of pure chemical compounds for the development of medicine. In recent years, the herbs and botanicals have become very popular in the US and Canada; however, they are still considered as nutritional supplements rather than medicines.

The Central and South American countries just like Africa have rich and diverse healing cultures, which are poorly known and have not been properly recorded. Traditional Indian medicinal herbs are also used extensively here by the African, European, and Spanish (Gurib‐Fakim, 2006).

Various healing traditions have merged to a greater or lesser extent, though regional and cultural differences do still exist. People use plants as per their knowledge of healing properties for simple health problems and grow them in their gardens or collect

10 from field and forests. For the serious systemic diseases, the help of a curandero is sought, who are skilled in the uses of medicinal plants and that they learn from their ancestors.

There are a number of methods used by indigenous people in Central America that may seem quite strange to many of us today, though in the past similar methods were also a common part of traditional European herbalism. Some practitioners specialize in the treatment of snakebites while older women frequently act as midwifes. Many people in Central America still adhere to ancient beliefs concerning the spirit world. The matters of this sort are usually dealt with by priests, diviners or shamans. The types of plants used to treat various kinds of illnesses very much depend on seasonal and local availability. The plants like wild pineapple (Bromelia pinguin L.), papaya (Carica papaya L.), coconut (Cocos nucifera L.), mangoes (Mangifera indica L.), avocado‐tree (Persea americana Mill.), allspice (Pimenta dioica (L.) Merr.) and corn (Zea mays L.) besides their food value are popularly used throughout the region for their medicinal properties (Morgenstern, 2001). Some other commonly used MAPs of the region include Cinchona pubescens Vahl (Peruvian bark), Erythroxylum coca Lam. (Coca), Ilex paraguariensis A. St.‐Hil. (Mate´), Myroxylon balsamum (L.) Harms (Tolu balsam), Paullinia cupana Kunth (Guarana), Peumus boldus Molina (Boldo), L. (Guava), Spilanthes acmella (L.) L. (Brazilian cress), Tabebuia impetiginosa (Mart. ex DC.) Standl. (Lapacho) and Uncaria tomentosa (Willd. Ex Schult.) DC. (Cat’s claw). There are hundreds of such plants being used on daily basis (Gurib‐Fakim, 2006). The ten most commonly used herbs in the United States in 2001 along with their medicinal uses and sales are listed in Table 2 (Bent and Ko, 2004). The first European settlers learnt from native Americans and adopted many of the herbal remedies, which later formed the basis of the Pharmacopeia of the United States. Much of the knowledge gained from native Americans is the foundation of the herbal medicinal industry today in the United States. In the late 1600s many herbal remedies used by Native Americans had been identified. Different reporter listed plant species of medicinal value to Native Americans tribes. Some of these plants include Agrimonia eupatoria L. (agrimony), Althaea officinalis L. (marshmallow), Baptisia tinctoria (L.) R. Br. (wild indigo), Polygonatum biflorum (Walter) Elliott (solomon’s seal), Sassafras albidum (Nutt.) Nees (sassafras) and Spigelia marilandica (L.) L. (snakeroot). Echinacea (Echinacea purpurea (L.) Moench) and Goldenseal (Hydrastis canadensis L.).

The discovery of synthetic drugs changed the MAPs industry in the early 1900s. There was an almost total rejection of medicinal plant remedies and a shift to synthetic drugs during the beginning of this century. However, in the early 1990s, a series of major factors helped spark a renewed interest in MAPs. The medical research findings helped to increase their demand. The positive results of taxol from Pacific yew on various cancers greatly increased demand for this drug. By 1994, taxol was approved by the FDA for treatment of ovarian cancer and some forms of breast cancer. Further interest in herbal

11 medicinal products was spawned by a 1993 Harvard Medical School study, which reported that millions of Americans regularly used alternative medicines. Further fuelling the renewed interest in botanical medicines were reports by reputed journals on the benefits of plants like Ginkgo biloba L. (slow dementia) and Hypericum perforatum L. (Fight depression), respectively. (Chamberlain et al., 1998).

In the Americas, there are considerable differences in the kinds of policies and regulations that have been developed. Many countries have regulation and registration systems for herbal medicines, yet the number of countries developing similar laws, regulations or national policies on TM/CAM is relatively small. However, the number of countries having expert committees, national research institutes and national offices is much higher, that mean such policies and regulations are being developed, or will be in the future (WHO, 2005).

Medicinal and Aromatic Plant Resources

Central America and the Caribbean are geographical regions known for their biological and cultural diversity. They are characterized by unique concentrations of plant species, and the tropical moist forests are classified among those with greatest habitat diversity worldwide. The floristic diversity of the Caribbean, presents a complex combination of elements of the continental ecosystems of North and South America, exotic species, as well as endemic plants. Islands of volcanic origin, like Cuba, the Dominican Republic and Haiti represent bio‐geographic areas with high numbers of endemic species (Cuba almost 50% of endemic species) (Sonia Lagos‐Witte, 2006).

Latin American countries have dozens of thousands of plants species and possess great part of the world’s biodiversity. Brazil alone possesses about 20–22% of all existing plants and micro‐organisms. However, not more than 25,000 plant species have been subjected to any scientific investigation (Calixto, 2005). These countries export significant quantities of crude drugs mainly in the dried form and to some limited extend, as simple extracts and even pure drug entities. These plants are mainly gathered from wild sources. Only a few countries like Brazil, Cuba and Guatemala, among others have some organized programmes for cultivation of a selected number of medicinal plants (Gupta and Caceres, 2003).

The most important medicinal plants cultivated in North America for domestic use in dietary supplement products (US) and/or natural health products (Canada) as well as for export include Allium sativum L. (garlic), Aloe vera (L.) Burm. f. (aloe), Capsicum spp. (cayenne), Echinacea purpurea (L.) Moench, Humulus lupulus L. (hop), Linum usitatissimum L. (flax), Mentha piperita L. (peppermint), Oenothera biennis L. (evening primrose), Panax

12 quinquefolius L. (American ginseng), and Tanacetum parthenium (L.) Sch. Bip. (feverfew). The most important wild‐collected medicinal plants in North America include Actaea racemosa L. (black cohosh), Echinacea angustifolia DC. root, E. pallida (Nutt.) Nutt., Frangula purshiana (DC.) J. G. Cooper (cascara sagrada), Hydrastis canadensis L. (goldenseal), Passiflora incarnata L. (passionflower), Serenoa repens (W. Bartram) Small (saw palmetto), and Ulmus rubra Muhl. (slippery elm).

The supplies for most North American botanical raw materials both the wild crafted and cultivated have been affected due to various reasons. For the wild crafted medicinal botanicals loss of habitat from development, logging operations, conversion of prairie to pasture, environmentalists and government agencies concerned with threatened or endangered species, collection by the ornamental plant trade, and to a lesser extent from the medicinal plant wild crafters themselves are the major factors. Many experienced wild crafters have given up the trade in recent seasons due to some or all of the aforementioned obstacles to trade. There is also concern that very few young wild crafters are learning the trade as the older experienced collectors are retiring. The quantity and quality of North American wild crafted medicinal plants is expected to decline if these trends continue.

Growers of medicinal botanicals for the phyto-pharmaceutical and dietary supplement industries, are also currently facing problems. During the industry’s high growth years of the mid to late 1990’s many growers planted, cultivated and harvested crops under contracts (mostly perennial crops taking more than one year before realizing a return on investment). Subsequently, a number of end‐user companies did not honor their contractual commitments as the boom years came to an end. As a result newer farm operations did not diversify sufficiently and are struggling to stay afloat, while some who depended too heavily on single medicinal plant crops have lost their farms entirely (ITC, 2002). A list of important medicinal and aromatic plants of the Americas with their respective source countries is given in Table 1 (Table missing) (Gupta and Caceres, 2003; Falcao et al., 2008).

13 Figure 1: Some important MAPs of the Americas

Aesculus hippocastanum L. Bixa orellana L.

Capsicum frutescens L. Cassia fistula L.

14 Hypericum perforatum L. Lippia alba (Mill.) N.E.Br.

Lippia dulcis Trevir Panax quinquefolius L.

15 Peumus boldus Mol. Pimpinella anisum L.

Quillaja saponaria Mol. Salvia spp.

16 Tanacetum Zingiber officinale Roscoe parthenium (L.) Sch.Bip.

17 Research and Development Activities

There are only a few countries of South American region that have National Commissions on the Utilization of Medicinal Plants or have National Research Programs for their study. However, the majority of the countries do not have a well‐defined national policy that may stimulate industrialization of medicinal plants and their use in primary health‐care. The problem of quality control and standardization of medicinal plants and phyto‐medicines represents a serious constraint. Countries like Argentina, Brazil and Mexico have national pharmacopoeias that are being presently updated. The fourth edition of Brazilian Pharmacopoeia (200 monographs, first and second fascicles, until Feb. 2001) lists 20 monographs on medicinal plants, of those six are on native plants. The lack of specifications to determine the authenticity, the purity and the quality of vegetable material is one of the limiting factors for phyto-pharmaceuticals production.

The Iberoamerican program of Science and technology for Development (CYTED), through its Fine Pharmaceutical Subprogram, initiated in 1990 has been contributing significantly towards a collaborative research and training program in the area of medicinal plants. The subprogram IV has been active in the area of aromatic plants. Currently, the subprogram X has five thematic networks and four pre‐competitive research projects. Over 1,500 scientists are involved on this programme.

The Network on Phyto‐therapeutic Products (RIPROFITO) is active in organizing training courses on agro technology, pharmaceutical technology of phyto‐therapeutic products, industrialization and quality control of medicinal and aromatic plants (Gupta and Caceres, 2003).

The area of phyto-medicines is currently receiving much attention in Brazil and most Latin American countries, both from the point of view of the academic community, and from the pharmaceutical companies. Over the last 25 years, there has been steady progress on natural product research in plants in Latin America. Considerable efforts have been made to establish collaboration between universities and local pharmaceutical companies, to produce new medicines with scientific proof of safety, quality and efficacy. This interaction between the pharmaceutical industry and the universities has in turn stimulated the appearance of pre‐clinical pharmacological studies and of well‐controlled and randomized clinical trials to prove their worth. The emphasis on domestication, production and biotechnological studies, followed by genetic improvements to medicinal

18 plants, are other fields of science that emerge from such progress in the use of medicinal plants in the Americas particularly in Latin American countries (Calixto, 2005).

The Caribbean and Central American countries are adopting common policies on MAPs conservation and establishing collaborative projects and appropriate agreements for research programs in order to protect their MAPs’ biodiversity. The TRAMIL‐Program (Scientific Research on Medicinal Plants in the Caribbean Basin) coordinated by ENDA‐ Caribe since 1982, is one of the initiatives existing in the region. This program has focused on conserving traditional community knowledge of folk remedies, and providing scientific validation of safety and efficacy needed to encourage national health policies that include traditional medicine in primary health care programs. The main objective of the TRAMIL has been validation and evaluation of useful information on of the local popular therapeutic traditions, through scientific studies conducted by a network of collaborators in the Caribbean Basin. In the Dominican Republic, Honduras, Nicaragua, and Panama, four of the countries in which this program is currently well established, interest within government ministries in linking sustainable use of biodiversity to other community benefits, such as public health, has been particularly encouraging.

In these countries and with support of a GEF Medium Size Project GF/2713‐01‐4356 Biodiversity Conservation and Integration of Traditional Knowledge on Medicinal Plants in National Primary Health Care Policy in Central America and Caribbean, the program will add a forest ecosystem conservation component to the existing regional applied research program on traditional remedies derived from medicinal plants. The project has been developed by ENDA‐Caribe with assistance and support from the Medicinal Plant Specialist Group (MPSG) of the IUCN (Sonia Lagos‐Witte, 2006).

The Caribbean Herb Business Association (CHBA) has completed the Handbook of Selected Caribbean Herbs for Industry‐Phase I. The handbook provides information on herb growers, extension workers, and other partners in the trade. It will be made available as a reference material to research institutions and herbal organizations. The handbook contains plant profiles on the 20 species of economic potential that include Aloe vera (L.) Burm. f., Andrographis paniculata (Burm. f.) Wall. ex Nees, Carapa guianensis Aubl., Colubrina arborescens (Mill.) Sarg., Croton eluteria (L.) W. Wright, Curcuma longa L., Cymbopogon citratus (DC.) Stapf, Eryngium foetidum L., Hibiscus sabdariffa L., Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson, Maranta arundinacea L., Momordica charantia L., Myristica fragrans Houtt., Pimenta dioica (L.) Merr., Pimenta racemosa (Mill.) J. W. Moore, Quassia amara L., Senna alata (L.) Roxb., Smilax regelii Killip & C. V. Morton, Vetiveria zizanioides (L.) Nash, and Zingiber officinale Roscoe (ITC, 2006).

19 Several MAP species are now cultivated rather than solely gathered from the wild by collectors. The American Herbal Products Association (AHPA) in February 2007 published its 5th survey on selected North American MAPs harvested from wild populations. This report, the 2004–2005 Tonnage Survey of Select North American Wild‐ Harvested Plants, covers 26 botanicals derived from 22 plant species. The report includes data on both fresh and dried quantities of wild harvested and cultivated materials. It also includes data from earlier four surveys dating back to 1997. MAPs included in the survey include, among others, arnica (Arnica spp.), black cohosh root & (Actaea racemosa L.), blue cohosh root (Caulophyllum thalictroides (L.) Michx.), wild yam tuber (Dioscorea villosa L.), Echinacea spp. (Echinacea angustifolia DC.), Echinacea pallida (Nutt.) Nutt. and Echinacea purpurea (L.) Moench) herb & root, cascara sagrada bark (Frangula purshiana (DC.) J. G. Cooper), goldenseal leaf, root & rhizome (Hydrastis canadensis L.), bloodroot root (Sanguinaria canadensis L.), saw palmetto fruit (Serenoa repens (W. Bartram) Small), slippery elm inner bark (Ulmus rubra Muhl.), and usnea lichen (Usnea spp.) (ITC, 2007).

Canada is the world‘s largest producer of North American ginseng (Panax quinquefolius L.) root, most of which is grown in Ontario Province that is a world leader (CDN88 million) in its export industry. Ontario has over 220 ginseng growers and approximately 6,000 acres in production; harvesting about 1.8 million kg of root annually with ginseng ranking as Ontarioʹs fifth largest cash crop. A research projects has been started recently in Ontario, to aid in securing its position as the leading producer of Ontario grown American ginseng root (Panax quinquefolius L.) in the world and grow revenue and yields from both the Asian and domestic markets over the next five year time frame.

The project titled New Technologies for Ginseng Agriculture and Product Development: Developing a unique Ontario ginseng variety, is supported by provincial funding through the Ontario Ministry of Research and Innovation. Funding will be matched by industry and other partners participating in this collaboration between academia, government and industry working together through the entire value chain for production and export to improve the quality, safety and therapeutic properties of Ontario ginseng. The lead investigators are situated at the University of Western Ontario and the key private sector project partners are the Ontario Ginseng Growers Association (OGGA), Canadian natural health product company Jamieson Laboratories Ltd., the French herbal extraction company Naturex, and one of Ontarioʹs largest Agricultural and Environmental Laboratories, A&L Canada Laboratories Inc.. Other partners include researchers from other Canadian universities (McMaster, Guelph, Ottawa and Toronto) and Agriculture and Agri‐Food Canada (AAFC) (ITC, 2008).

20 Trade and Marketing

The MAPs pharmaceutical industry is in the early stages in most of South American countries except for a few like Argentina, Brazil, Chile and Mexico. Due to lack of reliable information on trade statistics it is very difficult to estimate the South American market of the MAPs and their products.

According to a recently published study ʺStudy of the Agro industrial of Medicinal and Aromatic Plants Complex of the Paraná State‐Diagnostics and Perspectivesʺ despite Brazil‘s capability to produce herbs and spices, Brazil remains a net importer of MAPs. The State of Paraná is responsible for 90% of Brazil‘s botanical raw material production. Over 70% of the botanical species that are used by the Brazilian pharmaceutical, cosmetic, dye, herbal tea and drinks industries are cultivated on an area of about 2,700 hectares, by thousands of small rural farmers. Chamomile flower (Matricaria recutita L.) and ginger rhizome (Zingiber officinale Roscoe) are among the most widely cultivated MAP species in the region with about 95% of all ginger production is exported. The annual cultivated MAP production value is estimated at USD11.4 million. About 2,600 tonnes of MAPs are wild collected in Paraná forests which brings the total production value (cultivated and wild) to USD13.2 million (ITC, 2008).

Constraints and Problems

In spite of the very rich natural resources, the American countries have never used properly their great biodiversity in benefit of their own development. Furthermore, in function of the uncontrolled exploitation, most of the relevant areas of these countries biodiversity are being reduced rapidly, and important plant species are disappearing. Despite the many individual efforts of the governments to preserve the biodiversity for future generations, the traditional knowledge, especially that of derived from traditional medicine is fast disappearing in the rural American communities. It is attributed to the loss of traditional cultural systems and conversion of local agricultural and forest ecosystems to other purposes. Modifications of primary and secondary forest also affected principally the native species, consequently affecting also traditional knowledge and cultural practices associated with the management of the wild, semi‐wild and domesticated species at the local level.

In America particularly South America the lack of appropriate regulations for registration and quality control of phyto‐medicinals have hindered development of plants‐ based pharmaceutical industry. Practically, all the countries of the region use Food and Drug Administration of the USA (USFDA) regulations as reference for the registration and quality control of pharmaceutical products. As a consequence of the dependence of the

21 Latin American Drug Control Organisations on FDA regulations, the registration of phyto‐ medicinals has not been possible. The laboratories working on industrialization of MAPs face a difficult problem, as their products are not accepted as drugs and these products are classified frequently as dietary supplements.

The major difficulties in the development of plant‐based pharmaceutical industry in Latin America are the lack of awareness of socio‐economic and medical benefits of this industry; lack of manufacturing technical and technological know‐how; lack of a national policies; lack of quality control and standardization techniques; unavailability of large quantities of good quality MAPs materials; lack of research and development in agro technology, chemical evaluation and validation of MAPs; registration of phyto‐medicines; lack of awareness and information on market trends; and lack of government, interests in financing and development of this sector.

It is important to note that while historical records indicate that Central and South American populations have practiced traditional medicine with dietary herbs since the time of Incan, Mayan and Aztec civilizations, the existing literature on health benefits of herbs used by the Hispanic culture is very limited. A systematic, functional evaluation of herbs commonly used in traditional Hispanic cuisines and traditional medicine has never been performed either in vitro or in vivo systems, and their complete health benefits have not been elucidated. Therefore this valuable knowledge needs to be documented and preserved and the individual countries should take steps in this direction to restore their valuable traditional knowledge regarding MAPs and their uses.

Considerable efforts and funding will be necessary to properly preserve the fantastic biodiversity of the region. Some efforts have been done to publish both basic and clinical studies on herbal medicines in the past; however, so far insufficient data exists to provide an accurate assessment of the quality, efficacy and safety of most of the herbal medicines currently available on the market. A great effort in training more scientists in the relevant areas is still necessary in order to establish a rational and sustainable exploitation of the great American biodiversity and also to attend the needs of the pharmaceutical companies in these countries.

The countries should understand the importance of herbals and support their own scientists and universities, as well as develop the right legislation to protect nature and utilize species sustainably. There is a real need of cooperation among governmental departments, foundations and pharmaceutical companies to develop this sector and provide its people with economic and health benefits for the years to come.

22 Table 1: South American medicinal and aromatic plants with commercial potential (Falcao et al., 2008; Gupta and Cáceres, 2003)

Botanical name Family Use(s) Source countries

Achillea millefolium L. disinfectant Brazil, Portugal

Achyrocline satureioides (Lam.) Asteraceae antispasmodic Uruguay DC.

Aesculus hippocastanum L. Sapindaceae varicose veins Chile

Allium cepa L. Alliaceae flu Dominican Republic, Venezuela

Allium sativum L. Alliaceae antiulcer, Bolivia, Colombia, arteriosclerosis, Ecuador, circulatory system, Dominican hypotensive Republic, USA, Venezuela

Aloe barbadensis Mill. (=Aloe vera Asphodelaceae anti‐inflammatory, Guatemala, (L.) Burm. f.) cathartic, cosmetic, Paraguay, Portugal, dermatology, wound Dominican healing Republic, Venezuela

Amphipterygium adstringens Anacardiaceae antiulcer Mexico (Schltdl.) Schiedeex Standl

Arctostaphylos uvaursi (L.) Ericaceae antiseptic, urinary Chile Spreng.

Arnica montana L. Asteraceae tonic Guatemala

Artemisia absinthium L./ Asteraceae abortive, antitussive, Brazil, Ecuador, Artemisia ludoviciana Nutt. diabetes, digestive, Guatemala, dyspepsia Portugal, Venezuela

Artemisia annua L. Asteraceae antiulcer Brazil

23 Artemisia douglasiana Besser Asteraceae antiulcer Argentina ex Hook.

Artemisia vulgaris L. Asteraceae nervousness Guatemala

Aster squamatus Asteraceae antiulcer Brazil (Spreng.) Hieron.

Astronium urundeuva (Allemã Anacardiaceae antiulcer Brazil o) Engl.

Avena sativa L. tonic Chile

Baccharis Asteraceae antiulcer Bolivia genistelloides (Lam.) Pers.

Baccharis illinita DC Asteraceae antiulcer Brazil

Baccharis rubricaulis Rusby Asteraceae antiulcer Bolivia

Baccharis teindalensis Kunth Asteraceae antiulcer Ecuador

Baccharis trinervis Pers. Asteraceae hepatic diseases Bolivia, Uruguay

Bauhinia candicans Benth. Fabaceae hypoglycemic Chile

Bidens pilosa L. var. radiata Sch. Asteraceae antiulcer Cuba Bip.

Bidens subalternans DC. Asteraceae antiulcer Argentina

Bixa orellana L. Bixaceae coloring agent, wound Brazil, Ecuador, healing, Dominican Republic

Borago officinalis L. Boraginaceae depurative, Colombia, Ecuador, expectorant, lipolytic Peru, Venezuela

Bryophyllum calycinum Salisb. Crassulaceae antiulcer Brazil

Bursera graveolens (Kunth) Tria Burseraceae analgesic Peru na & Planch.

Caesalpinia ferrea Mart. ex Tul Fabaceae antiulcer Brazil

Caesalpinia tinctoria (Dombey Fabaceae astringent, wound Peru ex Kunth) Benth. ex Taub. healing

Calendula officinalis L. Asteraceae antiseptic, digestive, Bolivia, Brazil, rheumatic pains Chile, Colombia, Ecuador, Guatemala

Calophyllum brasiliense Cambe Clusiaceae antiulcer Brazil ss.

24 Capsicum annuum L./ Capsicu Solanaceae analgesic, vasodilator Panama, Venezuela m frutescens L.

Carica papaya L. Caricaceae digestive Colombia, Ecuador, Guatemala, Venezuela

Casearia sylvestris Sw. Salicaceae antiulcer Brazil

Cassia angustifolia Vahl Fabaceae cathartic, laxative Chile, Guatemala, Paraguay, Peru, Uruguay

Cassia fistula L. Fabaceae laxative Dominican Republic

Cephaelis ipecacuanha (Brot.) Rubiaceae expectorant Guatemala

Tussac

Cestrum parqui LʹHer. Solanaceae antiinflammatory Bolivia

Chenopodium ambrosioides L. Chenopodiaceae antiparasitic, liver Bolivia, Ecuador, disorders Dominican Republic

Chrysanthemum parthenium Asteraceae stomachache Guatemala (L.) Bernh.

Cinchona succirubra Pav. ex Rubiaceae antipyretic, Chile, Ecuador, Klotzsch antiparasitic Guatemala, Peru

Copaifera officinalis (Jacq.) L. Fabaceae wound healing, Peru antiseptic

Cordia verbenacea DC. Boraginaceae antiulcer Brazil

Crataegus oxyacantha L cardiac tonic, Chile cardiovascular

Crescentia cujete L. respiratory diseases Peru

Croton cajucara Benth. Euphorbiaceae antiulcer Brazil

Croton draconoides Müll. Arg., Euphorbiaceae wound healing Ecuador, Peru Croton lechleri Mull. Arg.

Curcuma longa L. Zingiberaceae antiinflammatory Guatemala

Cyclanthera pedata (L.) Schrad. Cucurbitaceae hypocholesterolemic Peru

Cymbopogon citratus (DC.) Poaceae carminative, digestive, Bolivia, Brazil, Stapf flavoring agent Guatemala, Dominican

25 Republic

Cynara scolymus L. Asteraceae circulatory system Bolivia, Brazil, cholagogue, liver Colombia, Ecuador, disorders Peru, Venezuela

Davilla rugosa Poir. Dilleniaceae antiulcer Brazil

Desmodium molliculum Fabaceae depurative Peru (Kunth) DC.

Elettaria cardamomum (L.) Zingiberaceae digestive, flavoring Guatemala Maton agent

Equisetum spp. Equisetaceae antiseptic, blood Bolivia, Brazil, purifier, diuretic, Ecuador, Peru, vasoconstrictor Venezuela

Erythroxylum coca Lam. Erythroxylaceae stomachache Bolivia

Eucalyptus globulus Labill. antiseptic, antitussive, Chile, Ecuador, diuretic, expectorant, Guatemala, Peru flu

Foeniculum vulgare Mill. Apiaceae digestive, female Bolivia, Colombia, disorder Guatemala

Franseria artemisioides Willd. Asteraceae antiulcer Bolivia

Genipa americana L. Rubiaceae respiratory affections Peru

Geranium sessiliflorum Cav. Geraniaceae hypoglycemic Peru

Ginkgo biloba L. Ginkgoaceae cerebral vasodilatator Brazil, Chile

Gnaphalium viravira Molina Asteraceae expectorant Bolivia

Hibiscus sabdariffa L. Malvaceae diuretic Brazil, Guatemala

Hippocratea excelsa HBK. Hippocrateaceae antiulcer Mexico

Hyptis mutabilis (Rich.) Briq. Lamiaceae antiulcer Brazil

Jatropha curcas L. Euphorbiaceae herpes Guatemala, Mexico

Juglans neotropica Diels Juglandaceae antiseptic, cosmetic Peru

Krameria triandra Ruiz & Pav. Krameriaceae astringent, hemostatic Peru

Lamium album L. Lamiaceae arthritis, depurative, Guatemala rheumatism

Lepidium meyenii Walp. Brassicaceae aphrodisiac, tonic Peru

Lippia citrodora Kunth Verbenaceae antimicrobial, digestive Chile, Ecuador, Guatemala

Lippia dulcis Trevir. Verbenaceae expectorant Guatemala

26 Lippia graveolens Kunth/ Verbenaceae Antispasmodic, Chile, Colombia Lippia micromera Schauer aromatic, diabetes Dominican Republic

Lonchocarpus nicou auct. Fabaceae insecticide Peru

Lycopus spp. Lamiaceae antitussive Ecuador

Malva parviflora L./ Malvaceae digestive, emollient, Colombia, Ecuador, expectorant, Guatemala Malva sylvestris L. respiratory disorders

Mammea americana L. Clusiaceae antiulcer Brazil

Marrubium vulgare L. Lamiaceae digestive, diuretic, Guatemala, febrifuge Venezuela

Matricaria recutita L. (=Matricari Asteraceae anti‐inflammatory, Argentina, Bolivia, a chamomilla L.) antispasmodic, Brazil, Colombia, aromatic, digestive, Ecuador, disinfectant Guatemala, Paraguay, Dominican Republic, Uruguay, Venezuela

Maytenus aquifolium Mart. Celastraceae antiulcer Brazil

Maytenus ilicifolia Celastraceae antiulcer, diuretic, Brazil, Uruguay Mart. ex Reissek wound healing

Maytenus macrocarpa (Ruiz Celastraceae antirreumatic, Peru aphrodisiac & Pav.) Briq.

Medicago sativa L. Fabaceae mineral replenisher, Brazil, Chile, reconstituyent Ecuador

Melia azedarach L. Meliaceae antiinflammatory Venezuela

Melissa officinalis L. Lamiaceae digestive, sedative, Bolivia, Brazil, tranquillizer Chile, Venezuela

Mentha ×piperita L./ Mentha Lamiaceae digestive, eupeptic Chile, Ecuador, viridis (L.) L. (=Mentha spicata Guatemala, L.) Portugal,

27 Venezuela

Mentha citrata Ehrh. (=Mentha Lamiaceae colic, cough, nervous Bolivia, Colombia, ×piperita nothosubsp citrata disorders, stomachache Guatemala (Ehrh.) Briq.)

Mentha pulegium L. Lamiaceae aromatic, digestive, Brazil, Chile, urinary system Colombia, Peru

Mikania guaco Humb. & Bonpl. Asteraceae antiallergic Venezuela

Mimosa tenuifolia L. Fabaceae cosmetic, wound Mexico healing

Momordica charantia L. Cucurbitaceae hypoglycemic Venezuela

Moringa oleifera Lam. Moringaceae antiinflammatory Venezuela

Morus alba L. Moraceae hypoglycemic Chile

Musa ×paradisiaca L. Musaceae antiulcer Brazil, Saint Lucia

Myrciaria dubia (Kunth) Myrtaceae vitamin supplement Peru McVaugh

Myroxylon peruiferum L. f. Fabaceae antiseptic, wound Peru healing

Nasturtium officinale W. T. Brassicaceae bronchitis Dominican Aiton Republic, Venezuela

Neurolaena lobata (L.) Cass. Asteraceae antiulcer Brazil

Ocimum basilicum L. / Ocimum Lamiaceae Antispasmodic, Brazil, Guatemala, sanctum L. digestive, flavoring Dominican agent Republic, Venezuela

Olea europaea L. Oleaceae hypotensive Chile

Origanum vulgare L./ Lamiaceae antispasmodic, Chile, Colombia, Origanum virens Hoffmanns. & aromatic, diabetes Dominican Link/ Republic

Panax ginseng C.A. Mey. Araliaceae nervous system Brazil, Guatemala, Paraguay

Passiflora incarnata L. / Passifloraceae sedative Chile, Guatemala, Passiflora quadrangularis L. Venezuela

Persea americana Mill. Lauraceae abortive, circulatory Colombia system

Petiveria alliacea L. Phytolaccaceae abortive, Brazil, Dominican

28 antiinflammatory, Republic, febrifuge Venezuela

Peumus boldus Molina Monimiaceae cholagogue, digestive, Brazil, Chile, hepatic ailments Guatemala, Paraguay, Uruguay

Phyllanthus niruri L. Phyllanthaceae antiviral, diuretic, Ecuador, Peru hepatoprotector

Pimpinella anisum L. Apiaceae aromatic, carminative, Bolivia, Guatemala, digestive Paraguay

Piper angustifolium Lam. Piperaceae antiseptic, wound Peru healing

Plantago australis Lam. Plantaginaceae antiulcer Bolivia

Plantago major L. Plantaginaceae cancer, colds, Bolivia, Brazil, disinfectant, wound Ecuador, healing Dominican Republic, Venezuela

Polypodium aureum L. Polypodiaceae antiinflammatoty, Ecuador, immunomodulator Guatemala

Psidium guajava L Myrtaceae diarrhoea Guatemala, Mexico

Quassia amara L. Simaroubaceae antiparasitic, antiulcer, Brazil, Guatemala tonic

Rhamnus frangula L. Rhamnaceae laxative Chile

Rheum palmatum L. Polygonaceae appetite stimulant, Chile, Colombia, laxative Guatemala, Paraguay

Rhizophora mangle L. Rhizophoraceae antiulcer Cuba

Rosa rubiginosa L ./ Rosa Rosaceae cosmetology, food Argentina, Brazil, moschata Desf. ex J. St.‐Hil Chile

Rosmarinus officinalis L Lamiaceae antiulcer, Bolivia, Brazil, aromatic,digestive, Colombia, eupeptic, flavorizing, Guatemala, respiratory system, Venezuela rheumatism

Rumex obtusifolius L. Polygonaceae antiulcer Bolivia

29 Ruta graveolens L./ Ruta chalepen Rutaceae female disorders, Brazil, Colombia, sis L. nervousness, pain Dominican Republic

Salvia spp. Lamiaceae hepatic disorders Bolivia, Brazil, Ecuador,

Sambucus nigra L./ Adoxaceae diuretic, flu, laxative, Brazil, Colombia, Ecuador

Sambucus mexicana auct. respiratory system Guatemala

Sapindus saponaria L. Sapindaceae antiulcer Brazil

Satureja boliviana Briq. Lamiaceae antiulcer Bolivia

Schinus molle L Anacardiaceae diuretic Bolivia, Ecuador, Peru

Silybum marianum (L.) Gaertn Asteraceae cholagogue, Argentina hepatoprotector

Sinapis nigra L. Brassicaceae vomitive Portugal

Smilax spp. Smilacaceae antioxidant, diuretic Brazil, Ecuador, Guatemala, Venezuela

Solanum melongena L. Solanaceae diuretic, obesity Colombia, Venezuela

Solanum paniculatum L. Solanaceae antiulcer Brazil

Solanum radicans L. f. Solanaceae laxative Bolivia

Stachytarpheta cayennensis Verbenaceae antiulcer Brazil (Rich.) Vahl.

Stryphnodendron Fabaceae antiulcer Brazil adstringens (Mart.) anon.

Styrax camporum Pohl Styracaceae antiulcer Brazil

Tabebuia spp. Bignoniaceae antiarthritic Venezuela

Tagetes lucida Cav Asteraceae Antimicrobial, Guatemala dysentery, flatulence

Tanacetum vulgare L. Asteraceae antiulcer Argentina

Taraxacum officinale F. H. Asteraceae depurative, diuretic, Bolivia, Brazil, Wigg aggr. hepatoprotector, Ecuador, Peru, Venezuela

Tessaria integrifolia Ruiz & Pav. Asteraceae respiratory disorders Peru

30 Thymus vulgaris L. Lamiaceae antiseptic, aromatic, Brazil respiratory

Tilia spp. Malvaceae emollient, sedative, Chile, Ecuador, tranquillizer, Guatemala, Portugal, Dominican Republic, Uruguay

Trigonella foenum graecum L. Fabaceae emollient, gastritis, Guatemala ulcers

Triumfetta semitriloba Jacq Malvaceae antiulcer Costa Rica

Turnera diffusa Willd. ex Schult. Turneraceae antiulcer Brazil

Turnera ulmifolia L. Turneraceae antiulcer Brazil

Uncaria tomentosa (Willd. ex Rubiaceae antiinflammatory, Ecuador, Schult.) DC. revitalizer Guatemala, Paraguay, Peru

Urtica dioica L. / Urtica urens L. Urticaceae antiallergic, Bolivia, Colombia, rheumatism Ecuador, Guatemala, Venezuela

Valeriana officinalis L. / Valerianaceae ansiolytic, sedative, Bolivia, Brazil, Valeriana wallichii DC. tranquillizer Chile, Colombia, Ecuador, Guatemala, Peru

Verbena litoralis Kunth Verbenaceae colds, digestive, Colombia, febrifuge Guatemala

Vernonia condensata Baker Asteraceae antiulcer Brazil

Xanthium spinosum L. Asteraceae hepathic disorders Bolivia

Zea mays L. Poaceae digestive, diuretic Ecuador, Portugal

Zingiber officinale Roscoe Zingiberaceae antiemetic, antiulcer Brazil, Ecuador, carminative, Dominican Republic

Zollernia ilicifolia (Brongn.) Fabaceae antiulcer Brazil Vogel

Zuccagnia punctata Cav. Fabaceae antiulcer Argentina

31 The 20 Top – Selling Herbal Dietary Supplements in the Food, Drug, and Mass Market Channel in the United States for 2009 (per IRI) *

Common Name Latin Name $2009 Sales (USD) % Change 2008

1. Cranberry Vaccinium macrocarpon 31,314,220 23.28.00

2. Soy Glycine max 19,647,980 -12.35

3. Saw Palmetto Serenoa repens 18,813,300 7.09

4. Garlic Allium sativum 17,908,530 -7.66

5. Echinacea Echinacea spp. 16,230,560 6.94

6. Ginkgo Ginkgo biloba 16,011,830 -8.10

7. Milk Thistle Silybum marianum 11,162,670 19.72

8. St. John´s wort Hypericum perforatum 8,758,233 5.90

9. Ginseng† Panax ginseng 8,292,474 1.65

10. Black Cohosh Actaea racemosa‡ 8,123,878 -0.29

11. Green Tea Camellia sinensis 6,715,113 21.71

12. Evening Primrose Oenothera biennis 4,259,037 9.17

13. Valerian Valeriana officinalis 4,142,231 24.76

14. Horny Goat Weed Epimedium spp. 2,819,403 16.94

15. Bilberry Vaccinium myrtillus 1,983,723 7.41

16. Elderberry Sambucus nigra 1,837,587 -0.42

17. Grape Seed Vitis vinifera 1,783,874 -3.78

18. Ginger Zingiber officinale 1,183,641 24.81

19. Aloe vera Aloe vera 646,164 -04.08.00

20. Horse chestnut seed Aesculus hippocastanum 558,946 -29.19.00

Total All Herb Sales (including herbs not shown) Ref: (15) $ 335,585,700

32 14.38

* Source: Information Resources Inc., FDM Market Sales Data for Herbal Supplements, 52 weeks ending December 27, 2009.

† It is not clear from the IRI data whether this figure also includes the sales of American ginseng root products (made from Panax quinquefoius), the sales of which are not as high as sales from supplements made from Asian ginseng (P. ginseng)

‡ Synomym: Cimicifuga racemosa

REFERENCES

Bent, S. and Ko, R., 2004, Commonly used herbal medicines in the United States: a review. The American Journal of Medicine, 116(7): 478‐485

Brandao, M. G., Zanetti, N. N., Oliveira, P., Grael, C. F., Santos, A. C. and Monte‐Mór, R. L., 2008, Brazilian medicinal plants described by 19th century European naturalists and in the Official Pharmacopoeia. Journal of Ethnopharmacology, 120(2): 141‐148

Calixto, J. B., 2005, Twenty‐five years of research on medicinal plants in Latin America: A personal view. Journal of Ethno-pharmacology, 100: 131–134

Chamberlain, J., Bush, R. and Hammett, A. L., 1998, Non‐Timber Forest Products: The Other forest products. Forest Products Journal, 48(10): 10‐19

Cavaliere C., Rea, P., Lynch, M. E., Blumenthal, M. HerbalGram 2010; 86, 62- 65.Falcao,

H. S., Mariath, I. R., Diniz, M. F. F. M., Batista, L. M. and Barbosa‐Filho, J. M., 2008, Plants of the American continent with antiulcer activity. Phytomedicine, 15: 132–146

FAO, 2000, Global Forest Resources Assessment 2000. Forestry Department. Available at: http://www.fao.org/DOCREP/004/Y1997E/y1997e00.htm#Contents (01 Oct. 2008)

Gurib‐Fakim, A., 2006, Medicinal plants: Traditions of yesterday and drugs of tomorrow. Molecular Aspects of Medicine, 27: 1–93

Huerta, V., Mihalik, K, Maitin, V., Crixell, S. H. and Vattem, D. A., 2007, Effect of Central/South American medicinal plants on energy harvesting ability of the mammalian GI tract. Journal of Medicinal Plants Research, 1(2): 038‐049

ITC, 2002, Market News Service, Medicinal Plants & Extracts, 03: 3, Jun. 2002, Geneva, Switzerland

33 ITC, 2006a, Market News Service, Medicinal Plants & Extracts, 21: 7, Dec. 2006, Geneva, Switzerland

ITC, 2007, Market News Service, Medicinal Plants & Extracts, 22: 9, Mar. 2007, Geneva, Switzerland

ITC, 2008, Market News Service, Medicinal Plants & Extracts, 26: 34, Mar. 2008, Geneva, Switzerland

Morgenstern, K., 2001, Traditional plant medicine in Central America. Available at: http://www.sacredearth.com/ethnobotany/medicines/centralamerica.php (14 Jul. 2008)

Sonia Lagos‐Witte, S., 2006, Conservation of Medicinal Plants in Central America and the Caribbean. IK Notes No. 93. Available at: http://www.worldbank.org/afr/ik/iknt93.pdf (14 Jul. 2008)

WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

34 1. The Status of Medicinal and Aromatic Plants in South America

1.1 Argentina The Argentine Republic, the second-largest country in South America, is bound on the north by Bolivia and Paraguay, on the east by Brazil, Uruguay, and the Atlantic Ocean and on the south and west by Chile. It has an area of 2,780,400 square kilometres. Argentina comprises a diverse territory of lofty mountains, arid deserts, vast plains, and swampy forests. The rugged Andes Mountains stretch along the country’s western border. A bare, windswept plateau called Patagonia extends across the south. The Pampa, a fertile, grassy plain, lies near the middle of the country. The southernmost tip of Argentina lies only about 970 kilometer from Antarctica while the northernmost part has a nearly tropical climate. The western boundary of the country follows the Andes, beginning with the Patagonian Andes in the south and extending up the main Andean cordillera to the Bolivian frontier. While seldom exceeding 3,600 m in the south, peaks in the north exceed 6 400, the highest being, Aconcagua (6,960 m), the highest peak outside those of Central Asia. East of the Andes, the terrain is generally flat or gently undulating, sloping gradually from an elevation of about 600 m to sea level. The Gran Chaco lies between the Paraná River on the east and the lower ranges of the Andes on the west. The region, mostly covered with scrub forest, is dry for most of the year, but often has heavy rains during the summer. The region called Mesopotamia or Entre Ríos lies between the Paraná and Uruguay rivers. Mesopotamia has a hot, humid climate and much of it is productive agricultural land. Swampy forests cover the extreme north-east. The Pampas, treeless plains that include the most productive agricultural regions of the country, extend about 1,600 kilometres south of the Gran Chaco. It covers nearly a fifth of the country. In Patagonia, south of the Pampas, the terrain consists largely of arid, windswept, desolate steppes. While it occupies more than a quarter of Argentina, poor soil and little rainfall make most of Patagonia unsuitable for farming. The island of Tierra del Fuego lies at the southern tip of South America, separated from the mainland by the Strait of Magellan. Argentina and Chile share the island. Argentina largely has a temperate climate except for a small tropical area in the north-east and the subtropical Chaco in the north. Considerably higher temperatures prevail in the north. Climatic conditions are cold in the higher Andes, Patagonia, and Tierra del Fuego.

35 In 2000 it was estimated that natural forests covered a total area of 34.6 million hectares (12.7% of the country’s total area). In recent years, a major effort has been made to create forest stands totaling about 1 million hectares. In 2001, the area under management for recreation and tourism (national and provincial parks and multipurpose reserves) amounted to some 3 million hectares, or 9.7% of forest land. In Argentina, 50% of the plantations are conifers, 30% Eucalyptus spp., 16% Populus spp. and Salix spp. and 4% others. The country has suffered severe soil erosion in such regions as Patagonia and the northeast. The loss of natural forest and the decrease in biological diversity, particularly genetic resources, have not been paid sufficient attention (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Argentina is a country with both rich floral biodiversity and cultural diversity. Traditional herbal medicines are important in the health care of most people, and rely heavily on the use of indigenous plants. Their use has a long history and wide acceptability in the country. The plant materials, sometimes preferred to the pure pharmacologically active constituents for reasons of safety and cost, are freely found in the locality. Traditional herbal medicines are important in the health care of most people who rely heavily on the use of indigenous plants (Goleniowski et al. 2006).

Government Efforts in Development of Traditional Medicine/Phytomedicine The national policy on TM/CAM in the Argentine Republic is currently in development. In 1998, Resolution 144/98 established laws and regulations on TM/CAM, specifically on phytotherapeutic medicines and vegetable drugs. Under this same resolution, a national programme was established. The national office on TM/CAM is administered by the Ministry of Health, and is called the Committee on Harmonization of Vegetable Drugs; it was founded in 1992. An expert committee on TM/CAM was created in 1999. No national research institutes on TM/CAM currently exist. Herbal regulation in Argentina was introduced in 1998 in Resolution 144/98. It established regulations that were partly the same as, but separate from, those used for conventional pharmaceuticals. In Argentina, herbal medicines are regulated as prescription medicines, over the counter medicines and dietary supplements. By law, medical claims may be made about herbal medicines.

36 The national pharmacopoeia is called the Farmacopea Nacional Argentina (1965); in addition, other pharmacopoeias used include the United States Ppharmacopoeia, European Pharmacopoeia and British Ppharmacopoeia. The information in these pharmacopoeias is legally binding. National monographs are in preparation; however, the following materials are currently used and are legally binding: United States pharmacopoeia, EuropeanPpharmacopoeia, British Pharmacopoeia, European Scientific Cooperative on Phytotherapy (ESCOP) monographs and the WHO monographs.

The relevant regulatory requirements for manufacturing include adherence to information in pharmacopoeias and monographs and special GMP rules. The safety assessment requirements include traditional use without demonstrated harmful effects, reference to documented scientific research on similar products, toxicological studies when traditional use cannot be demonstrated and submission of a full toxicological and pharmacological dossier. Compliance with these requirements is ensured by the requirement for a formal registration process submitted to the Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (National Administration of Drugs, Foods and Medical Devices – ANMAT), which ensures full compliance with the manufacturing and safety assessment requirements. There is a registration system for herbal medicines, but the number of registered medicines is not currently available. No herbal medicines are included on an essential drug list. Argentina has a post marketing surveillance system that includes a national system to monitor adverse effects of all medicines, including herbal medicines, which was established in 1993. In Argentina, herbal medicines are sold in pharmacies as prescription and over the counter medicines, in special outlets and by licensed practitioners (WHO 2005).

Medicinal and Aromatic Plant Resources In Argentina, 602 plant species are reported to have medicinal properties. The use of herbal medicines was observed to be widespread and prevalent over orthodox medicine. Medicinal native plants from this mountain range make up 31% of the total Argentina medicinal native flora. In addition, there are 15 endemic species that grow only in the region. Of the 602 MAP species documented on folk medicinal practice in Argentina, 186 correspond to “Sierra de Comechingones” in Central Argentina. Table 1 lists MAPs used in traditional medicine along with their traditional uses (Goleniowski et al. 2006).

Research and Development Activities

37 The Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, and Facultad de Ciencias Agropecuarias, Universidad Nacional de Entre Rıos, Parana, Argentina carried an ethnopharmacological screening of selected medicinal plants used in the country for the treatment of infectious diseases. Among the five species analysed four (viz. Lithraea molleoides (Vell.) Engl., Polygonum punctatum Elliott, Sebastiania brasiliensis Spreng. and Sebastiania klotzschiana (Mull. Arg.) Mull. Arg.) were reported to have antiherpetic activity (Kott et al. 1999). An ethnobotanical survey of the “Sierra de Comechingones” made over a 26-year period (1979–2005), indicated that 65 families and 149 different genuses were used in traditional medicines. This survey summarized the botanical name, popular uses, parts utilized, as well as the distribution of these medicinal plants in the region. Previous literature reports on phytochemical and biological activities of these plants in relation to their use in cancer, as antimicrobials and pesticides were also included (Goleniowski et al. 2006).

Trade and Marketing Estimated Argentinean exports during 2004 under HS code 0909 (that includes caraway and coriander) were 0.9 million kg (ITC, 2005). However, there is no more information available currently regarding the trade in Maps and their products in the country.

Constraints and Problems In Argentina, there is an urgent need to systematically document the traditional knowledge on the use of medicinal plants in all autonomous areas or communities, many of which are still largely unexplored. Such documentation is necessary because old people are usually the only custodians of such information, and the fast disappearance of traditional culture and natural resources arising from urbanization and industrialization of such areas suggests that unrecorded information may be lost forever. The potential of the regional flora and vegetation is still incompletely known. The documentation of the ethnobotanical information, creation of protected areas for conservation purposes, and education and training of people in sustainable harvesting of MAPs and their utilization are highly recommended. Different research organization, relevant government bodies and NGOs should join their efforts in inventorying and conservation of both wild and cultivated medicinal and aromatic plants.

REFERENCES Estomba, D., Ladio, A., Lozada,M., 2006. Medicinal wild plant knowledge and

38 gathering patterns in a Mapuche community from North-western Patagonia Original . J. Ethnopharmacol 103, 109-119.

FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Gette, M., Petenatti, M., Del Vitto, L., Zacchino, S., Petenatti, E. 2009. Comparative pharmacobotanic study and ethnopharmacological uses of the “Botones de oro” from Argentinean folk medicine Brazilian Journal of Pharmacognosy 19(1A): 14-19 Goleniowski, M. E., Bongiovanni, G. A., Palacio, L., Nunez, C. O. and Cantero, J. J., 2006, Medicinal plants from the “Sierra de Comechingones”, Argentina. Journal of Ethnopharmacology, 107: 324–341 ITC, 2005, Market News Service, Medicinal Plants & Extracts, 17: 45, Dec. 2005, Geneva, Switzerland Kott, V., Barbini, L., Cruanes, M., Munoz, J. de D., Vivot, E., Cruanes, J., Martino, V., Ferraro, G., Cavallaro, L. and Campos, R., 1999, Antiviral activity in Argentine medicinal plants. Journal of Ethnopharmacology, 64: 79–84 Martinez, G., Barboza, G., 2010. J. Ethnopharmacol.,13286. Natural pharmacopoeia used in traditional Toba medicine for the treatment of parasitosis and skin disorders (Central Chaco, Argentina) Roig, F. A., 1999, Inventory and Need of Conservation of the Medicinal Flora in The Arid Centre-West Of Argentina. Acta Hort. (ISHS), 500: 161- 168 Scarpa, GF, 2004. J.Ethnopharmacol. Medicinal plants used by the Criollos of Northwestern Argentine Chaco J. Ethnopharmacol. 91,115-135 Svetaz, L., Zuljan, F., Derita, M., Petenatti, E., Tamayo, G., Cáceres, A., Cechinel Filho, V., Giménez, A., Pinzón, R., Zacchino, S., Gupta, M., 2010. J. Ethnopharmacol. 127, 137-158.Value of the ethnomedical information for the discovery of plants with antifungal properties WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

39 Table 1: Some MAPs from Central Argentina and their medicinal uses (Goleniowski et al. 2006)

Botanical name Vernacular Family Part Medicinal uses name used

Acacia caven Espinillo Fabaceae Seeds, Antiasthmatic, (Molina). Molina leaves Astringent, cough var. caven disinfectant Acanthospermum Torito Asteraceae Leaves, astringent, diaphoretic australe (Loefl.) stems Kuntze Acanthospermum Cuajilla Asteraceae Leaves, astringent, diaphoretic hispidum DC. stems Adiantum raddianum Culandrillo Pteridaceae Leaves curative of cough, C. Presl expectorant, pectoral Aloysia gratissima Palo Verbenaceae Flowers, cardiotonic, (Gillies & Hook.) amarillo leaves carminative, Tronc. diaphoretic, digestive, sedative Ambrosia elatior L. Altamisa Asteraceae Leaves, contraceptive, stems expectorant, headache Ambrosia tenuifolia Altamisa Asteraceae Leaves, antineuralgic, Spreng. stems digestive, headache, rheumatic pains Anemone decapetala Centella Ranunculaceae Leaves, caustic, narcotic, Ard. stems rubefacient

Arenaria lanuginosa Arenaria Caryophyllaceae Leaves astringent (Michx.) Rohrb. var. and lanuginose stems

Asclepias mellodora A. Yerba de la Apocynaceae Leaves emetic St.-Hil. vida Aspidosperma Quebracho Apocynaceae Bark antiasthmatic, quebracho-blanco blanco antidisneic, Schltdl. cicatrizant, febrifuge Baccharis articulata Carquejilla Asteraceae Leaves, diuretic, hepatic (Lam.) Pers. stems affections Baccharis coridifolia Nio Asteraceae Leaves, pesticide DC. stems Baccharis pingraea Chilca Asteraceae Leaves anticancer, anti- DC. and inflammatory, stems antirheumatic, antisyphilitic Baccharis salicifolia Chilca Asteraceae Leaves anticancer, anti- (Ruiz & Pav.) Pers. amarga and inflammatory, stems antisyphilitic, rheumatic pains

40 Boerhavia diffusa L.var. Yerba Nyctaginacae Bark diuretic, emetic, difusa tostada purgative Buddleja cordobensis Salvia Buddlejaceae Leaves astringent, vulnerary Griseb. blanca Buddleja mendozensis Salvia Buddlejaceae Leaves antiparalytic, Benth. blanca Cyperaceae Stems, muscular tonic Bulbostylis capillaris Bulbostylis contraceptive (L.) Clarke leaves

Caesalpinia gilliesii Lagana de Fabaceae Seeds toxic (Hook.) D. Dietr. perro Canna glauca L. Achira Cannaceae Roots diaphoretic, diuretic Capsicum chacoense Ají del monte Solanaceae Fruits rheumatic pains Hunz. against hepatic affections Cardionema Dicha Caryophyllaceae Leaves hepatic affections ramosissima (Weinm.) A. Nelson & J.F. Macbr. Cardiospermum Globito Sapindaceae Roots deodorant, diuretic halicacabum L. var. halicacabum Celtis tala Gillies ex Tala Cannabaceae Leaves digestive, disinfectant, Planch. respiratory affections Cestrum parqui L'Hér. Duraznillo Solanaceae Leaves anticancer, negro antihemorroidal, antispasmodic, carminative, diaphoretic Chenopodium Paico macho Chenopodiaceae Leaves diaphoretic, digestive, ambrosioides L. stimulative, vermifuge Colletia spinosissima J. Tola Rhamnaceae Leaves astringent, febrifuge F. Gmel. and stems Commelina erecta L. Flor de Commelinaceae Flowers antihaemorrhagic, Santa Lucia antiviral, ophtalmic Condalia microphylla Piquillın Rhamnaceae Flowers laxative Cav. Conyza bonariensis Rama negra Asteraceae Leaves antiacid, cough, (L.) Cronquist var. pectoral bonariensis Cortaderia selloana Cortadera Poaceae Roots capillary tonic, hepatic (Schult. & Schult. f.) & renal affections Asch. & Graebn. Croton parvifolius Yerba del Euphorbiaceae Leaves digestive Mull. Arg. venado Cuphea glutinosa Siete Lythraceae Leaves, antihypertensive, Cham. & Schltdl. sangrias stems diuretic, malaria

41 Cyclospermum Apio silvestre Apiaceae Fruits, carminative, vulnerary leptophyllum (Pers.) leaves,

Sprague ex Britton & stems P. Wilson Cynodon dactylon (L.) Gramon Poaceae Rhizome, antiblennorrhagic, Pers. roots diuretic, laxative Discaria americana Brusquilla Rhamnaceae Bark and dermic affections, Gillies. & Hook. roots febrifuge, stimulative Ephedra americana Tramontana Ephedraceae Stems diuretic Humb. & Bonpl. ex Willd. Eryngium elegans Cardilla Apiaceae Roots diuretic Cham. & Schltdl.

Eupatorium Romerillo Asteraceae Leaves, aperitive tonic buniifolium Hook. & stems Arn. Var. buniifolium

Eupatorium - Asteraceae Leaves, cough, hepatic macrocephalum Less. stems affections Eupatorium Pilarcito Asteraceae Leaves, anti-inflammatory, subhastatum Hook. & stems antipruritus, Arn. hepatic affections, vulnerary Fagara coco (Gillies ex Coco Rutaceae Bark astringent, diaphoretic Hook. & Arn.) Engl. Gaillardia Topasaire Asteraceae Flowers, antialopecic, megapotamica leaves antineuralgic, (Spreng.) Baker var. antiseborrhoeic, megapotamica headache Gaillardia Gaillardia Asteraceae Flowers antialopecic, megapotamica and antineuralgic, (Spreng.) Baker var. leaves antiseborrhoeic, radiate (Griseb.) headache Baker Gamochaeta coarctata Vira Asteraceae Leaves, cough (Willd.) Kerguélen stems Glandularia peruviana Margarita Verbenaceae Leaves antispasmodic (L.) Small punzo Glandularia platensis Verbena Verbenaceae Leaves, antihysteric, (Spreng.) Schnack & Blanca flowers contraceptive Covas Gnaphalium Marcela Asteraceae Flowers, digestive, depurative cheiranthifolium Lam. macho leaves of blood and stems Hedeoma multiflora Tomillo de Lamiaceae Flowers, aromatizant and Benth la sierra leaves digestive and stems Heimia salicifolia Link Quiebra Lythraceae Roots diuretic, pesticide, 42 arado purgative, vulnerary Hybanthus parviflorus Mautecillo Violaceae Leaves emetic, purgative (Mutis ex L. f.) Baill. and stems Hydrocotyle Paraguita Araliaceae Leaves emetic, hepatic bonariensis Lam. affections Hydrocotyle Paraguita Araliaceae Leaves emetic, hepatic ranunculoides L. f. affections Hyptis mutabilis Verbena Lamiaceae Leaves carminative, (Rich.) Briq. negra diaphoretic, vulnerary Iresine diffusa Humb. Peludilla Amaranthaceae Flowers hepatic affections & Bonpl. ex Willd. and var diffusa leaves Jodina rhombifolia Peje Santalaceae Fruits, antidiarrheic, anti- Hook. & Arn. leaves inflammatory, cough and bark Kageneckia lanceolata Sacha Rosaceae Leaves febrifuge and emetic Ruiz & Pavon durazno and stems Larrea divaricata Cav. Jarilla Zygophyllaceae Fruits, anti-inflammatory, leaves deodorant, rubefacient Lithrea molleoides Molle de Anacardiaceae Leaves as sweetener, diuretic (Vell.) Engl. beber and digestive Ludwigia peploides Duraznillo Onagraceae Leaves emollient (Kunth) P. H. Raven de agua subsp. Peploides Lycopodium clavatum Pillijan Lycopodiaceae Leaves, carminative, diuretic, L. stems expectorant

Malvastrum Escoba dura Malvaceae Leaves, diuretic, emollient coromandelianum (L.) macho stems Garcke astringent, diuretic Margyricarpus Yerba de la Rosaceae Leaves pinnatus (Lam.) perdiz and cathartic, febrifuge Kuntze stems Maytenus boaria Maiten Celastraceae Leaves hepatic affections Molina Mimulus glabratus Berro Phrymaceae Leaves Kunth and antidiarrheic, stems Minthostachys mollis Peperina Lamiaceae Flowers, Griseb. leaves, antispasmodic, stems digestive, rheumatic pains Mirabilis jalapa L. Dondiego de Nyctaginaceae Leaves emetic, purgative noche Modiola caroliniana Sanalotodo Malvaceae Leaves, emollient, sedative (L.) G. Don stems

43 Morrenia odorata Tasi Apocynaceae Roots galactogoge, (Hook. & Arn.) odontalgic Lindl. Oenothera affinis Suspiros Onagraceae Leaves, disinfectant, vulnerary Cambess. flowers Parthenium Vira-vira Asteraceae Flowers, analgesic, aperitive hysterophorus L. leaves tonic, febrifuge Paspalum notatum Pasto Poaceae Roots antigonorrheic, Flüggé var. notatum horqueta diuretic Passiflora caerulea L. Pasionaria Passifloraceae Leaves sedative

Passiflora foetida L. Pasionaria Passifloraceae Leaves sedative

Perezia multiflora Escorzonera Asteraceae Roots digestive, diuretic, (Bonpl.) Less. subsp. emollient multiflora Petunia axillaris Tabaco de Solanaceae Leaves narcotic, toxic (Lam.) Britton et al. indio (Steere) Cabrera

Pluchea sagittalis Lucera Asteraceae Leaves antisyphilitic, (Lam.) Cabrera and aperitive tonic, stems aromatizant Polygonum punctatum Ajicillo Polygonaceae Leaves antidiarrheic, caustic, Elliott disinfectant Polylepis australis Tabaquillo Rosaceae Leaves astringent Bitter. Porlieria microphylla Guayacan Zygophyllaceae Leaves, rheumatic pains, (Baill.) Descole et al. stems vulnerary

Prosopis alba Griseb. Algarrobo Fabaceae Fruits astringent, lithiasis, var. alba blanco ophtalmic Prosopis nigra Algarrobo Fabaceae Fruits digestive, ophtalmic (Griseb.) Hieron. var. negro nigra Psidium luridum Alpamato Myrtaceae Flowers aromatizant, digestive (Spreng.) Burret Rhynchosia diversifolia Porotillo Fabaceae Leaves drastic, emollient, Micheli hepatic affections, purgative Rivina humilis L. Hierba del Phytolaccaceae Leaves expectorant, hepatic cancer affections

44 Rumex cuneifolius Lengua de Polygonaceae Leaves, emollient, purgative, Campd. vaca roots stimulative, vulnerary Ruprechtia apetala Manzano Polygonaceae Bark diuretic Wedd. del campo Salvia gilliesi Benth. Salvia Lamiaceae Leaves febrifuge and against morada palpitations Sambucus australis Sauco Adoxaceae Flowers diaphoretic, digestive, Cham. & Schltdl. diuretic Samolus valerandi L. Arambola Primulaceae Leaves antiscorbutic Blanca Sapium Curupi Euphorbiacea Seeds odontalgic, toxic haematospermum Müll. Arg. Satureja odora Salvilori Lamiaceae Leaves digestive and antiacid (Griseb.) Epling. and stems Schinus areira L. Aguaribay Anacardiaceae Leaves anti-inflammatory, aromatizant, hepatic affections, laxative, rheumatic pains Senna corymbosa Sen del Fabaceae Fruits, strong purgative (Lam.) H. S. Irwin & campo leaves Barneby Solanum Espina Solanaceae Leaves, analgesic, anti- sisymbriifolium Lam. colorada stems inflammatory, hepatic var. sisymbriifolium affections, sedative

Sorghastrum pellitum Pasto vaca Poaceae Roots antidisenteric (Hack.) Parodi Sporobolus indicus (L.) Esporobolo Poaceae Leaves contraceptive R. Br. Talinum paniculatum Carne gorda Portulacaceae Leaves refreshment (Jacq.) Gaertn. Leaves astringent, diuretic, Urtica dioica L. Ortiga Urticaceae hepatic affections Leaves antispasmodic Verbena bonariensis L. Verbena Verbenaceae Leaves blood depurative Ximenia americana L. Albaricoque Olacaceae

45 1.2 Bolivia

The Republic of Bolivia, located in central South America, is bounded on the north and east by Brazil, on the south-east by Paraguay, on the south by Argentina and on the west by Chile and Peru. Its total area is 1,098,581 square kilometres.

As in other Andean countries, the extremes in latitude and elevation produce a diversity of ecological conditions. Some peaks in the highlands exceed 6,000 m, while Guayaramerín in the far north-east and Puerto Suárez in the south are respectively 170 and 145 m above sea level.

The most distinctive physical feature of the country is the Andes mountain range, which extends generally north to south across the western part of the country. The Andes form two ranges in Bolivia, the western range (Cordillera Occidental), which runs along the Chilean border, and the eastern range (Cordillera Oriental), the main range, which crosses the west central part of Bolivia. The Cordillera Oriental contains some of the highest Andean peaks, notably Ancohuma (6,388 m), Illampu (6,360 m), and Illimani (6,462 m).

Between the Cordillera Occidental and the Cordillera Oriental lies the Altiplano, a high plateau about 800 kilometres long and about 130 kilometres wide. Lake Titicaca, the highest navigable lake in the world, lies at the north end of the Altiplano at 3,812 m. The southern part of the plateau is arid and barren.

The Yungas, a series of well-watered valleys on the eastern mountain slopes, make up a small region north-east of the Andean Highlands. The region has steep hills covered with forests. The Valles, a region of gently sloping hills and broad valleys, lie in the south-central part of the country. Stretching east and north-east from the mountains is the Oriente, the great Amazonian plains containing large grassy tracts and, along the rivers, dense tropical forests. Much of this region becomes swam pland during the wet season, from December through February. In the south-east, separated from the Amazonian plains by the Chiquitos highlands are the dry, semitropical plains of the Chaco.

Although situated entirely within the tropics, Bolivia has a variety of climates. In the higher regions the climate is cold and dry. The temperature on the Altiplano averages 13° C in January and about 4° C in July, the winter season. Temperatures are even lower at higher elevations in the Andes. The Yungas have a warm, humid climate, while that of the Valles is less humid.

The rainy season in most parts of Bolivia lasts from December through February. The Oriente receives up to 2,000 mm of rain; while much less falls on the Altiplano and the desert areas in the south may only receive 50 mm.

Roughly half of Bolivia’s land area (53.1 million hectares) is covered by natural tropical 46 forests, and more than 2,000 tree and species have been identified. The forests are part of the Amazon Basin system and the species found here include large-leafed (Swietenia macrophylla King), Cinchona spp., Terminalia spp. and Calophyllum spp. Areas of dry tropical forest and savannah are also found in the lowlands. The dominant species change gradually depending on altitude, ranging from Phoebe porphyria (Griseb.) Mez to Eugenia spp. and Podocarpus spp. then at the highest altitudes to Polylepis spp. The country has an extensive network of more than 66 protected forest areas.

Bolivia holds first place in the world in terms of certified natural tropical forests, mainly according to the principles and criteria laid down by the Forest Stewardship Council (FSC). By end of 2003, about 1.4 million hectares was targeted for certification.

Planted forests cover about 46,000 hectares, 52% of them made up of Eucalyptus spp., 40% of Pinus spp. and 8% of other forest species. There have been no government promotion programmes or incentive mechanisms to encourage afforestation and enrichment planting in the country’s natural forests.

There are no official figures on the contribution of the forestry sector to Bolivia’s gross domestic product. However, about 3% to the gross domestic product are estimated to be contributed by the Bolivian forestry sector.

Bolivia has a huge variety of non-wood forest products, especially in the Amazon forests. Brazil nuts and palm hearts are the main economically harvested non-wood forest products today. Products such as latex and quinine used to hold primary positions (FAO, 2008).

Traditional Medicine Systems/Phytomedicine

In Bolivia there are 31 indigenous groups and many mestizo communities living in different natural areas of the country, as Altiplano, Yungas, Chaco or lowlands. Each ethnic culture has its own medical knowledge that uses specific medicinal species. Today, medicinal plants are widely used not only in the countryside, but also in the main cities. Such plants are sold in all the main cities through specific shops and small markets. People use medicinal plants as curatives or palliatives of main health problems according to their cultural background (Maciá et al., 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine

In the Republic of Bolivia, there is currently a national policy on TM/CAM. There are laws and regulations on TM/CAM that were issued in 1987. There is a national programme on TM/CAM in existence. There is a National Pharmacological Committee of experts that evaluates the introduction of new medicines for public consumption and a sub-committee

47 that evaluates, provides or denies, health registration of natural product remedies. Research on herbal medicines is mainly undertaken, in La Paz, at two institutes viz.,: The Instituto de Investigaciones Fármaco Bioquímicas (IIFB), Faculty of Pharmaceutical and Biochemical Sciences, and The Instituto de Investigaciones Químicas (IIQ), Faculty of Exact and Natural Sciences, both from The Universidad Mayor de San Andrés (UMSA) and some research on bioprospection for development is under taken at the Faculty of Science and Technology, Universidad Mayor de San Simón (UMSS) in Cochabamba.

Herbal regulation in Bolivia was introduced in 1996 in Law No. 1737; this legislation is partly the same as that which regulates conventional pharmaceuticals. Herbal medicines are regulated in Bolivia as over the counter medicines and in their own independent regulatory category. Claims that may be made by law are limited to medical claims. There is no national pharmacopoeia, some efforts have been made by the Ministry of Health, but not yet completed; however, there is a document entitled “Normas para Medicamentos Naturales, Tradicionales Homeopáticos” issued by the Ministry of Health, that includes the British Herbal Pharmacopoeia (1992) as well as some native plants used in the country. No information is available on national monographs or other monographs used.

Special GMP rules apply to herbal medicines, yet there is no mechanism for ensuring their implementation. Safety assessment requirements are limited to traditional use without demonstrated harmful effects; again, there is no existing control mechanism. There are currently 52 registered herbal medicines. No herbal medicines are included on the essential drug list. A post marketing surveillance system is being planned. In Bolivia, herbal medicines are sold in pharmacies as over the counter medicines and in special outlets with no restrictions (WHO, 2005).

Medicinal and Aromatic Plant Resources

The country of Bolivia lies in the centre of South America. It is part of the Andean countries whose flora is one of the richest in the world. Some general studies have been carried out on useful plants, including specific studies on Bolivian folk medicine, mainly from the Andean region. The majority of the indigenous cultures in Bolivia live in the eastern part of the Andes. Traditionally, some of the widely used MAPs here have been also used in the Andean region (Maciá et al., 2005).

Many non-governmental organizations have shown interest in furthering work on the agricultural production of some MAPs like Artemisia absinthium L., Matricaria chamomilla L., Plantago major L. and Salvia officinalis L. in order to diversify the means of production and improve the standard of life of the peasants. The work mainly focused on improvement of the primary processing to increase the yield and the benefits for the producers. International cooperation programs such as the Institut de Recherche pour le Développement, IRD (France) SIDA/SSAREC (Sweden) and others together with UMSA, with the National Herbarium at La 48 Paz, and UMSS with The Centre for Botanic and Ecological Research collaborate on these studies. In order to preserve the native medicinal flora, the work on the reforestation of mountain slopes with the help of international agencies was also carried out. As a result of these efforts some 5,000 species used in traditional medicine were catalogued.

The Agrochemical project (started in 1981) of the University of San Simon initiated to set up a pilot plant to study the feasibility of processing aromatic plants for essential oils. There are now 13 rural primary processing plants for essential oils that provide a steady source of eucalyptus oil, lemongrass and Japanese mint. The raw materials from 31 species including 21 native was characterized thus opening up the possibility for commercial exploitation. This also led to the drafting of a work plan aimed at improving reproduction techniques of the most useful species from wild and cultivated species and for their preservation (Leigue et al., 1993).

Research and Development Activities

Research on medicinal plants and studies about their traditional application have been very heterogenous and frequently focused only as ethnobotanical, chemical and therapeutical inventories.

The researchers at UMSA and IRD, Bolivia screened over 250 extracts of 122 different plant species traditionally used by the Tacaná (native community living in lowland forest at the base of the last foothills of the Cordillera Oriental of the Bolivian Andes) for antimalarial activity (Deharo et al., 2001).

The Herbario Nacional de Bolivia, Universidad Mayor de San Andrés (UMSA), Bolivia along with Real Jardin Botánico de Madrid (CSIC), Spain carried out a study with four-fold objectives of (1) to document the medicinal and magic uses of plants commercialized in the markets of the cities of La Paz and El Alto; (2) to gather information on vernacular names, plant parts used, mode of preparations, and ways of remedy administration; (3) to assess knowledge consensus among informants; (4) to study the original habitats and ecological status of these species. A total of 129 species distributed in 110 genera, belonging to 55 families and one uncertain lichen family, were reported as medicinal and magic plants in the markets of La Paz and El Alto, Bolivia as presented in Table 2 (Table missing) (Maciá et al., 2005).

Within the UMSA/SIDA strengthening program (2000), the Faculty of Pharmaceutical Sciences and Biochemistry at UMSA, together with the Immunology Department from the Stockholm University, with support of the Swedish Cooperation, and the OSCAR Project, have initiated (2007, and still under development) a case study (clinical studies phase II) at the tropical Hospital of Palos Blancos, La Paz, the use of Galipea lonfgiflora (Evanta) a medicinal plant, used by the Tacaná, Mosetene and Tsimane ethnic groups in the treatment of

49 cutaneous leishmaniasis. The pharmaceutical formulations based on the total alkaloids of the plant are prepared at the IIFB-UMSA and are evaluated against Glucantime®, so far with very encouraging results.

No further information on research activities on MAPs and their products in the country is currently available.

Trade and Marketing

The Bolivian exports during 2007 for selected Botanicals under the HS codes 0902-0910 (includes South American grown botanicals such as black pepper fruit, capsicum fruit, ginger rhizome, mate leaf, and vanilla fruit, among others); 1211 (includes South American botanicals such as anguraté herb, boldo leaf, cat’s claw bark, coca leaf, condurango bark, ipecac rhizome, marapuama, pau d’arco bark, rhatany root, and stevia leaf among many others); 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms among other balsams and oleo-gum-resins); 130219 (includes most herbal saps and extracts such as those of ginger, guaraná, ipecac, maca, mate, marapuama, pfaffia, and pau d’arco, among others); 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others); and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils) were 338,121; 83066; 22; 595; 171,607; and 59,209 kg respectively. The total exports under these HS codes were 674,998 kg (ITC, 2008).

Constraints and Problems

Despite a great diversity of MAPs and potential for their commentarial production, the local pharmaceutical industry has made little use of resource. There have been only a few studies on the exploitation or the conservation of MAPs in the past. However, recently Bolivia has greatly increased its activity in this area as evident from the existence of some 23 state or non-governmental organizations working in this field. They are working mainly for diversification of the agricultural work, production of raw material for industry, and fo alternat health care products. It is necessary to integrate all these efforts to obtain more efficient short and long term results. For the production of raw material, it is important to widen the scope of the work with rural communities through a greater speed in the transfer and application of technology, design of more efficient equipment and a better organization and training of the people.

50 Table 1: Some MAPs commercialized in Bolivian markets (Maciá et al., 2005) Botanical name Vernacular name Family Part used Uses Allium spp. Ajo macho Alliaceae Root Diabetes, high blood pressure. Aloe vera (L.) Burm. f. Sabila Asphodelaceae Leaves Dandruff, stomach ulcer. Aloysia triphylla (L'Hér.) Cedrón Verbenaceae Aerial part High blood pressure stomach Britton pain, tranquilizer. Ambrosia arborescens Altamisa, marco; Asteraceae Aerial part Abortion, menstrual retardation, Mill. markju rheumatic pain. Anadenanthera colubrina Willka Fabaceae Seeds Abortion, menstrual retardation. (Vell.) Brenan Artemisia absinthium L. Ajenjo, ruda Asteraceae Aerial part Intestinal parasites, stomach ache. macho; ajinju Baccharis genistelloides Carqueja; charara; Asteraceae Aerial part Diabetes, high blood pressure. (Lam.) Pers. kimsa kkuchu Baccharis latifolia (Ruiz & Chilca; chilka Asteraceae Leaves Sprains. Pav.) Pers. Borago officinalis L. Borraja Boraginaceae Aerial part Cough, hoarseness.

Brassica rapa L. Mostaza Brassicaceae Aerial part Fever, headache. Brugmansia arborea (L.) Flurifundio Solanaceae Flower Swellings due to freezing cold. Lagerh. Brugmansia sanguinea Flurifundio Solanaceae Flower swellings due to by freezing cold. (Ruiz & Pav.) D. Don Buddleja coriacea J. Rémy Kiswara Scrophulariaceae Leaves Diuretic, prostate disorders. Cantua buxifolia Lam. Cantuta; kantuta Polemoniaceae Flower Cough, rheumatism. Capsella bursa-pastoris Bolsa bolsa, bolsa Brassicaceae Whole plant Kidney swelling, urine disorders. (L.) Medik. de pastor Cestrum parqui L’H´er. Andres wailla Solanaceae Aerial part Depurative, fever, swellings. Chenopodium Paico; paikko Chenopodiaceae Aerial part Bile and vesicular disorders, ambrosioides L. stomach pain. Chrysanthemum Santa María Asteraceae Aerial part Abortion, during menstruation, coronarium L. depurative, high blood pressure, rheumatism. Citrus sinensis (L.) Osbeck Flor de azahar, Rutaceae Leaves In menstrual retardation, as naranja tranquilizer. Coffea arabica L. Sultana Rubiaceae Fruits Diabetes, high blood pressure Cortaderia spp. Sewenka Poaceae Leaves Abortion, menstrual retardation, diuretic. Cupressus sargentii Jeps. Pino Cupressaceae Branch apex Cough. Cymbopogon citratus Hierba Luisa Poaceae Leaves Stomach pain, swellings by (DC.) Stapf freezing cold. Cynara cardunculus L. Alcachofa Asteraceae Bile and vesicular disorders. and leaves Dianthus caryophyllus L. Clavel, clavel Caryophyllaceae Flower Dizziness, headache. blanco Dianthus plumarius L. Clavel, clavel Caryophyllaceae Flower Eyes problem, heart pain. blanco, clavel rojo, clavilina Dodonaea viscosa Jacq. Chakhataya Sapindaceae Leaves Uterus ailments. Echeveria spp. Congona Crassulaceae Aerial part Ear pain, otitis.

51 Ephedra americana Humb. Cola de caballo Ephedraceae Stem apex Kidney swelling, urine disorders. & Bonpl. ex Willd. hembra Equisetum giganteum L. Cola de caballo Equisetaceae Aerial part Diuretic, kidney swelling. macho Erodium cicutarium (L.) Aguja aguja; yauri Geraniaceae Whole plant Diuretic, prostate disorders. L'Hér. yauri Erythroxylum coca Lam. Coca Erythroxylaceae Leaves Colds, headache, stomach pain. Eucalyptus globulus Labill. Eucalipto, Myrtaceae Branch apex Cough, flu. iucalipto and leaves Ficus carica L. Hoja de higo Moraceae Leaves Abortion, menstrual retardation. Foeniculum vulgare Mill. Hinojo Apiaceae Aerial part Galactogogue, kidney ailments. Gnaphalium Wira wira Asteraceae Aerial parts Cough. cheiranthifolium Lam. Juglans boliviana (C. DC.) Nogal Juglandaceae Leaves Diabetes, kidney & liver ailments. Dode Kageneckia lanceolata Lloke Rosaceae Bark Intestinal parasites. Ruiz & Pav. Alchemilla spp. Pimpilina, Rosaceae Whole plant Dizziness, headache, heart pimpinina ailments. Lavandula latifolia Medik. Alhucema, Lamiaceae Inflorescence Aromatic smoke, pains after alusima childbirth. Linum usitatissimum L. Linaza Linaceae Seeds Fever, stomach trouble.

Lupinus bogotensis Benth. Kela Fabaceae Aerial part Abortion, as depurative during menstruation. Malva parviflora L. Malva Malvaceae Aerial part Anti-inflammatory, colds, fever, headache. Matricaria recutita L. Manzanilla Asteraceae Flowering Colds, cough, gum swelling, tops stomach ache, vulnerary. Medicago sativa L. Alfa, alfalfa Fabaceae Whole plant Diuretic, kidney & lung ailments. Melissa officinalis L. Toronjil Lamiaceae Aerial part Heart ailments, tranquilizer. Mentha spicata L. Hierba buena Lamiaceae Aerial part Intestinal parasites. Mentha ×piperita L. Menta Lamiaceae Aerial part Intestinal parasites, stomach pain. Mulinum spinosum Pers. Choke kalla Apiaceae Whole plant Cough, hoarseness. Mutisia acuminata Ruiz & Chinchirkuma Asteraceae Flowering Dizziness, headache, kidney Pav. tops ailments. Myroxylon balsamum (L.) Kina kina Fabaceae Seeds Ear pain. Harms Myrtus communis L. Arrayan Myrtaceae Leaves Gum swelling. Opuntia ficus-indica (L.) Penca, tuna Cactaceae Stem Kidney pain. Mill. Otholobium pubescens Grimes Bilia, Fabaceae Aerial part Depurative during menstruation, (Poir.) J. W. Grimes billa; wallakaya prostate disorders. Passiflora mollissima Tumbo Passifloraceae Flower Diabetes. (Kunth) L. H. Bailey Peumus boldus Molina Boldo Monimiaceae Leaves Kidney & liver swelling. Pimpinella anisum L. Anis Apiaceae Seeds Diarrhoea, stomach ache. Piper elongatum Vahl Matico; matiku Piperaceae Leaves Colds, kidney & liver swelling, rheumatism, urine disorders. Plantago major L. Llanten, llantina Plantaginaceae Whole plant Kidney & liver swelling.

52 Rosa spp. Rosita blanca, Rosaceae Flower Dizziness, heart ailments. rosa Rosmarinus officinalis L. Romero Lamiaceae Aerial part Colds, general body pain, pains after childbirth. Rubus boliviensis Focke Khari khari Rosaceae Leaves Cough. Rubus megalococcus Focke Khari khari Rosaceae Leaves Cough, diarrhoea. Ruta chalepensis L. Ruda Rutaceae Aerial part Headache, stomach pain. Schinus molle L. Molle Anacardiaceae Leaves Rheumatic joints pain, Sisyrinchium spp. Aika aika Iridaceae Whole plant Infantile diarrhoea Smilax spp. Wila layu; Smilacaceae Root Acne, general body pain. zarzaparrilla Solanum marginatum L. f. Cardo santo, Solanaceae Aerial part Cough, joints pain. carlosanto Solanum palitans C.V. Kuti kuti Solanaceae Fruits Eye swellings. Morton Sonchus oleraceus L. Janapakho Asteraceae Whole plant Bile disorders, liver trouble. Spartium junceum L. Retama, ritama Fabaceae Flower Heart ailments Tagetes terniflora Kunth Chijchipa Asteraceae Aerial part Pains after childbirth Taraxacum officinale F. H. Achicoria, diente Asteraceae Aerial part Bile disorder, kidney & liver pain. Wigg. aggr. de león Tropaeolum tuberosum Isano Tropaeolaceae Root Prostate disorders. Ruiz & Pav. Urtica urens L. Itapallu; ortiga Urticaceae Aerial part Depurative, diuretic, prostate disorders. Vicia faba L. Haba Fabaceae Inflorescence Cough. Xanthium spinosum L. Amorseco, Asteraceae Aerial part Chickenpox, measles, fever. anuchápi Zea mays L. Pelo de choclo Poaceae Styles and Diuretic, kidney ailments. stigmates

53 1.3 Brazil The Federative Republic of Brazil has continental dimensions. It extends over 8,514,215.3 square kilometers, 40 degrees of longitude, from the extreme east of the state of Paraiba on the Atlantic, to the extreme West of the state of Acre on the border with Peru, and 39 ° of latitude, from the Northern tip of the territory of Roraima bordering Guyana and Venezuela, 5°15’N, to the Southern tip of the state of Rio Grande do Sul on the Atlantic coast and bordering Uruguay. Its population is about 190,732,694 (2010) which represents 22.4 hab/km2 with 5.435 cities and a GNP of USD 90 tri (2009) and an IDH of 0.699 (UNESCO, 2010). The topography is, in most parts, gentle and 93% of the country is below 800 m. The highest peaks are confined to two regions, the Northern border with Venezuela in the territory of Roraima and the state of Amazonas and the states of Espirito Santo, Minas Gerais, Rio de Janeiro and São Paulo, in the Southeast Atlantic coast. Two geographic features dominate the landscape of Brazil the vast Amazon Basin, which spans the width of Northern Brazil, and an extensive highland plateau, known as the Brazilian Highlands, which covers most of the South and Southeast. The Amazon Basin contains the world's largest river and the world's largest tropical rain forest. In the South and South-east, the Brazilian Highlands an eroded plateau, dotted with irregular mountains and crossed by river valleys, forms the major feature of the landscape. The highlands separate Brazil's inland regions from a narrow coastal plain that stretches from Ceará in the Northeast to the Uruguayan border in the South. The Amazon River and its tributaries is the largest in the world based on its flow, and the second longest in the world after the Nile. The Paraná River drains much of the Southern part of the country and empties into the Río de la Plata estuary in Argentina. The principal river of the Eastern plateau region is the São Francisco. Many smaller rivers drain the land sloping to the Atlantic seaboard. The climate of Brazil is largely tropical or subtropical. Annual rainfall varies from 3,000 mm or more in some parts of the Northern region (the Colombian border and the delta of the Amazon river) to 1,600 mm in central Brazil to as little as 300 mm in some parts of the "drought polygon" in the Northeastern region (in particular the states of Rio Grande do Norte, Paraiba, Pernambuco, Alagoas and Sergipe). Brazil has the largest expanse of tropical forest in the world and approximately 64% (about 544 million hectares) of its territory has some form of forest cover. An estimated 15% of the 12 million hectares of forest with timber potential are under permanent conservation. Forest plantations cover

54 approximately 6 million hectares, which places Brazil first in Latin America. Eucalyptus accounts for 59% of this area, pine for 37% and other species for 4%. Non-wood forest products, such as the Brazil nut, rubber, palm hearts and medicinal and aromatic plants are very important and generate significant local employment and income (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The use of medicinal plants in the world, and especially in South America, contributes significantly to primary health care. Brazil is no exception. There are many plants used in the country in the form of crude extracts, infusions or decoctions to treat common ailments. Brazil is considered having rich biodiversity in the world, with more than 20% of the total number of species on the planet. This rich biodiversity is accompanied by a long acceptance of use of medicinal plants through traditional knowledge (Rodrigues, 2006; Carvalho et al., 2008 a, b). These facts suggest an economic market potential, especially considering the Brazilian demand by herbal medicines (Carvalho et al., 2011). In Brazil, there are an estimated 12,000 homeopathic physicians, 200 homeopathic veterinarians, 100 homeopathic dentists, 1,300 homeopathic pharmacists and six homeopathic laboratories. Brazil has no updated official data, but it is estimated that the herbal medicines market turnover is around US$ 160 million per year, growing at an annual rate of 15%, while the synthetic medicines market grows around 4% per year. Considering the full productive chain, the herbal medicines sales comprise of US$ 500 million yearly (FEBRAFARMA, 2002) (Carvalho et al., 2011). Brazilian producers are represented by at least 103 industries with 367 phytomedicine entities in 53 therapeutic classes, being 238 single plant drugs. São Paulo has 51.0% of the phytomedicine industries. The top 20 industries phytomedicines sell about USD 300 millions which corresponds to 84.7% of the total value of sale. The biggest laboratory is Altana Pharma, a German joint venture, followed by Farmasa and Marjan (Freitas, 2007). The regulations such as Política de Atenção Integral à Saúde Indígena from FUNASA, promotes and respect for the traditional systems, health care products in Brazil. The Brazilian Medical Association recognized homeopathy as a medical speciality in 1980 and in 1988 government included homeopathy in the National Health System (WHO, 2001).

