department of parasitology, wrair landscapes, medicines and healing maurice m. iwu executive...
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Department of Parasitology, WRAIR
Landscapes, Medicines and Healing
Maurice M. IwuExecutive Director, BDCP
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 is the nature of the Human Person?
What is Disease to an African Healer?
What 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 landscapesThese 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:WHERE WE ARE TODAY:HUMAN LEISHMANIASISHUMAN 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
Department of Parasitology, WRAIR
Emerging Infectious Diseases
Thirty (30) New Diseases Have Emerged in the Past 20 Years - WHO 1996
Globalization of Some Old Diseases
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
Department of Parasitology, WRAIR
bringing ancient wisdom to life
ETHNOMEDICINE
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
STRATEGY
WHAT?Whole herbs, standardized extracts
phytomedicines, formulation
WHO?Through a wholly owned
subsidiary (AXXON Biopharm.)
HOW?Establish local base/ Partnerships/ SBA
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
PhysicianPhysician
Traditional HealerTraditional Healer
EthnobotanistEthnobotanist
Data - Collection Forms
New Realities of Global Economy The Trans-National Nature of Capital, Industry
and Labor
Changing Waves of the Biotechnology Sector
Recognition 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
mAU
2 4 6 8 10 12 14 16 18
0
2.5
5
7.5
10
12.5
15
17.5
20
Time (min)
standard
Hangover tonic1
2
4
Electropherograms of Hangover tonic preparation and a standard containing Kolaflavanone, GB1 and GB2
1. Kolaflavanone, R1 = OCH3, R2 = H2. GB1, R1 = OH, R2 = H4. GB2, R1 = R2 = OH
O
O
OH
OH
HO
O
O
HO
OH
R2
R1
3 4 5 6 7 8 9
0
5
10
15
20
Time (min)
mAU
Electropherograms of Hepa-Vital tea and a standard containing Kolaflavanone, GB1 and GB2
standard
Hepa-Vital tea
1
24
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
N+
N
HCryptolepine
N+
N
OOCH3
Sanguinoletine
N
S
Cl
Cl-Cl-
M-3
Alkaloids of Cryptolepis sanguinoleta
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
O
O
OCH3
OCH3
Berberine
H3CO
H3CO
OCH3
OCH3
Palmatine
Protoberberines from Enantia chlorantha
* Optimization studies has shown that high lipophilicity caused 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
ConservationDrug Development
Economic
Developm
entICBG
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. Virtual Drug Company - Multidisciplinary StaffB. Rich in Tropical Diseases ExpertiseC. Not Profit DrivenD. Interactive With W.H.O., Academia, Industry
West and Central Africa ICBGObjectives
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.
Department of Parasitology, WRAIR
Project Background
Korup Forest: access bridge Cameroon
Field Camp: Korup Forest, CameroonField 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
Department of Parasitology, WRAIR
Drug Development LeadsDISEASES SAMPLES LAB. ACTIVITY% LEADS
TESTED
Malaria 500 WRAIR 343 (69%) 20Leishmania 130 WRAIR 52 (40%) 6Cytotoxicity 20 U of Utah 16 (80%)* 5Viral 30 SRI 16 (53%) 2Trypanosomiasis 27 PACE 13 (48%) 3Trichomonas 25 PACE 10 (40%) 7O.I.: Cryptosporidium 22 NIAID 7 (31%) 2Toxoplasmosis 22 NIAID 6 (27%) 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. Cyrus Bacchi Dr. Chike Onyechere Dr. Joan Jackson Prof. Johnson Ayafor Dr. Angela Duncan Dr. David Skanchy Dr. Claire Wirmum
Thank You !!!
Bioresources Development and Conservation Programme (BDCP)
Phone: Nigeria: (234)-42-253905U.S.A.: (301) 962-6201
Email: bdcp@bioresources.orgwww.bioresources.org
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