Transcript Landscapes, Medicines, and Healing, Dr. Maurice M. Iwu, Executive

Landscapes, Medicines and Healing
Maurice M. Iwu
Executive Director, BDCP
Department of Parasitology, WRAIR
To Heal is to Restore Order

Physical treatment with
medicines and body
manipulations

Psychosomatic interventions
as in mental illness

Spiritual interventions among
the religious
Healing is a journey
 From
disorder to order
 State of illness to good health
 Could
be voluntary i.e. participatory
 Or forced, i.e. by a benevolent leader or escort
 In most cases the desired outcome is achieved
 But not always …
Understanding the Nature of Things
 What
 What
 What
is the nature of the Human Person?
is Disease to an African Healer?
is the meaning of Life in the African
Cosmology ?
What is Man?
A holistic being that is related to all
that is terrestrial, extra-terrestrial
and cosmogenic
Five Elements of the Self
 The
Physical: biological and the bioenergetic,
bio-luminescent and biomagnetic body
 The Inner Mind: rubbish bin of modern medicine
 The Morale: seat of religious experiences
 The Soul: our true self/ capable of multiple
forms
 The Spirit
Dimensions of Human Spirituality





Level - 1: ancestors
Level - 2: ethereal beings or life spirits that
govern the world
Level-3: morphic resonance or collective
memory
Level-4: a group of 256 well-known, well codified and well
classified spirits – “Fa”, “Ifa” or “ofo”.
Level-5: The Spirit
Sickness or Disease is defined as lack of
balance between the different aspects of
self, the spiritual entities and the
environment.
Healing Elements or Healing Tools
The Spirit Entities
 The Healer
 The patient
 The Healing Objects: plants, minerals, animals
etc.

The African Healer’s World
There are several realities of existence or worlds
 There is a spiritual component in all living things and
existence is often a product of negotiated order between
beings.
 Certain events are preordained or determined at
completely different sphere of existence far from where it
becomes manifest.
 There is no physical limitation to the power of the
human spirit.

Communal Healing or Group Therapy
NDEPP
 Collective
healing through ceremonies and
cleansing rituals
 Restores harmony between families,
communities and societies
 Example is the Ndeep at Yoff – Mame Ndiarre is
the healing divinity.
 African Millennium for Science and Technology
Landscape and Healing
The importance of place and specificity
of cultural context when investigating
health care beliefs and practices.
Therapeutic landscapes
These are places, settings, situations,
locales, and milieus that encompass
both the physical and psychological
environments associated with treatment
or healing, and the maintenance of
health and well-being.
Sacred Therapeutic Landscapes
Places, settings, situations, locales, and
milieus that provide platform for
communion with the spirits and the
sacred. Its sacrality derives from a
recognition and acceptance of the
landscape as spiritual meeting place
between different entities involved in
healing .
High Mountain Climatotherapy
 reduced
partial pressure of oxygen,
 intensified sun radiation,
 low temperatures, and
 lower water vapor content in the inhaled air
– XXXXXXX
 Apparently
harmless to permanent inhabitants buy
biotropic to temporary residents
Global Epidemiological Status of
Malaria
 Over
90 Countries / Territories Affected
 Over 2020 Million Persons at Risk (36% of
World’s Population)
 1.5-2.7 Million Deaths Per Year
 300-500 Million Clinical Cases Per Year
 Increase in the Prevalence and Severity of
Multiple Drug Resistance
WHERE WE ARE TODAY:
HUMAN LEISHMANIASIS
 Endemic
to 88 countries, 350 million at risk, 12
million infected, annual incidence 2-3 million
 Pentavalent antimonial resistance widespread
 Subclinical infections >30 years
 Opportunistic infection with HIV.
 No FDA approved drug exists
 No chemoprophylaxis exists
Emerging Infectious Diseases
Thirty (30) New Diseases Have Emerged in the
Past 20 Years - WHO 1996
Globalization of Some Old Diseases
Department of Parasitology, WRAIR
Global Intervention Efforts