55 Government Efforts in Development of Traditional Medicine/Phytomedicine In the Federative Republic of Brazil, there is currently no specific national policy on TM/CAM, but the Ministry of Health published two policies stating the role of medicinal plants and herbal medicines in Brazilian Public Health System: the National Policy of Integrative and Complementary Practice (PNPIC) in the Unified Health System (SUS) - MS/GM 971/2006 (Ministério da Saúde/Gabinete do Ministro) and the National Policy of Medicinal Plants and Herbal Medicines (PNPMF, Decree 5813/2006, and PNPIC, Statement 971/2006), which include phytotherapy, acupuncture, homeopathy and anthroposophic medicine. These documents have been promoting and stimulating research and use of medicinal plants and herbal medicines (mainly from the Brazilian biodiversity origin), assuring quality, safety and efficacy (Carvalho et al., 2011). A standardization proposal for the use of medicinal plants and phytotherapeutic in the Sistema Único de Saúde (Unified Health System–SUS) has been introduced and a list of 71 plant species of interest (RENISUS, 2009) is given in Table 2. There is no national office nor any specific national research institute, but phytotherapy has been promoted since 1978, with ups and downs during the period from 1997 to 2006 in terms of policies and funding, although the academic institutions kept working in this field. The products derived from plants can be regulated as foods, cosmetics and drugs. However, only the products manufactured as medicine may make therapeutic claims in their leaflets, packaging and advertising (Carvalho et al., 2011). Regulation of herbal medicine has existed in Brazil since 1967 (RDC 22/1967), and the fourth version of the regulations, RDC 48/2004, was put in place in 2004. It is partly the same as the legislation on conventional pharmaceuticals. Herbal medicines are regulated in the following categories: herbal drugs (both prescription medicines and over the counter medicines), functional foods, probiotics, bioactive substances and cosmetics. Medical claims can only be made if the product is registered as an herbal drug. The national pharmacopoeia is the Farmacopéia Brasileira (5th ed., 2010); the information it contains is legally binding. The National Pharmacopoeia also contains the National monographs and a Brazilian Homeopathic Pharmacopeia was published in 2011. The regulatory requirements for manufacturing include adherence to the information contained in pharmacopoeias and monographs, and the same rules of Good Manufacturing Practices as for conventional pharmaceuticals, as well as special rules. These requirements are ensured through certification of GMP for the production and pharmaceuticals. Safety assessment

56 requirements include the same requirements as for conventional pharmaceuticals and special requirements of traditional use without demonstrated harmful effects; again, there is no existing control mechanism. A list of phytotherapeutic medicines is also ready. There is a post marketing surveillance system that includes adverse effect monitoring, established in 2001. Herbal medicines in Brazil are sold in pharmacies and drugstores as prescription or over-the-counter medicines (Carvalho et al., 2011). In 2001, the total sales of herbal medicines reached an estimated US$ 400 million (WHO, 2005). Nevertheless, the phytomedicine market from November 2003 to October 2006 was about a billion USD (R$ 1.840.228.655) with sales of 122.696.549 units (Freitas, 2007). In Brazil, the Feevale Central University and the University of Anhembi Morumbi offer chiropractic programmes recognized by the World Federation of Chiropractic (WHO, 2001). Homeopathy and phytotherapy are also given as extracurricular or postgraduate courses in several public universities such as the Federal University of Viçosa, Rio de Janeiro, Lavras, and the State University of Bahia, among others.

Medicinal and Aromatic Plant Resources Approximately two thirds of the biological diversity of the world is found in tropical zones, mainly in developing countries. Brazil is considered the country with the greatest biodiversity on the planet, with nearly 55,000 native species distributed over six major biomes which are Amazon (30,000), Atlantic rainforest (10,000), Caatinga (4,000), Cerrado (10,000), Pantanal (10,000) and the subtropical forest (3,000). The Brazilian Amazon Forest (tropical rainforest) covers nearly 40% of all national territory, with about 20% legally preserved. It is estimated that there are about 800 plant species of economic or social value in the Amazon including many medicinal and aromatic plants. From Cerrado, the second largest ecological dominion of Brazil, about 220 species are reported as used in the traditional medicine. Various fruit species and MAPs have their centers of genetic diversity in the Caatinga region, where the use of local folk medicines is common. Several important MAPs are found in the Atlantic Forest region that include plants like Bauhinia forficata Link, Mikania glomerata Spreng., Ocotea odorifera (Vell.) Rohwer and Psychotria ipecacuanha (Brot.) Stokes. In the territory of the Meridional Forests and Grasslands MAPs such as calendula (Calendula officinalis L.), chamomile (Matricaria recutita L.), lemon balm (Melissa officinalis L.), basil (Ocimum basilicum L.), and oregano (Origanum vulgare L.) and rosemary (Rosmarinus officinalis L.) have been introduced and adapted by immigrants. The Pantanal flora is formed by

57 species from both Cerrado and Amazon vegetation. More than 200 species useful for human and animal consumption as well as for industrial use have been recorded in this region. Several exotic, introduced and adapted species have been widely used and cultivated in Brazil. Many of them such as lemongrass (Cymbopogon citratus (DC.) Stapf) and aloe (Aloe spp.), are cultivated in backyard gardens. Others, such as mentrasto (Ageratum conyzoides L.), picão-preto (Bidens pilosa L.) and mastruço (Chenopodium ambrosioides L.), adapted through years, have allowed a spontaneous wide distribution throughout the country and have well documented uses. In southern Brazil, due to favorable cultural and environmental conditions, several exotic species are cultivated in large areas. These include chamomile, calendula, rosemary, Duboisia spp., and Japanese mint (Mentha arvensis L.). The species Coleus barbatus (Andrews) Benth., introduced from Africa and propagated clonally in Brazil, has several volatile oils chemotypes found here (Vieira et al., 1999).

Research and Development Activities During 20 years the Center of Medicines (CEME) of the Ministry of Health was in charge of stimulating funding different fields of medicinal plants research (Research Program on Medicinal Plants – PPPM) such as agronomy, botany, chemistry, pharmacology and toxicology. This incentive has given the scientific basis of the knowledge and of the qualified human resources in the field. The National Genetic Resources and Biotechnology Research Center (CENARGEN/EMBRAPA), a government organization, linked to the Ministry of Agriculture, has been working on MAPs since 1984 with the objectives to collect and preserve the genetic diversity of wild Brazilian medicinal plants and to document information about traditional medicine through ethnobotanical surveys. The work included collection and introduction of germoplasm, multiplication and conservation of MAPs (Vieira and Skorupa, 1993). In 2002, the Brazilian Institute of Environment and Renewable Natural Resources (IBAMA) announced the creation of a database and research centre on medicinal plants. The agency is also to set up a working group to develop a conservation programme for the sustainable use of medicinal plants. So far traditional remedies involving 300 medicinal plant species have been recorded. The new database should allow Brazilian scientists to protect their medicinal plants from bio piracy by foreign pharmaceutical companies (Mantell, 2002). The agency’s efforts are also directed towards sustainable

58 development projects for rural communities to provide them with alternative income. The country also seeks to guarantee intellectual property rights for its indigenous populations over their herbal remedies (Baldwin, 2002). The Departamento de Farmacologia of Instituto de Biociencias de Botucatu, Sao Paulo, and the Departamento de Fitotecnia of Universidade Federal de Santa Catarina, Brazil, carried a preliminary survey of medicinal plants utilization by rural and urban communities of the three cities of the Tropical Atlantic Forest, the Region of Vale do Ribeira and the State of Sao Paulo, Brazil. The study recorded 114 herbal remedies from local users and traditional healers giving their Latin, vernacular and English names, plant part used, forms of preparation and application of the herbal remedies, medicinal or food uses, areas of plant collection, economic importance and other data were presented. The same group in a previous study has reported 117 medicinal plants used in the Brazilian Amazon (Di Stasi et al., 2002). A joint ethnobotanical study was carried out (1995-2002) by the Universidade Federal Rural de Pernambuco, Departamento de Biologia, and the Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Ciências Farmacêuticas, in an important traditional market in the city of Recife (Pernambuco, northeastern Brazil). This study investigated the differences between the species’ relative importance, and presented descriptions of their main uses. The list of plants traded at São Jose Market, and their traditional medicinal uses is presented in Table 1 (de Albuquerque et al., 2007). The researchers at Research Center for Chemistry, Biology and Agriculture, State University of Campinas, Brazil, screened essential oils from 29 medicinal plants commonly used in Brazil against 13 different Escherichia coli serotypes (Duarte et al., 2007). There are many other studies performed by Brazilian researchers on the agricultural, chemical and pharmacological aspects of medicinal plants, which were not systematically published, but only presented in local or regional meetings, unfortunately.

Trade and Marketing According to a 2002 study published in the joint report Plantas Medicinais do Brasil: Aspectos Gerais sobre Legislação e Comércio (Medicinal Plants of Brazil: General Aspects of Legislation and Trade) by TRAFFIC and IBAMA, there is a lot of unreported use and trade throughout Brazil. The study reveals that only a total of 119 (88 native species) of native and exotic medicinal plant species have been identified and reported to be traded domestically or internationally in Brazil.

59 Only some 70 companies and individuals have registered with IBAMA allowing them to officially trade. However, this number is very small and many more species are traded on daily basis than those recorded officially. Number of producers of medicinal plant products registered with IBAMA are located in the state of Maranhão and MAP producers in the state of Acre. The states of Paraná and São Paulo are the largest exporters of medicinal plant materials, while USA followed by Germany is the largest importers of MAPs from Brazil. Some of the traded MAPs like Aniba rosaeodora Ducke, Brosimum glaziovii Taubert, Caesalpinia echinata Lam. and Ocotea pretiosa (Nees) Mez have been classified as endangered due to habitat destruction and unsustainable harvesting and are included in the 1997 IUCN Red of Threatened species. This study revealed that species like Fava d´anta (Dimorphandra mollis Benth.) and Jaborandi (Pilocarpus spp.) are being exported from the country despite prohibition from export. These two species represented the majority of exports of native medicinal plants by volume corresponding to a 57% of a total of US$ 47.8 million in 1995 and 48% of a total of US$ 53.9 million in 1996 (Anonymous, 2002). Presently, Brazil has a US$ 22 billion medicinal plant economy, which comprises around 7% of the entire pharmaceutical industry in Brazil (Anonymous, 2008). The Brazilian exports during 2007 for selected Botanicals under the HS codes 0902-0910 (includes South American grown botanicals such as black pepper fruit, capsicum fruit, ginger rhizome, mate leaf, and vanilla fruit, among others); 1210 (includes only hop strobile Humulus lupulus L.); 1211 (includes South American botanicals such as anguraté herb, boldo leaf, cat’s claw bark, coca leaf, condurango bark, ipecac rhizome, marapuama, pau d’arco bark, rhatany root, and stevia leaf among many others); 121220 (includes seaweeds and algae); 130190 (includes botanicals such as balsam-of- Peru Myroxylon balsamum (L.) Harms among other balsams and oleo-gum- resins); 130219 (includes most herbal saps and extracts such as those of ginger, guaraná, ipecac, maca, mate, marapuama, pfaffia, and pau d’arco, among others); 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others); 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils); and 400130 (includes botanicals such as gutta percha latex Payena spp. and Palaquium gutta (Hook.) Baill., balata Manilkara bidentata (A. DC.) A. Chev., chicle Manilkara zapota (L.) P. Royen, guayule Partheniu) were 89,982,290; 5,114; 1,791,814; 80,561; 8,576,378; 20,204,698; 279,033; 75,651,045 and 2,917 kg respectively (ITC, 2008).

60 Constraints and Problems The demand of Brazilian MAPs for local use and foreign companies and laboratories is growing. This has pressurized many plant species with unsustainable harvesting and many of Brazil’s medicinal plants are currently threatened by such practices. There is a severe lack of information on the use and trade of medicinal plants in Brazil. Clarity in the legal instruments and recording systems that are regulating harvest and trade in the medicinal plants is urgently needed. There is need for co-ordination and implementation of control systems by the authorities. More information exchange between research institutions, control authorities and healthcare industry for better analysis and understanding of the impact of use and trade on wild medicinal plant populations is required. More research is also needed on trade dynamics and implementation of related laws and regulations in order to promote better management of trade and conservation of medicinal plants resources.

REFERENCES Albuquerque, U. P., Monteiro, J. M., Ramos, M. A., and de Amorim, E. L. C., 2007, Medicinal and magic plants from a public market in northeastern Brazil. Journal of Ethnopharmacology, 110: 76–91 Anonymous, 2002, Urgent action needed for managing Brazil’s medicinal plant trade. TRAFFIC News Anonymous, 2008, Emerging Markets: Brazil. Milward Brown. Available at: https://www.millwardbrown.com/(A(-QHkPuok5oG- EAaHnrTf4fuvO_yIIIkUzDsQnPxU_RPOAB6WvYmCT1C0oxg- nA6L9aIQDxbRvNWGWxIEubepSMo4f5SK5Qq3UZqBR6_Wofo1))/Sites/ MillwardBrown/Media/Pdfs/en/MarketFocus/1374C288.pdf (10 Jul. 2008) Baldwin, K., 2002, Brazil starts mapping medicinal plant potential. Available at: http://www.ibama.gov.br/ (8 Jul 2008) Brasil, Congresso Nacional. Portaria no. 22, de 30 de outubro de 1967. Estabelece normas para o emprego de preparações fitoterápicas. Diário Oficial da União. Brasília, 16 nov. 1967. Seção 1, p.45-46 Brasil, Presidência da República. Decreto no. 5813, de 22 de junho de 2006. Aprova a Política Nacional de Plantas Medicinais e Fitoterápicos e dá outras providências. Diário Oficial da União. Brasília, 23 jun. 2006a. Seção 1, p.2-4

61 Brasil, Ministério da Saúde. Portaria no. 971, de 03 de maio de 2006. Aprova a Política Nacional de Práticas Integrativas e Complementares (PNPIC) no Sistema Único de Saúde. Diário Oficial da União. Brasília, 04 mai. 2006b. Seção 1, p.20-25 Carvalho, A. C. B., Balbino, E. E., Maciel, A. and Perfeito, J. P. S., Situação do registro de medicamentos fitoterápicos no Brasil. Rev. Bras. Farmacogn., v.18, n.2, p.314-319. 2008a Carvalho, A. C. B., Santos, L. A., Silveira, D., La regulación de los medicamentos herbarios en Brasil. Bol. Latinoam. Caribe Plantas Med. Aromat., v.8, n.1, p.7-11. 2008b Carvalho, A. C. B., Perfeito, J. P. S., Silva, L. V. C., Ramalho, L. S., Marques, R. O., Silveira, D., Regulation of herbal medicines in Brazil: advances and perspectives, Braz. J. Pharm. Sci. 47 (3), 2011 Di Stasi, L. C., Oliveira, G. P., Carvalhaes, M. A., Queiroz-Junior, M., Tien, O. S., Kakinami, S. H. and Reis, M. S., 2002, Medicinal plants popularly used in the Brazilian Tropical Atlantic Forest. Fitoterapia, 73: 69-91 Duarte, M. C., Leme, E. E., Delarmelina, C., Soares, A. A., Figueira, G. M. and Sartoratto, A., 2007, Activity of essential oils from Brazilian medicinal plants on Escherichia coli. Journal of Ethnopharmacology, 111(2): 197-201 FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Farmacopéia Brasileira, ANVISA and Fundação Oswaldo Cruz, Brasília, 5th ed., vol. 1 ( 523 pp.) and 2 ( 899 pp.), 2010 Farmacopéia Homeopática Brasileira, Anvisa, Brasília, 3th ed., 364 pp., 2011 FEBRAFARMA. Federação Brasileira da Indústria Farmacêutica. Fitoterápico atrai investimentos; 2007 [Citado: 2007 ago. 22] Disponível em: http://www. febrafarma.org.br/areas.php?area=pu&secao=38&modul o=materias Freitas, A. Estrutura de mercado do segmento de fitoterápicos no contexto atual da indústria farmacêutica brasileira, Ministério da Saúde - Secretaria Executiva, Área de Economia da Saúde e Desenvolvimento, Núcleo Nacional de Economia da Saúde, Brasília – DF, Brazil, 28 pp., 2007 ITC, 2008, Market News Service, Medicinal Plants & Extracts, 27: 46, Jun. 2008, Geneva, Switzerland Mantell, K., 2002, Brazil takes stock of its medicinal plants. Available at: http://scidev.net/en/agriculture-and- environment/bioprospecting/news/brazil-takes-stock-of-its-medicinal- plants.html (8 Jul. 2008)

62 RENISUS, Relação Nacional de Plantas Medicinais de Interesse ao SUS, DAF/SCTIE/MS – Brasil, Feb 2009 Rodrigues, A. G., Fitoterapia no Sistema Único de Saúde. In: Anais da V Jornada Catarinense e I Jornada Internacional de Plantas Medicinais, Joinville: Ed. Univille. 2006. p.68-69 UNESCO, Relatório UNESCO sobre a Ciência 2010 – O atual status da ciência em torno do mundo, Resumo Executivo, SC-20/WS/25, Brasil, 2010 (available at www..org/science/psd) Vieira, R. F. and Skorupa, L. A. 1993. Brazilian medicinal plants gene bank. Acta Hort. (ISHS), 330: 51-58 Vieira, R. F., 1999, Conservation of medicinal and aromatic plants in Brazil. p. 152–159. In: Janick, J. (eds.), Perspectives on new crops and new uses. ASHS Press, Alexandria, VA. Available at: http://www.hort.purdue.edu/newcrop/proceedings1999/v4- 152.html#brazilian (8 Jul. 2008) WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

63 Table 1: List of the plants traded in local markets of State of Pernambuco, Northeast Brazil, Albuquerque et al., 2007)

Botanical name Family Common Part used Use(s) name Acanthospermum Asteraceae Espinho-de- Whole Asthma, bronchitis, cough, hispidum DC. cigano plant tiredness. Aloe vera (L.) Burm. f. Asphodelaceae Babosa Leaf, stem, Cancer, eczema, gastritis, root hair loss, hemorrhoids, inflammation, pain in the bones, prostate, rheumatism, vermifuge. Alpinia speciosa (J. C. Zingiberaceae Colônia Leaf, flower Fever, headache, influenza, Wendl.) K. Schum. magical-religious, sinusitis Amburana cearensis Fabaceae Imburana-de- Stem, seed Bronchitis, cough, fever, (Alemão) A. C. Sm. cheiro gastritis, influenza. Anacardium occidentale Anacardiaceae Caju Roxo Stem (inner Cough, diabetes, L. bark) inflammation, hepatitis, leucorrhea, wound- healing. Anadenanthera Fabaceae Angico Stem (inner Anaemia, asthma, cough, colubrina (Vell.) bark) inflammation, influenza. Brenan. Annona salzmannii A. Annonaceae Condessa, Leaf Diabetes DC. Araticum-da- praia, Araticum- bravo Argemone mexicana L. Papaveraceae Cardo santo Seed, leaf Blood circulation, cholesterol. Artemisia vulgaris L. Asteraceae Losna Leaf, bark Common cold, inflammation. Averrhoa carambola L. Oxalidaceae Carambola Leaf Kidney troubles. Baccharis trimera (Less.) Asteraceae Carqueja Leaf Diabetes, high blood DC. pressure, menopause, urinary inflammation. Bambusa Poaceae Bambu Root Erysipelas Bauhinia Fabaceae Pata-de-vaca Leaf cholesterol, diabetes, high blood pressure. Boerhavia diffusa L. Nyctaginaceae Erva-tostão, Root, fruit Urinary inflammation, Pega-Pinto venereal diseases. Borreria verticillata (L.) Rubiaceae Vassoura-de- Leaf, root hemorrhoids, impotency, G. Mey. Botão vaginal discharge. Bowdichia virgilioides Fabaceae Sucupira Bark Arthritis, diabetes, Kunth osteoporosis, rheumatic pains. Brassica integrifolia (H. Brassicaceae Mostarda Seed Stroke West) Rupr. Bryophyllum calycinum Crassulaceae Corona, Leaf Cough, pains in general. Salisb. Folha-da-

64 Fortuna Caesalpinia echinata Fabaceae Pau -Brasil Stem Abortion, diabetes. Lam. Caesalpinia ferrea Mart. Fabaceae Pau-ferro Fruit, leaf Anti-inflammatory, ex Tul. diabetes, lung infection. Cecropia Urticaceae Embauba Leaf Diabetes, high blood pressure, tranquilizer Cedrela odorata L. Meliaceae Cedro Stem Swelling, testicle inflammations. Cereus jamacaru DC. Cactaceae Mandacaru Stem Kidney troubles.

Chenopodium Chenopodiacea Mastruço Leaf Bronchitis, influenza, ambrosioides L. e tuberculosis, worm infestation. Chrysobalanus icaco L. Chrysobalanace Abajerú Bark, root Cholesterol, diabetes. ae Cinnamomum Lauraceae Caneleira Leaf, bark Dysentery, nausea, zeylanicum Blume stomach trouble, tranquilizer. Cissus spp. Vitaceae Insulina Root, leaf Diabetes Citrus aurantium L. Rutaceae Laranja Leaf Tranquilizer amarga Cleome spinosa Jacq. Cleomaceae Mussambê Flower Cough Cnidoscolus urens (L.) Euphobiaceae Urtiga branca Root Cancer, dysentery, Arthur hemorrhage, inflammation, menstruation. Coffea arabica L. Rubiaceae Café Leaf Swelling Coriandrum sativum L. Apiaceae Coriandro, Seed Digestive Salsa- Mexicana Costus spicatus (Jacq.) Costaceae Cana-de- Stem (inner Kidney trouble Sw. macaco, bark) Cana-do brejo Cymbopogon citratus Poaceae Capim santo, Leaf, whole Blood pressure, headache, (DC.) Stapf Capim limão plant tranquilizer. Echinodorus spp. Alismataceae Chapéu de Leaf Inflammation, kidneys couro troubles. Erythrina velutina Fabaceae Mulungu Leaves, Sinusitis, tranquilizer. Willd. stem Eucalyptus globulus Myrtaceae Eucalipto Leaf Asthma, chicken pox, Labill. fever, gripe, measles, rhinitis, sinusitis, stroke. Foeniculum vulgare Apiaceae Endro Seed Bursitis, liver, pains in Mill. general. Guazuma ulmifolia Malvaceae Mutamba Flower Hair growth Lam. Helianthus annuus L. Asteraceae Girassol Seed Cholesterol, stroke Heliotropium indicum L. Boraginaceae Fedegoso Root, leaf blemishes, leg pain, stroke

65 Ilex paraguariensis A. Aquifoliaceae Erva-mate Leaf Nerves, fatigue, digestive St.-Hil. Illicium verum Hook. f. Illiciaceae Anis Seed Colic, rheumatic pain, estrelado vomiting. Imperata brasiliensis Poaceae Sapé Root Spine pain. Trin. Ipomoea asarifolia Convolvulaceae Salsa-da- Leaf Inflammation, swelling (Desr.) Roem. & praia Schult. Jatropha curcas L. Euphobiaceae Pinhão Seed Stroke branco Jatropha gossypiifolia L. Euphobiaceae Pinhão roxo Leaf Hepatitis Justicia pectoralis Jacq. Acanthaceae Chamba Leaf Bronchitis, colds, cough, fever. Laurus nobilis L. Lauraceae Louro Leaf Amenorrhea, diarrhea, dyspepsia, gastritis Lavandula spica L. Lamiaceae Alfazema Leaf Fever, stomachache.

Lippia alba (Mill.) N. E. Verbenaceae Erva-Cidreira Leaf Anemia in children, colic, Br. ex Britton & P. tranquilizer. Wilson Luffa operculata (L.) Cucurbitaceae Cabacinha Fruit Sinusitis Cogn. Matricaria chamomilla Asteraceae Camomila Flower High blood pressure, L. tranquilizer. Mentha spp. Lamiaceae Hortelã Leaf Common cold, menstrual Miudo/Vega- cramps, worms. morta Miconia albicans (Sw.) Melastomatacea Carrasco Stem Fever, magical-religious, Triana e vitiligo. Momordica charantia L. Cucurbitaceae Melão de São Fruit, leaf skin itching (scabies). Caetano Myracrodruon Anacardiaceae Aroeira Stem (inner Abdomen colic, acne, urundeuva Allemão bark) allergy, arthritis, bacteria, feet fungus, fungus, germs, hemorrhage, inflammation, insect bites, itching, mycosis, pain in the digestive organs, rheumatism, skin problems, tumors, women’s pains, wound- healing. Ocimum americanum L. Lamiaceae Manjerona Leaf Cholesterol, magical- religious, stomach ache. Ocimum basilicum L. Lamiaceae Manjericão Leaf Conjunctivitis, earache, magical-religious, stomach ache Ocimum gratissimum L. Lamiaceae Alfavaca Leaf, whole Dizzy spells, magical- plant religious, sinusitis, stomach ache

66 Origanum vulgare L. Lamiaceae Orégano Leaf Mouth inflammations, nausea, nephralgia. Passiflora edulis Sims Passifloraceae Maracujá Leaf Tranquilizer Paullinia cupana Kunth Sapindaceae Guaraná Seed Stimulant, tonic. Peperomia pellucida (L.) Piperaceae L;ingua de Whole Blood pressure, high Kunth sapo plant cholesterol, magical- religious. Persea americana Mill. Lauraceae Abacate Leaf Abortion, kidneys.

Petiveria alliacea L. Phytolaccaceae Pipi, Guiné Leaf Itching, magical-religious, pain in the legs, rheumatism, swelling. Peumus boldus Molina Monimiaceae Boldo Leaf Constipation, heartburn, liver. Pfaffia glomerata (A. Amaranthaceae Para-tudo, Fever Spreng.) Pedersen Ginseg brasileiro Phyllanthus niruri L. Euphobiaceae Quebra- Leaf, stem Abortion, kidneys, late pedra periods. Pimpinella anisum L. Apiaceae Erva Doce Fruit, leaf Indigestion, tranquilizer, liver, magical-religious. Piper marginatum Jacq. Piperaceae Caapeba Root, leaf, Asthma, blood pressure, stem diuretic, erysipelas, problems in the urinary system, stomach. Piper nigrum L. Piperaceae Pimenta Seed Throat preta Plantago major L. Plantaginaceae Trançagem Leaf Stroke, throat Plectranthus amboinicus Lamiaceae Hortelã- Leaf Common cold, cough, hair (Lour.) Spreng. Graúdo loss, magical-religious. Psidium guajava L. Myrtaceae Goiaba Flower Liver Psychotria ipecacuanha Rubiaceae Ipeca, Whole Bronchitis, cancer, (Brot.) Stokes Ipecauanha plant children’s teething, dysentery, whooping- cough, worms. Punica granatum L. Punicaceae Romã Fruit Anemia, gastritis, indigestion, throat. Rosmarinus officinalis L. Lamiaceae Alecrim Leaf Cough, fever, hair loss, high blood pressure, influenza, magical- religious, sinusitis, tiredness. Ruta graveolens L. Rutaceae Arruda Leaf Earache, late periods, lice, stroke. Sambucus nigra L. Adoxaceae Sabugueiro Flower Chicken pox, common cold, cough, fever, measles, tiredness Schinus terebinthifolius Anacardiaceae Aroeira Inflammation, magical- Raddi religious women’s pains, wound-healing

67 Senna alata (L.) Roxb. Fabaceae Mata-pasto Leaf Anemia, stroke. Senna occidentalis (L.) Fabaceae Manjerioba Leaf Anemia, late periods, lose Link weight, stroke. Sesamum orientale L. Pedaliaceae Gergelim Seed Blood circulation, stroke. Sida cordifolia L. Malvaceae Malva branca Leaf Toothache Sideroxylon Sapotaceae Quixaba Stem, leaf Blows, cleansing uterine obtusifolium (Roem. & wounds, general Schult.) T. D. Penn. inflammations, injuries, wound-healing. Solanum americanum Solanaceae Erva Moura Leaf Inflammation Mil Solanum paniculatum L. Solanaceae Jurubeba Fruit, root, Anemia, diabetes, liver, Seed, leaf spleen inflammation, tuberculosis. Stryphnodendron Fabaceae Barbatimão Stem (inner Bad circulation, cleansing adstringens (Mart.) bark) uterine wounds, anon. inflammations, wound- healing. Syagrus spp. Coco catole Leaf Spine Symphytum officinale L. Boraginaceae Confrei Leaf Asthma, diabetes, gastritis, hepatitis, liver, inflammations in general, leukemia, ulcer, prostate. Tabebuia avellanedae Bignoniaceae Pau D’Arco Bark Backache, impotency, Lorentz ex Griseb. inflammations, intestinal inflammations, stomatitis, throat ulcers. Urena lobata L. Malvaceae Malva rosa Leaf Cough, fever, influenza. Zingiber officinale Zingiberaceae Gengibre Root Throat problems. Roscoe

68 Table 2 – RENISUS – National list of Medicinal Plants of interest to SUS (Brazilian Public Health System)

69 *To define cultivated species with studies and use indication. Source: DAF/SCTIE/MS - Brazil – RENISUS – Feb. 2009

70 1.4 Chile The Republic of Chile is bound on the north by Peru, on the east by Bolivia and Argentina and on the south and west by the Pacific Ocean. Long but narrow, it stretches 4,270 kilometres from north to south but only 427 kilometres wide at its widest point. The country has a total area of 756,626 square kilometres. Chile is a land of great variety, ranging from the dry Atacama Desert in the north to the cold, stormy south. The Andes Mountains form Chile’s backbone, while lower mountains line the Pacific coast. A series of fertile river basins called the Central Valley lies between the mountain ranges in central Chile. Chile can be divided into three regions from north to south: the Northern Desert, the Central Valley, and the Archipelago. The Northern Desert stretches 1,690 kilometres south from the Peruvian border to the Aconcagua River, just north of Valparaiso. The Atacama Desert, one of the driest places on earth, covers the northern half of the region. The land becomes slightly less arid area to the south. The Andes are widest and highest in this region, with elevations beyond 6,100 m, including the country’s highest peak, Ojos del Salado, 6,880 m. The Central Valley extends about 970 kilometres from the Aconcagua River to the city of Puerto Montt. Industry, agriculture, and most of the nation’s population are concentrated in this region. The central Andes are narrower with lower elevations. The Archipelago extends about 1,600 kilometres from Puerto Montt to the southernmost tip of South America, Cape Horn. It is a wild, windswept region of steep, rocky slopes, dense forests, glaciers, and lakes. The region’s western edge is broken into thousands of islands. In the far south, the Strait of Magellan separates mainland Chile from the group of islands known as Tierra del Fuego. Cape Horn is the southernmost point of the continent. Elevations in the southern Andes seldom exceed about 1,800 m. Chile owns several small islands in the Pacific, including Easter Island and the Juan Fernández group. Most rivers are relatively short, generally rising in the Andes and flowing west to the Pacific. The most important are the Loa, Elqui, Aconcagua, Maipo, Maule, Biobío and Imperial. There are a number of major lakes, including Lake Llanquihue, in the southern region. Because of its great range of latitude and elevation, Chile has a variety of climates. The northern region is almost entirely desert and may not have rain for years. Temperatures, however, are moderated by the offshore Humboldt Current. The Central Valley has a mild, Mediterranean type of climate, with dry summers and rainy winters. Santiago receives about 360 mm of rain

71 annually. Frequent cold, stormy weather characterizes the Archipelago. The city’s average annual precipitation is 2,180 mm, but parts of the Archipelago receive up to 5,000 mm of rain a year, much of it in the form of snow in the far south (FAO, 2008).

Traditional Medicine Systems/Phytomedicine In Chile, there is a vast traditional knowledge on medicinal plants, a fundamental resource of primary health care for a great part of the population in indigenous and rural zones, as well as an important source of income for these sectors. In addition to that, the National culture also is not homogeneous and cultural differences are reflected in the practice of medicine. Most Mapuche live in southern Chile, although there is also a sizeable population in neighboring Argentina. The Mapuche are the largest group of indigenous people in Chile and one of the largest in South America. Most live in the region of the Aruncanía south of Santiago. Machis (traditional healers) are well respected within their communities and are consulted for issues such as ill fortune besides related to health and illness. They may also be consulted by non indigenous Chileans particularly in respect to stubborn or unusual disease (Evans, 2002). There are different levels of herbal medicine practiced within Mapuche society. Minor illnesses may be treated with herbs within the home, but for more serious illnesses the machi, or shaman is consulted. The herbs used for simple illnesses within the home may be of either indigenous or non- indigenous origin (Jagtenberg and Evans, 2003). The Mapuche Community Hospital offers traditional and allopathic treatment options. The hospital is affiliated with Mapuche University. Both the hospital and the university receive financial support from the Ministry of Health. In Chile, 10 to 12% of the population is indigenous. Seventy-one per cent of the population uses complementary/alternative medicine. There are between 2000 and 10,000 traditional health practitioners in Chile. Principal traditional medical specialities are herbalism, spiritualism, traditional birth attendance, aromatherapy, bach flowers, acupuncture, bone-setting, and chiropractic. National policies emphasize equal treatment for traditional and allopathic medicine. Homeopathy and the Homeopathic Pharmacopoeia are legally recognized. The Public Health Institute recognizes homeopathic remedies (WHO, 2001). The book of Cruz-Coke (1995) is one of the first work of collection of this information, which details the investigations of the Father Luis Feuilleé,

72 published in 1714, who indicated medicinal uses of plants of Peru and Chile; it also emphasizes the social and medical work of the Doctor Adolfo Murillo, mainly the publication of the Chilean Pharmacopoeia in 1886; as well as Guajardo’s work in the year 1890, who described chemical characteristics of some Chilean medicinal plants. Gusinde (1936) published works related to the traditional uses of medicinal plants by the southern indigenous tribes of the country. The diversity of the Chilean flora made possible the natural growth of more than a thousand species of medicinal plants, forming diverse pharmacological varieties of astringent, diuretic, analgesic, antipyretic and soothing, among others attributes, identified by the doctors then. Native plants like cachanlagua (Centaurium cachanlahuen), paico (Chenopodium ambrosioides), quinchamalí (Quinchamalium chilense), viravira (Gnaphalium viravira) and cinnamon tree (Drymis winteri) are some of the best-known by their therapeutic uses during the Colonial Period in Chile (Cruz-Coke 1995). In the early twentieth century, plants in their natural state were already part of medical studies; supported by the constant development of chemistry, it was possible to investigate their active ingredients. Scientific publications from the second half of last century strengthened medicinal herbs through the study of the chemical components that give value to medicinal plants, diversifying the medical practices (Pacheco et al. 1977; Montes and Wilkomirsky 1987; Muñoz et al. 2001). In 2003, Hoffman et al. identified and described medicinal plants commonly used in Chile through ethnobotanical information about the traditional medicinal uses of more than 60 species of Chilean plants (Hoffman et al. 2003). Looser and Rodríguez (2004) described the medicinal attributes of the Chilean Pteridophytes based on an unpublished manuscript of the naturalist Walterio Looser. However regarding Chilean herbs “many points that have to be clarified still remain”. In the year 2009, Montenegro et al. in their work “Secret of our plants and other species: how to use them for the benefit of the people”, made a contribution to the rescue and preservation of the cultural patrimony of Chile, compiling antecedents related to the multiple uses of the plants (medicinal, cosmetic, and domestic uses, among others) that form part of the traditions and traditional knowledge of our country (Montenegro et al. 2009). In a similar trend Montenegro (2000) and Montenegro et al. (2010) rescue the value of those native plants used selectively by honeybees (Apis mellifera) to collect nectar to produce honey that inhered it the medicinal properties of the plant (Montenegro 2007). There is also an ancient knowledge regarding the identification, harvesting and medicinal uses of Chilean native plants and their chemical principles (active ingredients) that are used in fields like medicine,

73 perfumery, cosmetics, food industry, industrial and agricultural use . The species of plants that are used with medicinal purposes are the basis for two types of products, as traditional medicines, by itself or in formulations, recommended by traditional doctors, not professionals, and as commercial products with medical prescription, patented medical products. The drugs used with medicinal purposes are mainly formulated based on wild or cultivated plants and their derivatives (Pearce and Puroshothaman 1993), and used as traditional medicines in developing countries, covering most needs of great part of the population (Simpson and Craft 1996). However, there is no legislation for the conservation of native germplasm of medicinal plants that are exploited indiscriminately (FIA 2001), therefore, becomes extremely necessary to regulate access to genetic resources in Chile, given its high value, prevent leakage of material and protect traditional knowledge (Manzur 2004).

Government Efforts in Development of Traditional Medicine/Phytomedicine A national policy on TM/CAM is in development in the Republic of Chile, as are laws and regulations. In 1992, a national programme was established, and in the same year the national office, Unidad de Medicina Tradicionaly Otras Practicas Médicas Alternativas (Unit for Traditional Medicine and Other Alternative Medical Practices) was established within the Ministry of Health. No national research institutes on TM/CAM or herbal medicines have been established. In 2002, Chile began regulation of herbal medicines, with a separate, specialized law. Herbal medicines are regulated as over the counter medicines, as dietary supplements and as an independent regulatory category. By law, medical and health claims may be made about herbal medicines. In place of an outdated national pharmacopoeia, alternatives are used, including the following: International Pharmacopoeia, United States Pharmacopoeia, British Pharmacopoeia, German Pharmacopoeia and German Homeopathic Pharmacopoeia. National monographs are in production. There is also a historical-cultural context regarding the listing of plant species with healing properties and symbolic to the indigenous peoples of Chile (Olivos 2004). The third and final version of the Farmacopea Chilena (1941) had a total of only 84 curative species with their corresponding scientific names. The Regulations of the National System of Pharmaceutical Control, Foods for Cosmetic and Medical Use (1982) only contains articles that regulate pharmaceutical products, being medicinal plants identified merely as "native and foreign herbs of popular use", stating that they must be

74 sold without therapeutic properties and dosage. Thus, medicinal plants sold freely as those used by the indigenous medical systems remained for several years in a legislative limbo (Medina 2005). There is no registration system, nor are herbal medicines included on an essential drug list. There is a national post marketing surveillance system that includes adverse effect monitoring for herbal medicines. In Chile, herbal medicines are sold in pharmacies as over the counter medicines and in special outlets (WHO, 2005). However, in a regulatory context, existing regulations regarding medicinal plants are associated, firstly, to the stage of production-extraction of plant species oriented to the sustainable use of plants or plant structures such as leaves and fruits, specifically the exploitation of quillaya (Quillaja saponaria) from which mainly its bark is extracted; boldo (Peumus boldus) for the removal of its leaves, and shrubs and native trees in general; and secondly, to the species processing for therapeutic use, regulating the processing of medicinal herbs in order to obtain and register a pharmaceutical product with medicinal properties. Regulatory requirements for manufacturing include observation of information in pharmacopoeias and monographs and special GMP rules for herbal medicines. These requirements are guaranteed through authorization and control of packaging establishments. Special rules for safety assessment include traditional use without demonstrated harmful effects and reference to documented scientific research on similar products. Implementation of these requirements is ensured by an official listing system and hygienic controls placed on packaging establishments and on the medicines itself. The Ministry of Health oversees the Unit of Traditional Medicine, which also governs complementary/alternative medicine, and the Unit of Indigenous Community Health. The Unit of Traditional Medicine was established in August 1992. Its objectives are to set standards for the safety and efficacy of traditional medicines and to encourage the use of proven traditional medicines, including incorporating them into allopathic health programmes. The Unit of Indigenous Community Health develops the primary health care system at the community level. The Health Ministry issues licences for the practice of traditional medicine, but very few traditional medicine practitioners are licensed. The Government has recognized homeopathy as a medical system, but there are no officially recognized training programmes or examinations. A chiropractic college is being established (WHO, 2001). A group of experts called by the Department of Health carried out a land registry of the medicinal plants empirically used by the Chilean

75 population, registering 460 different vegetable species (PROTEGE 2009). This work is a significant contribution to the protection of our national flora as well as to the revaluation of the national medical herbarium as an official therapeutic resource. In Chile, the Ministry of Health has generated and incorporated changes in the legislation to ensure the rational use of medicines derived from medicinal plants and natural products (Parada 2011).

Medicinal and Aromatic Plant Resources The geographical isolation of Chile provided by the Andean range, the Pacific Ocean and the Atacama dessert, has produced unique flora with a total of 5,082 species including 5,012 native species of which 2,561 (51%) are endemic. The traditional pharmacopoeia consists of nearly 300 native species of which only some 90 have been studied chemically. Chilean mediterranean climate areas, with their long dry summers and winter rainfall, support high species richness, a rich array of life forms, and high levels of endemism (Arroyo et al. 1993). These features have been related to those of Mediterranean flora origin (Raven and Axelrod 1978; Raven 1988), with transitional position of Mediterranean vegetation between cool-temperate and dry tropical types (di Castri 1990), and strong temporal fluctuations in precipitation, deterring spatial and temporal patchiness (Zedler 1990) and low nutrient soils (Westoby 1988). The Chilean traditional medicine practices were enriched further with the arrival of European settlers through the incorporation of the part of European traditional pharmacopoeia and by the use of native plants similar to those known to Europeans e.g. Cichorium intybus L. and Matricaria chamomilla L., which are species from Europe incorporated into the traditional Chilean pharmacopoeia. The degree of endemism (30%) is substantially lower for native Chilean medicinal plants than that of the country flora in general (Niemeyer, 1995). Furthermore the survival of some species, particularly endemic species and those of restricted distribution is threatened by indiscriminate extraction for medicinal and aromatic uses (Montenegro 2000; Montenegro et al. 2003). Thus, conservation and proper utilization of these resources are becoming more pertinent issues to be discussed. In general, the plants that belong to the medicinal category include a group of vegetable species with chemical principles (active ingredients ) that provide benefits in areas of the medicine, cosmetics and perfumery, among others; this is why, in recent years, investigation institutions and private companies in our country have initiated and developed the study of diverse

76 native and introduced species with considerable productive potential, like Rosa mosqueta, hierba de San Juan, boldo, bailahuén, peumo and cinnamon, traditionally produced and wildly harvested. Nevertheless, and despite existing information coming from diverse units of investigation, it is fundamental to systematize the scientific and traditional information found about the medicinal plants in order to generate conservation opportunities for native species that are threatened by barely regulated processes of production-extraction, and at the same time, to open trade opportunities in the internal and external markets, adding value to the productive chain through greater investigation and innovation. Internationally, Hawkins (2008) described the important role that plays the ex-situ conservation on threatened medicinal plants, describing the different forms in which botanical gardens provide integrated solutions for the local, regional and global plant species conservation, allowing free access to an enormous collection of data. In Chile, the National Botanical Garden of Viña del Mar do not have an ex situ garden of medicinal plants, encouraging to implement it in a near future for education purpose.

Research and Development Activities Chile has found interesting opportunities for certain species, based on specific and potential demands, making the country exports to focus on their cultivation. This is the case of Rosa mosqueta and hipérico, which according to market requirements, regarding their volume and concentration of active ingredients, have created the right transition conditions in Chile for growing plants through the incorporation of more technology. Such transition began last decade led mainly by public and private companies with investments in research and development. Thus, a new development phase of this industry has gradually originated in Chile, which has incorporated new technology and diversified crop species and varieties, increasing the national supply and including primary processing, such as the outdoor drying of medicinal plants in the northern part of the country. Science and Technology (S&T) are fundamental tools to achieve a smooth transition toward the conservation and sustainable use of biodiversity. Nowadays, great part of the world is booming about the use of biologically active compounds (antibacterial, antifungal, antioxidant, etc.) from natural sources in order to treat diseases and maintain good health. Associated with this higher demand, there has been a steady and sustained increase in the search for natural sources that contain significant amounts of such compounds.

77 The Chilean flora has shown to be a good resource (Montenegro 2000; Vogel 2000; Muñoz et al. 2001; Montenegro et al. 2001; Montenegro et al. 2003; Montenegro et al. 2005; Montenegro 2006; Fischer et al. 2007; Vogel et al. 2010; Fischer et al. 2010) which added to the high degree of endemism, primarily from the native flora of Chile’s central regions (Arroyo and Cavieres 1997), leads us to reasonably propose that products with unique and particular bioactive properties could be obtained from it, such as chemical compounds present in honey and propolis, which are closely associated with the botanical origin that they have (Ávila et al. 1993; Montenegro 2000; Muñoz et al. 2001; Muñoz et al. 2007; Montenegro et al. 2008; Montenegro et al. 2009; Montenegro et al. 2010). The study of conservation and sustainable use of medicinal plants developed at the Catholic University as part of the International Cooperative Biodiversity Group (ICBG) was to pursue the objective to strike a balance between exploitation and conservation of natural plant resources collaborating and working closely with people who collect and sell medicinal plants, explaining the impact of local practices on the conservation of species intensively harvested in natural communities for commercial purposes (Montenegro 1994; 2005). During this process, the species threatened by overexploitation were evaluated and data was collected in the field about areas of exploitation, the amount of biomass gathered, the frequency of collections and methods of plant harvesting. Along with the work on the field, the biology of these plants was studied in order to develop morphological models of regeneration based on position and location on types of branches of renewal buds. In order to calculate their rate of regeneration after harvesting, the dynamics of growth of these species were followed in the field using experimental plots and by monitoring the growth of tagged branches after clipping. Doing that it was possible to evaluate the rate of recovery and the plant ability to cope with the rate of exploitation (Montenegro et al. 2003). Montenegro et al.( 2007) developed a management strategy that makes possible to implement regeneration models of medicinal plants, a fundamental basis for a sustainable crop . The quantification of the increment rates of the number of leaves, foliar area and length of the stems helps to clear the seasonal dynamics of vegetation growth (Montenegro et al. 1979; Montenegro et al. 1982; Montenegro 1987). The vegetative growth rates depend on genetic factors as well as on the environmental resources in which the plant is growing (Rathcke and Lacey 1985). Growth measurements, in combination with the information about the availability of resources, are the base to determine the use of resources by the specie and, eventually, by the community (Montenegro 1987), as well as the efficiency in the use of the available resources.

78 The knowledge of the specific growth rates helps to evaluate the capacity of regeneration of the species (Montenegro 1986; Ávila et al. 1988) when facing natural impacts produced by men, such as cutting down trees (for coal, firewood or wood) and the use of the vegetation with medicinal purposes or as food for cattle and for themselves. Knowing the specific diversity and the cover of the species in a community, the regeneration of the system and its vulnerability can be predicted. Furthermore the study of the mechanisms of species regeneration used in folk medicine, specifically the location and activity of the renewal buds, their growth dynamics and the way and time that they sprout can determine sustainable harvesting methods. By studying the location of the renewal buds, how and when they develop, patterns of regeneration of the species used can be determined (Montenegro et al. 2003). Also, the ability of a species to recover from extraction can be established, correlating the regeneration rate with the frequency and amount of material removed. Through an analysis of productivity per season, the rate of productivity per plant with the rate of removal by harvesters can be compared. Comparing the extraction and regeneration of plants at individual sites currently used by growers with the ones used in the past and projecting the data to be applied at community level, it is possible to evaluate whether the population of a given species is maintaining or decreasing as result of resource extraction. Some results show that regeneration is possible when the harvest is done allowing the renewal buds to remain untouched in the plant. According to this procedure, species like Chorizanthe vaginata Benth. and Margyricarpus pinnatus (Lam.) O. K., can regenerate lost biomass in the following growing season (Montenegro et al. 2001). The results of the scientific investigations carried out in Chile ratify the efficacy of the majority of the medicinal plants used by native towns on specific illnesses, like skin and urinary infections or hypertensive crisis, as well as for their antioxidant, anti-rheumatic or diuretic properties, making evident the traditional knowledge of the local communities on the medicinal use of diverse species of plants (Ruz 2011). The research work in determining levels of antimicrobial activity (Hederra 2011), about the antioxidant, antimicrobial and antihypertensive activity levels of native plants and the identification of types of responsible compounds for this activity through the combination of bioassays with chemical analysis has been extensively developed (Montenegro 2000; Simonsen et al. 2006; Montenegro et al. 2008; Montenegro et al. 2009; Montenegro et al. 2010). Extraordinary medicinal and cosmetic properties have been identified in murta or murtilla (Ugni molinae), a southern native Chilean fruit that historically has been part of the diet of native towns (INIA 2005). It has a high content of poliphenols, terpenes and tannins, compounds that make murta a very attractive element for the dermatological industry

79 given its regenerative tissue and healing qualities, besides multiple uses already applied in the national agro food industry. The knowledge about life cycles of the species helps using products of economic interest in the biologically most appropriate periods. For example, in the case of extract pieces of bark of Quillaja saponaria, a saponin-rich species, exploiting individuals during their biological inactivity, i.e. in autumn and part of winter would be a good idea. So when they start their growth stage, the extracted bark can be regenerated. Another example is the use of the leaves of Peumus boldus Mol., boldine-rich. Its leaves grow from September to December, their extraction during the inactive time is more advisable from a management point of view because the old leaves have more amount of this compound and also because extracting leaves during the growing season, reduces the photosynthetic activity that affects the formation of new organs. Thus, the knowledge about the life cycle of species helps to quantify, with some accuracy, the pattern of biomass productivity throughout the growing season, being able to determine the rate of accumulation of dry matter through the measurement of how much the plant seasonally produces and how long it takes to do so (Montenegro et al. 1988). Apart from all the procedures used to make a sustainable use of the natural plant resources, the spread of species through seed germination, vegetative propagation and/or tissue culture will provide a powerful tool to recover degraded areas and to conserve endangered species helping to preserve the fragile plant biodiversity of our planet. The Laboratorio de Productos Naturales, Departamento de Química, Universidad de Antofagasta, Chile recently reported the antimicrobial activity of three Baccharis species (Baccharis microphylla; Baccharis petiolata; Baccharis santelicis) used in the traditional medicine of Northern Chile. The genus Baccharis is widespread throughout South America and is represented in Chile by 48 species. Several of these are used in traditional medicine (Morales et al., 2008).

Trade and Marketing Chile possesses the wealthiest economy in Latin America and therefore the usage of fresh medicinal herbs is less important than in Mexico because of a well developed pharmaceutical industry and modern medicinal knowledge. The species consumed are sometimes imported from abroad or from other provinces (Madaleno, 2005). Chile does a great deal of business with Europe in botanicals and natural remedies. The trade with US is also emerging greatly (Hall, 2001). Data from 2007 showed that the entrance of medicinal herbs in Chilean homes, with an average growth in the consumption of

80 around 20%, ratifying the fact that medicinal plants are being consolidated as another product inside the national food and agriculture possibilities (PROCHILE 2007). Few commercial enterprises are involved in the international trade of medicinal plants. Chile exports over 20 million dollars of medicinal plants, among which Origanum majorana L., Peumus boldus Molina, Quillaja saponaria Molina, Rosa moschata Herrm. and Smilax medica Schltdl. & Cham. are the important ones. The amount exported during the years 1992 - 1994 reached 10,000-11,000 tonnes/year. Peumus, Quillaja and Rosa are collected in the wild. Rosa and Peumus are exported mainly to Brazil and Argentina and Origanum and Quillaya are exported mainly to Germany (Gupta, 2001). There is an informal market regarding medicinal herbs, in which fruit pickers and herbalists participate. The products are characterized for their irregular quality, hand-packed and marketed mainly in fairs and local markets. In the internal market, there is a permanent demand for products based on aromatic and medicinal plants related to the pharmaceutical, cosmetic, homeopathic, tea bags or tea elaboration industries, as well as to uses in the complementary medicine, in which traditional pharmaceutical laboratories have incorporated new natural products. The general opinion among the consumers is that the active ingredients contained in these herbs contribute to improve or to alleviate some affections in a more natural and economical way. The publication of the study “Results and lessons in the production of aromatic and medicinal plants projects of innovation in the Regions V, VII, VIII and X”, carried out by the Unidad de Valorización de Resultados de FIA (2008), presents the results of evaluation, cultivation and export of some species of medicinal plants, contributing to the diversification of the traditional agriculture of the country. The main species exported are Rosa mosqueta and Oregano, with a considerable increase in the production of chamomile and boldo. Rosa mosqueta and hazelnut seed oils occupy an important place in the national and international cosmetic industry, with Chile the major producer and exporter of Rosa mosqueta oil in the world, mainly to France, Germany and Japan (FIA 2008). Also, the exports of plants extracts have considerably increased, among them, processed extracts of quillay, hiperico, vanilla and parsley, and also a growing production and export of peppermint essential oils.

Constraints and Problems Wild harvesting of plant material from natural habitats of the medicinal species in central Chile is the most popular tradition and practice,

81 but there is concern due to the great amount of biomass collection that takes place each year, especially over those plants classified as vulnerable by the last survey and review of species classification in categories of threatened in Chile (Squeo et al. 2010). Furthermore for some plant species that are already has demand, the chances of survival are reducing because of the traditional collection in which probably greater than reported. On top of that, the identities of the species extracted without considering the use of certain morphological structures that recur in the collection, such as roots or bark, being obtaining complete copies of herbaceous species, which causes destruction far greater than the harvesting of fruits and seeds. Few case studies focusing on species biology have been done (Montenegro et al. 1973; Montenegro et al. 2001; Montenegro et al. 2003; Montenegro 2006; Wilckens 2005; Fischer et al. 2010) in order to establish models of plant regeneration based on morphology, seasonally and the position of renewal buds, suggesting the right way to harvest a given species in a sustainable way. Other challenge for the sustainability of raw material supply is fire. Natural fires have not played an important role in plant species evolution of the matorral (Armesto and Gutierrez 1978; Muñoz and Fuentes 1989; Montenegro et al. 2004), however, anthropogenic fires affect thousands of hectares each year in central Chile, with matorral the most damaged ecosystem (CONAF 2010). Several fires strongly reduced the soil seed bank since it has been shown the native species seeds generally cannot tolerate extreme temperatures such as over or equal 100°C (Muñoz and Fuentes 1989; Gomez-Gonzalez and Cavieres 2009). Helenium aromaticum, an important medicinal plant growing on the herbaceous strata of matorral, has been reported that its seedlings do not emerge after applying intense fires on soil samples (Gomez-Gonzales et al. 2011), appearing today as one of the most vulnerable annual species to severe fires and heavy harvesting during the vegetative growth period for commercial purposes. Charcoal production from woody shrubs is one of the main threats to native vegetation in arid zones of the country (Estevez et al. 2010). Balsamocarpon brevifolium, Adesmia hystrix, Fabiana imbricata, Acacia caven, Peumus boldus, Quillaja saponaria, Porlieria chilensis and Schinus polygamus are the main species used for that purpose in the Mediterranean arid and semiarid zone. New issue related to native herbal medicinal use and regulation in the production of native plants, is the lack of adequate technical work to develop production, plant extraction and product packaging. Also, there are deficiencies regarding the production process, like the wild extraction, with a progressive decrease in the number of flora involved, as well as the poor quality control of the extracted material and processes prior to their sale

82 (botanic identification, drying, storage, etc.). Out of a total of 464 medicinal plants empirically used by the Chilean population (Mellado et al. 1996), only 132 had sufficiently reliable scientific information to ensure a safe therapeutic use, evidencing uncertainties in terms of identifying the morphological and chemical characterization of the species used. Despite well-known attributes of plants and their applications in traditional and commercial medicine, there remain some uncertainties regarding, on the one hand, the economic assessment of production and marketing, such as toxicity of certain compounds found in plants, and failure to register as a therapeutic product of some species; on the other hand, the lack of funding for basic and clinical research, and the incipient scientific assessment of the contribution of medicinal plants in clinical therapies, among others (Polanco 2011; Lobos 2011; Marles 2011). The country should carry out research and development work on MAPs in the area of agro-technology, pharmaceutical technology, extraction processes and quality control, development on high yielding varieties of medicinal plants and the domestication of native species, product and process development and training of qualified man power. Chile needs to develop the technological and scientific capabilities and improve the production of plant derived products to the internationally accepted standards. The research should be directed for pharmacological evaluations of its traditional remedies and testing of isolated compounds in pharmacologically relevant systems so as to associate the traditional use of the plants with the presence of active compounds.

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89 PROTEGE 2009. MHT Medicamentos Herbarios Tradicionales. Red de Protección Social, Ministerio de Salud, Gobierno de Chile Rathcke B and EP Lacey 1985. Phenological patterns of terrestrial plants. Annual Review of Ecology and Systematiscs 16: 179-214 Raven PH & AI Axelrod 1978. Origin and relationship of the California Flora. U. Calif. Pub. Bot. 72: 1-134 Raven PH 1988. The California Flora. In: Barbour MG & J Mayer (eds.) Terrestrial Vegetation in California. Calif. Native Plants Soc. Spec. Pub. 9 USA. Pp. 109-138 Ruz J 2011. Producción de extractos estandarizados de origen vegetal. Seminario ‘Desafíos y oportunidades para los productos medicinales de origen vegetal’, Instituto de Salud Pública, Proyecto Farmacopea Chilena. Santiago, Chile, 3-5 de agosto de 2011 Simonetti J and G Montenegro 1996. Conservación y uso de la biodiversidad de la zona árida y semiárida de Chile. En: Conservación y uso sostenible de la biodiversidad en zonas áridas y semiáridas de América Latina y el Caribe. FAO, PNUMA. 178 pp Simonsen HT, A Andersen, L Berthelsen, SB Christensen, A Guzman & P Mølgaard 2006. Ethnopharmacological evaluation of radal (leaves of Lomatia hirsuta) and isolation of 2-methoxyjuglone. BMC Complementary and Alternative Medicine 6(29): 1-4 Simpson RD & AB Craft 1996. The Social Value of Using Biodiversity in New Pharmaceutical Product Research. Resources for the Future. Discussion Paper 96-33 Squeo F, C Estades, N Bahamonde, L Cavieres, G Rojas, I Benoit, E Parada, A Fuentes, R Aviles, A Palma, R Solis, S Guerrero, G Montenegro, and JC Torres-Mura 2010. Review of the species classification in categories of threat in Chile. Revista Chilena de Historia Natural 83: 511-529 Timmermann B & G Montenegro 1997 (eds.). Aspectos ambientales, éticos, ideológicos y políticos en el debate sobre bioprospección y uso de recursos genéticos en Chile. Noticiero de Biología 5(2): 1-119 Vogel H 2000. Avances del cultivo de especies medicinales nativas de Chile. Seminario Internacional y Rueda de negocios Plantas medicinales: Mercado, cultivo y procesamiento. Marzo 29–32. Fac. Agronomía. Universidad de Concepción, Chillán, Chile Vogel H, I Razmilic, X Polanco, ME Letelier 2010. Effect of different provenances and production conditions on antioxidant properties in Buddleja globosa leaves. Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas 9 (5): 333-342 90 Westoby M 1988. Comparing Australian ecosystems to that elsewhere. Bioscience 38: 549-556 Wilckens R 2005. Adaptación de plantas medicinales en la zona centro-sur y sur de Chile: resultados proyecto FIA PI-C-2000-1-A-003. Universidad de Concepción, Facultad de Agronomía. 162 pp WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva Zedler PH 1990. Life histories of vernal pool vascular plants. Pages 123-146. In: DH Ikeda and RA Schlising (eds). Vernal Pool Plants: Their Habitat and Biology. Studies from the Herbarium, Number 8, California State University. Chico, CA.

Table 1: Some MAP species of the native flora of Chile (unpublished information Montenegro G et al) Botanical name Family Acacia caven Fabaceae alpina Rosaceae Acaena splendens Rosaceae Acantholippia deserticola Verbenaceae Adesmia emarginata Fabaceae Aloysa salvifolia Verbenaceae Araucaria araucana Araucariaceae Argemone hunnemannii Papaveraceae Argemone subfusiformis Papaveraceae Aristolochia chilensis Aristolochiaceae Aristotelia chilensis Elaeocarpaceae Azara mycrophylla Flacourtiaceae Azorella compacta Apiaceae Berberis empetrifolia Berberidaceae Bomarea salsilla Alstroemeriaceae Buddleja globosa Buddlejaceae Calceolaria arachnoidea Scrophulariaceae Calceolaria thyrsiflora Scrophulariaceae

Centaurium cachanlahuen Cestrum parqui Solanaceae Cheilanthes glauca Pteridaceae Cissus striata Vitaceae Colletia spinosa Rhamnaceae Colliguaja odorifera Euphorbiaceae

91 Convulvulus arvensis Convulvulaceae Coriaria ruscifolia Coriariaceae Corynabutilon viride Malvaceae Corynabutilon vitifolium Malvaceae Cryptocarya alba Lauraceae Cuscuta chilensis Convolvulaceae Discaria serratifolia Rhamnaceae Drimys winteri Winteraceae Elytropus chilensis Apocynaceae Ephedra chilensis Ephedraceae Equisetum bogotense Equisetaceae Escallonia illinita Escalloniaceae Escallonia pulverulenta Escalloniaceae Escallonia revoluta Escalloniaceae Escallonia rubra Escalloniaceae Escallonia virgata Escalloniaceae Eucryphia cordifolia Eucryphiaceae Fabiana imbricata Solanaceae Francoa appendiculata Saxifragaceae Fuchsia magellanica Onagraceae

Gaultheria mucronata Ericaceae Geranium core-core Geraniaceae Geum quellyon Rosaceae Gevuina avellana Proteaceae Gnaphalium viravira Asteraceae Gunnera tinctoria Gunneraceae Haplopappus baylahuen Asteraceae Haplopappus foliosus Asteraceae Haplopappus multifolius Asteraceae Helenium aromaticum Asteraceae Kageneckia oblonga Rosaceae Lampaya medicinalis Verbenaceae Latua pubiflora Solanaceae

Laurelia sempervirens Monimiaceae Linum chamissonis Linaceae Lithrea caústica Anacardiaceae Lobelia tupa Campanulaceae Lomatia dentata Proteaceae Lomatia ferruginea Proteaceae Lomatia hirsuta Proteaceae Lophosoria quadripinnata Dicksoniaceae Luma apiculata Myrtaceae Luma chequen Myrtaceae Margyricarpus pinnatus Rosaceae Maytenus boaria Celastraceae Mitraria coccinea Gesneriaceae Muehlenbeckia hastulata Polygalaceae Mulinum spinosum Apiaceae

92 Myrceugenia exsucca Myrtaceae Myrceugenia planipes Myrtaceae Nothofagus obliqua Nothofagaceae Oenothera stricta Onagraceae Passiflora pinnatistípula Passifloraceae Peumus boldus Monimiaceae Podanthus mitiqui Asteraceae Puya berteroniana Bromeliaceae Puya chilensis Bromeliaceae Quillaja saponaria Rosaceae Quinchamalium chilense Schoepfiaceae Retanilla trinervia Rhamnaceae Schinus molle Anacardiaceae Schinus latifolius Anacardiaceae fistulosus Asteraceae

Solanum crispum Solanaceae Sphacele salviae Lamiaceae Stachys albicaulis Lamiaceae Stellaria arvalis Caryophyllaceae Triptilion spinosum Asteraceae Tristerix corymbosus Loranthaceae Ugni molinae Myrtaceae Weinmannia trichosperma Cunoniaceae

93 1.5 Colombia The Republic of Colombia, located in the north-western part of South America, is bounded on the north by Panama and the Caribbean Sea, on the east by Venezuela and Brazil, on the south by Peru and Ecuador and on the west by the Pacific Ocean. Its total land area is 1.141.748 square kilometers. Coastal lowlands lie along the Caribbean Sea and the Pacific Ocean. Those along the Caribbean are mostly agricultural lands. The arid, narrow Guajira Peninsula forms the northernmost tip of Columbia. The Pacific Lowlands consist mostly of swamps and dense forests. Heavy rains fall there nearly every day. The Andes Mountains cover about a third of Colombia. These consist of three parallel ranges, the Cordillera Central, the Cordillera Oriental, and the Cordillera Occidental which stretch north-east across western Colombia. An isolated range of the Andes, the Sierra Nevada de Santa Marta, rises from the Caribbean coast. It includes Colombia’s highest point, Pico Cristóbal Colón, 5 775 m above sea level, and several volcanoes, including Huila (5,750 m) and Tolima 5.215 m. Between the cordilleras are high plateaux (some up to 2,400 above sea level) and fertile valleys. The Cordillera Oriental descends to the east into vast areas of torrid lowlands. The Caquetá River and other tributaries of the Amazon River drain the southern portion of this region, which is covered by tropical rain forests. The northern part of the region is vast plains, or llanos, drained by the Meta and other tributaries of the Orinoco River. Other principal rivers are the Magdalena, the Cauca, and the Patía. Elevation has a profound effect on Colombia’s climate. The low regions along the coast and in the Patía and Magdalena River valleys are torrid. Temperatures vary little throughout the year. Throughout most of the country, three-month periods of rain and dry weather alternate. Along the Pacific coast precipitation is heavy, up to 8,000 mm. At Bogotá the annual rainfall averages about 1,060 mm and at Barranquilla it averages about 800 mm. Dry conditions prevail on the slopes of the Cordillera Oriental and on the Guajira peninsula. The country’s main types of land cover are forests and woodlands (45%), agroecosystems (34%) and savannah (14%). There are also smaller areas of swamp forest, xerophytic forest, moorland, rockland forest and . represents a serious environmental threat. There has been a steady increase in the rate of reforestation since 1993, when the Ministry of the Environment was established. The annual rate has now reached 32,937 hectares, 64.4% corresponding to protective plantations and

94 35.6% to commercial plantations. The environmental importance of Colombia’s forest resources is incalculable, in as much as these harbor one of the greatest ranges of biodiversity and most extensive water resources in the world. Within the framework of the policies of Ministry of Agriculture and Rural Development, the National Forestry Research and Promotion Corporation has the task of generating technology needed to establish plantations and promote sustainable forest management (FAO, 2008). From the biogeographic point of view, Colombia is divided in six natural regions, five continental regions (Caribbean, Andean, Pacific, Amazonian, Orinoquia regions one insular region). Colombia has a system of national parks with 54 protected areas covering diverse ecosystems like , cloud forests, marshes, tropical forests , prairies and coral reefs which account for 11% of the national territory (Ministerio de Medio Ambiente de Colombia, 2009).

Traditional Medicine Systems/Phytomedicine Health care has improved dramatically over the last 30 years, but mainly in urban areas. The urban poor and people in remote regions have limited access to food, housing, and medical treatment. The traditional remedies are still commonly used, particularly in rural and remote areas. Many forms of traditional medicine rely on indigenous plants. Traditional healers called Taitas from the yagé culture have tried to maintain their indigenous medical practices (Anonymous, 2008). Traditional medicine is widely practised in Colombia. Forty per cent of the population has used complementary/alternative medicine. There are six chiropractors practising in Colombia. The Congress of Deputies officially recognized homeopathy as a system of medicine way back in 1905. The Institute of Medicaments and Food (INVIMA) regulates the manufacturing of homeopathic remedies. Integration of homeopathy into the Public Health Services is planned. Chiropractors are not permitted to use X-ray equipment. However, chiropractors may request radiologists to provide X-ray services for their patients (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine In the Republic of Colombia, a national policy on TM/CAM neither exists nor is pending. Laws and regulations on TM/CAM were first issued in

95 1964 in Decree1950, and were updated and expanded in 1995, 1997, 1998 and 2001. No national programme has been issued, nor has a national office been established. An expert committee on TM/CAM was established in 1976. The Instituto Humboldt, founded in 1900, serves as a national research institute in CAM. Herbal medicine is regulated in Colombia by means of Decree 677 of 1995 and Decree 337 of 1998. The regulations established are partly the same as those for conventional pharmaceuticals, while some are separate for herbal medicines. Herbal medicines are regulated as over the counter medicines and as an independent regulatory category. Claims that are made about herbal medicines include medical, health and structure/function claims, but none are recognized by law. No national pharmacopoeia exists, nor is one planned; in lieu of this, the United States Pharmacopoeia, Codex Francés and British Herbal Pharmacopoeia, Spanish Pharmacopoeia, Mexican Pharmacopoeia and Brazilian Pharmacopoeia are used. The information is considered legally binding. El Vademecum Colombiano de Plantas Medicinales is an official document and contains monographs on accepted medicinal plants of Colombia. Regulatory requirements for manufacturing include adherence to the information contained in pharmacopoeias and monographs, the same rules of GMP as for conventional pharmaceuticals, and special rules. No information on control mechanisms is available. Safety assessment requirements include traditional use without demonstrated harmful effects, reference to documented scientific research on similar products and clinical studies. Compliance with these requirements is ensured by a health registry. There is a registration system for herbal medicines; the number of registered medicines is not available. Herbal medicines are not included in the essential drug list. No system of post marketing surveillance exists. Herbal medicines in Colombia are sold in pharmacies as over the counter medicines and special outlets without restriction (WHO, 2005). Homeopathy is taught in three schools authorized by the Ministry of Education. The regular three-year courses are limited to licensed allopathic physicians (WHO, 2001).

Medicinal and Aromatic Plant Resources Colombia is one the most bio-diverse countries in the world and some statistics state that it is the second one after Brazil. It has approximately 50,000 species of plants (a third of them are endemic). Since the end of 1990 medicinal plants and their derivatives have played an important role in the rural development strategy in Colombia. This is attributed mainly to the great

96 biodiversity of medicinal plants found in the country (more than 6,000); the growing market for MAP based products; the cultural importance attached to the use of plants by indigenous communities; and the ecological relevance of MAPs. The destruction of habitats due to intensive use without management plans, deforestation and contamination has also risked the country flora significantly and nearly 1,000 plants have been listed as endangered. Although Colombia is a mega-diverse country, most of the medicinal flora is not used commercially because there are very few organized companies and community initiatives producing raw materials or collecting them from the wild in a sustainable way, and second, the legislation does not permit the use of most endemic or native plants in finished products. Medicinal plant growers and collectors in Colombia are mainly indigenous communities, rural communities and small growers from around the country, mainly in the Andean, Amazon and Pacific regions. In 2001 a study entitled “Characterization of the Colombian market of medicinal plants” prepared by the “Biocomercio Sostenible Programme” (Sustainable Biotrade Programmme) carried out with the support of some natural product laboratories, it was observed that most of the commercialized medicinal plants in Colombia were around 156, but only 42% of them are permitted by the Ministry of Health to be used in natural products. About 14% of the medicinal plants used by laboratories are collected from the wild, 16.7% are either collected or cultivated, and 39.7% are only cultivated. Since Colombia lacks a representative natural products sector association, there is no political representation for the sector (Merchán and Ibañez, 2004). The Decree 2266 of 2004 in its Article 5 authorizes the Ministry of Social Protection to issue the Vademacum Colombiano de Plantas Medicinales, which comprises 119 plant species of which 24 were prioritized for their medicinal and industrial uses. (Vademecum Colombiano de Plantas Medicinales, Ministerio de Proteccion Social, Bogota, D. C., 2008).

Research and Development Activities The Colombian government recently announced the creation of a rainforest reserve dedicated to the protection of medicinal plants. The process of creating, designing, and declaring the Orito Ingi-Ande sanctuary has been the result of a coordinated effort among the Ministry of the Environment, Housing, and Territorial Development; the Special Administrative Unit of the Colombian National Park System; the Amazon Conservation Team (ACT); Rosario University; and especially the Union of Traditional Yagé Healers of the Colombian Amazon (UMIYAC), whose traditional healers and apprentices provided the support and knowledge necessary to undertake the

97 process. This sanctuary encompasses 10,626 hectares of biologically-rich tropical rainforest. Members of the native communities participating in this effort include the Coreguaje, Inga, Kamtsá, Kofán and Siona tribes. Orito Ingi-Ande will be the only protected area in Colombia dedicated primarily to the conservation of MAPs flora. The special emphasis has been given to the presence of the yoco plant (Paullinia yoco R. E. Schult. & Killip), one of the highly regarded medicinal plants in the northwest Amazon. By combining technology with traditional plant knowledge, the effort helped strengthen cultural ties between indigenous youths and elders at a time when such cultures are disappearing even faster than rainforests (Butler, 2008; McLean, 2008).

Trade and Marketing The herbal market is not a very specialized sector in Colombia and the natural products laboratories buy the raw materials to make their own products such as cosmetic, pharmaceuticals, food supplements etc. for consumers in local markets. These products are sold through multiple channels, such as telesales, health shops, drugstores, supermarkets concessionaries, and medical centres. The raw material is either imported or obtained in the country from local traditional markets and small direct suppliers in small volumes. It is not common for laboratories to import raw material directly. Specialized agents engaged in grinding and pulverizing the plants as per the buyer's needs carry out these imports. All the imported raw material for the natural products sector is dehydrated, while the national material could be fresh or dried. Most of the Colombian natural products laboratories are small and medium-scale companies. The oldest are around thirty years old, but these are only a few. According to the sector association (FENAT) - Colombian Federation of Naturists - there are around 100 laboratories producing natural products and more than 2,500 shops commercializing their products in Colombia mainly in big cities. Colombian manufacturers have little exporting experience. They produce finished products for national demand since there are no associations or companies that could possibly produce raw material in the right volumes and with the right quality for exporting. Very few companies have the infrastructure and equipment needed to reach international markets. Legislation is another big obstacle for the companies. The national legislation only permits the use of around 95 plants in pharmaceutical products. This is an obstacle for the development of the sector as the

98 permitted plants are the ones that other countries can produce more efficiently (Merchán and Ibañez, 2004). The Colombian exports during 2007 for selected Botanicals under the HS codes 0902-0910 (includes South American grown botanicals such as black pepper fruit, capsicum fruit, ginger rhizome, mate leaf, and vanilla fruit, among others); 1211 (includes South American botanicals such as anguraté herb, boldo leaf, cat’s claw bark, coca leaf, condurango bark, ipecac rhizome, marapuama, pau d’arco bark, rhatany root, and stevia leaf among many others); 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms among other balsams and oleo-gum-resins); 130219 (includes most herbal saps and extracts such as those of ginger, guaraná, ipecac, maca, mate, marapuama, pfaffia, and pau d’arco, among others); 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others); 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils); and 400130 (includes botanicals such as gutta percha latex Payena spp. and Palaquium gutta (Hook.) Baill., balata Manilkara bidentata (A. DC.) A. Chev., chicle Manilkara zapota (L.) P. Royen, guayule Partheniu) were 3,072,273; 1,782,271; 10,303; 5,636; 443,673; 23,831; and 2,811 kg respectively (ITC, 2008).

Constraints and Problems Despite having many potential plants to work with, there is little scientific research to make industrial developments possible. The main challenge of the sector, therefore, is to achieve export development by using Colombian endemic plants in a sustainable way. The natural products sector has interesting opportunities in international and regional markets. There is a common interest in the discovery of new products and new uses; and this represents an opportunity for the sector in Colombia. Although legislation is an obstacle for the development of local markets, it is not for the development of international markets. Nevertheless, changes in Colombian legislation are required and would be very useful as a basis for positioning of the products abroad. In order to promote the MAPs trade first the country needs proper infrastructure for drying and primary processing the plants and well developed demand and supply channels to facilitate laboratories for large scale productions. Another important issue regarding the raw material supply is the quality. The government should develop relevant laws and policies

99 pertaining to collection, production, and quality control criteria in product development for the companies. The country should focus on involving indigenous and rural communities in the production chain of natural ingredients, and to start using endemic plants. It may have a considerable impact at the social, economic and environmental level also contributing to the improvement of the standard of living of rural communities and for the conservation of zones rich in biodiversity. The people involved in raw material production and collection may be given training in good agricultural and conservation practices, in good manufacturing practices, quality standards and technology, and traders, in market access norms and regulations. In order to derive commercial and health benefits from MAPs biodiversity and to use it sustainably in an economic, environmental and social way, scientific research among government and private sector has to be coordinated. The research should be carried out according to the needs of the companies. Specific projects that integrate technological, agro- industry and research should be promoted. The generation of ethno-botanical studies to document the traditional knowledge regarding the use of MAPs and their products, creation of MAPs inventories and gene banks; and development of agricultural protocols for native plants are the areas need special attention.

REFERENCES Anonymous, 2008, Culture of Colombia. Available at: http://www.everyculture.com/Bo-Co/Colombia.html (17 Jul. 2008) Butler, R. A., 2008, Colombia creates rainforest reserve to protect medicinal plants. Available at: http://news.mongabay.com/2008/0612-colombia.html (17 Jul. 2008) FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) ITC, 2008, Market News Service, Medicinal Plants & Extracts, 27: 46, Jun. 2008, Geneva, Switzerland McLean, K. G., 2008, Colombia creates rainforest reserve to protect medicinal plants. Traditional Knowledge Bulletin, Traditional Knowledge Policy Analysis and Information Service. Available at: http://tkbulletin.wordpress.com/category/1-policy-analysis/health-and- medicine/ (17 Jul. 2008)

100 Merchán, J. A. D. and Ibañez, L. M., 2004, Sector assessment: Natural ingredients for cosmetics and pharmaceuticals in Colombia. United Nations Conference on Trade and Development, The BioTrade National Programme, Colombia, the Alexander von Humboldt Institute and Proexport Colombia. UNCTAD /DITC/TED/2004/2 Ministerio de Medio Ambiente, Vivienda y Desarrollo Territorial, 2009. Guía de Parques Nacionales Naturales de Colombia, Bogota, Colombia WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva, Switzerland WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva, Switzerland

Table 1: Approved species of medicinal and aromatic plants in Colombia Botanical name Family Common Uses name Aesculus hippocastanum Hippocastanaceae Castaño de Febrifuge, analgesic, Indias descongestant. Allium sativum Liliacea Ajo Hypotensive. Aloe vera Liliaceae Sábila Laxative, wound healing. Aloysia trphylla Verbenaceae Cidrón Antiflatulent, sedative. Anethum graveolens Apiaceae Eneldo Carminative. Apium graveolens Apiacea Apio Antiflatulent. Artemisa absinthium Asteracea Ajenjo Appetite stimulant. Avena sativa Poacea Avena Antiinflammatory. Bixa orellana Bixacea Achiote Antiinflammatory. Brassica oleraceae Cruciferae Col Expectorant, febrifuge, hypoglycaemic. Calendula officinales Compositae Caléndula (Via Antiinflammatory, would local) healing. Capsicum annuum Solanacea Ají Rubefacient. Carica papaya Caricaceae Papapya Digestive. Chamomilla recutita Asteraceae Manzanilla Antiinflammatory, antispasmodic. Coffea arabiga Rubiaceae Café Stimulant, vasodilator. Cymbopogon citratus Poaceae Limoncillo Antiflatulent. Cynara scolymus Aasteracea Alcachofa Choleretic, Cholagogue. Elettaria cardamomum Zingiberaceae Cardamomo Antiflatulent, appetite stimulant. Eucaliptus globulus Myrtaceae Eucalipto Expectorant. Foeniculum vulgare Apiaceae Hinojo Diuretic, digestive, galactogogue. Hytis capitata Lamiacea Botón negro Topical anti-inflammatory. Juglans cinerea Juglandaceae Nogal blanco Antidiarrheic. Linum usitatissimum Linaceae Lino Antidiarrheic, antispasmodic.

101 Malva sylvestris Malvaceae Malva Expectorant. Melissa officinalis Lamiaceae Toronjil Sedative. Momordica charantia Cucurbitacea Balsamina Hypoglycemic. Ocimum vulgaris Lamiacea Albahaca Antiflatulent. Origanum majorana Lamiaceae Mejorana Antispasmodic. Origanum vulgare Lamiaceae Orégano Antiinflammatory. Panax ginseng Araliaceae Ginseng Stimulant tonic. Passiflora mollissima Passifloraceae Curuba Sedative, hypnotic. Peamus boldus Monimiacea Boldo Hepatoprotector and anticholinergic. Phytolaca bogotensis Phytolaccaceae Extracto de Antiinflammatory. Guaba Plantago mayor Plantaginaceae Llanten Wound healing, topical use. Rhamnus purshianus Rhamnaceae Cáscara Laxative. sagrada Silybum marianum Asteraceae Cardo mariano Coadjuvant in cases of hepatotoxicity. Taraxacum officinale Asteraceae Diente de león Diuretic. Vitis vinifera Vitaceae Vid Vasodilator. Zingiber officinale Zigiberaceae Jenjibre Expectorant, circulatory stimulant.

102 1.6 Ecuador

The Republic of Ecuador, located in north-western South America, is bounded by Colombia on the north, by Peru on the east and south, and by the Pacific Ocean on the west. The country also includes the Galápagos Islands (Archipiélago de Colón) in the Pacific, about 965 kilometres west of the mainland. Ecuador, as its name implies straddles the equator and has an area of 283,560 square kilometres. Despite its small size, Ecuador has a great variety of environmental conditions as a result of the presence of the Andes, which divide the country from north to south, and the cold, dry Humboldt current, which is responsible for xerophytic vegetation found along the southern coast and reaching roughly as far as the equator. The coastal plain along Ecuador’s Pacific coast covers a little more than a fourth of the country. It was formed by alluvial deposits from the mountains and ranges from 20- 160 kilometres wide. In the north, it is wet and swampy. In the south, near Peru, it is a desert thanks to the drying effect of the Humboldt current. In between, tropical forests cover much of the lowland, although some of it has been cleared for farms. The highlands of the Sierra make up about another fourth of Ecuador. Two parallel ranges of the Andes Mountains extend the length of the country from north to south with high plateaus between them. Mountain peaks rise over 6,000 m, some of them are active volcanoes. To the east, the Oriente lowlands cover the remaining half the country. Thick tropical forests cover the eastern foothills of the Andes and part of the Amazon River Basin. The rivers draining the Oriente, including the Napo and the Pastaza, are part of the Amazon River system. The region is mostly undeveloped. The Galapagos Islands cover about 7,800 square kilometres. Most of the islands are volcano peaks, some of which rise to 1,500 m. The five largest islands are Isabela (Albemarle), Santa Cruz (Indefatigable), San Cristobal (Chatham), Fernandina (Narborough), and San Salvador (James). The coastal region and the Oriente are generally hot and humid. The climate of the Galapagos Islands is moderated by the cool Humboldt Current. Rainfall averages 1,400 mm, although over 2,000 mm may fall in the Oriente. The southern coastal lowlands receive much less rainfall, as do the Galapagos Islands. Ecuador has a good age of forests, with forest cover on 12.4 million hectares, or 44.8% of its total land area. The country can basically be divided into three ecological zones 1) a fertile coastal plain in the west; 2) high valleys in the mountainous centre; and 3) forested plains in the east. Most of the forests are found in the eastern, Amazon region. Tree species with commercial value include Cedrela fissilis Vell., Ochroma lagopus Sw., and Virolla spp., while the alluvial plains contain a major concentration of palm species. The wide diversity of plant and animal wildlife make Ecuador one of the richest countries in the world in terms of biodiversity, both for the total number of species and for the number of species in proportion to area. 103 About 17% of the country’s area is protected, forming a network of more than 20 national parks and reserves, one of the most important being the Galapagos Islands. Ecuador has only 167, 000 hectares of forest plantations, mainly of Pinus spp. and Eucalyptus spp. (roughly 75%). About 90% of these plantations are found in the mountains, while the remaining 10% are found in the coastal and Amazon regions. In the Amazon region, the most noteworthy element is the presence of trees among crops (agro-forestry systems), the result either of planting or of the management of natural regeneration. Trees growing within agro-forestry systems are a major source of wood products. The loss of forests and changes in the natural plant cover are to a large extent the result of harvesting activities, which in most cases have been of a forest mining type, driven by the economic and subsistence importance of agricultural and livestock rearing activities. Other factors are poorly controlled land settlement policies combined with laws that have encouraged deforestation, the economic advantages of other types of land use over forestry, insecurity of landholding, the undervaluing of forests and wood, and weak State control. Some of Ecuador’s more important non-wood forest products are fibre, bamboo, latex, gum, palm products (palm hearts and tagua nuts), mushrooms and medicinal and aromatic plants (FAO, 2008).

Traditional Medicine Systems/Phytomedicine About 80% of the population of Ecuador depends on the traditional medicine for its health and well being and, consequently, on the plants or natural products on which those medicines are based. This tendency is growing due to the difficult access of the population to medical attention based on commercial drugs, and to medical social security (Buitrón, 1999). In Ecuador, there are associations of traditional medicine practitioners that work at regional and local levels. Some of these associations were created by indigenous organizations and others by state initiatives. In Ecuador, there are no specific programmes linking traditional medicine with allopathic medicine. But, with increasing interest in traditional medicine, particularly Quichua medicine, the State is focusing more attention on official linkages. Some efforts have been made to coordinate with institutions and organizations affiliated with traditional medicine in Ecuador. In 1983, the Government recognized homeopathy as a medical practice. The Ecuadorian Medical Federation began officially recognizing homeopathy as a medical speciality in 1988. It is also recognized in the Constitution of the National Assembly (WHO, 2001).

104 Government Efforts in Development of Traditional Medicine/Phytomedicine In the Republic of Ecuador, national policy on TM/CAM is currently at the development stage; however, laws and regulations were issued in 1998. A national programme is being planned currently, as is a national office. No expert committee exists, nor do any national research institutes. Ecuador does not currently regulate herbal medicines; the regulatory status given to herbal medicines includes prescription and over the counter medicines, self medication, dietary supplements, health foods and cosmetics. Medical and health claims may be made by law. A national pharmacopoeia is being developed; no information is available on national monographs. Likewise, there is no information on manufacturing requirements for herbal medicines; there are no safety requirements. Herbal medicines are not registered or included on an essential drug list. No post marketing surveillance system exists. In Ecuador, herbal medicines are sold in special outlets without restriction (WHO, 2005). Universidad Andina Simón Bolívar, a private Andean university in the city of Quito, is responsible for teaching traditional medicine in Ecuador. Offerings include certificate programmes, seminars, workshops, and meetings. The Ministry of Public Health established training courses for traditional birth attendants in 1974 with the aim of incorporating them into the health services of rural areas. There is no official training in traditional medicine offered to allopathic health personnel (WHO, 2001).

