Zimbabwe Must Regulate Traditional Herbal Medical Products

By Dr Masimba Mavaza

The Ministry of Health an Child Care must seriously look into whether to regulate practitioners of herbal medicine and the products they use to keep the public safe.
In September 2024, I lost my brother to a curable ailment. But the influence from the self proclaimed herbalists had blinded my brother from scrutinising the wonder herbs and acting on the advice of the herbalists my brother fiercely resisted morden medication taking it to far to the extent his ailment progressed to stage 4. My brother did not give any one any chance to distinguish unproved herbal therapies from more rational treatments.

While Medicines derived from plants, such as digoxin, morphine, and vincristine, are important in conventional Western therapy. These examples also demonstrate that natural is not synonymous with innocuous, since these medicines have narrow safety margins. We should be able to judge herbal medicines by the same criteria we judge any other medicine. We can agree that there are some herbal medicines of demonstrable efficacy. For most herbal treatments, however, good trials of efficacy are lacking, and conducting them would be expensive and this has given the herbalists a freeway of taking money from the vulnerable.

Without evidence of efficacy, it is hard to judge the safety of herbal medicines, not least because the risk of an adverse effect that might be acceptable for an effective treatment will be unacceptable for an ineffective one. It should be known that the precise chemical content depends on the variety and the growing conditions, processing, and storage. These basic botanical principles are generally accepted, but incompletely understood.This is because herbal supplements are not subject to clinical trials or to the same manufacturing standards as prescription or traditional over-the-counter medicines. There is no research that proves a certain herb cures or treats a health problem or prevents a certain condition. We have a situation where vulnerable patience are being told the same herb treats all disease .

Evidence for the effectiveness of herbal medicines is generally very limited or completely nonexistent. Although some people find them helpful, in many cases their use tends to be based on traditional use rather than scientific research.

Yes it is accepted that used correctly, herbs can help treat a variety of conditions, and in some cases, may have fewer side effects than some conventional medications. Never assume that because herbs are “natural,” they are safe. Some herbs may be inappropriate for people with certain medical conditions
And, herbs can pack in just as much nutrition as vegetables! Just like green leafy vegetables, fresh herbs contain large amounts of vitamins A, C and K. Many herb plants also contain polyphenols. Polyphenols are plant compounds that have both antioxidant and anti-inflammatory.

According to the Human Medicines Regulations (2012), of the UK a product is a herbal medicinal product if the active ingredients are herbal substances and/or herbal preparations only. 

In certain circumstances vitamins and minerals may be added to the product provided that their action is ancillary to that of the herbal active ingredients regarding the specific claimed indication(s). It is reasonable for any herbal medicines to be registered before it’s out for sale. This is to ensure that any safety issues have been properly identified to support the traditional use of the product. The ministry of health must take note of all herbs used and do their own research,then they should publish its own list of herbal substances, preparations and combinations for use in traditional herbal medicines. This will be updated as new discoveries arise.

Zimbabwe should have provisions which will apply to traditional herbal medicines intended to be marketed in Zimbabwe regardless where they come from. Zimbabwe is having a serious influx of herbs from China Ghana and Nigeria. Our people do stampede to those herbs as they are very cheap but fatal.

The Ministry of Justice, Legal and Parliamentary Affairs must ensure that traditional medicine use, evidence should be provided that the product or a corresponding product is tested and tried and its side effects are known and there is a way to deal with the side effects.
The ministry must insist on evidence in the public domain relating to the safety of herbal medicines and herbal medicines practice in Zimbabwe.
In order to avoid confusion to the people the ministry must regard herbal medicines as dietary supplements, not medicines. Such products must not bear claims that they can prevent, treat, cure, mitigate, or diagnose disease unless the claims are substantiated by scientific evidence. Many Zimbabweans have died under the hands of these herbalists who will tell them that one herb treats cancer, headache, BB, Diabetes and other illnesses that are on earth. Seriously! Zimbabwe must propose rules on good manufacturing practice for dietary supplements.

The government must take a hand in the regulation of herbal products. It must put in place a special, simplified registration procedure for certain medicinal products, particularly herbal ones, that have a long tradition of use.In this context, a long tradition of use is one that goes back to 30 years. The argument seems to be that longstanding use and experience make efficacy plausible, and that only safety need therefore be considered. Since plausible traditions such as using moringa, zumbani,emetics, alovera,purgatives, and leeches persisted for much of the past millennium, to the great detriment of patients, the arguments against an evidence based approach seem weak.

The government must appoint a Herbal Medicines Advisory Committee—with members representing Local,Western, Chinese, and ayurvedic herbalism, as well as lay members and experts on conventional medicines—should advise ministers directly on the regulation of herbal medicines, this will be the best way of safeguarding our own people.

To the traditionalists , this seems perverse, but no this should be done because the advisory bodies are there to ensure that medicines are reasonably safe, effective, and of good quality. It is difficult to think of good reasons why some products that make medicinal claims should be able to satisfy the advisory bodies by relying on folklore. Perhaps, though, it is appropriate that alternative medicines should be judged by a separate committee that relies on plausibility rather than analysis. After all, traditional medicine does not fit the orthodox medical paradigm, but rest on theoretical foundations that are, perhaps, closer to the thinking of traditional fathers of medicine, who will rely on dreams. The problem is no one knows if the dreams are being dreamt these days. This is not a challenge to our traditions but it is to safeguard our people.

Herbal products for which there are reliable data could be granted standard marketing authorisations. If the rest were judged by a separate body, and by different criteria, we could clearly distinguish rational therapies based on good evidence of efficacy and safety from products that lack those attributes. Advocates of the use of unproved herbal products would be able to take separate and full responsibility for them, and for making decisions on their safety and efficacy in the absence of information from satisfactory clinical trials—or, indeed, any evidence at all.

A Government setting up statutory regulation for herbal medicine practitioners will be a way to go.
There is a public safety issue involved and it must be taken seriously. Currently, anyone can set up as a herbal practitioner and sell powerful herbs. There is no requirement to be registered and as a result, the herbal industry is littered with underqualified and incompetent people, freely treating patients. Members of the public are often unaware of this fact.

An extreme example of the dangers this poses is the experience of patients who suffer from cancer and kidney problems and are told to stop chemotherapy and abandon their medications. We do not have any regulation robust enough to prevent these cases.
There is public demand for the herbs in Zimbabwe sadly it is a public demand to death. Surely it is better to have a state regulated system where herbalists must have undergone recognised training that includes herb toxicity issues, drug-herb interactions, ethics and notifiable diseases?

Regulated herbalists should be trained to know when to offer treatment and when to refer patients to mainstream healthcare colleagues.

We should accept that traditional medicine has remained as the most affordable and easily accessible source of treatment in the primary healthcare system in Zimbabwe. It’s no longer the thing for the poor. Zimbabweans have a long history of traditional plant usage for medicinal purposes. Despite the increasing acceptance of traditional medicine in Zimbabwe, this rich indigenous knowledge is not adequately tested and tried. There is no clear documentation of this knowledge. Documentation of plants used as traditional medicines is needed so that the knowledge can be preserved and the utilized plants conserved and used sustainably.

While we advocate for registration it should be noted that the importance of traditional medicines in the treatment and management of human diseases and ailments in Zimbabwe must not be overlooked. Traditional medicines still play an important role in meeting basic health care of local communities in Zimbabwe.
However it is the duty of Zimbabwean government to protect its people.