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Islands as is evidenced from the historical Lelu ruins in Kosrae (FSM) in 1400 AD and the Nan Madol ruins of Pohnpei (1000 AD). World Journal of Microbiology ...
World Journal of Microbiology & Biotechnology 20: 903–934, 2004.  2004 Kluwer Academic Publishers. Printed in the Netherlands.

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The Pacific Islands: a biotechnology resource bank of medicinal plants and traditional intellectual property Edgar J. DaSilva1,*, V.K. Murukesan2, Dilip Nandwani3, Mary Taylor4 and P.C. Josekutty5 1 Ex-UNESCO, Member, Island Council for Development (INSULA), c/o UNESCO, 1 rue Miollis, Paris 75015, France 2 Agricultural Experiment Station, College of Micronesia-FSM, Yap Site, P.O. Box 1226, Colonia, Yap, FM 96943, Federated States of Micronesia (Tel.: +691-350-5752, Fax: +691-350-2325, E-mail: [email protected]) 3 Cooperative Research and Extension, College of the Marshall Islands, P.O. Box 1258, Majuro, MH, 96960, Marshall Islands (Tel.: +692-625-5340/3236, Fax: +692-625-7203, E-mail: [email protected], [email protected]) 4 Regional Germplasm Centre, Secretariat of Pacific Community, PMB, Suva, Fiji (Tel.: +679-337-9271, Fax: +679-337-0021, E-mail: [email protected]) 5 Micronesia Plant Propagation Research Centre, College of Micronesia-FSM, Kosrae, FM 96944, Federated States of Micronesia (Tel.: +691-370-2768, Fax: +691-370-3000, E-mail: [email protected]) *Author for correspondence: Tel.: +33-1-4250-1993, E-mail: [email protected] Received 28 June 2004; accepted 3 July 2004

Keywords: Biotech resource bank, IPRS, medicinal plants, women and traditional knowledge

Summary Traditional medicines, the mainstay of medical treatment for virtually all minor ailments in many developing countries, have been tapped for the production of new therapeutics in the sustenance of human health and wellbeing. Vulnerable to the vicissitudes of globalization issues such as intellectual property rights, trade and gender are of relevance in the Pacific region that is a source of some unique traditional healing systems. Introduction The calming remedy and the therapeutic serenity in a world of socio-cultural development in the Pacific region, and more particularly the South Pacific region, has been captured in the Pulitzer Prize-winning novel Tales of the South Pacific by James Michener, and in the cinematic musical South Pacific by Richard Rodgers and Oscar Hammerstein Jr. This region of geographical and political significance, whose strategic location has been described as the Pacific Rim or the Pacific Arc, is spread wide across some 165.384 million km2 of the Pacific Ocean that is home to about 30,000 islands. These in turn constitute some 22 countries and territories with a land surface of 550,000 km2 contained in either single island states or in groups of large and small dispersed islands, and which are inhabited by a total population of some 8.5 million inhabitants. The Pacific region, with its exclusive economic zone of 15 million km2, possesses a unique and unrivalled combination of geographically located bioresources of cultural and socioeconomic significance that today is being threatened by the novel all-encompassing waves of globalization. The world of medicinal plants is part and parcel of these threatened and vulnerable indigenous resources in the small island states and territories of the Pacific region.

The Pacific region and medicinal plants Your food shall be your medicine and your medicine shall be your food. Hippocrates (460–377 BC) The island states and territories of the Pacific region, collectively called Oceania,1 have been grouped into 1 Oceania is the collective name that is occasionally used for the islands in the Pacific Ocean, and the exact number of which is not known. A general accepted estimate is of 25,000–30,000. The islands were first described as Polynesia (a combination of the Greek poly and nesos meaning ‘many’ and ‘islands’) by Charles de Brosses, French magistrate and scholar, following his visit in 1751 and publication of his Histoire des navigations aux terres australes in Paris in 1756. The grouping of islands as Melanesia (a combination of the Greek melas and nesos meaning ‘black’ and ‘islands’) results from the visit in 1824 of Jules Se´bastien Ce´sar Dumont d’Urville, botanist and linguist. d’Urville coined this name on account of the predominant dark skin colour of the inhabitants in this group of islands. D’Urville coined the term Micronesia (a combination of the Greek mikros and nesos meaning ‘small’ and ‘islands’) to describe the thousands of small islands that constitute this grouping together of these islands. Archaeological and linguistic evidence indicate that the islands were first discovered and settled between some 3000 years ago by settlers of Austronesian origin who brought with them horticultural skills and valuable maritime knowledge. These first settlers are thought to have migrated eastwards from Southeast Asia to Yap (FSM), and then to Papua New Guinea, Solomon Islands, to Kiribati and the Marshall Islands as is evidenced from the historical Lelu ruins in Kosrae (FSM) in 1400 AD and the Nan Madol ruins of Pohnpei (1000 AD).