Medicinal and Aromatic Plant Resources Ecuador, located in Equatorial America, is considered one of the countries possessing the highest biodiversity in the world. The local population still maintains their ancestral traditions in the use of natural remedies. Among the various plants used for their medicinal properties only 500 are known among which 228 species are the most used and 125 are also the most traded ones. Many species like Matricaria chamomilla L. were introduced by the Spaniards; others like Aloe vera (L.) Burm. f. have been introduced, naturalised and cultivated with many others such as Croton spp. are native. There is not enough basic scientific or technical information nor an ecological profile from most of these species. It is estimated that more than 90% of the plants are obtained from wild resources and are not cultivated or managed (Buitron, 1999).

Research and Development Activities In 1980 a biomedical study for studying the role of medicinal plants conducted by a team from Stanford and Duke Universities among the Waorani Indians of eastern Ecuador. The study though revealed very vast knowledge of ethno-ecology among all adult Waorani; discovered relatively few medicinal plants. This survey also presented the implications in terms of the origin of plant medicines among indigenous peoples (Davis and Yost, 1983). 105 A study conducted by University of Hawaii, Honolulu, USA examines the traditional use of medicinal plants in Loja province, Southern Ecuador. Two hundred fifteen plant species were collected, identified and their vernacular names and traditional uses recorded indicating a very high knowledge of plants by the healers, market vendors and public. in this study the highest number of species is used for the treatment of "magical" (psychosomatic) ailments (39 species), followed by respiratory disorders (34), problems of the urinary tract (28), Fever/Malaria (25), Rheumatism (23) and nervous system problems (20) (Bussmann and Sharon, 2006). An ethnobotanical survey was carried by the Universidad Tecnica Particular de Loja, Ecuador and Dipartimento di Chimica Organica and Centro di Etnobiofarmacia, Universita degli Studi di Pavia, Italy on the uses of medicinal plants by inhabitants of two southern Ecuadorian provinces of Loja and Zamora-Chinchipe. In this region, two surviving ethnic groups, the Saraguros and the Shuars, and the descendants of a now extinct culture, the Paltas, have been identified. The survey carried out between September 2002 and December 2003, reported a total of 275 plant species, having 68 different therapeutical uses. The plants with their therapeutical applications used in the traditional medicine of peoples of Loja and Zamora (Ecuador) are presented in Table 1 (Tene et al. 2007).

Trade and Marketing Numerous ethnobotanical studies exist but there is no information on medicinal plant's trade. Ambato, also located in the Andean region, is one of the largest commercial cities in the country and the biggest centre of wholesale storage and distribution of medicinal plants coming from the three regions. Medicinal plants gatherings are carried out directly by the consumers, in the case of local rural or indigenous people for daily consumption or, in the case of commercialization, after the order of middlemen, suppliers or stores, or by order of researchers, transnational or tourists, although the latter also collect them directly. They are used and traded as raw material, and also in the form of extracts, semi purified, as pure chemical substances or semi-synthetic. They are used for infusions or tea, as well as for the cure of all type of illnesses, from headaches and back pain to skin illnesses, or as invigorating, antibiotics, and antimycosis among others. The trade structure is complex and diverse, and involves several actors and sectors. The spectrum covers from a single investigator to a transnational firm or a tourism company, and medicinal plants laboratories, as part of the commercialization channels. Trade is not monitored nor registered and, still less, controlled. The official and available data on the trade of medicinal plants and derived products do not reflect the reality of this activity and minimize its importance at local and international levels, in clear contrast with unofficial data. Import and export official data are based on common global level import tariffs and plants, parts of plants, seeds and fruits used in medicine and perfumery are registered as others. Only Ginger and Ginger oil, Musk, Cascarilla, Red Cascarilla (Cinchona pubescens Vahl), Yellow Cascarilla, Cascarillon and Condurango (without specifying the species) are 106 registered as export products, and as imported product only Oregano (Origanum vulgare L.). Other species that are known to be regionally and globally marketed mainly Dragons Blood (Croton spp.) and Cats claw (Uncaria tomentosa (Willd. ex Schult.) DC. and Uncaria guianensis (Aubl.) J. F. Gmel.), are not registered under others nor under official tariffs that could be related to cosmetics, foods, perfumery and wood, among others. Companies registered in the private sector's database as exporters of medicinal plants do not report trade data, and some do not even exist. It is inferred then that we are confronted with an informal trade. Although, because of the lack of trade monitoring, actual official data do not exist about imports or exports carried out by Ecuador in relation to medicinal plants and derived products, it is known that most part of the natural products that are marketed in and from the country are imported mainly from Colombia, Europe, Japan, Peru and the United States. Apparently the biggest demand is a local one, but due to the lack of records and of trade statistics it is not known if this estimate is real. The native species and most demanded products at local and international levels are the Dragons Blood, the Cats Claw, and the Cascarilla among others (Buitron, 1999). Ecuador exports during 2007 for selected Botanicals under the HS codes 0902-0910 (includes South American grown botanicals such as black pepper fruit, capsicum fruit, ginger rhizome, maté leaf, and vanilla fruit, among others); 1210 (includes only hop strobile Humulus lupulus L.); 1211 (includes South American botanicals such as anguraté herb, boldo leaf, cat’s claw bark, coca leaf, condurango bark, ipecac rhizome, marapuama, pau d’arco bark, rhatany root, and stevia leaf among many others); 121220 (includes seaweeds and algae); 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms among other balsams and oleo-gum-resins); 130219 (includes most herbal saps and extracts such as those of ginger, guaraná, ipecac, maca, maté, marapuama, pfaffia, and pau d’arco, among others); 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others); and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils)were 2,391,672; 2; 1,169,680; 21,938; 17,153; 39,115; 264,705; and 67,453 kg respectively (ITC, 2008).

Constraints and Problems A number of MAPs are threatened because of the problems at the political, legal and administrative levels, and the lack of education and awareness, unsustainable gathering practices, overexploitation and destruction and loss of habitats. However, due to lack of information about species and their trade, it is impossible to know how many species are threatened.

107 A combined, coordinated and integrated work by different sectors and actors for mutual benefit, to conserve the species and their habitats, to improve the use and trade, and to benefit the population's health is highly recommended. There is need of a proper legislation and control through appropriate instruments, modifications and improvements, the integration and coordination of operative responsibilities; information and education for all the involved sectors; an improvement of trade control through monitoring and appropriate recording, market studies, economic valuation, specific and high-priority actions for selected threatened species, in relation to research and conservation, such as carrying out inventories and ecological studies, promoting cultivation and in situ and ex situ conservation or pilot programs and elaboration of specific strategies for participative management, integrating the local communities and finally, specific actions of cooperation and support at national, regional and international level as the strengthening research centres and exchange of information. It is required to save the cultural heritage of the natives, by confirming the therapeutical uses of the plants with scientific criteria and fostering the phytochemical research on species containing potentially active principles. In this context, more detailed studies about the use of medicinal plants by the various native communities should be carried out and the biological activity of the most promising plants should be evaluated.

Table 1: Therapeutical applications of plants used in the traditional medicine of peoples of Loja and Zamora (Ecuador) (Tene et al. 2007) Botanical name Vernacular Family Part used Use(s) name

Abutilon striatum Malva goma Malvaceae Flower headache Dicks. Ex Lindl.

Acacia macracantha Faique Mimosaceae Bark conjunctivitis, kidney Humb. & Bonpl. problems ex Willd.

Acmella alba (L’H Botón Asteraceae Leaf, disinfectant, healing of ´er.) R.K. Jansen Amarillo flower wounds, hepatic pain, tooth decay

Acmella Botoncillo Asteraceae Flower analgesic, astringent, hair oppositifolia (Lam.) tonic, tooth decay R.K. Jansen

Adenostemma Curarina Asteraceae Stem, leaf antiophidic serum lavenia (L.) Kuntze

Adiantum Culantrillo Pteridaceae Leaf, hepatic pain, stomach pain concinnum Humb. flower

108 & Bonpl. ex Willd.

Adiantum poiretii Culantrillo Pteridaceae Stem, leaf, asthma, diabetes, influenza, Wikstr. flower kidney problems, pneumonia

Agave americana L. Mejico Agavaceae Juice internal inflammation, kidney problems

Ageratum Pedorrera Asteraceae Leaf, stomach pain conyzoides L. flower

Albizia spp. Sekemur Mimosaceae Leaf hepatic pain Durazz.

Alcea rosea L. Malva Malvaceae Whole kidney problems, tonic plant

Alnus acuminata Aliso Betulaceae Leaf, bark astringent, dermatitis, Kunth. headache, lacerations, rheumatism, tonsillitis

Aloysia triphylla Cedrón Verbenaceae Leaf, diuretic, fever, headache (L’H´er.) Britton flower

Alternanthera Lancetilla Amaranthaceae Root, leaf, fever, gastritis, hepatic pain, porrigens var. grande flower influenza, kidney problems, piurensis (Standl.) menstruation pain, pneumonia Eliasson

Alternanthera Lancetilla Amaranthaceae Leaf, hepatic pain, influenza, kidney porrigens var. grande flower problems porrigens (Jacq.) Kuntze

Alternanthera spp. Lancetilla Amaranthaceae Root kidney diseases Forssk. pequena

Amaranthus Ataco Amaranthaceae Stem, leaf diuretic, kidney problems cruentus L.

Amaranthus Bledo Amaranthaceae Leaf, cold, headache, internal hybridus L. flower inflammation, stomach pain

Ambrosia Marco Asteraceae Leaf postpartum bath, rheumatism arborescens Mill. “Espanto”

Ambrosia Altamisa Asteraceae Stem dermatitis, internal infections, artemisioides kidney problems, Meyen & Walpers menstruation pain ex Meyen

109 Amicia glandulosa Orozus Fabaceae Root bronchitis, cough, internal Kunth. inflammation

Annona muricata L. Guanábana Annonaceae Leaf rheumatism

Apium graveolens L. Apio Apiaceae Stem, leaf antiacid, diarrhoea, kidney problems, menstruation & stomach pain

Apium Culantrillo Apiaceae Leaf gangrene, hepatic pain, leptophyllum (Pers.) gateador stomach pain F. Muell.

Argemone mexicana Cardo santo Papaveraceae Leaf antiparasite, internal infections L.

Arracacia Zanahoria Apiaceae Leaf stomach pain xanthorrhiza Bancr. Blanca

Artemisia sodiroi Ajenjo Asteraceae Leaf cough, fever, hepatic pain, Hieron. internal infections, internal inflammation, kidney problems, stomach pain

Artocarpus altilis Fruto del pan Moraceae Leaf diabetes, high cholesterol (Parkinson) Fosberg

Baccharis Tres filos Asteraceae Stem, leaf diabetes, diuretic, influenza, genistelloides kidney problems, lose weight, (Lam.) Pers. stomach pain

Baccharis latifolia Chilca negra Asteraceae Leaf fractures, gangrene, (Ruiz & Pav.) Pers. hepatic pain, internal & external inflammation, rheumatism, stomach pain

Baccharis obtusifolia Chilca Asteraceae Whole antimycotic, cold, rheumatism Kunth. redonda plant

Banisteriopsis caapi Ayahuasca Malpighiaceae Stem disinfectant, headache, healing (Spruce ex Griseb.) of wounds, kidney problems, C.V. Morton liver, rheumatism

Barnadesia arborea Clavelillo Asteraceae Flower dermatitis, influenza Kunth.

Bauhinia Pata de vaca Caesalpiniaceae Leaf diarrhoea tarapotensis Benth.

Begonia fischeri Begonia Begoniaceae Leaf stomach pain

110 Schrank

Bejaria aestuans L. Payamo Ericaceae Leaf arthritis

Bejaria resinosa Payama Ericaceae Flower arthritis, heart problems, Mutis ex L.f. kidney pain, relaxant

Bidens andicola Nachi Asteraceae Whole headache, sunstroke Kunth. plant

Bidens pilosa L. Guichingue Asteraceae Leaf, influenza, menstruation pain, flower prostate disturbances, pneumonia, scurvy, stomach pain

Bixa orellana L. Achiote Bixaceae Leaf arthritis, bronchitis, tonic

Boehmeria ramiflora Hierba de la Urticaceae Stem, leaf dermatitis Jacq. guanchaca

Borago officinalis L. Borraja Boraginaceae Leaf, burnings, conjunctivitis, flower headache, hepatic pain,

influenza, kidney pain, menstruation pain

Brachyotum sp. (A. Quilliyuyo Melastomataceae Leaf stomach pain DC.) Triana

Brassica napus L. Yuyo Brassicaceae Leaf sedative

Briza monandra Atalpa Poaceae Stem and hepatic & stomach pain (Hack.) Pilg. micuna leaf

Brugmansia candida Guando Solanaceae Flower antimycotic, bone fractures, Pers. disinfectant, kidney, rheumatism

Bryophyllum Monte del Crassulaceae Stem, leaf blood purification, cancer, pinnatum (Lam.) aire menstruation pain Oken

Buddleja americana Salvia Buddlejaceae Leaf diarrhoea, headache, L. hepatic & kidney pain,

parasite, relaxant

Bursera graveolens Palo santo Burseraceae Leaf, bark dermatitis, insecticide (Kunth.) Triana & Planch.

Calceolaria Hierba del Scrophulariaceae Leaf, dermatitis 111 tripartita Ruiz & sapo flower Pav.

Callisia gracilis Calcha Commelinaceae Leaf, hair tonic, high blood (Kunth.) D.R. Hunt flower pressure, rheumatism

Callisia repens Calcha Commelinaceae Leaf fever, gangrene, gastritis, high (Jacq.) L. blood pressure, internal infections, relaxant, rheumatism

Campyloneurum Calaguala Polypodiaceae Whole antiinflamatory, pneumonia, spp. C. Presl plant kidney pain

Canna indica L. Achira negra Cannaceae Flower relaxant, stomach pain

Cardamine Berro negro Brassicaceae Leaf cough, influenza, pneumonia bonariensis Pers.

Cavendishia Zalapa Ericaceae Leaf rheumatism bractetata (Ruiz & Pav. ex J.St.-Hil.) Hoerold

Ceiba samauma Seibo Bombacaceae Stem internal inflammation, kidney (Mart.) K. Schum. pain

Celtis iguanaea Tsachik Ulmaceae Leaf, hepatic pain, kidney pain (Jacq.) Sarg. flower

Centaurium Canchalagua Gentianaceae Stem, leaf blood purification, influenza, erythraea Rafn. internal infections, kidney problems

Cestrum Sauco Solanaceae Leaf blood purification, psicomotor peruvianum Willd. development ex Roem. & Schult.

Cestrum racemosum Sauco negro Solanaceae Whole cold, fever, gastritis, Ruiz & Pav. plant headache, high blood pressure, influenza,

internal & external infections, relaxant, stomach pain, tooth decay

Cestrum Sauco negro Solanaceae Leaf, cough, fever, gangrene, sendtnerianum C. flower head pain, influenza, internal Martius infections, purgative, rheumatism,

112 stomach pain

Cestrum Sauco lanudo Solanaceae Leaf, influenza tomentosum L. f. flower

Cinchona officinalis Cinchona Rubiaceae Bark, leaf antimycotic, fever, malaria, L. stomach pain

Citrus limonum Limón Rutaceae Leaf relaxant Risso.

Citrus sinensis (L.) Naranja agria Rutaceae Fruit cold, hair tonic, kidney Osbeck

Clethra revoluta Almisque Clethraceae Stem, leaf, asthma, dermatitis, tonsillitis (Ruiz & Pav.) flower Spreng.

Clinopodium Poleo de Lamiaceae Stem, leaf cough, internal inflammation, taxifolium (Kunth.) castilla malaria Harley

Conyza canadensis Contrahierba Asteraceae Flower cough, hepatic pain, stomach (L.) Cronquist pain,

Costus comosus Cana Costaceae Stem diabetes, diuretic, headache, (Jacq.) Roscoe hepatic pains, influenza, kidney problems

Crassula spp. L. Siempre viva Crassulaceae Root ear infections

Crotalaria sp. L. Fenogreco Fabaceae Leaf cancer, hepatic pain, stomach pain

Croton mutisianus Sangre de Euphorbiaceae Latex disinfectant, gastritis, internal Kunth. drago & external inflammation, wound healing

Croton lechleri Sangre de Euphorbiaceae Latex dermatitis, disinfectant, M¨ull. Arg. drago diuretic, hepatic pain, wound healing

Croton wagneri Moshquera Euphorbiaceae Leaf antiacid, diabetes, fever, M¨ull. Arg. gastritis, stomach pain, tonsillitis

Cucurbita ficifolia Zambo Cucurbitaceae Seed antiparasite, hair tonic Bouch´e

Cucurbita sp. L. Sampu Cucurbitaceae Latex antiparasite

Cuphea racemosa (L. Hierba del Lythraceae Leaf urinary tract infections

113 f.) Spreng. toro

Cupressus Ciprés Cupressaceae Leaf dermatitis lusitanica Mill.

Cymbopogon Hierbaluisa Poaceae Leaf diarrhoea, gastritis, relaxant, citratus (DC.) Stapf stomach pain,

Cynanchum sp. L. Cola de Asclepiadaceae Stem kidney problems caballo

Cynodon dactylon Grama dulce Root, hepatic pain, kidney problems (L.) Pers. Poaceae stem, leaf

Cyperus sp. L. Dıctamo real Cyperaceae Stem and dermatitis, diarrhoea, kidney leaf problems

Cyphomandra Tomate de Solanaceae Fruit high cholesterol, stomach pain, betacea (Cav.) árbol tonsillitis Sendtn

Chenopodium album Palitaria Chenopodiaceae Leaf analgesic, anti-inflammatory, L. antiparasite, internal infection, strokes

Chenopodium Paico Chenopodiaceae Seed, leaf analgesic, antiparasite, internal ambrosioides L. inflammation, lacerations, stomach pain

Chuquiraga jussieui Chuquiragua Asteraceae Whole allergy, internal infections, J. F. Gmel. plant malaria

Daucus montanus Cominillo Apiaceae Stem, leaf, hepatic pain, internal Humb. & Bonpl. flower infections, stomach pain ex Spreng.

Desmodium San Antonio Fabaceae Whole disinfectant, kidney problems, molliculum plant wound healing (Kunth.) DC.

Desmodium sp. Hierba de Fabaceae Leaf wound healing Desv. Infante

Desmodium San Antonio Fabaceae Leaf, stem menstruation pain, tortuosum (Sw.) psychomotor development, DC. stomach pain

Dicliptera sp. Juss. Chinchimaní Acanthaceae Leaf blood purification

Dodonea viscosa Chamana Sapindaceae Leaf internal inflammation Jacq.

Echeveria quitensis Condorcol Crassulaceae Leaf cancer 114 (Kunth.) Lindl.

Elleanthus Guabiduca Orchidaceae Leaf hepatic pain, kidney problems aurantiacus (Lindl.) Rchb. f.

Epidendrum Flor de cristo Orchidaceae Leaf, kidney problems fimbriatum Kunth. flower

Epidendrum Flor de Cristo Orchidaceae Leaf kidney problems jamiesonis Rchb. f.

Epidendrum sp. L. Espíritu de Orchidaceae Leaf, conjunctivitis, fever, influenza mujer flower

Equisetum Cola de Equisetaceae Whole antiparasite, diuretic, kidney bogotense Kunth. caballo plant problems

Equisetum Cola de Equisetaceae Whole diuretic, kidney problems, giganteum L. caballo plant stomach pain

Eriobotrya japonica Níspero Rosaceae Leaf, antiacid, diuretic, gastritis, (Thunb.) Lindl. flower high cholesterol, influenza, kidney problems pneumonia, prostate disturbances, rheumatism

Erodium Aujilla Geraniaceae Leaf cough, influenza, moschatum (L.) L’H menstruation pain, pneumonia ´er. ex Aiton

Eryngium humile Achiote del Apiaceae Leaf arthritis, relaxant Cav. monte

Eryngium sp. L. Recaída Apiaceae Leaf hair tonic, headache, influenza

Erythrina edulis Guato Fabaceae Bark disinfectant, headache, high Triana ex Micheli blood pressure, lacerations, wound healing

Euphorbia laurifolia Pinchú Euphorbiaceae Leaf, latex cough Juss.

Euphorbia laurifolia Porotillo Euphorbiaceae Bark hair tonic Juss.

Ficus carica L. Higo Moraceae Leaf bronchitis, menstruation pain, sedative

Ficus maxima Mill. Higuerón Moraceae Leaf internal inflammation

115 Ficus subandina Mata palo Moraceae Latex cystitis, fractured bones, Dugand strokes

Foeniculum vulgare Hinojo Apiaceae Leaf, cancer, conjunctivitis, gastritis, Mill. flower nursing, relaxant

Fragaria vesca L. Uvilla Rosaceae Leaf, disinfectant, tonsillitis, wound flower healing

Fuchsia canescens Pena pena Onagraceae Leaf, analgesic, high blood pressure, Benth. flower relaxant

Fuchsia hybrida Pena pena Onagraceae Leaf antiacid, high blood pressure, Hort. Ex Siebert. & postpartum, relaxant Voss

Fuchsia hypoleuca I. Pena pena Onagraceae Leaf, disinfectant, wound healing M. Johnst. flower

Fuchsia magellanica Pena pena Onagraceae Leaf disinfectant, diuretic, kidney Lam. problems, wound healing

Fuchsia sp. L. Pena pena Onagraceae Leaf, relaxant flower

Gaiadendron Violeta de Loranthaceae Leaf, bronchitis, cough, hair tonic, punctatum (Ruiz & campo flower hepatic pain, influenza Pav.) G. Don

Galinsoga Pacunga Asteraceae Whole hepatic pain, yellow fever caracasana (DC) Blanca plant Sch. Bip.

Galinsoga parviflora Pacunga Asteraceae Whole fever, internal inflammation, Cav. amarilla plant kidney pain

Gallesia integrifolia Palo de ajo Phytolaccaceae Bark arthritis, rheumatism, strokes (Spreng.) Harms

Gamochaeta Lechuguilla Asteraceae Leaf, diarrhoea Americana (Mill.) flower Wedd

Guarea kunthiana Tapirk Meliaceae Leaf disinfectant, wound healing A. Juss.

Guarea sp. Allam. Samik Meliaceae Leaf hepatic pain ex L.

Guazuma ulmifolia Guázimo Sterculiaceae Fruit influenza Lam.

Gynoxys verrucosa Guángalo Asteraceae Whole allergy, dermatitis, relaxant 116 Wedd. plant

Hedyosmum Guayusa del Chloranthaceae Leaf stomach pain anisodorum Todzia monte

Heliconia sp. Chiguango Heliconiaceae Stem, leaf, arthritis, external flower inflammation

Hypochaeris Chicoria Asteraceae Leaf hepatic &, kidney pains, sessiliflora Kunth. stomach pain

Hyptis pectinata (L.) Pambapoleo Lamiaceae Leaf stomach pain Poit.

Hyptis sidifolia Tipo Lamiaceae Leaf cough, malaria, stomach pain (LˇıH´er.) Briq.

Hyptis sp. Jacq. Mastrando Lamiaceae Leaf diarrhoea

Ilex guayusa Loes. Guayusa Aquifoliaceae Leaf gastritis, increase woman’s fertility, relaxant

Impatiens balsamina Chabela Asteraceae Leaf, internal infections L. flower

Inga acreana Harms Zamique Mimosaceae Stem, leaf malaria, rheumatism

Iresine herbstii Escancel Amaranthaceae Flower fever, kidney, relaxant Hook.

Iresine sp. P. Tigrecillo Amaranthaceae Seed headache Browne

Iris germanica L. Lirio Iridaceae Flower conjunctivitis

Jacaranda Arabisco Bignoniaceae Whole antiparasite, dermatitis mimosifolia D. Don plant

Jatropha curcas L. Piñón Euphorbiaceae Leaf, seed antiparasite, herpes

Juglans neotropica Nogal Juglandaceae Leaf hepatic pain, rheumatism Diels

Justicia pectoralis Moradilla Acanthaceae Leaf cold, cough, diuretic, Jacq. Blanca menstruation pain

Lavatera Amapola Malvaceae Leaf, seed asthma, bronchitis, catarrh, assurgentiflora rheumatism Kellogg

Lavatera sp. L. Menta Malvaceae Leaf diarrhoea, stomach pain

Lepidium chichicara Alpa Chichira Brassicaceae Leaf purgative Desv.

117 Lepidium thurberi Chichira Brassicaceae Leaf bladder, internal Wooton inflammation, kidney problems, postpartum, sedative

Lilium candidum L. Azucena Liliaceae Root ear infections

Linum Linaza Linaceae Seed kidney problems usitatissimun L.

Ludwigia peruviana Mejorana Onagraceae Leaf diuretic, hepatic pain, kidney (L.) H. Hara problems

Lupinus mutabilis Chocho Fabaceae Leaf fever Sweet

Lycopersicon Chichira Solanaceae Stem postpartum hirsutum Dunal

Lycopodiella Cordoncillo Lycopodiaceae Leaf hangover pendulina (Hook) B. Ollg.

Macleania rupestris Joyapa Ericaceae Leaf tonic (Kunth.) A.C. Sm.

Malachra alceifolia Malva Malvaceae Leaf stomach pain Jacq.

Mansoa sp. DC. Ajocaipe Bignoniaceae Leaf cold, internal infections, purgative, rheumatism

Margyricarpus Nigua Rosaceae Flower hepatic pain, relaxant, stomach pinnatus (Lam.) pain Kuntze

Marsdenia Condurango Asclepiadaceae Bark, leaf cancer condurango Rchb. f.

Matricaria ricutita Manzanilla Asteraceae Stem, leaf, stomach pain L. or Matricaria flower chamomilla L. or Chamomilla recutita (L.) Rauschert

Melilotus indica (L.) Alfalfilla Fabaceae Whole disinfectant, external All. plant infections

Melissa officinalis L. Toronjil Lamiaceae Stem, leaf insomnia, relaxant

Mentha spicata L. Menta Lamiaceae Leaf earache, haemorrhage, influenza, relaxant, stomach

118 pain

Mentha piperita L. Hierbabuena Lamiaceae Leaf stomach pain

Mentha pulegium L. Menta Lamiaceae Leaf stomach pain

Miconia sp. Ruiz & Miconia Melastomataceae Leaf scurvy Pav.

Mikania sp. Willd. Chapongo Asteraceae Stem, leaf antiparasite, hepatic pain, stomach pain

Minthostachys Poleo del inca Lamiaceae Whole cough, influenza malaria mollis (Kunth.) plant Griseb.

Muehlenbeckia Anguyuyo Polygonaceae Leaf influenza, menstruation pain tamnifolia (Kunth.) Meisn.

Myrcia sp. DC. ex Arrayán Myrtaceae Root, tonic Guill. aromático stem, leaf

Myrcianthes Arrayán Myrtaceae Leaf, bark tonic, gastritis rhopaloides (Kunth.) McVaugh

Myrica pubescens Laurel Myricaceae Stem, leaf rheumatism, stomach pain Humb. & Bonpl. ex Willd.

Myroxylon Chaquino Fabaceae Bark allergy, cancer, dermatitis, balsamum (L.) disinfectant, gastritis, hepatic Harms pain, kidney problems, internal & external infections, rheumatism, stomach pain, wound healing

Nasa loxensis Ortiga del Loasaceae Root internal infections (Kunth.) Weigend monte

Nasa olmosiana Ortiga de león Loasaceae Root infections (Gilg ex J.F. Macbr.) Weigend

Nasturtium Berro Brassicaceae Stem, leaf blood purification, hepatic officinale R. Br. pain, kidney pneumonia,

Neonelsonia Zanahoria Apiaceae Leaf stomach pain acuminate (Benth.) blanca J.M.Coult. & Rose

119 ex Drude

Nicotiana tabacum Chamico Solanaceae Leaf allergy, rheumatism, strokes L.

Niphidium Calaguala Polypodiaceae Root hepatic & kidney pain crassifolium (L.) Lellinger

Ocimum basilicum Albahaca Lamiaceae Leaf fever, gastritis, influenza, high L. blood pressure, internal infections, relaxant, stomach pain

Oenothera Shullo Onagraceae Whole hepatic pain pubescens Willd. ex Amarillo plant Spreng.

Oenothera rosea Shullo Onagraceae Leaf amarillo hepatic pain, kidney LˇıH´er. Ex Aiton problems

Oenothera sp. L. Shullo blanco Onagraceae Leaf kidney

Oreocallis Cucharillo Proteaceae Leaf, bark, cough, diabetes, fever, grandiflora (Lam.) flower headache, hepatic pains, R. Br. kidney problems

Oreopanax Pumamaki Araliaceae Leaf dermatitis, disinfectant, andreanus Marchal wound healing

Oreopanax Pumamaki Araliaceae Leaf headache ecuadorensis Seem

Oreopanax sp. Pumamaki Araliaceae Leaf dermatitis, internal & external Decne. & Planch. infections, wound healing

Otholobium Teculen Fabaceae Leaf, stomach pain mexicanum (L. f.) flower J.W. Grimes

Otholobium Culen Fabaceae Root, leaf, diarrhoea, hepatic pain, pubescens (Poir.) bark stomach pain Grim.

Oxalis corniculata Chulquillo Oxalidaceae Leaf diarrhoea L.

Oxalis peduncularis Chulco Oxalidaceae Leaf, fever, scurvy Kunth. flower

Passiflora ligularis Granadilla Passifloraceae Leaf, external & internal Juss. flower inflammation, hepatic pain,

120 high cholesterol,

high blood pressure, scurvy

Pelargonium Rosas blancas Geraniaceae Flower conjunctivitis graveolens L’H´er. ex Ait

Pelargonium Malva olorosa Geraniaceae Leaf internal & external odoratissimum (L.) inflammation, stomach pain, L’H´er. wound healing

Pelargonium zonale Malva Geraniaceae Flower influenza (L.) L’H´er.

Pentacalia sp. Cass. Bejuco Asteraceae Root, hair tonic, influenza stem, leaf

Peperomia congona Congona Piperaceae Stem, leaf anxiety, earache, headache, Sodiro hepatic pain, kidney problems, stomach pain

Pernettya prostrata Motilón Ericaceae Leaf headache (Cav.) DC.

Persea americana Aguacate Lauraceae Leaf, fruit diabetes, bronchitis, hair tonic, Mill. influenza, menstruation pain, rheumatism, stomach pain

Petroselinum Perejil Apiaceae Whole disinfectant, wound healing crispum (Mill.) plant A.W. Hill

Physalis peruviana Uvilla Solanaceae Flower disinfectant, wound healing L.

Phytolacca Atugsara Phytolaccaceae Leaf, hepatic & stomach pain americana L. flower

Phytolacca dioica L. Humilla Phytolaccaceae Leaf diarrhoea, high blood pressure

Piper aduncum L. Matico Piperaceae Leaf, cough, disinfectant, gastritis, flower influenza, rheumatism,

Piper barbatum Cordoncillo Piperaceae Whole dermatitis, disinfectant, Kunth. plant headache, stomach pain, wounds

Piper bogotense C. Sacha guando Piperaceae Leaf hepatic pain DC.

121 Piper crassinervium Guabiduca Piperaceae Stem, leaf diabetes, gastritis, prostate Kunth. problems

Piper ecuadorense Matico del Piperaceae Leaf disinfectant, hangover, wound Sodiro monte healing

Plantago major L. Llantén Plantaginaceae Root, hepatic pain, insomnia stem, leaf, flower

Podocarpus sprucei Romerillo Podocarpaceae Leaf malaria Parl.

Polygonum Soliman Polygonaceae Leaf fractures, lacerations hydropiperoides Michx.

Portulaca oleracea L. Verdolaga Portulacaceae Leaf gastritis, internal inflammation, internal infections, kidney, relaxant

Prestonia mollis Bejuco del Apocynaceae Root, cancer, disinfectant, wound Kunth. cáncer stem, leaf healing

Prosopis juliflora Algarrobo Mimosaceae Leaf, seed disinfectant, scurvy, wound (Sw.) DC. healing

Psidium guajava L. Guayaba Myrtaceae Leaf diarrhoea

Psidium guineense Guayabilla Myrtaceae Leaf disinfectant, wound healing Sw.

Puya eryngioides Achupalla Bromeliaceae Leaf relaxant, rheumatism Andr´e

Rosa centifolia L. Rosa de Rosaceae Flower conjunctivitis, relaxant castilla

Rosmarinus Romero Lamiaceae Leaf anaemia, headache, internal officinalis L. infections, stomach pain

Rubus glaucus Mora de Rosaceae Leaf disinfectant, menstruation Benth. castilla pain, wound healing

Rubus robustus C. Mora silvestre Rosaceae Leaf hepatic pain, lacerations Presl

Rubus urticifolius Mora Rosaceae Leaf, lacerations Poir. flower

Rumex crispus L. Lengua de Polygonaceae Leaf external infections, gangrene, vaca postpartum

122 Rumex obtusifolius Sachagula Polygonaceae Leaf internal inflammations L.

Salvia hirta Kunth. Santa María Lamiaceae Leaf, antiparasite, kidney pain flower

Salvia sp. L. Monte del Lamiaceae Stem, leaf hepatic pain susto

Salvia tiliifolia Vahl Santa María Lamiaceae Leaf headache, relaxant

Sambucus nigra L. Sauco tilo Caprifoliaceae Leaf, cold, cough, fever, headache, flower influenza, kidney pain

Saurauia bullosa Chupana Actinidiaceae Leaf scurvy Wawra

Scoparia dulcis L. Teatina Scrophulariaceae Whole antiophidic, dermatitis, plant disinfectant, rheumatism, wound healing

Schinus molle L. Molle Anacardiaceae Leaf, fruit cough, postpartum, rheumatism

Serjania sp. Mill. Bejuco de la Sapindaceae Stem, leaf dermatitis erisipela

Sida rhombifolia L. Pichana Malvaceae Root disinfectant, gastritis, wound healing

Siparuna eggersii Monte del oso Monimiaceae Leaf diabetes, fractured bones, Hieron. kidney problems, rheumatism, strokes

Siparuna muricata Limoncillo Monimiaceae Stem, leaf antiacid (Ruiz & Pav.) A. DC.

Smallanthus Jícama Asteraceae Root disinfectant, wound healing sonchifolius (Poepp.) H. Rob

Solanum albidum Hoja de oso Solanaceae Leaf fractures Dunal

Solanum Mortiño Solanaceae Stem, leaf, cold, dermatitis, fever, americanum Mill. flower hangover, headache, hematoma, hepatic pain, influenza, internal infections & inflammation, kidney problems, pneumonia,

123 stomach pain

Solanum Uvilla Solanaceae Leaf stomach pain sisymbrifolium Lam.

Solanum sp. L. Nara Solanaceae Leaf headache

Sonchus oleraceus L. Cerraja Asteraceae Leaf internal infections

Sorocea trophoides Yamila Moraceae Leaf, antimicotic, insecticide W.C. Burger flower

Stachytarpheta Rabo de ratón Verbenaceae Stem, leaf antiacid, relaxant straminea Moldenke

Symphytum Consuelda Boraginaceae Leaf disinfectant, fractures, officinale L. Asteraceae gastritis, relaxant

Tagetes filifolia Lag. Sacha anís Asteraceae Stem, leaf menstruation pain

Tagetes terniflora Sacha ruda Asteraceae Root, leaf antimycotic, disinfectant, Kunth. wound healing

Tamarindus indica Tamarindo Caesalpiniaceae Fruit Hepatic & stomach pain L.

Tanacetum Santa María Asteraceae Leaf parasites parthenium (L.) Sch. Bip.

Taraxacum Diente de león Asteraceae Leaf blood purification, officinale Weber disinfectant, hepatic pain, kidney problems wound healing

Tibouchina laxa Garra del Melastomataceae Leaf cataract (Desr.) Cogn. Diablo

Tradescantia sp. L. Calcharón Commelinaceae Stem fever

Tradescantia zebrina Calcio Commelinaceae Leaf, gastritis, internal infections, Hort. Ex Bosse flower relaxant

Triumfetta Abrojo, Tiliaceae Root, leaf, cough, fever, hepatic althaeoides Lam Cadillo stem, pain, internal infections & flower inflammation, kidney

problems, stomach pain

Uncaria tomentosa Uña de gato Rubiaceae Bark cancer, internal inflammation, (Willd. Ex Roem.& 124 Schult) DC. kidney problems

Urena lobata L. Cosa cosilla Malvaceae Leaf hepatic pain

Urera caracasana Ortiga Urticaceae Root, internal inflammation (Jacq.) Griseb. stem, leaf

Urtica urens L. Ortiga Urticaceae Root, leaf circulation problems, hangover, kidney problems

Valeriana Valeriana Valerianaceae Root hepatic pain, sedative microphylla Kunth.

Verbena litoralis Verbenaceae Whole blood purification, dermatitis, Kunth. plant disinfectant,

hair tonic, headache, hepatic pain,

high cholesterol, influenza, internal infections, kidney problems, menstruation pain, parasites, stomach pain, strokes, scurvy, treatment of wounds

Vernonanthura Aritaco Asteraceae Leaf antiophidic patens (Kunth.) H. Rob

Vicia faba L. Haba Fabaceae Flower headache

Viola arguta Will. Violeta de Violaceae Flower fever, influenza ex Roem. & Schult. campo

Viola odorata L. Violeta Violaceae Flower, bronchitis, cough, fever, leaf influenza, pneumonia, stomach pain

Viola tricolor L. Pensamiento Violaceae Leaf Headache, heart problems, relaxant

Waltheria ovata Chicharrón Sterculiaceae Root internal inflammation Cav.

Xanthium spinosum Casha Asteraceae Leaf blood purification, diuretic, L. marucha relaxant

Zea mays L. Maíz Poaceae Flower dermatitis, stomach pain

125 1.7 Guyana

The Republic of Guyana covers 214,970 square kilometres. It is bounded by Venezuela, Brazil and Suriname. Four main regions can be distinguished: The northern coastal belt, consisting of low-lying alluvium with a varying width up to a maximum of 65 kilometres inland (in the east). This is the main agricultural region of the country; The lowland region of undulating forest land covering most of the northern and central parts of the country, generally with an elevation below 150 m and consisting of broad belts of white sand; The Pakaraima mountain region in the west, an elevated table land of sandstone escarpments between 300 and 1,200 m in elevation corresponding to similar formations in the south-east of the Venezuelan Guyana and the Brazilian territory of Roraima; The southern uplands, a vast area mostly over 150 m in elevation covered with undulating forestland. The country has many rivers, generally running from south to north towards the Atlantic Ocean. The main streams (Essequibo, Demerara and Berbice) are navigable in their lower reaches for distances of between 60 and 160 kilometres. The climate of Guyana is tropical, with little seasonal temperature change. Guyana is a highly forested country, with 78.5% forest cover. Six major forest formations are recognized in Guyana viz. broadleaved rain forest, seasonal evergreen and semi- evergreen forest, dry evergreen forest, montane forest, alluvial marsh forest and swamp forest. Mangroves once stretched along the length of the coast but have been seriously depleted by overexploitation and pollution and natural causes since the mid-twentieth century. In general, the extent of intact natural ecosystems results more from the low population density and lack of population pressure than from systematic conservation planning. Major threats to forest ecosystems include logging, uncontrolled fires, soil erosion and overexploitation of wildlife resources. Guyana has only one protected area, Kaieteur National Park (12,000 hectares). All the forests are State owned, although small areas are administered by village councils. Because of the abundance of natural forests, plantations have not been important. However, they are recognized in the forest policy to have a role in watershed protection and rehabilitation. Guyana has about 12,000 hectares of forest plantations. Pinus caribaea Morelet is the main plantation species. A small trial area has been established with Acacia mangium Willd.. Manicole palm is the most commercially important non-wood forest product. Annual removals of palm hearts processed and canned for sale to mostly European markets, are more than 6.6 million stems. Act No. 6, 1976, set aside 65 areas for the exclusive use of native communities. Approximately 40,000 Amerindians occupy and have legal title to some 14,000 square kilometres of land, much of which is forested. Forest resources are important to Amerindians for food (wildlife, fruit, seeds and nuts), medicines (from more than 130 plant species), building materials, fibres for textiles and weaving and tannins and dyes. Some communities have undertaken commercial harvesting of the resource. Amerindian 126 land is managed and regulated by the resident communities, and no formal distinction between production and protection areas is made. The Iwokrama International Centre for Rain Forest Conservation and Development established in 1992 promotes the conservation and sustainable use of tropical rain forests in a manner that will lead to lasting ecological, economic and social benefits to the people of Guyana and to the world in general, through research, training and development and dissemination of technologies (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The indigenous tribes in the country mainly in the North-West District use a large number of medicinal plants to treat variety of common health problems such as colds, skin cuts and sores. Many indigenous communities are almost completely dependent on medicinal plants for their health care, since modern health facilities are limited and prescription medicine is either unavailable or too expensive. Although in many Amerindian communities medicinal plants form the only available source of medical treatment; however, the use of local indigenous remedies is declining (van Andel, 2000).

Government Efforts in Development of Traditional Medicine/Phytomedicine No information concerning government efforts in development of traditional medicine in the country is presently available.

Medicinal and Aromatic Plant Resources A total of 294 medicinal plant species belonging to 214 genera and 99 families, and involved in more than 800 different treatments and recipes were reported from the North- West District of Guyana, which along with the Rupununi savannas in the southern part of the country, forms the main Amerindian region in Guyana. Some most widely used medicinal plant species include Carapa guianensis Aubl., Desmodium barbatum (L.) Benth., Irlbachia alata (Aubl.) Maas subsp. Alata, Senna occidentalis (L.) Link and Stigmaphyllon sinuatum (DC.) A. Juss. Among these MAP species about 80% are collected exclusively from the wild and about 12% of these are taken from the forest and planted in home gardens or agricultural fields (e.g., Lonchocarpus chrysophyllus Kleinhoonte and Martinella obovata (Kunth) Bureau & K. Schum.). Around 20% of the species involved in herbal healing practises are cultivated plants. Although most of these were cultivated primarily as a food crop (e.g. Carica papaya L. and Manihot esculenta Crantz), they were valued for their healing properties as well. Only 6% of the medicinal species are cultivated exclusively for their medicinal value (van Andel, 2000).

Research and Development Activities The country has received much less ethnobotanical attention than many of its smaller neighbours. Several anthropological and ethnographical studies have been conducted on the indigenous tribes present in Guyana. Most of these studies have paid

127 some attention to traditional health care, but little effort has been done to verify the scientific names of the medicinal plants mentioned by local informants. Most works have just cited vernacular plant names, without supporting them with herbarium collections. The few extensive studies on the region’s useful plants lack up-to-date botanical information. In some of the recent ethnomedicinal studies for Guyana in which plant collection was part of the research methods, many specimens were lost or could not be identified properly due to incomplete sampling. Only a handful of ethnobotanical studies have been published in international journals (van Andel, 2000).

Trade and Marketing Medicinal plants and their parts are not only used by Amerindians, but also by the Afro-Guyanese and East Indian population in the urban areas. There is a modest, but steady demand for medicinal plants in the capital. Although modern medicine was commonly available in the major urban centres, some diseases were preferred to be treated with bush medicine. MAPs are sold by market vendors throughout the country. In Guyana, a few medicinal plants are exported to the UK and some basic screening and bioprospecting attempts have been done in the past. Guyana’s neighbour Suriname exports substantial volumes of fresh, dried, and frozen medicinal plants to the Netherlands. Many of these species marketed by Suriname also occur in Guyana; however, this country still has to discover the commercial potential of its medicinal flora on the world market (van Andel, 2000).

Constraints and Problems The main problems in getting the health benefits and realising the commercial potential of Guyana’s MAPs flora are the loss of traditional knowledge, neglecting the role of MAPs in primary health care and importance of traditional health care systems in Guyana. Community health workers in Guyana should be made aware of the great possibilities of medicinal plants and incorporate elder community members with traditional knowledge in the diagnosis and treatment of patients. There is a great need for the documentation and revitalisation of indigenous knowledge, as this may help to preserve both cultural and biological diversity. Efforts should be made that the documented knowledge is made available to the indigenous groups and economic benefits from ethnobotanical research are shared with the communities involved. The great diversity of Guyanese medicinal plants could have a much larger potential for the (inter-) national market than it has today, if are processed in a more sophisticated manner, such as ready-to-use tonics, powders, tablets, ointments, or pre-packed ingredients for herbal teas and baths. The commercial harvesting of MAPs and their bioprospecting should be carried out according to the guidelines of the Convention of Biological Diversity.

128 1.8 Paraguay Paraguay, located in the centre of South America, is bounded on the north-west and north by Bolivia, on the east by Brazil and on the south and south-west by Argentina. The total area of the country is 406,757 square kilometers. The Paraguay River divides the country into two distinctive regions, namely, in the west, the Gran Chaco, or Occidental region, and the east, or Oriental region. The Gran Chaco is part of an alluvial plain extending into Bolivia on the west, Argentina on the south, and Brazil on the east. Coarse grasses, scrub forests, and salt marshes cover the area. The oriental region consists mainly of the southern extension of the Paraná plateau, generally from 300 to 600 m high. The highest point is Cerro Tres Candú at 842 m. The land has rolling hills, fertile soil, and thick forests. Even though the country lies only partially within the tropics, the forests are characterized by a large number of tree species along with epiphytes, lianas, ferns and palms. On its western edge the plateau falls off sharply to fertile grassy lowlands along the Paraguay River; in the east it descends gradually toward the Paraná River. The subtropical climate of Paraguay is warm and humid. In Asunción the average temperatures range from about 17°C in July to about 27°C in January. Annual rainfall averages about 1,100 in the Asunción area, about 800 mm in the Gran Chaco, and some 1,500 mm in the forested eastern regions. Most of the rainfall in the Chaco falls during the summer months. It is calculated that Paraguay had 23.37 million hectares of forest cover in 2000, representing 58.8% of its land area, with forest plantations accounting for 27,000 hectares of the total. Average annual deforestation between 1990 and 2000 has been estimated at 123,000 hectares. Some 1.69 million hectares are designated as protected areas (FAO, 2010). The institution in charge of the administration of forest resources in Paraguay is the Instituto Forestal Nacional (INFONA) created as a decentralized institution by the Law 3464/2008, and linked to the Ministry of Agriculture. INFONA is the charge of the general administration, promotion, and sustainable development of the forestry national resources, with actions directed to their protection, improvement and rational use (INFONA, 2012).

Traditional Medicine Systems/Phytomedicine Various indigenous cultures that coexist in the country still practice traditional medicine, and rural communities and even city dwellers use medicinal plants to prevent and cure all kinds of illnesses. Most of the

129 physical and human resources in the health sector in Paraguay are concentrated in the capital city and not easily accessible to the rural population and especially the indigenous populations (Anonymous, 2005). An important number of species employed as medicinal are native from Paraguay and the region, however about 20% of them came from Europe and other regions of the world. The use of both native and introduced species has a tradition of four centuries. The medicinal plants currently used in Paraguay proceed from three origins, introduced species, species from the same region and those native from this country (Pin et al, 2009).

Government Efforts in Development of Traditional Medicine/Phytomedicine In 1938, the Paraguayan Pharmacist Rómulo Feliciángeli developed a project to develop a Paraguayan Pharmacopeia, including an Addendum where 36 species of medicinal plants were mentioned. In 2011 the Ministry of Health and Social Welfare asked the cooperation of Academia de Ciencias Farmacéuticas del Paraguay, the universities and local pharmaceutical industries in order to complete that project, within the framework of the Farmacopea del MERCOSUR. This project, conducted in Paraguay by the Dirección Nacional de Vigilancia Sanitaria, includes a working group on medicinal plants.

Medicinal and Aromatic Plant Resources The use of plants for medicinal purposes in Paraguay comes from the pre-Columbian years. It is strongly associated with folkloric practices, and is orally transmitted until the present time (MAG, Dirección de Investigación Agrícola, 2008). Currently, both native and exotic species are popularly employed as medicinal for the treatment and prevention of several diseases, including some chronical conditions as diabetes and hypertension, besides the use of medicinal plants for fertility regulation (Basualdo et al. 2004). Concerning the number of medicinal plants in Paraguay there is not a definitive value, ranging from 200 (Bertoni, 1927) to 279 species (Michalowki, 1955), and 266 (Table 1) (Basualdo, et al. 2004) to 510 species (Pin et al., 2009). Within the country, there are differences in the number of plants employed for medicinal purposes in the main regions of Paraguay (Mereles, 2007). In the central area of the western region (Chaco) 31 species belonging to 16 botanical families are employed (Mereles and Degen, 1997). The native habitants of this region use a lower number of species than those of Guaraní groups or those from the neighboring Andean communities (Arenas, 2009).

130 Research and Development Activities From early 1980’s some academic institutions made efforts in recording the species, popular use, distribution and chemical properties of the medicinal plants employed by the population, being the Facultad de Ciencias Químicas (FCQ) of the Universidad Nacional de Asunción (UNA), Paraguay, a pioneer in this approach. From that time to the present the FCQ Herbarium became the greatest active collection of medicinal plants in the country, giving support to chemical and pharmacological studies. The same institution received in the period 1982 – 1985 a UNESCO project directed to the establishment of research capacities for the study of medicinal plants (Berganza, 1984), and a collaborative study with the Toyama Medical and Pharmaceutical University of Japan strengthen the human and laboratory resources for a multidisciplinary approach in the study of medicinal plants, introducing some bioassays and starting an experimental pharmacology laboratory (Shimizu et al., 1987). The surveys performed in this project recorded 288 species employed as medicinal (Japan International Cooperation Agency, 1987). The research activities on medicinal plants in the FCQ – UNA comprises botanical, phytochemical, pharmacological and technological aspects, until the present. Solanum sisymbrifolium Lam. is one of the medicinal plants evaluated with a multidisciplinary approach, including chemical composition and highly relevant preclinical data with a clear connection with its popular use (Ibarrola and Degen, 2011). A survey of the Composites used in traditional medicine and as economic plants by Paraguayan country people was undertaken by FCQ- UNA to identify the components of crude drugs traded by herbalists. Forty- five medicinal and economic species have been identified through field work in the rural areas and enquiries in the markets, as well as by examination of the literature in the Spanish language. The survey also evaluated the role of indigenous plant remedies within the local health care system (Schmeda- Hirschmann and Bordas, 1990). The Instituto de Investigaciones en Ciencias de la Salud (IICS) of the Universidad Nacional de Asunción (UNA) evaluated the insecticidal, molting inhibition and trypanocidal effects of some Paraguayan plants belonging to Asteraceae family including Achyrocline satureioides (Lam.) DC., Mikania cordifolia (L. f.) Willd and Vernonia brasiliana (L.) Druce. No ethnobotanical information on these plants was reported earlier related to similar use in Paraguay, and this was the first report of the potential anti-trypanocidal and molting inhibition of by these plants (Rojas de Arias et al., 1995). The antioxidant properties of six herbs Aristolochia giberti Hook., Cecropia pachystachya Trecul, Eugenia uniflora L., Piper fulvescens DC., Schinus terebinthifolius Raddi and Schinus weinmanniifolius Mart. ex Engl. used in the

131 traditional Paraguayan medicine were studied at FCQ-UNA, Paraguay in collaboration with Universities in Argentina and Bolivia (Velázquez et al., 2003). A 1998 project was carried by Medicinal Plants South American Network to promote applied multidisciplinary research on medicinal plants and their sustainable use in the Southern Cone of Latin America (Argentina, Brazil, Chile, Paraguay and Uruguay) and to devolve the research results to local communities. The project aimed at establishing a network of institutions and researchers working on medicinal plants in the region and ensuring efficient exchange of information between them via electronic and traditional means. The network was linked to IDRC-supported Central American Network on Medicinal Plants (TRAMIL). This project was completed in 2000. The implementing institution (CETAAR - Centro de Estudios sobre Tecnologías Apropiadas de Argentina), during the first year invited institutions from other countries to participate in the network. Sobrevivencia was identified as reference centre in Paraguay. The reference centers and CETAAR met to work out the operational aspects of the network. They adopted an ethno-pharmacological survey instrument based on the model used by TRAMIL, for implementation in each of the participating countries. Also, the reference centers made and strengthened contact with other groups interested in medicinal plants, including non-governmental organizations (NGOs), universities, community groups, businesses and cooperatives (Anonymous, 2001). An environmental network Friends of the Earth Paraguay has created two school farms in the forested hills of Los Altos. Ecosystem restoration and conservation, sustainable agriculture and non-agricultural production practices are tested and developed on these training farms, and capacity is built among people from the local communities. Both farms contain living pharmacies, areas where native and non-native medicinal plants utilized in traditional herbal medicine are cultivated, and where courses are given to community members. Communities are also assisted in creating, recreating or maintaining their own living pharmacies, and in restoring and conserving the local ecosystems where native medicinal plants grow naturally. About 300 species of medicinal plants are now grown on the farms and a number of wild MAP species are found in the surrounding area, although their detailed botanical evaluation is still pending (Anonymous, 2005). The CYTED Program, that connected research groups and enterprises from Spain, Portugal, Central and South America, gave valuable opportunities to several research groups on medicinal plants, mainly from the

132 Universidad Nacional de Asunción, to participate in cooperation networks that expanded the knowledge about these natural resources. The Governments of the MERCOSUR launched in 2005 the PLAMSUR Project (Programa Regional de Apoyo a la Red de Desarrollo de Fitoterápicos en el MERCOSUR), with the support of the International Fund for Agricultural Development (IFAD), in order to strengthen the production of MAPs and to impulse innovations and technology transfer to local producers. The project brought in contact NGOs, enterprises and the academia, and several joint projects were supported (MAG-DGP, 2009). It is remarkable work performed by the Jardín Botánico y Zoologico de Asunción, Paraguay and the Centro de Conservación y Educación Ambiental (CCEAM) of Asunción municipal government for the development of educative, conservation and training activities concerning medicinal plants. These institutions with the cooperation of the Conservatory and Botanical Garden of Geneva, Switzerland, performed the Proyecto Etnobotánica Paraguaya (EPY), and transferred the experience in a very well organized book issued in 2009 (Pin et al., 2009). Other effort in this sense is conducted by Fundación Moisés Bertoni, performing surveys and conservation activities on medicinal plants in protected areas of Paraguay (Vera Jiménez, 2009). More recently, the collaboration between FCQ-UNA and JICA resulted in the edition of an illustrated catalogue of 80 medicinal plants from Paraguay, with the aim of disseminate scientific knowledge concerning the most popular medicinal plants (Ibarrola and Degen, 2011).

Trade and Marketing The plants and herbs from all over Paraguay are mainly traded at Mercado Cuatro, a big traditional marketplace in Asuncion, Paraguay by folk healers who also practice ancient arts (Istvan, 2003). Concerning the production of medicinal and aromatic plants, the Dirección de Extensión Agraria of the Ministry of Agriculture keeps a basic record of producers, with more than 36.000 of them, grouped in 2363 organizations, for the period 2006-2007 (Fundación José Cardijn, 2008). Besides the popular uncontrolled trade of medicinal plants, some local industries had initiated the packaging of dried material to prepare infusions and or decoctions which can be purchased in pharmacies and supermarkets. Also some pharmaceutical preparations based on medicinal plants can be found in the pharmacies. Concerning the medicinal plants commercialized in Paraguay as powders for infusion, 108 species were recorded. 66% (71) of the species are native from Paraguay, 25% were introduced but are cultivated in the country,

133 and 9% correspond to imported dry material. Only 13 native species are cultivated. It is relevant to consider that 21 native species grow in forestry environments (Degen et al., 2004). Very little information is currently available regarding the volumes and MAPs products being produced and traded, but it was observed that increasing amounts of the export of medicinal plants, being Aloysia tryphylla and Stevia rebaudiana the species on the top of the list (Fundación José Cardijn, 2008).

Constraints and Problems Over the years, local knowledge about biodiversity and agricultural practices has been lost due to widespread forest destruction and the expansion of large scale agriculture. Precious medicinal plants are hard to find due to the loss of their natural ecosystems and excessive gathering in the dwindling areas where they still grow naturally. Additionally, for several species roots and are employed in traditional medicine, putting at risk the conservation of the species (Basualdo et al., 1991). The informal trade of medicinal plants in Paraguay is highly related to extractive practices without replacement, performed by low income people from rural or suburban areas. The formal trading of the medicinal plants is encouraging the cultivation of the more requested species. The higher demand of medicinal plants is directed to Allophyllus edulis A. St. Hill, Scoparia dulcis L., Stevia rebaudiana Bertoni, Mentha piperita L., Maytenus ilicifolia Mart., Cecropia pachystachya Tréc., Cassia angustifolia L. and Peumus boldus Molina (Degen et al., 2004). Medicinal plants have traditionally been used as a source of affordable and accessible primary health care and are important biological resources. Nevertheless, traditional knowledge of medicinal plants is being lost and the biological resource base is being threatened by expanding urbanization. A number of different stakeholders (researchers, non-governmental organizations (NGOs), health care workers, government officials, entrepreneurs, etc.) have been working to promote their sustainable utilization; however, there is need to coordinate their efforts to implement the results effectively. Industrial processing of medicinal plants is incipient, but a remarkable increase in the number of commercial products based on plants is observed. The commercial use of the native plant resources is being made with un- planned procedures, putting at risk the conservation of several species. (MAG-Dirección de Investigación Agrícola, 2008).

134 REFERENCES Anonymous, 2001, Projets au Paraguay. Available at: http://www.crdi.ca/fr/ev-69894-201_050308-1-IDRC_ADM_INFO.html (30 Jul. 2008) Anonymous, 2005, Ancient solutions for today's headaches - promoting medicinal plants in Paraguay. Available at: http://www.foei.org/en/publications/link/poverty/36top.html (30 Jul. 2008) Arenas, P. 2009. Los estudios sobre medicina y farmacopea vernácula en el gran Chaco. Revista Rojasiana 8 (2): 81-100 Basualdo, I, Zardini E, Ortiz, M. 1991. Medicinal plants of Paraguay: the underground organs. Economic Botany, 45(1):86-96 Basualdo, I., Soria, N., Ortiz, M. & Degen, R. 2004. Plantas medicinales comercializadas en los mercados de Asunción y Gran Asunción. Parte I. Rojasiana 6 (1):95-114 Berganza, LH. 1984. Entrenamiento e investigación en química de productos naturales a nivel de postgrado. Conclusiones y recomendaciones del proyecto. Proyecto PAR/81/T01 FCQ-UNESCO, Asunción. 91 pp. Bertoni, M.S. 1927. Descripción física, económica y social del Paraguay. La civilización guaraní. Parte III. Conocimientos. La higiene guaraní. La medicina guaraní. Puerto Bertoni. Alto Paraná, Paraguay. Imprenta y edición “Ex sylvis” Breuer, N., 2008. Modeling potential adoption of medicinal plant cultivation in Paraguay using Ethnographic Linear Programming. Available at: ftp://ftp.fao.org/UPLOAD/AGRIPPA/621_EN.PDF (30 Jul. 2008) Degen, R., Basualdo, I., Soria, N. 2004. Comercialización y conservación de especies vegetales medicinales en Paraguay. Revista de Fitoterapia. 4 (2): 129-138 Dirección General de Planificación. Ministerio de Agricultura y Ganadería. Paraguay, 2009. Programa Regional de Apoyo a la Red de Desarrollo de Fitoterápicos en el MERCOSUR. 2009. Breve síntesis de PLAMSUR. Available at: http://www.mag.gov.py/dgp/PLAMSUR%20-%20Breve %20Sintesis.pdf (8 Mar. 2012) FAO, 2010. Forest and forestry sector. Avaliable at: http://www.fao.org/forestry/country/57478/en/pry/ (09 Mar. 2012)

135 Fundación José Cardijn. 2008. Elaboración del estudio de la recolección, producción y comercialización de plantas medicinales y aromáticas del Paraguay. MAG-UNOPS-FIDA-PLAMSUR, Asunción. Available at: http://www.mag.gov.py/dgp/Informe%20Final%20PLAMSUR%20- %20Fundacion%20J%20Kardijn.pdf Ibarrola, D. A., Degen de Arrúa, R. L. (editores), 2011. Catálogo ilustrado de 80 plantas medicinales del Paraguay. Facultad de Ciencias Químicas, UNA - Agencia de Cooperación Internacional del Japón (JICA). Asunción. 178 pp. Available at: http://www.qui.una.py/pdf/80_plantas_med.pdf (09 Mar. 2012) INFONA, 2012. Ley nº 3464 que crea el Instituto Forestal Nacional – INFONA. Available at: http://www.infona.gov.py/Leyes_web/ley_3464_que_crea_instituto_fore stal_nacional_infona.pdf (09 Mar. 2012) Istvan, Z., 2003, Paraguay's Folk Healing in Transition, National Geographic Channel. Available at: http://news.nationalgeographic.com/news/2003/06/0626_030626_tvparag uaymedicine.html? fs=www3.nationalgeographic.com&fs=plasma.nationalgeographic.com (30 Jul. 2008) Japan International Cooperation Agency, 1987. Interim Report on Cooperation in Study (Chemical and Pharmaceutical Study on Herbs with Paraguay), JICA. 178 pp. MAG-Dirección de Investigación Agrícola.2008. Proyecto GCP/GLO/190/SP. Segundo informe nacional sobre el estado de los recursos Fitogenéticos de importancia para la alimentación y la agricultura. Asunción, Paraguay, pp 112. Mereles, F., Degen, R.. 1997. Contribución al conocimiento de los arboles y arbustos indígenas utilizados como medicinales en el Chaco Boreal, Paraguay. Parodiana. 10 (1-2): 75-89 Mereles, F. 2007. Diversidad vegetal en el Paraguay. In: Salas-Dueñas, D and Facetti J. F. (editors). Biodiversidad del Paraguay, una aproximación a sus realidades. Fundación Moisés Bertoni, USAID, GEF/BM. Asunción. P 89 Michalowki, M. 1955. Plantas medicinales del Paraguay. Bol. Nº 173, Serv. Tec. Interam. de Cooperacion Agrícola/MAG. Asunción, Paraguay. 27 pp.

136 Pin, A., González, G., Marín, G., Céspedes, G., Cretton , S. Christen, P., Roguet, D. 2009. Plantas Medicinales del Jardín Botánico de Asunción. Municipalidad de Asunción, AEPY, Université de Genève. Asunción. 441 pp. Rojas de Arias, A., Ferro, E., Inchausti, A., Ascurra, M., Acosta, N., Rodriguez, E. and Fournet, A., 1995, Mutagenicity, insecticidal and trypanocidal activity of some Paraguayan Asteraceae. Journal of Ethnopharmacology, 45(1): 35-41 Schmeda-Hirschmann, G. and Bordas, E., 1990, Paraguayan medicinal compositae. Journal of Ethnopharmacology, 28 (2): 163-171 Shimizu, S., Orie, S., Arisawa, M., Hayashi, T., Suzuki, S., Yoshizaki, M., Kawasaki, M., Terashima, S., Tsuji, H., Wada, S., Ueno, H., Morita, N., Berganza, L.H., Ferro, E.A., Basualdo, I. 1987. Chemical and pharmacological studies on medicinal plants in Paraguay. Isolation and identification of lens aldose reductase inhibitor from Tapecué, Acanthospermun australe O.K. Chem. Pharm. Bull. 35 (3):1234-1237 Velázquez, E., Tournier, H. A., Mordujovich de Buschiazzo, P., Saavedra, G. and Schinella, G. R., 2003, Antioxidant activity of Paraguayan plant extracts. Fitoterapia, 74(1-2): 91-97 Vera Jiménez, M. 2009. Plantas medicinales de tres áreas silvestres protegidas y su zona de influencia en el sureste de Paraguay. Fundación Moisés Bertoni. Asunción. 160 pp.

137 Table 1. Medicinal plants traded at the popular markets in the Asuncion Metropolitan area (Basualdo et al. 2004)

Scientific name Popular name Part of the Family (in Guaraní or plant Spanish) employed as medicinal Adiantum poiretti Wikstri culantrillo whole plant Adiantaceae Adiantum raddianum C. culantrillo whole plant Presl. arroyo Hemionitis tormentosa doradilla whole plant (Lam.) Raddi. crespa Hemionitis rufa Lam. doradilla negra whole plant Alternanthera brasiliana penicilina aerial parts Amaranthaceae (L) OK. Alternanthera pungens yerba de pollo; aerial parts HBK perdudilla negra Celosia cristata L. penacho Inflorescence Gomphrena decumbens perdudilla whole plant Jacq. blanca Gomphrena perennis L. siempre viva flowers, aerial parts Iresine difusa HBK ex mboi ka’a aerial parts Willd Pfaffia glomerata Spreng batatilla roots Lithaea molleoides Engler chichita leaves Anarcardiaceae Mangifera indica L. mango flowers, leaves Schinus terebinthifolia molle aerial parts Engl. Schinus weinmannfolia molle i aerial parts Engl. Rollinia emarginata Schld aratiku i leaves Annonaceae Anethum graveolens L. eneldo fruits Apiaceae

138 Apium graveolens L. apio paraguay whole plant Coriandrum sativum L. kuratú seeds Eryngium karaguata ruá leaves flowersibundum Cham & Schlecht Eryngium foetidum Linn. karaguata í whole plant Foeniculum vulgare hinojo roots Willd. Pimpinella ansium L. anís fruits Hydrocotyle umbellata L.; acaryso whole plant H. leucocephala Cham & Schl. Petroselium crispum perejil roots (Mill.) Nym. Aspidosperma quebracho quebracho bark Apocynaceae blanco Schlecht blanco Ilex paraguarienses A. St. yerba mate, leaves Aquifoliaceae Hil ka’a Pistia stratiotes L. llaten de agua whole plant Araceae Tetrapanax papyriferum ambay sayju leaves Araliaceae (Hook) K. Koch Acrocomia aculeata Mart. mbocaja i small plant, Arecaceae leaves Syagrus romanzoffiana pindó roots (Cham) Glassman Aristolochia gibertii patito tallo, leaves Aristolochiaceae Hooker Aristolochia triangularis ysypo tallo Cham & Schlecht milhombre Acanthospermum australe tapekué whole plant Asteraceae (Loef) O.K. Acanthospermum hipidum ovecha ka’a, aerial parts DC. toro rati Achyrocline alata DC jatei ka’a inflorescence Achycroline sauteroides marcela inflorescence

139 (Lam.) DC. Ambrosia elatior L. altamisa aerial parts Ambrosia tenuifolia L. altamisa i aerial parts Artemisa absinthium L. ajenjo aerial parts Baccharis articulata chirca melosa aerial parts (Lam.) Pers. Baccharis trimera (Less) jaguarete ka’a aerial parts DC.; B. cilíndrica (Less) DC.; B. microcephala (Less.) DC.; B. myriocephala DC. Bidens pilosa L. kapi una aerial parts Carthamus tinctorius L. alazor, falso flowers azafrán Cotula coronopifolia L. palmita leaves Asteraceae Chaptalia nutans Hemsl. lengua de vaca whole plant Chrysanthemum manzanilla flowers anethifolium Willd. Elephantopus mollis llaten hu whole plant H.B.K. Eupatorium inulaefolium doctorcito aerial parts H.B.K. Eupatorium teju ka’a leaves macrocephalum Less. Gamochaeta americana L. vira vira whole plant Gochnaitia polymorpha kambara aerial parts (Less) Cabrera. Helianthus annus L. girasol seeds Hipochoeris microcephala chicoria roots (Sch.Bip.) Cabrera Matricaria recutita L. manzanilla flowers Pluchea sagittalis Lam. yerba de lucero aerial parts Porophyllum ruderale kurupa mi, aerial parts

140 (Jacq). Cass. yryvy kaa Pterocaulon alopecuroides toro ka’a inflorescence (Cam.) DC. moroti Pterocaulon lorentzii toro ka’a jhovy inflorescence Malme. Pterocaulon virgatum tuja kaso inflorescence DC. Schkuria pinnata var. kanchalagua í aerial parts Abrotanoides (Rot.) Cabrera Senecio grisebachii Baker agosto poty aerial parts Senecio chilensis. Meyen mbuy say ju, aerial parts cohete ruguái Soliva anthemifolia (Juss) ñuati pé whole plant Asteraceae Brown Sonchus oleroseus L. cerraja aerial parts Stevia entreriensis charrúa ka’a roots Hieron. Stevia rebaudiana Bert. ka’a he’e leaves Tagetes minuta L. suico aerial parts Tagetes patula L. terciopelo flowers Trixis pallida Less. urusu kati roots Vernonia cognata Less. jagua ray roots Xanthium spinosum L. cepa caballo aerial parts Zinnia elegans Jacq. raído sombrero inflorescence Begonia cucullata Willd. agrial whole plant Begoniaceae (y variedades) Adenocalymma ysypo hu roots Bignoniaceae marginatum (Cham.) DC. Amphilophium ka’i cuchara pericarp paniculatum (L.) HBK. Jacaranda mimosifolia D. karoba; bark Don jacarandá Macfadiena ungis-catis (L) mbarakaja roots

141 A. Gentry pyape Tabebuia aurea (Manso) para todo bark Benth et Hook Tabebuia impetiginosa lapacho bark (Mart. ex DC.) Toledo colorado Bixa orellana L. uruku seeds Bixaceae Borago officinalis L. borraja flowers Boraginaceae Bromelia serra Mez karaguata fruits Bromeliaceae Bromelia serra Mez karaguata rapó rhizome Buddleja madagascariensis cambará leaves Buddlejaceae L. Protium heptaphyllum ysy leaves, Burceraceae (Aublet) Marcham. exudate Rhipsalis cereusculus suelta con whole plant Cactaceae Haw. suelta Acicarpha tribuloides Juss. toro rati aerial parts Calyceracecae Sambucus australis Cham sauco leaves Caprifoliaceae & Schl. Carica papaya L. mamón macho flowers Caricaceae Cecropia pachystachya ambay leaves Cecropiaceae Trec. Maytenus ilicifolia Reiss. cangorosa root bark Ccelastraceae Commelina erecta L. santa lucia roots, Commelinaceae moroti muscilage Cuscuta sp. cabello de whole plant Convolvulaceae ángel Dichondra repens Forst. mbarakaja whole plant namby Ipomoea carnea var. mandyju ra roots Fistulosa Mart Lepidium bonariensis L. mastuerzo aerial parts Cruciferacea Raphanus sativusL rábano aerial parts Cayaponia bonariensis mbaracaja leaves Cucurbitacea (Miller) Marínes Criveto nambi

142 Cayaponia espelina Cong tajuja roots Cucurbitacea Ceratosantes sp. tajuja roots Citrullus vulgaris Schard. sandía seeds Cucumis maxima Duch. zapallo seeds Momordica charantia L. calbacita aerial parts Fimbristylis capillaris A. espartillo whole plant Cyperaceae Gray Kyllinga odorata Vahl. kapí i kati rhizome Scipus californicum pirii whole plant (Meyer) Steud. Chenopodium ambrosiodes kaaré whole plant Chenopodiaceae L. Chenopodium burtkartii kino kino leaves (Aellen) Worschilov Discorea campestris mecho aka roots Disocoreacea Griseb.; D. guaranitica Chodat & Hassler Equisetum giganteum L. cola de caballo aerial parts Equisetaceae Croton sparciflowersus typycha ne whole plant Euphorbiaceae Morong typycha villeta Croton urucurana Baill. sangre de leaves drago Euphorbia serpens H.B.K. tupasy kamby whole plant Jatropa isabelli Muell. jagua rova roots Arg. Phyllantus niruri L. para para í aerial parts Sapium haematospermun kurupika y bark Euphorbiaceae Muell Arg. Anadenanthera colubrina kurupa’y kuru bark Fabaceae (Vell.) Brennan Bauhinia bauhinoides pata de buey leaves (Mart.) J.F.Macbr. Bauhinia forficata Link. pata de buey leaves

143 Caesalpinia paraguayensis guayacán bark (D. Parodi) Burkart Cajanus cajn (L .) Millsp. kumanda leaves, yvyra’ í flowers Cassia augustifolia Vahl. sen leaves Dioclea paraguariensis kurugua’í seeds Erythrina crista galli L. ceibo bark Gleditsia amorphoides yvope, espina leaves, fruits Taub. de corona Genista sp. retama whole plant Hymenaea courbaril L. jatayva fruits Inga verna Wild. Susp. inga bark Affinis (DC.) T.D. Penn. Myrocarpus frondosus incienso bark Allemao Medicago sativa L. alfalfa aerial parts Peltophorum dubium yvyra pyta bark (Spreng) Taub. Phaseolus sp. kumanda pire epicarp Prosopis sp. algarrobo bark Prosopis alba Griseb. espinillo bark Fabaceae Prosopis ruscifolia Griseb. viñal leaves Rynchosia edulis Griseb. urusu he’e roots Senna occidentalis (L.) taperyvá hu roots Barneby Banara arguta Briq. francisco leaves Flacoutiaceae álvarez Cassearia silvestris Sw. burro ka’a aerial parts Rheedia brasiliensis pakuri leaves Guttiferae (Mart.) Planch. & Triana Trimezia martii(Baker) ruibarbo del roots Ridaceae R.C. Foster paraguay, ruibalbo Lavandula officinalis L. alhucema aerial parts Lamiaceae 144 Leonotis nepetaefolia R. toronjil guasu aerial parts Brown Melissa officinalis L. toronjil whole plant paraguay Mentha x piperita menta í aerial parts Mentha sp. menta aerial parts Mentha rotundifolia (L.) yerba buena parte aerea Huds. Ocimun balansae Griseb. albahaca del whole plant campo Ocimun basilicum L. añbahaca seeds, blanca inflorescence Ocimun tweedianum albahaca inflorescence Benth morada Ocimun vulgare L. orégano whole plant Pogostemun pacholí aerial parts Lamiaceae patchouliPellet Rosmarinus officinalis L. romero aerial parts Salvia cardiophylla Benth. kavara ka’a aerial parts Salvia verticillata L. poleo menta aerial parts Cinnamomun triplinerve canela leaves Lauraceae (Riuz & Pav.) Kostern. Laurus nobilis L. laurel leaves Nectandra megapotámica laurel hu leaves (Spreng.) Mez. Persea americana Mill. aguacate leaves Herreria montevidensis zarzaparrilla roots Liliacee Koszch ex Griseb. Linum usitatissimum L. lino seeds Linacee Phoradendrom liga ka’avotyrey whole plant Loranthaceae (Gillies) Eichler Licopodiella alopecuriodes ita poty whole plant Lycopodiaceae (L.) Gran.

145 Cuphea racemosa (L.f) perchicaria, aerial parts Lythaceae Spreng. siete sangría Cuphea lysimachioides ysypo pere whole plant Cham. & Schl. Heimia salicifoia (HBK) yerba de la vida whole plant Link Heteropteris angustifolia tilo inflorescence Malpighiaceae Gris. Illicium verum Hook. anís estrellado fruits Magnoliaceae Malva sylvestris L. malva de aerial parts Malvaceae castilla Sida cordifolia L. malva blanca inflorescence Sida spinosa L. typycha hu aerial parts Sidatrum paniculatum L. malva hu aerial parts Melia azederach L. paraiso roots Meliaceae Cisamplos pareirae L. ka’apeva stems, leaves, Menispermaceae roots Peumus boldus Molina boldo leaves Monimiaceae Dorstenia brasiliensisLam. taropé whole plant Moraceae Ficus carica L. higo leaves Morus alba L. mora leaves Musa paradisiaca L. pakova hu rhizome Musaceae Campomanesia guavira fruits Myrtaceae sessiliflowersa var. Bullata Landrum Campomanesia pubescens guavira mi fruits (A.P. de C.) Berg Eucaliptus sp. eucalipto leaves Eugenia myrcianthes yva hai mi leaves Nied. Eugenia uniflowersa L. ñngapiry leaves Haxaclamys edulis (O. yva hai leaves Berg) Kausel & Legrand Psidium cinereum Mart. katu ava leaves 146 ex DC. Psidium guajava L. guayaba leaves Boerhavia paniculata Rich. ka’arurupe roots Nyctaginaceae Victoria cruziana D’ Orb. jacare yrupe leaves Nymphaceae Cyrtoppodium pflanzii tamanda kuna leaves Orchidaceae Schl. Argemone mexicana L. cardo santo roots, seeds Paveraceae Passiflora caeruleae L. mburukuja roots Passifloraceae Passiflra cincinnata Mast.; mburukuja’i flowers P. alata Dryaner Petiveria alliaceae L. pipi whole plant Phytolacaceae Peperonia cincinnata Link. jayevu ka’a whole plant Piperaceae Peperonia aceroana DC. ypeku ka’a whole plant Piper fulvescens DC. yaguarundi leaves Plantago tomentosa Lam. llantén de tierra Plantaginaceae Polygonum acuminatum ka’atai guasu aerial parts Polygonaceae Kunth Polygonum punctatum ka’atai whole plant Elliot Campyloneuron phyllitidis calaguala whole plant Polypodiaceae L. Microgramma vaccinifolia anguja ruguai whole plant (Langd. & Fisch.) Copel Cymbopogon citratus kapi’i leaves Poaceae (DC.) Staph. Digitalia sanginalis (L.) cebadilla aerial parts Scop. Eleonorus latifolius Ness espartillo guasu whole plant Hordeum sativum L. cebada fruits Imperata brasiliensis yahape rhizome Trim. Paspalum insularis Sw. kapi’i pororo whole plant Paspalumvaginatum Sw. kapi’ipe poi rhizome

147 Pahrus lappulaceus ka’i arroz aerial parts Aublet Saccharum officinarumL. caña de azúcar flowers Zea mays L. barba de choclo stigma Eichornia crassipesK aguape purua whole plant Pontederiaceae (Mart.) Solms-Lamb. Punica granatum L. granada fruits Punicaceae Ramnidium elaeocarpum taruma í leaves Rhamnaceae Reiss. Eriobothrya japonica níspero leaves Rosaceae (Thunb.) Lindley Rosa blanksiae Ait. rosa mosqueta flowers Rosa sp. rosa china flowers Rosa sp. rosa pytaite flowers Rubus frutescens L. zarzamora roots Borrelia verticillata Lam. typycha aka whole plant Rubiaceae voto Genipa americana L. ñandypa leaves Citrus aurantium L. naranja agria leaves Rutaceae Citrus medica L. sidra leaves Citrus reticulata Blanco mandarina leaves Citrus sinensis Osbeck naranja dulce epicarp Helletia apiculata Benth. yvara ovi bark Pilocarpus pennatifolius yvyra tai leaves Lam. Ruta chalepensis L. ruda macho aerial parts Ruta graveolens L. ruda aerial parts Allophylus edulis (St. Hil.) koku leaves Sapindaceae Radlk. Scoparia dulcis L. typycha kuratu aerial parts Scrophulariaceae Scoparia ynambu ka’a aerial parts montevidensis(Spreng.) R.E.Friess

148 Picrasma crenata (Vell.) pirero, palo bark Simarubaceae Engl. amargo Smilax campestris Griseb. j’uapeka rhizome Smilaceae Nicotiana tabacum L. pety hu leaves Solanaceae Physalis viscosa L. kamambu aerial parts Solanum americana L. arachichu fruits Solanum paniculatum yuruveva leaves Dunal Solanum sisymbrifolium ñuati pyta roots Lam. Luehea divaricata Mart. ka’aoveti flowers Tiliaceae Parietaria debilis Frost. ka’apiy whole plant Urticaceae Urtica dioca L. pyno’i aerial parts Urera baccifera Gaudich. pyno guasu roots Aloysia gratissimaK poleo i aerial parts Verbenaceae (Gill.& Hook.) Troncoso Aloysia polystachya burrito aerial parts (Griseb.) Mold. Aloysia sp. poleo de aerial parts castilla Aloysia virgata (Ruiz & poleo guasu aerial parts Pavon) Juss. Aloysia tryphylla cedrón aerial parts (L’Herit) Britton paraguay Citharexylum sara moroti bark myrianthum Cham. Glandularia peruviana (L.) margarita pyta whole plant Small. Lippia alba (Miller) N.E. salvia inflorescence Brown Lippia globiflowersa O.K. salvia ne inflorescence Stachystarpheta tatu ruguai aerial parts cayenensis Vahl Vervena litoralis HBK verbena aerial parts

149 Vervena bonariensis L. verbena’i aerial parts Cissus verticillata (L.) insulina Leaves Vitaceae Nicolson Costus pilgeri L. caña brava Rhizome Zingiberaceae Hedychium coronarium caña brava Rhizome Koenig. Bulnesia sarmientoi palo santo Stem, Zygophyllaceae Lorentz ex Griseb sawdust

* Basualdo I, Soria N, Ortíz M, Degen R. 2004. Plantas medicinales comercializadas en los mercados de Asunción y Gran Asunción. Parte I- Rojasiana. 6: 95 – 114.

150 1.9 Peru The Republic of Peru, located in west central South America, is bounded on the north by Ecuador and Colombia, on the east by Brazil and Bolivia, on the south by Chile and on the west by the Pacific Ocean. The area of Peru, including several offshore islands, is 1,285,220 square kilometers. The country can be divided into three natural regions viz. Coast, Mountains (called Sierra) and Forest. The coastal region is a narrow strip over 3,000 kilometers long with an average breadth of 60 kilometers, bordered on the west by the Pacific Ocean and on the east by the mountains. It is for the most part an arid zone, with good-quality farmland only in the valleys formed by the 52 seasonal rivers that flow into the sea. The mountain region, or sierra, is the second largest natural zone in the country. Narrow valleys and plateau make up much of the region. The main mountain range is the Western Mountain Range (Cordillera Occidental in Spanish); other ranges include the Eastern Mountain Range (Cordillera Oriental), the Central Mountain Range (Cordillera Central) and a number of lesser chains. Bordered on the west by the coastal region and on the east by the Peruvian forest, this is traditionally a farming region and has always suffered major demographic pressure, so that areas suitable for forest use have been turned to agricultural use. Several of the highest peaks in the world are located in various highlands, mountain ranges and plateaux, notably Huascarán (6,768 m), the highest point in Peru. Lake Titicaca lies to the south- east. Earthquakes occur frequently. The forest region is the largest and most sparsely populated in the country. Bordered on the west by the mountains, it stretches to the borders with Ecuador, Colombia, Brazil and Bolivia. Physiographic, floristic, edaphic and socio-economic conditions permit this natural region to be classified as high forest and low forest. The high forest is the belt lying between 3,600 m on the eastern slope of the Peruvian Andes (on the border with the mountain region) down to 700 m. Altitudes above 2,500 m in this sub-region are usually called "forest rim". The broad Amazon plain - the low forest - is the least populated zone, not only of the forest region, but also of the whole country, so that its original features are still relatively intact. The climate of Peru varies widely, ranging from tropical in the east to arctic in the highest mountains of the Andes. In the coastal plain the temperature normally averages about 20°C throughout the year. The coastal climate is moderated by winds blowing from the cool offshore current known as the Peru or Humboldt Current. The coast receives less than 50 mm of precipitation each year, largely because the mountain ranges receive most of the rain carried by the trade winds from the east. Rainfall is usually scanty,

151 but in some localities heavy rains fall from October to April. In Cusco, in the south-eastern Andes, annual rainfall averages some 815 mm. The forest is extremely hot and humid, although moderated at higher altitudes. The prevailing easterly winds blowing across the region gather moisture that is later deposited on the eastern Andean slopes. Annual rainfall in some districts averages as much as 4,000 mm. Peru’s vegetation and hence its forestry sector are strongly influenced by the conditions in three large and very different geographical regions: the western coastal region along the Pacific Ocean, which is for the most part arid desert, with strips of vegetation along rivers; the range of the Andes in the centre, reaching altitudes of 6,768 m and including valleys and plateaux; and the eastern flank of the Andes, with moist forests covering the tropical lowlands in the east. It is worth mentioning that Peru is a country with 28 out of the 32 climates existing on the planet, 84 out of the 103 life zones known on earth, with multiple ecological levels which places it within the 5 countries with major biodiversity. Peru is in ninth place in the world in terms of the area of its forest resources and second place in Latin America. The country has 104.9 million hectares of forest land or potential forest land. Of this total, 71.8 million hectares are covered with natural forests and 726,300 hectares had been planted up to 2001, mostly with eucalyptus and pine, which leaves 32.4 million hectares under improper non-forest use. There are 27.9 million hectares of designated production forests, while 10 million hectares of forest are designated for future harvesting. Forests in indigenous communities cover 7.9 million hectares, while protected natural areas cover 19.1 million hectares. More than 130 non-wood forest products have been identified, which are consumed locally or traded on the domestic or international markets. Items in the greatest international demand are cat’s claw, Brazil nuts, palm hearts, dragon’s blood and various medicinal and aromatic plants including cochineal, an insect from which its coloring is extracted. Within the context of the national forestry policy, the Law on Forestry and Wildlife No. 27308, enacted on 2000, approved on April 2001 and ruled by Supreme Decree 026-2002. This legislation focuses on sustainable use and conservation of forest resources and wildlife for country’s social, economic and environmental interests. Various NGOs, mainly national or linked to international organizations, carry out extensive training activities, the promotion of public awareness concerning sound environment management, reforestation initiatives and support to community activities for forest and forest soil management (FAO, 2008).

