• Explained the differences between the Ocimum species.

• Most of the samples kept as Tulsi (Ocimum tenuiflorum) may actually be Ocimum gratissimum (ID confirmed by Allan Patton, Kew)-This has been confirmed by the DNA analysis.

• Confirmed the samples which are not like any of the Ocimum samples were a different species, most likely a weed which has contaminated the soil.-Soil was autoclaved but the weed still managed to germinate.

Tulsi in the UK

Verification of Ocimum samplesA Celebration of Herbal Medicine History: researching botanical

knowledge and discovery

Traditional practice – future

wisdom? Quality, safety and

evidence of herbal medicines from

an ethnopharmacological

perspective

Michael Heinrich

Pharmacognosy and Phytotherapy,

UCL School of Pharmacy, 29 - 39 Brunswick Sq.,

London, WC1N 1AX, UK (England)

The grand developments today include:

• Fast urbanisation with about 55% of the world’s

population living in cities

• Dramatic socio-economic changes including

nutritional changes

• The aging-population resulting in increased

demand on health services and a shift in health

care challenges to chronic and degenerative

diseases

• Improved, but inequitable access to health care in

many but not all regions of the world

• Global network of goods and services with often

poor quality assurance

2

3Age-standardised mean BMI in girls (children and adolescents) in 1975 and 2016 (Lancet 2017)

Body Mass Index – changes over 30 years

4Age-standardised mean BMI in boys (children and adolescents) in 1975 and 2016 (Lancet 2017)

Body Mass Index – changes over 30 years

Trends in age-standardised prevalence of BMI

categories in children and adolescents

(Children and adolescents were aged 5–19 years).

Male children and

adolescents

Female children and

adolescents

Age standardised prevalence of obesity

6

Herbal Medicines

in the Global

South – Who

wants to know?

Herbal medicines and

ethnopharmacology

Zapotec

herbalism, Mexico

Mixe health

rituals, Mexico

Cho’rti rituals,

Guatemala

From a macro- to the micro-perspective

8

Is this still the field site to study ‘traditional

knowledge (Popoluca region, México 2000)

9

The Ch’orti’ of Eastern Guatemala

• Ch’orti’ Maya mainly live in hamlets, (culturally non-indigenous) “Ladinos” in towns

• Studied by C. Wisdom (1930s), unpublished MS on plant use

Ch’orti’ area

Ethnobotany of a Mayan group

Kufer, Poell, Foerther & Heinrich (2005) J Pharm Pharmacol 57: 1127–1152

10

Guatemala as tourists “know” it

11

An Ethnobotanist’s view of Guatemala

12

Methods

• Total of 17 months of fieldwork, resident in town, visits to hamlets

• Licences for research and plant collection

• Collection and identification of voucher specimens

• (Semi-) Quantitative data: semi-structured interviews

• Qualitative data: unstructured interviews, participant observation

• Interviews mostly in Spanish, some in Ch’orti’ with interpreter

• Selection of 40 interviewees :

– plant knowledge main criterion

– Active search for informants

13

Doña Balbina, a traditional healer (divining cause ofsoul loss for patient)

Juana Pérez (engaging in self-treatment)

Plant knowledge and usedo not depend on specialist healer status

14

Analysis of data

• (Semi-)quantification

• Separation into ten use groups based mainly on body system

• Comparison with uses in other regions of Guatemala and adjacent countries

• Analysis for a different variables:

- introduced/native

- comparison with 70 year old MS by Ch. Wisdom

• Analysis of current bioscientific knowledge about

most popular species

15

Charles Wisdoms’s manuscript

• A detailed unpublished MS (Field Museum Chicago) by an US-American anthropologist Charles Wisdom documenting plant uses among the Ch’orti’ Maya in the 1930s offers an exceptional opportunity to explore questions of continuity and change in Maya medical ethnobotany.

• His classic “The Chorti Indians of Guatemala”.

• While it is unfortunate that he did not collect any voucher specimens of the plants whose uses he documented, the MS benefits greatly from tentative plant identifications provided by the leading expert on the flora of Guatemala of his time, Paul Standley, based on vernacular names and descriptions. It seems from the data, though, as if Standley was more familiar with local plant names and uses in other parts of Guatemala than in the eastern part.