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Box 1 (a) Island States and Territories of the Pacific Region – Source: WorldAtlas.com Melanesia Group of islands northeast of New Caledonia and including the independent countries of Fiji, Papua New Guinea, the Solomon Islands and Vanuatu

Micronesia Group of islands east of the Philippines, the Mariana Islands, and including Palau, the Federated States of Micronesia, Marshall Islands, Kiribati and Nauru

Polynesia Group of numerous islands including all of French Polynesia and the Austral Islands, the Easter and Pitcairn Islands, Wallis and Futuna and the Cook Islands, Niue, Samoa, Tuvalu and Tonga

(b) Governance in the Pacific Region – Schoeffel (2000)a Independent states Fiji, Kiribati, Nauru, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu

States in Free association Cook Islands (New Zealand); Federated States of Micronesia, Palau and the Marshall Islands (USA)

three distinct socio-cultural regions (Box 1) namely, Micronesia, Melanesia and Polynesia. The World Health Organization (WHO) defines traditional medicine to include diverse health practices, approaches, knowledge and beliefs incorporating plant-, animal- and/or mineral-based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain wellbeing, as well as to treat, diagnose or prevent illnesses (WHO 2002). This review does not attempt to cover all of traditional medicine nor all of the occurrence and use of herbal and medicinal plants in all the Pacific island states and territories. Attention has been given to activities concerning the use of herbal medicines2 and medicinal plants in the • • • • • • • • • • • • • •

Cook Islands, the Federated States of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, the Republic of Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu.

National activities in the larger well-developed states of Australia and New Zealand and their Pacific territories and those of Chile, France, the UK and the USA are not dealt with as these have been covered elsewhere (WHO 1998a). 2

Herbs, herbal materials, herbal preparations and finished herbal products containing as active ingredients parts of plants, or other plant materials, or combinations thereof are referred to as herbal medicines (see WHO 2002).

Territories Easter Island (Chile); French Polynesia, New Caledonia,and Wallis and Futuna (France); Tokelau (New Zealand); American Samoa, Guam and Marianas (USA)

The Pacific region enjoys widespread geographic and geological diversity in terrestrial and marine environments. Naturally endowed with a biodiversity of endemic, rare, endangered and threatened species this valuable bioresource is constantly at risk of irreparable loss resulting from exposure to the growth and expansion of the tourist industry that is in search of newer havens conducive to corporal and mental relaxation. Fragile and valuable natural ecosystems in these Pacific island states are susceptible to imminent disruption and destruction. Furthermore, several island states on account of their small size, limited natural resources of economic significance and geographical isolation have a limited range of options in overcoming their vulnerability in a worldwide market-oriented economy. Of economic significance for the sustenance and development of several Pacific island communities, traditional intellectual property (TIP) concerning medicinal plant resources is being tapped for use in emerging new markets as an alternative to the rising costs of commercialized healthcare and globalizing market-economy pressures. TIP or traditional knowledge has been accumulated through the experiences of self-taught village practitioners and observations of rural users of medicinal plants in past and present generations. Today TIP is an active contributor to the understanding of present-day cultural heritage and societal practices concerning the conservation of health and human resources through the use of medicinal plants (Figure 1). Management and use of traditional medicinal plants for sustenance of human health resources and technical development in these islands result from such folklore science. Indigenous and traditional knowledge – in itself a precious and priceless heritage – which, akin to that witnessed with fermented foods, has been transmitted orally or through sketch work from generation to generation on a familial and tribal basis (Nandwani & DaSilva 2003). Humankind since time immemorial has depended upon plants as a source of food and medicine for its well-being, shelter, protection and survival against

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Types of ailments

Medicinal plants in the Pacific Islands Stomach ailments Wounds, burns, boils Sprain, rheumatism, arthritis Skin rashes, sores Cough, bronchitis, sore throat Mouth infections Infant diseases Headache, fever Venereal diseases Pregnancy related, menstrual Eye ailments Insect bite, rat bite, fish Haemorrhoids Sinusitis, cold, nasal Urinary infection Liver ailments Internal injury, bleeding Diabetes, hypertension 0