152 Government Efforts in the Development of Traditional Medicine/Phytomedicine

In Peru, traditional medicine is in force, although it has a history that goes back further than 3,000 BC, with Caral Civilization where medicinal plants were found in the offering buried as part of the medical knowledge of such time, and the development of the cranial trepanation evidenced in Paracas Culture as well. Currently, traditional medicine has several traditional therapeutic agents such as herbalist or herborist, bone-setter, midwife and folk healer. Herbalist sells curative plants, herbs and charms in the streets and markets of most towns. Bone-setters are consultants who treat diseases and injuries by bone manipulation; Midwives are persons who assist women in childbirth; while Folk healers claim diagnostic, divinatory and healing powers and have existed in Peru since pre-Inca days (Anonymous, 2008). Currently there is no Official Registry of traditional medicine practitioners, there was a legislative bill but it was not approved by the Executive Power. In the reviewed there is no Law prohibiting Traditional Medicine. In 1990, by Legislative Decree No. 584 and Supreme Decree No. 002 92 SA, the Republic of Peru established a national policy on Traditional Medicine and Complementary and Alternative Medicine, TM/CAM, laws. Regulations and a national program must be developed. The National Institute of Traditional Medicine (Instituto Nacional de Medicina Tradicional, INMETRA in Spanish) was established in 1990. In 2002, by Law No. 27657, INMETRA was included in the National Institute of Health (Instituto Nacional de Salud) changing its name to National Centre for Intercultural Health, (Centro Nacional de Salud Intercultural, CENSI in Spanish). CENSI is the regulatory technical line center of the National Institute of Health which aims to propose policies and norms in intercultural health and promotes the development of research, teaching, programs and services, technological transfer and integration of traditional medicine and complementary and alternative medicine with conventional medicine, to help improve the health status of the population. CENSI comprises two Executive Offices: Executive Director of Traditional Medicine and Executive Director of Complementary and Alternative Medicine. The Executive Director of Traditional Medicine is responsible for developing, regulating, evaluating and disseminating research, technology transfer, teaching, training, standards, programs and services regarding traditional medicine, in order to integrate academic medicine. It also

153 promotes the revaluation of traditional medicine people oriented, while respecting their traditional practices, proposes and implements agreements with national research institutions abroad for the joint implementation of projects on traditional medicine. It contributes through the development of ethnomedical studies, ethnobotanical, anthropological, phytochemical, pharmacological, toxicological, preclinical and clinical studies in general and natural resources for medicinal purposes and foodstuffs, to the best knowledge of the health problems in the field of competence. It also promotes the preservation and sustainable development of renewable natural resources, nonrenewable medicinal and proposed rules to protect natural resources and traditional medical technology. On the other hand, in accordance with the recommendations of the World Health Organization (WHO), and within the framework of its faculties, the Executive Direction of Alternative and Complementary Medicine has been promoting the formalization and the safe and informed use of alternative and complementary therapies (Homeopathy, Acupuncture, Neural Therapy, Reflexology, etc.), for the benefit of the population (CENSI, 2011). Although the benefits received from these therapies, there are unfortunately many functions - for which CENSI was created - that are not in practice, they have not been fulfilled yet. In 1997, by Law No. 26842, General Law of Health, Peru established regulations on herbal drugs and medicines through the same law used for conventional medicines. Herbal medicines are regulated as over the counter medicines and dietary supplements. According to the law, herbal medicines may be sold, depending on their health and nutritional content. A technical committee led by CENSI has been formed for the regulation of Law No. 27300 given on 2000 - on Sustainable Utilization of Medicinal Plants- ruled by D.S. 068-2001-PCM. The Law No. 27821 was given on 2002 by the Ministry of Health on Promotion of Nutritional Complements for Alternative Development but it has not been regulated yet. In November 2009 the Law No. 29459 was published, Law on Pharmaceutical Products, Medical Devices and Sanitary Products. The Article 3° thereof establishes the security, efficacy, quality, accessibility and equality principles. In Article 4° the terms of bio-availability, bio-equivalence and traceability are defined. Additionally, Article 6° includes the herbal medicaments, dietetic, sweeteners, biological and galenic products. This law describes the herbal medicaments the ones presented as philosophized extracts, distilled, tincture, decoction or any other galenic preparation with therapeutic purposes such as master formulas, optional solutions or drugs and subject to requirements and conditions established by the respective

154 regulation. Likewise it is established the requirements of Manufacture Good Practices, BPM, Laboratory Good Practices, BPL, and Agricultural Good Practices, BPA. This Law is ruled by Supreme Decree No. 016-2011-SA. The responsibility in this field is assumed by the following three institutions: the National Authority for Pharmaceutical Products (ANM in Spanish), the National Authority for Health (ANS in Spanish), and the General Direction for Medicine and Drugs (DIGEMID in Spanish). There are some other laws such as Law No. 26821, Organic Law for the Sustainable Use of Natural Resources; Law No. 28216, Law on the Protection for Access to the Peruvian Biological Diversity and Collective Knowledge of Natives or Indigenous Towns and the Ministerial Resolutions 585-99, and 125- 2000 dealing with the Storage and Manufacturing Good Practices respectively (Official Journal El Peruano, files regarding all legal regulations). There is no national pharmacopoeia. There are no national monographs. Currently CENSI is developing the Peruvian Medicinal and Related Plants Pharmacopeia Project. On the other side, the Social Insurance of Health (EsSalud in Spanish), named IPSS before, has elaborated almost 100 monographs embracing its form of herbal medicines which originate a National Register of Natural Resources and Related, with 20 herbal medicines, the same that are bought by the Social Safety of Health, to freely supply them to the insured patients, all this within the National Program in Complementary Medicine EsSalud created on 1998. These plants must have the Sanitary Register issued by DIGEMID (EsSalud, 2002, 2008). There is a registration system for herbal medicines, but there is no information as to the number of herbal medicines registered. None are on the list of essential drugs. No national information is available on manufacturing requirements or their enforcement. Safety requirements are limited to the stipulation of traditional use without demonstrated harmful effects; there is no control mechanism for this regulatory requirement The establishment of a post marketing surveillance system is being considered. The Law No. 27300 points out on its Article 13° that adulteration is subject to sanction. Herbal medicines in Peru are sold as over-the-counter medicines without restriction (WHO, 2005). Students of traditional medicine learn via apprenticeships. In some cases, medical skills are passed down within families. As above mentioned, CENSI must provide official training programs on traditional medicine but they are not doing it yet. Nevertheless, some universities and non- governmental organizations registered at the Ministry of Health offer programs in traditional medicine for traditional medicine practitioners. Some universities offer seminars, workshops, meetings, and conferences on traditional medicine for students studying allopathic medicine. Although

155 article 8° of the Law No. 27300 rules to include into the curricula of the universities’ subjects referred to medicinal plants, their classifications, biology and uses. Courses, workshops, and informal presentations are also offered to official health personnel (WHO, 2001). In Peru a sui generis experience is being developed in the medicines articulation, the Social Security of Health for more than 12 years applies on its health system the use of alternative/complementary medicine offering services to more than 250,000 patients, the pathologies most attended are degenerative chronic diseases especially the rheumatic origin with promising results and the satisfaction of the patients is high (more than 80%), likewise the consumption of medicines have diminished (more than 50%). In 2000, a study of cost/effectiveness of its use was executed, verifying that this strategy is cost/effective in 60% in relation to conventional medicine (EsSalud, 2011a, 2011b).

Medicinal and Aromatic Plant Resources Peru is considered among the 12 mega-diverse countries of the world, and its number of vascular plants species is estimated to be around 19,500, representing 10% of the global plant diversity. The richness of this diversity reflects also in its use, as for most people in Peru, it constitutes the prime resource for food, medicine, energy, craft, dye, fiber, art, ritual and symbolic human activities. In the Andean region of Peru, indigenous communities still maintain traditional uses linked with biodiversity, and that medicinal plants are sometimes the only possible available treatment for treating illness, generally together with spiritual practices, in form of a traditional cure (De-la- Cruz et al., 2007). Peru is home to more than 4,000 species of medicinal and aromatic plants, MAPs. An estimated 1,500 species are used in Peru’s traditional medicine for health care. This country has significant biodiversity with several unique ecological zones including dry forest, tropical rainforest, coastal desert, and mountainous regions. Numerous native plants with high genetic variability have been domesticated (Brack, 1999). Some common MAPs found and used are presented in Table 1 (Hammond et al., 1998, Rojas et al., 2003). Currently CENSI has a botanical garden dedicated to spreading the rich botanical and allows the community to observe the main medicinal plants in their original botanical form and receive information about their properties and ways of use. The reason for this herbarium is showing the diversity of our country medical botany, common names, medicinal uses and geographical distribution of species, encouraging research on medicinal

156 plants through proper identification thereof (CENSI, 2011).

According to a market study carried out by the Commission for Export Promotion (PROMPEX in Spanish) Peru is the number one country in the world for the per capita use of medicinal plants by its own population. Processing local medicinal herbs into medicines for domestic use is increasing steadily. Two of the most important native medicinal herbs for domestic consumption and for export are maca root (Lepidium meyenii Walp.) and cat’s claw stem bark (Uncaria tomentosa (Willd. ex Schult.) DC.) (ITC, 2003).

Research and Development Activities In Peru, in general the universities of each department or each region as well as some institutes execute researches in Medicinal Plant, mainly in the botanic, ethnobotanical, phytochemical, pharmacological and toxicological aspects. It is important to mention that in the last decade some universities had assumed a knowledge creative role and are supporting the scientific research somehow in a restricted manner. The detailed studies of the plant to determine its chemical composition, biological activity, toxicity as well as the preclinical and clinical studies are important to validate scientifically the traditional knowledge. Some of them carried out in collaboration with some foreign universities are mentioned:

Ethnobotanical studies The scientists from the University of Hawaii, and San Diego Museum of Man, USA examined the traditional use of medicinal plants in Northern Peru, with special focus on the Departments of Piura, Lambayeque, La Libertad, Cajamarca, and San Martin. According to this study the roots of traditional healing practices in this region go at least as far back as the Moche period (BC 100–800). Although about 50% of the plants in use reported in the colonial period have disappeared from the popular pharmacopoeia, the plant knowledge of the population is much more extensive than in other parts of the Andean region. A total of 510 taxa belonging to 250 genera and 126 families were collected, identified along with their vernacular names, traditional uses and applications (Bussmann and Sharon, 2006). A survey aiming to document medicinal plant uses was performed in Canta Province, Lima Department, in the Peruvians Andes of Peru by the Faculty of Biological Science, Pedro Ruiz Gallo University, Lambayeque and Faculty of Sciences, La Molina Agrarian National University, Lima, Peru. Eighty-seven species were collected and identified that had indigenous uses.

157 Common names, habit, part of the plant used, preparation, administration and illnesses treated were recorded for each species (De-la-Cruz et al., 2007).

Phytochemical and Pharmacological Researches In the 1990 decade there was an intensive phytochemical research program at the Pontifical Catholic University of Peru (PUCP in Spanish), Department of Chemistry. They got the inscription of the first university patent in 1996 with a research about the Tara, Ceasalpinia spinosa, oriented to give added value to this important resource (Lock et al., 1996). Others researches about endemic plants were executed with the collaboration of Salerno University from Italy. As a result there were isolated tens of molecules of new structures and others well known which are building up a chemical arsenal to be investigated further on for its pharmacological relevance. A summary has been published (Lock, 2009). The Department of Microbiology, Cayetano Heredia Peruvian University, Lima, Peru, along with Department of Chemistry and Biochemistry, University of Massachusetts; and Department of Biology, Rhode Island College, Providence, USA screened eight medicinal plants from the Callejon de Huaylas in Peru for antibacterial activity in eighteen bacterial strains (Neto et al., 2002). Researchers from the Pontifical Catholic University of Peru, Cayetano Heredia Peruvian University, and University of Louisville (USA) tested the antimicrobial activity from twenty four plants, all of them currently used in the Peruvian traditional medicine for the treatment of several infectious and inflammatory disorders, against four bacteria and four fungi (Rojas et al., 2003). In the same way they evaluated the in vitro antioxidant activity from forty plants and the anti- Mycobacterium tuberculosis activity of 84 plants using a rapid, inexpensive colorimetric assay (Lock et al., 2005; Rojas et al., 2006 a). An assay- guided fractionation of the most active plant extracts is currently in progress in order to isolate the respective active principles (Rojas et al., 2004, Rojas et al., 2006 b, Rojas et al., 2006 c). An evidence-based analysis of the chemistry, biological properties, and anti-tumor activities for the three plants endemic to Peru namely Dragon's blood (Croton lechleri Mull., Arg.), Maca (Lepidium meyenii Walp) and Cat's claw (Uncaria tomentosa (Willd ex Schult DC) have been presented by the scientists from Cayetano Heredia Peruvian University, Lima, Peru (Gonzales and Valerio, 2006).

The immunomodulatory activity in vitro of Uncaria tomentosa was investigated by researchers from the Pontifical Catholic University of Peru,

158 Cayetano Heredia Peruvian University and the University of Ottawa (Canada) (Allen et al., 2007).

A collaboration between the Cayetano Heredia Peruvian University and the Institute of Research for Development (IRD-France) was dedicated to the ethnomedical, phytochemical and pharmacological investigation of hundreds of plants used traditionally by Chayahuitas and Yaneshas communities for the treatment of cutaneous leishmaniasis (Castillo et al., 2007, Estevez et al., 2007, Valadeau et al., 2009, Odonne et al., 2009, Cabanillas et al., 2010).

Peruvian scientists along with foreign scientists have also investigated many other plants of the Peruvian biodiversity leading to the isolation of several active principles (López Fando et al., 2004, Torpoco et al., 2007, Mesa- Siverio et.al., 2008, Aponte et al., 2008, 2010, Cioffi et al., 2011).

Trade and Marketing

Medicinal plants have been used for centuries in Peru. However, since 1994 the trade of these plants has boomed. Local collectors gather the fresh material which they trade in markets in the principal cities throughout Peru. The larger commercial collections have occurred since 1994 to meet the international demand for Uncaria guianensis (Aubl.) J. F. Gmel., and U. tomentosa (Willd. ex Schult.) DC. Collection is still the dominant form of procurement of medicinal plants in Peru. It is the initial step of a production chain of activities, including pharmaceutical companies that prepare a number of derivatives traded as food additives nationally and to some extent internationally. These companies are mostly located in Lima and they buy their raw material from intermediaries with whom they mostly have informal agreements. In some cases these agreements are entered with members of indigenous towns (Nalvarte et al., 1999). In the last years the generation of value chains has been observed originating the strengthening of the product quality verifying that the traceability, safety and other parameters are accomplished. The Peruvian Institute of Natural Products (IPPN in Spanish), a private organization created in 1999 and integrated approximately by 70 affiliated enterprises takes into account these criteria for its associated members. On the other hand, it is giving impulse to the bio-commerce which is the activity groups of recollection, production, processing and trading of goods and services derived from native biodiversity –species, genetics resources and ecosystems- under environmental, social and economic sustainability. The sustaining use

159 of the native biodiversity is a better economical incentive for the protection of biological resources. The Table 2 shows the evolution of the exports for nine important products exported of the Peruvian biodiversity for the years 2006, 2008 and 2010, the FOB value is expressed in $USD whereas the net volume or weight is expressed in kilograms (Prom Peru, 2011). Table 2 indicates that there is an important increase in the exportation FOB values since 2006 up to 2010 for the cat´s claw (Uncaria tomentosa (Willd. Ex. Schult.) DC) ( 37.07%), maca (Lepidium meyenii Walp.) (76.84%), sacha inchi (Plukenetia volubilis L.) (784.44%), achiote or annato (Bixa orellana L.) (90.15%), purple corn (Zea mays L.) (74.56%), tara (Caesalpinia spinosa (Molina) Kuntze) (91.87%) and cochinilla (Dactylopius coccus Costa) (579.60%) , whereas in the cases of camu camu (Myrciaria dubia (Kunth) McVaugh) and dragon´s blood (Croton lechleri Mull. Arg.) a decrease in the FOB values is observed: -71.28% y -57.15% respectively It is worth mentioning that the achiote, purple corn, and the cochinilla are included in the natural dyes group, being the cochinilla an insect that is hosted by the Opuntia ficus Indica. It is remarkable to notice that the commercial value for the cochinilla has increased from $USD 37.18 in the 2006 up to $USD 171.70 per kg by 2010. Other products exported as natural dyes are the capsicum (Capsicum annuum L.) and the marigold (Tagetes erecta L.) (Prom Peru, 2011). In relation with the tara, although it has several medicinal uses, the most important utilization is in the alimentary and tannery industries. The sacha inchi trading was initiated in 2004, however for the last years there has been a special interest on its use due to the high unsaturated fatty acid contents in 3, 6 and 9 omegas. Another important group of products exported by Peru are the seaweeds and other algae including, among others, hijiki (Hizikia fusiforme), kelp (Laminaria spp. or Macrocystis pyrifera), sea tangle (Laminaria japonica or Echlonia kurome), black moss (Nostoc flagelliforme), laver or nori (Porphyra spp.) and sargassum (Sargassum pallidum or Sargassum fusiforme). Table 3 shows the main forms of presentation in kg, for the 09 products considered in Table 2, and at the same time the main markets for the 2010. USA is the largest buyer of medicinal plants from Peru, these plants are, after processing, sold to other destinations. It is observed that USA is the main country importing cat’s claw, maca, dragon’s blood, sacha inchi, purple corn and camu camu; competing this latter product with Japan, representing both countries the 90% of camu camu imports; regarding the cat’s claw together with France, Germany and Spain import about the 70% and for the sacha

160 inchi with Japan and Colombia account for 54%. For the case of purple corn USA only imports 50%, being the same proportion with the maca. Venezuela’s imports for achiote accounts for 52% Regarding their presentations for sell, it can be noted that three of the products have a little aggregated value: the camu camu as an elaborated pulp, (73.43%), the sacha inchi oil (53.9%), and the purple corn extract with a high content of antocianyns (60.19%). Some other traded products are not chemical transformed, they are only carried out through a grounded operation such as is the case of the cat’s claw (27.70%), maca (63.30%) and tara (83.71%). A third case is the products traded as recollection product, for instance the achiote seeds (57.89%), unless is trade as bixine or norbixine which occurs in some cases (Prom Perú, 2011). It is very important that these products can be traded with aggregated value; therefore a relation university-industry (non-existent for now) that allows developing them would be desirable. Besides, a high percentage of trading products are lacking of authorized quality qualification which is a factor for competitiveness adding a significant value and increasing the assurance for buyers and making easier the access to national and international markets.

Constraints and Problems a.- The knowledge of medicinal plants is still taught orally, without written record. However, traditional medicine is experiencing an increasing demand, especially from a Peruvian perspective and a wide variety of medicinal plants from all over the country can be found in the global market. While this trend might help to maintain traditional practices and give traditional knowledge the respect deserved, it poses a serious threat since signs of overharvesting of important species are becoming increasingly apparent b.- In the last two decades an impulse is noted concerning the scientific research by the collaboration with foreigners universities at USA , Spain, Canada, France, etc., in order to get a scientific validation of the traditional uses and in the seeking of active principles of the plants. Currently, the Academic Sector in this decade has received a greater support from universities but the relation university-industry is still negligible. c.- Nowadays the most serious threat to this millennial tradition is the destruction of medicinal plant habitats. Urban sprawl has already greatly altered the coastal plains around Trujillo and Chiclayo. Climatic change is threatening the mountain forest systems that are the source of many medicinal species. Most importantly, the high Andean ecosystems and sacred

161 lagoons where many medicinally active species are found are in danger of being destroyed by large-scale mining activities and exploration activities. d.- Peru has so far had little access to international markets because of limited dominance of the required technology and high processing costs. The added value of the export of medicinal plants is therefore quite low. The control of country’s forest resource is insufficient. Current legislation does not guarantee the sustainable harvesting, management, or restoration of natural populations of MAPs. There is insufficient knowledge for the production of medicines that can meet strict standards imposed by law. Consequently, many companies are considering abandoning the manufacture of medicinal plant derivatives. There is a need for adequate research, legal instruments and policy to enable greater benefits to the Peruvian economy and people from its natural MAP resources.

162 Table 1: Some MAPs from Peru with their medicinal uses (Hammond et al., 1998, Rojas et al., 2003)

Common Botanical name Family Part used Uses name Adiantum capillus- veneris L. Culantrillo Pteridaceae Leaves bronchitis, coughs, emmenagogue Alnus acuminata Kunth subsp. Acuminate Huayo Betulaceae Leaves rheumatism, uterine cancer Aloysia scorodonioides Aerial (Kunth) Cham. Españolada Verbenaceae part treatment of diarrhea, vaginitis Ambrosia arborescens Stem, Mill. Marco Asteraceae, leaves antiseptic, anti-inflammatory Leaves, Aspidosperma rigidum stem, Rusby Remo caspi Apocynaceae barks treatment of diarrhea, malaria

Borago officinalis L. Borraja Boraginaceae Leaves coughs Huillash or Cassia tomentosa L. f. Wishllac Fabaceae Leaves cuts & wounds, disinfectant Cestrum auriculatum L. Leaves, treatment of allergies, fever, diarrhea, wound Heritier Hierba santa Solaneaceae stems healing Cestrum auriculatum L'Hér. Hierba santa Solanaceae Leaves antibacterial, antipyretic Chuquiraga spinosa D. Aerial Don Huamanpinta Asteraceae part anti-inflammatory, gonorrhea Croton ruizianuz Muell- Leaves, Arg Kasmanlle Euphorbiaceae stems wound healing, antiseptic Cynanchum Aerial corystephanum Malm. Aurinsha Asclepiadaceae part treatment of vaginitis, wound healing Desmodium molliculum Aerial (Kunth) DC Manayupa Fabaceae part wound healing, anti-inflammatory, antiseptic Whole Equisetum bogotense Cola de plant, Kunth caballo Equisetaceae roots anti-inflammatory, prostate cancer Leaves, Euterpe precatoria Mart Chonta Arecaceae roots treatment of hepatitis, dysmenorrhea, diarrhea Flaveria bidentis (L.) Aerial treatment of coughs and intestinal parasites., Kuntze Matagusano Asteraceae part antiseptic Gamochaeta spicata Lengua de Whole Cabrera perro Asteraceae plant health tonic for the liver, inflammations Geranium sessiliflorum Cav. Mitzca-mitzca Geraniaceae Roots liver & kidney inflammation, uterine cancer Iochroma umbellatum (R. Leaves, & P.) San Pablo Solaneaceae stems wound healing , antiseptic Leaves, Iryanthera lancifolia stems, Ducke Suessung Cumalilla Myristicaceae barks .treatment of diarrhea, fever, antispasmodic Jungia paniculata (DC.) Aerial A. Gray Caramate Asteraceae part wound healing, antiseptic, anti-inflammatory Aerial Justicia sericea R. & P. Arzobispo Acanthaceae part treatment of vaginitis, anti-inflammatory Krameria lappacea (Dombey) Burdet & B. B. Root Simpson Ratanya Krameriaceae stem diarrhoea, stomach cancer

Lavatera arborea L. Malva Malvaceae Leaves treatment of vaginitis, wound healing Lepechinia meyenii Aerial treatment of coughs and diarrhea, (Walp.) Epling Tecuar Lamiaceae part antispasmodic

Melissa officinalis L. Toronjil Lamiaceae Leaves hypotensive, sedative Bark, Mentzelia cordifolia leaves, Dombey ex Urb. & Gilg Anhuarate Loasaceae stem ear aches, wound healing Minthostachys mollis Griseb. Muna Lamiaceae Leaves anthelmintic, aphrodisiac, digestive ailments Muehlenbeckia Puma- tamnifolia (Kunth) Meisn. huascan Polygonaceae Leaves uterine cancer, wounds Mutisia acuminata Ruiz & Pav. var acuminata Leaves, Cabrera Chinchircuma Asteraceae shoot liver inflammation, wound healing Oenothera multicaulis R. Whole & P. Chupasangre Onagraceae plant wound healing, antiseptic

163 Ophryosporus Leavea, peruvianus (Gmelin) Sheklla Asteraceae stems wound healing, antiseptic Orthrosanthus chimboracensis (Kunth) Whole Baker Parajsha Iridaceae plant uterine cancer Otholobium glandulosum (L.) J. W. Leaves, Grimes Culen Fabaceae shoot diarrhoea, health tonic Peperomia galioides Whole Kunth var galioides Congona Piperaceae plant gastric ulcers, wound healing Polylepis racemosa Ruiz Bark, Lopez & Pavon Quenual Rosaceae stems inflammation of uterus, uterine cancer Sambucus peruviana Sabucu or Leaves, Kunth Samucu Caprifoliaceae shoot kidney inflammation, wound healing Satureja elliptica (R. & Aerial P.) Briq Anchis Lamiaceae part treatment of coughs and flu Leaves, Schinus molle L. Molle Anacardiaceae resin asthma, colds, coughs, rheumatism Senecio culcitioides Aerial treatment of coughs, asthma, respiratory Schultz-Bip Ancosh Asteraceae part diseases asthma, bronchitis, coughs, increase biliary Llanchuasa,H secretion, Senecio spp. uamanripa Asteraceae Leaves wound healing Senecio violaefolius Aerial treatment of coughs, asthma, respiratory Cabrera Huamanripa Asteraceae part diseases Whole Tagetes filifolia Lag. Anis serrano Asteraceae plant discomfort, intestinal pain, stomach ache Tanacetum parthenium Flowers, (L.) Sch. Bip. Santa Maria Asteraceae leaves antispasmodic Tetracera volubilis L. Leavea, ssp. volubilis Paujil chaqui Dilleniaceasma stems treatment of diarrhea and syphilis

Verbena litoralis Kunth Verbena Verbenaceae Leaves, anthelmintic, rheumatism Linlish-ccora, Whole Werneria spp. Recrish-ccora Asteraceae plant uterine cancer Wigandia urens (R. & P.) Whole Kunth Shinua Hydrophyllaceae plant treatment of cough, flu, bronchitis

Table 2: Evolution of the exports of 9 products from 2006 to 2009

Value FOB USD and Export Volumes, kg

2006 2008 2010

PRODUCTS FOB Value Export FOB Value Export FOB Value Export (US $) Volume (kg) (US $) Volume (kg) (US $) Volume (kg)

Cat’s claw 1,005,193.77 174,227.19 1,150,417.76 185,572.44 1,377,872.15 220,435.06 Maca 3,485,300.45 411,722.04 4,274,305.73 537,483.35 6,163,481.28 726,283.40 Dragon’s 257,019.95 3 1,654.68 136,211.84 14,942.88 110,123.63 10,048.35 blood Camu-camu 2,091,648.18 365,964.88 1,769,193.02 467,256.80 600,629.59 72,119.94 Sacha inchi 127,715.02 14,352.81 592,977.63 49,372.37 1,133,396.31 111,400.32 Purple Corn 1,075,724.03 879,133.96 1,477,862.79 1,118,768.96 1,877,781.61 1,314,629.88 Cochinilla 30,714,338.75 826,138.27 40,796,365.53 1,226,175.42 208,734,176.49 1,215,686.62 Achiote 5,817,031.98 1,312,429.02 8,043,214.82 1,653,948.04 11,060,891.54 1,842,227.20 Tara 22,530,802.66 18,579,310.77 41,639,932.27 17,889,676.23 43,229,812.72 27,614,932.82

From Prom Peru: http://www.siicex.gob.pe/siicex/portal5ES.asp?_page_=480.47900

164 Table 3: Exports of the 9 products as per the main presentations and markets as of 2010

MAIN PRODUCTS MAIN MARKETS (%) PRESENTATIONS (%)

Cat’s claw Powder (27.70); bark USA (28.44); France (19.49); Germany (10.78); others (41.29) (24.64); chopped (22.91); others (25.75) Maca Powder(63.60); USA (47.97); Japan (10.34); others (41.69) capsules (18.47); others (17.93) Dragon’s Resin (40.40); natural USA (36.16); Chile (13.91); Czech Republic (11.90); others Blood (37.75); extract (13.39); (20.03) others (8.46) Camu-Camu Pulp (73.43); powder USA (46.18); Japan (44.44); others (9.38) (11.68); extract (9.83); others (5.06) Sacha Inchi Oil (53.19); cosmetic USA (22.57); Japan (17.32); Colombia (13.97); others (46.14) (28.96); others (17.85) Maíz Morado Extract (60.19); natural USA (50.74); Bolivia (9.78); Venezuela (8.74); others (30.74) (31.51); powder (5.71); others (2.59) Cochinilla Coloring (67.71); Germany (16.14); USA (15.09); Denmark (10.77); others extract (1.63); others (58.00) (30.66) Achiote Seed (57.89); coloring Venezuela (30.22); USA (22.26); others (47.52) (19.42); natural (11.28); others (11.41) Tara Powder(83.71); tanning China (34.81); Brazil (15.06); Italy (9.52); others (40.61) (10.25); others (6.04)

From Prom Peru: http://www.siicex.gob.pe/siicex/portal5ES.asp?_page_=480.47900

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Planta Medica, 76: 705-707. 165 Brack, A., 1999, Diccionario Enciclopédico de Plantas Útiles del Perú. PNUD, Centro de Estudios Regionales Andinos Bartolomé de las Casas, 595 pp. Cusco. Bussmann RW, and Sharon D., 2006, Traditional medicinal plant use in Northern Peru: tracking two thousand years of healing culture. J Ethnobiol Ethnomed. 2: 47. Cabanillas BJ, Le Lamer A-C, Castillo D, Arevalo J, Rojas R, Odonne G, Bourdy G, Moukarzel B, Sauvain M, Fabre N., 2010, Caffeic acid esters and lignans from Piper sanguineispicum. Journal of Natural Products, 73: 1884-1890. Castillo D, Arevalo J, Herrera F, Ruiz C, Rojas R, Rengifo E, Vaisberg A, Lock O, Lemesre J-L, Gornitzka H, Sauvain M., 2007, Spirolactone iridoids might be responsible for the antileishmanial activity of a Peruvian traditional remedy made with Himatanthus sucuuba (Apocynaceae). Journal of Ethnopharmacology, 112: 410-414. CENSI, http://www.ins.gob.pe/portal/jerarquia/1/250/censi/jer.250 . Available at 28 Oct. 2011. Cioffi G, Montoro P, Lock O, Vasallo, A, Severino L, Pizza C, Tommasi N.,2011, Antioxidant bibenzil derivatives from Notholaena nívea, Des. Molecules, 16: 2527-2541. De-la-Cruz H, Vilcapoma G and Zevallos PA., 2007, Ethnobotanical study of medicinal plants used by the Andean people of Canta, Lima, Peru. Journal of Ethnopharmacology, 111: 284–294. EsSalud, Seguro Social de Salud, 2011a, Informe de la producción de los centros y unidades de medicina complementaria 2010, Gerencia Central de Prestaciones de Salud. Dirección de Medicina Complementaria, Lima. EsSalud, Seguro Social de Salud, 2011b, Informe de la calidad en la atención de los centros y unidades de medicina complementaria 2010, Gerencia Central de Prestaciones de Salud. Dirección de Medicina Complementaria, Lima. EsSalud, Seguro Social de Salud, 2002, Formulario Nacional de Recursos Naturales y Afines, Gerencia Central de Prestaciones de Salud. Dirección de Medicina Complementaria, Lima. EsSalud, Seguro Social de Salud, 2008, Petitorio Nacional de Productos, Recursos e Insumos Terapéuticos y Afines de Uso en Medicina Complementaria, Gerencia Central de Prestaciones de Salud. Dirección de Medicina Complementaria, Lima. Estevez Y, Castillo D, Tangoa Pisango M, Arevalo J, Rojas R, Alban J, Deharo E, Bourdy G, Sauvain M., 2007, Evaluation of the leishmanicidal activity 166 of plants used by Peruvian Chayahuita ethnic group. Journal of Ethnopharmacology, 114: 254-259. FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008. Gonzales GF, and Valerio LG Jr., 2006, Medicinal plants from Peru: a review of plants as potential agents against cancer. Anticancer Agents Med Chem., 6(5): 429-44. Hammond GB, Fernandez I, Villegas LF, and Vaisberg A., 1998, A survey of traditional medicinal plants from the Callejon de Huaylas, Department of Ancash, Peru. Journal of Ethnopharmacology, 61: 17–30. ITC, 2003, MNS special regional focus: Peru. Market News Service, Medicinal Plants & Extracts, 08: 41, Sep. 2003, Geneva, Switzerland. ITC, 2007, Market News Service, Medicinal Plants & Extracts, 24: 7, Sep. 2007, Geneva, Switzerland. Lama A, 2000, Peru: traditional knowledge enhances modern medicine. Available at: http://www.twnside.org.sg/title/enhance.htm (01 Aug. 2008). Lock O, 1996, Patent 000151/96 INDECOPI/OINT, Lima, Peru. Lock O, Castillo P, Doroteo V, Rojas R., 2005, Antioxidant activity in vitro of selected Peruvian medicinal plants. Acta Horticulturae, (ISHS) 675: 103- 106. Lock O., 2009. Flora Andina y Amazónica. Un aporte a su conocimiento científico. Boletín Academia Nacional de Ciencias, Perú, 3:34-42. Lopez-Fando A, Gomez-Serranillos P, Iglesias I, Lock O, Apumayta U, Carretero ME., 2004, Lepidium peruvianun Chacon restores homeostasis impaired by restraint stress, Phytotherapy Research, 18: 471-474. Mesa-Siverio D, Machín RP, Estevez-Braun A, Ravelo AG, Lock O., 2008, Structure and estrogenic activity of new lignans from Iryanthera lancifolia, Bioorganic and Medicinal Chemistry, doi:10.1016/j.bmc.2007.12.003. Nalvarte AW, de Jong W, and Dominguez G., 1999, Plantas Amazonicas de uso medicinal: diagnostico de un sector economico con un potencial 90 de realizacion. CIFOR and Universidad Nacional Agraria La Molina, Lima, Peru, Bogor, Indonesia. Available at: http://www.cifor.cgiar.org/Publications/Detail.htm?&pid=746&pf=1 (01 Aug. 2008).

167 Neto CC, Owens CW, Langfield RD, Comeau AB, Onge JS, Vaisberg AJ and Hammond GB., 2002, Antibacterial activity of some Peruvian medicinal plants from the Callejon de Huaylas. Journal of Ethnopharmacology, 79: 133–138. Odonne G, Bourdy G, Castillo D, Estevez Y, Lancha-Tangoa A, Alban-Castillo J, Deharo E, Rojas R, Stien D, Sauvain M., 2009, Ta'ta', Huayani: perception of leishmaniasis and evaluation of medicinal plants used by the Chayahuita in Peru. Part II. Journal of Ethnopharmacology, 126: 149- 158. Official Journal El Peruano, Files regarding all legal regulation, http://www.el peruano.com.pe Prom Peru, Avalaible (26 Oct. 2011),at: http://www.siicex.gob.pe/siicex/portal5ES.asp?_page_=480.47900. Rojas R, Bustamante B, Bauer J, Fernández I, Albán J, Lock O., 2003, Antimicrobial activity of selected Peruvian medicinal plants. Journal of Ethnopharmacology, 88: 199-204. Rojas R, Doroteo V, Bustamante B, Bauer J, Lock O., 2004, Antimicrobial and free radical scavenging activity of nitida. Fitoterapia, 75: 754- 757. Rojas R, Caviedes L, Lock O, Gilman RH., 2006a, Anti-Mycobacterium tuberculosis activity of Peruvian plant extracts using a rapid, inexpensive colorimetric assay. In: J.N. Govil (Ed.), Recent Progress in Medicinal Plants, Vol. 12. Studium Press LLC, Houston. pp. 429-441. Rojas R, Bustamante B, Ventosilla P, Fernández I, Caviedes L, Gilman RH, Lock O, Hammond GB., 2006b, Larvicidal, antimycobacterial and antifungal compounds from the bark of the Peruvian plant Swartzia polyphylla DC. Chemical & Pharmaceutical Bulletin, 54: 278-279. Rojas R, Caviedes L, Aponte JC, Vaisberg AJ, Lewis WH, Lamas G, Sarasara C, Gilman RH, Hammond GB., 2006c, Aegicerin, the first oleanane triterpene with wide-ranging antimycobacterial activity, isolated from Clavija procera. Journal of Natural Products, 69: 845-846. Torpocco V, Chavez H, Estevez-Braun A, Gutierrez Ravelo A., 2007, New Dammarane Triterpenes from Maytenus macrocarpa. Chem. Pharm. Bull., 55(5): 812-814. Valadeau C, Pabon A, Deharo E, Alban-Castillo J, Estevez Y, Lores FA, Rojas R, Sauvain M, Castillo D, Bourdy G., 2009, Medicinal plants from the Yanesha (Peru) : evaluation of the leishmanicidal and antimalarial activity of selected extracts. Journal of Ethnopharmacology, 123: 413-422.

168 WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva. WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

169 1.10 Suriname

The Republic of Suriname is situated on the north coast of South America. It is bounded on the north by the Atlantic Ocean, on the east by French Guiana, on the south by Brazil and on the west by Guyana. It covers an area of 163,270 kilometres. Suriname, a former Dutch colony with more than 80% of its surface covered by dense tropical forest, has only 468,613 registered inhabitants. The population, concentrated around the capital of Paramaribo (pop. 294,000), is mainly Creole, East Indian, Javanese, and Chinese. The country’s interior is inhabited by several groups of indigenous peoples: Amerindians (Native Americans) and Maroons, descendants of enslaved Africans who escaped into the forest where they created their own autonomous societies. The Courantyne River forms its western border with Guyana and the Marowyne River forms the boundary in the east with French Guiana. Apart from these, there are six major rivers, flowing generally from south to north, turning westwards in the coastal area. The interior of the country consists of a dissected peneplain, sloping gently towards the low-lying coastal region between ranges of hills and low mountains (maximum elevation 1,280 m). Topography varies from undulating to steep and rugged. A geographic division into four main natural regions is generally made that is also useful for soils and vegetation. The young coastal plain increases in width in east from 10 to 50 kilometres in the west that intrude deeply into the old coastal plain. It forms by far the most important agricultural zone of the country. The old coastal plain does not form a continuous zone but consists of hundreds of undulating surfaces, separated by creek systems and swamps belonging to the young coastal plain. The "Zandery" landscape is a dissected plain, rising from 10 to 70 m. It consists of bleached white quartz sands and unbleached yellow or brown sands, forming a continuous belt across the country. Some shifting cultivation is practiced. The old basement complex forms the remaining 80% of the country and consists of lowlands south of the coastal sedimentary basis. This zone corresponds with the "lowland region" and the "southern uplands" in Guyana. It forms part of the pre-Cambrian Guyana shield. However, sandstone mountains exist only in a few places in the central ranges of the country, in contrast with Guyana where the Roraima and Pakaraima mountains extend over a large area. The climate is tropical. Locally, rainfall may be higher (in the central mountain ranges) or lower (in a narrow coastal strip and in the south-western part of the country) than the indicated range. The civil war of the 1980s, road improvement, and the lack of employment and educational opportunities in the interior have caused the continuing migration of Amerindians and Maroons to Paramaribo. Apart from contributing to their health, the harvest and sale of medicinal plants in Suriname seem to provide a significant income for rural and urban individuals. The Surinamese government does not consider NTFPs to contribute substantially to the economic development of the country. Until 2004, no requests for permits were submitted for either the commercial or the non-commercial 170 export of medicinal plants. As a result, neither medicinal plants nor other NTFPs have been included in Suriname’s economic planning or development policies (van Andel et al., 2007).

Traditional Medicine Systems/Phytomedicine Suriname is a very diverse country, where numerous ethnicities strongly maintain separate cultural identities and languages. Of these cultures, the Maroon culture in particular is linked to a good many rainforest plant species (Havinga, 2006). Maroons are subdivided in Aucan (Ndyuka) living in the east of Suriname, Saramacan originally living next to the sarramacariver, Paramacan, Kwinti, Aluku’s and Matawai. They still live in isolated areas of the tropical rainforest of Suriname (e.g. Brokopondo, Marowijne, Saramacca), but many moved to Paramaribo. Their religion is mostly winti. Winti is a mixture of voodoo (which West African slaves took to Surinam) and American Indian rituals. Plants are component to virtually all winti rituals (Koopmans, 2008).

Government Efforts in Development of Traditional Medicine/Phytomedicine In the Republic of Suriname, no national policy, laws, regulations, national programme or national office on TM/CAM exist, nor are they in the process of being developed. There is also no expert committee and there are no national research institutes on TM/CAM or herbal medicines. Herbal medicines are not regulated in Suriname and consequently have no regulatory status, nor can claims be legally made about them. Neither a national pharmacopoeia nor national monographs exist, and no information is available on other materials used in their place. No information is available on manufacturing regulatory requirements or any control mechanism to ensure compliance. Safety regulations are limited to reference to scientific research on similar products; no information is available on a control mechanism for this requirement. No registration system exists for herbal medicines, nor are they included on a national essential drug list. No post marketing surveillance system for herbal medicines exists, nor is one being planned. In Suriname, there are no restrictions on the sale of herbal medicines (WHO, 2005).

Medicinal and Aromatic Plant Resources Some 600 indigenous plants are reported to be used for medicinal purposes in Suriname. However, all the plants used by the people in Suriname have not been inventorized yet. The plants like Bixa orellana L., Hura crepitans L., Phyllanthus amarus Schumach., Quassia amara L. Ruellia tuberosa L. etc are commonly used for common health problems (FAO, 1995).

171 Research and Development Activities The medicinal plants of Suriname has been described in Medicinal plants of Suriname by S. Tirimanna 1987; and by H. Heide in Surinaamse Medicijn planten, 1987 and Genees planten in Suriname, 1992 (FAO, 1995). Several projects have quantified the importance of medicinal plants for Surinamese communities and have developed initiatives to integrate their use in the formal health care system (Kwamalasamutu, Amazon Conservation Team project on Ethnomedicine; CI’s Shaman’s Apprentice programme focusing on the transfer of traditional knowledge to new generations). A joint effort to explore the potential medicinal uses of plants in the Surinamese forest, in the framework of the International Cooperative Biodiversity Group (ICBG), consisting of several US-based research institutes was undertaken. As a partner of the ICBG, Conservation International initiated a bio-prospecting program in Suriname with the Saramacca Maroons. The research institutes in the ICBG cooperate with the local pharmaceutical company (Bedrijfs Geneesmiddelen Voorziening Suriname, BGVS), the National Herbarium of Surinam (BBS), and Forest People of Suriname (a local NGO). Benefit sharing occurs at several levels (national and local), upfront through financial compensation for traditional healers and local para-taxonomists, information, training, and technology transfer and later through sales-based royalty-payments. A ‘Forest Peoples Fund’ has been created for the purpose that was endowed with an initial deposit and will be further filled by contributions from royalty payments. It is controlled by the leaders of the country’s traditional peoples and by Conservation International and is used to promote sustainable forest use and conservation (Anonymous, 2004). A joint collaboration of the Amazon Conservation Team (ACT) and Medische Zending Suriname (MZ) strives to develop and validate a replicable model for the integration of traditional medicine as a sustainable and cost-effective method for health promotion in two distinct indigenous communities of Suriname, the Saramaccan Maroon village of Kajana and the Wayana village of Apetina. ACT’s established traditional healthcare preservation program in Suriname, the Shamans and Apprentices Program prevents the disappearance of traditional knowledge of medicines from the rainforest by encouraging young apprentices to learn from their elder shamans. A traditional medicine clinic operated and directed by elder tribal shamans, works adjacent to and in conjunction with MZ primary care providers at the village health outpost. The clinic provides a facility for apprentices to directly observe the shamans actively practicing their medicine with opportunities for graduated clinical responsibility, enabling the transmission and preservation of clinical skills and rituals through generations. A Shamans & Apprentices school supports the traditional medicine clinic in each project site by teaching the younger apprentices medicinal plant knowledge. The traditional clinic in the project site of Kajana, named Sangaafu after an important Saramaccan healing plant, was constructed and ceremonially opened in October

172 2004. The clinic has become a centre for Maroon culture and healing. The second traditional medicine clinic, named Epipakolon (medicine house) was established on February 2005 in conjunction with MZ primary care providers in the Wayana village of Apetina. The clinic, built adjacent to the MZ health outpost, provides sufficient space for Wayana shamans to practice medicine and for apprentices to actively participate at their side. Shortly after the openings, the traditional medicine clinic staffs of Apetina and Kajana were trained to complete record forms transcribed into their language that document the incidence of conditions and treatments utilized for each patient at the clinics. Highly accurate, culturally appropriate and precise translations of Wayana and Maroon disease concepts and medico-anatomical terminology are being articulated. The ACT-Suriname health program plan focuses on fostering promotion and integration of traditional medicine and facilitating the preservation and transfer of traditional knowledge and culture, and near-term activities build upon this project. Further strengthening of the Suriname traditional medicine system will entail construction of new clinics upon request of the indigenous population, continuation and ongoing evaluation of ongoing clinic operations, training for clinic personnel and communities, and inter-community exchanges between traditional healers to facilitate knowledge transfer and the eventual creation of a Surinamese traditional healers’ union (Anonymous, 2005). An extensive market survey, conducted in Suriname in 2006 with objectives to describe and quantify the market in herbal medicine and the diversity of the species traded was carried out as part of the project “Medicinal plants of Suriname: Changes in plant use after migration to the Netherlands” (ongoing) by the National Herbarium of the Netherlands, in collaboration with the National Herbarium of Suriname (van Andel et al., 2007).

Trade and Marketing Almost half of the Surinamese population has migrated to the Netherlands since 1972. Even after decades of living in Holland, many still maintain strong social and economic ties with their home country. Although they make use of Dutch health-care facilities, Surinamese immigrants continue to use herbal therapies and keep their cultural concepts of health and illness. Only recently has the trade in herbal medicine from Suriname attracted the interest of researchers. A 2000 pilot study on medicinal plant use among Surinamese immigrants in the Netherlands reported the availability of more than 180 species of fresh, dried, and frozen medicinal plants in a small shop run by Saramaccan Maroons in Amsterdam. The first two studies on Paramaribo markets focused on social aspects and did not include the collection of plant material. A total of 110 different species, 76 of which could be identified to species level were discovered in the markets. According to the reports the main market

173 selling fresh medicinal herbs was the Vreedzaam Market, located in the city centre on the bank of the Suriname River. In 2006, three shipping agents were active in Suriname the government-owned Suriname Postal Corporation (Surpost) and the private companies Jos Steeman and Central Freight Services. None of them kept official figures on the amount of herbal medicine that was exported to the Netherlands. The official data on the scale of the medicinal plant trade are lacking in Suriname. However, the annual value of the domestic and export market add up to the medicinal plant trade worth $1,576,180 per year (van Andel et al., 2007). Some most frequently sold plant medicines in the local markets of Suriname are listed in Table 1 (Havinga, 2006).

Constraints and Problems The country need to develop an inventory of the botanical varieties and medicinal plants resources occurring in the wild. The over harvesting and depletion of the resource is a serious conservation issue. There have been several ethnobotanical projects in Suriname, both from botanical and anthropological perspective. A problem is to consolidate this information with regard to sources as species and names vary between botanists, anthropologists and forest peoples. Ethnobotanical knowledge is under threat by neglect and oppression and by erosion of traditional cultures. Specific research needs to be done to calculate sustainable harvest levels for medicinal plants harvested from primary forest. Attention should be given to the method of harvest, the amount of harvest, the frequency of harvest, and cultivation possibilities for valuable medicinal plant species. The medicinal plant trade should be monitored, in order to follow the development. Suitable projects should be put up in order to promote and stimulate cultivation of species, which might become rare and also train people engaged in wild collection for their sustainable harvesting in order to have long term benefits.

Table 1: Some frequently sold MAPs in local markets of Suriname (Havinga, 2006) Botanical name Family Part sold

Aciotis spp. Melastomataceae Twigs, leaves

Begonia glabra Aubl. Begoniaceae Whole plant

Campomanesia aromatica (Aubl.) Griseb. Myrtaceae Twigs, leaves

Crescentia cujete L. Bignoniaceae Fruit shells

Justicia pectoralis Jacq. Acanthaceae Whole plant

Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson Verbenaceae Twigs, leaves

174 Lonchocarpus spp. Fabaceae Wood

Lycopodiella spp. Lycopodiaceae Whole plant

Mansoa alliacea (Lam.) A. H. Gentry Bignoniaceae Wood

Ocimum campechianum Mill. Lamiaceae Twigs, leaves

Piper marginatum Jacq. Piperaceae Twigs, leaves

Pityrogramma calomelanos (L.) Link Pteridaceae Whole plant

Renealmia spp. Zingiberaceae Twigs, leaves

Scoparia dulcis L. Plantaginaceae Whole plant

Sesamum indicum L. Pedaliaceae Seeds

Siparuna spp. Siparunaceae Twigs, leaves

175 1.11 Uruguay

Uruguay is on the southeastern Atlantic coast of the Southern Cone of South America, bordering Argentina to the west and south and Brazil to the north. The Atlantic Ocean is on the east and the estuary of the Río de la Plata is on the south. The land area is about 176,220 square kilometres. The population of Uruguay is 3 million people and roughly half of them live in Montevideo, the capital city. Most of the country consists of gently rolling plains interrupted by two ridges of low hills. The remainder consists of fertile coastal and riverine lowlands, including a narrow sandy and marshy coastal plain. The climate is generally mild, and freezing temperatures are almost unknown. Because of the absence of mountains, all the regions are vulnerable to rapid changes in weather. It is calculated that Uruguay had 1.3 million hectares of natural forests in 2000, representing 7.4% of its land area, with forest plantations accounting for 622,000 hectares of the total. There is no significant deforestation and forest degradation has been considerably reduced. Between 1990 and 2003, 12,000 hectares of natural forests were placed under sustainable management, representing approximately 20% of all such forests (FAO, 2008).

Traditional Medicine Systems/Phytomedicine According to a survey carried by Departamento de Fitoterapia Laboratorios Gautier Democracia, Montevideo, Uruguay the use of MAPs is widely distributed in Montevideo. Among the people surveyed, 27% reported self-sourcing of MAPs indicating a deep knowledge of MAPs and their use, which was widespread among ages with greater use among the elderly (>60 years old). The survey also indicated a wider usage of MAPs by rural populations who also have better knowledge of herbal medicine compared to urban population (Parrillo et al., 1999). In general complementary and alternative medicine has not been practiced traditionally in Uruguay. However, this pattern has been changing and the use of such medicine e.g. acupuncture, homeopathy, and herbal medicine has been increasing in recent times.

Government Efforts in Development of Traditional Medicine/Phytomedicine Cardiovascular diseases are the leading cause of death, and hypertension is among the primary causes for medical visits. A high prevalence of obesity is associated with a high incidence of diabetes. Cancer accounts for 23% of all deaths. Alcoholism is a problem among men age twenty to forty-nine years, which is associated with a high prevalence of cirrhosis of the liver. Approximately 60% of the population is covered by private non profit collective health care associations known as mutualistas. Free coverage through the Ministry of 176 Public Health covers approximately 20% of the population, and military and/or police or private company insurance covers approximately 10%. The rest of the population has no formal coverage. There is no information available regarding government efforts to promote or develop traditional medicine in the country at present.

Medicinal and Aromatic Plant Resources Some commonly occurring and used MAPs in Uruguay include Achyrocline satureioides (Lam.) DC., Aloysia citrodora Palau, Baccharis trimera (Less.) DC., Chamomilla recutita (L.) Rauschert , Ilex paraguariensis A. St.-Hil., Malva parviflora L., Mentha ×piperita L., Peumus boldus Molina, Phyllanthus niruri L. and Tilia spp. (Parrillo et al., 1999). The information regarding MAPs resources, their collection and cultivation etc. in the country is currently unavailable.

Research and Development Activities The phytochemical and biological activities of some Uruguayan medicinal plants have previously been reported in the literature. In a study by Ccftedra de Farmcognosia y Productos Naturales, Facultad de Quimica, General Fiores; Catedra de Bothica; and Catedra de Microbiologia, Facultad de Quimica, General Flores Montevideo, Uruguay the screening for antimicrobial activity of a number of plants used in popular medicine for the treatment of mucosal and skin infections in Uruguay was reported. The studied plants were collected from several localities in Uruguay and are listed in Table 1 along with their popular uses (Olano et al., 1996). Various studies related to different aspects of MAPs have been reported by different institutions in Uruguay. Cátedra de Botánica, Facultad de Química (Alonso Paz et al., 1995); and Cátedra de Farmacognosia y Productos Naturales, Facultad de Química, Avenida General Flores, Montevideo, Uruguay have reported their studies on screening of Uruguayan medicinal plants for various activities (Gonzalez et al., 1993). The Catedra de Farmacognosia y Productos Naturales, Facultad de Química, General Montevideo investigated the stem bark of Ocotea opifera Mart. leading to the isolation and characterization of asaricin, a phenolic derivative with antifungal and insecticidal activity, as the main component described for the first time for the genus Ocotea (Lorenzo et al., 2001). Department of Neurochemistry, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo, studied the plants Achyrocline satureioides (Lam.) DC. and Epilobium parviflorum Schreb. with antioxidant activity for applications in cosmetic preparations for skin care (Morquio et al., 2005). A project (2002-2005) was carried out by the Southern Cone Medicinal Plant Network to promote the sustainable use, conservation and knowledge of medicinal flora, as well as access to the use of medicinal plants by local communities. It worked for strengthening communication between members and other interested parties in Latin America, and by building on the experience of its members to elaborate political strategies 177 regarding access to and protection of biodiversity. The network is active in Argentina, Brazil, Chile and Uruguay, with some exploratory activities in Paraguay (Anonymous, 2008).

Trade and Marketing The Uruguayan exports during 2007 for selected Botanicals under the HS codes 0902-0910 (includes South American grown botanicals such as black pepper fruit, capsicum fruit, ginger rhizome, maté leaf, and vanilla fruit, among others); 1211 (includes South American botanicals such as anguraté herb, boldo leaf, cat’s claw bark, coca leaf, condurango bark, ipecac rhizome, marapuama, pau d’arco bark, rhatany root, and stevia leaf among many others); 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms among other balsams and oleo-gum-resins); 130219 (includes most herbal saps and extracts such as those of ginger, guaraná, ipecac, maca, maté, marapuama, pfaffia, and pau d’arco, among others); 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others); and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils) were 391,513; 5,456; 720; 4,361; 5; 224,742 kg respectively (ITC, 2008).

Constraints and Problems The knowledge of traditional medicine, as well as the ecosystems and biodiversity from which medicinal plants are derived, runs the risk of being lost. Therefore efforts should be made to preserve this knowledge by documentation and also making people aware of the sustainable utilization of natural resources of MAPs to derive long term health and commercial benefits from them. Research should be devoted to cultivation technologies as well as product development based on traditional medicines used in the country. This should be backed by suitable regulations for their development, integration of traditional medicines in national health care systems and to prevent overexploitation of MAPs.

178 Table 1: Some medicinal and aromatic plants of Uruguay (Olano et al., 1996) Botanical name Common Family Part Uses name used

Conyza bonariensis (L.) Yerba Asteraceae Aerial antiseptic, antiulcerative, Cronquist carnicera parts diuretic, hepatoprotective, urinary antiseptic

Eryngium paniculatum Caraguata Apiaceae Root, leaf antiseptic, astringent, cicatrizant Cav. & Dombey ex F. Delaroche

Eugenia uniflora L. Pitanga Myrtaceae Leaf antidiarrheic, antirheumatic, astringent, digestive aid

Heimia salicifolia Link Quiebra Lythraceae Leaf cicatrizant, diuretic laxative arado

Limonium brasiliense Guaycuni Plumbaginaceae Aerial antirheumatic, antiseptic, (Boiss.) Kuntze parts, antiulcerative, astringent, roots urinary, vulnerary

Margiricarpus pinnatus Yerba de la Rosaceae Whole antirheumatic, astringent, (Lam.) O. Kze. perdiz plant diuretic, urethral washes

Psidium luridum (Spreng.) Araza Myrtaceae Fruit antiulcerative, digestive aid, eye Burret washes, emmenagogue, vulnerary

Schinus molle L. Anacahuita Anacardiaceae Fruit, leaf antirheumatic, antiseptic, cicatrizant, vulnerary

Sesbania punicea (Cav.) Acacia Fabaceae Leaf, root antiseptic, astringent Benth. mansa

Solanum chenopodioides Pipi Solanaceae Leaf cicatrizant, laxative Lam.

Xanthium spinosum L. Cepa caballo Asteraceae Aerial antiulcerative, descongestive, part diuretic

179 1.12 Venezuela Republic of Venezuela, located in northern South America, is bounded on the north by the Caribbean Sea and the Atlantic Ocean, on the east by Guyana, on the south by Brazil, and on the south-west and west by Colombia. The total area is 912,050 square kilometres. The country can be divided into four major geomorphologic zones. The mountain ranges of the north-west, consisting of two branches of the Andes and the coastal mountain range, with elevations from 500-5,000 m. With a very long and wide ‘valley’ between, which is barely above sea level in the north, the Mérida range and that of Perijá are here considered two branches of the Andes. The Mérida Range terminates just south of Barquisimeto. The coastal ranges are normally considered as the Cordillera Central and the Cordillera Oriental. The highlands extend from south-west of the Maracaibo Basin across northern Venezuela. The Merida Range consists of mountain ranges and high plateaus. Pico Bolivar, the highest point in Venezuela, rises 5,007 m above sea level. The central highlands consist of two parallel mountain ranges along the Caribbean coast with fertile valleys between them. The north-eastern highlands consist of low mountains and hilly land. Much of the Llano, an immense plain of tertiary rocks and alluvial deposits lying between the Andean Highlands and the Guiana Highlands, is under 50 m elevation. The Orinoco River, which begins in the Guiana Highlands, flows from west to east along the southern border of the Llanos, flooding huge areas during the wet season. The river and its tributaries drain most of Venezuela. The Orinoco extends 2,066 kilometres and is the longest river in the country. The Guiana Highlands, of Precambrian rocks, lie to the south of the Llanos and the Orinoco river, with elevations less than 3,500 m. The highlands cover nearly half of Venezuela and extend into Brazil and Guyana. The chief ranges are the Sierra Parima and Sierra Pacaraima, which form part of the boundary with Brazil. Swift-flowing rivers have deeply eroded the region’s high plateaus, and tropical forests cover much of the southern part of the region. The delta of the Orinoco is formed from recent alluvial deposits and is subject to periodic flooding. It is associated geomorphologically with the Maracaibo Basin lying in north-western Venezuela and consisting of Lake Maracaibo and the lowlands around it. Lake Maracaibo is the largest lake in South America, covering 13,512 square kilometres. The climate of Venezuela is tropical on the Llanos and along the coast and temperate in the mountainous regions. Annual rainfall averages about 3,000 mm in the Perija Mountains, which are west of Lake Maracaibo, and in the southern Guiana Highlands, although some areas in the highlands receive 8,000 mm yearly. In contrast, much of the Caribbean coast is dry, and some areas receive only 120-400 mm of rainfall yearly. Most of the rest of the country has a wet season from May through November. In the eastern Llanos, annual rainfall averages about 1,000 mm.

180 The area of natural forests is shrinking at an average annual rate of 218,000 hectares as a result of cutting to provide pasturage for cattle and a still defective style of forest management. The Venezuelan forestry policy promotes the conservation and management of natural resources, the establishment of forest plantations and agroforestry, social development based on forestry activities, forest research and forest industry development. The largest forest protection zones are the national parks (32 in all, with a total area of 81 million hectares) and wildlife reserves and sanctuaries - all designated as Areas under a Special Administration System. The drawback with regard to management of these areas is that most of them have no management plan and few if any personnel on site, and there is constant violation of the regulations of their use. Little information is available on the production and use of other forest products besides timber and fuel wood (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Venezuela's health-care system has a large array of public and private hospitals and clinics. Most deaths in Venezuela are due to heart attacks, cancer, fatal accidents, and crime2. 3Although Western medicine is the most popular mode of health care, different traditional medicines are still being used that are surviving in many rural belief systems. The herbal remedies are still widely used for various common ailments (Benavides, 2007). Traditional and esoteric medical practitioners have, in past years, received as many or more patients as first consultation than allopathic doctors, especially in the rural and lower classes. This has reduced in the present government with the programs of ‘Barrio Adentro’ and the ‘Medicaturas’ staffed mainly by Cuban ‘doctors’. ‘Traditional practitioner’ includes: brujos, curanderos, curiosos, ‘botánicos’, the cult of María Leonza, the Cuban ‘babalao’, and various other beliefs – apart from indigenous Amerindian systems, and Afro-American systems inherited from the slaves.

Government Efforts in Development of Traditional Medicine/Phytomedicine In recent years, Venezuelan authorities have drawn up legislation formalizing the relationship between traditional and modern medicine in the national health system. Article 122 of the new constitution (which took effect in 2000) recognizes indigenous patients’ right to culturally appropriate treatment and establishes doctors’ duty to take local beliefs and cultural norms into account. A proposed national health law, currently before the National Assembly, states that indigenous people have the right to use traditional systems of health care and traditional medicine; however, this right does not in any way prejudice their right to access state health care systems (Johnson, 2002). In Venezuela, health care is restricted legally3 to formally trained medical professionals except for traditional birth attendants who have received a ministerial permit. Allopathic physicians may practice homeopathic medicine after completing specialized postgraduate studies. There is no chiropractic law, although the practice of 181 chiropractic is permitted under common law by officially recognized health care providers. The School of Homeopathic Medicine of the Venezuelan Homeopathic Medical Association is responsible for training allopathic physicians specializing in homeopathy. The Liga Medicorum Homeopathica Internationalis has 41 members in Venezuela. There are approximately 10 chiropractors practising in Venezuela (WHO, 2001).

Medicinal and Aromatic Plant Resources4 TRAFFIC’s work in Venezuela focused on identifying research priorities, the main species in trade, and legislation related to harvest and trade controls. In Venezuela, this project resulted in a preliminary list of the 50 most commonly used species among the more than 800 documented species used medicinally, a priority list of 20 species for research and conservation, and a list of the Amazonian and Andean regions that are most important for conservation as areas of origin of the species in greatest demand for trade (Buitrón, 2004). The plants like Bactris gasipaes Kunth, Manihot esculenta Crantz, Musa paradisiaca L., Nicotiana tabacum L., Phyllanthus piscatorum Kunth, Xanthosoma spp. and Zea mays L. are commonly cultivated in home gardens especially by one of the ethnic communities the Yanomami Amerindians in southernmost Venezuela. These plants are used by these communities for magical and medicinal purposes (Gertsch et al., 2004).

Research and Development Activities Various institutes and departments in universities in Venezuela like Laboratorio de Cristalografía, Facultad de Ciencias, Departamento de Química, Universidad de Los Andes, Mérida (Mora et al., 2001); Universidad Simón Bolívar, Caracas (Taddei and Rosas- Romero, 2000); Universidad del Zulia, Maracaibo (Paez et al., 2000); Laboratorio de Productos Naturales, Centro de Química Orgánica, Escuela de Química, Facultad de Ciencias, Universidad Central de Venezuela, Caracas (Jiménez et al., 2001); Departamento de Botánica, Facultad de Agronomía, Universidad del Zulia, Maracaibo (Caraballo et al., 2004); Department of Natural Products, School of Pharmacy, Universidad Central de Venezuela, Caracas (Noguera et al., 2004) are involved in research concerning to MAPs in Venezuela. A sample of 30 medicinal species was prepared as a result of an ethnobotanical and ethnomedical research carried out in the State of Mérida, Venezuela. Species were gathered all along the different farming settlements and urban areas. The botanical samples were processed at the MERF herbarium of the Pharmacy and Bioanalysis Faculty of Universidad de Los Andes. Relevant material for medicinal species not commonly found was obtained, and common names, uses, parts of the plants used, preparation methods and dosages were recorded. Many of the collected species were grown at the

182 Medicinal Plant Garden of the Pharmacy and Bioanalysis Faculty of the University (Gil Otaiza et al., 2006). There is a rich and growing literature referent to medicinal plants, dating from the time of the ‘conquest’. The beginning of the modern era could be considered the compilation of Pittier (Pittier, H. 1970. Manual de las plantas usuales de Venezuela y su suplemento. Fundación Eugenio Mendoza; Caracas. 620 p.) with data from others published since the beginning of the 20th Century, and is still widely used. Most of these publications are simply reports of the use of the plants for certain ailments, without further detail, and, unfortunately, this is still the style of many publications, frequently published locally in non-peer reviewed journals or privately in small paperbacks (Rodríguez, M. P. 1983. Plantas de la medicina popular venezolana de venta en herbolarios. Soc. Venez. de Ciencias Nat. ; Caracas. 267p.). Nevertheless, these lists are useful starting points for further investigation. There are scientists in almost every university studying medicinal and/or aromatic plants, and it is a favourite area for chemists in the laboratories of Natural Products. (One of the favourite topics is anti-inflammatory, perhaps for the simple tests with laboratory animals). Ethno botanical studies are frequent for graduating theses of biology and anthropology students. The Herbario ‘Ovalles’, as the ethno botanical herbarium of the country, has collaborated or tutored many of these, as well as PhD theses of national and foreign students. Apart from many isolated publications on ethno botany and chemical analysis of medicinal plants, some texts have been published: Warao and Wayuu ethno medicines, a comprehensive text is in preparation on the ‘Plantas útiles y comunes del Estado Amazonas’, CONAPLAMED has published a fascicle (‘cuaderno’) of a text of phytotherapy (Delens M. Edidtor. 2000. Cuaderno de Fitoterapia Clínica, Tomo I (Afecciones Respiratorios y Digestivos). Edigráfica C.A. Mérida, Venezuela. 172 p.), and several researchers collaborate with Tramil and use its ethno pharmacological system in their circum-Carribean studies (www.tramil.net).

Trade and Marketing Currently there is no data available concerning the trade in MAPs and their products, their production or processing within the country. There are a few commercial producers with products on the market, registered with the Health Ministry, some with excellent strict controls, at least one with their own organic production; others purchase from or contract small farmers. There are still many illegal ‘natural products’ appearing on the local market.

Constraints and Problems The traditional knowledge regarding MAPs and their uses is at risk, particularly as communities begin to adopt Western habits and gradually abandon aspects of traditional culture. Research on plants with medicinal properties growing in Venezuela and the identification of their chemical components responsible for their activities need to be carried out in order to corroborate the traditional uses of ancient healing wisdom and lore 183 and have proven the enduring healing potential of many plant medicines in today’s community.

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192 2. The Status of Medicinal and Aromatic Plants in North and Central America

2.1 Antigua and Barbuda Antigua and Barbuda, part of the Leeward Islands, consists of three islands— Antigua and Barbuda. The islands lie about 692 kilometres north of Venezuela. Antigua and Barbuda has a total land area of 442 square kilometres (Antigua, 280 square kilometres; Barbuda, 161 square kilometres. Redonda Island is also claim by Montserrat and St Kitts. The islands of Antigua and Barbuda are mostly flat. They were formed from volcanoes that were worn down by wind and rain. Antigua’s coast has numerous bays and inlets. Redonda is rocky and has little plant life. Without any high mountains and after deliberate cutting down of trees to plant sugar cane during the colonial era, both islands have very low rainfall, and droughts occur every 3 to 7 years. There are few streams and no rivers. The medicinal and aromatic plants, used in traditional medicine and increasingly in modern reparations are found primarily in forest areas.

Traditional Medicine Systems/Phytomedicine The Ministry of Health is the primary provider of public sector health care services. Holberton Hospital, a 141-bed hospital in Antigua, is the main provider of public, inpatient, and outpatient services. The Adelin Medical Centre, a 21-bed facility, is the only private inpatient hospital in Antigua. Health services in Barbuda are provided at the eight- bed Hannah Thomas facility; there also is the 100-bed geriatric Fiennes Institute. The Ministry of Health, Sports, and Youth Affairs is responsible for human resources working in public health. There is a shortage of medical personnel in the public sector and, among other initiatives, the Government is addressing this through technical cooperation agreements with the government of Cuba, whereby a cadre of health personnel (anesthetists, radiologists, internists, an oncologist, nurses, pharmacists, and laboratory technologists) from that country is deployed to Antigua and Barbuda on fixed- term assignments to complement national health personnel (Anonymous, 2007). However recently, alternative medical sector, which is now well represented, and includes doctors trained in both conventional & naturopathic traditions. There are no regulations existing on traditional medicines at present. The Ministry of Health is examining the possibility of establishing guidelines through the recently inaugurated Pharmacy Council to regulate the import and sale of herbal medicines. An extensive list of the plants traditionally used for medicinal purposes in Antigua and Barbuda exists which makes reference to local names, scientific names and reported uses (WHO, 1998). However, there is no information regarding the extent of use and popularity of traditional medicine in the country.

193 Government Efforts in Development of Traditional Medicine/Phytomedicine In Antigua and Barbuda, no national policy, laws and regulations, national programme, national office, expert committee or national research institutes have been issued or established for TM/CAM and none are in development currently. The herbal medicines are not regulated in the country nor do they have any regulatory status. No claims can legally be made about herbal medicines. There is neither a national pharmacopoeia nor national monographs, and no others are used in their place. There are no manufacturing or safety assessment regulatory requirements, nor is a registration system in place. Herbal medicines are not included on an essential drug list. No post marketing surveillance system exists or is planned. Though, herbal medicines are sold in pharmacies as over the counter medicines, in special outlets and without restriction (WHO, 2005).

Medicinal and Aromatic Plant Resources The natural indigenous vegetation of Antigua was virtually decimated during the sugar production years (1660 - 1960). The result is that the majority of Antigua’s existing land cover is made of secondary growth with a few areas of original vegetation cover. Barbuda, on the other hand retains much of its original forest and is primarily covered by evergreen bush land - a mixture of white cedar, loblolly, cinnamon, bearded fig and shrub species. The number of plants used medicinally is a lot more than 50-60 species but most of the commonly-used (often pan-tropical plants are in the list). Among them, 16 are listed as rare, 26 as uncommon, and 12 as common Most of these plants are found around human habitation and on farms. Those communities listed as being rare must be considered endangered or vulnerable. The documented flora comprise 1158 species of plants, 45 species of ferns and fern allies, 4 species of gymnosperms, and 1109 species of angiosperms (Anonymous, 2001). There is a cottage scale preservation of MAPs being practiced in Antigua and Barbuda however there is no information available on the number of species of MAPs being harvested from wild or under cultivation in the country.

Research and Development Activities An ethnopharmacological survey was done in 1993 by the Ministry of Agriculture for the TRAMIL network (TRAMIL 2006). Currently there are no specific efforts for conservation of MAPs resources of the country. Tourism development and activity has mostly affected coastal ecosystems, however biodiversity is highest in the uplands of Antigua, where there is regeneration of forest estimated about 700 species of native plants.

194 In Antigua and Barbuda, medicinal plants (especially trees and shrubs) have been affected by the contraction of agriculture and the expansion of domestic housing, with lawns, rather than gardens. This has also affected access to fruit trees, e.g. guava and other native Rhamnaceae. Heavy overgrazing by Antigua's enormous population of livestock is also very important in changing the ecological landscapes. During the 1990s, a series of hurricanes decimated the remaining tree cover. Some of the MAPs and their traditional uses in the country are listed in Table 1. These plants were investigated at the Chemistry and Food Technology Division, Ministry of Agriculture, Dunbars (Antigua) as part of an OAS Regional Project - Economic Biology of Underutilized Tropical Plants (EBUTROP) terminated in 1989 (Grant, 1995).

Trade and Marketing The Ministry of Health is responsible for the regulation and control of pharmaceutical services and general medical supplies. The Government continues to receive assistance from the Eastern Caribbean Drug Service. Vaccines are procured by the government through the Pan American Health Organization’s Revolving Fund. There is a National Drug Formulary and a National Formulary Committee that regulate the purchase and use of pharmaceuticals (Anonymous, 2007). However, there is no information on the trade and production of herbal medicine and MAPs products in the country.

Constraints and Problems The area of herbal medicine opens a new dimension of the untapped resource found in Antigua and Barbuda. The scientific investigation of their natural resources is required to have commercial and health benefits for country populations.

Table 1: List of some plants with traditional medicinal uses in Antigua and Barbuda (Grant, 1995) Botanical name Family Medicinal uses Abrus precatorius L. Fabaceae colds Achyranthes indica (L.) Mill. Amaranthaceae colds, diabetes, hypertension, pain Allium cepa L. Alliaceae gas Allium sativum L. Alliaceae hypertension (high blood pressure), indigestion, gas Aloe barbadensis Mill. Asphodelaceae burns, healing of sores, stomach and intestinal disorders (laxative), colds Annona muricata L. Annonaceae soporific (to induce sleep), fevers Annona squamosa L. Annonaceae colds, hypertension Antigonon leptopus Hook. & Polygonaceae colds and flu, period pains, hypertension, Arn. diabetes Argemone mexicana L. Papaveraceae cold, fever, coughs

195 Aristolochia trilobata L. Aristolochiaceae abortion, fever, diabetes, hypertension Artocarpus altilis (Parkinson) Moraceae hypertension Fosberg Azadirachta indica A. Juss. Meliaceae pesticide, diabetes, fever, heavy colds hypertension Bambusa vulgaris Schrad. ex Poaceae colds, hypertension J. C. Wendl. Borrichia arborescens (L.) DC. Asteraceae heavy colds Bryophyllum pinnatum Crassulaceae coughs, colds, fevers, diabetes, diuretic (Lam.) Oken Caesalpinia bonduc (L.) Roxb. Fabaceae heavy colds Cajanus cajan (L.) Millsp. Fabaceae cleaning of teeth, gum boil Capraria biflora L. Plantaginaceae diarrhoea, hypertension, nausea, colds Carica papaya L. Caricaceae boils, ringworm, worms Cassia occidentalis L. Fabaceae stomach and kidney troubles, colds, cough, fever, toothache Catharanthus roseus (L.) G. Apocynaceae diabetes, high blood pressure, stomach Don pains Chenopodium ambrosioides L. Chenopodiaceae vermifuge Cymbopogon citratus (DC.) Poaceae Fever, colds Stapf Datura stramonium L. Solanaceae jaundice, fever, colds, biliousness Eucalyptus citriodora Hook. Myrtaceae colds Eupatorium odoratum L. Asteraceae colds, fever Euphorbia prostrata Aiton Euphorbiaceae bronchitis, rheumatism, inflammation, skin disease, boils, scabs and burns Foeniculum vulgare Mill. Apiaceae nausea, colic and gripes in babies, gas, palpitation Indigofera tinctoria L. Fabaceae jaundice Ipomoea batatas (L.) Lam. Convolvulaceae mumps Jatropha gossypiifolia L. Euphorbiaceae diarrhoea, bath for pain, colds, fever, juice used on sores Justicia secunda Vahl Acanthaceae colds Lepidium virginicum L. Brassicaceae gas Leucaena leucocephala (Lam.) Fabaceae gas, colds, to wash swollen feet de Wit Maranta arundinacea L. Marantaceae diarrhoea Merremia dissecta (Jacq.) Convolvulaceae colds Hallier f. Momordica charantia L. Cucurbitaceae fever, gas, hypertension, diabetes, abortion Nopalea cochenillifera (L.) Cactaceae hair conditioner, food, poultice on swelling Salm-Dyck Ocimum basilicum L. Lamiaceae upset stomach, indigestion Ocimum canum Sims Lamiaceae colds, fever Parthenium hysterophorus L. Asteraceae colds, fever Peperomia pellucida (L.) Piperaceae diuretic, inflammation Kunth Phyllanthus amarus Phyllanthaceae diabetes, stomach gripe in children, clear Schumach. clots after childbirth Pluchea symphytifolia (Mill.) Asteraceae colds, fever

196 Gillis Portulaca oleracea L. Portulacaceae worms in children Psidium guajava L. Myrtaceae stomach pains and diarrhoea Punica granatum L. Lythraceae astringent Ricinus communis L. Euphorbiaceae joint pains, stomach disorders Solanum bahamense L. Solanaceae cleaning tongue Solanum torvum Sw. Solanaceae colds, fever Spigelia anthelmia L. Loganiaceae worms Stachytarpheta jamaicensis Verbenaceae vermifuge, boils, diabetes (L.) Vahl Stellaria media (L.) Vill. Caryophyllaceae bronchitis, coughs, colds, hoarseness, rheumatism, inflammation, skin disease, burns Stylosanthes hamata (L.) Fabaceae colds Taub. Tamarindus indica L. Fabaceae hypertension Tragia volubilis L. Euphorbiaceae diuretic Zingiber officinale Roscoe Zingiberaceae indigestion, gout, rheumatism

197 2.2 Bahamas

The Commonwealth of the Bahamas, located in the West Indies, consists of a chain of about 700 islands and islets and many more cays, reefs and rocks, extending for about 1200 kilometres from a point off the east coast of Florida to the north-eastern tip of Cuba. The principal islands include Acklins, Andros, Cat, Eleuthera, Grand Bahama, Great Abaco, Great Exuma, Great Inagua, Little Abaco, New Providence, and San Salvador. Only about 40 of the islands are inhabited. Total area is estimated at 13,880 square kilometres. Most of the Bahamas are long, narrow strips of limestone, covered by a thin layer of stony, infertile soil. Pine forests cover parts of many of the islands. The forest resources of the Bahamas have been classified into three distinct types, namely pine forests (~200 000 ha), coppice forests (= secondary hardwood forests, ~200 000 ha) and forest (~400 000 ha). These figures are rather rough estimates since there are no inventory data available for coppice and mangrove forests. Approximately 80 percent of the forest resources are on State lands (Crown land), with the remaining 20 percent in private holdings. The pine forests (Pinus caribaea var. bahamensis) are considered the most productive and commercially viable forest resources, found on four of the most northerly islands. The commercial utilization of the pine forests starting from early 1900s until the early 1970s, lead to complete exploitation of their resources. The current stock, last inventoried in 1986, is the result of natural regeneration after the exploitation. The coppice hardwood forests are found predominantly in the central and southern Bahamas and have never been inventoried. Some noted valuable species include buttonwood, mahogany, gum elemi, ratwood, black ebony and red cedar. The mangrove forest ecosystems occur predominantly on the lee shores of most Bahamian Islands. There has been no attempt to quantify the extent of coastal deforestation or changes in forest cover. Since the late 1980s the focus of the forestry sector shifted from one of forest exploitation to that of the multipurpose functions of the Bahamian forests. Forest management is not actively practiced in the Bahamas. There are currently no formal primary forest industries in the Bahamas since forest exploitation ceased in the late 1970s. Consequently the Bahamas relies heavily on imports of forest products to sustain the demand for goods and services. The sector contributes little to GDP. Nevertheless, the naturally regenerating pine forests on State lands promise a renewed asset for sustainable forest utilization for small local industries. The passage of Hurricane Floyd in September 1999 severely damaged and destroyed native and introduced trees in the urban areas of New Providence Island. To address the destruction the government embarked on an island-wide plant beautification programme with the importation of 10,000 exotic trees (coconut palms, royal palms, etc.) to be planted in rural, urban and coastal areas, complemented by trees purchased from

198 local growers. The attempt to salvage the wind blown trees in the pine forests never materialized. The forest resources offer some opportunities to provide non-wood forest products. The best arable lands for agroforestry are those under natural pine forests, particularly in the northern Bahamas. Large areas of this arable land are currently under citrus cultivation and other cash crops for domestic and export markets. Small farmers are encouraged to cultivate cash crops intermixed with forest trees and to adopt other agroforestry systems. The unique features of the Bahamian forests include the multiform vegetation, flowers, fruits, and medicinal plants. Selected areas of forest have been designated as conservation forest (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Bahamians have used indigenous plants for medicinal purposes for hundreds of years. This tradition is called "bush medicine," and is used in the out islands where doctors are rarely available. Some of these herbal remedies are being researched and used by herbalists and natural health practitioners worldwide (Anonymous, 2008). No more information is available on the use of traditional medicine in the country. The use of bush medicine is declining currently (Laflamme, 2007).

Government Efforts in Development of Traditional Medicine/Phytomedicine There is one large hospital in Nassau, and over a hundred government clinics are scattered elsewhere. An air ambulance service transports out islanders to the hospital in emergencies. There are about twelve-hundred people per physician, but nurses and paramedics often serve as primary care professionals, especially in remote settlements (Laflamme, 2007). No information is currently available as per the government efforts to promote the use and development of such medicine in the country.

Medicinal and Aromatic Plant Resources Nearly 100 plants in the islands of the Bahamas have been used to cure common ailments such as indigestion, colds, diarrhoea, and headaches. Some of the commonly used plants in Bahamian bush medicine are Lignum vitae (Guiacum officinale Linn.), the national tree of the Bahamas used to treat weakness and strengthen your back. The bark of cascarilla (Croton eleuteria L.), also called Sweetwood, is used to make a tonic for digestive irritations and stomach aches. The

199 parts of the plant are used as an expectorant, or to treat chronic diarrhea or vomiting and as digestive tea. The Gale of Wind/Hurricane weed (Phyllanthus amarus Schumach.) has been used for generations to eliminate gallstones or kidney stones. It is also used in Bahamas for poor appetite, constipation, typhoid fever, flu, and colds. Kalanchoe (Kalanchoe pinnata (Lam.) Pers.) is mostly used for Asthma or shortness in breath. Bahamians use the leaves of the Spotted Basil, to treat asthma, bronchitis, chest colds, and skin rashes. Some studies report about 163 plants are used medicinally on Cat Island and about 140 on Long Island with about 120 being used by both islands. There are many medicinal plants used throughout the Bahamas, as different islands have different flora compositions. Andros, a pine island, has several medicinal species not found in the Southern Bahamas (Anonymous, 2008). However, there is no detailed study available regarding the medicinal plant species available on the islands and the status of their natural resources, harvesting from wild as well as from cultivated sources.

Research and Development Activities In November 1998, the Government of the Bahamas formally agreed to and approved its first official National Forest Policy. The policy commits the government to the conservation, management and development of forest in the national interest and establishes a Forestry Unit in the Department of Lands and Surveys, mandated to implement the policy. This unit is responsible for encouraging tree planting on suitable private lands; making recommendations for the development and the implementation of a comprehensive sustainable forest research programme besides other objectives. Some other public-sector agencies having direct influence on the forestry sector include the Conservation Unit of the Department of Agriculture, mandated to conserve Bahamian biodiversity and responsible for the Wild Birds Protection Act (1952), Plants Protection Act (1916), Wild Animals Protection Act (1968) and CITES; the Department of Physical Planning, which under environmental legislation (the Conservation and Protection of the Physical Landscape of the Bahamas Act, 1997) provides conservation of certain endangered native protected tree species; and the Water and Sewerage Corporation, as the majority of fresh water is located on forest lands in the northern Bahamas. In 1996, the Government requested the forestry institution to review the 1987 draft forestry legislation, based on a process of consultation with all stakeholders. The draft legislation was amended to take into account the new environmental conservation ethics in addition to the incorporation of additional areas of hardwood coppice forests into the schedules for reservation purposes. The bill awaits the government’s consideration prior to its presentation to Parliament. Once enacted, the Forestry Law will provide the legal basis for the Forestry Unit to implement the national forest policy and other forestry- 200 related programmes and activities. Currently there are no formalized investments in the forestry sector (FAO, 2008). No information on the research and development efforts in the area of MAPs is currently available from Bahamas.

Trade and Marketing There is no information on MAPs trade in Bahamas.

Constraints and Problems Very little information is available regarding the number and type of species of MAPs available on the islands. Country therefore needs to inventories their natural resources, as well as the traditional knowledge regarding their use in bush medicine. Government support is also required for conservation its valuable MAPs and make people aware of their health as well as economic potential of such plants. Encouragement of the people to cultivate such plants and their sustainable utilization may help the populations in a big way.

201 2.3 Barbados

Barbados is an island country in the West Indies. It lies east of Saint Vincent and the Windward Islands of the Lesser Antilles and approximately 400 km north-east of Venezuela. The island has a total area of 430 square kilometres. Barbados is generally flat but hilly in the interior. Coral deposits from the surface of the island and are underlain by sedimentary rock. Hurricanes occasionally strike the island, sometimes causing extensive damage (FAO, 2008). Residual forested land is limited in Barbados. Recent estimates suggest that forest cover represents about 2% of the area of the island. Tree cover is isolated in gullies, coastal woodlands and undercliff woods. Some of these areas include Welchman Hall Gully, Turners Hall Woods, Hackleton Undercliff Woods, Joes River Forest (a secondary forest) and Newcastle Wood. Turners Hall Woods is described as the least disturbed wooded habitat in Barbados and the best local example of a Tropical Mesophytic forest. In the Wild Plants of Barbados, Carrington states that Turners Hall Woods has long been acknowledged as the most species rich community in Barbados. In addition Hackleton Undercliff Woods has been identified as the site of identification of many native plant species not previously recorded. Pasturelands, gullies, wayside gutters and trenches, abandoned agricultural land and roadsides provide habitats for herbs, shrubs and trees (Peter, 2008).

Traditional Medicine Systems/Phytomedicine Barbadians share a rich tradition with the inhabitants of the other islands in the Caribbean Archipelago of usage of medicinal plants. The usage of medicinal plants can be traced back to the African populations introduced to toil on sugarcane plantations. This heritage knowledge has suffered from isolation in modern times as Barbadians have demonstrated increasing confidence in modern medicine and have moved away from traditional methods of healing. A body of knowledge regarding usage of medicinal plants in Barbados is, however, accessible in rural communities. Evidence indicates that traditional medicine is still practiced in the rural villages for a myriad of ailments including the common cold, arthritis, dermatitis and asthma (Peter, 2008). Alternative health and medicines services used in Barbados include chiropractic, osteopath, acupuncture, massage, spiritual retreats, self improvement, Reiki and reflexology (Anonymous, 2008).

202 Government Efforts in Development of Traditional Medicine/Phytomedicine A collaborative effort “Convention” between the Ministry of Physical Development and Environment, in Barbados, and other stakeholders including scientists, government officials, community officers and residents led to the development of the National Biodiversity Strategy and Action Plan (NBSAP) for Barbados. This document outlines the target areas for strategic planning to mitigate the impact of biodiversity loss and improve the management of natural genetic resources. The medicinal and aromatic plants are given consideration in the NBSAP as a resource of economic and traditional knowledge value (Peter, 2008). There is no other information regarding the government efforts in Barbados for development of traditional medicine in the country at present.

Medicinal and Aromatic Plant Resources The country's naturally occurring plant genetic resources have not been fully documented. The rapid development of the island's sugar industry, led to mass deforestation. The only areas where original vegetation occurs are Turner's Hall woods, Foster Hall Wood and possibly in some of the natural gullies and water courses. Barbados recognizes the existence of a moderate degree of plant biodiversity within the Caribbean sub region in crops used for food, beverages, medicines, marine plants, pest control and industry (FAO, 1996). Some the plant species used for medicinal purposes in the rural communities of Rock Hall, Arch Hall and Black Bess in Barbados and their habitat status are listed in Table 1 (Peter, 2008).