Vaccine Development

Rational Drug Development: Single Chemical
Entities

Herbal Medicines: including phytomedicines

Nutritional Aides
Drug Development Choices

Phytomedicines
– Quicker to market
– Low safety problems

New Chemical Entities
– Good acceptance
– IND possibility
– Industry support

Rational Design
– New chemotypes
– External support
ETHNOMEDICINE
bringing ancient wisdom to life
Department of Parasitology, WRAIR
Classification of Ethnomedicine
 The
personalistic systems where supernatural
causes ascribed to angry deities, ghosts, ancestors
and witches predominate, and
 The
naturalistic systems where illness is
explained in impersonal, systemic terms.
BDCP - Herbal Product Plan
WHAT?
Whole herbs, standardized extracts
phytomedicines, formulation
STRATEGY
HOW?
WHO?
Establish local base/
Partnerships/ SBA
Through a wholly owned
subsidiary (AXXON Biopharm.)
ETHNOBOTANICAL SURVEY

Record folk use of plants

Survey conducted by a
physician/botanist/sociologist team

Vouchers collected after interview
ETHNOMEDICAL ANALYSIS

Determination of disease being treated

Level of equivalence in diagnosis by
traditional/modern medicine

Apply expanded diagnostic criteria
CLINICAL OUTCOME EVALUATION

Leads are de-replicated

Safety is determined in animals

Appropriate dosage formulation

Clear end-point determined
Ethnomedical Team
Physician
Traditional Healer
Ethnobotanist
Data - Collection Forms
New Realities of Global Economy
 The
Trans-National Nature of Capital, Industry
and Labor
 Changing Waves
 Recognition
of the Biotechnology Sector
of Exclusion (or Discrimination)
and Not Exploitation as the New Threat on Equity
and Sustainable Development
Garcinia kola Seeds

Respiratory tract
infectious

Anti-inflammatory

Antiviral

Tonic
Electropherograms of Hangover tonic preparation and a standard containing Kolaflavanone, GB1 and
GB2
OH
HO
O
2
OH
O
R1
HO
O
R2
20
OH
17.5
O
15
mAU
1. Kolaflavanone, R1 = OCH3, R2 = H
2. GB1, R1 = OH, R2 = H
4. GB2, R1 = R2 = OH
12.5
1
10
4
Hangover tonic
7.5
5
2.5
standard
0
2
4
6
8
10
Time (min)
12
14
16
18
Electropherograms of Hepa-Vital tea and a standard containing Kolaflavanone, GB1 and GB2
20
15
mAU
4
10
2
5
Hepa-Vital tea
0
standard
3
4
1
5
6
Time (min)
7
8
9
Aframomum danielli & related Spp.

Seeds and rhizome used
as antifungal agents

Showed good activity
against Leishmaniasis
spp.

COE for Opportunistic
fungal infections
Chasmanthera depedens
Chasmanthera dependens

Leaves used as topical
antifungal paste

Showed good activity against
malaria & Leishmaniasis spp.

COE for opportunistic fungal
infections

Lead compounds being
developed
Cryptolepis sanguinoleta

Used for malaria treatment

Positive clinical outcome

In vitro and in vivo activity against
Plasmodium spp

Cryptolepine isolated as most active compound
Alkaloids of Cryptolepis sanguinoleta
ClCl-
N+
+
N
N
N
O
OCH3
Cryptolepine H
Sanguinoletine
N
S
Cl
M-3
Enantia chlorantha

Used for treatment of malaria & liver diseases

Positive clinical outcome for both diseases

Good in vitro activity against Plasmodium spp
but poor in vivo activity or inactive

Palmatine and related protoberberines isolated as the
active compound
Protoberberines from Enantia chlorantha
H3CO
O


H3CO
O
OCH 3
OCH 3
OCH 3
OCH 3
Berberine
* Optimization studies has shown that high lipophilicity caused
Palmatine
by modification of the substituents appears to
increase biological activity.
* Preparation of structurally related non-quarternary salts with antimalarial activity.
* Testing of Enantine and other non-protoberberine alakaloids found in the same plant for antimalarial activity
Dracaena mannii