5

10

15

20

25

30

35

40

45

Number of plants Figure 1. Number of plants used in the Pacific region in treatment of different ailments.

climatic forces and changing environments. Thus, entrepreneurial rural and village cultures worldwide constitute a rich source for anthropological, botanical and ecological research vis-a`-vis the search for new drugs, foods, pesticides, natural products, etc., to meet the demands of the age of global consumerism. Like the Asian and the Caribbean regions, the Pacific region is rich in traditional medicinal knowledge that has been accumulated for use over a span of some 3000 years. Home to a large number of varied cultural and ethnic groups, the Pacific islands possess a wealth of bioresources. Micronesia, Melanesia and Polynesia are acknowledged treasure houses of traditional medicine and domesticated medicinal skills (Figure 1). Folk medicine in Tonga has been used in rural areas for obstetric and gynecological conditions and disorders (Singh et al. 1984). Medicinal applications and decoctions refined and ‘standardized ’ through repeated domestic use have contributed to the development of self-sustaining traditional healthcare systems in the conservation of early and contemporary human health resources in the Pacific region (Table 1). Moreover, resort is being made to use the medicinal plants as nutraceuticals and dermaceuticals in the light of the rising costs of allopathic medicine in contemporary healthcare systems in developed societies. Traditional medicine in the Pacific region, having evolved from the applications of a wide range of medicinal plants, is a much coveted heritage whose preciousness has been fiercely guarded and secretly preserved by family and tribal descendents. Some methods of treatment and preparation of medicines are generally known whereas other techniques and accompanying knowledge are not, as they are integral components of the cultural heritage and intellectual property of communal healers and tribal island practitioners (Nandwani 2003). Moreover, such heritage and property is the raison d’eˆtre of their livelihoods and an indisputable factor for

their self-sustaining existence. Notwithstanding the attraction, the introduction, and efficiency of modern medicine, many Pacific island communities are unwilling to forego their confidence, cultural customs and reliance in relation to their traditional medicines that have contributed to their healthcare for decades through use of one or more parts of one or more medicinal plants (Figure 2). Medicinal plants of marine origin occur in the Pacific region (Table 2). Several of these plants are green, brown and red algae whose many species contain between 10 and 20% protein, fibre, calcium, iodine, iron and potassium, trace elements, and vitamins A, C, E, and the vitamin-B group inclusive of especially vitamin B12, and bio-active compounds of medical significance. In reality and given their usage in traditional Chinese, Japanese and Pacific island medicine, seaweeds are a natural resource bank of agroceuticals, cosmoceuticals, dermaceuticals, and nutraceuticals that are finding their way into contemporary pharmaceutical processes for new health and skincare market products.

Aboriginal and Maori medicine Activities in Australia and New Zealand concerning medicinal plants have not been included in this review. Nevertheless, Aboriginal and Maori traditional medicine based on medicinal plants merits some mention. Early Aboriginal and the Maori communities, seemingly, were far healthier than their current day descendents and compatriots whose ancestral settlers arrived from the northern hemisphere some hundreds of years ago. The traditional knowledge and use of native plants by the early communities of these native inhabitants for food and medicinal purposes have contributed through migration and tribal trade to the introduction and evolution of medicinal plant usage in Micronesia, Melanesia and Polynesia. Moreover, the practice of such medicine by current day Aboriginal and Maori

Cook Islands – kapu kapu; Fiji – 00 00 tantandra; Chuuk – niiko toko t, Pohnpei – lawa´t (islands of FSM); Niue – tono; Palau – elischur; Samoa – togo

Leaves

Leaves alone or in combination commonly used to treat infant ailments of the fontanel or soft spot (deformed skull) (mavaeua) and navel (tapitopito)

Bark infusion commonly used to treat stomach ache; garlands of plant used to provide a ‘good feel’ status

Bark

Cook Islands – moto‘oi; Fiji – mokosoi; Chuuk – pwalang; Kosrae – ilanlang, ilahnglahng (islands of FSM); Marshall Islands – ilanilan; Niue – motoi; Palau – chira´ng; Samoa – moso‘oi; Tonga – mohoki, mohokoi