Research and Development Activities Conservation activities are conducted mainly by institutions involved in breeding or other activities. However, there is no national programme and no concerted efforts for conserving plant genetic resources and their natural resources. Surveys of three Barbadian communities were carried out by the Department of Environmental Science, Division of Natural Sciences, Barbados to document their knowledge and practice in the usage of medicinal plants. Investigations of selected plants were subsequently carried out to validate documented usage. The objectives of this study were to assess the scope of use of medicinal plants in each community; identification of commonly used medicinal plants; and selection of species for their bioactivity investigation. The information was gathered on plant species that are used in medicinal preparations (Peter, 2008). The Laboratory of Bioorganic Chemistry, Department of Biological and Chemical Sciences, University of the West Indies, Cave Hill Campus, Barbados has been carrying 203 out work on isolation of chemical constituents and their structure elucidation from plants collected in this country. Some recent papers have been published on work carried out on plants like Caesalpinia pulcherrima (Roach et al., 2003); Leonurus sibiricus (Boalino et al., 2004); and Simarouba amara (Grosvenor et al., 2006).

Trade and Marketing During 2007, Barbados reported botanical exports under HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others), 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum and American storax balsam Liquidambar styraciflua, among many others), 130219 (includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others), and 3301 (that includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils) of 15,219, 139, 160, 27 and 315 kg respectively (ITC, 2008). No other information regarding trade and marketing of MAPs and their products within Barbados is currently available.

Constraints and Problems The MAP species are under threat by developmental activity. A burgeoning tourism sector and the development of golf courses, which requires vast stretches of land, provide the greatest challenge to the conservation of their biodiversity. Lack of awareness by urban communities of the importance of local flora and the potential economic resource presents unique problems to strategic planning for biological conservation. A strategy for the conservation of medicinal plants requires the involvement of communities that practice the use of traditional methods of healing. The research on scientific validation of herbal medicine should be promoted. The traditional knowledge also requires complete documentation and investigation for validation of usage. The programmes aimed at the conservation of the biodiversity of the medicinal plants must be implemented.

204 Table 1: The plant species used for medicinal purposes in the rural communities in Barbados (Peter, 2008) Botanical Name Family Habitat Usage

Aloe barbadensis Mill. Asphodelaceae Coastal (St. Phillip) Home acne, common cold, gardens dermatitis problems

Annona muricata L. Annonaceae Cultivated colds, insect repellent, sedative

Annona squamosa L. Annonaceae Cultivated fainting spells

Argemone mexicana L. Papaveraceae Open disturbed habitats diabetes, diuretic, high blood pressure

Artocarpus altilis Moraceae Widespread diabetes, high blood (Parkinson) Fosberg pressure

Bryophyllum pinnatum Crassulaceae Gully floor and wooded areas common cold, coughs, (Lam.) Oken skin irritations

Carica papaya L. Caricaceae Cultivated constipation

Cordia obliqua Willd. Boraginaceae Wasteland insomnia

Cymbopogon citratus (DC.) Poaceae Cultivated common cold, gastric Stapf problems

Hyptis pectinata (L.) Poit. Lamiaceae Roadside coughs, fever

Leonurus sibiricus L. Lamiaceae High rainfall areas coughs

Momordica charantia L. Cucurbitaceae Waysides common cold, diabetes

Morinda citrifolia L. Rubiaceae Gullies and wasteland anti-inflammatory, common cold

Ocimum basilicum L. Lamiaceae Not common in wild, high blood pressure cultivated, common in home gardens

Opuntia cochenillifera (L.) Cactaceae Cultivated in gardens dandruff, intestinal Mill. problems

Persea americana Mill. Lauraceae Cultivated common cold, insomnia

Petroselinum crispum (Mill.) Apiaceae Cultivated diuretic Nyman ex A. W. Hill

Pimenta racemosa (Mill.) J. Myrtaceae Gullies and cultivated carminative (gas relief) W. Moore

205 Psidium guajava L. Myrtaceae Disused agricultural land, low blood pressure, widely cultivated muscular cramp & ringworm

Pluchea carolinensis (Jacq.) Asteraceae Damp open habitats arthritis G. Don

Tamarindus indica L. Fabaceae Coastal lands, also cultivated asthma, common cold

206 2.4 Belize

Belize covers an area of 22,965 square kilometres along the eastern coast of Central America. It is bounded on the east by Guatemala and on the south by Mexico. A low coastal plain occupies the greater portion of the northern half and eastern fringe of the country. The Maya Mountains, with an average altitude between 300 and 600 m (and a maximum elevation of 1120 m atop Victoria Peak), occupy the south-western half. The principal streams are the Belize River; the Río Azul, which forms much of the boundary with Mexico; and the Sarstún River, which forms the south-western boundary with Guatemala. The climate of Belize is subtropical, moderated by sea breezes along the coast (FAO, 2008). Belize offers one of the most diverse plant life regions in Central America. The rain forests, which are a significant attraction in the growing tourism industry, are essential for the animal life and traditional medicines they provide. The local plants continue to be used for healing (Chanecka, 1998).

Traditional Medicine Systems/Phytomedicine Several types of traditional healers practice in Belize, including birth attendants, bush doctors, granny healers, spiritual healers, and snake doctors. Community health workers act as liaisons between the traditional healers and the district health care system. It is not uncommon for an individual to hold several of these titles. Traditional birth attendants are unlicensed midwives and receive basic training from the Public Health Department to ensure safety and continuity of care for the mother and baby. The majority of traditional birth attendants use herbs and massage. There are usually one or two bush doctors or granny healers in each Mayan village. The knowledge of the uses of plants usually passed down orally through the generations. However, a few bush doctors travel to Guatemala, Honduras, or other villages within Belize for training with renowned healers. Spiritual healers practice as bush doctors (Chanecka, 1998). There is a tradition of magic and ritual in the herbal medicine of the ethnic groups Maya and Garifuna. The herbs whether having a Garifuna, Maya, Creole, East Indian or Mestizo name are utilized across cultures for various ailments and it is not unusual to find many cross-cultural similarities. Traditional healers are for many the primary source of medical care for the community. This was especially true for the population living in areas, which are frequently inaccessible to medical personnel. However, despite the resurgence, the usage of traditional herbal medicine among current generations is declining (Ellis, 2003).

207 Government Efforts in Development of Traditional Medicine/Phytomedicine Approximately 75% of the Belize population has access to relatively good health care services, including hospitals, rural health centers, and mobile clinics. However, about half of those living in rural areas have difficulties accessing the health care system. The government recognizes the importance of the traditional healers in the villages. It respects the knowledge of traditional healers and permits them to practice. Though, traditional healing is not fully integrated into the health care system (Chanecka, 1998). There is no information regarding the institutions, laws, policies etc. for the development of traditional medicine in Belize by the government.

Medicinal and Aromatic Plant Resources A 1998 assessment reported that over 600 of the 3,409 higher plants found in Belize have medicinal use. The issue of conservation of these species has been raised at the local and regional level. Recommendations have been made to revise the procedure for obtaining a Permit to collect medicinal herbs to include specified volume/quantity of various species that can be extracted within an established quota system for threatened species. A list of MAPs identified as threatened by IUCN and the Forest Department is presented in Table 1 (Ellis, 2003).

Research and Development Activities Numerous ethnobotanical studies aimed at identifying new pharmaceutical products have been initiated in recent times with initiatives from governmental agencies and the private sector. Many of these projects are interdisciplinary efforts involving scientists from the fields of anthropology, botany, medicine, pharmacology and chemistry. The Belize Ethnobotany Project links pharmaceutical prospecting with the conservation of traditional medical systems and biological resources. It illustrates the concept of the 'ethno-biomedical reserve' and provides an opportunity for pharmaceutical and herbal industries to contribute to the conservation effort. Terra Nova Rainforest Reserve is an ethno-biomedical reserve in Belize that was given legal status in June of 1993 (Balick, 1994). Belize became a signatory to the Convention on Biodiversity in 1992. The Belize Biodiversity Strategy and Action Plan 1998-2003 outline a comprehensive list of objectives and actions to conserve and use sustainably Belize’s Biological Diversity (Ellis, 2003). These plans address the issue of herbal medicine promotion, utilization and marketing in the following areas:  Conservation Laws and Policy  Human and institutional capacity for the conservation can sustainable use of medicinal plants  Research and monitoring and sustainable use of medicinal plants 208  Information management  Community participation, education and public awareness  Institutional collaboration and coordination In 1993, the Belizean government established the world's first medicinal plant reserve. This 6,000 acre reserve, dedicated to the preservation of potential lifesaving herbs, is called the Terra Nova Medicinal Plant Reserve. The reserve is run by the Belize Association of Traditional Healers (Anonymous, 2008). The original concept of Terra Nova was that it would be a medicinal plant reserve with emphasis on training for traditional healers, research and ecological tourism. Best Enterprise for Sustained Technology (BEST) is the most recent custodian of Terra Nova. Extensive Research has been conducted locally by New York Botanical Gardens. The National Cancer Institute with the assistance of its affiliate Ix Chel Tropical Research conducted in vitro testing for anti-AIDS and anti-cancer activity. One hundred of the most commonly used plants among healers in Belize have been listed in a book co-authored by Dr. Balick and Rosita Arvigo. Daniel Buffington conducted one of the earlier studies of traditional medicine and healers in Belize in 1983. Additional research includes work from local researchers such as Aunt Barbara Fernandez, Medicine Woman, The Herbal Tradition of Belize. Another compilation of herbs of Belize for use by under the guidance of the Research Entomologist of the Government Research Station was also published. These along with A story of Bush Medicine Belizean Herbs and Barks published in 1977 brought the information on herbal medicine to the wider public. Technical research was conducted by the Ministry of Agriculture and Fisheries through its former training institution the Belize College of Agriculture entitled "The environmental requirements of and propagation of some important medicinal plants". This research provided database giving growth conditions required by five medicinal plants. This would enable mass production by providing the characteristics of local herbs. The Conservation Department of the Ministry of Natural Resources has a herbarium with specimens of all the flora of Belize. The upgrading of the classification was a major project of the Forest Planning and Management Project 1995-1999 (Ellis, 2003). Ix Chel Tropical Research Foundation, Cayo District, San Ignacio, Belize in collaboration with institutes in Italy and USA evaluated 21 extracts from the plants Aristolochia trilobata L., Bursera simaruba (L.) Sarg., Guazuma ulmifolia Lam., Hamelia patens Jacq. and Syngonium podophyllum Schott, used in traditional medicine of Belize as wound healers, for anti-bacterial properties (Camporese et al., 2003).

Trade and Marketing The major exporters of herbal medicine are Agapi Herbs and Ix Chel Tropical Research Foundation. Some traditional healers, suppliers/collectors are also involved in the extraction process on a small scale (Ellis, 2003). 209 The mechanisms for exporting of medicinal plants are clearly defined and in place. Rainforest Remedies, a cooperative enterprise makes and markets herbal remedies in liquid form, as well as dried herbs to be used to make medicinal teas. These alternative medicine remedies are sold in most gift shops in Belize. These are also marketed overseas in the Caribbean and in Europe (Anonymous, 2008). The selected botanical exports of Belize during 2007 under the HS code 0902-0910 that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others were 18,704 kg. Under HS codes 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils) the reported export volumes were 35 and 728,595 kg respectively (ITC, 2008).

Constraints and Problems The limitations on the production and commercial exploitation of medicinal and aromatic plants in Belize are the lack of projects involving the use of natural resources, inadequate technical assistance and training; the unpreparedness of local practitioners to negotiate against the exploitation of indigenous knowledge; and the absence of protection from government. There is a need for increased efforts to develop technologies for sustainable utilization of MAPs. There is need for appropriate policy changes in the sectors of health, forestry, agriculture, education and trade in order the production of medicinal plants to be an economically viable venture. Efforts to promote traditional health care in both developing and developed societies must begin by strengthening the pre-existing pathways of healing traditions in the target culture. The rich traditions of information specific to a community are held tenuously in a population of practitioners of whom we know relatively little. The mechanisms by which these traditions were once transmitted from generation to the next no longer exist due to systematic repression of traditional knowledge by colonial administrators, a breakdown of the apprenticeship system, modernization, acculturation and competition from western biomedicine.

210 Table 1: A list of threatened medicinal and aromatic plant species (Ellis, 2003) Botanical name Family Part used Method of harvesting

Aristolochia trilobata L. Aristolochiaceae Vines Cutting of vines

Cedrela odorata L. Meliaceae Bark Stripping

Croton guatemalensis Euphorbiaceae Bark Stripping Lotsy

Dioscorea spp. Dioscoreaceae Swollen The whole swollen base is uprooted and stem removed in one harvest, plant intact, or for the bases to be harvested by the upper part along with the main stem

Myroxylon balsamum (L.) Fabaceae Bark Stripping Harms

Simarouba glauca DC. Simaroubaceae Bark Stripping

Smilax spp. Smilacaceae Swollen As above stem

211 2.5 Canada

Canada is the second largest country in the world and extends across the continent of North America from Newfoundland on the Atlantic coast to British Columbia on the Pacific coast. Canada is slightly larger than the United States, its southern neighbour, but has only about a tenth as many people. Much of Canada is uninhabited or thinly populated due to rugged terrain and a severe climate. Canada occupies an area of 9,970,610 square kilometres, of which 7.6 percent or 755,180 square kilometres is covered by fresh water such as rivers and lakes, including part of the Great Lakes. It is bounded on the north by the Arctic Ocean; on the north-east by Baffin Bay and Davis Strait, which separate it from Greenland; on the east by the Atlantic Ocean; on the south by the United States; and on the west by the Pacific Ocean and Alaska. It extends 4,600 kilometres from its northernmost to its southernmost point and 5,500 kilometres from east to west. Canada has eight major land regions: (1) the Pacific Ranges and Lowlands, (2) the Rocky Mountains, (3) the Arctic Islands, (4) the Interior Plains, (5) the Canadian Shield, (6) the Hudson Bay Lowlands, (7) the St. Lawrence Lowlands, and (8) the Appalachian Region. The Pacific Ranges and Lowlands make up most of British Columbia and the south- western part of the Yukon Territory, including the Queen Charlotte Islands and Vancouver Island. The Coastal Mountains rise along the coast of British Columbia. The glacier-covered St. Elias Mountains in the Yukon include Canada's highest peak, Mount Logan, near the Alaskan border with an elevation of 5,951 m. The coast of British Columbia has many islands and fjords. Except for the valleys and the upper slopes of the mountains, much of this region is heavily forested. Inland from the coast is an area of plains, river valleys, and smaller mountains. The Rocky Mountains are east of the Pacific Ranges and Lowlands. The Arctic Islands lie almost entirely within the Arctic Circle, north of Hudson Bay and between the Beaufort Sea and Davis Strait. They include about a dozen large islands and hundreds of smaller ones. All the islands are barren, and most remain unexplored. Two of the largest islands, Baffin Island and Ellesmere Island, have many glaciers, tall mountains, and deep fjords. Victoria Island and the other western islands are extremely flat. The seas surrounding the islands remain frozen most of the year. The subsoil of the islands is permanently frozen, and only a thin surface layer of soil thaws during the brief, cool summers. The Interior Plains include the north-eastern corner of British Columbia, much of Alberta and Saskatchewan, and the south-western part of Manitoba. The region extends north through the Northwest Territories to the Arctic Ocean. About 1,300 kilometres wide at the US border, it narrows to about one-quarter of that size west of Great Bear Lake and widens again to about 500 kilometres at the mouth of the Mackenzie River on the Arctic Ocean coast. Grasslands form the natural cover of the vast prairies in the southern Interior

212 Plains, although much of it is now farmed. Farther north, evergreen forests form part of the great northern forest that sweeps across Canada from Alaska to the coast of Labrador. Near the Arctic Ocean, the forests gradually give way to tundra that is frozen for more than half the year. Canada has the world’s third-largest forest resource after the Russian Federation and Brazil. Forests cover 245 million hectares, well over two-fifths of its land area; forest area per caput is among the highest in the world. Canadian forests represent more than 10 percent of the world’s forested area. About half of the country’s forest is available for timber harvesting. About 24.5 million hectares are national parks, while provincial parks cover 32.3 million hectares. The forests are extremely diverse, with a total of some 180 tree species. More than 67 percent of the forest cover is composed of conifers, 15 percent broad-leaved species and 18 percent mixed species. Of the approximately 1 million hectares of forest land harvested each year, 53 percent is regenerated naturally, 43 percent is replanted and 4 percent direct- seeded. From 1990 to 2000 there was no change in forested area. The Canadian public owns 94 percent of the nation’s forests. Provincial governments manage 71 percent of Canada’s forests, while 23 percent are under federal jurisdiction. The remaining 6 percent are the property of more than 425,000 private landowners. Forest management is largely a matter of provincial jurisdiction. The federal government’s role in forestry pertains mainly to such areas as science and technology, trade, international affairs, the environment, management of federal lands and aboriginal matters related to forestry. The forest industry is Canada’s largest single employer with the country being world’s largest exporter of timber, pulp and newsprint. Canadian Council of Forest Ministers (CCFM) is seeking the views of Canadians on a new approach to better conservation of forest ecosystems while ensuring the forest sector’s economic prosperity and the well-being of forest-dependent communities. Known as Forest 2020, the initiative is designed to respond to demands for greater emphasis on recreation, resource protection and species at risk. Several issues are being examined to ensure balanced stewardship of the forest resource. For example, discussions are taking place on possible approaches for the intensive management of some forest areas for timber production, the management of other areas for multiple benefits, and ways to increase the conservation value of the forest. Roughly 1 million aboriginal people live in Canada. Approximately 80 percent live in areas covered by boreal forest or temperate rainforests. Their special cultural and spiritual connection with the land and intimate knowledge of the forest and other ecosystems are increasingly recognized, leading to their wider involvement in forest management (FAO, 2008).

213 Traditional Medicine Systems/Phytomedicine Herbal medicine use is widely popular in Canada, in part because of growing interest in health promotion and folk healing in the general population, disenchantment with some biomedical therapies, and public awareness of herbal remedies due to advertising and media reports. Many therapeutic herbs are gathered from their natural habitats; few are widely cultivated (Westfall and Glickman 2004). In Canada, complementary/alternative and traditional medicines are known as natural health products and are subject to food and drug regulations. Natural health products include herbal medicines; traditional Chinese, Ayurvedic, and native North American medicines; homeopathic preparations; and vitamin and mineral supplements. The use of complementary/alternative medicine is increasing in Canada. According to a study by the Fraser Institute, of the Canadians who have used complementary/alternative medicine, 36% have consulted a chiropractor, 23% have used relaxation techniques, 23% massage, 21% prayer, 17% herbal therapies, 12% special diet, 12% folk remedies, 12% acupuncture, 10% yoga, 8% self-help groups, 8% lifestyle diets, and 8% homeopathy. In general, the use of complementary/alternative health care in Canada is higher at younger ages, among women, among people with higher formal education and higher incomes, and in the West. The most common reasons for which patients consult complementary/alternative practitioners are problems of the musculoskeletal system and connective tissue. These complaints account for 56% of consultations. Other problems include respiratory diseases, injuries, poisonings, ill-defined conditions, and special investigations. Complementary/alternative practitioners provide most complementary/alternative treatments. However, allopathic physicians are increasingly involved in the provision of complementary/alternative medicine. There are approximately 4500 chiropractors practising in Canada (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine Canada has no national policy, laws or regulations or national programme on TM/CAM. No national laws or regulations apply to any health disciplines, as power in these areas lies entirely with the provinces and territories. A national office exists, the Natural Health Products Directorate of the Health Product and Food Branch. It was established in 1999, and is administered by the Ministry of Health. The office also serves as the expert committee and national research institute. Regulation of herbal medicines was introduced in Canada in 2003 in separate laws within the Food and Drugs Act. Herbal medicines are regulated as over the counter medicines, self medication, dietary supplements and as natural health products. By law,

214 medical, health, nutrient content and structure/function claims may be made about herbal medicines. No national pharmacopoeia exists. National monographs are in development. In place of a national pharmacopoeia and national monographs, the following materials are used: Compendium of pharmaceuticals and specialties, Canadian drug reference for health professionals, Compendium of non prescription products (CNP), United States pharmacopoeia, Herbal medicines, Expanded Commission E monographs, ESCOP monographs, WHO monographs, Pharmacopoeia of the People’s Republic of China, PDR for herbal medicines, British herbal compendium and British herbal pharmacopoeia. Special GMP rules are required for manufacturing of herbal medicines; these are enforced by submitting to inspection to ensure the granting of a site licence to manufacturers, importers and labellers. To market an herbal product, the manufacturer, importer or labeller must have both a site licence and a product licence. Special requirements for safety assessment include special requirements of traditional use without demonstrated harmful effects and reference to documented scientific research on similar products. Requirements for safety assessment are enforced by the need for a product licence that is conditional on providing satisfactory evidence of compliance with the safety requirements laid down in the regulations. Under the current system of herbal registration, over 10,000 herbal medicines were registered. No herbal medicines are included on an essential drug list. A post marketing surveillance system that includes monitoring of adverse effects of herbal medicines was established in 1965 and is the same as for conventional pharmaceuticals. In Canada, herbal medicines are sold in pharmacies as over the counter medicines, in special outlets, by licensed and unlicensed practitioners and in multi level marketing (WHO, 2005). On January 1, 2004, under Health Canada's Natural Health Products Directorate, the Natural Health Product Regulations came into effect. Previously, natural health products were classified as either foods or drugs under the Food and Drugs Act and Regulations, as there was no separate category under which they could be classified. The regulations include provisions for definitions, product licensing, site licensing, good manufacturing practices, clinical trials, and labelling and packaging requirements. Medicinal herbs play an important role in the natural health product industry. Natural health products include vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines, probiotics, and other products such as amino acids and essential fatty oils (Anonymous, 2008).

215 Regulatory situation Traditional Native North American medicine In the Yukon Territory, the Health Act of 1990 endorses traditional native North American medical practices. The Minister of Health also “promote(s) mutual understanding, knowledge, and respect between providers of health and social services offered within the health and social service system and the providers of aboriginal nutrition and healing”. In Ontario, traditional birth attendants providing midwifery services to aboriginal persons or members of an aboriginal community are exempt from the general rule that restricts “managing labour or conducting the delivery of a baby” to allopathic physicians, nurses, and midwives. Manipulative therapy In at least nine Canadian provinces, special statutes restrict the practice of manipulative therapy to persons who fulfil specific requirements and have been registered and/or licensed. All provinces have laws regulating the practice of chiropractic. Chiropractors have professional status in Alberta. In 1994, Alberta introduced requirements for the continuing education of licensed chiropractors. Practitioners must acquire 75 hours of continuing education every three years as a condition for renewal of their annual licence. In Saskatchewan, the Chiropractic Act of 1994 repeals the 1978 Act on the same subject and prohibits anyone other than a member of the Chiropractors’ Association from using the titles “Chiropractor”, “Doctor of Chiropractic”, or “any word, title or designation, abbreviated or otherwise, to imply that the person is engaged in or qualified to engage in the practice of chiropractic.” Traditional Chinese medicine and acupuncture Health Canada, through the Therapeutic Products Programme, is actively pursuing the National Initiative on Traditional Chinese Medicine. British Columbia, Alberta, and Quebec include acupuncture among their regulated health professions. Saskatchewan and the Yukon Territory have guidelines on the practice of acupuncture. Naturopathy Naturopathy is regulated in Alberta, Manitoba, and Saskatchewan. In each of these three provinces, naturopaths must meet specified educational requirements and be registered in order to practise naturopathy or use the title of “Naturopath”. In all provinces, naturopaths are prohibited from performing certain health care activities, such as the prescription and administration of allopathic drugs, obstetrical practice, and surgery.

216 Education and training Complementary/alternative training programmes are provided by private institutes, universities, and community colleges, but there is no universal system of accrediting and validating programmes. Though there is no standardized complementary/alternative component in allopathic curricula, most medical schools offer some form of training in complementary/alternative medicine to their students of allopathic medicine, but this usually takes the form of a two-hour to four-hour lecture. The 1998 Standing Committee Report states that there is increasing interest in having more training programmes and more standardized training curricula in complementary/alternative medicine for both complementary/alternative and allopathic providers. In 1985, the Institute of Chinese Medicine and Acupuncture was established to promote the training standards of the Chinese Medicine and Acupuncture Association of Canada. Students interested in entering the four-year programme offered by the Institute are required to have first completed three years of coursework in the sciences at a recognized university. There are two chiropractic colleges in Canada recognized by the World Federation of Chiropractic. Coverage of complementary/alternative therapies by provincial health insurance plans and workers’ compensation boards is selective and minimal. Some provincial health insurance plans cover chiropractic (Alberta, British Columbia, Manitoba, Ontario, Saskatchewan, and New Brunswick only for seniors who purchase extended coverage), and one covers naturopathy (British Columbia). Osteopathy is covered in Alberta (WHO, 2001).

Medicinal and Aromatic Plant Resources The medicinal and aromatic plants have a long history of use in Canada. Hundreds of species were used by The First Nations Canadians in traditional medicine. North American ginseng is Canada's most important medicinal crop, while other major crops include Echinacea, Ginkgo, liquorice, and St. John's Wort. Canadian production of medicinal plants is small compared to world production. In Canada, medicinal plants are generally grown on small plots of land due to the large amount of maintenance and highly specialized growing equipment required. Production may also require relatively high capital investment. Although there are a vast number of medicinal plants, few are cultivated commercially on a large scale. The majority of the supply of medicinal plants is collected from the wild (Anonymous, 2008). Canada is the world leader in American ginseng root production (ca. 60%) followed by the US (ca. 30%) and the People’s Republic of China (<10%). Canada’s ginseng production is concentrated mainly in two Provinces, 66% in Ontario (3,600 acres) and 28% in British Columbia (2,000 acres). However, in Canada, wild American ginseng is classified as endangered, and is also listed in Appendix II of the “Convention on International Trade in Endangered Species” as protected. Though currently it is not threatened with extinction 217 but may become so unless trade is closely controlled (ITC, 2002). Canada is also world’s largest producer and exporter of flaxseed (Linum usitatissimum L.). The Alberta Agriculture, Food and Rural Development Crop Diversification Centre South (CDCS) has reported that fenugreek has considerable potential as a new Canadian crop for food, pharmaceutical and industrial uses. Fenugreek cultivation is well suited to Canadian regions. So far, about 140 hectares are planted for seed production in Western Canada. Fenugreek line selections for spice and medicinal qualities are now in progress at the CDCS (ITC, 2004). According to Agriculture and Agri-Food Canada (AAFC), production of smaller area special crops such as herbs and spices, including borage (Borago officinalis), caraway (Carum carvi), coriander (Coriandrum sativum ), fenugreek (Trigonella foenum -graecum), and hemp (Cannabis sativa), is expected to increase over the next decade. Canadian spice crops production is concentrated in Saskatchewan, with smaller amounts produced in Manitoba and Alberta. Ginseng production is concentrated Ontario, with smaller amounts produced in British Columbia. Most Canadian caraway and coriander are exported to the USA, and most Canadian ginseng to China (ITC, 2005). In British Columbia there are more than 50 medicinal plant species that are harvested for the herbal, nutraceutical and pharmaceutical industries. In British Columbia, the harvesting of medicinal forest plants and the gathering of other Non-Timber Forest Products (NTFPs), are currently unregulated. Harvesting is carried out by individual entrepreneurs on both crown and private lands across the province and generally is never reported. Many rare, native, North American medicinal plants, such as wild ginseng (Panax quinquefolium), ladyslipper orchids (Cypripedium spp.), and sundew (Drosera spp.), are so valuable, that demand for harvest, coupled with ecological hypersensitivity, places these plants at serious risk of extinction. In British Columbia, the history of two medicinal forest plants, which have been intensely harvested in the past (cascara and Pacific yew), provides substantial insight into the severity of over-exploitation. In the early part of this century, North American pharmaceutical manufacturers harvested cascara bark (Rhamnus purshiana) for use as a laxative. Initially, bark was harvested from Washington and Oregon. However by 1915, over-harvesting had depleted populations to the extent that pharmaceutical companies began to harvest cascara in British Columbia. By 1958, over-exploitation in B.C. prompted the creation of the interim Cascara Bark Regulation, to conserve remaining populations of this plant (Lantz, 2001). Many therapeutic herbs are gathered from their natural habitats; few are widely cultivated. In addition, some consumers express a preference for ‘wild crafted’ over cultivated herbs. In Canada, there is no formal system of accounting for medicinal plant harvesting, so little is known about which plants are being harvested, from where, and in what quantity (Westfall and Glickman 2004).

218 Research and Development Activities On 11 June 2002 the Canadian government passed Bill C-5, creating the bill known as Species at Risk Act (SARA). The bill was finally proclaimed in 2003. SARA aims to protect endangered and threatened species, to provide an avenue for their recovery, and to “encourage the management of other species to prevent them from becoming at risk”. It is supported by the Committee on the Status of Endangered Wildlife in Canada (COSEWIC), to which any individual can apply to have the status of a species assessed. The effect of SARA on the wild harvesting of medicinal plants may be minimal since currently only two medicinal plants of commercial importance goldenseal (Hydrastis canadensis L.) and American ginseng (Panax quinquefolius L.) are listed as Endangered or Threatened under SARA (Westfall and Glickman 2004). In July 2003, Agriculture and Agri-Food Canada (AAFC) announced plans for conducting an in-depth, national study on the feasibility of developing new crops for Canadian farmers that have potential for health promotion. Some of the herb crops selected for the study include European elder fruit (Sambucus nigra L.) and sea buckthorn fruit (Hippophae rhamnoides L.), among other medicinal herbs (ITC, 2003). In 2005, the University of Guelph have begun a 2-year pilot project, focusing on viability of growing sea buckthorn (Hippophae rhamnoides) in Ontario. The specific focus of research will be economic aspects, from planting to processing, as well as optimal plant varieties, since some types are adapted for machine harvest while others must be hand-picked. The project is funded by The Healing Arc in Kitchener and Agriculture and Agri-Food Canada through the Agricultural Adaptation Council's CanAdapt Program (ITC, 2005a). The Western Canadian Functional Food & Natural Health Product Network (WCFN) has published its “Western Canadian Natural Sources Directory 2007/08,”, an industry directory for herbs, nutraceuticals, functional foods, and natural health products. The directory includes business descriptions and contact details for medicinal plant farms in Canada (ITC, 2007). Some institutions engaged in MAPs research in Canada include Garden River First Nation, Sault Ste. Marie, Ont., Department of Biology, University of Ottawa; Natural Resources Canada, Great Lakes Forestry Centre, Sault Ste. Marie, Ont.; Faculte de Sciences, Universite du Benin, Lome, Togo; Department of Biology, Carleton University, Ottawa, Ont. (Jones et al., 2000); School of Pharmacy, Memorial University of Newfoundland, St. John’s (Loomis et al., 2004); Institut de recherche en biologie vegetale, Jardin botanique de Montreal; and the Department of Pharmacology, Universite de Montreal; and Cree Nation of Mistissini, Que (Leduc, 2006).

Trade and Marketing In Canada, medicinal plants are finding a new, expanding market as herbal components of health foods and preventative medicines, especially under the terms functional foods and nutraceuticals and natural health products. They can be processed 219 into a wide range of products including tablets, capsules, teas, tinctures, creams, oils, and liquids. The most popular herbal remedies tend to be those that address the same ailments as over-the-counter medications such as laxatives, weight-loss remedies, immune system enhancers, anti-aging remedies, and products to relieve anxiety and stress. The medicinal plant over-the-counter industry has experienced reduced sales over the past three years due to bad publicity arising from quality issues. However, the opportunity for increased demand is currently present due to trends such as dissatisfaction with western health care, increasing costs of western health care, cultural, spiritual, and religious needs, interest in returning to a more natural lifestyle, growing public willingness to take responsibility for their own health, and increased acceptance that food has therapeutic value (Anonymous, 2008). Annual market sales based on a market survey of herbal medicines for Canada in 1999 was USD380 million, in 2000 USD400 million and in 2001 USD400 million. In 1999, sales of herbs and vitamins were estimated at 937million Canadian dollars (USD715 million) (WHO, 2005). The selected botanical exports of Canada during 2007 under the HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others), 1210 (includes only hop strobile Humulus lupulus), 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum and American storax balsam Liquidambar styraciflua, among many others), 130219 (Includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others), 140490 (includes botanicals such as broussonetia Broussonetia papyrifera, canaigre Rumex hymenosepalus, oak bark Quercus robur, quebracho bark Aspidosperma quebracho-blanco, quillaja bark Quillaja saponaria, among others), 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils), and 400130 (botanicals such as gutta percha latex Payena spp. and Palaquium gutta, balata Manilkara bidentata, chicle Manilkara zapota, guayule Parthenium argentatum, leche caspi sorva Couma macrocarpa, among other similar natural gums) were 19,310,339; 3,801; 3,590,502; 356,130; 457,431; 1,015,081; 1,727,900; and 2,164 kg respectively (ITC, 2008).

Constraints and Problems Wild medicinal plants are threatened by land clearing and development, logging, and invasive weedy species. The herbal medicine trade add further pressure on these plants. There is little production, marketing, and regulation information available. Canada needs to have an enforceable legislative policy that protects medicinal wild plants from unsustainable harvesting on both public and private land. A monitoring system is also needed for all commercial harvesting of wild plants on both public and private

220 property. In the absence of such a system, it is difficult to estimate how much wild crafted medicinal plant material is produced. The federal government should initiate a policy that encourages the propagation and cultivation of economically important medicinal plant species in order to reduce the harvesting pressure on wild populations and to promote the development of continuous sources of quality controlled medicinal plants. This ought to include, as much as possible, plants that are imported for medicinal use as well as those that are found locally. This would enable agriculturalists to diversify their crop bases, encourage academic research in new crop propagation, cultivation, and breeding, and allow for the reintroduction of cultivated native plants into areas where they are now locally extinct, which would benefit both the economy and the environment .

221 1.6 Costa Rica The Republic of Costa Rica, located in southern Central America, is bounded on the north by Nicaragua, on the east by the Caribbean Sea, on the south-east by Panama, and on the south-west and west by the Pacific Ocean. Cocos Island, about 480 kilometres to the south-west in the Pacific Ocean, is also part of Costa Rica. The total area is 51,100 square kilometres. Most of Costa Rica is rugged highlands, about 900 to 1 800 m above sea level. Several mountain ranges extend nearly the entire length of the country. These include the Cordillera de Talamanca, Cordillera Central, and Cordillera de Guanacaste. The highest peaks are Cerro Chirripó (3819 m) and the active Irazú volcano (3,432 m). A central plateau, the Meseta Central, is located between the ranges and is the country’s main agricultural region. Wide lowlands, much of it swampy tropical jungle, extend along the Caribbean coast. The lowlands along the Pacific are narrower and drier. The climate of Costa Rica ranges from tropical on the coastal plains to temperate and pleasant in the interior highlands. According to the 2011 edition of FAO’s State of the World’s Forests (SOFO), the Costa Rican forest area is 2605 ha with a 51% of land area and an annual change (2000-2010) of 0.9%. Costa Rica has set aside 26.21% of the country for conservation, divided into national parks, biological reserves, wildlife refuges, protected areas, forest reserves, wetlands and others protected lands (this is about 1 339 579 ha of inland area). Regarding protected marine and costal areas, there are about 446 745 ha under this regime (SINAC-MINAE, 2006). Primary forest outside these areas covers about 180,000 hectares, 60% of it concentrated in three areas - the northern, Baja Talamanca and Osa Peninsula zones - and the other 40% scattered over small areas. Planted forests covered about 158,000 hectares in 1999 and the forest industry is coming to depend increasingly on raw materials from these plantations. The deforestation rate in hectares during the years 2000-2005 was estimated as 214 894. This losts was attributed mainly to soil use change from forest to agricultural purposes (GFA Consulting Group, 2010). Costa Rica’s economy is based on tourism and agriculture (bananas, pineapples, coffee, beef, sugar, rice, dairy products, vegetables, fruits, ornamental plants, corn, beans, potatoes and timber. ). The agricultural sector contributes about 6.5% to the gross domestic product. According to official statistics, in the past ten years the forestry sector has contributed 5% to the total agricultural product and about 1% to the gross domestic product. In the new perspective of the 1996 Forest Law and the 1997 regulations, Costa Rica’s forestry policy lays emphasis on forest conservation by encouragement through the creation of the Forest Conservation Certificate

222 system and the National Forest Financing Fund, which establishes rules and procedures for the release, application and control of such certificates. Non- governmental organizations have played a major role in forest resources management in Costa Rica (FAO, 2008).

Traditional Medicine Systems/Phytomedicine There are no associations of traditional medicine practitioners in Costa Rica. Women do not practice traditional medicine. There are at least 19 practitioners practising indigenous traditional medicine. Though the production of traditional medications is regulated, the practice of traditional medicine is ignored in official health laws. There is no registry of traditional health practitioners in Costa Rica. Traditional medicine practitioners are not licensed, nor are they sanctioned for practising medicine. There are no official programmes linking traditional medicine with allopathic medicine (WHO, 2001). The herbal medicines are sold in the country in pharmacies as over the counter medicines and in special outlets without restriction (WHO, 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine In 1996, a multidisciplinary committee composed of representatives from the Ministry of Health and colleges of pharmacy in Costa Rican universities convened to formulate regulations on herbal medicines. In 1998, the committee published Decree 26782S regulating the industrialization, registration, commercialization, and publication of herbal preparations and herbal products (WHO, 2001). A national policy on TM/CAM and a national programme have not been issued and are not currently being developed in Costa Rica. Laws and regulations on TM/CAM currently exist. A national office solely for TM/CAM does not exist; however, the Ministry of Health includes units responsible for the regulation of TM/CAM, including an expert committee that controls and registers products. National institutes of herbal medicines exist at the Escuela de las Ciencias de la Tierra y el Mar (School of Earth and Marine Sciences, National University established in 1980) and Centro de Investigaciones de Productos Naturales (Natural Products Research Centre, CIPRONA, University of Costa Rica, established in 1979). The regulation of herbal medicines involves separate regulations that are partly the same as those for conventional pharmaceuticals and cover the registration, importation, marketing and advertising of herbal medicines. These are not classified in any regulatory category. By law, statements may be

223 made regarding medical, health, nutrient content and structure/function claims; however, medical claims must be supported by the scientific literature. No national pharmacopoeia exists. None is planned, and no others are used instead, the following, among others, are used, although they are not legally binding: Complete German Commission E monographs and WHO monographs on selected medicinal plants. The same GMP rules are required for the manufacture of herbal medicines as are used for conventional pharmaceuticals; compliance with these is guaranteed by means of routine inspections and an initial inspection for permission to begin manufacturing. Special GMP rules are currently being developed especially for herbal medicines. The same requirements for safety assessment apply to herbal medicines as to conventional pharmaceuticals; implementation is ensured by laboratory analysis and user reports and complaints. A total of 359 herbal medicines are registered; there is no national essential drug list. There is a national post marketing surveillance system that includes herbal medicines. In Costa Rica, herbal medicines are sold in pharmacies as over the counter medicines and in special outlets without restriction (WHO, 2005). The College of Physicians and Surgeons recognized homeopathy as a medical speciality in 1994. By a pronouncement of the Sala de Jurisdicción Constitucional of the Supreme Court on 9 January 1998, allopathic medical doctors can be accredited postgraduate homeopathic studies under the Medical Speciality Regulations. Homeopathy is thereby treated as a branch of allopathic medicine and governed by the same regulations as other allopathic specialities. A chiropractic law is pending. There are no institutions officially responsible for teaching traditional medicine. Postgraduate homeopathic studies are available through an institution recognized by the College of Physicians and Surgeons (WHO, 2001).

Medicinal and Aromatic Plant Resources Costa Rica is a relatively small country, but in spite of its size, Costa Rica encompasses twelve ecological zones and contains 5% of all known species (flora and fauna) on earth. The flora of Costa Rica is particularly rich, with over 9,000 species of higher plants (Lynch, 1998). The mountainous Fila Chonta region of Costa Rica has a high species diversity, multiple ecozones, and exquisite variety of ecological niches. It

224 conserves an exceptional wealth of tropical flora. The plant species include many of the trees common in the tropical canopy, caryocar, cecropia, costus, ficus, acacia virola, and lesser known medicinal plants such as Hamelia patens Jacq., which is antibacterial and antifungal, and Psidium guajava L., the common guava, the leaves of which when infused display the same properties. Despite the rigors of the higher elevations, much of the area is accessible to field botanists escorted by native guides. Rainmaker Mountain is an example of a privately held area that may be available for useful germplasm conservation in the future (McKeown, 1996). The plants like Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson and Tagetes lucida Cav. (syn. T. florida Sweet, T. schiedeana Less.) are also cultivated commercially in Costa Rica as a spice herb (Ciccio, 2004; Ciccio and Ocampo, 2006). A small company, Bougainvillea, S.A, has developed three important activities in Costa Rica regarding MAPs: a) training in management and conservation of the natural resources of the humid tropical zone, with emphasis on native plants which are used in the wild condition for commercial purposes; b) domestication (cultivation) of resources from this area, acting as an agro-ecological model, with the purpose of attaining an industrial production for biopesticides and dyes, as well as natural extracts for the preparation of phytopharmaceuticals; and c) the development of and agro-ecological garden of medicinal plants. This group has underway studies for the domestication of crajirú or bejuco fierro (“iron vine”, Arrabidaea chica), an important natural colorant of ancestral use by the indigenous people in the American continent; Sarsaparilla (Smilax chiriquensis), of wide use in America and Europe; Cuculmeca (“American gingseng”) (Smilax dominguensis), a plant traditionally used as energizer; escalera de mono (“monkey´s ladder”, Bauhinia guianensis); Aceituno (Simarouba glauca); Anamú, or zorrillo (garlic weed, conga-root, Petiveria alliacea); juanilama (colic mint, Lippia alba); pichichío (bachelor´s pear, love apple, Solanum mammosum); hombrón (“huge man”, Dracontium gigas); cat´s claw, Uncaria guianensis.

No more information is available concerning the cultivation and harvesting of MAPs from their natural resources. However, there is a growing group of private initiatives and ONG that have joint efforts to create several medicinal plant gardens with the purposes of conservation and eco- and rural tourism around the country. Some of the commercially important MAPs of Costa Rica are listed in Table 1.

225 Research and Development Activities Some studies on MAPs in the country have been reported from various institutes in the country. The scientists at Instituto de Investigación en Ciencias Farmacéuticas (INIFAR), Facultad de Farmacia, Universidad de Costa Rica, San José Costa Rica studied the anti-inflammatory properties of Chaptalia nutans (L.) Pol., Loasa speciosa Donn. Sm., Loasa triphylla Juss., Urtica baccifera L. and Urtica leptophylla Kunth. Aqueous extracts of each plant were made according to the ethnobotanical use (Badilla et al., 1999). Research studies on MAPs have been reported by the Centro de Investigación en Productos Naturales (CIPRONA), Universidad de Costa Rica. This centre studied several biological activities of MAPS and its chemical composition. For example the antifeedant activity of a plant extract (common rue, Ruta chalepensis L.) and a semi purified fraction (from "tacaco cimarrón", Sechium pittieri (Cogn.) C. Jeffrey) (Mancebo et al., 2001). In another study, the plant Croton draco Schltdl. from Guadalupe, San José, Costa Rica was collected in July 1992 and phytochemically studied (leaves, seeds, wood, bark, sap and flowers separately). Commonly known compounds were obtained and further studied (Murillo et al., 2001). The work on the comparison of the essential oil from leaves and spikes of Piper friedrichsthalii C. DC. from Costa Rica and Panama and on the composition of the leaves’ essential oil of P. pseudolindenii C. DC. from Costa Rica was reported from Centro de Investigaciones en Productos Naturales (CIPRONA) and Escuela de Química, Universidad de Costa Rica in collaboration with institutes in France, Panama and Spain (Vila et al., 2003). For complete details of these studies please see a cited list of publication from CIPRONA regarding MAPs (CIPRONA 2006 - 2010). Costa Rica's National Institute of Biodiversity INBio (Instituto Nacional de Biodiversidad) is a non-profit governmental organization in Costa Rica, established in 1989 to promote awareness of the value of biodiversity and thereby through conservation efforts, improve the quality of life for Costa Ricans. In September, 1991 Merck & Co. (the world’s largest pharmaceutical company) and INBio made an agreement under which Merck will pay INBio 1 million dollars for all the plant, insect and soil samples that INBio could collect in addition to equally splitting any royalties Merck obtained from developing drugs from those samples. As a result of the Merck-INBio agreement, INBio was allowed to collect samples on national lands, including those of eight indigenous tribes. Projects related to phytomedicinal prospecting and screening plants for biological activity were undertaken by INBio, who will be cataloguing all species of plants and animals in the country (Bosze, 2000).

226 Lisanatura (http://www.lisanatura.com/) is a branch of a Costa Rican pharmaceutical company (Laboratorios Lisan) which has two registered herbal medicines derived from Quassia amara (Cuassia®) and Justicia pectoralis (Estilo®). These two are one of the first products on that line registered in Costa Rica.

Trade and Marketing Comex, the Ministry of Foreign Commerce through PROCOMER (Foreign Commerce Promoter of Costa Rica (http://www.procomer.com/contenido/), has registered the export (in thousands of US dollar) of goods like ipecac root, curcuma, orange essential oils to different parts of the world in their data base since 1998. No information of other MAPs exports is currently available.

Constraints and Problems The conservation, research, trade development, quality control and utilization of MAPs and their products are the areas that need government’s attention and support to derive the commercial and health benefits from country’s natural resources of such plants.

REFERENCES Badilla, B., Cambronero, J., Cicció, J. F., Cordero, T., Mora, G. A., “Determination of topical anti-inflammatory activity of the essential oil and extracts of Lippia alba (Mill.) N. E. Brown (Verbenaceae), using the model of mouse ear edema induced by TPA and AA”. Pharmacognosy Magazine 3, 139-144, 2007 Badilla, B., Mora, G. and Poveda, L. J., 1999, Anti-inflammatory activity of aqueous extracts of five Costa Rican medicinal plants in Sprague-Dawley rats. Rev Biol Trop., 47(4): 723-727 Bok, J. W., Hoffmeister, D.; Maggio-Hall, L. A., Murillo, R.; Glasner, J. D., Keller, N.P. “Genomic mining for Aspergillus natural products”, Chem. Biol. 13, 31-37, 2006 Bosze, S., 2000, Medicinal Plants in the Rainforest: Effects on Biodiversity and Indigenous Peoples. Available at: http://jrscience.wcp.muohio.edu/FieldCourses00/PapersCostaRicaArticles /MedicinalPlantsintheRainfA.html (22 Aug. 2008) Chaverri, C., Cicció, J. F., “Essential Oils from Ocotea austinii C. K. Allen (Lauraceae) from Costa Rica”, J. Essent. Oil Res. 19, 439-443, 2007

227 Chaverri C., Cicció J. F. and Díaz C. “Chemical composition of Aiouea costaricensis (Lauraceae) essential oils from Costa Rica and their cytotoxic activity on cell lines”, J. Essent. Oil Res. 2010, 22, 524-529 Cicció, J. F., 2004, A source of almost pure methyl chavicol: volatile oil from the aerial parts of Tagetes lucida (Asteraceae) cultivated in Costa Rica. Rev. Biol. Trop. (Int. J. Trop. Biol. ISSN-0034-7744), 52 (4): 853-857 Cicció, J. F. and Gómez-Laurito, J., “Volatile constituents of the fruits of Siparuna thecaphora (Siparunaceae) from Costa Rica”, J. Essent. Oil Res. 2010, 22, 328-330 Cicció, J. F. and Ocampo, R. A., 2006, Variación anual de la composición química del aceite esencial de Lippia alba (Verbenaceae) cultivada en Costa Rica. Lankesteriana, 6 (3): 147-152 Cicció, J. F., Ocampo, R., Ryan, P., “Quassia amara L. (Simaroubaceae)”, In Cáceres, A. (Ed.). Propuesta de monografías farmacopeicas de 10 plantas medicinales Centroamericanas. (Proyecto Desarrollo de Tecnología de cultivo de plantas medicinales y producción de fitoterápicos (OEA/AICD/AE-089/05), Guatemala, 74-80, 2006 Cicció, J. F., Chaverri, C., Díaz, C., Volatile compounds of Nectandra salicina (Lauraceae) from Costa Rica and their cytotoxic activity on cell lines. Quimica Nova 32, 417-420, 2009 Cicció, J. F., Chaverri, C., “Volatile constituents of the oils from Povedadaphne quadriporata (Lauraceae) from "Alberto M. Brenes" Biological Preserve, Costa Rica”, Química Nova 31, 605-609, 2008 CIPRONA 2006 -2010: Sonia Lagos-Witte & Danna Leaman (eds.) “La experiencia TRAMIL en Centroamérica y Caribe: Una contribución multidisciplinaria al estudio, uso y conservación de la diversidad de plantas medicinales”, 2006 Daum, M., Schnell, H.-J., Herrmann, S., Gunther, Murillo A. R., Rolf M "Functions of Genes and Enzymes Involved in Phenalinolactone Biosynthesis", ChemBioChem ., 11, 1383, 2010 Díaz, R., Hernández, L., Ocampo, R., Cicció, J. F., “Domesticación y fitoquímica de Quassia amara (Simaroubaceae) en el trópico húmedo de Costa Rica, Lankesteriana 6, 49-64, 2006 Díaz, C., Quesada, S., Brenes, O., Aguilar, G., Cicció, J. F., “Chemical composition of Schinus molle essential oil and its cytotoxic activity on tumour cell lines”, Natural Products Research 22, 1521-1534, 2008 Doyle, B. J., Locklear, T. D., Pérez Sánchez, A. L., Brenes, J. C., Jorge Laurito- Gómez, J., and Mahady, G. B., “Natural therapies from Costa Rica for the

228 management of menopause: Estrogenic activity in the in vitro ER-CALUX reporter gene assay”, FASEB J., 21, 572.2, 2007 Doyle, B. J., Frasor, J., Bellows Lauren, E., Locklear, T. D., Pérez Sánchez, A. L., Gómez-Laurito, J., Mahady G. B., “Estrogenic effects of herbal medicines from Costa Rica used for the management of menopausal symptoms”, Menopause 16, 748-55, 2009 Dupuy, O. A., Murillo, R., Bonilla, J. A., “Actividad supresora del millerólido sobre células de sangre periférica humana”, Rev. Med. Chile 135, 1429, 2007 Dupuy, O., Murillo, R., Bonilla, J., “Actividad supresora del millerenólido sobre células mononucleares de sangre periférica humana”, Revista Médica de Chile, 136, 64-72, 2008 Durr, C., Schnell, H. J., Luzhetskyy, A., Murillo, R., Weber, M., Welzel, K., Vente, A., Bechthold, A. “Biosynthesis of the terpene phenalinolactone in Streptomyces sp. Tu6071: analysis of the gene cluster and generatios of derivatives”, Chem. Biol. 13, 365-377, 2006 FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Flores, G., Hilje, L., Mora, G. A., Carballo, M., “Antifeedant activity of botanical crude extracts and their fractions on Bemisia tabaci (Homoptera: Aleyrodidae) adults: I. Gliricidia sepium (Fabaceae)”, Rev. Biol. Trop., 56, 2099-2113, 2008Flores, G., Hilje, L., Mora, G. A., Carballo, M., “Antifeedant activity of botanical crude extracts and their fractions on Bemisia tabaci (Homoptera: Aleyrodidae) adults: III. Quassia amara (Simaroubaceae)”, Rev. Biol. Trop. 56, 2131-2146, 2008 Flores, G., Hilje, L., Mora, G. A., Carballo, M., “Antifeedant activity of botanical crude extracts and their fractions on Bemisia tabaci (Homoptera: Aleyrodidae) adults: II. Sechium pittieri (Cucurbitaceae)”, Rev. Biol. Trop. 56, 2115-2129, 2008 GFA Consulting Group, S.A., “Estudio del estado de la producción sostenible y propuesta de mecanismos permanentes para el fomento de la producción sostenible”. Consultoría SP-12-2009, Infrome final noviembre 2009-abril 2010 Grassl, G. A., Fessele, S., Merfort, I., Lindenmeyer, M. T., Castro, V., Murillo R., Nelson, P. J., Autenrieth, I. B., “Sesquiterpene Lactones Inhibit Yersinia invasin protein-induced IL-8 and MCP-1 production in epithelial cells”, Int. J. Med. Microbiol., 295, 531-538, 2006 Hernández, L., Chaverri, C., Cicció, J. F., “Aceites esenciales de Persea povedae W. C. Burguer (Lauraceae) de Costa Rica”, Ing. Cienc. Quím. 22 , 74-80, 2006

229 Hernández, L., Chaverri, C., Cicció, J.F., “Constituyentes volátiles de Ocotea sinuata (mez) Rohwer (Lauraceae) de Costa Rica”, Ing. Cienc. Quim. 23, 17-26, 2008 Kos, O., Castro, V., Murillo, R., Poveda, L., Merfort, I. “Ent-kaurane glycosides and sesquiterpene lactones of the hirsutinolide type from Vernonia triflosculosa”, Phythochemistry, 67, 62-69, 2006 Lindenmeyer, M.T., Hrenn, A., Kern, C., Castro, V., Murillo, R., Muller, S., Laufer, S., Schulte-Monting, J., Siedle, B., Merfort, I. “Sesquiterpene lactones as inhibitors of IL-8 expression in HeLa cells”, Bioorg. Med. Chem. 14, 2487-2497, 2006 Locklear, T. D., Doyle, B. J.; Huang, Y., Pérez, A. L., Cáceres, A., Mahady, G. B. “Menopause, A Universal Female Experience: Lessons from Mexico and Central America”, Current Women’s Health Reviews, 4, 3, 2008 Locklear, T. D., Doyle, B. J., Pérez Sánchez, A. L., Laurito-Gómez, J., Brenes, J. C., Huang, Y., and Mahady, G. B., “Alternative therapies from Costa Rica for the management of PMS and dysmenorrhea: Justicia pectoralis Jacq.: mechanisms of action”, FASEB J. 21, 572.1, 2007 Locklear, T.D., Huang, Y., Frasor, J., Doyle, B. J., Pérez Sánchez, A. L., Gómez-Laurito, J., Mahady, G. B., “Estrogenic and Progestagenic effects of Justicia pectoralis Jacq., an herbal medicine from Costa Rica used for the treatment of Menopause and PMS”, Maturitas 66, 315-322, 2010 López-Anton, N., Hermann, C., Murillo, R., Merfort, I., Wanner, G., Vollmar, A.M., Dirsch, V.M., “Sesquiterpene Lactones Induce Distinct Forms Of Cell Death That modulate human monocyte-derived macrophage responses”, Apoptosis 12, 141-153, 2007 Lynch, S., 1998, Traditional medicinal plant use in modern Quepoan society. Available at: http://www4.ncsu.edu/~twallace/Lynch.PDF (21 Aug. 2008) Mahady, G. B., Pérez Sánchez, A. L., Cáceres, A., Locklear, T. D., Doyle, B., Michel, J., “Menopause in Central America: Attitudes, Symptoms and Treatment”, Maturitas 63 Supplement 1, Page S112, 2009 Mancebo, F., Hilje, L., Mora, G. A., Castro, V. H. and Salazar, R., 2001, Biological activity of Ruta chalepensis (Rutaceae) and Sechium pittieri (Cucurbitaceae) extracts on Hypsipyla grandella (Lepidoptera: Pyralidae) larvae. Rev Biol Trop., 49(2): 501-508 McKeown, K. 1996. Germplasm conservation of neotropical medicinal plants and a workshop on Fila Chonta in Costa Rica. Acta Hort. (ISHS), 426: 133- 138 Michel, J. L., Chen, Y., Zhang, H., Huang, Y., Krunic, A., Orjala, J., Veliz, M., Soni, K.K., Soejarto, D.D., Cáceres, A., Pérez Sánchez, A. L., Mahady, G. 230 B., "Estrogenic and serotonergic butenolides from the leaves of Piper hispidum Swingle (Piperaceae)", J. Ethnophar, 129, 220-226, 2010 Montero Villegas, S., Cicció Alberti, F., Cortés Bratti, X., Crespo, R., Polo, M., García de Bravo, M., Effect of a chemotype of Lippia alba from Costa Rica on cellular growth and lipid metabolism. SAIB. 45th Annual Meeting Argentine Society for Biochemistry and Molecular Biology. San Miguel de Tucumán, Argentina, November, (BIOCELL, 2009. Vol.33 Suppl., 88), 2009 Murillo, R., Castro, V., Araya, J.J., Nueva metil-coumarina de Chaptalia nutans, Ing. Cien. Quím. , 2007 Murillo, R., Castro, V., Chavarría, M., Poveda, L., “Lignanos de Phenax sonneratii”, Ing. Cien. Quím. 22, 12-18, 2006 Murillo, R., Castro, V., Chavarría, M., Poveda, L., Lignanos de Zanthoxylum acuminatum. Ciencia y Tecnología 24, 227-232, 2007 Murillo, R., Castro, V., Chavarría, M.; Poveda, L., Un nuevo estudio fotoquímico de la Amyris brenesii. Tecnología y Ciencia Química. 24, 2007 Murillo, R. M., Jakupovic, J., Rivera, J. and Castro, V. H., 2001, Diterpenes and other constituents from Croton draco (Euphorbiaceae). Rev Biol Trop., 49(1): 259-264 Quintão, N. L. M., da Silva, G. F., Antonialli, C. S., Rocha, L. W., Cechinell- Filho, V., and Cicció, J. F., Chemical composition and evaluation of the anti-hypernociceptive effect of the essential oil extracted from the leaves of Ugni myricoides on inflammatory and neuropathic models of pain in mice. Planta Medica 76, 1411-1418, 2010 Ricciardi, G., Cicció, J. F., Ocampo, R., Lorenzo, D. Ricciardi, A., Bandoni, A. and Dellacassa, E., Chemical Variability of Essential Oils of Lippia alba (Miller) N. E. Brown Growing in Costa Rica and Argentina. Natural Product Communications 4 (6), 853-858, 2009 SINAC-MINAE. 2006. Informe Nacional sobre el Sistema de Áreas Silvestres Protegidas.Abril, 2005. Gerencia de Áreas Silvestres Protegidas. Sistema Nacional de Áreas de Conservación. Ministerio del Ambiente y Energía. San José, Costa Rica. 96 p. Taylor, P. 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231 Wagner, S., Arce Cordoba, R., Murillo, R., Terfloth, L., Gasteiger, J., Merfort, I., “Neural Networks As Valuable Tools To Differentiate Between Sesquiterpene Lactones’ inhibitory activity on serotonin release and on NF- B”, J. Med. Chem. 51, 1324-1332, 2008 WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

Table 1: Some commercially significant MAPs of Costa Rica Botanical name Family Common name Aloe barbadensis Miller. Xanthorrhoeaceae Sábila Justicia pectoralis Jacq. Acanthaceae Tilo Lippia alba (Mill.) N.E. Br. Verbenaceae Juanilama Lippia graveolens Kunth Verbenaceae Ruda Matricaria recutita L. Asteraceae Manzanilla Quassia amara L. Simaroubaceae Hombre grande Senna reticulata L. Leguminosae Saragundi Psychotria ipecacuanha (Brotero) Stokes Rubiaceae Raicilla

232 2.7 Cuba

Cuba is the largest island in the Caribbean. Its territory covers 110,860 square kilometers. It forms, along with numerous adjacent islands and cays, the Republic of Cuba. Approximately two-thirds of Cuba consists of plains or rolling lands with low elevation. The rest of the territory is formed by three groups of mountains, where most of the remaining natural forests occur. In Cuba there are five mountain ranges that due to their importance have received differentiated attention: Guaniguanico, at north of Pinar del Rio Province; Bamburanao Guamuhaya, located along Villa Clara, Cienfuegos and Sancti Spiritus provinces; Sierra Maestra, covering southern coast of Granma, Santiago de Cuba and Guantanamo provinces; and Nipe-Sagua-Baracoa, which occupies an important part of the provinces of Santiago de Cuba, Guantanamo and Holguin. This entire mountain ecosystem covers a total area of 18,208 km2 (National Office of Statistics, 2008).

The Cordillera de Guaniguanico lies in both, Pinar del Rio and a small portion of Havana province. It includes two main blocks: Sierra de los Organos and Sierra del Rosario. Northeast of the Sierra del Rosario is the highest elevation of this Cordillera, known as the Pan de Guajaibón, with 627 m altitude (National Commission of Geographical Names of Cuba, 2000). The mountain range Guamuhaya lies in the southeastern part of central Cuba, in Villa Clara and Sancti Spiritus provinces. It is composed of two mountain cores: the mountains of Trinidad (west) and the mountains of Sancti Spiritus (East). The Pico San Juan or La Cuca (1,140 m) represents the highest point of Trinidad mountains, while the higher peak in Sancti Spiritus Mountains (842 m) is at the Banao hill. The mountain range of Sierra Maestra is located south of Granma, Santiago de Cuba and Guantanamo provinces, spanning the southern part of the western and central portion of eastern Cuba. The topography is characterized by its youth, with the formation of several steps of low mountains (800-1 200 m) and middle mountains (up to 2 000 m), where the highest point is reached at Pico Real del Turquino (1,972 m), which represent the highest peak of Cuba (National Commission of Geographical Names of Cuba, 2000). The mountain group Nipe-Sagua-Baracoa is located at the northwest of the east of the country, dominated by medium mountains, low mountains, small mountains, and pre-to a lesser extent the tectonic-lithological heights, where maximum height is at the Pico Cristal (1,231 m) in the Sierra de Cristal (Acevedo, 1992; Viña et al., 1998; IGACC-ICGC (1989a).

233 Cuba is near the Tropic of Cancer, and has a seasonally wet tropical climate with marine and semi-continental influences (Centelles et al., 1997). The trade winds moderate the climate throughout the year (Centro del Clima, 2007; Voluntad Hidráulica, 2006; Capote et al., 1989).

It should be noticed that climate has changed in Cuba since the early 70s. Overall, we are seeing an expansion of summer and a contraction of winter length. On the other hand, the rainfall behavior has showed significant increases in drought periods since 1960. The annual average in coastal regions can vary between 1,000 and 1 200 mm, while in most flat and rolling zones is close to 1,400 and 1,600 mm.

The original vegetation cover in Cuba has been estimated between 70-80%, mainly represented by semideciduous and evergreen forests. Until 1812, there were still 90% of original forests (IGACC-ICGC, 1989b). The forested area has been steadily rising since the year 1959, reaching 25.26% of the total land area in 2007.

The areas that still have the major natural-biotic resources, showing highly naturals and representative ecosystems and landscapes, are accounting up to 14% of the country. These are characterized by a lower degree of transformation due to its inaccessibility, and are found primarily in the mountain ranges, swamps and wetlands (CNAP, 2002; Melander, 2007), where most of the major country forest areas are found.

Most of the forests in Cuba belong to State companies, while a smaller number belong to the cooperative and private sectors (FAO, 2002). The forests at present, occupy 2.35 million hectares (21.4% of the country’s total land area). Natural forests represent 81% of the total forest cover and 61.2% of the forest heritage. All forest heritage land, whether or not it has forest cover, is divided into seven established categories of forest: national park forests, recreation forests, wildlife protection and conservation forests, nature reserves, soil and water conservation forests, coastal protection forests, and production forests. In terms of the volumes produced and services currently provided, Cuba’s forestry sector accounts for only 0.6% of the country’s gross domestic product and an average of 8.5% of agricultural, hunting, forestry and fishery activities in the past two years. These low figures are mainly a result of the fall in forest production since 1990. Although it has been recovered since 1994, it is still insufficient.

234 The forests are managed according to their functions and geographical location, and are classified on the basis of a set of elements of physical, biological, ecological, and social and economic development. a) Forest production: Its main function is to meet the needs of the national economy of timber and non timber products, through its development and rational use. b) Protection forests: Those whose surface should be preserved permanently to protect the renewable resources associated to them, but avoiding its damage may be subjected to productive activities prevailing in its reproductive role. c) Forest conservation: By its nature and location serve to preserve and protect natural resources, including those intended for scientific research, ornamental and protective action of the environment. These forests must be maintained constantly, logging is not allowed, but only minor logging oriented to strength its main function and the production of secondary products.

The “Forestry Programme to 2015”, approved by the Government, intends to use up to 500 000 ha of lands for new plantations, looking to raise the forested area to about 27% of the national territory and thus, the areas devoted to planting will over one million hectares, representing the ultimate goal.

Economic activities, both in terms of forestry initiatives and forest resources harvesting, are basically carried out by specialized State forestry enterprises, other farming and livestock enterprises of the Ministry of Agriculture and other bodies and the private sector (FAO, 2002).

Traditional Medicine Systems/Phytomedicine Since pre-Colombian times there exist records on the knowledge and use of plants among aboriginal Cubans: in medicine, nutrition, religion and construction. Thereafter, with the arrival of Europeans, Africans and Asians to the island the use of plants diversified. This cultural heritage has survived until recent times and has been transferred orally from one generation to another. One reflection of this traditional knowledge is the “yerberias”, establishments where plants and their derivatives are sold, which can be found throughout the country. In Havana City there are 50 “yerberias”, and at least 10 more according to local collaborators, where the population can find plants for medicinal and/or ritual use (Melander, 2007). Among the trees of our forests,

235 with many popular applications, from which many myths and legends were woven, is Akoko or Ceiba (Ceiba pentandra (L.) Gaertn). It is known for its beauty, and considered a sacred tree for Afro-Cuban religions. The Atori (Trichilia havanensis Jacq.), popularly known as Siguaraya, is a tree highly valued by the population, especially its religious use and catchy name, exploit their properties to combat skin diseases a decoction of the leaves is used. A decoction of the root is useful for albuminuria, the fruit juice diluted in alcohol is helpful in arthritic inflammation, and pain associated rheumatism. Yaba (Andira inermis L.), is a wild tree with some medicinal properties, containing active principle andirine, a known anthelmintic agent (Pérez de los Reyes,2009).

The lack of imported conventional medicines meant that green medicines also became important in the 1990s. Despite the growth of use of modern medicines, and the development of the public health system, Cubans, particularly those living in the countryside, have always used medicinal plants. During the economic crisis their use was reassessed (Wezel, 2003). Cuban officials estimate that 52% of all medical treatment in Cuba is with traditional natural medicine. In the year 2002 alone, more than 26 million applications of traditional medicine have been documented, including over 9 million prescriptions of herbal medicine, nearly 4 million applications of acupuncture and related modalities, almost a half-million uses of muds and medicinal waters and over 13,000 uses of acupuncture for general anaesthesia and tooth extractions (Kondwani, 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine Cuba has a history of using native plants as medicines. In the 1960s doctors in Cuba began to practice acupuncture; however, until the late 1980s, when the Ministry of Public Health (MINSAP) established the first plan to develop Natural and Traditional Medicine (known in Cuba as “Medicina Tradicional y Natural” or MTN), both medicinal plants and eastern modalities were used in an individual and isolated manner. This initial plan had various positive outcomes, chiefly with regards to the scientific study of herbal medicines and their expanded cultivation. The economic crisis in the early 1990s, due to the imposition of the Soviet Union and the strengthening of the US economic blockade against Cuba began to negatively affect Cuba's National Health System. MTN was one of the areas targeted for rapid expansion to meet this challenge. In 1995, the National Health System was directed to integrate MTN into the health system, and by the late 1990s, the National Program for the Development and Generalization of the Traditional and Natural Medicine was established. The general aim of the National Program is to provide the bases for the full integration of MTN 236 throughout the country to improve the quality of medical attention offered to the population and the satisfaction of the population with those services. The four areas listed in the plan for development include empowering human resources; research; organization of MTN into the network of the National Health System; and production, storage and sale of MTN products and supplies. In 1991, the Ministry of Agriculture (MINAGRI) in coordination with the Ministry of Public Health constituted a plan for cultivation of medicinal plants across the country. MINAGRI created a national company with 15 provincial extensions, dealing with sowing, harvesting and drying of medicinal herbs. There is also a national plan of the Ministry of Public Health for securing material for the production of drugs from medicinal plants that includes the need for equipment, accessories, laboratory equipment and so on. The main production of herbal medicines is carried out by local industries, which is done in accordance with the standards of specifications for raw drugs, extracts and tinctures. There are 80 local production sites, of which 51 are dedicated to these preparations and to control the quality of these products, 17 laboratories are distributed throughout the country. The preparation of herbal medicines at the dispensary is conducted in 479 community pharmacies out of total the 1 760 pharmacies existing in the country. There are 167 hospital pharmacies with clinics, of which 136 produced herbal medicines. Since 1992, the Public Health Ministry has approved 233 phytopharmaceutical and 15 apipharmaceutical products described in the Therapeutics and Dispensarial Guideline for Herbal Medicine and Apipharmaceuticals, published in 1992 by the Center for Pharmaceuticals Research and Development and the Cuban National Formulary. In 2002, the Agreement No. 4282 of the Executive Committee of the Council of Ministers was adopted. This agreement established a set of measures, among which is the creation of the National Centre for the Development of MTN, rector of all program activities in the country (MINSAP, 2007).

MTN is part of the curriculum at all medical schools and is a medical specialization that students can choose to pursue after finishing their studies. The push to integrate MTN has provided new sources of employment in areas such as the cultivation, production and distribution of herbal medicines, the training of people who, in turn, train others as herbalists, acupuncturists, etc. and in the production and distribution of educational materials (Anonymous, 2004). Statistics from the Ministry of Public Health of Cuba reported that at the end of 2002, over 70% of professionals have received basic training in MTN (Padrón y Pérez, 2002).

237 In 1992, the Ministry of Health officially recognized homeopathy. Homeopathic dispensaries are spread all over the country. Standard good manufacturing practice for the manufacture of homeopathic remedies has been accepted. In 1992, acupuncture was integrated into the Cuban health care system. In 1995, the Traditional Medicine Programme was instituted (MINSAP, 1995; Padrón y Pérez, 2002; MINSAP, 2007), prioritizing the cultivation of medicinal plants, the education of practitioners, research in traditional medicine, and the integration of traditional medicine into the national health care system. Courses on introductory and advanced homeopathy are given at the medical and pharmaceutical schools (WHO, 2001). The volume of production of herbal and apipharmaceuticals from local production centers and clinics has increased; in 1994 totaled 21.1 million items while in 1997 over 22 million units were developed (Soler and Porto, 1997). Between 1995 and 2002 there were 342 million bottles of natural products, which meant a saving of 17 million U.S. dollars by import substitution concept of raw materials, and 334 million pesos from public retail (Padrón y Pérez, 2002).

Considering the services provided by MTN specialized centers, national statistics for 2002 showed the following data:

 26,268,035 MTN applications, of which deserve special mention:

 9,089,145 prescriptions of herbal medicine and hive-derived products

 3,857,517 applications of acupuncture and related forms

 464,844 treatments with mud and mineral waters

 569 surgeries with acupuncture analgesia

 12,456 dental extractions with acupuncture, homeopathy and hypnosis In 2003, MTN made up 50% of patient visits and was used in 25% of hospital visits and 22% of emergency visits. MTN is now used in 29.4% of dental visits; 8.7% of surgeries use some acupuncture anaesthesia, with 4.6% only using acupuncture anaesthesia. The United Nations selected Cuba's Program for the Development of Natural and Traditional Medicine as one of the five most important programs worldwide (Anonymous, 2004). On the other hand, the screening of Adverse Drug Reactions (ADRs) caused by the use of natural and traditional medicine (MNT) has been incorporated as a priority

238 task by the National Coordinating Unit of Pharmaco-vigilance since 2001, which recognized that its coverage is still insufficient (Avila et al., 2007).

Cuba has shown that MTN can be integrated into the health system at any level of geographic aggregation or population stratum, and can be done both at local and national level as shown in Figure 1. Currently, the functions of the National Center moved to the Department of Pharmacy of the Ministry of Public Health.

Medicinal and Aromatic Plant Resources Cuba, hosts 7,020 taxa of vascular plants with 50% being endemic. However, only 20% of the total flora has been evaluated (Melander, 2007). It is estimated that about 16% of the species conforming the Cuban flora are in a state of severe threat of extinction, and about 2% have disappeared. A total of 1 174 species lie in different categories of threats (Vales y collaborators, 1998).

Fuentes (2008) reported that species with medicinal properties in Cuba reached 1241 (97 endemic) belonging to 725 genera of 172 families. From these, 17 have different threatened categories: 4 critically endangered, 7 endangered and 6 vulnerable. With the exception of two, all threatened species are endemic. These species live in nine types of vegetation: 6 forests, 2 shrubs and 1 herbaceous. This study also refers to the threats on these taxa, such as the characteristic sensitivity of island flora, its high aesthetic value, over-exploitation of species for economic interest, and the reducing populations due to environmental changes that have led to deterioration or destruction of habitats.

In recent years many natural and traditional medicine clinics have opened to provide primary health care services, and specialised farms growing medicinal plants are found in all parts of the country. The medicinal plants are also grown on a smaller scale in the urban areas. The cultivation of different plants in home gardens for self-sufficiency has a long tradition in Cuba, but knowledge about home gardens in Cuba is small. In a study, the cultivated plants of 31 home gardens were surveyed in three villages in eastern Cuba in 2001. These included fruits, vegetables, tubers, medicinal and aromatic plants. The most common spices found in home gardens were Coleus amboinicus L., Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson, Lippia graveolens Kunth and Ocimum basilicum L. The highest diversity was found within the medicinal plants. However, a great number of medicinal plant species only occurred in one or two of the studied home gardens.

239 Medicinal plants most frequently found in the different home gardens were Cassia occidentalis L., Jatropha gossypiifolia L., Pluchea odorata (L.) Cass. and Zanthoxylum pistacifolium Griseb (Wezel, 2003). Over 6,000 square meters of area is under MAPs cultivation in Ciego de Ávila province. In each municipality of the province some land has been devoted to wild growing medicinal and aromatic plants such as aloe, indigo, linden, marjoram, oregano, passion fruit, and rosemary. Peasant cooperatives also grow various species of medicinal and aromatic plants throughout the countryside. The urban agriculture system is responsible for delivering those plants to pharmacies and sale stands. This province of Cuba also has a plantation specialized in the production of aloe, with 10,000 tons of aloe plant material export to Europe (Anonymous, 2008).

Research and Development Activities In the 40's, the Cuban scientist Dr. Juan Tomás Roig (botanist, pharmacist and agronomist) made the largest compilation about the use of plants, especially medicinal plants, in Cuba. He compiled a dictionary (published in 1928) on medicinal plants and their scientific names (Roig, 1965), and a book about medicinal, toxic and aromatics plants (Roig, 1988) that has been re-edited several times. He identified 582 Cuban plants used by the Cuban people for healing from the 986 plant species listed in his work. In the preface to his book "Medicinal, Aromatic and Poisonous Plants in Cuba", called the national scientific community to study our plants to verify their pharmacological activities, and noticed about the possibility of developing a national pharmaceutical industry based on our flora. The books are still widely used.

In the 60´s started a growing development in scientific research on medicinal plants, but rather for academic purposes and made by isolated researchers. The Experimental Station for Medicinal Plants Research "Dr. Juan Tomás Roig," was inaugurated in the 70 ´s in order to initiate a comprehensive study of medicinal plants.

Alemán et al. (1972) conducted screening of 1 165 species, including many of the plants described by Roig, among others species not studied that far, collected from botanical gardens. This work constituted the first effort for phytochemical study of the Cuban flora, and identified 677 Cuban species with alkaloids, saponins, or both. However, it was not until the 80´s that a rescue work about traditional medicine started. The strategy was focused to evaluate the existing potential, taking into account the recommendations from WHO and of course, the traditional knowledge in the island. 240 Fuentes (1981) considered enormous phytomedicinal potential of the still unknown Cuban flora, and pointed out 1 124 species reported to have medicinal properties (267 endemic species). He compared them with 5,900 higher plant species, which represented only 18.76% of the Cuban vascular flora (Berazaín, 1976). These data demonstrated that studies Cuban medicinal plants were insufficient if one considers that over 50% of these species are endemic. Since 1986 the department area of Science and Technology of the Ministry of Public Health, started a program of traditional herbal medicine devoted to scientifically evaluate the effectiveness and safety of medicinal plants of popular use, and to incorporate them as a therapeutic options into the Health System.

In 1991 the government approved a plan conceiving the research of 60 species of medicinal plants, the creation of an informational system (FITOMED), a training program for professionals and technicians, an outreach educational program for population, the elaboration of standardized rules for phytopharmaceuticals and apipharmaceuticals uses for both enterprises and Medical Specialties, and the elaboration of a guideline for using phytopharmaceuticals and apipharmaceuticals by herbal medicine dispensaries (Padrón and Pérez, 2002).

The National Advisory Group led by the Ministry of Public Health was created for coordination, assessment and evaluation of research, designed for a multidisciplinary approach involving botanical, agrotechnical, chemical, pharmacological, toxicological, and clinical studies. This group was divided into six working committees led by four reference centers: Agrobiology (Center for Pharmaceuticals Research and Development and Ministry of Public Health), Pharmaceutical Chemistry (Institute for Food and Drugs, Havana University), Pharmacology (Institute of Medical Sciences of Havana), Toxicology (Institute of Military Medicine), completed Forms (Center for Pharmaceuticals Research and Development) and clinical trials (Institute of Military Medicine).

In Cuba, the results of more than 506 research protocols and 105 clinical trials validate the use of medicinal plants.

Some of the universities/institutes in Cuba doing research on MAPs: are as follows:

• Center for Pharmaceuticals Research and Development (CIDEM), Ministry of Science Technology and Environment (CITMA), Plaza, La Habana.

241 • Experimental Station of Medicinal Plants "Dr Juan Tomás Roig" (EEPM). Center for Pharmaceuticals Research and Development (CIDEM), San Antonio de los Baños, Artemisa.

• Laboratory of Pharmacology. Center of Pharmaceutical Chemistry (CQF) Playa, La Habana1.

• Department of Pharmacology and Toxicology. National Center for Animal Health (CENSA), Ministry of Agriculture (MINAGRI), San José de Las Lajas, Mayabeque.

• Finlay Institute, Lisa, La Habana.

• Department of Pharmacology, Faculty of Pharmacy. Central University of Las Villas. Ministry of Higher Education (MES), Santa Clara, Villa Clara.

• Genetic Toxicology Laboratory, Faculty of Biology, University of Havana (UH), Plaza, La Habana.

• Department of Investigation. Institute of Gastroenterology, Department of Public Health (MINSAP), Plaza, La Habana.

• School of Dentistry. University of Havana (UH). Ministry of Higher Education (MES), Plaza, La Habana.

• Central Laboratory of Pharmacology, Faculty of Medicine "Dr. Salvador Allende.” MINSAP (Cerro, La Habana).

• Institute of Ecology and Systematic (IES), Ministry of Science, Technology and Environment (CITMA), Boyeros, La Habana.

• Eastern Center of Ecosystems and Biodiversity (BIOECO), Ministry of Science, Technology and Environment (CITMA), Santiago de Cuba.

• Institute of Military Medicine (ISMM) Ministry of the Revolutionary Armed Forces (MINFAR), Habana del Este, La Habana.

• Provincial Groups across the country for the development of green medicine.

Martinez et al., (1996), from Central Laboratory of Pharmacology, from “Dr. Salvador Allende” medical school, tested the antimicrobial activities of 23 extracts of 12 Cuban plant species reported in traditional medicine.

1 Currently the Pharmaceutical Chemistry Center (CQF) is no longer existing. 242 The Center for Pharmaceuticals Research and Development (CIDEM), screened 45 species of plants used for medicinal purposes in Cuba, to search for antioxidant agents, which protect DNA against oxidative stress. Medicinal plants screened in this study were collected in 2001 at the Experimental Station of Medicinal Plants “Dr. Juan Tomás Roig”, in San Antonio de los Baños, Artemisa Province (Ramos et al., 2003). This institution often elaborates agro-technological charts of the different species for subsequent production of plant biomass as raw material. The Center of Pharmaceutical Chemistry along with the Institute of Ecology and Systematics (IES) undertook a project for the exploration of biodiversity with pharmaceuticals interest. They succeeded 49 endemic species with medicinal property for the treatment of viral diseases, and selected the most promising. They designed effective tools for determining antiviral activity based on chemical structures and bioinformatics tools.

Researchers from Eastern Center of Ecosystems and Biodiversity (BIOECO), Cuba in collaboration with Laboratorio di Agroecologia ed Etnobiologia, Dipartimento di Biologia, Università di Padova, Italy investigated the traditional herbal mixtures in Eastern Cuba through interviews with traditional healers of the provinces of Santiago de Cuba and Guantánamo. They reported one hundred seventy plant species and other products used in 199 formulas. Some MAPs used in herbal mixtures in Eastern Cuba are listed in Table 1 (Cano and Volpato, 2004). The Ministry of Public Health has evaluated the properties of some medicinal plants published in foliates, Fitomed (Cuba, 1995). These plants are cultivated in farms of the Ministry of Agriculture, administered in form of crude drug to the “Empresa de Medicamentos” for evaluation in the Laboratories of Control and Quality. These are processed as products at the Centre of Local Production for distribution to the pharmacies. During the last 30 years research has been conducted by various workers on the related aspects. A fieldwork conducted in “yerberias” in Havana City by researchers from the Institute of Ecology and Systematic (IES). These investigations were directed towards toxic plants and aphrodisiacs, in “yerberias” in one of Havana City’s municipals, Habana Vieja. Another fieldwork was conducted during four months (October 2005 – January 2006) in the 15 municipals of the Cuban capital by Committee of Tropical Ecology, Uppsala University, Sweden. The objective of the project was to detect endangered species of the Cuban flora presently sold on the market in Havana City, Cuba, to make an inventory of plant species sold on the Cuban market and study the multipurpose use of the wild natural resources. Through free listing, semi-structured and structured 243 interviews, 420 plant species were found commercialised in Havana City, Cuba. Of these, five species Garcinia aristata (Griseb.) Borhidi, Pinus caribaea Morelet var. caribaea, Copernicia curbeloi León, C. fallaensis León and C. x textilis León are endangered (Melander, 2007).

Trade and Marketing With the collapse of the Soviet Bloc, Cuba lost the foreign exchange needed to pay for expensive drugs and medicines. As a result, much of Cuba's medicine today is based on medicinal plants. These are grown on farms, processed in small labs and made available to patients through an extensive network of medical clinics. The Cuban government signed letters of intent with nine Chinese provinces and municipalities to cooperate in the cultivation of medicinal plants and technology for making herbal medicines, as well as the setting up of Cuba as a distribution point for traditional Chinese herbal medicines for export to the Central and South American markets. According to a statement from Cuba’s Natural and Traditional Medicine Program, traditional Chinese medicine has been practiced in Cuba for about 150 years and approximately one million Cubans see acupuncturists annually. The annual value of Chinese herbal medicines presently sold in Cuba is USD60 million (ITC, 2002). There are 579 registered herbal products made in Cuba. An additional 295 registered herbal products are imported (WHO, 2001). In Cuba, the number of plant species sold for ritual use is greater than those sold for medicinal use. Plants are brought from the whole country to be sold in Havana City. About 420 plant species are commercialised in Havana City (Melander, 2007).

Constraints and Problems Natural disasters represented almost yearly hurricanes, and the lack of products on the markets, lead to a reliance on the local natural resources, creating a heavy pressure on the Cuban biodiversity.

The conservation status for the endangered MAP species is affected by their commercialisation. It is necessary to work with the “yerberos” and collectors with education for conservation of the endangered species, and with strategies for domestication and reintroduction.

244 It is important to contribute to the public knowledge of the endangered species of the Cuban flora; work with the “yerberos” and collectors to form a system of education for conservation of the detected endangered species; propose a strategy for the domestication and reintroduction of these endangered plants in natural habitats; study the phytochemistry and physical properties of the endangered and related species to see if other non threatened species could be introduced as substitutes. It should be noted that there is an urgent need for an efficient production chain, from harvest to the industrial production of herbal medicines, in ways that minimize the impact on these species.