16

Plant species Total URs vers

Citrus limon (L.) Burm. 96 10

Matricaria recutita L. 54 9

Chenopodium ambrosioides L. 54 5

Tecoma stans (L.) H.B.K. 46 7

Buddleja americana L. 43 5

Allium sativum L. 41 9

Citrus sinensis (L.) Osbeck 37 7

Ruta chalepensis L. 36 6

Nicotiana tabacum L. 32 9

Pluchea symphytifolia (Mill.) Gillis 32 5

Introduced Native

Most frequently cited species (top 10 of all use groups in our ethnographic data)

vers = versatility(number of use groups)

17

Historical data

• Unpublished MS by US anthropologist Charles Wisdom

• List of 648 entries, 356 with medical uses

• Basic unit of information: entry/plant species (Plant uses)

• No historical voucher specimens - botanical identification by botanist Paul Standley based on vernacular names and description → Botanical

authentication essential

169

51

5680

Misinterpretedby Wisdom

More detailedID achieved

ConfirmedWisdoms ID

Noinformation

9 47

78222

species

genus

family

not botanicallyidentified

Level of botanical identificationmedicinal plants

Quality of botanical identificationmedicinal plants

N = 356

18

A comparison

Historical and modern ethnobotanical

data• 29.1% of all contemporary MPUs overlapped with

the historical data, i.e. the same plant taxa were mentioned in Wisdom’s MS as being used for treating conditions in the same use group

• A further 42.7% of cMPUs = species which are recorded in the MS as medicinals, but for treating conditions of a different UG (OUG).

• 12.8% of all cMPUs = plants with an entry in the MS, but no record for medicinal use (NMU),

• 15.4% of plant species’ cMPUs have no entries in the MS (ABS).

24

Comparison of today’s and historical data

29%

42%

11%

18%

47%

34%

9%

10%

Same UG

Other UG

Nonmedical

Absent

inner circle: plant uses

outer circle: use reports

The most widely

used species are

more likely to be

found in Ch.

Wisdom’s MS

Without proper and full botanical

documentation and authentication

any study on medicinal plants

remains preliminary

Fast forward – Guatemala in 2019

Green health: improving indigenous

participation through the CBD's ABS (Access and Benefit Sharing Mechanism of the Convention on Biological Diversity)

❖This project is funded by the Darwin

initiative, a funding scheme of the UK

government which supports local projects

for the conservation of biodiversity and

the environment in general.

❖Location: Guatemala, Petén region

❖Major ethnic group: Qeq’chi’

❖Overarching aim: implementation framework for

sustainable use, access and benefit-sharing in

Guatemala involving consensus between

indigenous groups, government, academia and

industry, based on natural capital and traditional

knowledge to sustain healthy livelihoods.

❖The CBD’s main objectives are all related to the future of the world’s biodiversity’: CONSERVATION, SUSTAINABLE USE, FAIR AND EQUITABLE SHARING OF THE BENEFITS ARISING DERIVED FROM GENETIC RESOURCES

❖The Nagoya protocol attempts to regulate access and benefit sharing (ABS) to support the implementation the ‘fair and equitable sharing of the benefits arising out of its uses’

❖Difficulties in applying the principles of the Nagoya protocol – inconvenient for businesses? Unfair to locals? Too complicated for institutions?

❖How can we ascertain that benefits are equitably shared? → Agreements, through discussions, TransDisciplinary workshops

Jumping to the UK (2019) – Herbal

Medicines – Who cares?

28

Aim: To gain insight into the

public’s perception of herbal

medicine/ general use of herbal

medicines for health care, as well

as on the growing of plants for

medicine.

29

Why are respondents attracted

to herbal remedies? (N=307).

Online Survey 2018 (UK):

• Covered participants’ views

about herbal medicines.

• Survey responses were

categorised and analysed

using Qualtrics

• 408 participants (numbers

varied across questions)

• Herbal medicines are

popular, particularly amongst

the 36 to 55 year old age

group.

• Used herbal medicines for

minor-self-limiting conditions.