Cananga odorata

Apiaceae Hydrocotyle asiatica

Bark infusion used to treat stomach ache

Bark

Cook Islands – tapotapo; Palau – ngel ra ngebard; Tonga – ‘apele papalangi, ‘apele Tonga; Tuvalu – andnameana

Leaves used to prepare a bath to calm infants suffering from unspecified ‘nervous’ ailments or rashes

Bark infusion used to treat stomach ache and diarrhoea, leaf infusion used as drip in eye ailments

Annona squamosa

Bark, leaves

Cook Islands – vi; Fiji – wi; Samoa and Tonga – vi

Bark infusion used to treat mouth infections in children; fruits are rich source of vitamins A and C

Juice from leaves dripped onto wounds to prevent tetanus, and to help heal sub-incision wounds

Sap squeezed out from stems and leaves is applied to framboesia lesions of the body part that is wrapped in a poultice leaf of Morinda citrifolia

Medicinal uses

Leaves

Bark, leaves

Leaves

Stem, leaves

Plant part(s) used

Kiribati – te mangko; Yap – manga (island of FSM); Samoa – mago

Ifaluk – gogo, Satawal – eeg’gohu, Ulithi – koi, Woleai – gugu (islands of FSM); Samoa – tamatama; Tonga – tamatama

Yap – malai (island of Federated States of Micronesia (FSM)

Local Name (in italics) in Pacific island states

a

Aitutaki – naponapo taratara; Mangaia – katara‘apa (Cook Islands); Kosrae – sosap (FSM); Marshall Islands – jojaab; Niue – talapo fotofoto; Palau – sausab; Samoa – sasalapa; Tonga – ‘apele ‘initia

Annonaceae Annona muricata

Spondias dulcis

Anacardiaceae Mangifera indica

Amaranthaceae Achyranthes aspera

Flowering plants: Dicotyledons Acanthaceae Blechum brownie

Botanical Name

Table 1. Plants of medicinal importance and their uses in the Pacific island countries.

Cook Islands, Fiji, FSM, Niue, Palau, Samoa, Tonga

Cook Islands, Fiji, Palau, Tonga, Samoa, Tuvalu

Cook Islands, Fiji, Palau, Tonga, Tuvalu

Used in most Pacific Islands

Fiji, Samoa, Tonga

Widespread in most Pacific Islands

FSM, Samoa, Tonga

FSM

Pacific Island countries

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Leaves

Fiji – vutikaumondro; tho vuka; Palau – etngeong; Tonga – fisi puna

Vernonia cineria

Leaves, flowers

Satawal – atiat; Ulithi – eatheuth; Woleai –yatiuyet; yatuyet; Yap – thuh; (islands of FSM)

Wollastonia biflora

Heliotropium anomalum

Boraginaceae Cordia subcordata Bark, leaves, flowers, fruits

Stem, leaves

Cook Islands – tou; Fiji – nawanawa; Chuuk – anika¨t; Kosrae – ikwaiak, Namoluk – aleu; Pohnpei – eekoh-eek, Satawan – alau (islands of FSM); Samoa – tuanave; Tonga – puataukanave

Niue – toihune fifine

Seeds, leaves

Leaves

Cook Islands – kamika; Samoa – ‘ami’a; Tonga – kakamika

Sigesbeckia orientalis

Cook Islands – ‘utu; Fiji – vutu; Chuuk – kun, Pohnpei – we (islands of FSM); Kiribati – te bairati; Samoa – futu; Tonga – futu

Leaves

Cook Islands – pokutekute; Fiji – wa mbosuthu, wa mbosuvu; wa mbutako; Niue – fue saina; Palau – teb el yas; Samoa – fue saina

Mikania micrantha

Barringtoniaceae Barringtonia asiatica

Leaves

Cook Islands – piripiri; Niue – kofe Tonga; Tonga – fisi’uli

Asteraceae Bidens pilosa

Leaves

Bark

Kiribati – te meria; Samoa – pua fiti; Tonga – kalosipani

Plumeria rubra

Samoa – fue selela; olive vao; Tonga – lau matolu

Bark

Kiribati – kiebutinang; Samoa – fao; Tonga – fao

Neisosperma oppositifolia

Asclepiadaceae Hoya australis

Leaves

Chuuk – se´uriinen (island of FSM); Samoa – leva

Apocynaceae Cerbera manghas

Plant pounded with salt and applied to sprains and fractures; tea used to treat diabetes