REFERENCES

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248

Table 1: Some medicinal plants with their uses in Eastern Cuba (Cano and Volpato, 2004)

Botanical name Common name Family Uses Acanthospermum humile Abrojo Asteraceae Renal afflictions (Sw.) DC. Agave spp. Maguey Agavaceae Skin afflictions Allium sativumL. Ajo Alliaceae Gastro-intestinal, rheumatism Allophylus cominia (L.) Palo de caja Sapindaceae Diabetes Sw. Aloe vera (L.) Burm. f. Sábila, aloe Asphodelaceae Diabetes, liver & vesicular afflictions Alpinia zerumbet (Pers.) Colonia Zingiberaceae Fever B.L. Burtt& R.M. Smith Amyris balsamifera L. Cuaba Rutaceae Rheumatisms. Anacardium occidentale L. Marañon (rojo) Anacardiaceae Diabetes, gastro-intestinal afflictions Ananas comosus (L.) Piña Bromeliaceae Liver and vesicular afflictions Merr. Annona muricata L. Guanábana Annonaceae Respiratory afflictions Annona squamosa L. Anòn de ojo Annonaceae Gastro-intestinal disorders Avicennia germinans (L.) Mangle negro o Acanthaceae Reproductive afflictions L. prieto Bambusa vulgaris Schrad. Bambú Poaceae Renal disorders ex J. C. Wendl. Bidens pilosaL. Romerillo Asteraceae Diabetes, gastro-intestinal, renal & respiratory afflictions Brachiaria mutica Parana Poaceae Antiparasitic (Forssk.) Stapf Bromelia pinguinL. Maya Bromeliaceae Antiparasitic Bursera simaruba(L.) Almácigo Burseraceae Respiratory afflictions Sarg. Caesalpinia pulcherrima Clavellina Fabaceae Fever (L.) Sw. (amarilla) Cajanus cajan (L.) Millsp. Frijol gandúl Fabaceae Parasitic and respiratory afflictions Capraria biflora L. Magüiro Plantaginaceae Gastro-intestinal afflictions Carica papaya L. Papaya Caricaceae Antiparasitic Cassia fistula L. Caña fistula Fabaceae Liver & vesicular afflictions Cassia spp. Sen Fabaceae Liver & vesicular afflictions Cecropia peltataL. Yagruma Urticaceae Gastro-intestinal & respiratory afflictions Cedrela odorataL. Cedro Meliaceae Reproductive & respiratory afflictions Ceiba pentandra(L.) Ceiba Malvaceae Gastro-intestinal disorders Gaertn. Chenopodium Apasote Chenopodiaceae Antiparasitic and rheumatism ambrosoidesL. 250 Chioco ccaalba (L.) Verraco Rubiaceae Liver vesicular, renal & reproductive Hitchc. afflictions, rheumatism Chromolaena odorata (L.) Rompezaragüey Asteraceae Gastro-intestinal & respiratory R.M. King & H. Rob. afflictions Cinnamomum verum J.S. Canela Lauraceae Reproductive afflictions, rheumatism Presl. Cissus sicyoides L. Bejucoubí Vitaceae Diabetes, respiratory afflictions Citrus aurantifolia Limon, limón Rutaceae Fever, liver & vesicular afflictions, Swingle cv. Mexicana criollo antiparasitic, respiratory trouble Citrus sinensis(L.) Naranja (dulce) Rutaceae Gastro-intestinal disorders Osbeck Cleome gynandra L. Uña de gato Cleomaceae Renal afflictions Cocos nucifera L. Coco Arecaceae Antiparasitic, renal, reproductive & respiratory afflictions Colubrina elliptica (Sw.) Carbonero Rhamnaceae Rheumatisms Brizicky & W. L. Stern Commelina erecta L. Yerba de sapo Commelinaceae Renal afflictions Corchorus siliquosus L. Malva té, malva Malvaceae Liver & vesicular afflictions de tabaquito Coriandrum sativum L. Cilantro de Apiaceae Respiratory afflictions Castilla Crescentia cujete L. Güira, güira Bignoniaceae Respiratory afflictions cimarrona Cuminum cyminum L. Comino Apiaceae Gastro-intestinal, reproductive & respiratory afflictions Cymbopogoncitratus Yerba de Poaceae Fever, insomnia, nervousness (DC.) Stapf calentura Cyperus rotundusL. Caramana, Cyperaceae Renal afflictions coquito Elephantopus spicatus B. Lengua de vaca Asteraceae Respiratory afflictions Juss. exAubl. Eugenia axillaris (Sw.) Guairaje, Myrtaceae Diabetes Willd. guairajón Euphorbia hirta L. Coronilla Euphorbiaceae Rheumatisms Euphorbia lacteal Haw. Espiritu santo Euphorbiaceae Skin afflictions Ficus caricaL. Higo Moraceae Respiratory afflictions Garcinia aristata (Griseb.) Manajú Clusiaceae Respiratory afflictions Borhidi Gossypium arboreumL. Algodón Malvaceae Renal, respiratory afflictions and skin afflictions Guazuma ulmifoliaLam. Guásima Malvaceae Renal afflictions Hibiscus rosa-sinensisL. Mar Pacífico Malvaceae Respiratory afflictions Jatropha curcasL. Piñon criollo, Euphorbiaceae Gastro-intestinal & skin afflictions piñon botija Justicia pectoralisJacq. Carpintero Acanthaceae Diabetes, insomnia, Nervousness 251 Lactuca sativa L. Lechuga Asteraceae Insomnia, nervousness. Lawsonia inermisL. Resedá Lythraceae Gastro-intestinal afflictions, insomnia, nervousness Lepidium virginicumL. Mastuerzo Brassicaceae Reproductive afflictions, rheumatism Lippia alba (Mill.) N. E. Menta americana Verbenaceae Insomnia, Br. ex Britton & P. Gastro-intestinal afflictions, Wilson nervousness Lonchocarpus domingensis Guamá Fabaceae Liver & vesicular afflictions (Turpin ex Pers.) DC. Luffa cylindrica M. Roem. Friega plato, Cucurbitaceae Antiparasites estropajo Mangifera indica L. Mango (de Anacardiaceae Fever mamey) Melia azedarach L. Pulsiana Meliaceae Diabetes, rheumatism Mentha ×piperita L. var. Torongil Lamiaceae Gastro-intestinal afflictions citrata (Ehrh.) Briq. Mentha spicata L. Yerba buena Lamiaceae Gastro-intestinal & reproductive afflictions Momordica charantia L. Cundeamor Cucurbitaceae Liver & vesicular afflictions, antiparasites Myristica fragrans Houtt. Nuez moscada Myristicaceae Reproductive afflictions Nicotiana tabacum L. Tabaco Solanaceae Respiratory afflictions Ocimum basilicum L. Albahaca blanca Lamiaceae Insomnia, nervousness, skin afflictions Ocimum campechianum Albahaca Lamiaceae Renal afflictions Mill. mondonguera Ocimum tenuiflorum L. Albahaca morada Lamiaceae Diabetes, insomnia, nervousness Opuntia cochenillifera (L.) Tuna de Castilla Cactaceae Liver & vesicular afflictions, skin Mill. afflictions Origanum majorana L. Mejorana Lamiaceae Diabetes, gastro-intestinal afflictions, insomnia, nervousness Oxandra lanceolata (Sw.) Yaya Annonaceae Respiratory afflictions Baill. Panicum maximum Jacq. Yerba de Guinea Poaceae Fever Pectis ciliaris L. Chincha Asteraceae Fever Peperomia pellucida Corazón de Piperaceae Renal afflictions, rheumatism Kunth hombre Petiveria alliacea L. Anamú Phytolaccaceae Renal & respiratory afflictions, rheumatism

Petroselinum crispum Perejil Apiaceae Diabetes, respiratory afflictions (Mill.) Nyman ex A. W. Hill Phylas caberrima auct. pl. Orozul Verbenaceae Diabetes Picramnia pentandra Sw. Aguedita Picramniaceae Fever

252 Pimenta dioica (L.) Merr. Pimiel de Myrtaceae Gastro-intestinal afflictions guiranta dulce, pimiel de guiranta gorda Pimpinella anisum L. Anís Apiaceae Liver, vesicular and, respiratory afflictions Piper auritum Kunth Anizón Piperaceae Gastro-intestinal & reproductive afflictions Plantago major L. Llantén Plantaginaceae Liver, vesicular and renal afflictions, rheumatism Plectranthus amboinicus Oreganón Lamiaceae Respiratory afflictions (Lour.) Spreng. Pluchea carolinensis Salvia Asteraceae Rheumatism (Jacq.) G. Don Portulaca oleraceaL. Verdolaga Portulacaceae Gastro-intestinal afflictions, antiparasitic Psidium guajavaL. Guayaba Myrtaceae Gastro-intestinal & respiratory afflictions PunicagranatumL. Granada Punicaceae Diabetes, Gastro-intestinal afflictions RicinuscommunisL. Higuereta Euphorbiaceae Renal afflictions Rorippanasturtium- Berro Brassicaceae Liver, vesicular and, respiratory aquaticum (L.) Hayek afflictions Ruellia tuberosa L. Raíz de pantano Acanthaceae Renal afflictions Ruta graveolens L. Ruda Rutaceae Gastro-intestinal afflictions Sansevieria trifasciata Guataca de burro Ruscaceae Liver, vesicular and, skin afflictions Prain Senna alata (L.) Roxb. Palo santo, Fabaceae Diabetes guacamaya francesa Senna occidentalis (L.) Platanillo Fabaceae Rheumatisms Link Senna uniflora (Mill.) H. Guanina Fabaceae Rheumatisms S. Irwin & Barneby Solandra longiflora Tussac Dajao, palo dajao Solanaceae Rheumatisms Solanum americanumMill. Yerba mora, Solanaceae Diabetes, gastro-intestinal afflictions, joruro antiparasitic, rheumatisms Solanum torvumSw. Pendejera Solanaceae Renal afflictions Stachytarpheta jamaicensis Verbena Verbenaceae Diabetes, insomnia, nervousness (L.) Vahl skin afflictions

Swietenia mahagoni (L.) Caoba Meliaceae Respiratory afflictions Jacq. Tagetes erecta L. Escarola, flor de Asteraceae Reproductive afflictions muerto Tamarindus indica L. Tamarindo Fabaceae Gastro-intestinal, liver & vesicular afflictions

253 Tecoma stans (L.) Juss. ex Sauco amarillo Bignoniaceae Diabetes Kunth Thymus vulgaris L. Tomillo Lamiaceae Respiratory afflictions

Tournefortia hirsutissima Cayaya Boraginaceae Respiratory afflictions L. Trichostigma octandrum Guaniquiqui Phytolaccaceae Gastro-intestinal afflictions (L.) H. Walter Vitex agnus-castus L. Vencedor de Lamiaceae Respiratory afflictions jardın Xanthium strumarium L. Guizazo de Asteraceae Liver & vesicular and, renal Baracoa, guizazo afflictions de Mabujabo Zea mays L. Maíz Poaceae Renal afflictions Zingiber cassumunar Gengibre amargo Zingiberaceae Respiratory afflictions, rheumatisms Roxb.

254 2.8 Dominica The Commonwealth of Dominica is an island in the Caribbean Sea approximately midway between the islands of Guadeloupe (to the north) and Martinique (to the south) and approximately 794.2 kilometers north of Venezuela. One of the Windward Islands, Dominica is about 47 kilometers long, 29 kilometers wide, with an area of 751 square kilometres. Dominica is volcanic in origin and thus is mountainous, although there are some flat areas along parts of the coast. The highest point is Morne Diablotin (1,447 m) and several other peaks exceed 1,000 m. The island has an oceanic tropical climate with an average annual temperature of about 27 °C, seldom exceeding 32°C or falling below 18°C. The annual rainfall is considerable, ranging from about 2,000 mm at Roseau, on the south-west to three times that figure or more in the mountains (FAO, 2008). There is general consensus that the Dominican forest is the finest in the Caribbean with 66% of the land area (51,752 hectares) covered by vegetation ranging from dry scrub woodland on the coast to lush, tropical forest in the interior. Two main types of vegetative zoning characterize the island. The first is a wetter eastern coast due to prevailing rain-bearing systems, which leads to a more lush vegetative community and a rain shadowed western coast that has more scrub-like characteristic. The second and more important is an altitudinal zone of plant communities dependent on precipitation, temperature and wind levels (Anonymous, 2001). Dominica’s undisturbed forests are the most extensive in the Eastern Caribbean. The vegetation consists of more than 1,000 species of flowering plants and about 60 woody plants and tree species. Dominica contains 52,000 ha of natural forest, woodland and bush. There is an impressive plant diversity of 155 families, 672 genera and 1,226 species of vascular plants and trees. The natural vegetation on the island consists of Swamp Forests, Dry Scrub Land, Littoral Woodland, Deciduous Forest, Rain Forest, Mountain Forest, and Elfin Woodland (FAO, 1995). Dominica has an extensive operational and legislative protected area system consisting of forest reserves and national parks covering approximately 17,084 hectares. The island’s legally defined forests reserves and national parks together incorporate 20% of the country’s forest base. There are two Forest Reserves - the Central Forest Reserve (410 hectares) and the Northern Forest Reserve (5,476.9 hectares). In addition, there are three National Parks - Morne Trois Pitons (6,879.8 hectares) established in 1975, officially declared as a UNESCO World Heritage Site in 1998; Cabrits National Park (531 hectares) established in 1986, and Morne Diablotin National Park (3,335.49 hectares) established in January 2000. National parks

255 legislation provides protection for the genetic resources within park zones (Anonymous, 2001).

Traditional Medicine Systems/Phytomedicine In keeping with modern trends Dominica despite the introduction of western drugs and cures continues to rely on traditional medicine incorporating plant based herbal remedies for the relief of pain and cure of many diseases (Patel, 2005). The principal traditional medical speciality is plant based herbalism. The numbers of herbal practitioners in Dominica have never been documented. There is no official registry of traditional health practitioners, and traditional medicine practitioners are not licensed in Dominica. (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine A national policy on TM/CAM is being developed in the Commonwealth of Dominica, as is a national programme. There are, however, currently no plans to develop laws or regulations. No national office exists, and information is unavailable about any plans to develop one. An expert committee has been created. No national research institutes currently exists. Herbal medicines are not regulated in Dominica; however, these are sold without health claims. In place of a national pharmacopoeia, the British pharmacopoeia is used and is legally binding. No national monographs presently exist. There are no manufacturing requirements for herbal remedies and safety requirements are limited to traditional use without demonstrated harmful effects. There is no quality control mechanism for this requirement. There is no registration system, nor are herbal medicines included in the essential drug list. A post marketing surveillance system is planned. In Dominica, herbal medicines are sold as over the counter medicines and in special outlets without restriction (WHO, 2005). There are no institutions that teach traditional medicine. Instead, traditional medicine is taught through apprenticeships with experienced practitioners. Traditional medical knowledge may also be transmitted through dreams and personal revelations. There are no official training

256 programmes in traditional medicine for allopathic health personnel (WHO, 2001).

Medicinal and Aromatic Plant Resources Dominica’s biological resources include a large number of medicinal plants, which are largely unexploited. Many of these have not been fully investigated for their medicinal and commercial potential. These plants are collected largely from the wild. There is no information available on the extent of overexploitation of these plants and their availability (FAO, 1995). Work is currently underway at a national and international level to remedy these deficiencies. Dominica boasts of a remarkable plant diversity and has the most extensive and diverse vegetative cover in the Eastern Caribbean. This vegetation consists of approximately 155 families, 672 genera and 1226 species of vascular plants. The country has several plant species, which are endemic to the island, like the national flower Sabinea carinalis Griseb. (Bwa kwaib) and two genera, Agave spp. and Furcrea spp. that are endemic to the Caribbean. The species thought to be endemic to Dominica are being identified in the other islands. About 167 species of plants of medicinal and pharmaceutical value widely used in curing diseases such as cardiovascular, digestive, genital, urinary, respiratory, and nervous system disorder have been reported in Dominica (Anonymous, 2001). A list of some commonly used plants in Dominica; compiled under a project (May 24-June 14, 2005) by Texas A&M University’s Study Abroad Program is given in Table 1 (Patel, 2005).

Research and Development Activities No information is currently available regarding ongoing or completed research and development activities concerning MAPs in the country.

Trade and Marketing The selected botanical exports of Dominica during 2007 under the HS code 0902-0910 that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others were 65,138 kg. Included in this figure is a growing volume of medicinal herbs which are now being marketed as manufactured tea bags and ground and leafy herbs. This country also reported 2007 exports under HS

257 130190 that includes botanicals such as balsam-of-Peru (Myroxylon balsamum (L.) Harms) and American storax balsam (Liquidambar styraciflua L.), among many others of 960 kg. While for HS 3301 that includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils the volume reported was 14,937 kg (ITC, 2008). No further information on trade in MAPs and their products in Dominica is currently available.

Constraints and Problems The country should first identify all its MAP resources available on island and further to identify ways in which these resources can be utilized in a sustainable way to provide medicinal as well as economic benefits to country population. A first step of the process toward sustainable utilization of these resources requires knowledge of what exists in terms of location, quantity, and quality, followed by the development of mechanisms for the protection of these resources to realise the full potential of these resources.

REFERENCES Anonymous, 2001, Initial national communication of the Commonwealth of Dominica under the United Nations Framework Convention on Climate Change. Environmental Coordinating Unit, Ministry of Agriculture and the Environment, Roseau, October 2001. Available at: http://unfccc.int/resource/docs/natc/domnc1.pdf (25 Aug. 2008) FAO, 1995, Dominica: Country report to the FAO International Technical Conference on Plant Genetic Resources Leipzig, 1996, Ministry of Agriculture, Roseau, June 1995 FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) ITC, 2008, Market News Service, Medicinal Plants & Extracts, 27: 40, Jun. 2008, Geneva, Switzerland Patel, M., 2005, Medicinal Plant Use in Dominica. Texas A&M University Study Abroad, May 24-June 14, 2005. Available at: http://dominica.tamu.edu/student%20projects/Dominica%20Projects %20pdf%20copy/Patel_Megha.pdf (25 Aug. 2005)

258 WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva

Table 1: Some commonly used species of medicinal and aromatic plants in Dominica (Patel, 2005)

Botanical name Family Common Uses name Aloe vera (L.) Burm. f. Asphodelaceae Laloes Sunburn Anacardium occidentale L. Anacardiaceae Cashew Remove warts Ceiba pentandra (L.) Gaertn. Malvaceae Silk cotton Body sore tree Chenopodium ambrosioides Chenopodiaceae Wormbush Tea for pregnant L. mothers, worms Cymbopogon citratus (DC.) Poaceae Lemon grass Cough, pneumonia Stapf Dacryodes excelsa Vahl Burseraceae Gommier Toothache Erithalis fruticosa L. Rubiaceae Bois Cold chandelle Eryngium foetidum L. Apiaceae Herbe a fer Headache, ulcer Leonotis nepetifolia (L.) R. Lamiaceae Gros tete Cough Br. Mangifera indica L. Anacardiaceae Mango leaves Body sore Morinda citrifolia L. Rubiaceae Noni Blood circulation, body sore Ocimum basilicum L. Lamiaceae Basilic Fever Peperomia pellucida (L.) Piperaceae Cochlaia Asthma Kunth Pimenta racemosa (Mill.) J. Myrtaceae Bay leaf Headache W. Moore Psidium guajava L. Myrtaceae Guava Diarrhoea Ricinus communis L. Euphorbiaceae Castor Constipation, worms Rubus strigosus Michx. Rosaceae Raspberry Loose bowl Saccharum officinarum L. Poaceae Canne-a- Fever sucre Urena sinuata L. Malvaceae Chabonique Stomach ache Zingiber officinale Roscoe Zingiberaceae Ginger Cough

259 2.9 Dominican Republic

The Dominican Republic, located in the West Indies, occupies approximately the eastern two thirds of the Island of Hispaniola, while Haiti occupies the western part. A number of adjacent islands, among them Beata and Saona, are possessions of the Dominican Republic. The country covers a total area of 48,730 square kilometres.

Any land with relatively good soil is devoted to agriculture and stock raising areas, which means that no forests are now found in the north and centre of the country. Forested regions are found in the west along the border with Haiti from the coast to the Cibao valley, and along part of the eastern coast, always on poor soil or where the climate is very dry or the terrain particularly rugged or inaccessible. Four regions can be distinguished: the Bahoruco mountains, the Neiba mountains, the central mountain chain, and the east.

Much of the Dominican Republic is mountainous. The principal mountain range, the Cordillera Central, runs from north-west to south-east through the centre of the country. To the west of the Cordillera Central are arid lands. Mountain ranges in this region include the Sierra de Neiba and the Sierra de Bahoruco. To the north of the Cordillera Central lies the Cibao Valley, an area of pine-covered slopes and a fertile plain called the Vega Real, a productive agricultural area. The Cordillera Septentrional (Northerly Range) is in the far north.

The eastern end of the Dominican Republic is less mountainous and is mostly agricultural land. The Dominican Republic has a semitropical climate, moderated by the prevailing trade winds. Tropical hurricanes occasionally occur.

The Dominican Republic has a moderate forest cover of almost 32% (almost 1.4 million hectares). Since European settlers arrived, about two-thirds of the country’s forests have been cleared. The only extensive areas of natural forest are found in the Armando Bermúdez and José del Carmen Ramírez National Parks in the central mountains, both containing large pine stands (mainly of Pinus occidentalis Kunth).

About 80% of the country’s forests are moist or dry subtropical forests made up of broad-leaved species (most of them secondary forests), while the remaining 20% are pine forests. Forest plantations account for 1 or 2% of the total forested area. A pilot reforestation project has been started in the San José de las Matas area.

The country has a large network of protected areas and more than 25% of its total land area is under some form of legal protection. Almost all the country’s demand for timber and other forest products, apart from fuel-wood, is met from imports.

260 A Forestry Action Plan was launched in 1991 with the aim of reaching national timber and fuel-wood self-sufficiency by 2016. It included plans to establish forest plantations for timber and fuel-wood production, as well as catchment area protection.

The high deforestation rate has been a subject of concern since the 1960s. The new forestry policy as per its forest management and development plan stresses upon the sustainable harvesting and natural management of forests (FAO, 2008).

Traditional Medicine Systems/Phytomedicine

Medicinal plants are commonly used by several sectors of the Dominican population to cure illnesses, mainly for people coming from the rural and low income sectors. Along with the formal or official medical system represented by the Ministry of Public Health and Social Assistance, used by the majority of the population; the traditional medicine system is still used by a small fraction of the population. Nevertheless, an increment in the use of medicinal plants is expected due to economic reasons and access to the formal system of health.

Part of the population, mainly from the rural zones has difficulties to access the formal system of health. This fact did not influence significantly the preference of the population for the traditional medicine. In fact, medicinal plants are essentially found in the municipal market of the cities and, also in wild form or cultivated on individual houses. Medicinal plants are rarely sold in the streets and corners of the city. Medicinal plants are mainly used for self-medication (Roersch, 1999). This is related to knowledge being transmitted from one generation to the next. Traditional health practitioners are slowly disappearing.

The tisane is the more frequent form of use of medicinal plants, along with others practices such as poultices applied directly over the affected part of the body. Other specialties such as vodun, ensalmadorismo are practiced mainly by part of the Haitian population living in Dominican Republic.

Although in the Dominican Republic has been several efforts and initiative to link traditional medicine with allopathic medicine (WHO, 2001), practitioners of this medicine are not only officially non-accepted, but they can be prosecuted when practicing it illegally.

Government Efforts in Development of Traditional Medicine/Phytomedicine

In the Dominican Republic, national policy on TM/CAM is in development; in 2001, laws and regulations were adopted. No national programme has been issued. In 1993, the

261 national office on TM/CAM was established under the Ministry of Health. No expert committee currently exists. There are no national research programmes.

In 2001, regulations in the area of herbal medicine were introduced to control commercialization, distribution and use of products elaborated total or partially with vegetal materials, especially those imported. This regulation is partly the same as for conventional pharmaceuticals. Herbal medicines are sold as nutritional and dietetic supplements, and recommended by their medicinal properties, nutrient contents, and structure/function claims. For this kind of products there is not a national pharmacopoeia or monographs, instead preparation formula must be prepared for their registry.

Products elaborated, total or partially from plants, must meet the same GMP requirements as for conventional pharmaceuticals. Nevertheless, for these products there is not available information with respect to their industrial preparation neither related to any statutory food safety control requirement.

With respect to their commercialization, the national registry of pharmaceuticals included around 3000 products that have vegetal components and offered as nutritional and health supplements. Anyway, very few of the above products are prepared using plants from the Dominican traditional medicine. Although at some time in Dominican Republic there was an interest to apply a surveillance system post-commercialization, this kind of product (mainly from import) is sold without recipe in pharmacies and other commerce (OMS, 2005).

On the other hand, a search based on consultation, surveys, documents and textbooks about the topic (Lioger, 2000; Cordero,1978; Peguero y Jimenez, 2011, Farmacopea, 2005; Castillo et. al 2007), it is estimated that although the Hispaniola Island’s flora is composed of around 6000 species approximately, only 400 plants are used in the Dominican traditional medicine (see table 2).

The Ministry of Health and Social Wellness of the Dominican Republic has offered a program of instruction for the comadronas en Health Center around the country. More than 30 years ago, the Pan-American Health Organization offered assistance in the implementation and revision of these plans; nevertheless, actually there is not official programs aimed to capacitate people from the allopathic medicine in traditional medicine (OMS, 2001).

Medicinal and Aromatic Plant Resources

In the literature of medicinal and aromatic plants in Dominican Republic the most important medicinal plants for the treatment of various health problems and conditions are described (Lioger, 2000; Cordero,1978). Most of these plants have still being used in the

262 traditional medicine. Several important MAPs were reported in an inform prepared using information regarding plants used by Dominican living in NY, for women health’s conditions (Ososki et al., 2002).

Recent studies evaluating the phytopharmaceutical potential of MAPs and their relationship to the traditional medicine has been undertaken. In the first study, performed at Universidad Autonoma de Santo Domingo a survey was conducted in the municipal markets of Santo Domingo, Capital of Dominican Republic. From a total of 92 plants reported, five plants (M. annua, P. alliacea, A. antillarum, C. alba y S. virgata) were the most solicited by consumers, by considering the amounts sold much plants are consumed fresh (66%), and in a lesser amount dried (34%). Leafs (29%), the whole plant (28%), bark (16%) are the principal parts of the plants used, especially to prepare tisane. Of the MAPs used by consumers, 65% are native plants and 3% are endemic to the island. 53 families of plants are represented in the list, accounting for a 31.2% of the total of families existing in the island (Vásquez & Garcia, 1999).

In the second study, performed at the municipal markets of different cities (Santo Domingo, Santiago, San Cristobal, Azua, Barahona, etc.) 140 different plants were mentioned to be used extensively by consumer to treat several health diseases (Vásquez et al, 2009). Selected plants are mentioned in table 2. A distribution of the illness treated with MAPs is reported in Table 3.

Of concern is that existence of several plants such as “Melón de Breña” (Melocactus lemairei), “Palo de Brasil” (Caesalpinia brasiliensis), “Maguey de bestia” (Agave antillarum), “Bejuco de riñon” (Smilax domingensis), ”Canelilla” (Pimenta haitiensis), and others could be in danger due to comercial over-explotation (Peguero B. y F. Jimenez, 2011).

Research and Development Activities

An ethnobotanical literature survey, part of a study in New York City investigating Dominican and Chinese healing systems and the herbal treatments used for women's conditions such has uterine fibroids; menorrhagia; endometriosis; and hot flashes has been undertaken. The objectives of this survey were to search literature on medicinal plants used in the Dominican Republic and identify those used for the above listed conditions and their symptoms; to compare the use between herbal treatments reported in the literature with those prescribed by Dominican healers in New York City; and to evaluate the extent to which healers may have changed their use of plants in order to adapt to availability in the New York City environment. A total of 87 plant species were reported in the Dominican literature for these conditions and symptoms. The survey was conducted at the Biological Sciences, Lehman College and the City University of New York Graduate School, USA (Ososki et al., 2002).

263 The health department in coordination with the botanical department of the National Botanical Garden organized some seminars and courses to train health workers in the right use and management of MAPs. This training has been offered to medical doctors, nurses, students of medicine and natural practitioners. Some popular information booklets have also been distributed by the garden, educating people about the use of medicinal plants and concerning the toxicity of some plants frequently used by the common people (Almonte, 2007).

In Honduras, Nicaragua, Panama, and the Dominican Republic, four of the countries in which the TRAMIL Program is currently well established in local and national institutions, interest within government ministries in linking sustainable use of biodiversity to other community benefits, such as public health, has been particularly encouraging. In these countries and with support of a GEF Medium Size Project entitled “Biodiversity Conservation and Integration of Traditional Knowledge on Medicinal Plants in National Primary Health Care Policy in Central America and Caribbean” the TRAMIL Program will add a forest ecosystem conservation component to the existing regional applied research program on traditional remedies derived from medicinal plants.

The TRAMIL (Traditional Medicine for the Islands) research network was launched in 1982 in the Dominican Republic by the NGO, ENDA-Caribe (under responsibility of the regional office in Nicaragua), with intellectual assistance and support from the Medicinal Plant Specialist Group (MPSG) of the IUCN.

The primary project objective is to support the conservation and sustainable use of medicinal plants important to primary health in key forest eco-regions in Honduras, Nicaragua, Panama, and the Dominican Republic by assessing their conservation status and management needs; working with indigenous and local communities to develop appropriate management strategies; and working with research institutions, NGOs, and national government agencies to integrate conservation and management of medicinal plants with rational use of traditional remedies in primary health care (PHC).

The project will focus activities in these four countries, but also aims to develop models and expertise that will be more broadly useful within the region. A preliminary selection of project sites has been made from globally significant eco-regions identified as target areas for project implementation within each of the four countries involved in developing this project. National Park del Este and Zambrana Cotuí (Mestizo communities) is the project site selected in Dominican Republic (Lagos-Witte, 2006).

Trade and Marketing

The information concerning the marketing and production of medicinal and aromatic plants in the Dominican Republic are very scarce. A short survey about the

264 commercialization of medicinal plants in the principal market places of Santo Domingo, the capital of the Dominican Republic was made by Dominican Institute of Medicine, Santo Domingo during late 1990s. The results indicate the existence of a whole market infrastructure. There are specific regions for the collection and cultivation of the herbs; there are specific producers and collectors as well as sellers; and there are specific retail outlets. The import and export data for MAPs and essential oils are given in the survey. The general trend in the export of the MAPs and essential oils is descending while imports are increasing (Roersch, 1999).

Most MAPs are sold in the public markets for the use of common people. Several health food stores are now selling them in the dehydrated form. A growing the amount of MAPs is exported to Europe and United Stated (Almonte, 2007).

The current figures of the quantity of MAPs and their products being imported and exported from the country are not available.

Constraints and Problems

The Dominican government need to encourage the use of traditional remedies based on plants for health care, open the institutes and make laws in support of MAPs and their products to carry research, cultivation of important species, encourage trade and sustainable utilization of their natural resources.

Table 1: Medicinal plants used in the Dominican Republic mainly for women’s health conditions (Ososki et al., 2002) Botanical name Family Plant part Uses Acacia macracantha Humb. Fabaceae Fruit abundant menses & Bonpl. ex Willd. Agave americana L. Agavaceae Root Dysmenorrhea Agave fourcroydes Lem. Agavaceae Not specified regulate menses Allium cepa L. Alliaceae Onion bulb Infertility Allium sativum L. Alliaceae Peels raise uterus Aloe vera (L.) Burm.f. Asphodelaceae Leaves regulate menses Amaranthus Amaranthaceae Plant abundant menses hypochondriacus L. Ambrosia peruviana Willd. Asteraceae Root, leaves menstrual deficiencies, nervousness, regulate menses Ananas comosus (L.) Merr. Bromeliaceae Flowers, Leaves regulate menses Anemone pulsatilla L. Ranunculaceae Not specified menstrual cramps Angelica archangelica L. Apiaceae Not specified spasmodic action in painful menses Annona muricata L. Annonaceae Leaves Nervousness Artemisia absinthium L. Asteraceae Leaves, roots irregular menstruation, womb problems Beta vulgaris L. Chenopodiaceae Root menstrual disorders, tumors 265 Borago officinalis L. Boraginaceae Seeds, leaves, flowers stimulate ovaries Bunchosia glandulosa (Cav.) Malpighiaceae Leaves Dysmenorrhea DC. Calendula officinalis L. Asteraceae Flower regulate menses Capsicum annuum L. Solanaceae Leaves painful menses Centaurea benedicta (L.) L. Asteraceae Dried plant sweats, tumors Centella asiatica (L.) Urb. Araliaceae Not specified Menopause Centrosema virginianum Fabaceae Root Dysmenorrhea (L.) Benth. Chenopodium ambrosioides Chenopodiaceae Leaves, flowers dysmenorrhoea, regulate menses L. Cichorium intybus L. Asteraceae Leaves hot flashes, menopausal symptoms, nervousness Cinnamomum zeylanicum Lauraceae Oil abundant menses Blume Citharexylum fruticosum L. Verbenaceae Bark, Leaves dysmenorrhoea, menstrual irregularities Citrus aurantium L. Rutaceae Leaves Sweats Citrus limon (L.) Burm.f. Rutaceae Fruits abundant menses Citrus sinensis (L.) Osbeck Rutaceae Leaves Nervousness Coffea arabica L. Rubiaceae Seeds regulate menses Crescentia cujete L. Bignoniaceae Flower regulate menses Cucumis melo L. Cucurbitaceae Fruit uterine tumors Daucus carota L. Apiaceae Roots, leaves regulate menses, tumors Dioscorea villosa L. Dioscoreaceae Roots/rhizomes menstrual pain Gossypium barbadense L. Malvaceae Bark, roots regulate menses, uterine haemorrhaging Jatropha gossypiifolia L. Euphorbiaceae Plant regulate menses Kalanchoe gastonis-bonnieri Crassulaceae Leaves uro-genital problems Raym.-Hamet et H. Perrier Lactuca sativa L. Asteraceae Leaves painful menses Laurus nobilis L. Lauraceae Leaves Tumors Lavandula officinalis Chaix Lamiaceae Leaves, flowers promote menstruation ex Vill. Lepidium virginic um L. Brassicaceae Seeds Tumors Lippia micromera Schauer Verbenaceae Fresh plant leaves dysmenorrhoea, regulate menses, womb problems Malpighia punicifolia L. Malpighiaceae Fruit regulate menses, womb problems Mangifera indica L. Anacardiaceae Branches uterine haemorrhaging Matricaria chamomilla L. Asteraceae Leaves, flowers nervousness, uterine colic Momordica charantia L. Cucurbitaceae Leaves regulate menses, uterine Ocimum basilicum L. Lamiaceae Leaves painful menses Opuntia ficus-indica (L.) Cactaceae Stems stop menses Mill. Passiflora edulis Sims Passifloraceae Leaves Dysmenorrhoea Passiflora foetida L. Passifloraceae Leaves, fruit Dysmenorrhoea Persea americana Mill. Lauraceae Leaves, flowers, seeds regulate menses, tumors Petiveria alliacea L. Phytolaccaceae Root cramps, nervousness, womb inflammation Petroselinum crispum Apiaceae Fresh roots Whole plant infertility, regulate menses, (Mill.) Nyman ex A. W. sweats Hill Plantago major L. Plantaginaceae Leaves abundant menses, dysmenorrhoea Polianthes tuberosa L. Agavaceae Flowers, tea, Sweats Quercus ilex L. Fagaceae Bark abundant menses Ricinus communis L. Euphorbiaceae Oil Tumors 266 Rosmarinus officinalis L. Lamiaceae Flower, leaves regulate menses Ruta chalepensis L. Rutaceae Leaves menorrhagia, nervousness, regulate menses Ruta graveolens L. Rutaceae Not specified regulate menses, menopause (heart palpitations)

Saccharum officinarum L. Poaceae Leaves Tumors Salvia officinalis L. Lamiaceae Leaves Dysmenorrhoea Serenoa serrulata (Michx.) Arecaceae Fruit Infertility G. Nicholson Sesamum orientale L. Pedaliaceae Seeds regulate menses Tamarindus indica L. Fabaceae Root abundant menses Urtica dioica L. Urticaceae Aerial parts of young menopause, menstrual flow leaves Vinca minor L. Apocynaceae Leaves Tumors Zingiber officinale Roscoe Zingiberaceae Rhizome regulate menses

Table 2: Medicinal and Aromatic Plants of Dominican Republic and Frecuent Use (Vásquez et. al., 2009)

Plant Name Family Uses Used Part Status Acacia macracantha Humb. & Bonpl. Ex Willd. Mimosaceae Fiebrifugo Bark N Acalypha amanthacea subsp. Hepaticos Kidney wilkesiana (Muell. & Arg.) Fosberg. Euphorbiaceae Problems Whole plant IC Achyranthes aspera L. Amaranthaceae Liver Problems Whole plant N Vaginal Infections, Agave antillarum Descourt. Agavaceae Renal And Cancer Penca IC Allophyllus racemosus Sw. Sapindaceae Kidney Problems Stem, leaf N Burns, Infections Aloe barbadensis Mill. Liliaceae And Cancer Penca IC Alpinia zerumbet (Pers.) B.L. Burtt & R.M. Sm. Zingiberaceae Anti-Infective Rhizome, IC Diabetes And Ambrosia artemisiifolia L. Asteraceae Hepatitis Part Air N Anredera vesicaria (Lam.) C.F. Healing And Gaertn. Basellaceae Inflammatory Rhizome N Argemone mexicana L. Papaveraceae Genital Infections Whole plant Nat Arundo donax L Poaceae Kidney Infections Sheet N Anti-Infective And Bromelia pinguin L. Bromeliaceae Antiparasitic Fruit N Bryophyllum gastoni-bonnieri (Raym.-Hamet & H. Perrier) Lauz.- Kidney Infections March. Crassulaceae And Vaginal Sheet IC Bryophyllum pinnatum (Lam.) Oken Crassulaceae Liver Problems Sheet Nat Bunchosia glandulosa (Cav.) DC. Malpighiaceae Flu Sheet N Caesalpinia brasiliensis L. Caesalpiniaceae Kidney And Liver Stem, leaf E Throat Infections Caesalpinia coriaria (Jacq.) Willd. Caesalpiniaceae And Vaginal Fruit N Diabetes And Calophyllum calaba L. Clusiaceae Kidney Bark, leaf N

267 Plant Name Family Uses Used Part Status Capraria biflora L. Scrophulariaceae Infant Indigestion Part Air N Cassia fistula L. Caesalpiniaceae Antiparasitic Fruit, leaf IC Swelling And Cecropia schreberiana Miq. Cecropiaceae Albumin Leaves N Cestrum diurnum L. Solanaceae Antiparasitic Sheet IC Chenopodium ambrosioides L. Chenopodiaceae Vermin Part Air N Kidneys, Venereal And Sexual Chiococca alba (L.) Hitchc. Rubiaceae Impotence Stem, leaf N Cissus verticillata (L.) Nicolson & C.E. Jarvis Vitaceae Kidney Infection Stem N Diabetes And Citharexylum fruticosum L. Verbenaceae Amenorrhoea Part Air N Cleome viscosa L. Capparaceae Skin Part Air N Clusia rosea Jacq. Clusiaceae Anti-Infectives Part Air N Cupania americana L. Sapindaceae Kidney Whole plant N Cymbopogon citratus (DC.) Stapf. Poaceae Respiratory Root, leaf IC Cymbopogon nardus (L.) Rendle. Poaceae Respiratory Root, leaf IC Doyerea emetocathartica Grourdy Cucurbitaceae Venereal Diseases Fruit, stem N Eleutherine bulbosa (Mill.) Urb. Iridaceae Skin Problem Tubercle IC Asthma And Entada gigas (L.) Fawc. & Rendle. Mimosaceae Allergy Fruit, leaf N Infection In Kidney Equisetum giganteum L. Pteridophyta And Prostate Part Air N Sinusitis And Eucalyptus rostrata Cav. Myrtaceae Rheumatism Sheet IC Eupatorium aromatisans DC. Asteraceae Anti-Inflammatory Leaves N Eupatorium odoratum L. Asteraceae Skin Problems Part Air N Foeniculum vulgare Mill. Apiaceae Antiflatulent Whole plant IC Kidney Problems And Diabetes And Gnaphalium domingense Lam. Asteraceae Infections Part Air N Gossypium hirsutum L. Malvaceae Kidney Sheet Nat Kidney And Liver Guaiacum officinale L. Zygophyllaceae Problems Sheet N Kidney Problems Guazuma tomentosa Kunth Sterculiaceae And Skin Bark, leaf N Menstrual Hamelia patens Jacq. Rubiaceae Problems Sheet N Hymenaea courbaril L. Caesalpiniaceae For Anemia Bark, leaf N Asthma And Hymenocallis caribaea (L.) Herb. Amaryllidaceae Allergy Rhizome N Infectious Inga vera Willd. Mimosaceae Problems Bark, leaf N Ipomoea sp. Convolvulaceae Venereal Infections Stem, leaf Jatropha curcas L. Euphorbiaceae Skin Problems Sheet N Typhus Fever And Leonotis nepetifolia (L) R. Br. Lamiaceae Hepatitis Part Air N For Memory And Lippia nodiflora (L.) Michx. Verbenaceae Influenza Part Air N Macfadyena unguis–cati (L.) A.H. Gentry Bignoniaceae Sexual Impotence Stem, leaf N Marjorana hortensis Lamiaceae Earache, Skin And Part Air IC

268 Plant Name Family Uses Used Part Status Antihypertensive Prostate And Martynia annua L. Martyniaceae Kidney Problems Fruit N Prostate, Kidney Melocactus lamairei (Monv) Miq. Cactaceae And Cancer Whole plant E Heart, Cholesterol Mentha aquatica L. Lamiaceae And Calm Down Part Air IC Tonic Stomach, Mentha x piperita Lamiaceae Heart Problem Part Air IC Stomach And Flu Mentha x spicata Lamiaceae Tonic Part Air Nat Respiratory Problems And Merremia dissecta (Jacq.) Hallier f. Convolvulaceae Asthma Part Air N Diabetes And Skin Momordica charanthia L. Cucurbitaceae Problems Whole plant Nat Moringa Oleifera Moringa oleifera Lam. Moringaceae Lam. Leaf, fruit Nat Narvalina domingensis (Cass.) Less. Asteraceae Antiparasitic Sheet E Ocimum basilicum L. Lamiaceae Headaches Part Air IC Vaginal Infections Ocimum gratissimum L. Lamiaceae And Kidney Part Air Nat Ocimum tenuiflorum Burm. f. Lamiaceae Stomach Pain Part Air Parthenium hysterophorus L. Asteraceae Skin Infections Stem, leaf N Passiflora foetida L. Passifloraceae Albumin Part Air N Paullinia pinnata L. Sapindaceae Kidney Infection Stem, leaf N Pavonia spinifex (L.) Cav. Malvaceae Liver Problems Whole plant N Pelargonium X hortorum L.H. Bailey Geraniaceae For Hypertension Whole plant IC Sinusitis And Petiveria alliacea L. Phytolaccaceae Rheumatism Leaf, root Nat Pimenta racemosa var. grisea Sinusitis And Flu (Kiaersk.) Fosberg Myrtaceae Problems Sheet N Diabetes And Piper aduncum L. Piperaceae Kidney Sheet N Pisonia aculeata L. Nyctaginaceae Kidney Diseases Stem, leaf N Plantago major L. Plantaginaceae Kidney Infections Whole plant Nat Menstrual Pothomorphe peltata (L) Miq. Piperaceae Problems Stem, leaf N Diurectico, Renal Rhynchosia pyramidalis (Lam.) Urb. Fabaceae And Venereal Stem, leaf N Anti- Inflammatory, Pressure And Rosmarinus officinalis L. Lamiaceae Strengthen Hair Part Air IC Kidney And Ruellia tuberosa L. Acanthaceae Prostate Problems Root N Ruta chalepensis L. Rutaceae Stomach Problems Part Air IC Influenza And Rheumatic Satureja hortensis L. Lamiaceae Problems Part Air IC Scoparia dulcis L. Scrophullariaceae Kidney Infections Part Air N Kidney Infections Securidaca virgata Sw. Polygalaceae And Venereal Stem, root N Senna occidentalis (L.) Link Caesalpiniaceae Anti-Inflammatory Part Air N 269 Plant Name Family Uses Used Part Status Kidney Infection Smilax domingensis Willd. Smilacaceae Any Stem, leaf N Liver Problems Solanum americanum Mill. Solanaceae And Pressure Whole plant N Anticancel And Sonchus oleraceus L. Asteraceae Kidney Problems Part air pl Nat Spermacoce assurgens Ruiz & Pav. Rubiaceae Kidney Infections Part air pa N Infectious Tabebuia berteri i(DC.) Britton Bignoniaceae Problems Stem, leaf E Tagetes erecta L. Asteraceae Child Digestion Part Air IC Thespesia populnea (L.) Sol. ex Corrêa Malvaceae Kidney Infection Sheet N Trichilia hirta L. Meliaceae Vaginal Pain Sheet N Triumfetta bogotensis DC. Tiliaceae Liver Problems Whole plant N Urena sinuata L. Malvaceae Liver Problems Whole plant N Urera baccifera (L.) Gaudich. ex Kidney Disease Wedd. Urticaceae And Venereal Stem, leaf N Verbascum thapsus L. Scrophulariaceae Skin Infections Part Air Nat Respiratory Wallenia laurifolia SW. Myrsinaceae Infections Sheet N Xanthium strumarium L. Asteraceae Liver Problems Whole plant Nat Kidney Problems, Vaginal And Prostate Infection Yucca aloifolia L. Agavaceae Any Stem IC Zingiber cassumunar Roxb. Zingiberaceae Cancer Rhizome IC

Legend: N: native, E: Endemic; IC: Introduced/Cultivated, Nat: Naturalized

Table3. Distribution of affections and illnesses treated with MAPs (Vásquez & García, 1999)

% OF MAPS USED FOR THE AFFECTIONS TARGET ORGANS OF TARGET ORGANS Respiratory 4 Skin 5 Eyes, Nose and Ears 5 Circulatory 9 Infectious 22 Genitourinary 26 Digestives 28

270 2.10 El Salvador

The Republic of El Salvador is located on the Pacific Coast of Central America. It is bounded on the south by the Pacific Ocean, on the north-west by Guatemala, and on the north-east by Honduras. The country covers an area of 21,041 square kilometres. El Salvador has a fairly rugged landscape with very varied relief, made up mainly of two mountain ranges, the central coastal range and the northern range. The former is of recent volcanic formation and contains all the country's volcanoes, while the latter lies along the border with Honduras and contains the country's highest mountain, the Santa Ana volcano (2,385 m). A central plateau and interior valleys with fertile volcanic soils lie between the two ranges, while coastal plains 15 to 30 kilometres wide with alluvial soil stretch along the Pacific. El Salvador’s largest river, the Lempa, flows 320 kilometres to the Pacific. El Salvador's tropical climate varies due to elevation. The coastal plains along the Pacific are very hot, although the humidity is relatively low. From 600 to 1200 m a semitropical climate prevails, while above 1200 m the climate is temperate. El Salvador is the smallest country in Central America, covering approximately 23,000 square kilometres, and also the most densely populated, with 250 inhabitants per square kilometre. It has the smallest area of natural forest cover in the Americas: almost 6% of the country is covered by natural or secondary forests, 70% of soils show serious erosion problems and more than 80% of farming is carried out on steep land slopes. The Forest Service estimates that if land that has benefited from afforestation projects and coffee growing in recent years is taken into account, wooded and forest land could amount to as much as 12%. The system of protected areas is made up of 127 small scattered areas, totaling 37,200 hectares. The forest industry obtains most of its raw materials from neighbouring countries. El Salvador has the highest rate of degradation of forest resources in continental Latin America, with a forest cover representing 5.8% of the country’s total area. Five types of forest are found: scattered broad-leaved forests, mostly in the form of gallery forests; pine forests, sometimes mixed with broad-leaved species and also scattered; halophytic forests (mangroves); shrubland; and planted forests. There is practically no forest management in any of these types of forest. Activities are confined to granting felling permits or establishing plantations, without putting such stands under management. More attention is paid to planting than to the upkeep and management of the resulting stands. The few remnants of forest in El Salvador are being replaced by agriculture and urbanization. Nearly all forests, including protected areas, are in danger of being eliminated. Some conservation projects are currently being implemented. Reforestation activities focus on planting trees in specific forms as fences or shelterbelts, to mark off plots, in agroforestry, etc. but not on their management and upkeep. Planted forests represent only 0.3% of the country’s total area. There are about

271 180,000 hectares of coffee plantations identified as agroforestry systems, divided between 15,265 estates belonging to 12,207 producers, and these lands make important contributions to conservation and the generation of environmental services (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Traditional medicine is an integral part of rural health care in many areas of Central America, including El Salvador. Midwives and healers use local plants to effectively treat ailments, ranging from abrasions and fever to infections and breaks. In the rural villages people due to lack of hospitals or clinics and due to poverty rely on local herbalists for most medical needs (McDonnell, 2008). In El Salvador, herbal medicines are sold in pharmacies as prescription and over the counter medicines, and in special outlets (WHO, 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine The Republic of El Salvador has no national policy, laws, regulations, national programme, national office, expert committee or national research institute for TM/CAM. None of these is currently being developed. El Salvador established regulation of herbal medicines in 1988 through Decree No. 55; this is the same law that regulates conventional pharmaceuticals. Herbal medicines are regulated as prescription and over the counter medicines. Medical, health and nutrient content claims are made about herbal medicines. There is no national pharmacopoeia, nor is one in development. Instead, the following pharmacopoeias are used: German, Argentina, British, United States, Spanish, European, Swiss, International, Japanese and Mexican. The information contained in these pharmacopoeias is legally binding. No national monographs have been, or are being, developed; no others are used in their place. Manufacturing regulatory requirements consist of special GMP rules for herbal medicines; compliance with these rules is ensured through inspection and a manufacturing licensing system. Safety assessment regulatory requirements consist of special requirements including traditional use without demonstrated harmful effects and reference to scientific research on similar products. No control mechanism exists to ensure compliance with these safety requirements. There is a registration system, and 51 herbal medicines are registered. No herbal medicines are included on the national essential drug list. No post marketing surveillance system exists; however, one is being planned (WHO, 2005).

272 Medicinal and Aromatic Plant Resources A total of 6,594 species of plants have been recorded in El Salvador (2.58% of all those described worldwide). The number of endemic plant species is about 30, represented principally by bromeliads, orchids, ferns, herbs, shrubs and trees. These occur in the Montecristo and El Imposible National Parks and on the Cacahuatique and El Pital Hills (Catterson et al., 2004). The work by Guzmán early last century compiled 534 useful plants in El Salvador, and his book published originally in 1918 is of ample popular use (Guzman, 1975). There are 476 species of plants belonging to 134 families identified as being utilized for medicinal purposes in El Salvador. Of these 345 are natives and 131 exotic plants used to treat a total of 224 illnesses (Choussy, 1975-1978). The oleoresins obtained from the bark of balm (Myroxylon balsamum (L.) Harms) constitutes a commodity produced almost exclusively in El Salvador. The seed is used in the pharmaceutical industry for the production of medicines for the expulsion of renal calculations, as astringent, as well as for the elimination of spots and softener of facial wrinkles. The balm is marketed at national and international level (FAO, 2000).

Research and Development Activities The researchers from ProBioTec S. A. de C. V., San Salvador, El Salvador in collaboration with some German institutes and Universities evaluated several plants species from El Salvador mainly for antiplasmodial activities. These are the plants used as antimalarial or antipyretic remedies in traditional medicinal in the country. These plants along with their traditional uses are listed in Table 1 (Kohler et al., 2002). There is no information regarding research for conservation and development of country’s MAPs and their resources. A national program conducted during 1976-89 by El Salvador University has evaluated 283 plants of medicinal use in the country (about 70% native to Mesoamerica) and studying their chemical composition and some of the biological activities (Mena Guerrero, 1994). One of the most commonly used plants, Hamelia patensd Jacq., for skin afflictions has been evaluated by the double incision wound healing, demonstrating interesting activity (Gomez-Beloz et al., 2003).

Trade and Marketing The selected botanical exports of El Salvador during 2007 under the HS code 0902- 0910 that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others were 840,718 kg. This country’s exports under HS codes 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery

273 elm bark, and witch hazel leaf & bark, among many others), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (now mainly a product of El Salvador) and American storax balsam Liquidambar styraciflua, among many others), and 140490 (includes botanicals such as broussonetia Broussonetia papyrifera, canaigre Rumex hymenosepalus, oak bark Quercus robur, quebracho bark Aspidosperma quebracho-blanco, quillaja bark Quillaja saponaria, among others) were 22,428, 67366 and 71,479 respectively. Under the HS 3301 that includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils the reported export volume was 4,649 kg (ITC, 2008).

Constraints and Problems Little information is available regarding research, trade and government efforts in developing MAPs and their resources in the country. The country needs a clear, comprehensive policy for MAPs cultivation and their sustainable utilization along with research and development for deriving commercial as well as health benefits for its populations.

Table 1: Some medicinal plants of El Salvador along with their traditional uses (Kohler et al., 2002) Botanical name Family Part used Uses Calea tenuifolia Kunth Asteraceae Leaves bilharziose, diarrhoea, febrifuge, haemorrhage, malaria Hymenaea courbaril L. Fabaceae Stem Rheumatism, substitute for quinine, Jatropha curcas L. Euphorbiaceae Aerial parts febrifuge, molluscicidal Momordica charantia L. Cucurbitaceae Whole plant antimalarial, hypoglycemic Moringa oleifera Lam. Moringaceae Flowers, leaves, antibiotic, antitumor stem Samanea saman (Jacq.) Fabaceae Leaves, bark antimalarial Merr.

274 2.11 Grenada

Grenada, located between the Caribbean sea and the Atlantic Ocean, is the southernmost of the Windward Islands. It consists of the island of Grenada and some of the southern Grenadines. It lies about 140 kilometres north of Venezuela. The country´s total area is 344 square kilometres of which Grenada Island comprises 311 square kilometres. Grenada is of volcanic origin and is generally mountainous. The highest peak is Mount Saint Catherine (840 m). The valleys among the mountains are picturesque and also fertile, with many swift-flowing streams. The island also has hot springs, several mountain lakes, and excellent beaches. The climate is tropical. Trees and forests in Grenada are economically important for their role in ecotourism and recreation. They supply forest products such as timber, and various non- wood forest products (NWFPs) including medicinal plants, spices, nuts, gums and resins. Forest cover amounted to 5,200 hectares in 2000 and there were no major changes in forest cover from 1990 to 2000. The Grand Etang Forest Reserve, declared in 1906, covers 1,547 hectares. Another 3,200 hectares of former Crown lands are currently under protection at Mount Saint Catherine, Levera National Park, Morne Gazo and the Annandale Estate. The Grand Etang Forest Reserve contains approximately 166 hectares of exotic plantations established from 1957. Blue mahoe (Hibiscus elatus Sw.) is the main species, occupying about 75% of plantations. Pines (Pinus caribaea Morelet) account for about 20%, and mahogany (Swietenia macrophylla King) and Cupressus lusitanica Mill., 5%. Most of the plantations are located on steep slopes with poor accessibility. The major threats to forest loss are housing development in the south and charcoal burning and grazing on privately owned mangrove forests in the north. However, the current deforestation rate is practically zero (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Some local healers recommend and sell the herbal remedies; however, no information available regarding the extent of use and popularity of traditional medicine in the country at present.

Government Efforts in Development of Traditional Medicine/Phytomedicine Grenada has no integrated national programme or institutional framework for traditional medicine and plant resources management and conservation. There are also no policies or legislation directly related to the subject (FAO, 1995).

275 Medicinal and Aromatic Plant Resources Grenada has a diversity of plant resources that include species of medicinal and aromatic plants besides others. There are many species plants locally known to have medicinal properties. However, many wild species of plants have yet to be identified and documented. Some of the common MAPs found in the country are Cassia alata L., Cassia fistula L., Cassia occidentalis L., Cyperus rotundus L., Ricinus communis L., and Sauvagesia erecta L. etc. Grenada is known as the isle of spice because it produces a wide range of spices including cloves, cinnamon, bay leaf, tanka bean etc. (FAO, 1995).

Research and Development Activities The Caribbean Agricultural Research & Development Institute (CARDI) Grenada has been involved in a wide range of research in the field of plant genetics. The Grenada Science and Technology Council have been conducting research on medicinal plants. Several agencies have been involved in collection, prorogation and distribution of plant genetic resources including The Miribeau Agricultural nursery, the Grenada Cocoa Association, the Forestry Department and the Banana Tissue Culture Laboratory. The plants taken up in for such research work included Cinnamomum spp., Citrus spp., Mangifera spp., Musa spp., Persea americana Mill., Spondias spp. and Theobroma cacao L. etc. (FAO, 1995). A study entitled “Investigation of Grenadian medicinal plants for antibacterial activity in childhood diarrhoea” was undertaken by Windward Islands Research and Education Foundation (WINDREF), which is also registered in Grenada as an NGO. WINDREF Research Institute is located at St. George's University in Grenada West Indies. Two prior MSc theses have been conducted at WINDREF during the years of 1996-1997 which studied the tradition of bush medicine in Grenada. One was a survey of domestic/personal use of bush medicine while the second was a descriptive study based on interviews with bush doctors aimed at characterizing which plants were being used for which conditions. The results again identify diarrhoea as commonly treated (Anonymous, 2002). Some current research projects undertaken at the WINDREF Research Institute in Grenada include the investigation of and use of medicinal plants in Grenada and the effects of Grenadian medicinal plants on endemic microbial causes of diarrhoeal diseases (Anonymous, 2007).

Trade and Marketing No information is currently available regarding the MAPs trade in Grenada.

276 Constraints and Problems The main constraints affecting the effective management and utilization of MAPs resources are the lack of political awareness on their potential economic values, lack of research and development facilities and lack of trained human and financial resources. The country therefore needs political awareness and support, establishment of an institution for research and development, an inventory of Grenada’s indigenous MAP resources, development and implementation of a public awareness campaign on MAPs conservation and utilization and financial support.

277 2.12 Guatemala The Republic of Guatemala, located in Central America, is bounded on the west and north by Mexico; on the east by Belize and the Gulf of Honduras; on the south-east by Honduras and El Salvador and on the south by the Pacific Ocean. Its total area is 108,889 square kilometres. The country can be divided into three main regions: The great mountain chains stretch from the border with Mexico down to the border with Honduras, with the highest peaks being found in the west and deep valleys dividing the mountains. The southern edge of the western highlands is marked by the Sierra Madre range, which stretches from the Mexican border south and east, almost to Guatemala City. It then continues at lower elevations toward El Salvador, in an area known as the Oriente. The chain is punctuated by steep volcanic cones, including Tajumulco Volcano (4,220 m), the highest point in the country. The northern chain of mountains begins near the Mexican border with the Cuchumatanes range, then stretches east through the Chuacús and Chamá mountains and slopes down to the Santa Cruz and Minas mountains near the Caribbean Sea. The northern and southern mountains are separated by a deep rift, where the Motagua River and its tributaries flow from the highlands into the Caribbean. Most of the population lives in this region. The main conifer forests are also found here, but are subject to an ever-increasing demand for farmland and pasture. In the east of this zone, pressure has been so great that conifer stands are now only residual. The second region the low-lying Pacific coast is primarily agricultural, although the effects of deforestation of the highlands situated to the north are felt here too, since it is a flood-prone zone. Broadleaved tropical rainforests are found in El Petén. A strong settlement policy has been pursued in this region in recent years, thus the forested area has shrunk considerably. Until very recently, only a small part of El Petén region was accessible by road, river or tracks. The climate of Guatemala varies according to altitude, from hot coastal plains to cold mountain heights. Temperature vary greatly from area to area because of differences in altitude. It is calculated that in 2000 Guatemala had a forest cover of 26.3% (2.85 million hectares), 133,000 hectares of which were forest plantations. About 28% of the country (about 2.8 million hectares) is protected under the National Conservation System, with 2.1 million hectares of this area belonging to the Maya and Sierra de las Minas Biosphere Reserves. Forest harvesting increasingly follows sustainability criteria and standards. In past decades, development and settlement policies contributed heavily to deforestation, with the highest percentage occurring in the broad-leaved forests of

278 the northern lowlands (Franja Transversal del Norte and Petén), followed by pine and forests in Pacific Basin (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The use of medicinal plants in areas of Mayan culture, such as Guatemala, has been significant since ancient times. Today, many habitants of rural areas of Guatemala depend greatly on the use of medicinal plants for their primary health care needs. Guatemala is considered to be one of the poorest countries in Latin America, yet it is a nation extremely rich in traditional medical knowledge and biological resources. According to the Pan American Health Organization, 71% of its total population lives in poverty and less than 60% of the population has access to public services or biomedical health care facilities. However, Guatemala has a long history of use of traditional Maya medicine, and approximately 80% of the current population rely on medicinal plants as their primary source of medical treatment (Michel et al., 2007). The principal traditional medicine specialists in Guatemala are traditional midwives, bonesetters, herbalists, spiritualists, chupadores, massage therapists, and practitioners who specialize in muscle tears. There are approximately three traditional health practitioners per municipality. About 250 traditional health practitioners are registered with the TOTO-Integrado Association. The programme of the Integral Healthcare System links traditional and allopathic medicine. Although there is no official licence to practise traditional medicine, 10% of traditional medicine practitioners have a permit to practice. These permits are issued upon completion of a training course organized by the Public Health Ministry and local health centres. The permits are not available throughout the country. Traditional medicine practitioners without permits may practise within their own communities, but they are rejected by institutions and risk being sued for malpractice (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine The national policy of the Republic of Guatemala on TM/CAM was established in 2000 in the Políticas del Plan Nacional de Salud, 2000-2004 (Policies of the National Health Plan, 2000-2004). Laws and regulations are currently being developed. The national programme and national office were established in 2001; the office the Programa Nacional de Medicina Popular Tradicional (National Programme of Popular Traditional Medicine). The Ministry of Public Health and Social Assistance administers the office. There is no expert committee. National research institutes on traditional medicine are part of the Universidad de San Carlos de Guatemala, including the Centro de Estudios Folklóricos (Centre for Folklore Studies, established in 1981), the Faculty of Chemical Sciences and Pharmacy, the Faculty of Agronomy and the Centro de Estudios Interétnicos.

279 Guatemala has issued a number of regulations related to herbal medicines, which are partly the same as those for conventional pharmaceuticals. Herbal medicines are regulated as prescription and over the counter medicines. By law, medical and structure/function claims may be made. A national Vademecum and national monograph was published in 2009; the WHO monographs are used in place of the national ones. The manufacturing regulatory requirements are specific GMP for natural products adapted from those applied to conventional pharmaceuticals; implementation is enforced through annual self inspections. Special safety requirements include traditional use without demonstrated harmful effects and reference to documented scientific research on similar products. There are control mechanisms for these safety requirements, but no specific information is available. The registration system is currently under revision, so the number of registered herbal medicines is not known. There are no herbal medicines on the essential drug list. There is no post marketing surveillance system, nor is one currently being planned. In Guatemala, few herbal medicines are sold in pharmacies as prescription drugs and most of them are sold as over the counter medicines (WHO, 2005). Courses in traditional medicine are available through the Public Health Ministry. Additionally, CDRO in Totonicapan, Barefoot Doctors in Chinique, and Quiche Guatemala offer technical studies, seminars, informal presentations, and workshops that include instruction in traditional medicine. Traditional medicine is also learned through apprenticeships. Personnel in the official health services do not receive training in traditional medicine (WHO, 2001). Since 2004 there is a Master’s degree programme in multidisciplinary production and utilization of medicinal plants at University of San Carlos, and specialization studies has recently started for biological medicine for physicians.

Medicinal and Aromatic Plant Resources Guatemala has a very rich flora and biodiversity due to its different climatic zones, altitudes, soils and topography. Often people grow MAPs in small home gardens for personal use. Some indigenous plants and their traditional uses are listed in Table 1 (Poll, 2005). The flora of Guatemala is very rich in medicinal plants, though many of them have not been scientifically studied. The first work on traditional medicine from Mexico was written in Nahuatl in 1552, and mentioned the use of 251 plants (Poll, 1999). The Historia Natural del Reino de Guatemala written in 1722, described 127 useful plants found in Guatemala (Ximenez, 1967). The most important medicinal plants of Guatemala, by their marketed volumes and economic value are the calaguala (Polypodium leucotomos L.) and zarzaparrilla (Smilax domingensis). On a smaller scale, plants like Mimosa tenuiflora (Willd.) Poir., Petiveria alliacea L. Tridax procumbens L.,

280 Phyla dulcis (Trevir) Moldenke (FAO, 2000; Caceres et al., 2006), Valeriana prionophylla Standl., Lippia graveolens L., Curcuma longa L., and Bixa orellana L. are important.

Research and Development Activities The University of San Carlos is undertaking research on medicinal plants. The Faculty of Chemical Sciences and Pharmacy, University of San Carlos has carried out ethnobotanical surveys and literature review identifying 408 plants used in Guatemala for the treatment of gastrointestinal disorders (Caceres et al., 1993). 52 Plants were screened for antifungal activity in another study (Caceres et al., 1993a). A study on the plants used in Guatemala for the treatment of sexually transmitted diseases was carried out by the Faculty, specially plants popularly used for the treatment of gonorrhoea were tested for in vitro activity against Neisseria gonorrhoeae (Caceres et al., 1995). The plants used against protozoal infections were studied by the researchers. Extracts were prepared from 13 native plants used for the treatment of protozoal infections (Caceres et al., 1998). A collaborative study carried out by Institute of Chemical and Biological Investigation of the Faculty along with Universities in Austria, Germany, Italy, Spain and Brazil was reported. In these studies, some commonly used plants in Guatemala were evaluated for platelet antiagregant activity (Villar et al., 1997), the treatment of protozoal infections (Berger et al., 1998; Berger et al., 2001), neuropharmacological profile (Morales-Cifuentes et al., 2002), antioxidant activity (Navarro et al., 2003), virucidal activity against HIV-1 infection (Bedoya et al., 2008), anti-fungal (Gaitan et al., 2011) among others. Antioxidative and vasorelaxant activity of Valeriana prionophylla Standl. was evaluated (Piccinelli et al., 2004) and further preclinical evaluation demonstrated activities equivalent to V. officinalis (Holzman et al., 2011). An ethnobotanical survey was carried out at the Universidad del Valle de Guatemala to document the valuable knowledge from different ethnic groups in various regions about the use of medicinal and aromatic plants. The plants were collected, taxonomically identified, and incorporated as herbarium specimens at the Herbarium UVAL. Interesting plants for medicinal use were analyzed in laboratory screening for active substances. Plants with the most promising attributes were taken to the Universidad del Valle for evaluation. Domestication projects or cultivation protocols were recommended for plants used by local people and collected from their natural habitats (Poll, 2005). Investigation on the medical ethnobotany of the Q’eqchi Maya of Livingston, Izabal, was undertaken, initially to know their general ethnobotany, detecting 102 plants of medical use (Girón et al., 1991), and lately to explore their perceptions, attitudes, and treatment choices related to women’s health. The Q’eqchi, third largest Maya population in Guatemala (700,000) occupy the largest geographic area of any other ethnolinguistic group in the country and like most Maya communities, they maintain a rich tradition of medical beliefs and practices that include the use of the native flora to treat a variety of illnesses. Through participant observation and interviews a total of 48 medicinal plants used to treat conditions related to 281 pregnancy, childbirth, menstruation, and menopause were collected and identified followed by the evaluation of 20 species in bioassays relevant to women’s health. The study was conducted by the Department of Environmental Engineering, Rural University of Guatemala; Herbarium of the School of Biology and School of Biological Chemistry of the Faculty of Chemical Sciences and Pharmacy, University of San Carlos along with Department of Pharmacy Practice, College of Pharmacy, and UIC/NIH Centre for Botanical Dietary Supplements Research, College of Pharmacy, University of Illinois at Chicago, USA. Some local plants along with their uses by the Q’eqchi are listed in Table 2 (Michel et al., 2007). Other ethnobotanical surveys include Ch’orti’ Maya in Eastern Guatemala, where 381 plant taxa were detected as being used in ten categories of illnesses (Kufer et al., 2005).

Trade and Marketing 1 The selected botanical exports of Guatemala during 2007 under the HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others), 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), 121220 (includes botanicals such as kelp Laminaria spp., laver or nori Porphyra spp., and sea tangle Laminaria japonica or Echlonia kurome, among many others.), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms and American storax balsam Liquidambar styraciflua L., among many others), 130219 (Includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others), 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others), 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils), and 400130 (botanicals such as gutta percha latex Payena spp. and Palaquium gutta (Hook.) Baill., balata Manilkara bidentata (A. DC.) A. Chev., chicle Manilkara zapota (L.) P. Royen, guayule Parthenium argentatum A. Gray, leche caspi sorva Couma macrocarpa Barb. Rodr., among other similar natural gums) were 29,693,661, 612,552, 45, 153,784, 4,907, 770,220, 73,934 and 80,692 kg respectively (ITC, 2008). 2 None of the products listed in the ITC reports are currently exported from Guatemala (Cáceres, A., 2011. Personal communication) 3 No more information regarding trade in MAPs and their products in Guatemala is currently available.

282 Constraints and Problems People of rural Guatemala use many plants in their daily lives, but specific knowledge about healing benefits is restricted to elderly persons. Most of the plants used in Guatemala in traditional medicine are not scientifically studied. The country should encourage the use of traditional medicine based on scientific validation, carry research, promote cultivation of important species, encourage trade and sustainable utilization of natural resources of MAPs.

REFERENCES Bedoya, L.M., Alvarez, A., Bermejo, M., González, N., Beltrán, M., Sanchez-Palomina, S., Cruz, S.M., Gaitán, I., del Olmo, E., Escarcena, R., Garvía, P.A., Caceres, A., San Feliciano, A., and Alcamí, J., 2008, Guatemalan plants extracts as virucides against HIV-1 infection. Phytomedicine, 15:520-524. Berger, I., Barrientos, A. C., Cáceres, A., Hernández, M., Rastrelli, L., Passreiter, C. M. and Kubelka, W., 1998, Plants used in Guatemala for the treatment of protozoal infections: II. Activity of extracts and fractions of five Guatemalan plants against Trypanosoma cruzi. J Ethnopharmacol., 62(2): 107-115 Berger, I., Passreiter, C.M., Cáceres, A., Kubelka. W., 2000, Antiprotozoal activity of Neurolaena lobata. Phytother Res., 14:1-4 Cáceres, A., Fletes, L., Aguilar, L., Ramirez, O., Figueroa, L., Taracena, A. M. and Samayoa, B., 1993, Plants used in Guatemala for the treatment of gastrointestinal disorders. 3. Confirmation of activity against enterobacteria of 16 plants. J Ethnopharmacol., 38(1): 31-38 Cáceres, A., Lopez, B., Juarez, X., del Aguila, J. and Garcia, S., 1993a, Plants used in Guatemala for the treatment of dermatophytic infections. 2. Evaluation of antifungal activity of seven American plants. J Ethnopharmacol., 40(3): 207-213 Cáceres, A., Menendez, H., Mendez, E., Cohobon, E., Samayoa, B. E., Jauregui, E., Peralta, E. and Carrillo, G., 1995, Antigonorrhoeal activity of plants used in Guatemala for the treatment of sexually transmitted diseases. J Ethnopharmacol., 48(2): 85-88 Cáceres, A., Lopez, B., Gonzalez, S., Berger, I., Tada, I. and Maki, J., 1998, Plants used in Guatemala for the treatment of protozoal infections. I. Screening of activity to bacteria, fungi and American trypanosomes of 13 native plants. J Ethnopharmacol., 62(3): 195-202 Cáceres, A., Gupta, M. P., Ocampo, R.A., Mendoza, J., Herrera, M.R., Solis, P.N., Cruz, S.M., and Martínez, V., 2006, Multidisciplinary development of phytotherapeutic products from native Central American Plants. Acta Hort. (ISHS), 720:149-155.

283 Cáceres, A., 2009, Vademécum Nacional de Plantas Medicinales. Guatemala, Editorial Universitaria, USAC, 313 p. Cáceres, A., 2011, Personal communication. FAO, 2000, Country Compass: Guatemala. Non-Wood News 7, March 2000. Available at: http://www.fao.org/docrep/x4945e/x4945e00.HTM (29 Aug. 2008) FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Gaitán, I., Paz, A.M., Zacchino, S.A., Tamayo, G., Giménez, A., Pinzón, R., Caceres, A., and Gupta, M.P., 2011, Subcutaneous anrtifungal screening of Latin American plant extracts against Sporothrix schenckii and Fonsecaea pedrosoi. Pharmaceut. Biol., 49:907-919 Girón, L.M., Freire, V., Alonzo, A. and Caceres, A., 1991, Ethnobotanical survey of the medicinal flora used by the Caribs of Guatemala. J. Ethnopharmacol., 34:173- 187 Hotlzmann, I., Cechinel Filho, V., Mora, T.C., Cáceres, A., Martínez, J.V., Cruz, S.M., and de Souza, M.M., 2011, Evaluation of behavioural and pharmacological effects of hydroalcoholic extract of Valeriana prionophylla Standl. From Guatemala. eCAM, 2011:1-9 ITC, 2008, Market News Service, Medicinal Plants & Extracts, 27: 40, Jun. 2008, Geneva, Switzerland Kufer, J., Förther, H., Pöll, E., and Heinrich., M., 2005, Historical and modern medicinal plant uses – the examples of the Cho’orti’ Maya and Ladinos in Eastern Guatemala. J. Pharm. Paharmacol., 57:1127-1152 Michel, J., Duarte, R. E., Bolton, J. L., Huang, Y., Caceres, A., Veliz, M., Soejarto, D. D. and Mahady, G. B., 2007, Medical potential of plants used by the Q'eqchi Maya of Livingston, Guatemala for the treatment of women's health complaints. J Ethnopharmacol., 114(1): 92-101 Morales-Cifuentes, C., Gómez-Seranillos, Iglesias, I., Villar del Fresno, A.M., Morales, C., Paredes, M.E., Caceres, A., 2002, Neuropharmacological profile of ethnomedicinal plants of Guatemala. J Ethnopharmacol., 79:395 Navarro, M.C., Montilla, M.P., Cabo, M.M., Galisteo, M., Caceres, A., Morales, C., and Berger, I., 2003, Antribacterial, antiprotozoal and antioxidant activity of five plants used in Izabal for infectious diseases. Phytother. Res. , 17:325-329. Piccinelli, A.L., Arana, S., Caceres, A., di Villa Bianca, R. E., Sorrentino, E. and Rastrelli, L., 2004, New lignans from the roots of Valeriana prionophylla with antioxidant and vasorelaxant activities. J. Nat. Prod., 67:1135-1140 Poll, E., 1999, Medicinal plants of Guatemala with hypoglycemic effects. Acta Hort. (ISHS), 500: 197-202

284 Poll, E., 2005, Medicinal and aromatic plants of Guatemala and the need for their conservation. Acta Hort. (ISHS) 676:167-170 Villar, R., Calleja, J.M., Moeales, C., and Caceres, A., 1997, Screening of 17 Guatemalan medicinal plants for platelet antiaggregant activity. Phytother. Res., 11:441-445 WHO, 2001, Legal Status of Traditional and Complementary/Alternative Medicine: A Worldwide Review, WHO/EDM/TRM/2001.2, WHO, Geneva WHO, 2005, National policy on traditional medicine and regulation of herbal medicines, Report of a WHO global survey, WHO, Geneva Ximenez, F., 1967, Historia Natural del Reino de Guatemala, Editorial Jose de Pineda Ibarra, Guatemala

Table 1: Some medicinal and aromatic plants with their traditional uses in Guatemala (Poll, 2005)

Botanical name Family Part used Uses Bocconia arborea Papaveraceae Sap Toothache Watson Chenopodium Chenopodiaceae Leaves, Burns, expelling intestinal parasites, ambrosioides L. seeds hemorrhoids, insect bites & ulcers. Drimys granadensis L. f. Winteraceae Leaves, Analgesic to relieve toothache. bark Eryngium foetidum L. Apiaceae Leaves Diarrhoea, dispel flatulence, indigestion, stomach pains. Hamelia patens Jacq. Rubiaceae Roots, Antiseptic, burns, expel kidney stones, leaves fungal infections, skin rashes, rheumatism. Lippia graveolens Kunth Verbenaceae Leaves Colic, diarrhoea, fever, headaches, heartburn, nausea. Ocimum micranthum Lamiaceae Leaves Colds, cough, diarrhoea, Wild. Fever, rheumatism, stomach disturbances.

Parthenium Asteraceae Leaf and Colds, leishmania, malaria, rheumatic hysterophorus L. flower pains. Petiveria alliacea L. Phytolaccaceae Leaves Asthma, diabetes, rheumatism, treatment of sinusitis Piper auritum Kunth Piperaceae Leaves, Fevers, food flavouring, rheumatism, stem stimulant for its gastric properties. Simarouba glauca DC. Simaroubaceae Bark Astringent, diarrhoea, dysentery, haemorrhage, malaria. Tagetes lucida Cav. Asteraceae Flowers, Anaemia, antifungal, antimicrobial, leaves diarrhoea, digestive disturbances, nervous affections, rheumatism. Tridax procumbens L. Asteraceae Leaves Diabetes, gastrointestinal and respiratory affections, high blood pressure, inflammation. Yucca elephantipes Agavaceae Leaves Bronchitis, cough. Regel, nom. inval. 285 Table 2: Some local plants used by the Q’eqchi in Guatemala (Michel et al., 2007)

Botanical name Local Family Part used Uses name Camphyloneurum spp. Cola de Polypodiaceae Leaves Body aches. pavo Cassia reticulata Willd. Barajo Fabaceae Leaves Dysmenorrhoea Cecropia peltata L. Guarumo Urticaceae Leaves Expel placenta, insomnia. Cephaelis tomentosa Ak Pere Rubiaceae Leaves Post-partum (Aubl.) Vahl Tzo’ haemorrhaging. Cissampelos tropaeolifolia Bejuco de Menispermaceae Leaves Releases placenta. DC. ombligo Citrus aurantium L. Naranja Rutaceae Leaves Body aches & sweats, agria insomnia. Clidemia setosa (Triana) Ixq Q’een Melastomataceae Leaves Fertility regulation. Gleason Crossopetalum eucymosum Ra Mox Celastraceae Leaves Body aches, cold. (Loes. et Pitt.) Lundell Dioscorea bartlettii C. V. Cocolmeca Dioscoreaceae Rhizomes Anaemia. Morton Henriettea cuneata Ixq Q’een Melastomataceae Leaves Fertility regulation. (Standl.) L. O. Williams Hibiscus rosa-sinensis L. Utz Uj’ Malvaceae Leaves, Hemorrhage, infertility. flowers Hyptis verticillata Jacq. Verbena Lamiaceae Leaves Erratic menses releases placenta. Justicia breviflora (Nees) Rax Pim Acanthaceae Leaves Menorrhagia, post- Rusby partum hemorrhage. Justicia fimbriata (Nees) Numay Acanthaceae Leaves Insomnia V.A.W. Graham Pim Mimosa pudica L. Dormilona Mimosaceae Leaves Insomnia Momordica charantia L. Sorosi Cucurbitaceae Leaves Amenorrhea, dysmenorrhea. Neurolaena lobata (L.) Kamank Asteraceae Leaves Dysmenorrhoea, Cass. vaginal infection. Ocimum micranthum Obej’ Lamiaceae Leaves Dysmenorrhoea, Willd. vaginal hemorrage. Piper auritum Kunth Ob’el Piperaceae Leaves Dysmenorrhoea, galactagogue. Piper hispidum Sw. Puchuq Piperaceae Leaves Amenorrhea, body aches, dysmenorrhoea. Piper tuerckheimii C. DC. Caite de Piperaceae Leaves Inflammation Diablo Rondeletia stachyoidea Kandel Rubiaceae Leaves Insomnia. Donn. Smith Che Scoparia dulcis L. Como Plantaginaceae Leaves Labor pains. Escobillo Sida rhombifolia L. Mesbel Malvaceae Leaves Burning urine, labor pains.

286 Smilax domingensis Willd. Chub Smilacaceae Rhizomes Night sweats. Ixim, Cocolmeca Solanum americanum Mill. Hierba Solanaceae Leaves Anaemia, Mora, dysmenorrhoea. Quilete, Macuy Zebrina pendula Schnizl. Cha cha Commelinaceae Leaves Dysmenorrhoea. Zingiber officinale Roscoe Xinxibeer Zingiberaceae Rhizomes Dysmenorrhoea, night sweats.

287 2.13 Haiti The Republic of Haiti occupies the western third of the island of Hispaniola. It is bounded on the north by the Atlantic Ocean, on the east by the Dominican Republic, on the south by the Caribbean Sea, and on the west by the Windward Passage, which separates it from Cuba. Its area is 27,750 square kilometres. Two chains of rugged mountains run across the northern and southern parts of Haiti. They form two peninsulas at the western end of the island with the Gonâve Gulf and the Ile de la Gonâve between. The Chaîne du Haut Piton, which runs along the northern peninsula, reaches a height of 1,183 m. The Massif de la Hotte reaches a height of 2,347 m at the extreme western end of the southern peninsula. The Massif de la Selle, which begins just south-east of Port-au-Prince, reaches a height of 2,680 m at Pic la Selle, the highest point in Haiti. Other mountain ranges include the Massif des Montagnes Noires and Chaîne des Cahos and the solitary peak of Montagne Terrible. The wide Artibonite Valley of the Artibonite River lies between the mountains in eastern Haiti. The Île de la Tortue (also called Tortuga Island) lies off the northern coast. Haiti has a mild tropical climate greatly influenced by topography. The country is vulnerable to destructive hurricanes, usually occurring between June and October. The current forest cover of Haiti is about 88,000 hectares or 3.2% of the land area. The deforestation process that began under colonization has continued to be severe 5.7% (7,000 hectares) per year in the period 1990-2000. The greatest cause of deforestation has been the demand for fuel wood (which provides almost all residential fuel), as well as logging for construction (scaffolding, timber), furniture and handicrafts. The main vegetation types are pine forests, chiefly at high elevations; closed broadleaf forests at elevations above 800 m; humid upland and lowland forests; dry forests; mangroves; and scattered trees in agricultural areas. There are 20,000 ha of forest plantations. Of the remaining forests, virtually all have been drastically modified. Deforested areas are burnt, cultivated and grazed by untended goats. Loss of forest cover has resulted in soil erosion, silting of dam and other hydraulic works and reduction in quality and quantity of water resources. The densest forests remaining are in the National Parks. The major parks are Pic Macaya Peak (2,000 hectares) and Parc La Visite (4,000 hectares). The absence of well defined boundaries and limited funding prevent effective protection. The other large forest area in the country is the Forêt des Pins of 32,000 hectares (of which 15,000 hectares is actually forest). It is valued for its 288 species richness and its protective and recreational roles. This forest is the chateau of the Plaine du Cul de Sac, providing water for Port-au-Prince. It has a great variety of tree species more than 100 including some colorful and beautiful umbelliferous species and agave (Agave antillanum). The island of Hispanola is the only natural growing place of Pinus occidentalis Kunth . The main non-wood forest products are honey, the fruit caïmite (Chrysophilum spp.), edible mushrooms, snails, flowers and leaves for infusions and medicinal and aromatic plants (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The herbal medicine is widely used in Haiti especially in rural areas. Most people continue to meet their health-care needs through traditional remedies. In addition to home remedies, traditional medicine specialists (doktè fey) provided massage and herbal medicines. Traditional midwives, who also receive training in modern methods from the government, assist in births mainly in rural areas (Anonymous, 1989). Nearly half of Haiti’s health services are concentrated in the capital and its poor neighborhoods, with the rest located in rural areas. Although Haiti has very well qualified health workers, there are no comprehensive statistics on the health workforce in the country. Traditional medicine plays an important role, since it constitutes the first recourse for almost 80% of the population due to its low cost and proximity (Anonymous, 2008).

Government Efforts in Development of Traditional Medicine/Phytomedicine Haiti is one of the poorest and most vulnerable countries in the Americas. In recent years, conditions have worsened as a result of the unstable social and political situation, and the impact of natural disasters, which have affected large areas of the country. The political and economic turmoil has disrupted Haiti's health care infrastructure severely. However, since the United Nations intervention, there has been some improvement in health conditions. The Ministry of Health prioritizes developing family medicine in order to provide the country with well-trained physicians who can treat most of the common health problems of Haiti. The common preventable and treatable problems are contributing to short life expectancy and high infant mortality (Fournier and Dodard, 1997).

289 There is no information regarding the government efforts to promote and develop traditional herbal medicines in the country.

Medicinal and Aromatic Plant Resources Some information on the plants used in the country for treatment of various health problems has been gathered in the past in ethnobotanical surveys. About 20 plants including Casearia ilicifolia Vent., Eleutherine bulbosa (Mill.) Urb., Rhoeo spathacea (Sw.) Stearn and Stemodia durantifolia (L.) Sw. are reported to be popularly used in Haiti as abortifacients or emmenagogues by women (Weniger et al., 1982). However, much information on the number and types of plants used as medicine, their availability, harvesting practices, cultivation and status of natural resources is currently unavailable.

Research and Development Activities Some studies have been reported from the Laboratoire de Pharmacognosie, Faculté de Pharmacie, Université Louis Pasteur de Strasbourg, Illkirch, France. An ethnomedical and ethnopharmacological research on the traditional use of plants to cure human diseases, carried out in the Thomonde area located in the Central Plateau of Haïti was reported during late 1980s from France. The research published in two parts included ethnomedical study of the traditional folk therapy system (part one) and listed 161 local plants used for treating 38 common diseases (part two). These species were collected, and identified with their Latin names, local names, medicinal uses, part used along with the medicinal preparations (Weniger et al., 1986; 1986a). The TRAMIL Programme (Applied Research on the Traditional Popular Medicine in the Caribbean Basin) since 1983 has been underway in several countries of the West Indies and Central America. The programme was started in Haiti and in the Dominican Republic, has now extended to several other countries of the region. The goal of the programme is to evaluate the traditional use of medicinal herbs in order to help unprivileged populations from this geographical area. The TRAMIL Programme leads to protection of cultural heritage and integration of effective and secure traditional remedies in primary health care (Weniger, 1991). However, there are no reports currently available regarding the national institutes involved in research on MAPs and kind of development efforts being made in this direction.

290 Trade and Marketing Haiti is a major supplier of vetiver oil to the world market (total sales of US$8.2mn in 2005). Vetiver oil production is located in the South Western part of the island, near Les Cayes. Haiti also produces essential oil from the wood of Amyris balsamifera and from orange and other Citrus fruits (Anonymous, 2007).

Constraints and Problems Haiti needs adequate legislation to address the issue of development of traditional medicine in the country in order to properly document its valuable knowledge on such medicines, proper research, inventorization of their natural resources, cultivation efforts to save their diminishing population and trade development on MAPs. The poverty and institutional weakness are major factors which need to be addressed in the structuring of such development programme for deriving long term health and economic benefits for its people.