• Herbal medicines are

‘natural’ and ‘have fewer side

effects’.

UK: Herbal Medicines. Who Cares?

Lazarou and Heinrich 2019

Phytother. Res.

30

Use herbal remedies for groups of

health conditions (N=324) -

multiple answers possible

Online Survey 2018 (UK):

• Covered participants’ views

about herbal medicines.

• Survey responses were

categorised and analysed

using Qualtrics

• 408 participants (numbers

varied across questions)

• Herbal medicines are

popular, particularly amongst

the 36 to 55 year old age

group.

• Used herbal medicines for

minor-self-limiting conditions.

• Herbal medicines are

‘natural’ and ‘have fewer side

effects’.

UK: Herbal Medicines. Who Cares?

31

"In general, herbal remedies are

effective for minor health

conditions" (N=144)

"In general, herbal remedies

are effective for major health

conditions" (N=144)

UK: Herbal Medicines. Who Cares?

32Lazarou & Heinrich 2019 Phytother. Res.

UK: Herbal Medicines. Who Cares? Main kitchen plants

used in healthcare (

33

Medicinal plants commonly grown at home

34

Response No. selecting

this answer

% of

Participants

I don’t know 64 21.1

I trust the supplier 30 9.9

I see if it works 49 16.1

Packaging 5 1.6

Smell, colour and taste 23 7.6

THR 10 3.3

Research 27 8.9

Using suppliers that use good manufacturing

practice (GMP)

7 2.3

Brand reputation 31 10.2

Reviews/ word of mouth 37 12.2

1

How do you know if a herbal product is of good or bad quality

(N=304

Informal interviews showed that

people were unaware of how

poor the quality of some products

are on the market, which could

perhaps be why THR was so

lowly valued.

Do people tell their doctor of pharmacists about using

traditional remedies? (British Indian)

0

10

20

30

40

50

60

70

80

90

Doctor Pharmacist

Nu

mb

er o

f p

art

icip

an

ts

Yes

No

Not applicable

Of the total research population, 106 participants who took

prescribed medication were asked if they told their doctor or

pharmacists about the concurrent use of traditional remedies.

Telling healthcare professionals?

Bhamra et al 2019.

Phytotherapy

Research

36

St. John’s Wort and its

variable quality

Lanzhou China, May 2016

37

[FS1]

Fingerprints of 47 St. John’s Wort samples (commercial products) organised by

similarities in the fingerprint under UV 366 nm after derivatisation: images under

UV 366 nm after derivatization with NP and PEG;.

Rutin (Rf = 0.1) and hyperoside (Rf O.28) left side = extra band at RF 0.48

The challenges of good quality: St. John’s Wort

Key findings from the HPTLC analysis• 48 samples (mostly commercial products)

investigated

• All THR / licensed samples (except sample 8)

show a flavonoid fingerprint in compliance

• Sample 8 shows an additional yellow zone due to

avicularin but also the yellow zone underneath

chlorogenic acid

• 26 samples show a fingerprint in compliance with

the USP description

• 11 samples show an extra yellow zone at RF 0.49,

due to avicularin

• 8 samples show a faint fingerprint with and without

avicularin,

• 2 samples show a very weak fingerprint.38

Food dyes in unlicensed SJW preparations

39

Samples 11, 13, 17, 23, 24, 28, 31, 40, and 46 contained food dyes, identified as Brilliant Blue (E133; Rf = 0.1 ), Sunset Yellow (E110; yellow zone at Rf = 0.35 ), Amaranth (E1023; pink zone at Rf = 0.58), and Tartrazine (E102; very faint yellow zone above Amaranth at Rf = 0.65).

Image under white light, after development (no derivatisation).

Food dyes in unlicensed SJW preparations

40

Samples 11, 13, 17, 23, 24, 28, 31, 40, and 46 contained food dyes, identified as Brilliant Blue (E133; Rf = 0.1 ), Sunset Yellow (E110; yellow zone at Rf = 0.35 ), Amaranth (E1023; pink zone at Rf = 0.58), and Tartrazine (E102; very faint yellow zone above Amaranth at Rf = 0.65).