Very positive clinical outcome studies
In vitro activity against Leishmaniasis spp.
Activity against cutaneous Leishmaniasis
Active substance problematic for rodent studies
THE BDCP APPROACH
1.
Capacity building through the organization of traditional healers and
enhancement of their associations, establishment of ethnobotanical
database of medicinal and aromatic plants.
2.
Establishment of a sui generis system of compensation through the Fund for
Integrated Rural Development and Traditional Medicine (FIRD-TM).
3.
Advocacy for legislation on regulation and standardization of traditional
medicine in Nigeria and other African countries .
4. Establishment of the International Centre for Ethnomedicine and Drug
Development (InterCEDD), a full service research facility to enhance local
capacity to conduct integrated research for drug development, and
commercialization of potentially useful natural products.
Integration of Goals
ICBG
African ICBG
(International Cooperative Biodiversity Group)
Large integrated program with the core
requirement to identify new drug candidates from
natural products.
Funded by U.S. –NIH, NSF, USDA, USAID
WALTER REED ARMY INSTITUTE OF
RESEARCH - AFRICA ICBG
BUILT ON THE FOUNDATION OF A SUCCESSFUL DRUG
DEVELOPMENT PROGRAM
A.
B.
C.
D.
Virtual Drug Company - Multidisciplinary Staff
Rich in Tropical Diseases Expertise
Not Profit Driven
Interactive With W.H.O., Academia, Industry
West and Central Africa ICBG
Objectives
1-Establish and maintain inventory of species used in traditional
medicine.
2-Identify lead compounds for the treatment of human diseases.
3-Establish and maintain study plots for long-term assessment of
rainforest ecological dynamics.
4-Conduct economic value assessment of major species in the host
country and the study area.
5-Train scientists and technicians from participating countries in
various aspects of drug development, plant research and
biodiversity conservation.
Project Background
Department of Parasitology, WRAIR
Korup Forest: access bridge
Cameroon
Field Camp: Korup Forest, Cameroon
Collaborating Institutions
Walter Reed Army Inst. of Research, Wash.D.C.
 Pace University
 University of Pittsburgh
 Southern Research Institute
 University of Minnesota
 University of Florida
 Florida State University
 University of Utah
Smithsonian Institution, Wash. D.C.


Smithsonian Tropical Research Institute,
Smithsonian Man and the Biosphere Program
Bioresources Development and Conservation Program (BDCP),
Nigeria and Cameroon
 University of Dschang, Cameroon
 University of Buea, Cameroon
 International Center for Ethnomedicine and Drug
Development Nsukka Nigeria.
 University of Jos, Nigeria
 Biodiversity Support Program (c/o WWF)
Active Investigators: 64
Drug Development Leads
DISEASES
SAMPLES
TESTED
Malaria
Leishmania
Cytotoxicity
Viral
Trypanosomiasis
Trichomonas
O.I.:
Cryptosporidium
Toxoplasmosis
500
130
20
30
27
25
22
22
LAB.
WRAIR
WRAIR
U of Utah
SRI
PACE
PACE
NIAID
NIAID
ACTIVITY%
343
52
16
16
13
10
(69%)
(40%)
(80%)*
(53%)
(48%)
(40%)
7 (31%)
6 (27%)
Department of Parasitology, WRAIR
LEADS
20
6
5
2
3
7
2
2
Acknowledgements








Dr.
Brian Schuster
Prof. Elijah Sokomba
Prof. Paul Akubue
Dr.
Chris O. Okunji
Prof. Francis Okwuasaba
Prof. Louis Barrows
Prof. Simon Efange
Dr.
Chioma Obijiofor
Prof.
 Dr.
 Dr.
 Prof.
 Dr.
 Dr.
 Dr.

Cyrus Bacchi
Chike Onyechere
Joan Jackson
Johnson Ayafor
Angela Duncan
David Skanchy
Claire Wirmum
Thank You !!!
Bioresources Development and Conservation
Programme (BDCP)
Phone: Nigeria: (234)-42-253905
U.S.A.: (301) 962-6201
Email: [email protected]
www.bioresources.org