REFERENCES Anonymous, 1989, Haiti-A country study. Based on the Country Studies Series by Federal Research Division of the Library of Congress. Available at: http://www.country-data.com/ (29 Aug. 2008) Anonymous, 2006, The challenge of Haiti. Health: A right for all. Pan American Health Organization, Regional Office of the World Health Organization, Washington D.C. Available at: http://www.paho.org/english/d/csu/TheChallengeofHaiti.pdf (29 Aug. 2008) Anonymous, 2007, The global essential oils trade. Caribbean Regional Negotiating Machinery Private Sector Trade Brief, Vol. 27, Sept-Oct 2007. FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Fournier, A. M. and Dodard, M., 1997, The health care delivery crisis in Haiti. Fam Med., 29(9): 666-669 Weniger, B., Haag-Berrurier, M. and Anton, R., 1982, Plants of Haiti used as antifertility agents., Journal of Ethnopharmacology, 6(1): 67-84 Weniger, B., Rouzier, M., Daguilh, R., Foucaud, J., Robineau, L. and Anton, R., 1986, Traditional medicine in the Central Plateau of Haiti. 1. Study of the

291 traditional therapeutic system in a rural socio-cultural area. Journal of Ethnopharmacology, 17(1): 1-11 Weniger, B., Rouzier, M., Daguilh, R., Henrys, D., Henrys, J. H. and Anton, R., 1986a, Traditional medicine in the Central Plateau of Haiti. 2. Ethnopharmacologic inventory. Journal of Ethnopharmacology, 17(1): 13-30 Weniger, B., 1991, Interest and limitation of a global ethnopharmacological survey. Journal of Ethnopharmacology, 32(1-3): 37-41

292 2.14 Honduras The Republic of Honduras, located in Central America, is bounded on the north and east by the Caribbean Sea, on the south by Nicaragua, on the south-west by the Pacific Ocean and El Salvador and on the west by Guatemala. It has an area of 112,090 square kilometres. About 60% of Honduras is an upland plateau with broad, fertile plains broken by deep valleys and mountain ranges. The country´s highest point is 2,849 m above sea level in the Cerros de Celaque mountain range, but most Honduran mountains are much lower. The coastal plain of the north-west is an agricultural area, largely devoted to the production of bananas. The central coastal plain is largely undeveloped with grasslands, swamps, palm and pine forests. The north-eastern plain, or Mosquito Coast (Mosquitia), is the least developed, largely covered with tropical rain forests, grasslands, pine and palm forests. A narrow plain lies along the southern coast on the Gulf of Fonseca. Stands of mangroves line the shore, with mostly agricultural land inland. Navigable Atlantic rivers include the Ulúa, which drains approximately one-third of the country, and the Coco. The climate of Honduras is tropical, but temperatures in the interior are relatively cool due to the elevation. The northern coast is subject to hurricanes (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Honduras capital Tegucigalpa is a small city of approximately 1 million inhabitants. The remainder of the country’s population resides in isolated pockets in remote areas. The transportation problem to these areas makes complete modern medical care unavailable to many Hondurans. As a result, traditional healers continue to be a source of health care for rural inhabitants. In general, the people of Honduras have a well-developed pharmacopoeia based largely on vascular plants and many people still rely on medicinal herbs as primary medical care. The local medicine men (curanderos), who have extensive knowledge of native plants’ use, are often consulted by natives for common health problems (Lentz et al., 1998).

293 Government Efforts in Development of Traditional Medicine/Phytomedicine Section 130 of the Honduran Health Code of 1966 states that the practice of naturopathy, homeopathy, empiricism, and other occupations considered to be harmful or useless by the Secretariat for Public Health and Social Welfare, shall be prohibited in the country. Practitioners of traditional medicine are not granted due status (WHO, 2001).

Medicinal and Aromatic Plant Resources In Honduras nearly 700 medicinal plants exists. The wild population of these medicinal plants are threatened by the destruction of the habitat. The wild population of many commonly utilized plants such as Bauhinia spp., Eysenhardtia adenostylis Baillon., Fevillea cordifolia L., Machaerium cirrhiferum Pitt. and Machaerium isadelphum (E. Mey.) Amshoff), Quassia spp., Smilax spp. and Smilax spinosa Mill. have been threatened due to overexploitation over the years and unsustainable harvesting practices (FAO, 2000). Some medicinal and aromatic plants of Honduras with their most common medicinal uses are listed in Table 1 (Lentz et al., 1998). The comprehensive review of useful common plant from Honduras demonstrated at least 545 species (Nelson, 1986). The compilation by House et al. (1995) include 250 species used as medicine, including an important collection of drawings.

Research and Development Activities The TRAMIL Programme (Applied Research on the Traditional Popular Medicine in the Caribbean Basin) since 1983 has been underway in several countries of the West Indies and Central America. The programme, which started in Haiti and in the Dominican Republic, has now extended to Colombia, Costa Rica, Dominica, Guatemala, Honduras and Venezuela. The goal of the programme is to evaluate the traditional use of medicinal herbs in order to help unprivileged population from this geographical area. The TRAMIL Programme leads to protection of cultural heritage and integration of effective and secure traditional remedies in primary health care (Weniger, 1991). About 60% of Hondurans are Mestizo with the rest consisting of Europeans, Amerindians and Africans. Jicaque ethnobotany has been studied, demonstraties 57 useful species and other 43 species with specific name but no particular use (Lentz, 1986). Paya ethnobotany demonstrates 127 plant species traditionally used for different purposes, from which 68 plants are used as medicine (Lentz, 1993). Ninety-two plants used in the traditional pharmacopoeia of the Pech and Mestizo peoples of central

294 Honduras are reported in the investigation supported by Public Health Service grants from the National Institute of Dental Research and the National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA. The Pech are a Chibchan-speaking group settled in north-central Honduras for many centuries. The efficacy of extracts made from Honduran medicinal plants was tested to inhibit the growth of a broad assortment of human pathogens under in vitro conditions (Lentz et al., 1998). A total of 79 plant species used to treat 15 conditions occurring during pregnancy, birth and postpartum stages, were recorded in seven rural communities near La Ceiba, Honduras. The study was reported from the Department of Botany, University of Hawaii at Manoa, USA and the Department of Plant Science, McGill University, Canada. It was observed that though use of medicinal plants by midwives has decreased as a result of retraining programs by government health centres, midwives’ knowledge of medicinal plants may provide an important resource for improving maternal–infant health in Honduras (Ticktin and Dalle, 2005).

Trade and Marketing There is no data on the production, manufacturing, import and export of MAPs and their products in Honduras. Nevertheless exports of raw material and extracts of Polypodium decumanum Willd., Tagetes erecta L., and Mimosa tenuiflora (Willd.) Poir are well known.

Constraints and Problems There is lack of in-depth literature on medicinal plants used by people in this country. Special emphasis needs to be placed on the role of medicinal plants for health care. Ethnobotanical and ethnopharmacological research on the medicinal plants used in Honduras should be carried out with emphasis on quality control and evaluation of MAPs and their products. The cultivation efforts for the commonly used species should be made and people awareness on sustainable harvesting of such plants should be encouraged.

295 REFERENCES FAO, 2000, Country Compass: Honduras. Non-Wood News 7, March 2000. Available at: http://www.fao.org/docrep/x4945e/x4945e00.HTM (29 Aug. 2008) FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) House, P. R., Torres, C., Lagos-Witte, S., Mejía, T., Ochoa, L. and Rivas, M., 1995, Plantas Medicinales Comunes de Honduras. Tegucigalpa, UNAH, CIMN-H, CID/CIIR, GTZ. Lentz, D. L., 1986, Ethnobotany of the Jicaque of Honduras. Economic Botany, 40(2): 210- 219 Lentz, D. L., 1993, Medicinal and other economic plants of the Paya of Honduras. Economic Botany, 47(4): 358-370 Lentz, D. L., Clark, A. M., Hufford, C. D., Meurer-Grimes, B., Passreiter, C. M., Cordero, J., Ibrahimi, O. and Okunade, A. L., 1998, Antimicrobial properties of Honduran medicinal plants. Journal of Ethnopharmacology, 63(3): 253-263 Nelson, C. H., 1986, Plantas Comunes de Honduras. Tegucigalpa, Editorial Universitaria Ticktin, T. and Dalle, S. P., 2005, Medicinal plant use in the practice of midwifery in rural Honduras. Journal of Ethnopharmacology, 96(1-2): 233-248 Weniger, B., 1991, Interest and limitation of a global ethnopharmacological survey. Journal of Ethnopharmacology, 32(1-3): 37-41

Table 1: Honduras MAPs with their local medicinal uses (Lentz et al., 1998) Botanical name Local name Family Plant Uses part Acalypha arvensis Barbona Euphorbiaceae Whole Cancer, Poepp. plant digestive Ambrosia Pantanís Asteraceae Whole Fever cumanensis Kunth plant Annona purpurea Anona Annonaceae Leaves Fever Moc. & Sessé ex Dunal Aphelandra scabra Kuputí Acanthaceae Leaves, Carminative (Vahl.) Sm. roots

296 Arrabidaea chica Masipaka Bignoniaceae Bark, Infections (Humb. & Bonpl.) stem Verl. Asclepias curassavica Viborán, Apocynaceae Whole Aches and L. señorita plant pains, constipation Baccharis trinervis Susowá, Asteraceae Leaves, Aches & Pers. lengua de stem pains, dental, vaca digestive, fever, urinary tract Begonia plebeja Sani sani Begoniaceae Whole Astringent Liebm. plant Bixa orellana L. Achiote Bixaceae Leaves, Aches & stem pains, digestive, dysentery Brassica campestris Moustaza, Brassicaceae Leaves, Aches and L. mostasahá stem pains, digestive Buddleia americana Hoja blanca Loganiaceae Leaves, Aches and L. stem pains, digestive Bursera simaruba (L.) Indio Burseraceae Bark Digestive, Sarg. desnudo (Sp), female sorsorká disorders Byrsonima crassifolia Nance Malpighiaceae bark Digestive (L.) Kunth Cassia grandis L. f. Carao Fabaceae Leaves Dysentery, fever, intestinal parasites & worms Costus pulverulentus Caña de cristo Costaceae Leaves, Digestive C. Presl stem Cuphea utriculosa Abwájansiá Lythraceae Leaves Skin cleanser Koehne

297 Datura candida Flor de Solanaceae Flower, Aches and (Pers.) Saff. muerta Leaves, pains stem Dendropanax Arkemaská Araliaceae Fruit, Digestive arboreus (L.) Decne. Leaves, & Planch. stem Dorstenia contrajerva Contrahierba, Moraceae Leaves, Dysentery, L. xambalan stem insect or snake bite Enterolobium Guanacaste Fabaceae Leaves, Chest pain, cyclocarpum (Jacq.) stem skin cleanser Griseb. Eryngium foetidum Culantro (Sp), Apiaceae Leaves Digestive, L. makásewá earache Ficus cotinifolia Higo mate Moraceae Fruit, Intestinal Kunth Leaves, parasites & stem worms Ficus insipida Willd. Higo Moraceae Leaves, Aches & stem pains, female disorders (childbirth, haemorrhage, menstrual pain etc.), intestinal parasites & worms Ficus maxima Mill. Higillo, Moraceae Leaves, Gingivitis sasahá stem Gomphrena Siempre viva Amaranthaceae flowers, Coughs decumbens Jacq. Leaves Guazuma ulmifolia Cablote Malvaceae Bark, Dental, Lam. lice digestive, urinary tract infection

298 Heteranthera Berro, torá Pontederiaceae Leaves, Aches & reniformis Ruiz & sirá stem pains, Pav. anaemia, cough, skin cleanser Hyptis capitata Jacq. Miona Lamiaceae Flowers, Fever, Leaves, urinary tract root, infection stem Hyptis suaveolens Chichiguaste Lamiaceae Leaves, Aches & (L.) Poit. root, pains, stem arthritisconsti pation, digestive Hyptis verticillata Mata dolor, Lamiaceae Whole Aches & Jacq. surú porisiyá plant pains, chest pain, coughs Indigofera Rudilla Fabaceae Root, Digestive lespedezioides Kunth Leaves Jacquinia aurantiaca Barbasco Theophrastaceae Leaves, Fish poison W. T. Aiton stem Jatropha curcas L. Piñón Euphorbiaceae Br stem Coughs, digestive, female disorders (childbirth, haemorrhage, menstrual pain etc.), inflam- mation, intestinal parasites & worms Lippia graveolens Orégano Verbenaceae Leaves, Aches & Kunth stem pains, chest pain, cough, digestive, dysentery,

299 female disorders (childbirth, haemorrhage, menstrual pain etc.) Mandevilla hirsuta Ebis a keyá Apocynaceae Leaves, Insect or (Rich.) K. Schum. stem snake bite, skin cleanser Mikania micrantha Tabadillo Asteraceae Leaves Insect or Kunth snake bite Mimosa pudica L. Dormilona Mimosaceae Leaves, Dental, stem digestive, insomnia, skin cleanser, female disorders (childbirth, haemorrhage, menstrual pain etc.) Myrica cerifera L. Vegetal, Myricaceae Fruit, Constipation, pimentillo Leaves dental, digestive, skin cleanser Niphidium Calaguala Polypodiaceae Whole Cancer, crassifolium (L.) plant digestive Lellinger Nopalea cochenillifera Nopal, Cactaceae Stem Coughs (L.) Salm-Dyck tunahá Passiflora coriacea Media luna, Passifloraceae Leaves Aches & Juss. tikimí ya pains Pavonia rosea titiská Malvaceae Leaves, Female Schltdl. stem disorders (childbirth, haemorrhage, menstrual pain etc.)

300 Peperomia obtusifolia Paragua Piperaceae Flowers, Insect or (L.) A. Dietr. Leaves, snake bite, stem skin cleanser Peperomia Obarinsiyá Piperaceae Flowers, Insect or rotundifolia (L.) Leaves, snake bite Kunth stem Petiveria alliacea L. Ipasina Phytolaccaceae Leaves, Aches & stem pains, constipation, coughs

Pilea pubescens Totoneahá Urticaceae Leaves, Insect or Liebm. stem snake bite, skin cleanser Pinus oocarpa Pino, áro Pinaceae Leaves, Chest pain, Schiede ex Schltdl. stem coughs, intestinal parasites & worms, skin cleanser Piper aduncum L. Cordoncillo Piperaceae Fruit, Aches & Leaves, pains, stem digestive, female disorders (childbirth, haemorrhage, menstrual pain etc.), skin cleanser Piper hispidum Sw. Cordoncillo, Piperaceae Flowers, Insect or muchaora Leaves, snake bite, stem skin cleanser Pityrogramma Helacho Pteridaceae Leaves Chest pain, calomelanos (L.) Link macho coughs, digestive, intestinal parasites & worms

301 Pluchea odorata (L.) Siguapate, Asteraceae Leaves Aches & Cass. siwepathá pains, digestive Polygala paniculata Conchalagua, Polygalaceae Whole Fever, skin L. awan- siyá plant cleanser Pseudelephantopus Oreja de Asteraceae Whole Aches & spicatus (B. Juss. ex chancho, plant pains, female Aubl.) C. F. Baker cucuawa disorders (childbirth, haemorrhage, menstrual pain etc.)

Quercus. skinneri Roble, Fagaceae Leaves, Digestive Benth. sonkwá stem Rauvolfia tetraphylla Chalchupa Apocynaceae Leaves, Insect or L. stem snake bite, malaria Renealmia aromatica Chucho Zingiberaceae Leaves, Inflam- (Aubl.) Griseb. stem mation, skin cleanser Sambucus mexicana Sauco Adoxaceae Flowers, Aches & auct. Leaves, pains, chest stem pain, colds, coughs, fever Scutellaria spp. Evisukiyá Lamiaceae Flowers, Insect or Leaves, snake bite, stem skin cleanser Senecio Panecito Asteraceae Whole Aches & chenopodioides plant pains Kunth Solanum americanum Hierbamora Solanaceae Leaves, Anaemia, Mill. stem dental, inflammation Solanum torvum Sw. Cucu kiyá Solanaceae Leaves, Aches & stem pains, dental Spathiphyllum Hoja Araceae Fruit, Skin cleanser friedrichsthalii Schott cuyamel, Leaves, wamuká stem

302 Spigelia Flor blanca Loganiaceae Whole Insect or humboldtiana aun ka-masa´ plant snake bite, Champ. et Schlecht skin cleanser Stachytarpheta Verbena Verbenaceae Leaves, Aches & cayennensis (Rich.) root pains, Vahl coughs, fever Tagetes lucida Cav. Pericón Asteraceae Leaves, Aches & stem pains, blood strengthener, colds, cough, digestive, female disorders (childbirth, haemorrhage, menstrual pain etc.), fever, flu, urinary tract Thevetia ahouai (L.) Chilindron, Apocynaceae Fruit, Aches & A. DC. myseyá Leaves, pains, dental, labat stem digestive

303 2.15 Jamaica

Jamaica, one of the Greater Antilles, is located in the Caribbean Sea. It covers a total area of 10,990 square kilometres. It is an island with more than half the land over 20 degrees of slope. The Blue Mountains dominate the eastern end, rising sharply from sea level to their highest point at 2,256 m on Blue Mountain Peak. The Blue Mountains are mostly made up of metamorphic rocks with long steep slopes and soils liable to rapid surface erosion. In contrast, the major part of the central and western area of the island is made up of a hard white limestone of rugged karst topography. The Cockpit country in the west (named for the many deep depressions) has very broken karst topography with elevations generally over 1,200 m. A major feature in the central area is an elevated area of schist. Again, the slopes are very steep with soils liable to rapid surface erosion. Plains of alluvium and raised coral reefs, with good access, occur in various places along the coast. The island has a number of excellent natural harbors, including those at Kingston, Saint Ann's Bay, Montego Bay, and Port Maria. Jamaica falls within the "tropical region" of the Holdridge Life Zone classification. All land above 380 m is classified as being in the pre-mountain elevation belt of the tropical region. The hot, humid climate is moderated by ocean winds. The country is subject to hurricanes in late summer and early autumn. Of Jamaica’s land area of 1.1 million hectares, 30% (325,000 hectares) is forest. Forest plantations cover approximately 9,000 hectares, mostly Caribbean pine. Change in forest cover for the period 1990 to 2000 has been estimated as an annual loss of 5,000 hectares, or about 1.5% of the total forest cover. There is a net loss of forest cover, and much of it can be attributed to an increase in coffee plantations, although exact figures are not available. Originally, Jamaica was almost entirely covered with forest. However, virgin natural forest remains only in less accessible areas. The majority of remnant rain forest is tropical montane forest. Mountain mist forests, on the upper slopes of the Blue Mountains, are the least disturbed. The mist forest canopy is predominantly Podocarpus spp. The lower mountain and sclerophyll forests have been largely cleared for agriculture. Lowland vegetation tends to be dominated by scrub forest. Jamaica has two national parks. The Blue Mountain/John Crow Mountain National Park is the more important from a forest perspective. According to the national forestry policy guidelines, forest plantations are aimed at afforestation of suitable, accessible areas with a view to increasing timber production, encouraging afforestation and promoting sound forest management on private lands. The National Forest Management and Conservation Plan defined a target of 4 800 ha to be reforested between 2001 and 2005, of which 3,860 hectares are to be reforested on private land. In total, approximately 70,000 hectares of land are considered to have the potential to be reforested and 97% of this land

304 is privately owned. Jamaica’s Forestry Department encourages private forest plantations mainly through the free provision of tree seedlings and technical advice. Forest plantation activities started in the 1950s and peaked in the 1970s. In 1988, Hurricane Gilbert damaged a large area of forest plantations that were poorly managed or immature and caused a shortage of forest products. Before the hurricane, the area of forest plantations established with Pinus caribaea Morelet was about 11,250 hectares, and in 1990 this area had been reduced to about 5,200 hectares. The damage to P. caribaea Morelet plantations caused by the hurricane encouraged a shift to broadleaved species (teak, mahogany, eucalyptus, etc.) to reduce the dependency on imported hardwood timber. Jamaica is a net importer of timber and other forest products. The bulk of wood and paper products are imported. Yam sticks are cut in the natural hardwood forests and an extensive production of yam sticks has a negative impact on the natural regeneration of the forests in the yam growing areas of Jamaica. Following the National Land Policy, the Government of Jamaica approved the latest forest policy statement in a document entitled Forestry and Land Use Policy, October 1996. The document has a strong focus on biodiversity and forest conservation (FAO, 2008). The rich soils, hot climate with good rainfall and copious underground water permit a wide variety of crops to grow in Jamaica. The species of indigenous plant genetic resources of economic interest are some species of bamboo, Palms, and medicinal plants (FAO, 1995).

Traditional Medicine Systems/Phytomedicine Traditionally, there has been a strong dependency on medicinal plants to treat illness in Jamaica, as highlighted in a recent report from the Tropical Metabolism Research Unit (TMRU) of the University of the West Indies (UWI), Jamaica. Most Jamaican folk-uses tend to be for medicinal purposes such as antiworm concoctions, colds, coughs, fever, to build strength etc. Since the 1960s, the trend has been towards gaining a better understanding of traditional medicine and for the precise evaluation of how it can be incorporated into modern medical practice (Mitchell and Ahmad, 2006). In Jamaica, herbal medicines are sold in pharmacies as prescription and over the counter medicines, in special outlets and by licensed practitioners (WHO, 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine In Jamaica, a national policy, laws and regulations and a national programme are being developed. The national office was established in 2000 as part of the Ministry of Heath. An expert committee also exists, as does a national research institute on herbal medicines.

305 The policy to regulate herbal medicines in Jamaica is currently being developed by amending the previous policy to incorporate herbal medicines. Herbal medicines are classified as prescription and over the counter medicines, dietary supplements, health foods, functional foods and homeopathic products. Claims may be made about herbal medicines; for medical claims, a product must be registered, while for health, nutrient content and structure/function claims, product registration may be required, depending on the nature of the claims and the product components. In place of a national pharmacopoeia, the British herbal pharmacopoeia (1983) is used. In place of national monographs, the Complete German Commission E monographs and Herbal drugs and phytochemicals (1994, Wichtl and Grainger, eds.) are used. The latter contains 181 monographs. Neither is considered legally binding. The same manufacturing requirements apply to herbal medicines as to conventional pharmaceuticals; they are enforced by means of herbal product registration. Special safety assessment requirements apply to herbal medicines, including traditional use without demonstrated harmful effects, reference to documented scientific research on similar products and proof of safety from the regulatory authority of the country of origin. The registration system also enforces implementation of these requirements. There is a national herbal medicines registration system; however, the number of registered medicines is not known. Herbal medicines are not included on an essential drug list. Jamaica has a post marketing surveillance system that includes adverse effect monitoring. Consumers and health professionals are encouraged to report to the authorities using an adverse drug report form (WHO, 2005).

Medicinal and Aromatic Plant Resources Jamaica has 2,888 known species of flowering plants that are native or fully naturalized, 784 species (27.2%) of these are endemic to the island. As per the literature survey at least 334 plant species growing in Jamaica have been identified as having medicinal qualities, 193 of these have been tested for their bioactivity for possible pharmacological or physiological actions. Many of the plants used in the Jamaican folk medicine, and found to have medicinal and agricultural potential at UWI, are not endemic to Jamaica. Of the 334 identified medicinal plants growing in Jamaica, 31 were endemic (9.3%); another 12 have a restricted distribution range to the Caribbean, 50% were restricted to the Americas while 37% are found throughout the tropics (Mitchell and Ahmad, 2006). The MOA is currently playing an important role in the development of the herbal/nutraceutical industry, and is focused on the rejuvenation of crops such as allspice fruit (Pimenta dioica (L.) Merr.) and ginger rhizome (Zingiber officinale Roscoe). The MOA also plans to focus on production of cola nut (Cola nitida (Vent.) Schott & Endl.), turmeric rhizome (Curcuma longa L.), rosemary leaf (Rosmarinus officinalis L.) and sarsaparilla root (Smilax regelii Killip & C. V. Morton) among other herbs. At the same time, the Jamaica

306 Organic Agricultural Movement (JOAM) is working to expand organic herb production. With $20 million in financing from the MOA for an organic development project, the JOAM is working to develop the organic sector, including herb & spice farmers, in an effort to take advantage of organic export opportunities to Europe. Some herb crops already under organic cultivation include aloe (Aloe vera (L.) Burm. f.), ginger, and noni fruit (Morinda citrifolia L.). The MOA is working to increase its allspice and ginger production, although Jamaican ginger is significantly higher priced than ginger from other competing markets. To solve this problem MOA is promoting the production of ginger extracts and other value added ginger products, rather than only exporting the raw material. A ginger cultivation project has been established through the Eastern Jamaica Agricultural Support Project (EJASP), a European Union-Funded Project (ITC, 2005).

Research and Development Activities Extensive research aimed at determining the nature and potential of natural products taken from Jamaican-grown plants has been carried out at the University of the West Indies (UWI), Mona Campus, since its inception in 1948, in the Faculty of Pure and Applied Science (FPAS), Chemistry Department but no single source could be found listing all the medicinal plants of Jamaica, nor the research done on them. Researchers of the Biotechnology Centre, UWI, Jamaica made a review summarizing the research carried out on Jamaican medicinal plants at the Faculty of Pure and Applied Science of the university between 1948 and 2001. The plants identified as being medicinal are listed along with their folk use and a summary of the scientific research done at UWI leading to the identification of natural products (NPs) and determination of their bioactivity. Natural product research on Jamaican medicinal plants began with the inception of UWI in 1948, leading to many postgraduate degrees being awarded (22 MPhil and 31 PhD). Several plants have been studied at UWI for their bioactivity (Mitchell and Ahmad, 2006). The Scientific Research Council (SRC) is Jamaica’s principal public sector agency, responsible for the fostering and coordination of scientific research and the promotion of its application. The MOA/RADA (Ministry of Agriculture/Rural Agricultural Development Authority), SRC and UWI are the leading institutions working for promotion and commercialization of MAPs research outcomes for the manufacturer of important foods, nutritional supplements, drugs, cosmetics and other materials. The Environmental Foundation of Jamaica (EFJ) has assisted the research group to establish an ex situ medicinal plant garden at the Centre representing the most comprehensive attempt to gather all of the medicinal plants together in one location with replicates at Hope Gardens and the Institute of Jamaica. The EFJ has also supported a project to develop and disseminate medicinal plant monographs of selected Jamaican plants. These plants that are being multiplied by tissue culture will be planted at several locations and their mineral, microbial, biochemical, bioactive and genetic fingerprints will be obtained.

307 The Medicinal Plant Research Group was initiated at the Biotechnology Centre at the University of the West Indies with the aim to utilize biotechnology to harness the potentials of plants for health and wealth. Since its inception in 1999 to the end of 2006 this group has worked in three main areas 1) Formulation of antimicrobial products (including a neem Azadirachta indica A. Juss. disinfectant); 2) Tissue culture (micropropagation) studies of medicinal plants (including Ananas comosus (L.) Merr., Arthrostema fragile Lindl., Bryophyllum pinnatum (Lam.) Oken, Curcuma longa L., Cymbopogon citratus (DC.) Stapf, Hyptis verticillata Jacq., Mikania micrantha Kunth, Peperomia hernandifolia (Vahl) A.Dietr., Smilax regelii Killip & C. V. Morton and Zingiber officinale Roscoe; somatic embryogenesis of Blighia sapida K. D. Koenig and Petiveria alliacea L.; de novo organogenesis of Solanum chinense Dunal; and 3) Business studies including information gathering and dissemination (Jamaican folk medicine practises, UWI medicinal plant research 1948–2001, e-book on Caribbean medicinal plants, book chapter on Jamaica’s medicinal plant biotechnology experience, article on medicinal gene bank and folk recipes of 30 of these plants, over 56 newspaper articles, 13 e-newsletters, marketing and feasibility studies and business plans, plus several presentations at various audiences including of scientists, farmers, government bodies and industrial groups). There has been a conscious effort to be involved in and to tailor research to serve industrial needs. There has also been a conscious effort to mix short term research projects with immediate application (e.g. development of low-cost tissue culture kits) with longer term research that may take years to apply but for which the potential is much greater (e.g., molecular pharming, and somatic embryogenesis of elite trees) (Mitchell and Ahmad, 2007). The UWI and the Nature Conservancy are beneficiaries of grants in the amount of $9.8 million to fund the development of alternative livelihood activities, including the commercial cultivation of medicinal plants, for the communities in the Cockpit Country, a rugged, bio-diverse inland area of Northwestern Jamaica. The grants were issued by the United States Agency for International Development (USAID) through its Protected Areas and Rural Enterprise Project. This 2008 project funding will enable the UWI medicinal plant research group with the Jamaican Forestry Department to study the current rates of medicinal plants being harvested in the Cockpit Country and enable the transfer of technology and methods for medicinal plant propagation to members of the local forest management committee. The UWI Biotechnology Unit will work with the Forestry Department and the Cockpit Country community to propagate and replant prioritized medicinal plant species such as those that are being harvested unsustainably from the forest for the manufacture of popular roots tonic herbal drinks (ITC, 2007).

308 Trade and Marketing The government of Jamaica has been supportive of the growing MAP sector in the country. The government has been instrumental in developing a consortium of research, business and supportive ministries that have helped to guide the sector. However, the regulations presently in place make it easier for foreign products to enter the Jamaican marketplace than local ones. There is still the need to put in place regulations that will encourage local products while maintaining safety standards. At the moment, many of the MAP products used are on a small scale and use imported inputs due mainly to the need for traceability and to the lack of local lab authorised to produce certificates of analysis. The herbal drug industry in Jamaica currently depends on the importation of natural supplements such as spices, herbs and teas. It lacks suitable regulatory framework as well as financial assistance. It also has insufficient knowledge and trade information and no large‐scale cultivation for sustainable development. Jamaican imports of dietary supplements (excluding teas and spice imports) stood at approximately J$700 million in 2003. A regulatory framework in accordance with the Ministry of Health and the Herbal Industry (CHBA‐Jamaica Chapter and the Wholistic Herbal Association), has been forged and should be passed into law by 2008. Since 1995, however, and especially with the large jump in activity during 1999 and 2002 when new research activities and groups were started, an international symposium (the Caribbean Herbal Business and Science Forum) held and governmental interest generated, the MAP industry in Jamaica has shifted from a forgotten folk health cure from the bush to a central plank for development. With this increased knowledge and interest, the herbal industry in Jamaica has grown evidenced by the growing number of new companies from farmers to agro‐ processors, and the ever widening product lines, showing innovation and entrepreneurship that is inspiring and challenging (Mitchell et al., 2007). More than 8000 medicinal products, including 610 vitamins, 90 minerals, and 60 herbal remedies, were registered and licensed in Jamaica between 1975 and 2000. Of the 403 medicinal products registered in 1999, 9.5% were of herbal origin. Herbal products are a multi-million dollar industry in Jamaica (WHO, 2001).

Constraints and Problems In creating an environment that develops business opportunities within the herbal sector, the Government has put in place a number of policies, legislation and regulations, and is guided by the National Industrial Policy. Prior to 1999, there was no effort directed towards the conservation of the MAP species of Jamaica except for general conservation practises such as protected forest areas. Since then however, there has been increasing awareness of the need to conserve their biodiversity.

309 The National Strategy and Action Plan is not specific to MAPs to encourage and strengthen research into the evidence based practice of herbal medicine and more advocacy is needed. The importance of MAPs industry to Jamaica is well-recognized. There is certainly a lot of potential, both identified and still to be tapped. In order to derive the commercial benefits from MAPs resources Jamaica need to carry ethnomedical surveys, continue testing these plants for bioactivity and toxicity, develop commercial formulations and standardize such extracts, develop in vivo and in vitro germplasm collections, and develop tissue culture protocols for in vitro secondary metabolite production and for rapid multiplication of selected plants to produce elite planting material for commercial medicinal plant ventures. Protection of this knowledge, and fair share of the benefits, remain important. All these are areas of active research and will benefit the medicinal plant sector in the country and help to derive benefits for its poeple. The country is yet to fully capitalise on its rich plant heritage. A lot of support is needed for this fledging industrial sector to develop locally grown herbal medicinal plants from production, to distribution to quality control, to marketing and promotion.

310 2.16 Mexico

The United Mexican States (Estados Unidos Mexicanos), located in the southern part of North America, is bordered by the United States on the north, the Pacific Ocean on the west, the Gulf of Mexico and the Caribbean Sea on the east, and Guatemala and Belize on the south. It covers an area of 1,958,200 square kilometres. The central plateau (Meseta Central), running from the border with the United States to the Isthmus of Tehuantepec in the south, occupies much of the centre of the country. The average elevation ranges from about 900 m in the north to about 2,400 m in the south. The plateau is flanked by two major mountain ranges the Sierra Madre Occidental in the west and the Sierra Madre Oriental in the east that join together in the south. Most of Mexico's major peaks and active and inactive volcanoes are located on the plateau or in these mountain ranges. These include Popocatépetl (5452 m) and Ixtaccíhuatl (5286 m), both of which are located near Mexico City, and the highest peak in Mexico, Pico de Orizaba (Citlaltepetl), 5,700 m and located north-west of Veracruz. The plateau drops sharply to the coastal plains, particularly to the west. The western coastal plain, lying between the plateau and the Pacific Ocean and Gulf of California, ranges in width from about 50 km in the north to just a few kilometres wide south along much of the southern coast. It is a productive agricultural region. The coastal plain along the Gulf Coast is about 280 km wide at the border with Texas, narrowing to a width of a few kilometres near Veracruz in and then widening again at the Isthmus of Tehuantepec. The northern part is generally dry, while rainfall is more plentiful in the south. The Yucatán Peninsula extends north-east from the Isthmus of Tehuantepec into the Gulf of Mexico. It is a flat, low-lying limestone plateau with no rivers. The north-west is dry brushland but further south rainfall is plentiful and there the peninsula is covered by tropical rain forests. The Southern Highlands, located south of the central plateau, are made up of a number of steep mountain ranges, deep valleys, and dry plateaus. The Sierra Madre del Sur is the principal mountain range, running from near the mouth of the Balsas River in the west to the Gulf of Tehuantepec in the east. Only narrow coastal strips front the Pacific Ocean. South and east of the Isthmus of Tehuantepec, to the Guatemala border, are the Chiapas Highlands, with peaks to 2,700 m. This is a well-watered region; tropical forests cover much of it. In the far north-west is the Baja California Peninsula. Stretching south-east from the U.S. border for 1,300 kilometres, the peninsula is extremely dry and rugged, with a very narrow coastal plain. Although it varies considerably throughout the country, the climate of much of northern and central Mexico is characterized by high temperatures and moderate to low rainfall. The highlands of the central plateau generally have a moderate climate with few

311 extremes of hot or cold. Much of southern Mexico has a tropical climate with distinct rainy and dry seasons. The Gulf Coast is subject to hurricanes (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The poor people consult natural healers or curandero for medical treatments, while the middle and upper class Mexicans usually see a medical doctor. Due to high costs of modern medicines, many Mexicans living in the cities are also resorting to traditional remedies still common in the rural areas. The yerberias or herbalists specialize in herbal medicines for a wide range of ailments and also give advice to their buyers (Davis, 2003). The principal traditional medical specialists are traditional birth attendants, herbalists, bonesetters, curanderos, snake culebreros, shamans, spiritualists, and sobadores. Traditional birth attendants preside over more than two-thirds of childbirths in Mexico. There are 55 to 60 chiropractors practising in Mexico. There are about 3000 homeopathic physicians. Traditional medicine forms an integral part of the health care delivery system. Although there is no official licence for the practice of traditional medicine, other than for traditional birth attendants, the authorities are currently working on creating such a licence. Proposals for a bill to regulate traditional medical practice, aside from that of traditional birth attendants, have been made since 1989. There is a proposal to add provisions to the General Health Law that would regulate the quality control of medical activities, establishments, products, and services. Chapter 4 of these proposed changes covers herbal medicines. Homeopathy has been accepted and integrated into the national health system in Mexico. In 1996, the Government recognized homeopathy as a medical speciality. Licensing legislation regulates chiropractic educational standards and practice. Chiropractors have been licensed since 1988. Credentials must be periodically revalidated (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine The national policy of the United Mexican States was introduced in 2001; however, no laws or regulations have been issued or are being planned. The national programme was issued in 2001 in the Work Plan of the National Office, the Dirección de Medicina Tradicional (Traditional Medicine Directorate) for 2001-2006. The office is part of the Ministry of Health. In 2001, an expert committee on TM/CAM was created. National research institutes for traditional medicine include the National Institute of Anthropology and History and for herbal medicine the Herbarium of the Mexican Institute of Social Security.

312 In Mexico, regulation of herbal medicines was established in 1997; the law is partly the same as for conventional pharmaceuticals. Herbal medicines are regulated as prescription and over the counter medicines, dietary supplements, health foods and herbal remedies. By law, medical, health and structure/function claims may be made. The national pharmacopoeia, Farmacopea Herbolaría de los Estados Unidos de Mexico (2001), is legally binding. The national pharmacopoeia also includes monographs. Manufacturing requirements include the same GMP rules as for conventional pharmaceuticals, but also include adherence to information in pharmacopoeias and monographs and special GMP rules for herbal medicines. Implementation of these requirements is enforced through inspections. Safety assessment regulatory requirements are the same as for conventional pharmaceuticals, but also include references to documented scientific research on similar products, as well as the results of microbiological analysis and the absence of toxic residues. Inspections also serve as the control mechanism for safety requirements. There is a registration system, but it is not known how many herbal medicines are registered. Two herbal medicines are listed on the national essential drug list. There is a system of post marketing surveillance, which includes a national adverse effect monitoring system established in 2000. In Mexico, herbal medicines are sold in pharmacies as prescription and over the counter medicines and in special outlets (WHO, 2005). The National Indigenous Institute has a unit dedicated to the organization, coordination, and instruction of traditional medicine. In some states, the Institute coordinates with associations of traditional medicine practitioners to provide workshops, courses, and other activities where practitioners can gather and share their knowledge. Traditional medicine is taught through apprentice programmes, including practice, observation, and workshops. In some cases, families are known for a particular speciality. The Mexican Institute of Social Security offers informal presentations and workshops on traditional medicine, medical anthropology, and community work techniques to personnel working in the official health services. There are several schools and hospitals teaching homeopathy. Homeopatia de Mexico, an association for homeopathic practitioners, obtained official recognition for its postgraduate school in 1996. A chiropractic college is presently being established (WHO, 2001).

Medicinal and Aromatic Plant Resources The medicinal and aromatic plants are normally grown at home and used frequently in cooking. A number of medicinal plants are grown in tin-can containers suspended from adobe walls and home gardens (Davis, 2003). Mexico has a rich tradition in medicinal plant utilization among its varied folk healing practices. Approximately 62 different ethnic groups currently live in Mexico, each with its own culture and dialect and medicinal plant repertoire.

313 It is estimated that the Mexican medicinal flora contains between 3,000 -5,000 plants that have potential medicinal value. A total of 3,000 species have been compiled in an atlas of medicinal plants employed by diverse ethnic groups. However, only approximately 1% of these have been studied in depth, regarding their potential medicinal properties (Stuart, 2003). Another report highlights that there are about 21,600 species of vascular plants in the country, of which about 3,350 are used for medicinal purposes. Many of these medicinal plants are sold in local markets (Stanley, 2004).

Research and Development Activities In 1980, the Mexican Institute of Social Security created a unit to study traditional medicine and medicinal plants. Later, a programme was introduced to foster the integration of traditional and allopathic systems of medicine. The programme was designed to involve traditional practitioners in the health activities of 3500 rural medical units within the Social Security System. The Mexican Institute of Social Security is also working with the national plan for depressed zones and marginalized groups (Coplamar) to integrate allopathic and traditional medicine (WHO, 2001). A study sought to examine the use of medicinal plants in four indigenous groups of Mexican Indians Maya, Mixe, Nahua and Zapotec was conducted by the Institute of Pharmaceutical Biology, Albert-Ludwigs-University, Freiburg, Germany, and Department of Pharmacy, Swiss Federal Institute of Technology (ETH) Zurich, Switzerland. The study was conducted in Mexican Indian communities in the southern parts of Mexico during the 1990s. It dealt specifically with medicinal plants used in the respective cultures and their relevance in the treatment of the prevalent diseases (Heinrich et al., 1998). Another study by the Department of Applied BioSciences, Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) Zurich, Switzerland, and Centre for Pharmacognosy and Phytotherapy, The School of Pharmacy, University of London, UK identified a small, but highly conserved group of medicinal plants part of the medicobotanical heritage of two Macro-Mayan groups: Lowland Mixe and Zoque- Popoluca communities in the Isthmus of Tehuantepec, México. The ethnopharmacopoeias of the two groups have 123 out of 600 (Zoque-Popoluca) and 215 (Lowland Mixe) documented medicinal plants in common (Leonti et al., 2003). The National University of Mexico, and the National Medical Centre, Mexico in collaboration with Department of Microbiology and Immunology, and Faculty of Pharmaceutical Sciences of Fukuoka University, Japan studied the antibacterial activity of 22 Mexican plants. These plants are used in Mexican traditional medicine for the treatment of diseases presumably caused by bacteria. The plants examined in the study were collected locally and some were purchased at “Sonora Medicinal Plant Market” in Mexico City. These plants along with their local medicinal uses are listed in Table 1 (Yasunaka et al., 2005).

314 A recent review of some Mexican and Mexican-American herbal remedies for their pharmacological and physiological effects, potential side effects, and drug interactions have been made by Universidad Autónoma del Estado de Morelos, Mexico, and The University of New Mexico, College of Pharmacy Toxicology Program, USA. This review is limited to species grown and frequently used in Mexico for health problems. The plants included aloe (Aloe vera (L.) Burm. f.), chaparral (Larrea divaricata Cav.), chamomile (Matricaria recutita L.), peppermint (Mentha ×piperita L.), nopal (Opuntia ficus-indica (L.) Mill.), passionflower (Passiflora incarnata L.), dandlion (Taraxacum officinale aggr. ), linden flower (Tilia ×europaea L.), nettle or stinging nettle (Urtica dioica L.) and mullein (Verbascum densiflorum Bertol.). Based on our experience, these are the most frequent herbal medicines sought by people who have health problems (Rodriguez-Fragoso et al., 2008).

Trade and Marketing The Mexican exports of pharmaceutical plants in the 1990s fluctuated between 4,700 and 17,600 tones. During 2000 the exports increased to 42,550 tones in 2000, 81,550 tones in 2001, 130,150 tones in 2002 and to 147.300 tones in 2003. Up to 99% of these exports were destined to the USA (Lange, 2006). In terms of volume, the USA is the largest North American MAPs exporter, followed by Mexico and Canada. The selected botanical exports of Mexico during 2007 under the HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others), 121220 (Includes botanicals such as kelp Laminaria spp., laver or nori Porphyra spp., and sea tangle Laminaria japonica or Echlonia kurome, among many others.), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms and American storax balsam Liquidambar styraciflua L., among many others), 130219 (includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others), and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils) were 15828824, 199069, 69790, 3366376 and 5126423 kg respectively. Mexico is the leading North American exporter for botanicals traded under HS 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho-blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others), and 400130 (botanicals such as gutta percha latex Payena spp. and Palaquium gutta (Hook.) Baill., balata Manilkara bidentata (A. DC.) A. Chev., chicle Manilkara zapota (L.) P. Royen, guayule Parthenium argentatum A. Gray, leche caspi sorva Couma macrocarpa Barb. Rodr., among other similar natural gums). In 2007, Mexico exported 41880745 kg of HS 1211 medicinal plants with a reported value of USD $44181483. About 89% of these exports were destined for the USA. Other main importers 315 were Canada, Germany, China, and Italy. The export under HS 140490 was 11063221 kg with a reported value of USD $27579863. About 92% of these exports were destined for the USA. The other main importers were Switzerland, Germany, Honduras, and Belgium. Under HS 400130 Mexico exported 108,338 kg of natural gums with a reported trade value of USD $620527. About 65% of these exports were destined for Japan. The other main importers were Singapore, Costa Rica, Guatemala, and the USA (ITC, 2008).

Constraints and Problems The knowledge of the potential benefits and risks of herbal medicines used in Mexico is still limited. There is an enormous potential of Mexican medicinal flora that need to be fully explored yet. The measures of quality control and safety of the drugs for production and commercialization should be strictly implemented. The country urgently needs a national plan for the conservation, production, development, and exploitation of medicinal plants. Few plant species that provide medicinal herbs have been scientifically evaluated for their possible medical applications. The efforts to elucidate health benefits and risks of herbal medicines should be intensified. More research has to be undertaken in order to exploit the possible health and commercial benefit of Mexican MAPs.

Table 1: Some Mexican MAPs with their traditional medicinal uses (Yasunaka et al., 2005) Botanical name Local name Family Medicinal use

Aloysia triphylla (L'Hér.) Royle Te Verbenaceae diarrhea, stomach ache Britton cedrón

Annona cherimola Mill. Chirimoya Annonaceae anthelmintic, cough, diarrhea, emetic, fever

Annona muricata L. Guanábana Annonaceae diarrhoea, dysentery, leprae

Aristolochia taliscana Guaco Aristolochiaceae cutaneous disease Hook. et Arn.

Bixa orellana L. Achiote Bixaceae dysentery, measles, mouth pimples

Bursera simaruba (L.) Sarg. Palo mulato Burseraceae cough, diarrhoea, fever, gingivitis, measles

Calophyllum brasiliense Bari Clusiaceae diarrhoea, intestinal worms Cambess.

Chenopodium ambrosioides Epazote Chenopodiaceae cramps, diarrhoea, stomach ache L. morado

316 Chenopodium graveolens Epazote de Chenopodiaceae amebiasis, cough, diarrhoea, stomach Willd. zorrillo ache

Clusia salvinii Donn. Sm. Oreja de Clusiaceae gonorrhoea, kidney ache coyote

Croton draco Schltdl. Sangre de Euphorbiaceae dysentery, pimples, sores grado

Gliricidia sepium (Jacq.) Cocuite Fabaceae antipyretic, measles Kunth ex Walp.

Haematoxylum brasiletto Palo de Brasil Fabaceae fever H. Karst.

Hamelia patens Jacq. Balletilla Rubiaceae malaria, pimples, sores

Malvaviscus arboreus Cav. Azocopacle, Malvaceae cough, cutaneous disease, dysentery, manzanita fever, sores, stomach ache

Mammea americana L. Zapote Clusiaceae fever, cutaneous disease Domingo

Muntingia calabura L. Puan, Capulín Muntingiaceae measles, mouth pimples, stomach ache rojo

Phlebodium aureum (L.) J. Lengua de Polypodiaceae fever, kidney diseases, ulcer Sm. ciervo

Piper amalago L. Cordoncillo Piperaceae fever

Piper auritum Kunth Acuyo Piperaceae fever, skin infections

Piqueria trinervia Cav. Hierba de San Asteraceae dysentery, fever Nicolás

Zornia thymifolia Kunth Hierba de la Fabaceae fever Víbora

317 2.17 Nicaragua

The Republic of Nicaragua, located in Central America, is bounded on the north by Honduras, on the east by the Caribbean Sea, on the south by Costa Rica, and on the west by the Pacific Ocean. Its area is 129,494 square kilometres. Within its borders lie the two largest lakes in Central America, Lake Nicaragua and Lake Managua, totalling 9,300 square kilometres. Lowlands extend along the Pacific coast from Honduras to Costa Rica, with a chain of mountains and active volcanoes along the coastline. Lakes Managua and Nicaragua lie in the central and southern sections. The region is subject to severe earthquakes. The eastern lowlands, known as the Mosquito Coast, extend approximately 70 kilometres inland. Much of the land is forested, divided by rivers that flow from the highlands to the Caribbean. Among these are the San Juan, the Río Grande, the Escondido and the Coco. Nicaragua's climate is tropical, with temperatures varying mostly with the altitude. Hurricanes occasionally strike the eastern coast. Approximately 50% of Nicaragua, or 6.2 million hectares, is designated as forest land. Of this, 3,278,000 hectares actually had forest cover in 2000, while 1.8 million hectares were being used for livestock farming or were in process of degradation. Natural forests are concentrated in the Caribbean region, with a predominance of broad-leaved species (about 2.3 million hectares) and 460,000 hectares of pine. There are also an estimated 282,000 hectares of mangrove forests. The National System of Protected Areas covers 2,160,514 hectares, or 18.2% of the country, divided between 75 legally recognized areas. There are proposals to add 21 new areas to make the system more representative of the range of forest ecosystems. As in the other countries in the region, people live in the protected areas and carry on various types of agricultural and forest activity. With a view to the positive involvement of local inhabitants in conservation activities within their living environment, the policy of the Ministry of the Environment and Natural Resources is to work with the people within the protected or adjacent areas. Some 309,149 hectares (out of the 879,423 hectares under production systems in 1998) benefit from the incorporation of trees in various ways, combinations and densities - livestock-forests, agriculture-forests, agriculture-fruit trees-forests, agriculture-fruit trees- livestock-forests etc. This indicates that more than 35%of the country’s cultivated area is affected by tree-planting or reforestation, which makes a major economic and environmental contribution (FAO, 2008).

Traditional Medicine Systems/Phytomedicine The traditional healers in Nicaragua are known as curanderos (Spanish), bush doctors (English) and sukyas (Miskitu languages). In addition, healers are sometimes called science men or obeah-men. The traditional and modern medicine play complementary 318 roles in the pluralistic system of health care in Nicaragua especially its Southern Atlantic Autonomous Region. The official medicine under the auspices of the Nicaragua Ministry of Health has also started accepting traditional medicine. Individual patients integrate concepts and practices from both the systems (Barrett, 1997) There are 2,500 persons registered in the registry of traditional medical practitioners. The principal traditional medical specialities are traditional birth attendance, herbalism, spiritualism, and massage. The Department of Traditional and Popular Medicine of the Ministry of Health regulates traditional medicine in Nicaragua. No licence is required to practice traditional medicine. While there are no restrictions or legal barriers that limit its practice, the Nicaraguan Academy of Homeopathic Medicine is working towards gaining official status for homeopathy. The National Council of Universities supports homeopathy and accepts its practice by allopathic doctors (WHO, 2001).

Government Efforts in Development of Traditional Medicine/Phytomedicine In 1989, the Ministry of Health established the National Centre of Popular and Traditional Medicine with the objective of training health promoters and allopathic medical and paramedical persons in these fields. In 1991, courses in traditional medicine were introduced into allopathic nursing schools, and allopathic nurses began being trained in basic plant therapy and medical anthropology. After the change of government in the same year, the Centre became a non-profit foundation independent from the Ministry of Health. Along with the National Autonomous University of Nicaragua and several institutions under the leadership of the Ministry of Health, the Centre forms a part of the National Commission for Essential Investigation. Cecalli, Soynica, the School of Agriculture, UNAN, Real Nicaraguense de Sistemas Traditionales, and MINSA also offer training in traditional medicine. Though allopathic health personnel may follow these courses, training in traditional medicine is not offered through the official health services (WHO, 2001). Although Nicaragua does not have a national policy, laws or regulations on TM/CAM, they are currently being developed. No national programme has been introduced. The national office is being established. The national expert committee on TM/CAM was established in 2003. No national research institutes have been established for TM, CAM or herbal medicines. The regulation of herbal medicines was introduced in 1998 through Law 292, the national pharmaceuticals law. This law also regulates conventional pharmaceuticals; however, there are also special rules that apply only to herbal medicines. Herbal medicines are regulated as prescription medicines, over the counter medicines, dietary supplements, health foods and functional foods. By law, herbal medicines may be sold with medical, health, nutrient content and structure/function claims.

319 Although no national pharmacopoeia currently exists, one is being developed. No information is available on the other pharmacopoeias currently used and legally binding. Sixty three national monographs on herbal medicines may be found in the Compendia de Plantas Medicinales (2000). In addition, monographs in the Farmacopoeia caribeña are used; both are considered to be legally binding. Regulatory requirements for manufacturing include the same GMP rules as for conventional pharmaceuticals and special GMP rules. No control mechanism exists to ensure compliance with these requirements. Safety assessment requirements include those used for conventional pharmaceuticals and special requirements of traditional use without demonstrated harmful effects and reference to documented scientific research on similar products. No control mechanism has been established for safety assessment requirements. There is a registration system for herbal medicines; however, the number of registered herbal medicines is not available. No herbal medicines are included on the national essential drug list. A post marketing surveillance system is currently being planned for herbal medicines (WHO, 2005).

Medicinal and Aromatic Plant Resources The Caribbean Coast of Nicaragua because of its ethnic diversity and botanical splendor provides an excellent diversity of medicinal and aromatic plants. Six ethnic groups from four continents maintain healing traditions using a vast array of herbal and spiritual medicine. These groups are reported to use more than 200 of the estimated 7,000 plant species available in the region as medicines (Barrett, 1997). The vascular flora of the eastern Nicaragua is estimated at 2,500 species with 435 of them having medicinal value (Coe and Anderson, 2005). The non-wood forest products including medicinal and aromatic plants are collected in great majority from the tropical forests latifoliado, San Juan river, the oriental region, and from the central-north region. Some of the commercially important MAPs of Nicaragua are listed in Table 1 (FAO, 2000).

Research and Development Activities Among the plants used by the Garífuna of eastern Nicaragua, 229 species used for medicinal purposes were assayed for the presence of bioactive compounds. A review of the literature for alkaloids and glycosides showed that 113 species contained at least one of these bioactive compounds. The remaining 116 species not previously cited were tested for alkaloids among which 51 contained alkaloids. This study has been reported from University of Connecticut, USA (Coe and Anderson, 1996). In an ethnopharmacognostic study of snakebite treatments in eastern Nicaragua from the university data and specimens were collected during several years of field studies. Among the plants’ information gathered 435 species have medicinal application including 81 that are used in snakebite treatment in the country (Coe and Anderson, 2005).

320 A recent study on Rama midwives in eastern Nicaragua that use a wide array of plants in providing health care to women and infants has been reported by the University of Connecticut, USA. It documents the use of medicinal plants by Rama midwives on the island of Rama Cay in eastern Nicaragua. A total of 162 plant species were documented as useful in midwifery, over 5 years of fieldwork. Most medicinal plants are reported to be obtained from second-growth forest, and are used to treat more than 35 human ailments. Most midwifery species are wild, but many important species are introduced domesticates native to the New World and Old World tropics. This study is the first systematic study of midwifery in eastern Nicaragua and particularly of Rama midwifery (Coe, 2008). The information on the status of research and development efforts on MAPs by the national institutes or universities is not available currently.

Trade and Marketing In Nicaragua, herbal medicines are sold in pharmacies as over the counter medicines, in special outlets, by licensed practitioners, without restriction and in indigenous communities (WHO, 2005). However, the information regarding the production, consumption, import and export of MAPs and their products in Nicaragua is currently not available. Constraints and Problems Nicaragua should develop a national policy, laws or regulations on TM/CAM, and should introduce national programme for traditional herbal medicine. The country should make efforts to explore health benefits and safety assessment of its traditional herbal medicines. More research has to be undertaken in order to exploit the possible health and commercial benefit of its natural MAPs resources. Nicaragua needs a national plan for the conservation, production, development, and exploitation of MAPs and encourage research for evaluating their medicinal potential. Their natural populations available in the country should be inventoried along with knowledge of their traditional medicinal usage.

Table 1: Some commercially significant MAPs of Nicaragua (FAO, 2000) Botanical name Family Common name Bursera simaruba (L.) Sarg. Burseraceae Jinocuabo Equisetum arvense L. Equisetaceae Cola de caballo Hymenaea courbaril L. Fabaceae Guapinol Myroxylon balsamum (L.) Harms Fabaceae Bálsamo Petiveria alliacea L. Phytolaccaceae Zorrillo Quassia amara L. Simaroubaceae Hombre grande

321 2.18 Panama The Republic of Panama is the most southerly country in Central America. It is bounded on the north by the Caribbean Sea, on the east by Colombia, on the south by the Pacific Ocean and on the west by Costa Rica. It covers an area of 75,517 square kilometers and has a population of about 3.3 million. There is a spine running down the whole of Panama in the form of a central mountain range, starting in the west in Costa Rica, and decreasing to low mountains at the Panama Canal. On the other side of the canal, the ground rises again, forming the Portobello and San Blas mountains, but elevations do not exceed 1,000 m. The Baru volcano at 3,475 m, Panama's highest point, is found near the border with Costa Rica on the western Pacific coast. The Azuero chain and the Palm Mountains do not rise above 1,600 m. The Darien hills (800 m) lie east of the canal, stretching to the Pacific coast, while the San Blas Mountains continue as far as Colombia in the border mountains forming an arc. Most of Panama has a hot, humid tropical climate, with cooler temperatures at higher elevations. Prevailing winds carry moisture from the Caribbean Sea to the northern coast, making it wetter than the Pacific side. It is calculated that Panama had 2.9 million hectares of forest in 2000, representing 38.6% of its land area, with forest plantations accounting for 40,000 hectares of the total. Average annual deforestation between 2000 and 2008 is estimated at 13428 hectares/year. More than 29% of the country is designated as protected areas (ANAM, 2009). Although Panama has no explicit forestry policy, a new Forest Law of 3 February 1994 and a set of complementary laws were promulgated in 1994, defining the juridical framework for the sector. The Law is in general compatible with sustainable forest management and explicitly regulates the use of wood products. However, it is less explicit concerning the use of non-wood forest products including medicinal plants, which are treated more by the Law on Wildlife. Neither law, however, explicitly treats the various aspects of the environmental services provided by forests, although these open the way for the participation of the private and public sectors and communities, especially indigenous ones (FAO, 2008). Panama has put in place through Executive Decrees No. 257 of 17 October 2006 and No. 25 dated 29 April 2009 which now governs the access to genetic resources of Panama.

322 Traditional Medicine Systems/Phytomedicine In Panama, traditional medicine is practiced mainly among Indian ethnic groups, ritual peoples, and lower-income urban groups. Folk healers such as herbalists, masseurs, bone setters and spiritualists coexist, and in many cases take the place of, health professionals. The services of the traditional midwife ("parteras") are particularly used. There is an Association of Midwives.

There exist no laws that govern traditional healers, except for the Ngöbe-Buglé Reservation, which has specific Law 138. The main form of traditional medicine in current use in Panama is the use of herbal remedies, but acupuncture has now been started in some private clinics and is reimbursable by insurance companies. In Panama, it is difficult to know the precise number of traditional therapists and types of Traditional, Complementary and Alternative Medicine Therapies. There is no general policy or guidance on the use of traditional medicine. There is no government policy on the cultivation, sale and use of medicinal plants. Almost all of the traditional medicinal plants are locally cultivated or collected from wild sources. Recently, herbal teas imported from other countries are also being used. In addition, because of a large immigrant Chinese population in Panama, some traditional Chinese medicine products are also being sold locally in the Chinese "pharmacies". These products have not been legally registered in Panama. The dried products, which contain herbal preparations, are analyzed by a governmental laboratory, and before they can be sold, must be registered in the Department of Food and Drugs of the Ministry of Health (Gupta, 2005).

Ethnobotanical studies have been carried out among the Afro-Caribbean groups, in northern coast of Panama. This group, established in Panama since the Spanish colonization some 500 years ago, keeps alive their culture and traditional medicine. However, the traditional medicine is related to the use of medicinal plants. Initiative of TRAMIL Program, a network working in the Caribbean Basin, is particularly linked to applied research, with a view to improving and rationalizing popular medicinal practices based on the use of plants. One of the most important objectives is to reduce the cost of medicinal therapeutics by making available to the people and grassroot paramedic personnel, practical knowledge to treat certain common ailments with plants, thus, at a minimal cost and in harmony with popular tradition. In Panama, fifteen medicinal garden have been established in the communities where a survey was carried out, using the TRAMIL methodology, based on common illnesses.

The Government of Panama has made considerable efforts to register and train traditional birth attendants and to integrate them into the country’s health care system. Although there is only one chiropractor practising in Panama, both

323 the United States and Canada have been sending chiropractic missions to Panama since 1997 (WHO, 2001). Panama possesses five Amerindian groups: Ngöbe-Buglé, Kuna Yala, Emberá-Wounan, Naso or Teribe and Bri-Bri, representing 9.6 % of total population (Anonymous, 2011). Ethno-pharmacological surveys collected a large amount of data from three major groups in Panama namely the Kunas, the Ngöbe-Buglé and the Teribes. Among the indigenous groups of Latin America, the Kunas have been able to preserve their cultural and political autonomy by means of a robust social organization. In spite of the Panamanian government support in health care, this ethnic group relies in the use of medicinal plants to treat a variety of illnesses and to perform religious rituals. The most common health problems in this community are: malnutrition, tuberculosis, pneumonia, malign tumors in conditions like albinism and intestinal problems. From the 90 species of plants employed in their medicine and rituals (Caballero-George and Gupta, 2011), 49 plants were used topically to treat skin and eyes infections and as wound healing, 24 were used internally to treat fever, pain, cold and general weakness and 17 plants were used in both routes. Interestingly, 19% of the plants used in Kuna´s traditional medicine were related to childbirth (Gupta et al., 1993). The Ngöbe-Buglé represents indigenous group in Panama 65% of total indigenous population. During different field trips in the home land of the Ngöbe-Buglé since late eighties, a total of 286 plants have been collected of which 265 (92.6%) had a medicinal claim (Caballero-George ad Gupta 2011, Joly et al., 1998, 2003). The Teribes represent the third most important group of Amerindians in the country. The use of medicinal plants is very common in this group and the passing of this knowledge is responsibility of the elders. The most common applications for medicinal plants were: cold, headache, body aches, vertigo, cramps, diarrhea, furunculosis, leishmaniasis and snakebites. From this study, 108 plants were identified (Caballero–George and Gupta, 2011, Gupta et al., 2005).

Government Efforts in Development of Traditional Medicine/Phytomedicine Law 4376 of August 1999 created the Area of Traditional Medicine under the National Directorate of Health Promotion. The Area is charged with developing a strategy of action for the incorporation of traditional medicine into primary health care, including research on medicinal plants. 324 The Carta Orgánica Administrativa de la Comarca, following Executive Decree 194 of 26 August 1999, governs traditional medicine in the Ngöbe-Buglé region. Article 258 of the Carta classifies traditional medical specialities, the services they offer, and their legal status regarding diagnosing ailments and dispensing medicines. The same article recommends that traditional and allopathic medical practitioners cooperate and collaborate together. Article 257 creates the Special Medical and Technical Commission to bring together traditional medicine and allopathic medicine. Articles 261 and 262 refer to the organization of botanical gardens for the scientific study of medicinal plants and propose the publication of health manuals. In recognition of the existence, contribution, and importance of traditional medicine to the health of indigenous communities, Article 3 of Law 36 of 3 October 2000, a nationally applicable law, created an autonomous institute of indigenous traditional medicine. The institute recognizes, protects, and promotes traditional knowledge related to the medicinal properties of plants, access to genetic resources in indigenous regions, and the return and distribution of benefits from the commercial application of this knowledge. In Article 4 of Law 36, it is stated that at the institute there will be one representative of each indigenous community, one representative of traditional medicine practitioners, the Minister of Health or designate, and one representative of the Panamanian Medical Association. Article 7 establishes traditional medicine as the patrimony of the communities from which it comes and advances the conservation and promotion of traditional medicine in indigenous areas. It also states that allopathic medicine should not be forced upon these communities. Article 8 recognizes traditional health systems in indigenous communities. Article 10 mandates indigenous authorities to mount a campaign of protection, promotion, and conservation of traditional medical practices. Article 21 orders the establishment of a Faculty of Medicine and a Faculty of Pharmacy of indigenous materia medica and their use in the treatment of sickness. The rest of the articles of Law 36 refer to access to resources, benefit sharing, intellectual property, and the commercialization of medicinal plants. Licensing legislation regulates chiropractic educational standards and practice. A chiropractic law was adopted in 1967, permitting chiropractors to examine, analyse and diagnose the human body by way of any method physical, chemical, electrical, or the use of x-ray and provides for the adjusting, manipulation and treating of the human body (WHO, 2001).

325 Medicinal and Aromatic Plant Resources Panama is among the 25 most plant rich countries in the world. The Panamanian tropical rain forest has a high biodiversity of vascular plant species, estimated at 9893 of which 13.4% are considered endemic (Caballero-George and Gupta, 2011). The information regarding the exact number of MAP species found in the country and their source of harvesting in Panama is currently not known. However, Gupta and Santana (2012) have compiled a list of important medicinal plants of Panama (Table 1).

Research and Development Activities The Centre for Pharmacognostic Research on Panamanian Flora (CIFLORPAN) of the University of Panama, Panama City has been actively involved in research on MAPs in the country in collaboration with various national and international institutes/universities. Selected Panamanian plant extracts were subjected to a large variety of biological screens. These were tested for toxicity, against Artemia salina, and cancer cell lines, antimicrobial, antifungal, molluscicidal, DNA intercalation, as inhibitors of protease and reverse transcriptase, anti-plasmodial , anti-inflammatory [26, 27], antihyperglycemic [28], anti-HSV1 [24], toxicity against Aedes aegypti, as inhibitors of receptor- binding assays on endothelin ETA, angiotensin AT1 and neuropeptide Y Y1 receptors. During the last quarter century, a total of 390 compounds from 86 plants have been isolated to date, of which 160 are new to the literature. These belong to a very diverse compound classes: naphthoquinone, flavonoids, biphenyls, coumarins, acetogenins, xanthone, benzoic acid derivatives, monoterpenes, triterpenes, saponins, alkaloids, amides, procyanidins, quinones, iridoids, tannins, dimeric secoiridoids, and quassinoids. Among the isolated compounds 155 exhibited a range of biological activities. (Gupta et al, 1999, Gupta, 1995, Caballero-George and Gupta, 2011). The TRAMIL (Traditional Medicine for the Islands) research network was launched in 1982 in the Dominican Republic by the international nongovernmental organization (NGO), ENDA-Caribe, under the leadership of Dr Lionel Germosen-Robineau (under the responsibility of the regional office in Nicaragua) with the intellectual assistance and support from the Medicinal Plant Specialist Group (MPSG) at IUCN. The network was established after patent

326 drugs became more scarce and expensive as poverty increased and foreign currency dwindled. A regional office for Central America (Belize to Panama) was established in 1994. The project planners took as their point of departure the fact that rural people would use medicinal plants because of their familiarity and affordability. Universities in Costa Rica, Guatemala, Honduras, Nicaragua, and Panama play a major role in producing the research results. In Honduras, Nicaragua, Panama, and the Dominican Republic, four of the countries in which the TRAMIL Program is currently well established in local and national institutions, interest within government ministries in linking sustainable use of biodiversity to other community benefits, such as public health, has been particularly encouraging. In these countries with support of a GEF Medium Size Project entitled Biodiversity Conservation and Integration of Traditional Knowledge on Medicinal Plants in National Primary Health Care Policy in Central America and Caribbean the TRAMIL Program will add a forest ecosystem conservation component to the existing regional applied research program on traditional remedies derived from medicinal plants. The primary project objective is to support the conservation and sustainable use of medicinal plants important to primary health in key forest eco- regions in Honduras, Nicaragua, Panama, and the Dominican Republic by assessing their conservation status and management needs; working with indigenous and local communities to develop appropriate management strategies; and working with research institutions, NGOs, and national government agencies to integrate conservation and management of medicinal plants with rational use of traditional remedies in primary health care (PHC). The project will focus activities in these four countries, but also aims to develop models and expertise that will be more broadly useful within the region. A preliminary selection of project sites has been made from globally significant eco- regions identified as target areas for project implementation within each of the four countries involved in developing this project. The National Park del Este and Zambrana Cotuí (Mestizo communities) is the project site selected in Dominican Republic (Lagos-Witte, 2006). An IDRC, Canada funded research project was executed in Panama with aims to work for promoting the conservation of Emberá medicinal plants as well as the traditional knowledge associated with these plants. The project work was taken up in the community of Ipeti-Emberá, located on the side of the Ipeti River near the foothills of Serrenia Maje, province of Panama (Potvin and Barrios, 2004).

327 The researchers from the different departments of the university in collaboration with Toyama Medical and Pharmaceutical University, Toyama, Japan tested 39 Panamanian medicinal plants for anti-HIV activity. The plants were collected in Panama mostly based on their popular uses for the treatment of viral infections and cancer (Matsuse et al., 1999). Another study carried out at the Centre for Pharmacognostic Research on Panamanian Flora—CIFLORPAN College of Pharmacy of the University, Smithsonian Tropical Research Institute, Balboa, Panama, and University of Illinois at Chicago, USA to assess the potential economic value of plants from a tropical rain forest of Panama. This study focused on medicinal and pharmaceutical value of the plants and carried out biological evaluation of collected samples. The plants were selected and collected from a 50-hectare forest plot on the Barro Colorado Island (BCI) tropical rain forest that had been already established and inventoried (Calderon et al., 2000). The University’s Centre for Pharmacognostic Research of the Panamanian Flora (CIFLORPAN); Department of Pharmaceutical Sciences, University of Antwerp; and the Department of Molecular and Biochemical Pharmacology, Free University of Brussels (VUB), Belgium carried out the biological screening of 19 plants from Panama. The plants were selected by their traditional uses in the treatment of hypertension, cardiovascular, mental and feeding disorders. In another collaborative study between University of Panama and institutes in Costa Rica and Sweden, ethnomedical uses of 108 medicinal plant species used by the Teribe Amerindians of Bocas del Toro Province in Panama, along with their socio-cultural practices were reported. The methods of administration of the herbal remedies, the plant parts used, their families and local names were also documented (Gupta et al., 2005). A European Union Project within the framework of Seventh Program called AGROCOS is currently being executed in Panama in collaboration with a consortium of industries and Academic institutions in Europe, South Africa and Panama, with the aim to discover novel compounds for the agrochemical and cosmetic industries. The plants along with their traditional uses are listed in Table 1 (Gupta and Santana, 2012).

328 Trade and Marketing The selected botanical exports of Panama during 2007 under the HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others); 121220 (includes botanicals such as kelp Laminaria spp., laver or nori Porphyra spp., and sea tangle Laminaria japonica or Echlonia kurome, among many others.); 130219 (Includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others); and 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils), were 934; 5,679; 60,072; and 238 kg respectively (ITC, 2008). There are very small business groups of medicinal plants mainly selling in the local markets. However, details regarding production and trade in MAPs and their products in Panama are currently not available.

Constraints and Problems The country should make efforts to inventorise the natural resources of MAPs, the traditional knowledge regarding the use of various herbal remedies, their scientific evaluation, establish industry for MAPs and their products and measures to conserve the valuable species of medicinal and aromatic plants. The research on validation of traditional uses of MAPs, their quality control and production, conservation techniques and training of people for sustainable utilization of natural resources of their MAPs should be encouraged.

Table 1. Some common MAPs used in Panama (Gupta and Santana 2012)1

Botanical name Family Common Part(s) Uses name used Aiouea Fabaceae - Leaves Aromatic costaricensis (Mez) Kostermans Alibertia edulis (L. Rubiaceae Trompo Stem bark, Wound healing, Rich) A. Rich plant digestive, urinary antiseptic Alternanthera Amaranthaceae Hierba blanca Leaves Liver disoders pubiflora (Benth.) Kuntz

1 Gupta, M.P. and Santana, A.I. 2012. Plantas Medicinales de Panama. Project Utilization of Panamanian Biodiversity through Bioprospection and Biocomerce. Organization of American States. 329 Ambrosia Asteraceae Altamiz Aereal part, Postpartum, cumanensis Kunth Altamisa plant, hemorrhage, fever, Artemisa anthelmintic, Artemisia antitumor, Pantanis antirheumatic, enmenagogue Anacardium Anacardiaceae Marañón Plant, leaves, Antihypertensive, occidentale L. bark diarrhea, sore throats and inflammation of the extremities and diabetes, diuretic, asthma, cold and congestion Apeiba tibourbou Tiliaceae Cortezo, peine de Leaves Rheumatism, Aubl. mico, combwood, antiespasmodic cortés, cortezo blanco, erizo, fruta de piojo, monkey comb, palo de corteza Aphelandra Acanthaceae Camaroncillo Stem Antiemetic sinclairiana Nees Aphelandra Acanthaceae Hierba blanca Plant Antiemetic arnoldii Mildbr Aphelandra Acanthaceae Plant, fresh Before child-birth aurantiaca leaves (Scheidw) Lindl. Aphelandra Acanthaceae Ngia Plant Fever, rash, mumps tonduzii Leonard and erysipelas

Aristolochia Aristolochiacea Guaco Leaves, root, Stomach ache in maxima Jacq. twigs children, snake bites, diarrea, emmenagogue, erysipelas Aristolochia Aristolochiacea Buche de pavo, Stem, leaves, Antirrheumatic, trilobata L. contrayerba, root, diuretic, aphrodisiac, epák, ïpé-mí diarrhea, respiratory (pato pequeño), and urinary mil hombres, infections, patito, patito enmenagogue, coludo diaphoretic, antiasthmatic Asclepias Asclepiadaceae Bencenuco, mal Plant, root, Headache, curassavica L. casada, niño stem constipation, fever, muerto, quiebra intestinal infection, ojo parasites, asthma, Mal casada, niño tooth ache, snake muerto, pasorín bites Baccharis Asteraceae - - - pendunculata (Mill.) Cabrera Baccharis trinervis Santa María Asteraceae Aereal part, Antiseptic,

330 Pers. leaves, root, dizziness, fever stem, bark Bauhinia Fabaceae Sron Bejuco de Stem, leaves Diarrhea, bed guianensis Aubl. shon kogro cadena, Bejuco wetting de mono

Begonia glabra Begoniaceae Cria Flowes, plant Skin wrinkles, Aubl. cancer

Begonia hirsuta Begoniaceae - Plant, stem Renal disorders, cold Aubl. Bidens pilosa L. Arponcito, cadillo, Asteraceae Plant, flower, Rheumatism, sirvulada aereal part intestinal problems, cold, antifungal and cytotoxic Bixa orellana L. Bixaceae Achiote, gusewe, Seeds, leaves, Anti-inflammatory, puchote roots diuretic, emetic, emenagogue, purgative, vulnerary, antimicrobial, hepatoprotector, dysentery, diabetic Blechum Acanthaceae Mazorquilla, Plant, leaves Diuretic, spleen pyramidatum Doudou kochon affections, (Lam.) Urb emmenagogue, antiemetic, amoebiasis Boerhavia diffusa Nyctaginaceae Mata pavo Roots Anti-spasmodic, L. emetic Bromelia pinguin Bromeliaceae Oa, piñuela, piro Fruits, leaves, Anthelmintic, L. (Panamá) rhizomes, antiparsitic, diuretic, stem hoarseness, digestive disorders Brugmansia Solanaceae Campanilla, Leaves, Hallucinogenic sanguínea (Ruíz & Floripondio rojo, flowers Pav.) D. Don trompeta de angel Bursera simaruba Burseraceae Almácigo, carate, Bark Urinary infections, (L.) Sarg. cholo pelao, indio contraceptive, desnudo astringent, diuretic, anemia, diaphoretic, anti-inflammatory Byrsonima Malpighiaceae Nance Fruits, Bark Chronic colitis crassifolia (L.) Kunth Calea urticifolia Asteraceae Amargoso, Plant Antimalarial, cough, (Mill.) DC. chichilsaca, emetic, stomach chirivito, hoja de ache, diarrhea, anti- empacho tumoral, antacid., bactericide Calathea lutea Marantaceae Ura´dili Flowers, Increase learning (Aubl.) G. Meyer Urua Hoja de bijao, roots, plant capacity in children hoja blanca Carapa guianensis Meliaceae Kionlon Bark Diabetes, digestive 331 Aubl. arthritis, , insect bites, cut, bruses and wounds Carludovica Cyclanthaceae Nauyar Inflorescence Complications palmate Ruiz & during childbirth Pav.

Cassia fistula L. Fabaceae Cañafístula Fruits, seeds, Emetic, diabetes, leaves diarrhea, kidney ailments, leucorrhea, skin eruptions, dematitis, anti- inflammatory Cassia grandis L. f. Fabaceae Cañafístula Leaves, fruits, Anemia, nose bark bleeding, wound healing, cold, cough, diuretic, expectorant, febrifuge, galactogogue, laxative Cecropia peltata L. Cecropiaceae Guarumo Leaves Diuretic, anti- inflammation, rheumatism, gonorrhea, lesishmaniasis Chaptalia nutans Asteraceae Lechuguilla, Plant, root, Asthma, bronchitis, (L.) Pol pipita leaves convulsions, cough, tooth ache, hemorrage, anthelmintic, antinflammatory, wound healing, hemorroides, muscular pain Cissampelos Menispermaceae Mocrí Plant Cataract, snake bites pareira L. Coccoloba uvifera Polygonaceae Uvero de playa Bark, root, Hoarseness, asthma, (L.) L. leaves diarrhea, digestive Cochliostema Commelinaceae Tira Leaves Regulates odoratissimum menstruation Lem. Cochlospermum Cochlospermaceae Monor Roots Emenagogue vitifolium (Willd.) Spreng. Commelina diffusa Commelinaceae Biski Leaves Common cold, Burm. f. headache, emolient, wound healing, urinary infection Commelina erecta Codillo Plant, leave Diuretic, liver L. protection, asthma, analgesic 332 Crescentia cujete L Bignonaceae Calabazo, palo de Fruit, leave, Purgative, leucorrea, calabaza, palo flowers skin infections totumas, diblo Curatella Dilleniaceae Azufre, chumico, Leave, bark, Asthma, chronic americana L. curatela buttons cough, arthritis, diabetes, hypertension, diarrhea

Diphysa americana Fabaceae Guachipilín, Bark, leaves Wound healing, (Mill.) M. Sousa much, palo antiseptic, amarillo anticonvulsive Dorstenia Moraceae Contrahierba, Ina Plant Colds, snake bites, contrajerva L. niilaki’saila, klok muscle pain wua ko Echinodorus Alismataceae Chapeau-de- Leaves Antirrheumatic, grandiflorus couro, antihypertensive (Cham. & Schltdl.) cucharones, hat, diuretic, kidney and Micheli leather urinary tract disorders conditions, rash and to remove skin belemishes Eclipta prostrata Asteraceae Congalala, Plant Asthma (L.) L. cangulala Enterolobium Fabaceae Corotú, Árbol Bark, leaves Colds, hemorroid, cyclocarpum oreja de elefante snake bites, tumors (Jacq.) Griseb. Equisetum arvense Equisetaceae Cola de caballo Plant Diuretic, hemostatic L. Introducida Equisetum Equisetaceae Cola de caballo Aereal part Arthritis, headache, giganteum L. gastroinstinal problems, hemorrhoids Erythrina Fabaceae Cresta de gallo, Plant Women problems berteroana Urban gallito, parsu, pernilla de casa Erythrina fusca Fabaceae Bobo, bois Flowers, Antitusive, febrifuge, Lour inmortelle, roots, leaves prostate gallito, inmortal, inflammation machete, palo bobo, palo santo, pito Eugenia Myrtaceae - Leaves Aromatic acapulcensis Steud. Eugenia Myrtaceae - Leaves Aromatic octopleura Krug & Urb. Ficus insipida Moraceae Higuerón, suu Bark, leaves, Skin infections, Willd fruits stomach pain, emetic, insect bites Genipa americana Rubiaceae Guate, jagua, Fruit, plant Extraction of teeth, 333 L. Sabdir antimicrobial, dye Guarea guidonia Meliaceae Cedro macho, Seeds, bark Rheumatism, (L.) Sleumer Dorita, febrifuge Guaraguao, Kagaglin, Mameicillo blanco, Pico de loro Guazuma ulmifolia Sterculiaceae Cabeza de Fruit, bark Anti-inflammatory, Lam. negrito, guácimo diuretic, diaphoretic Hamelia patens Rubiaceae Coralillo, Uvero Leaves, stem Menstrual disorders, Jacq. as a post partum aid to relieve pain Hedysomum Chloranthaceae - Leaves Aromatic bonplandianum Kunth

Jatropha curcas L. Euphorbiaceae Coquillo Leaves Emetic, fever, colds, erysipela, wounds Justicia pectoralis Acanthaceae Mojo bren, Tilo Plant Stomach pain, cough, Jacq. lung diseases especially pneumonia Licaria sp Fabaceae - Leaves, bark, Aromatic stem, fruit Matayba Sapindaceae - Inflorescence Aromatic glaberrima Radlk Mimosa pudica L. Fabaceae Muigin, gauring, Stem Arthritis dormidera

Mimosa Fabaceae Cabrera, Plant Wound healing, tenuiflora(Willd.) carbonal, jurema burns Poir. preta, tepescohuite, tepesquehuite Myrcia aff. Fosteri Myrtaceae - Leaves Aromatic Croat Myrcianthes Myrtaceae - - Aromatic fragrans (Sw.) Mc Vaugh var hispidula Myrcia platyclada Myrtaceae - Leaves Aromatic DC. Nectandra Fabaceae - Leaves Aromatic cuspidate Nees & Mart. Neurolaena lobata Asteraceae Contragavilana Leaves Diabetes, stomach (L.) Cass. ache, anemia, dysentery, skin affections Ocimum Lamiaceae Albahaca, albaca Branches, Aromatic, campechianum (Labiatae) de monte, bisep plant headaches, regulate Mill. sapur menstruation, cold, diuretic, mosquito repellent 334 Ocotea darcy van Fabaceae - Leaves Aromatic der Werff Ocotea Paulii Allen Fabaceae - Leaves Aromatic Phyla dulcis Verbenaceae Oro ozul, orozul, Leaves Gastrointestinal (Trevir.) Moldenke orosú disorders, antitusive, bronchodilator

Petiveria alliacea L. Phytolaccaceae anamú, kuan Leaves, roots Cold, diuretic, enmenagogue, gastrointestinal problems, diabetes, headache, rheumatic pain Piper longispicum Piperaceae - Leaves Aromatic C.DC. Piper Piperaceae Bachar dubaled Leaves Body and stomach multiplinervium ache, headaches, C.DC. colds, appetite stimulant, carminative, diuretic, gastrointestinal disorders, aromatic Piper obliquuon Piperaceae - Leaves Aromatic Ruíz López & Pavón Piper peltatum L. Piperaceae Santa María Aereal part, Febrifuge, pain, leaves aromatic Piper reticulatum Piperaceae - Aereal part, Snake bite, aromatic C.DC. leaves Piper trigonum Piperaceae - Leaves Aromatic C.DC. Phyllanthus niruri Euphorbiaceae Viernes santos Leaves, seed Diuretic, diabetes L. introducida Plinia Myrtaceae - Leaves Aromatic cerrocampanensis Barrie Protium confusum Burseraceae - Leaves Aromatic Pittier Quassia amara L. Simarubaceae Hombre grande, Plant Amebicide, Quassia, Udud antiseptic, aperitive, bungid, Udut febrifuge, pulu, hombrón pediculicide, vermifuge Rauvolfia Apocynaceae Coataco Root, leaves, Malaria, snake bite, tetraphylla L. guataco sav or latex, stomach pains, bark, stem antihypertensive, dysentery, febrifuge, edema, wasp and scorpion stings

335 Sambucus Caprifoliaceae Sauco Bark, root, Ant-inflammatory, canadensis L. leaves galactogogue, laxative, expectorant Senna occidentalis Fabaceae Frijolillo Seeds, leaves Insomnia, stomach (L.) Link ache Senna reticulata Fabaceae Cura lo todo, Root Emetic (Willd.) H.S. Irwin laureña, Kranam & Barneby Siparuna Monimiaceae - - Aromatic thecaphora (Poepp & Endl.) A.DC. Simarouba amara Simarubaceae Aceituno, Plant Febrifuge, malaria, Aubl. Aceituno, Harino, snake bite, Olivo, Olivo, amebicide, Urgug astringent, stomach ache Sonchus oleraceus Asteraceae Amargon, cardo, Leaves, stem, Stomach ache, L. . colmillo de león, anemia, digestive, diente de león, flatulence, liver girasol, lechugilla ailments, diarrhea, hepatic colics Spigelia anthelmia Loganiaceae Lombricera, Ina Plant Skin infections, L. nusu conjuctivitis, anthelmintic Spondias mombin Anacardiaceae Jobo Bark, leaves Malaria, L. contraception, menstruation and prolonged bleeding Tabebuia rosea Bignonaceae Roble, Roble de Bark Wound healing, (Bertol.) A. DC. sabana fungal skin infections, ulcers, diarrhea, dysentery Tabernaemontana Apocynaceae Huevo de verraco Bark, leaves, Skin infections, markgrafiana J.F. látex, root, abscesses, influenza Macbr. and colds, diarrhea, febrifuge, emetic, diuretic, insomnia, stomach aches Tridax Asteraceae Hierba del toro Leaves, plant Anti-allergic, procumbens L. respiratory, anemia, diarrhea, stomach ache, headache, diabetes Vernonanthura Asteraceae Botón de pega- Leaves and Febrifuge, stomach patens (Kunth) H. pega, lengua de floral buttons ache, nause, nose Rob. buey, palo bleeding, regulation blanco, salvia, of menstruation sanalego Xanthosoma Araceae Badu, otó, otoe, Root, leaves Anthelmintic violaceum Schott coco, malanga Xylopia aromatica Annonaceae Malagueto Fruit Anthelmintic, (Lam.) Mart antipyretic, stomach pains, dyspepsia, snake bite, diuretic, uterine tonic 336 Piper aduncum L. Piperaceae Hierba del Leaves Stomach problems, soldado, matico colic, hemorrhage, wound, astringents, hemostatic, digestive, carminative, aromatic Piper auritum Piperaceae Anisillo, Santa Leaves, stem Common colds, Kunth María emmenagogue

Piper amalago L. Piperaceae Cordoncillo, Leaves Repellent of insect hierba salibares, higuillo oloroso Piper arboreum Piperaceae - Leaves, Snake bite Aublet branches Piper augustum Piperaceae - Leaves Aromatic Rudge Piper corrugatum Piperaceae - Leaves Aromatic Kuntze Piper curtispicum Piperaceae - Leaves Aromatic C.DC. Piper darienense Piperaceae Duerme boca, Plant Fish poison, snake C.DC. kana, tocoan bites, cold, aromatic Piper fimbriulatum Piperaceae canotillo Leaves Aromatic C.DC. Piper Piperaceae - Leaves Aromatic friedrichsthalii C.DC. Piper grande Vahl Piperaceae - Leaves Aromatic Piper hispidum Piperaceae Cordoncillo Aereal part Snake bites, malaria, Sw. muscle pain, fever, to expel worms, aromatic Piper Piperaceae Cordoncillo Leaves, Fever, headaches, jacquemontianum flowers cold, diabetes, Kunth aromatic

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349 Leduc, C., Coonishish, J., Haddad, P. and Cuerrier, A., 2006, Plants used by the Cree Nation of Eeyou Istchee (Quebec, Canada) for the treatment of diabetes: A novel approach in quantitative ethnobotany. Journal of Ethnopharmacology, 105(1‐2): 55‐63 Lentz, D. L., Clark, A. M., Hufford, C. D., Meurer‐Grimes, B., Passreiter, C. M., Cordero, J., Ibrahimi, O. and Okunade, A. L., 1998, Antimicrobial properties of Honduran medicinal plants. Journal of Ethnopharmacology, 63(3): 253‐ 263 Leonti, M., Sticher, O. and Heinrich, M., 2003, Antiquity of medicinal plant usage in two Macro‐Mayan ethnic groups (México). Journal of Ethnopharmacology, 88: 119–124 Lioger, A. H. 2000. "Botanical Dictionary of the Spanish Common Names." 2ND Printer Edition UNPHU. Loomis, T. F., Ma, C. and Daneshtalab, M., 2004, Medicinal plants and herbs of Newfoundland. Part 1. Chemical constituents of the aerial part of pineapple weed (Matricaria matricarioides). DARU, 12(4): 131‐135 Lynch, S., 1998, Traditional medicinal plant use in modern Quepoan society. Available at: http://www4.ncsu.edu/~twallace/Lynch.pdf (21 Aug. 2008) Mahabir, D. and Gulliford, M. C., 1997, Use of medicinal plants for diabetes in Trinidad and Tobago. Revista Panamericana de Salud Pública / Pan American Journal of Public Health, 1(3): 174‐179 McDonnell, M. B., 2008, Medicinal Plants of El Salvador: The Effectiveness of Traditional Healing. Available at: http://www.stlawu.edu/clas/insidethearea/mcdonnell/mcdonnell.pdf (26 Aug. 2008) Mancebo, F., Hilje, L., Mora, G. A., Castro, V. H. and Salazar, R., 2001, Biological activity of Ruta chalepensis (Rutaceae) and Sechium pittieri (Cucurbitaceae) extracts on Hypsipyla grandella (Lepidoptera: Pyralidae) larvae. Revista de Biologia Tropical, 49(2): 501‐508 Martinez, M. J., Betancourt, J., Alonso‐Gonzalez, N. and Jauregui, A., 1996, Screening of some Cuban medicinal plants for antimicrobial activity. Journal of Ethnophannacology, 52 (1996) 17 1 ‐ 174 Matsuse, I. T., Lim, Y. A., Hattori, M., Correa, M. and Gupta, M. P., 1999, A search for anti‐viral properties in Panamanian medicinal plants. The effects on HIV and its essential enzymes. Journal of Ethnopharmacology, 64:15–22

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355 2.19 Puerto Rico The Commonwealth of Puerto Rico with its archipelago (Vieques, Culebra, Mona, Monita, Desecho, Culebrita, Caja de Muerto, etc.) has a total land area of about 8,900 square kilometers. Puerto Rico is distinguished by a wide range of environmental conditions. The Cordillera Central, an east-west oriented volcanic (clastic) mountain chain straddles the central part of the island and reaches 1,388 m at its highest point. Other major mountain ranges are Sierra de Luquillo in the north east, Sierra de Cayey in the south east and Cordillera Jaicoa in the North West. The varied topography and complex geology are the cause of 28 geoclimatic zones in which vegetation and species have evolved and diversified. The vegetation cover of Puerto Rico has undergone significant changes. In the 1940s, deforestation was most intense, leaving only 6% forested land. With new economic and social trends agricultural activities lessened and by 1987, forests regenerated on abandoned agricultural fields, covering 35% of the island. The 1991 land cover map indicates that now at least 41.6% of the main island is classified as forest. Only a small part of the land of the Commonwealth of Puerto Rico (ca. 5.8%) is now under governmental protection. A preliminary analysis of the distribution of vegetation remnants and rare or threatened plant and animal species in Puerto Rico has confirmed the importance of the Forest Reserve network. Seventy percent of the ecosystems, 87% of the critical plant species and 48% of the critical animal species occur in the reserves. Puerto Rico harbours a diverse flora and fauna with a high level of endemism. The mountain habitats harbour the highest number of endemic tree species within the Commonwealth. Many species are endemic to the West Indies in general, to the main island, to individual islands of the archipelago and to isolated areas within each island. With two ecoregions, the Commonwealth of Puerto Rico is characterized by 25 vegetation formations; 2,891 vascular plant species; and 396 vertebrate species (Keel, 2005).