Image under white light, after development (no derivatisation).

All but two are samples

sourced via the internet and

are produced / commercially

available in the USA

There are numerous bottlenecks along the complex value chains of HMPs, which may result in poor quality products.

Registered / Licensed products have to comply with the regulatory requirements providing better patient safety

Key is the traceability along the value chains based on an

understanding of the materia prima:

Future vision - blockchain

Should we set a place for blockchain systems

Heinrich et al. 2009 Frontiers in Pharmacology (Ethnopharmacology)

• Blockchain systems are a fast emerging and a currently

widely discussed novel strategy for a decentralised

cryptographically-enhanced digital ledger recording

transactions among stakeholders. In essence they are a

form of digital book keeping.

• The may offer novel solutions for some of the key

challenges in herbal medicine supply: Quality /

authenticity, sustainability of the supply, equitable benefit

sharing and thus ultimately traceability from the primary

production to the products used.

• They can be based on simple (mobile phones) or

complex tools (phytochemical analysis)

• This follows up on our paper on the role of value chains in

ethnopharmacology (Booker et al 2012, J.

Ethnopharmacol.)

Key Challenges at each stage

Level of Complexity of the Blockchain

solution

Specific Benefits General BenefitsStage in the

Botanical Value Chain

• Ensure best practice (GACP) and sustainability

• Verifiable payment• Primary producers - benefits

• Obtaining high standard products

• Certainty of sustainability and equitable benefits

Blockchain

Cultivation and Collection

Primary Processing

Manufacturing

Retail

Consumer Incre

ases T

rustw

ort

hin

ess

Local E

conom

ic b

enefits

Tra

nspare

ncy (

consum

er)

Tra

ceabili

ty a

nd G

xP

• Ensure correct and clearly described procedures - SOP

• Minimising risk of contamination

• GMP – compliance and ascertaining Quality control

• Understanding of the underlying supply system

• Costs of acquiring technology

• Training for technology use

• As above plus• The need to capture the

technical complexities

• As above plus• Differences between

regulated and unregulated market elements

• The need for transparency towards consumers/patients

• Understanding of benefits

• Understanding of the underlying supply system ascertaining consumer trust

Should we set a place for blockchain systems

Heinrich et al. 2009 Frontiers in Pharmacology (Ethnopharmacology):

https://www.frontiersin.org/articles/10.3389/fphar.2019.00396/full

Conclusions

Herbal

Medicines

Claims, Efficacy and pharmaco-

logy / pharmaco-

kinetics

Quality, variability and safety

Knowledge and practice on the use of herbal

medicines

Sustainable sourcing (value

chains) and benefits

Ethnopharmacology

Future

wisdome:

Herbal

Medicines

Claims, Efficacy and pharmaco-

logy / pharmaco-

kinetics

Quality, variability and safety

Knowledge and practice on the use of herbal

medicines

Sustainable sourcing (value

chains) and benefits

Ethnopharmacology

Future

wisdom:

All health care professionals

including herbalists need to

engage with today’s challenges

and opportunities

• Herbal medicines and foods must be recognized as a global health care opportunity

• Herbalists have a role to play in the prevention and treatment and will so in the future, but we must get much better trained practitioners

• We can improve their use using science-based approaches

• Quality is requires much better (self-) regulation

Thank you Francesca Scotti, Katja Loebel, Anastasia

Agapounda, Tony Booker……

The team in Pharmacognoy and

Phytotherapy

Dr. Deborah Johnston, SOAS, London

Funding: W. Schwabe (charitable

donation), who have had no influence on

the design of the experiments and the

interpretation of the data

Acknowledgements ❑ Dr. Suky Bhamra, with collaborators in

Leicester❑ Tony Booker, Johanna Michl (LSoP)❑ Prof. M. Simmonds and collaborators

(Kew) Dr. Stefan Wanke, Prof. G Vollmarand Dr. Oliver Zierau (Univ. Dresden)

❑ Dr. Abdul Koshak (now Jeddah) and collaborators

❑ And the many others students who contributed to projects.

Funding❑ Leverhulme Trust, Bloomsbury

studentship. Saudi Arabian government