Traditional Medicine Systems/Phytomedicine A 1980s study evaluated the use of medicinal plants by the patients at the outpatient clinics of five health-care centers in Puerto Rico. As per this report medicinal plants were used by 57% of the population. Seven of the 11 most commonly used plants were to treat gastrointestinal disorders. Other medicinal uses given were for elevated blood pressure, kidney disorders, respiratory 356 ailments, sedation, and sleep disorders. Most herbs were used to treat self- limiting conditions but some were used to treat potentially serious medical problems, such as hypertension (Hernández et al., 1984). The use of plants for medicinal purposes is a common practice, especially among population living in the countryside. Many plants of local flora are used even in present times by the local population to treat conditions like bronchitis, cold, cough, diarrhoea, respiratory infections, skin lesions and urinary disorders (Melendez and Capriles, 2006). A recent TRAMIL ethnopharmacological study performed in the south eastern region of Puerto Rico documented the medicinal plants that are frequently used to treat health conditions and the trends in their use among the study population. Overall, 118 medicinal plants were recorded as being used to treat depression, nervousness, chronic sinusitis, gastritis, gastroesophageal reflux disease, allergic rhinitis, rhinopharyngitis, asthma, arthritis and migraine. Results showed that 33.6% of the families in the study used medicinal plants as the first treatment for at least one of the health problem surveyed (Gavillán- Suárez J, et al, 2009).

Government Efforts in Development of Traditional Medicine/Phytomedicine The herbs and other botanicals qualify as dietary supplements that do not have to meet the same standards as drugs and OTC products for safety, effectiveness, and GMP. The United States Pharmacopoeia XXX and the National Formulary XXV are the official reference books in the areas of Medicine and Health. All the plants growing in Puerto Rico and mentioned in these volumes have pharmacopoeial status (Jacome, 2007).

Medicinal and Aromatic Plant Resources A study by the Inter American University of Puerto Rico, San German Campus and Hewlett-Packard Caribe Ltd., Puerto Rico between 1983 and 1985, reported 172 species of medicinal plants, of 73 families collected from north- western and western regions of Puerto Rico (Melendez and Capriles, 2006). Approximately 3,000 plants, 239 endemic, 135 with recognized major medicinal uses and 170 species with minor therapeutic value are reported in Puerto Rico (Jacome, 2007).

357 Research and Development Activities Some institutes engaged in activities of MAPs are the School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan; Department of Chemistry, University of Puerto Rico at Cayey; Faculty of Sciences & Technology, Interamerican University, Metropolitan Campus, and Department of Microbiology & Immunology, Universidad Central del Caribe, Bayamón, Puerto Rico. The School of Pharmacy, University of Puerto Rico reported screening of 19 Myrtaceae plants collected in Puerto Rico for xanthine oxidase inhibition (Guerrero and Guzman, 1998). As part of a screening program of the flora of Puerto Rico, researchers from the Department of Pharmaceutical Sciences, School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan tested a number of higher plants for antiplasmodial and antimycobacterial activities. A total of 40 extracts belonging to 23 plant families and 37 species were tested for antiplasmodial activity against Plasmodium falciparum. Another 63 extracts belonging to 30 plant families and 50 species were tested in vitro against Mycobacterium tuberculosis in this study (Antoun et al., 2001). Some studies on the antimicrobial effects of endemic plants of Puerto Rico have been reported in the past. Recently the Department of Biology, Inter American University of Puerto Rico, and Hewlett-Packard Caribe Ltd., ISB- Americas R&D, Aguadilla, Puerto Rico in an effort to document the antibacterial properties of plants commonly used by the people of Puerto Rico, studied the effects of 172 plant species. A specimen of each species was preserved for future reference in the herbarium of the university. The plants that showed antibacterial activity in this study are listed in Table 1 (Melendez and Capriles, 2006).

Trade and Marketing A number of small companies are engaged in production and trade of medicinal plants and essential oils in Puerto Rico. They usually sell these oils in the local markets. The products based on plants like Passiflora spp., Pimenta racemosa (Mill.) J. W. Moore, and Rosmarinus officinalis L. are commonly sold (Jacome, 2007). However, there is no information on exact volumes of their production, consumption and trade in Puerto Rico at present.

358 Constraints and Problems

A combined effort from academia, government and private industry in the area of research, relevant policies and laws and product development from MAPs is needed for the development of this sector so as to exploit their health and commercial benefits in Puerto Rico.

REFERENCES Antoun, M. D., Ramos, Z., Vazques, J., Oquendo, I., Proctor, G. R., Gerena, L. and Franzblau, S. G., 2001, Evaluation of the flora of Puerto Rico for in vitro antiplasmodial and antimycobacterial activities. Phytother Res., 15(7): 638-642 Gavillán-Suárez, J., Alvarado-Guzmán, J. A., and Germosén-Robineau, Lionel, 2009, TRAMIL Ethnopharmacological Survey: Knowkledge Distribution of Medicinal Plant use in the Southeast Region of Puerto Rico. PRHSJ, 28(4): 329-339 Guerrero, R. O. and Guzman, A. L., 1998, Inhibition of xanthine oxidase by Puerto Rican plant extracts. P R Health Sci J., 17(4): 359-364 Hernández, L., Muñoz, R. A., Miró, G., Martínez, M., Silva-Parra, J. and Chávez, P. I., 1984, Use of medicinal plants by ambulatory patients in Puerto Rico. Am J Hosp Pharm., 41(10): 2060-2064 Jacome, R. O. G., 2007, Status of MAPs in Puerto Rico. In: Regional workshop on "Quality control, scientific validation and business prospects of medicinal and aromatic plants" Port of Spain, Trinidad and Tobago, 1-3 October, 2007, West Indies (ICS documents) Keel, S., 2005, Caribbean Eco-regional Assessment Puerto Rico: Terrestrial Biodiversity. The Nature Conservancy, Washington, U.S.A.

Table 1: Some of the MAPs from Puerto Rico with antibacterial properties (Melendez and Capriles, 2006)

359 Botanical name Family Plant part Citrus aurantifolia (Chrism.) Swingle Rutaceae Fruit Citrus aurantium L. Rutaceae Fruit Clidemia hirta (L.) D. Don Melastomataceae Leaves Crescentia cujete L. Bignoniaceae Leaves Lagerstroemia speciosa (L.) Pers. Lythraceae Leaves Melicoccus bijugatus Jacq. Sapindaceae Leaves Petitia domingensis Jacq. Verbenaceae Leaves Phyllanthus acidus (L.) Skeels Euphorbiaceae Fruit Psychotria nervosa Sw. Rubiaceae Leaves Punica granatum L. Punicaceae Fruit Rosmarinus officinalis L. Lamiaceae Leaves Tamarindus indica L. Fabaceae Leaves Terminalia catappa L. Combretaceae Leaves Urena lobata L. Malvaceae Leaves

360 2.20 Saint Kitts and Nevis

Saint Kitts and Nevis is located in the West Indies in the eastern Caribbean Sea about 310 kilometres east of Puerto Rico. It is comprised of two of the Leeward Islands, Saint Kitts or Saint Christopher, and Nevis, which lie about 3 kilometres apart. The country covers a total area of 261 square kilometres - St. Kitts Island covers 168 and Nevis covers 93 square kilometres. Both islands are of volcanic origin, with rolling hills and narrow fertile plains along the coasts. The island of Saint Kitts is traversed by a mountain range, the highest point being Mount Liamuiga, 1,156 m. The highest point on Nevis is 985 m. The climate is tropical; the average annual temperature is 27° C. Annual rainfall is about 1,400 mm. The islands of Saint Kitts and Nevis are moderately forested, with forests concentrated in the mountainous interiors of both islands. Forests cover approximately 30% of the land area on the bigger island of Saint Kitts and 15% of the land area on Nevis. Forest cover in 2000 was about 4,000 hectares. There is no established forest sector on the islands. Neither are there any exact figures available for forest cover data and the above figures are rather rough estimates. The forests are vital to water supplies, since most of the drinking water comes from streams within the forest. The steep terrain and the dense topography of both islands have discouraged human actions in forested areas. A small amount of building material is extracted form the forests, mainly for the production of fish traps (fish pots) and a small amount of charcoal is still made. The fuel wood collection is still frequent in Nevis. Prior to European settlement in the seventeenth century the islands were almost completely forested. The mountain peaks are still covered by forest, but it is unlikely that any virgin forest remains. Lowland forests have mainly been cleared for sugar plantations, while upland forests have been harvested for timber. Because of the decline of the sugar industry considerable tracts of lands are regenerating naturally into secondary forest. The islands have several distinct vegetative zones including moist tropical rain forest, dry evergreen forest, dry scrub woodland, elfin woodland, and littoral and mangrove forest. The small areas of rain forest are dominated by gommier (Dacryodes excelsa Vahl). The dry forest and woodlands are mainly upland or montane, notably on the slopes of Mount Liamuiga on Saint Kitts, and Nevis Peak on Nevis. Primary tree species include Ficus citrifolia Mill., screw pine (Pandanus utilis Bory) and white cedar (Tabebuia heterophylla (DC.) Britton). A variety of palms are also present. Saint Kitts and Nevis presently has no declared forest reserves (the focus of Brimstone Hill National Park is primarily historic rather than natural). Despite some recommendations and suggestions to establish plantations, no significant area has been established. Small areas of plantations were established in 1987/88. Planted species include Azadirachta indica A. Juss., Cedrela odorata L., Leucaena

361 leucocephala (Lam.) de Wit, Pinus caribaea, Samanea saman (Jacq.) Merr., Swietenia macrophylla King, and Swietenia mahagoni (L.) Jacq. Tending and management of forest plantations is inadequate because of lack of funds. Some reforestation projects have failed because of livestock grazing. A special problem in Saint Kitts and Nevis is the green or vervet monkeys, which were introduced from West Africa as pets in the seventeenth century, escaped into the wild and turned into a severe agricultural pest. Attempts to export the monkeys for medicinal purposes have never been as successful as for example in Barbados. In addition to the monkeys there is a large population of feral donkeys on Nevis. Originally the donkeys were used to carry loads but when no longer needed the animals were allowed to roam freely and to reproduce without any management. After the export of live donkeys to the French islands had to be stopped for veterinary reasons, the donkey population turned into an agricultural pest. Attempts to manage or control the donkey population have remained unsuccessful (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Saint Kitts and Nevis have good health care with a sufficiency of doctors who are usually British or Canadian trained. There is a hospital on Saint Kitts and an infirmary on Nevis. Pharmaceutical services are widely available. No information on the current prevalence and use of traditional herbal medicine on the island is available.

Government Efforts in Development of Traditional Medicine/Phytomedicine The Ministry of Health is responsible for the organization and management of the health services and has ultimate responsibility for health policy. Government provides most services and there has been continuous rationalization to improve efficiency. The health services are provided by four public hospitals (The J.N. France General Hospital, The Pogson, Mary Charles and Alexandra) and seventeen Health Centres. These institutions provide primary and secondary care. The Health Centres are located mainly in the rural areas. They are staffed with trained Public health nurses and medical doctors in an effort to provide quality care at the community level. There is no current information regarding the government efforts in promoting traditional herbal medicine use and laws or policies being implemented or in pipeline in this direction.

362 Medicinal and Aromatic Plant Resources The agricultural sector represents a key area of economic activity in the country. The agricultural sector is dominated by the sugar industry which occupies 4,000 hectares on St. Kitts. The data about the plant resources is incomplete and there is no inventory of flora. The natural vegetation of the islands is very limited (FAO, 1995). However, no information is available regarding country’s MAPs and their natural resources or their status as per wild harvesting or cultivation.

Research and Development Activities The National Conservation and Environmental Protection Act 1987 (NCEPA) provides for the establishment of protected areas of different categories viz. national parks, nature reserves, botanical gardens, marine reserves, historic sites, scenic sites and areas of special concern for the preservation of diversity of wild flora species that may be endermic, threatened or of special concern. There are no programmes or projects for on site conservation of plant genetic resources. There is also no national plant genetic resource collection. However, the forest areas form part of the natural reserves and protected areas. There is no systematic use of plant material for crop improvement from the genetic resources. There is no national plant breeding programme. The country also does not have any special relationship with any of the regional research centres that have significant plant genetic resources programmes (FAO, 1995). There is no information on any research and development efforts concerning MAPs in the country. However, a number of plants used for medicinal purposes in St. Kitts and Nevis are described and illustrated in the books entitled “Medicinal Plants of St. Kitts and Nevis” Part 1 and 2 by Whittaker, M. C. (Basseterre: Clarence Fitzroy Bryant College of Further Education, Federation of St. Kitts & Nevis). The plants are listed with their botanical name, local name, description and uses. The herbal medicines used in the country are also described in the books with information obtained from local healers.

Trade and Marketing No information is currently available on the trade and marketing of MAPs and their products within the country.

Constraints and Problems The critical constraints in development of MAPs sector can be grouped into three broad categories financial, institutional and human resources and training. A lack of public awareness on critical issues, the lack of institutional capacity both in the public and private sectors, the lack of coordinating mechanisms both at the national and regional levels, the absence of monitoring and a general lack of expertise and skills and the unsustainable harvesting of medicinal and aromatic plants. 363 Except for the central mountain spine, the rest of the island is not heavily forested. A number of unique natural habitats of such plants are in need of conservation and environmental protection. The safeguarding of vegetation biodiversity for present and future generation by preserving special plant communities and endangered species is a necessity. Presently, the greatest threat to wildlife in St. Kitts and Nevis is habitat alteration. Many parts of the rain forest have being altered. The country need to work for identification of wild progenitors of current or potentially important commercial agricultural forestry and medicinal plants, determination of their genetic diversity present in the wild, and training in the areas including , programme management, data management, germplasm health, seed science and agronomic evaluation. There is a need for closer local collaboration in respect of optimally utilising the scarce natural resources of MAPs.

364 2.21 Saint Lucia Saint Lucia is one of the Windward Islands in the West Indies, south- eastern Caribbean Sea. It lies about 380 kilometres north of Venezuela between Martinique on the north and Saint Vincent on the south. It has an area of 616 square kilometres. Of volcanic origin, Saint Lucia is traversed from north to south by a forested mountain range that culminates in Mount Gimie (950 m). In the south, Soufrière, a volcanic crater with hot sulphur springs, offers a potential source of geothermal energy. Gros Piton and Petit Piton, twin peaks in the south-west area, are ancient volcanic cones. The mountains contain many streams and fertile valleys. There is little flat land. Saint Lucia has a tropical oceanic climate. The average annual rainfall ranges from about 1500 mm on the coast to more than 2500 mm in the mountains. The rainy season lasts from May to August (FAO, 2008).

Traditional Medicine Systems/Phytomedicine Many indigenous species with well-known medicinal properties exist and used in the country. However, the use of the plant based remedies by local people is declining due to the increased availability and adoption of modern medicines (FAO, 1995).

Government Efforts in Development of Traditional Medicine/Phytomedicine The pharmacists are not involved in making formulations with medicinal plants in St. Lucia. The medicinal plant products are treated as OTC drugs. There are no regulations for herbal products as these are not considered to be drugs under the Pharmacy Act. The Ministry of Health follows the guidelines of the WHO for practices using traditional medicines. The Health Practitioner’s Act of 2006 makes provision for a board of “Allied Health Professions” comprising of herbalist, naturopathists and homoeopathists, though it is not in effect currently. Two surveys on traditional plant use in St. Lucia were part of the National Biodiversity Strategy and Action Plan. The policies approved by the Cabinet affecting the management and use of MAPs in St. Lucia are the National Agriculture Sector Policy, the Plant Protection Act, the Biodiversity Act, Biosafety framework, the Land

365 Conservation and Improvement Act and procedures manual for research using biological resources (Gustave and Severin, 2007).

Medicinal and Aromatic Plant Resources About 100 species of MAPs with medicinal properties have been identified in the country. These are used to treat a wide range of ailments including the chicken pox, common cold, diabetes, gas, high blood pressure, jaundice, menstrual pain, rheumatism, and venereal diseases. Some species are also used as shampoo, soap, and pesticides etc. A list of common medicinal and aromatic plants used in the country is presented in Table 1. Many of these species are maintained in the Medicinal Garden, Forestry Department at Union Station as a collection and for germplasm exchange with local users (FAO, 1995).

Research and Development Activities The St. Lucia National Trust, a private foundation, has a small collection of some native flora that was started to explore the medicinal properties of plants. The specimens are collected, studied, identified, and catalogued for storage. The Trust is in the process of transferring this collection to the Forestry Department which has more suitable facilities for upgrading and expanding the collection. A small medicinal plant garden has been established under the management of the Forestry Department as a collection to promote the awareness of their value (FAO, 1995). The main institutes involved in activities concerning MAPs are the Caribbean Research and Development Institute- Field Station La Ressource Dennery and Inter American Institute on Agriculture, Waterfront Castries St. Lucia. There is no formal multi-sectoral strategy for MAPs management in St. Lucia; however, there have been projects and activities amongst various government and non-governmental agencies, community groups and the public in an effort to understand their use. A project for preservation of traditional knowledge in St. Lucia was undertaken that led to documentation and development of a database of the information obtained from traditional healers. There are two studies on traditional plants of Saint Lucia which detail the aspects of local production of medicinal plants in Saint Lucia. The first is a survey undertaken by the Ministry of Agriculture, Forestry and Fisheries on the usage of traditional plants. The study showed that the vending and

366 purchase of herbs were dominated by females. The males were involved in collection of raw materials from wild. The second survey of plants also by the Ministry of Agriculture detected that culinary herbs were in sufficient supplies for domestic market but were not in adequate supplies for processing industries. Such herbs included Chives (Allium schoenoprasum L.), Basil (Ocimum basilicum L.), Rosemary (Rosmarinus officinalis L.) and garden Thyme (Thymus vulgaris L.). The natural population of lemongrass (Cymbopogon citratus (DC.) Stapf) is threatened by clearing of land for housing (Gustave and Severin, 2007). The Saint Lucia Biodiversity Enabling Activity Project under the National Biodiversity Strategy and Action Plan (NBSAP) entitled “Evaluation of the medicinal and culinary properties of herbs” aimed to foster greater awareness of the uses of local herbs; promote small-scale business activities based on the sustainable use of these resources; and contribute to agricultural diversification. The project will carry surveys for collection of information on the knowledge and herb usage in the country; preparation of technical packages to guide processing and commercial uses; dissemination of information to farmers and processors; and technical assistance for processing and producing MAPs. This project will be implemented by the Department of Forestry, in collaboration with the St. Lucia National Trust and other relevant organisations (Anonymous, 2008). However, the information on current status of this project as per time of start and completion is unavailable.

Trade and Marketing In St. Lucia MAPs and their products are produced and consumed locally. The production for local markets aimed mainly for culinary purposes, medicinal, aromatherapy in spas, landscaping and enhancement of eco-tourist sites and for religious purposes (Gustave and Severin, 2007). The quantitative data on the trade of medicinal and aromatic plants is currently not available.

Constraints and Problems St. Lucia needs to develop its own trained human resources for conservation and sustainable utilization of its MAPs. An extensive survey is required to document the available MAPs resources and traditional knowledge regarding their medicinal use in the country. Special attention should be given to endangered species, endemic species and wild relatives of cultivated crops with economic importance.

367 There is need for improved coordination of policies and activities relevant to, or impacting on, biological diversity of MAPs and their resources. There is need to establish effective partnerships among governmental and non-governmental agencies, in order to mobilise the resources available from the public and private sectors, and to decentralise management authority. Linkages between countries at regional and international levels are required for sharing of information on MAPs resources. There is a need to develop and strengthen the linkages between research institutions/universities to carry on research on various aspects of MAPs including their conservation, product development, quality control and medicinal evaluation etc. Assistance in the form of graduate training of local personnel; helping with the establishment of the infrastructure, such as research laboratories, experimental stations, etc., would be most beneficial.

REFERENCES Anonymous, 2008, The Saint Lucia Biodiversity Enabling Activity Project.- National Biodiversity Strategy and Action Plan (NBSAP): Projects, p. 49. Available at: http://www.slubiodiv.org/The_Project/Information/Printed_Materials/NB SAP/projects.pdf (01 Sep. 2008) FAO, 1995, Saint Lucia: Country report to the FAO International Technical Conference on Plant Genetic Resources (Leipzig, 1996), Ministry of Agriculture, Lands, Fisheries and Forestry Castries, June 1995 FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Gustave, D. and Severin, M., 2007, Status report of Medicinal and Aromatic Plants in St. Lucia. In: Regional workshop on "Quality control, scientific validation and business prospects of medicinal and aromatic plants" Port of Spain, Trinidad and Tobago, 1-3 October, 2007, West Indies (ICS documents)

Table 1: Some common medicinal and aromatic plants used in St. Lucia (FAO, 1995)

Botanical name Common name Family Abrus precatorius L. Crab’s eyes, Gwenn légliz, Fabaceae Jumbie Beads Ageratum conyzoides L. Labonn fanm, Latifi, Zèb a Asteraceae mouton

368 Aloe vera (L.) Burm. f. Aloe, Lalwè Asphodelaceae Alpinia zerumbet (Pers.) B. L. Burtt Shell ginger, Shellflower Zingiberaceae & R. M. Sm. Ambrosia hispida Pursh Labsent, Gap fwizé Tapis, Asteraceae Wormwood Anacardium occidentale L. Cashew, Ponm akajou, Nwa Anacardiaceae Annona muricata L. Kòsòl, Soursop Annonaceae Antigonon leptopus Hook. & Arn. Cemetry Vine, Coralita Coral Polygonaceae vine Aristolochia trilobata L. Tref, Tuf, Twef Aristolochiaceae Bidens pilosa L. Needle grass, Zèb a zédjwi Asteraceae Bixa orellana L. Roucou, Roukou, Woukou, Bixaceae Annatto Blechum pyramidatum (Lam.) Fonn san, Sonwe, Zo nwè Acanthaceae Urban Bryophyllum pinnatum (Lam.) Kawakté lézòm, Leaf-of-life, Crassulaceae Oken Wonder-of-the-World Caesalpinia pulcherrima (L.) Sw. Barbados Pride, Flè makata Fabaceae- Caesalpinioideae Cajanus cajan (L.) Millsp. Pwa angòl, Pigeon pea Fabaceae- Faboideae Canna indica L. Toloman, Malobi Cannaceae Capraria biflora L. Dité péyi Scrophulariaceae Capsicum frutescens L. Bird pepper, Piman gwiv Solanaceae Carica papaya L. Papaya Caricaceae Senna alata (L.) Roxburgh Christmas candle, Kasialata Fabaceae Catharanthus roseus (L.) G. Don Kaka Poul, Periwinkle Apocynaceae Chaptalia nutans (L.) Pol. Dandelion, Fèy do blan Asteraceae Dysphania ambrosioides (L.) Semen contwé, Wormgrass, Zèb a Amaranthaceae Mosyakin & Clemants vè Cinnamomum verum J. Presl Cinnamon, Kannel, Spice Lauraceae Citharexylum spinosum L. Bwa kòtlèt, Bwa kawé Verbenaceae Clusia major L. Awali, Pitch apple Clusiaceae Cocos nucifera L. Coconut Arecaceae Commelina diffusa Burm. f. Water grass, Zèb gwa. Commelinaceae Crescentia cujete L. Calabash, Kalbas Bignoniaceae Curcuma longa L. Tjitima, Turmeric Zingiberaceae Cymbopogon citratus (DC.) Stapf Citronnelle, Lemon grass, Poaceae Sitonnèl Cyperus rotundus L. Guinea seed, Gwendjin, Nutgrass Cyperaceae Eclipta prostrata (L.) L. Konngolala Asteraceae Eleusine indica (L.) Gaertner. Foul foot, Pyé poul Poaceae

369 Enicostema verticillatum (L.) Engl. Lanng poul Gentianaceae ex Gilg Eryngium foetidum L. Blessed thistle, Chadon beni Apiaceae Ayapana triplinervis (Vahl) R. M. Japana, Djapanna Asteraceae King & H. Robinson Euphorbia hirta L. Zèb malnonmen, Milk weed Euphorbiaceae Gliricidia sepium (Jacq.) Kunth ex Lila, Glory cedar Fabaceae Walp. Gossypium hirsutum L. Cotton, Kòtòn Malvaceae Hedychium coronarium J. Koenig Jjann doule, Lavann, Lavender Zingiberaceae Hibiscus rosa-sinensis L. Hibiscus Malvaceae Hymenocallis caribaea (L.) Herbert Cocoa onion, Spider lily, Wild Amaryllidaceae onion Hyptis atrorubens Poit. Wild Mint Lamiaceae Hyptis mutabilis (Rich.) Briq. Patjouli Lamiaceae Jatropha curcas L. Medsinnyé benni, Physicnut Euphorbiaceae Justicia pectoralis Jacq. Carpenter’s grass, Chapantyé Acanthaceae Justicia secunda Vahl St. John bush Acanthaceae Lantana camara L. Bwa-wa-tau, White sage, Yellow Verbenaceae sage Laportea aestuans (L.) Chew Zoti Urticaceae Leonotis nepetifolia (L.) R. Br. Gwo ponpon, Gros pompon Lamiaceae Lippia alba (Mill.) N. E. Br. ex Twa-tas Verbenaceae Britton & P. Wilson Lippia micromera Schauer Diten djiné, Diten kwéyòl Verbenaceae Ludwigia octovalvis (Jacq.) P. H. Jiwof glo, Jiwòf dlo, Water cloves Onagraceae Raven Mentha nemorosa Willd. Mint Lamiaceae Mimosa pudica L. Myhont, Sensitive plant Fabaceae- Mimosoideae Flemingia strobilifera (L.) W. T. Zèb sèk, Sesh, Zherbe Fabaceae Aiton Momordica charantia L. Indian cucumber, Karla, Cucurbitaceae Konmonm kouli Mucuna pruriens (L.) DC. Kafé gwo bouwo Fabaceae Nerium oleander L. Oleander Apocynaceae Ocimum basilicum L. Bazilik. Oktansya. Basil Lamiaceae Ocimum campechianum Miller Fonbwazen. Sweet basil Lamiaceae Ocimum gratissimum L. Basilic, Frobwazen, Frond bazin, Lamiaceae Mal fonbwazen, Mint Odontonema nitidum (Jacq.) Kuntze Chapantyé gwan bwa Acanthaceae Opuntia cochenillifera (L.) Mill. Prickly pear, Rachette, Watjèt Cactaceae

370 Parthenium hysterophorus L. Matnitjen, Whitehead Asteraceae Peperomia pellucida (L.) Kunth Shining bush, Zèb akouwès, Piperaceae Persea americana Mill. Avocado, Pear Lauraceae Petiveria alliacea L. Fèy douvan, Mawi pouwi Phytolaccaceae Pfaffia iresinoides (Kunth) A. Twenty-one-shilling Amaranthaceae Spreng. Phyllanthus amarus Thonning Gwenn anba fèy blan, Seed- Phyllanthaceae under-leaf Pimenta racemosa (Mill.) J. W. Bay leaf, Bay tree, Bwaden Myrtaceae Moore Plantago major L. Plantain, Planten Plantaginaceae Pluchea carolinensis (Jacquin) G. Tabak djab, Wild Tobbaco Asteraceae Don. Portulaca oleracea L. Koupyé, Purslane Portulacaceae Psidium guajava L. Guava, Gwiyav Myrtaceae Punica granatum L. Pomegranate, Ponm gwinad, Lythraceae Grenadine Ricinus communis L. Castor oil, Gwen makwisti, Huile Euphorbiaceae cawapate Rosa spp. White rose, Woi Rosaceae Ruellia tuberosa L. Minnieroot., Ti patat Acanthaceae Sambucus canadensis Linnaeus Elder, La fle siwo Adoxaceae Scoparia dulcis L. Balyé dou, Sweet broom Plantaginaceae Senna occidentalis (L.) Link Kafé zèpyant, Wild coffee Fabaceae Sida acuta Burman Balyé wonzè, Red Broom Malvaceae Solanum americanum Mill. Agouman Solanaceae Solanum torvum Sw. Béléjenn djab, Wild eggplant Solanaceae Stachytarpheta jamaicensis (L.) Vahl Vèvenn latjé wat, Vervain Verbenaceae Symphytum officinale L. Konsoud, Comfrey Wallwort Boraginaceae Trimezia martinicensis (Jacq.) Herb. Koko chat, Coco shot Iridaceae Chrysopogon zizanioides (L) Roberty Khus Khus, Voytivé Poaceae Wedelia trilobata (L.) Hitchc. Pis-a-bed, Venvenn kawayib Asteraceae Agave caribaeicola Trelease Sachpawè, Century plant Agavaceae Zingiber officinale Roscoe Ginger, Jenjanm Zingiberaceae

371 2.22 Saint Vincent and the Grenadines

Saint Vincent and the Grenadines is located in the West Indies in the Caribbean Sea. It is located about 300 kilometres north or Venezuela, south of Saint Lucia and north of Grenada. The country consists of the island of St. Vincent and about 100 small islands of the Grenadine chain, including Bequia, Canouan, Mayreau, Mustique, and Union. Total area is 389 square kilometres, but the largest area is that of Saint Vincent (344 square kilometres) The island of Saint Vincent is of volcanic origin. The centre of the island is forested mountains, cumulating in the peak of La Soufrière (1,234 m), an active volcano. The island has luxuriant vegetation thanks to abundant rainfall. The country has a tropical oceanic climate. The average annual rainfall ranges from about 1 500 mm on the coast to about 3800 mm in the central mountains (FAO, 2008). Approximately 39% of mainland St. Vincent is forested. The retention of this forest cover is primarily as environmental preservation and not from an economic utilization point of view (FAO, 1995).

Traditional Medicine Systems/Phytomedicine According to a self funded study by the Medicine, Milton Cato Memorial Hospital, Kingstown, Saint Vincent and The Grenadines, and Pediatrics, CHOC/UCI, Orange, CA, the local population often relies on traditional remedies for the treatment of asthma (Bacchus and Schwindt, 2004). Recently in St. Vincent and the Grenadines more and more people are turning to traditional herbal remedies for primary health care due to their easy access, availability, low cost and scientific information (Glasgow, 2007).

Government Efforts in Development of Traditional Medicine/Phytomedicine There is at present no regulations regarding traditional herbal medicines and MAPs even though an increasing number of persons still rely on homemade remedies for primary health care. However there is a bureau of standards that test products to make sure they meet the required standards in regards to ingredients and labelling. The Forestry Department is currently revising the National Forest Resource Policy which has been in use for the past fifteen years. It is also in the process of developing a herbarium and a herbal garden at its compound in Camden Park which will be used as a tool to educate the general public on MAPs (Glasgow, 2007). The information regarding development of herbal monographs, pharmacopoeias, laws and policies concerning traditional medicines and other government efforts for the development of these medicines is currently unavailable.

372 Medicinal and Aromatic Plant Resources In 2004 TRAMIL in conjunction with the Forestry Department carried out an Island wide survey on traditional medicine use and the important MAP species used against various ailments. The most commonly used MAPs in the country are listed in Table 1. Though very little is known about the indigenous plant genetic resources of this country except for a National Forest Inventory which was completed in 1992 (Glasgow, 2007). Some other MAPs and their local uses as listed by the Forestry Department of the Ministry of Agriculture Forestry and Fisheries are presented in Table 2 (Anonymous, 2006).

Research and Development Activities In situ plant genetic conservation began in St. Vincent and the Grenadines over 200 years ago with the establishment of oldest Botanic Gardens in the Western Hemisphere on 20 acres of land on the outskirts of Port Kingstown, the capital. Since then the area has served as the major site for the collection and introduction of over 300 plant species and cultivars including fruit trees, ornamentals and medicinal and aromatic plants. Since then several other areas have been designated reserves including the historic Kingshill Forest reserve (FAO, 1995). No other information is available for St. Vincent and the Grenadines regarding the research and development efforts for MAPs and their products.

Trade and Marketing Traditionally in St. Vincent and the Grenadines the herbal remedies were not used or exploited commercially. As the traditional healers or bush doctors used their skills to help people with their remedies. The Organization for Rural Development (ORD) promoted the production of turmeric (Curcuma longa L.) during the 1970s for exports as well as domestic use. Similarly some other plants like Momordica charantia L., Morinda citrifolia L. and Zingiber officinale Roscoe were also exported and used domestically. Their market however collapsed at an early stage. At present there are a few small businesses in relation to MAPs. Herbal remedies and spices are being sold locally by vendors in the market daily. There are no herbal drug manufactures in St. Vincent and the Grenadines currently. Unlike in the past when there was an oil factory that process Coconuts there is no factory that produces any of the above. What exists is more of a cottage industry where a few individuals would make these potions, bottle them and offer them for sale (Glasgow, 2007). However, with the availability of information regarding these plants and their utilization as well as broad markets it is possible to exploit their economic potential. There are no trade data available for domestic consumption and production or trade in MAPs and their products at present.

373 Constraints and Problems There is no doubt that the potential exists for a more advanced MAPs business in St. Vincent and the Grenadines. Information and some baseline data is already available, research is continuing, also the upsurge in the use of these plants are indications of the possibilities for the market to expand. The country needs document its natural MAPs population available in the country and their current status for conservation purposes as well as industrial exploitation. It also needs research and development efforts along with a national legal framework to protect and control/regulate their exploitation to derive commercial and health benefits for its people.

Table 1: Some common MAPs used in the country (Glasgow, 2007) Botanical name Common name Family

Allium sativum L. Garlic Alliaceae

Capsicum frutescens L. Hot pepper Solanaceae

Cassia alata L. River Guava Fabaceae

Cecropia peltata L. Trumpet tree Urticaceae

Cissampelos pareira L. Graveyard Menispermaceae

Cocos nucifera L. Coconut Arecaceae

Costus spp. Guinea Pepper Costaceae

Cymbopogon citratus (DC.) Stapf Fever grass/Lemon grass Poaceae

Euphorbia prostrata Aiton Check Weed Euphorbiaceae

Gliricidia sepium (Jacq.) Kunth ex Walp. Glory Cedar Fabaceae

Musa spp. Banana Musaceae

Zingiber officinale Roscoe Ginger Zingiberaceae

Table 2: Some MAPs with their traditional uses in the country (Anonymous, 2006) Botanical name Local Family Part Uses Name used

Annona spp. Sour Sop Annonaceae Leaves colds, fevers, heat & rashes

Capsicum frutescens L. Hot Pepper Solanaceae Leaves clear the blood, stimulant

Cassia occidentalis L. Wild Coffee Fabaceae Flowers, colds, stomach disorders root

374 Leonotis nepetifolia (L.) Golden- Lamiaceae Leaves fevers, flu, prickly heat R. Br. Baldhead

Momordica charantia L. Carilla Cucurbitaceae fruit cleaning of the skin, diabetes, gourd high blood pressure, menstrual problems, purgative

Phyllanthus tenellus Mascarene Phyllanthaceae Aerial baths, diarrhoea Roxb. Island leaf- parts flower

Pluchea carolinensis Cure-for-all Asteraceae Leaves cold, dislocations or strains (Jacq.) G. Don

Portulaca oleracea L. Purslane Portulacaceae Leaves gas or biliousness, painful backs, worms

Ruellia tuberosa L. Minnie Acanthaceae Root, colds, coughs, cooling drink, Root Leaves inflammation of the intestines

Senna alata (L.) Roxb. candlestick Fabaceae Flowers, baths to clean skin, senna Leaves hypertension, purgative

375 2.23 Trinidad and Tobago The Republic of Trinidad and Tobago comprises the southernmost islands of the Caribbean archipelago. Trinidad, the larger of the two islands (4,828 square kilometres), is located just 11 kilometre off the coast of Venezuela and it is thought to be a geologically extension of the South American continent. It is traversed roughly from east to west by three ranges of hills, the Northern, Central and Southern Ranges. The Northern Range contains vast tracts of rich rain forest with its highest point, El Cerro del Aripo at 940 m above sea level. By contrast the Central Plains consist of flat, mainly agricultural lands and the Southern region, gently undulating hillsides. Tobago, which is situated 35 km north-east of Trinidad, is only 300 square kilometres. Its topography consists of a central ridge of mainly volcanic rock that reaches an elevation of 550 m above sea level and lower lying lands which include a protected reserve area. Trinidad and Tobago has a tropical climate with two seasons – the dry season (January to May) and a rainy season (June to December). Temperatures can reach a maximum of 30oC (89oF) during the dry season. Annual rainfall averages about 200 cm over most of the country. (Government of the Republic of Trinidad and Tobago, 2011; FAO, 2008). In Trinidad & Tobago the area under wetlands (comprising mainly mangrove forests) is 23,540 hectares and natural forest cover, 230,000 hectares. Inclusive of plantations (21,400 hectares), other non forested areas within the natural forests (56,100 hectares), and private forests (54,400 hectares) this country has a healthy forest cover of approximately 60%. However, over the past two decades the natural forests have come under increasing developmental pressure.

Traditional Medicine Systems/Phytomedicine Herbal remedies from medicinal plants (known in the Caribbean as bush medicines or bush-teas) have been used traditionally in regions where access to formal health care is limited. Trinidad & Tobago is an upper middle-income country in which the population has tended to concentrate in urban areas. However, bush medicines are still widely employed despite a relatively advanced health care system that includes universal access to free prescription of pharmaceuticals. This country provides primary medical services through a network of just over 100 health centers. Use of bush medicines is less common among those with higher education (Mahabir and Gulliford, 1997).

376 Government Efforts in Development of Traditional Medicine/Phytomedicine The National Drug Policy for Trinidad and Tobago was approved in December 1998; under this policy of the Ministry of Health should regulate herbal medicines in the same way as are the conventional (chemical) drugs used in orthodox allopathic medicine. Since that time, regulations have been drafted for herbal medicinal products, by a Sub-Committee of the Drug Advisory Committee to the Minister of Health, towards producing an amendment to the Food and Drugs Act Chapter 30:01. But these draft regulations have not yet been passed into law. The Herbal and Alternative Medicine Sub-Committee of the Drug Advisory Committee evaluates all herbal medicinal products offered for official registration. It reviews each product dossier for label authenticity, safety claims, adverse effects and possible drug interactions and quality assurance as may be indicated by GMP and GLP and quality control. This Sub-Committee comprises of experts from the fields of Pharmacology, Pharmacognosy, Taxonomy, Conventional Medicine, Complementary and Alternative Medicine and Consumer Affairs. There is no National Pharmacopoeia for herbal drugs in Trinidad and Tobago. The Herbal Sub-Committee uses the Indian Pharmacopoeia, the German Commission E Monographs, the Merck Manual, and any other reference which provides relevant safety and standards information; but these are not legally binding (Tikasingh and Lee Lum, 2007).

Medicinal and Aromatic Plant Resources The forest resources of the country directly contribute to maintaining the integrity of ecosystems and wildlife habitats, watershed management and to mitigation of the influences of climate. More than one hundred plant species are known to be used for medicinal purposes in this country (Seaforth et al. 1985; Seaforth et al. 1998). Specific mention is made of Ryania speciosa, the stems of which are exported in limited quantities for use as an organic insecticide. The forest resources provide valuable medicinal and aromatic plants and have potential for cocoa and other commercial crops. Several MAPs described by Lans including those used traditionally for skin conditions and for stomach ailments in Trinidad and Tobago have been listed in the Table 1 (Lans, 2007). The multi-ethnic population of Trinidad and Tobago is reflected in the range of local common names used for MAPs. Difficulties arise when only the common names are used to identify MAPs. Confusion can arise when two or

377 more different MAPs are given the same local name, such as sage. Misidentification also occurs when a particular plant is known by two or more common names. For example Morinda citrifolia is better known locally as pain bush or pain-killer, and more recently as noni in Trinidad and Tobago. A number of studies on MAPs and their use in Trinidad & Tobago have been reported by various departments of University of the West Indies, St. Augustine, Trinidad and Tobago and at other campuses and organizations like the Nutrition and Metabolism Division, Ministry of Health. These studies have focused on the use of MAPs in the country for various health problems like diabetes (Mahabir and Gulliford, 1997), and asthma (Clement et al., 2005), for antimicrobial and insecticidal properties (Chariandy et al., 1999), and also for ethnoveterinary treatments (Lans and Brown, 1998; Lans et al., 2000; Lans et al., 2001).

Trade and Marketing There is no formal information available regarding trade data for MAPs exported imported in the country. There are many importers/distributors of MAP products, which are mainly sourced from Canada, China, India and the USA; however, this trade has not been properly evaluated. The use and sale of herbal medicinal products continue to grow rapidly that is reflected by the imports of such products into the region. Such products range from the raw plant material to refined plant extracts. Local MAPs are generally wild harvested; however, there is no information regarding the most harvested, the products these are used in, or exported or how these are used. Currently, there are no major essential oil and herbal extract manufacturers in Trinidad and Tobago. Some effort is being made to develop an essential oil plant in Tobago for the extraction of Bay oil (Pimenta racemosa (L.) Merr.) (Tikasingh and Lee Lum, 2007).

Constraints and Problems This country should evaluate its natural MAPs resources and document their existing population along with their traditional medicinal uses so as to evaluate them scientifically. The industry needs government support for proper development and marketing of products derived from MAPs. Training in sustainable utilization of their natural resources should be provided and people should be made aware of such measures for long term uses and health benefits from these MAPs.

378 REFERENCES Chariandy, C. M., Seaforth, C. E., Phelps, R. H., Pollard, G. V. and Khambay, B. P. S., 1999, Screening of medicinal plants from Trinidad and Tobago for antimicrobial and insecticidal properties. Journal of Ethnopharmacology, 64: 265–270 Clement, Y. N., Williams, A. F., Aranda, D., Chase, R., Watson, N., Mohammed, R., Stubbs, O. and Williamson, D., 2005 Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad. BMC Complementary and Alternative Medicine, 5: 3 FAO, 2008, Specialized Country Profiles and Information Systems, Available at: http://www.fao.org/corp/countries/en/ (01 Aug. 2008) Government of the Republic of Trinidad and Tobago, 2011, available at: http://www.ttconnect.gov.tt/gortt/portal/ttconnect/SharedDetail? WCM_GLOBAL_CONTEXT=/gortt/wcm/connect/GorTT%20Web %20Content/ttconnect/home/about+t+and+t/general+information/geograp hy (Accessed on 02 October 011) Lans, C., 2007, Comparison of plants used for skin and stomach problems in Trinidad and Tobago with Asian ethnomedicine. Journal of Ethnobiology and Ethnomedicine, 3: 3 Lans, C. and Brown, G., 1998, Ethnoveterinary medicines used for ruminants in Trinidad and Tobago. Preventive Veterinary Medicine, 35: 149-163 Lans, C, Harper, T., Georges, K. and Bridgewater, E., 2000, Medicinal plants used for dogs in Trinidad and Tobago. Preventive Veterinary Medicine, 45(3-4): 201-220 Lans, C., Harper, T., Georges, K. and Bridgewater, E., 2001, Medicinal and ethnoveterinary remedies of hunters in Trinidad. BMC Complementary and Alternative Medicine, 1: 10 Mahabir, D. and Gulliford, M. C., 1997, Use of medicinal plants for diabetes in Trinidad and Tobago. Rev Panam Salud Publica/Pan Am J Public Health, 1(3): 174-179 Seaforth, C.E., Adams, C.D. and Sylvester Y.S., 1985, “Guide to the medicinal plants of Trinidad and Tobago” Commonwealth Secretariat, London, U.K. 1985 Seaforth, C.E., Ballah, S., Rollocks, S. and Craig-James, S., 1998, Medicinal plants used in Tobago. Fitoterapia, LXIX (6): 523-527 Tikasingh, T. and Lee Lum, K. L., 2007, Status of medicinal and aromatic plants in Trinidad & Tobago. In: Regional workshop on "Quality control,

379 scientific validation and business prospects of medicinal and aromatic plants" Port of Spain, Trinidad and Tobago, 1-3 October, 2007, West Indies (ICS documents)

Table 1: Some common MAPs used in Trinidad and Tobago (Lans, 2007)

Botanical name Common name Family Uses Abelmoschus moschatus Gumbo musque Malvaceae Foot cramp Medik. Achyranthes indica (L.) Mill. Man better man Amaranthaceae Skin problems Acnistus arborescens (L.) Wild tobacco Solanaceae Baby for eczema Schltdl. Aframomum melegueta K. Guinea pepper Zingiberaceae Carminative Schum. Aristolochia rugosa Lam. Mat root, anico Aristolochiaceae Colic Azadirachta indica A. Juss. Neem Meliaceae Measles Bidens alba (L.) DC. / Bidens Needle Asteraceae Children baths pilosa L. grass/Railway daisy Bixa orellana L. Roucou Bixaceae Dropsy Brownea latifolia Jacq. Cooper hoop Fabaceae Griping, pain Cajanus cajan (L.) Millsp. Pigeon pea Fabaceae Colic, constipation, food poisoning Capraria biflora L. Du thé pays Plantaginaceae Purgative Cassia alata L. Senna Fabaceae Skin problems Cecropia peltata L. Bois canôt Moraceace Carminative Centropogon cornutus (L.) Deer meat, crepe Campanulaceae Scorpion bite Druce coq Chamaesyce hirta (L.) Millsp. Malomay Euphorbiaceae Diarrhoea Chamaesyce hypericifolia (L.) Malomay Euphorbiaceae Measles, skin rashes Millsp. Citharexylum spinosum L. Bois côtelette Verbenaceae Anthelmintic Cocos nucifera L. Coconut Arecaceae Dropsy, hernia Cola nitida (Vent.) Schott & Obie seed Malvaceae Pain Endl. Cucurbita maxima Duchesne Pumpkin Cucurbitaceae Anthelmintic Cucurbita pepo L. Pumpkin Cucurbitaceae Sprains Dorstenia contrajerva L. Refriyau Moraceae Food poisoning Eclipta prostrata (L.) L. Congolala Asteraceae Malnutrition Eleusine indica (L.) Gaertn. Pied poule Poaceae Diarrhoea Eupatorium macrophyllum L. Z'herbe chatte Asteraceae Pain Eupatorium triplinerve Vahl Ayapana, Asteraceae Stomach problems japanne Jatropha curcas L. White/Red Physic Euphorbiaceae Sore cleaning Nut Manihot esculenta Crantz Cassava Euphorbiaceae Eczema Momordica charantia L. Caraaili Cucurbitaceae Stomach problems

380 Morinda citrifolia L. Noni Rubiaceae Pains Neurolaena lobata (L.) Cass. Z'herbe á pique Asteraceae Arthritis Nicotiana tabacum L. Tobacco Solanaceae Arthritis Nopalea cochenillifera (L.) Rachette Cactaceae Snake bites Salm-Dyck Origanum vulgare L. Majoram Lamiaceae Baby bath Peperomia rotundifolia (L.) Mowon Piperaceae Diarrhoea Kunth Petiveria alliacea L. Mapourite Phytolaccaceae Arthritis, rheumatism Phyllanthus urinaria L. Red seed under Phyllanthaceae Diarrhoea leaf Portulaca oleracea L. Pussley Portulacaceae Anthelmintic Punica granatum L. Pome-granate Punicaceae Stomach problems Rosmarinus officinalis L. Rosemary Lamiaceae Arthritis, snake bites Scoparia dulcis L. Sweet broom Plantaginaceae Diarrhoea Solanum americanum Mill. Agouma, gouma Solanaceae Malnutrition Spondias mombin L. Hogplum Anacardiaceae Eczema Tagetes patula L. Marigold Asteraceae Anthelmintic Tamarindus indica L. Tamarind Fabaceae Scorpion bite Tournefortia hirsutissima L. Chigger bush Boraginaceae Carminative

381 2.24 United States of America

The United States of America consists of 48 contiguous states in North America and the non-contiguous states of Alaska in the north-west corner of North America and Hawaii in the Pacific Ocean. The conterminous 48 states are bounded on the north by Canada, on the east by the Atlantic Ocean, on the south by the Gulf of Mexico and Mexico, and on the west by the Pacific Ocean. The total area is 9,809,630 square kilometres. From northern Maine the Appalachian Mountains extend south-westward to northern Alabama. Although the Appalachians are fairly low (mostly below 2,000 m), they are rugged with many parallel ranges and valleys. Some of the individual mountain ranges include the White Mountains and the Green Mountains in northern New England, the Adirondack Uplands of northern New York and the Blue Ridge Mountains. Coastal lowlands extend down the east coast from south-eastern Maine to Florida and across the southern United States to eastern Texas. In the east, they can be broken into two divisions, the hilly Piedmont and the Atlantic Coastal Plain. The Gulf Coastal Plain borders the Gulf of Mexico from Florida to southern Texas. The plains are generally flat. From the Appalachian Highlands in the east to the Rocky Mountains in the west lie the interior plains. Glaciers covered much of the northern portion of this region during the Ice Age. The plains slope gradually upward from east to west and get progressively drier. The western part of the region, called the Great Plains, has vast grasslands and fertile soils suitable for dry-land farming. Some areas of rugged hills, such as the Black Hills of South Dakota and Wyoming and the Ozark-Ouachita Highlands of southern Missouri, north- west Arkansas, and eastern Oklahoma, rise up out of the plains. Along the northern border with Canada lie the five Great Lakes, the largest group of freshwater lakes in the world. The Mississippi River, together with its major tributaries, the Missouri and Ohio, are the major rivers of the interior plains. Much of the western United States is a land of high mountain ranges divided by high plateaus and deep valleys. The Rocky Mountains extend from Canada to Mexico, with many peaks over 3,000 m. Between the Rocky Mountains and the Cascade and Sierra Nevada ranges lies a series of arid basins separated by low mountain ranges. The Colorado river in the south-west and the Columbia River in the north-west, with their tributaries, and the major rivers draining the interior west. A series of low mountains borders much of the west coast, and fertile valleys lie between them and the parallel Cascade and Sierra Nevada ranges. Alaska's south-east coast is a spectacular series of islands and fjords with glacier- filled valleys, rising to permanent ice fields above. Southern Alaska is mountainous, cumulating in the highest peak in North America, Mt. Denali (6184 m). The centre of the state is a huge basin drained mainly by the Yukon river, rising to the Brooks Range in the north. A low coastal plain faces the Arctic Ocean. The Hawaiian Islands are of volcanic origin, lying in a north-west to south-east line. The islands to the north-west are the oldest, with deeper soils and more dissected topography. Volcanic action is still taking place on the youngest island, Hawaii. 382 Given the wide range of elevation, topography, and latitude, the climate of the United States is extremely varied. Average annual temperatures range from -13° C in Barrow, Alaska, to 25.7° C in Death Valley, California. The highest temperature ever recorded in the country was 57° C at Death Valley. The lowest recorded temperature was -62° C near Barrow. Precipitation varies from a yearly average of less than 50 mm at Death Valley to about 1,170 mm at Mount Waialeale in Hawaii. In general, however, much of the United States has a moderate temperate climate. The United States has about 6% of the world’s forest area. It has the fourth largest forest estate of any nation, with about 226 million hectares of forest, exceeded only by the Russian Federation, Brazil and Canada. Forest cover has been stable for almost 100 years following a period of heavy deforestation during the 1800s. About 30% of the land is forested, and about two-thirds of the nation’s forests are classed as productive forests that are not legally reserved from timber harvest. About 7% of United States forest land is reserved for non-timber uses and managed by public agencies as parks, wilderness or similar areas. Private forests comprise 63% of all forest land and 71% of productive forest land that is available for harvest of commercial forest products. Private lands supply 89% of the wood volume harvested in the United States. The USA is the world’s largest consumer and producer of forest products. It accounts for about 15% of world trade in forest products. Even though the forest products sector is small in comparison with the rest of the United States economy, it is significant on a global scale. The per capita consumption of forest products is high, twice that of other developed countries and four times the world average. Forest wildfire is the most serious forest problem, the result of a century of fire suppression and insufficient forest thinning activities. The United States has a basically decentralized system of policy-making for forests. Each of the 50 states has its own policies and forestry institutions. These states are individually responsible for guiding and regulating management of the privately held productive non-reserved forests. Each state has a state forester and forestry organization to provide direct technical and financial assistance to private forest owners, to protect forests from fire, insects and disease, and to implement state laws affecting the use and management of these lands. Many states also manage public forests. At the local level, hundreds of counties and many cities own and manage forest, park and municipal watershed areas. The institutional infrastructure in the forest sector is well developed. An extensive educational, management and policy infrastructure exists to support scientific forest management. The country has more than 50 professional forestry schools; considerably more students graduate in forestry than are able to find employment in the sector. Government, universities and industry are all actively involved in research. New and innovative ways are constantly being developed to use wood products more efficiently.

383 The United States also has major interests at the international level. It provides substantial forest-related assistance to developing countries and countries with economies in transition through the United States Agency for International Development (USAID) and other federal agencies, as well as through contributions to international organizations and financial institutions, such as the World Bank, and various innovative debt reduction initiatives (FAO, 2008).

Traditional Medicine Systems/Phytomedicine America had moved away from plant-based medicines during the early and mid 20th century. The revival of US interest in herbal medicines was initiated in the 1960s and by passage of the Dietary Supplement Health and Education Act (DSHEA) in 1994. Despite of the disapproval of this revived interest in plant based medicine by conventional medicine establishments, the consumers began to explore and use these products in the 1990s (Craker, 2008). Presently complementary/alternative medicine has a substantial presence in the United States health care system. Both public and professional interest in these therapies is increasing. A 1997 national survey estimated that in the previous year 42.1% of the adult population in the United States had used at least one of the complementary/alternative therapies included in the survey. This is an increase from 33.8% in 1990. The therapies with the greatest increases in use included herbal medicines, massage, megavitamins, self- help groups, folk remedies, energy healing, and homeopathy. The total number of visits to complementary/alternative medicine practitioners increased from 427 million in 1990 to 629 million in 1997, thereby exceeding total visits to all primary care allopathic physicians. Approximately 3,000 allopathic physicians and other health care practitioners currently use homeopathy. In 1993, more than 45 000 licensed chiropractors and 32,000 Doctors of Osteopathy were practising in the United States. The profession is responsible for approximately 10% of the total health care delivered in the country. Chiropractors currently see 10% to 15% of the population of the US. There are about 6,000 acupuncture practitioners and an estimated 3,000 allopathic physicians have taken courses in acupuncture with the intention of incorporating it into their medical practices. There are over 1,000 licensed naturopathic doctors and approximately 50,000 biofield practitioners. There are approximately 50,000 qualified massage therapists in the United States. There are 10 ayurvedic clinics in North America, including one hospital-based clinic that served 25,000 patients between 1985 and 1994 (WHO, 2001). The aging population in the US with a need for increased health care and the comparative high costs of conventional medicines have made herbal medicines attractive as an alternative adjunct to primary health care. The use of herbal medicines increased from 2% of the population in 1990 to 37% of the population in 2000 (Craker, 2008).

384 Government Efforts in Development of Traditional Medicine/Phytomedicine In 1991, Congress established the Office of Alternative Medicine within the National Institutes of Health to encourage scientific research in the field. The National Institutes of Health Revitalization Act of June 1993 expanded the Office of Alternative Medicine within the National Institutes of Health. The Office’s objectives include the facilitation and evaluation of alternative medical treatment modalities, including acupuncture and Oriental medicine, homeopathic medicine, and physical manipulative therapies. The Office is mandated to set up an advisory council, establish an information clearinghouse to exchange information on traditional medicine, support research and training, and provide biennial reports on the Office’s activities to the Director of the National Institutes of Health. These reports are then included in biennial reports to the President and Congress. In USA the regulatory controls on complementary/alternative medicine involve six related areas of law: licensing, scope of practice, malpractice, professional discipline, third- party reimbursement, and access to treatments. State laws dominate the first five areas. Federal laws, particularly food and drug laws, largely control the sixth. In each of these areas, legal rules aim to safeguard consumers against fraud and to ensure patient protection against dangerous practices and practitioners. Because allopathic medicine has historically dominated licensing, accreditation, reimbursement, and other regulatory structures, however, existing legal rules governing complementary/alternative therapies and providers arguably favour allopathic medicine and paternalism at the expense of concerns for patient choice and autonomy. Licensing laws in each state provide that the unlicensed practice of medicine is a crime and unlicensed medical practice risk prosecution. Although more and more complementary/alternative medical providers are being licensed in the United States, legal rules must continue to evolve to accommodate widespread consumer and provider use of therapies that have historically fallen outside the scope of allopathic medicine. The Traditional Native North American medicine in the United States is regulated under the Self-Determination. Arizona, Connecticut, and Nevada have specific licensing boards for homeopathic physicians. The market for homeopathic medicine in the United States is a multi-million dollar industry. Homeopathic remedies are recognized and regulated by the Food and Drug Administration and are manufactured by pharmaceutical companies under strict guidelines. Statutes regulating the practice of manipulative therapy exist in every state of the United States. Licensing legislation regulates chiropractic educational standards. In the United States, practitioners of manipulative therapy are sometimes considered on the same professional level as allopathic physicians. However, with the exceptions of South Carolina and Arizona, all states require chiropractors to add an accompanying qualifying reference to chiropractic following the use of the title Doctor or Physician.

385 In 1973, acupuncture was declared by the Food and Drug Administration (FDA) to be a method of treatment for investigational use by licensed practitioners only until substantial scientific evidence is obtained by valid research studies supporting the safety elements and therapeutic usefulness of acupuncture devices. States have an array of provisions regarding the practice of acupuncture. In New York, legislation was passed in 1974 on the recommendation of the State Commission on Acupuncture. The legislation allowed state boards responsible for medicine and dentistry to formulate rules and regulations governing the provision of acupuncture and to establish licensing procedures for its practice in New York. The main prerequisites for a licence were that the applicant had practised acupuncture for at least 10 years and had a licence as “a doctor of acupuncture, herb physician, or doctor of traditional Chinese medicine duly issued by the licensing board of any foreign country”. A 1991 statute altered the above position by substituting licensing rules; creating a board of acupuncture made up of acupuncturists, licensed allopathic physicians, and members of the public; and obliging licensed acupuncturists to advise patients about the importance of consulting a licensed allopathic physician concerning their prognosis, and keep a record of the dispensation of this advice. During the 1970s, the legislatures of several other states established conditions for the licensing of acupuncturists who were not allopathic physicians. As of 1981, non allopathic physicians have been permitted to practise acupuncture under various conditions in at least 15 states. The conditions for the issue of a licence in Rhode Island are as follows: the applicant must have successfully completed a course of study of 36 months in acupuncture at a college in the Hong Kong Special Administrative Region of China or have qualifications considered equivalent by the State Board of Acupuncture, the applicant must have practised acupuncture for 10 years, and the applicant must have passed examinations set by the Board. In Florida, only persons certified by the Department of Professional Regulation may practise acupuncture. It is a misdemeanour to practise acupuncture without a valid certificate in Florida. California’s Business and Professions Code lays down an extensive set of provisions regulating the acupuncture profession. California has appointed an Acupuncture Board, which consists of nine members; four of them must be acupuncturists with at least five years of experience. Naturopathy remains relatively marginalized in the United States. Few states license naturopaths. Although legislation on naturopathy varies between states, a number of general regulations do exist. Treatment involving the use of hypnosis is characterized as the practice of medicine and surgery and is therefore subject to licensing requirements. No state has licensing requirements for biofield practitioners. Since legal constraints in many states restrict the use of the terms patient and treatment, most biofield practitioners use the terms receiver and session in describing their work. 386 The majority of allopathic medical schools in the USA now offer courses on complementary/alternative medicine. Beginning in 1997, primary care allopathic physicians have been able to take courses designed to introduce them to homeopathy and to encourage them to incorporate homeopathy in their practices. The United States has the largest number of chiropractic colleges of any country. Sixteen colleges are recognized by the World Federation of Chiropractic and accredited by the Council on Chiropractic Education, the United States accrediting agency for the chiropractic profession. The Council on Chiropractic Education establishes minimum standards and assesses institutional compliance with these standards as well as overall effectiveness. With only a few states licensing naturopaths, all except two naturopathic colleges have closed. Entry to these colleges is conditional on two years of pre-professional coursework. The programmes are four years in length (WHO, 2001).

Medicinal and Aromatic Plant Resources The USA has at least 1,000 species of plants native to the country that are documented to have medicinal properties. Some of most important ones include Echinacea angustifolia DC., Hydrastis canadensis L., Panax quinquefolius L., Podophyllum peltatum L., Salix alba L., Sanguinaria canadensis L. and Taxus brevifolia Nutt.. However, the over collection has contributed to a significant decline in their wild population in the country (FAO, 1996). The American perspective on medicinal plants has changed considerably within past 25 years. Considerable changes have occurred in medicinal plant production and markets during these years. A reconsideration of the contributions that medicinal plant material can offer a contemporary health system has led to fresh views about medicine and plants. This reassessment of medicinal plants has stimulated cultivation of new species and led to increases in production of previously cultivated traditional species. A number of American growers began to cultivate a variety of medicinal plants. However, the globalization of trade in the late 1990s and early 2000s has reduced cultivation of some species. For example, American ginseng (Panax quinquefolius L.) production in the state of Wisconsin suffered as production moved to Canada during the 1990s (from 523 metric tons in 1992 to 227 metric tons in 2004). Yet, markets for other medicinal plants expanded and cultivation was initiated to meet the foreign and domestic demand. For example, the production of roots and rhizomes of goldenseal (Hydrastis canadensis L.) increased from 6,445 pounds dry weight in 1998 to 33,756 pounds dry weight in 2003 (Craker, 2008). The most important medicinal plants cultivated in North America for domestic use in dietary supplement products and/or natural health products (Canada) as well as for export include aloe, American ginseng root, cayenne fruit, Echinacea purpurea (L.) Moench flowering tops and root, evening primrose, feverfew leaf, flax seed, garlic bulb, hop strobile, and peppermint leaf. The most important wild-collected medicinal plants include black cohosh rhizome, cascara sagrada bark, Echinacea angustifolia DC. root, Echinacea

387 pallida (Nutt.) Nutt. root, goldenseal root, passionflower herb, slippery elm bark, and saw palmetto fruit. Currently the supply of wild harvested medicinal botanicals is increasingly impacted by due to factors such as loss of habitat from development, logging operations, conversion of prairie to pasture, environmentalists and government agencies concerned with threatened or endangered species, collection by the ornamental plant trade, and to a lesser extent from the medicinal plant wild collectors (ITC, 2002). The State of Alaska Department of Natural Resource (DNR) has published a manual Proposed Alaska Non-Timber Forest Products Harvest Manual for Commercial Harvest on State-Owned Lands. This manual provides direction (e.g. quantity limits, harvest season, and harvest protocols) for commercial harvest of many medicinal plants from general state-owned lands managed by the Division of Mining, Land and Water (DMLW) and includes harvesting guidelines for, among others yarrow (Achillea millefolium L.), uva ursi leaf (Arctostaphylos uva-ursi (L.) Spreng.), Iceland moss (Cetraria islandica L.), pipsissewa leaf (Chimaphila umbellata (L.) W. P. C. Barton), avens root (Geum spp.), juniper bark & cone (Juniperus communis L.), Labrador tea (Ledum spp.), bistort root (Polygonum bistorta L.), quaking aspen bark (Populus tremuloides Michx.), rose hip (Rosa acicularis Lindl.), raspberry leaf (Rubus idaeus L.), willow bark (Salix spp.), chickweed (Stellaria media (L.) Vill.), dandelion flower, leaf & root (Taraxacum officinale aggr.)’ stinging nettle herb (Urtica dioica L.), usnea lichen (Usnea hirta (L.) F. H. Wigg.), and bog cranberry (Vaccinium oxycoccos L.), and (ITC, 2007). The American Herbal Products Association (AHPA) (in February 2007) published its fifth survey quantifying annual harvests of selected North American MAPs that are harvested from wild populations. This report “the 2004–2005 Tonnage Survey of Select North American Wild-Harvested Plants”, covers the harvests from 2004 and 2005 for 26 botanicals derived from 22 plant species. The report includes data on both fresh and dried quantities of wild harvested and cultivated materials. It also includes data from the four earlier surveys dating back to 1997. MAPs included in the survey include, among others, black cohosh root & rhizome (Actaea racemosa L.), arnica (Arnica spp.), blue cohosh root (Caulophyllum thalictroides (L.) Michx.), wild yam tuber (Dioscorea villosa L.), Echinacea spp. herb & root (Echinacea angustifolia DC., Echinacea pallida (Nutt.) Nutt. and Echinacea purpurea (L.) Moench), cascara sagrada bark (Frangula purshiana (DC.) J. G. Cooper), goldenseal leaf, root & rhizome (Hydrastis canadensis L.), bloodroot root (Sanguinaria canadensis L.), saw palmetto fruit (Serenoa repens (W. Bartram) Small), slippery elm inner bark (Ulmus rubra Muhl.), and usnea lichen (Usnea spp.) (ITC, 2007a).

Research and Development Activities The need for scientific information on the production of culinary herbs and medicinal plants was recognized in the early 1980s in the USA and renewed research on MAPs began. The research in MAPs has focused to improve production, isolation of bioactive compounds and evaluation of their medicinal properties. 388 The American Herbal Products Association (AHPA) founded in 1983 is a national trade association which includes as its members growers, processors, private labellers and multi level marketers of herbal dietary supplements. AHPA is the recognised leader among policy-making organizations that comprise the US dietary supplement industry and a major force behind the adoption of the DSHEA, which provides the major legal framework under which US dietary supplement industry operates. AHPA also organizes conferences on various topics from medicinal plant production to marketing of new products. The American Botanical Council (ABC) founded in 1988 is one of the leading independent, non profit organizations in North America dedicated to the dissemination of information on MAPs. ABC publishes Herbalgram, a quarterly peer review journal along with other herbal research materials. The Council’s Board of Trustees and Advisory Board include some of America’s leading experts in the field of medicinal plants and phyto- medicine (ITC, 2002). The National Centre for the Development of Natural Products (NCNPR) based at the University of Mississippi, was opened in 1995. The Medicinal Plant Research Program of the centre has two major areas of research that include Botanicals and Human Health’ and Medicinal Plants as Alternative Crops. The goal of the Botanicals and Human Health Program is to identify botanical products with the potential to improve human health and to enable the safe, effective and proper use of high-quality botanical products by informed professionals and consumers. This program includes both research and educational activities. The research projects focus on enhancing product quality and safety through botanical, pharmacological, chemical and agronomic characterisation of botanical products, and the discovery of new botanical products. The current projects that focus on enhancing product quality and safety include working with the FDA to develop a model for the development of botanicals as drug products; developing analytical methods for bio-active constituents, degradation products, and contaminants; and working with USDA on the use of genetic profiling to certify authenticity of seeds and plant specimens. NCNPR’s approach for the development of new botanical products relies on traditional use/ethnobotanical information to identify leads, a battery of biological assays (cellular, biochemical and molecular) to detect biological activity and chemical standardisation technologies. The research program starts with gathering, assessing, and organising literature regarding traditional uses of botanicals throughout the world. This information is reviewed to identify lead candidates for new product research. The research program includes sample authentication, analytical and biological characterisation, and standardisation activities. Research is also conducted on the optimisation of yields of desirable bioactive constituents in plants. the recent projects are focused on identification and development of botanicals with antioxidant, immunostimulatory and anti- inflammatory activities.

389 Educational activities include providing practical information on botanical products to health-care professionals, government officials and consumers. Market research studies are conducted to asses the knowledge and awareness of health-care professionals and consumers regarding botanical products, their use, and to identify their supply chain issues. Scientists in the NCNPR and the academic departments of the School of Pharmacy are involved in continuing education programs for pharmacists, physicians and other health-care professionals, and serve on Pharmacopoeia (USP) and industry trade associations. The goal of the Medicinal Plants as Alternative Crops Program is to conduct research that can be used to develop medicinal plants as high value alternative crops for US farmers. Research focuses on identifying medicinal plants that provide viable economic opportunities for farmers, and correlating cultivation, harvesting and agronomic conditions to the plant’s ability to produce the desired chemical and pharmacological profile. Environmental chambers are used to simulate different growing conditions and experimental plots are grown at the Centre’s Medicinal Plant Garden. Other research activities include determining the optimal post-harvest processes to maximise desirable properties, genetic engineering, crop improvement studies, and translational research and marketing research. The projects within this program include economical production of podophyllotoxin; evaluation of agronomic potential of medicinal plants in Mississippi; value-added development of botanicals through harvest; post-harvest and storage practices; and market research to quantify commercial potential (Michael, 2000). The AHPA and American Herbal Pharmacopoeia (AHP) have completed a draft document titled Good Agricultural and Collection Practice for Herbal Raw Materials (GACP). The GACP has relevance to herbal raw materials in all herbal products, including foods, dietary supplements, drugs, cosmetics, etc. It is intended to have applications to all herbal raw material producers, both large and small and whether producing herbs by cultivation of by harvesting from the wild. It is presented as a draft for discussion and review, so comments are welcome, especially by farmers and collectors who use the draft in their facilities and operations (ITC, 2006). In the USA, the National Centre for Complementary and Alternative Medicine at the National Institutes of Health spent approximately US$ 33 million on herbal medicines in fiscal year 2005; in 2004 the National Cancer Institute committed nearly US$ 89 million to studying a range of traditional therapies. While this scale of investment pales in comparison to the total research and development expenses of the pharmaceutical industry, it nevertheless reflects genuine public, industry and governmental interest in this area (Tilburt and Kaptchuk, 2008).

390 Trade and Marketing The US botanicals market continues to undergo rationalisation with consolidation continuing within the industry. New product launches particularly Own-brand products by retailing giants such as Superdrug and Walmart continue to take place. These products are continuing to take market share from other established producers. The large pharmaceutical companies such as GlaxoSmithKline, Novartis and Bayer that entered this market only a few years ago, continue to offer higher priced and higher quality products to the discerning customer. Unlike Europe where licensing and insurance reimbursement help to differentiate the market, in the USA products are sold as a dietary supplement at prices much lower than comparable OTC medicines. Interest in functional foods is increasing with probiotics and sports products becoming increasingly popular. There are no established herbals on the US market right now although raw materials used in weight loss, sports medicine and women’s health have a steadily growing demand. The FDA recently ruled against companies wishing to make claims that antioxidants can help reduce the risk of certain types of cancer. The FDA maintained there was not sufficient evidence to allow such claims. This decision was a major disappointment to makers of antioxidant rich botanicals such as pine bark, blueberry, bilberry and cranberry. The overall protective benefits of antioxidants were, however, not denied in the ruling (ITC, 2001). The USA imported on average 51,200 tonnes of pharmaceutical plants valued at 1.4 billion US$ in the period 1992-2003. The export amounted to 13,050 tonnes, a value of 1.05 billion US$. The striking difference in the value of the imported and exported commodity shows that the USA imports mainly plant raw material or at least little processed products, but on export the degree of processing is increased. Any trends in imports may not be recognized; the imports fluctuated between ca 45,000 and 62,300 tonnes with a peak of almost 71,000 tonnes in 1997; the exports varied between 9,000 and 18,000 tonnes. In 2003, India was the USA’s most important source country for these botanicals, with an import share of 28%, followed by China with 12%, Azerbaijan (10%), Mexico (8.5%), and Egypt (6%). Further, countries with an export to the USA exceeding 1,000 tonnes were Albania, Germany, Morocco, Turkey, Turkmenistan and Uzbekistan. In contrast to the imports, 44% of the exports were allotted to American countries, 26% to Canada, 7% to Mexico and 10% to South-American countries. Further important destinations were Germany with a share of 17%, the Republic of Korea (12.5%) and Japan (10%) (Lange, 2006). USA exports of essential oils reached a record USD $1.05 billion in 2006, up nearly 5% from 2005, and up 1% from the previous record in 2004. The EU is the largest market, accounting for 25% of the total in 2006. Canada accounted for a little less than 25% of the total. The imports of essential oils reached a record $2.5 billion in 2006, although the rapid increases of the previous years have slowed. USA imports in 2006 were up only 2% following increases of 21% and 57% in 2005 and 2004, respectively. The largest jump in imports came in 2003 when the value of imports skyrocketed to $1.3 billion, more than 3½

391 times the previous year’s level. Almost all of the increases beginning in 2003 are attributed to new facility in Cork, Ireland, which supplied 79% of the total in 2006. While the category of essential oils contains single essential oils, such as orange (Citrus spp.), lavender (Lavandula spp.), rose (Rosa spp.), and mint (Mentha spp.), the single HS code that accounts for 73% of the total (in value terms) is HS 3302101000, “mixtures of odoriferous substances used as raw materials in the food or drink industries” (ITC, 2007a). The USA is the largest North American exporter of botanical raw materials, followed by Mexico and Canada. In 2007, the USA exported over 98 million kg of selected botanical raw materials, oils and extracts that are traded under below mentioned HS Codes. Under the HS codes 0902-0910 (that includes North American grown botanicals such as capsicum fruit, cardamom seed, ginger rhizome, and vanilla fruit, among others), 1210 (includes only hop strobile Humulus lupulus L.), 1211 (includes North American grown botanicals such as American ginseng root, black cohosh root, goldenseal rhizome, peppermint leaf, slippery elm bark, and witch hazel leaf & bark, among many others), 121220 (includes botanicals such as kelp Laminaria spp., laver or nori Porphyra spp., and sea tangle, among many others.), 130190 (includes botanicals such as balsam-of-Peru Myroxylon balsamum (L.) Harms and American storax balsam Liquidambar styraciflua L., among many others), 130219 (includes most herbal saps and extracts such as those of American ginseng, black cohosh, hops, and saw palmetto, among many others), 140490 (includes botanicals such as broussonetia Broussonetia papyrifera (L.) Vent., canaigre Rumex hymenosepalus Torr., oak bark Quercus robur L., quebracho bark Aspidosperma quebracho- blanco Schltdl., quillaja bark Quillaja saponaria Molina, among others), 3301 (includes essential oils, resinoids, extracted oleoresins, concentrates of essential oils, aqueous distillates and aqueous solutions of essential oils), and 400130 (botanicals such as gutta percha latex Payena spp. and Palaquium gutta (Hook.) Baill., balata Manilkara bidentata (A. DC.) A. Chev., chicle Manilkara zapota (L.) P. Royen, guayule Parthenium argentatum A. Gray, leche caspi sorva Couma macrocarpa Barb. Rodr., among other similar natural gums) were 29736767, 7945530, 11371047, 1244940, 5807887, 6066996, 3470305, 33060867, and 95102 kg respectively. The UN COMTRADE database under HS 0902-0910 reports the exports of 29,736,767 kg of botanicals while the US Department of Commerce trade database reports a lower export quantity of 23,332,100 kg for 2007. In terms of reported value, the top-five destinations for USA exports of botanicals of this group were Canada, Japan, Mexico, China, and the UK. The top-five destinations for US hops (HS 1210) were Canada, Germany, Poland, Belgium, and the UK. In 2007, the reported value for US exports of botanical extracts traded under HS 130219 was USD $ 78,942,543. The top-five destinations for USA herbal extracts were Canada, South Korea, Japan, the Netherlands, and Ireland. Under HS 3301, the USA exported essential oils with a reported trade value of USD $ 402,961,295. The top-five destinations for USA essential oils were the UK, Japan, Mexico, China, and Canada (ITC, 2008).

392 Constraints and Problems Over the past 30 years, the American public has become much more aware that medicinal plants can have positive effects on improving and sustaining health. Still, a large percentage of the population (approximately 80%), have not tried natural products as a treatment alternative. The number of users of MAPs and their products will likely increase as people become more aware of benefits that can be derived from them. The increase in demand for species collected continues to threaten native species in some localities. Concerns about loss of species and genetic diversity have led to regulation of collection practices on public and private land in order to preserve wild stands The farmers engaged in growing MAPs in addition to traditional cropping uncertainties of weather, pests and other limitations; also face changes in consumer interest, trade policies, and other issues that control demand. For these reasons, an understanding of trends in the estimated $25 billion natural product industry, to which medicinal plants belong, is necessary to enable growers to envision and invest in crops to meet market needs. Beginning in the 1970s, America has reconsidered the role of medicinal plants in its health care system. The future for MAPs in America will depend to large extent on continued recognition by the conventional medical establishment that the use of plant materials is an acceptable alternative in the treatment for some afflictions. This recognition will require cultivation, collection, and processing of quality plants and continued research into biological actions of the plants and plant extracts to demonstrate efficacy and safety. Methods must be developed to ensure consistent, standardized treatments for the various ailments in which medicinal plants would be an effective alternative.

393 2.25 United States Virgin Islands

The US Virgin Islands is an unincorporated territory of the United States, consists of St. Croix, St. John, St. Thomas, and numerous smaller islands. With Puerto Rico to the west and the British Virgin Islands to the east and north, the U.S. Virgin Islands lie at the eastern extreme of the Greater Antilles. The country lies seventy miles east of Puerto Rico, in the Lesser Antilles of the Caribbean, and is composed of three large and fifty small islands totalling 352 square kilometres. Saint Croix, the southernmost and largest island, has land suitable for agriculture. Saint Thomas, forty miles to the north, has the highest point on the islands, with little tillable land. With a good port at Charlotte Amalie, it became a commercial centre with reliance on the slave trade. The smallest of the main islands, Saint John, was donated by Laurence Rockefeller in 1956 as a national park. In 1996, Water Island, off the southern coast of Saint Thomas, was officially added to the country. In 1999, the population was estimated at 120,000. The main population groups are West Indian (74% born in the Virgin Islands and 29% born elsewhere), United States mainland (13%), Puerto Rican (5%) and others (8%). Blacks constitute 80% of the population, whites 15%, and others 5% (Peters, 2007). Forest products are used in arts and crafts, botanicals and medicinals, and charcoal- making. Forest covers 21,237 hectares of the US Virgin Islands, 61% of the total land area. St. John had the highest percentage of forest land (92%), followed by St. Thomas (74%), and St. Croix (50%). There are 12,533 hectares of forest in the subtropical dry forest life zone, which occurs at lower elevations. At higher elevations, there are 8,704 hectares of forest in the subtropical moist forest life zone. Forest land decreased 7%, or 1,671 hectares, from 1994 to 2004. Most notably, St. Croix lost 986 hectares (11%) of subtropical dry forest and St. Thomas lost 307 hectares (13%) of subtropical dry forest. The forest of the US Virgin Islands consists of very young stands, reflecting past and present land use and disturbances. Eighty percent of the forest inventoried was stands mostly made up of saplings and seedlings. Twenty percent of the forest found was in stands where small trees predominated. The areas recently colonized by forest vegetation were only found on St. Croix (Brandeis and Oswalt, 2004).

Traditional Medicine Systems/Phytomedicine There are modern hospitals on Saint Croix and Saint Thomas and a clinic on Saint John. However, alternative healing methods such as faith healing, chiropractic, and traditional bush remedies based on indigenous plants are widely used (Peters, 2007).

394 Government Efforts in Development of Traditional Medicine/Phytomedicine At present there is no information available on the government efforts in the direction of development of traditional herbal medicine in the country.

Medicinal and Aromatic Plant Resources The destruction of the natural vegetation on the island of St. John has been extensive, spreading over nearly 90% of the island. The most immediate threat to the regeneration of natural vegetation is inflicted by development and by the growing population of feral pigs, goats, and donkeys. Some of the native and endemic plant species have become extinct or nearly extinct with their populations reduced to a few individuals. Examples of these are Solanum conocarpum, S. mucronatum, Malpighia infestissima, M. woodburyana, and Mammillaria nivosa. The invasion by aggressive exotic plants has also contributed to the demise of some of St. John's native plants. Their populations outside St. John are rather small and restricted to some of the Virgin Islands and Puerto Rico. St. John and the Virgin Islands have a very low percentage of endemism since their isolation from Puerto Rico. It is not clear whether this low percentage is due to recent land use history (last three to four hundred years of intensive deforestation) or to its smaller size, fewer habitats and greater distance from continental areas (Acevedo-Rodríguez, 1996). Despite a relatively low economic value, MAPs and their products have a long history in the islands and are an important component of Virgin Islands’ culture heritage. The MAPs are harvested from the forest for use in cooking, making bush teas, and traditional herbal remedies that also accounts for a relatively small percentage of the income derived from forest products (Brandeis and Oswalt, 2004). However, there is no information available currently on the kind of MAPs harvested and grown (wild or cultivated) in the country.

Research and Development Activities In 1985 a team from The New York Botanical Garden (NY), the University of Puerto Rico (UPR), and Yale University did some field work on the island of St. John. The objective of this work was to establish permanent vegetation study plots in order to monitor vegetation changes in three different watersheds. Numerous specimens, of the flora of the island were collected. With the financial support of the Homeland Foundation and The New York Botanical Garden after 9 years of fieldwork and research, the manuscript for the flora of St. John was completed. The Smithsonian Institution also collaborated on this project (Acevedo-Rodríguez, 1996). There is no other information on MAPs development efforts or research projects being carried in the country be any national or international institutes.

395 Trade and Marketing Locally harvested forest products including MAPs do play a role in the economy and culture of the US Virgin Islands; however, there is no information available regarding their production and trade in the country.

Constraints and Problems The complete documentation of country’s MAPs including their detailed distribution and utilization for medicinal purposes by local people should be carried out. A thorough evaluation of their natural resources coupled with research on cultivation techniques, their medicinal properties and relevant laws and policies by the government may help in their sustainable utilization for health care and providing a valuable source of income to its people.

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