Used as aperitif, analeptic, general tonic, an infusion of the leaves and the fruits of milo (Thespesia populnea) and nonu (Morinda citrifolia) used to treat abdominal swellings and urinary tract infections, for general body growth of babies, sea sickness Flowers, bark, and leaves used to treat a variety of internal ailments such as bronchitis, he’a ailments, and cirrhosis of the liver

Anti-fungal agent; grated leaves and seed mixed with coconut cream to treat burns, wounds and ringworm

One of the ancient medicinal plants of the Pacific used for treating sprains, wounds, bruises, infant rashes and skin infections Leaf juice dripped onto cuts to prevent tetanus

Leaves rubbed on bee stings and in common use for bleeding cuts

Leaf juice used to treat cuts, boils, and swollen eyes

Leaf infusion applied to several kinds of inflammations

Conjunctivitis

Sap or bark sometimes applied to stonefish and insect stings

Anti-tussive; bark infusion in common use to treat diabetes and hypertension

Leaves with coconut oil used for dermal sores

Niue

Used in Polynesia and Micronesia

Used in most of Polynesia and Micronesia

FSM, Niue, Samoa, Tonga

Cook Islands, Samoa, Tonga

Cook Islands, Fiji, Niue, Palau, Samoa

Cook Islands, Niue, Tonga

Fiji, Samoa, Tonga

Fiji, Palau, Tonga

Cook Islands, Fiji, Kiribati, Samoa, Tonga

Niue, Kiribati, Samoa, Solomon Islands, Tonga

Fiji, FSM, Samoa

Medicinal plants in the Pacific Islands 907

Combretaceae Terminalia catappa

Mammea odorata

Clusiaceae Calophyllum inophyllum

Casuarinaceae Casuarina equisetifolia

Cassythaceae Cassytha filiformis

Caricaceae Carica papaya

Capparaceae Crataeva speciosa

Brassicaceae Rorippa sarmentosa

Tournefortia argentea

Botanical Name

Table 1. (Continued)

Bark

Bark, leaves (with coconut oil), fruits

Chuuk – lifaus; Namoluk – lifaus; Pohnpei – lu´was; Ulithi – lı¨fo¨s, Woleai – livaus; Yap -lubdol (islands of FSM)

Fiji – tavaola; Chuuk – asas, Pingelap – tepuup, Pohnpei – dipwoapw (islands of FSM); Palau – mia; Samoa – talie; Tonga – telie

Leaves

Bark

Stem, whole plant

Bark, leaves, flowers, seeds

Bark, leaves

Cook Islands – tamanu; Fiji – te ital; Chuuk – re´kiic; Yap – biyuch (islands of FSM); Kiribati – te ital; Palau – aptahas; Samoa – fetau; Tonga – feta’u

Cook Islands – toa; Ulithi – lach; Woleai – laash; Yap – nach (islands of FSM); Samoa – toa; Tonga – toa

Chuuk – anaw; Satawal – tig; Ulithi – ulol; Woleai – ifaluk; Yap – buk (islands of FSM)

Chuuk – kippwau¨; Namoluk – moniap; Pingelap – kaineap (islands of FSM); Kiribati – te babaia; Palau – babai; Samoa – esi; Tonga – lesi; Tuvalu – olesi

Chuuk – afuch; Pohnpei – apoot; Puluwat – yafuur; Satawal – afur; Ulithi – abwuch, Woleai – Yafuch; Yap – abeech (islands of FSM); Palau – adepsum; Sonsorol – xalifat (island of Palau)

Leaves

Bark, leaves

Kiribati – te ren; Samoa – tausuni; Tonga – touhuni

Samoa – toatoa’enua; Tonga – a’atasi

Plant part(s) used

Local Name (in italics) in Pacific Island states

Bark infusion used to treat coughs and buccal infections

Crushed leaves in water often used to treat sore eyes and as a Ôghost medicineÕ in baths or steam baths; oil from the seed – an ingredient of ÔTongan oilÕ is used in massage Used as a demulcent; bark is used to treat ‘wakh’ or Ôbad veins.Õ Leaves are used to treat pains of bruises

Bark infusion used to treat mouth infections stomach aches, and as an emetic to rid the throat of phlegm

Analgesic, antispasmodic; stem infusion used to treat haemorrhoids and diarrhoea; in convulsions (ira uti) of infants

Young seeds swallowed to treat diarrhoea; leaves are heated and applied externally to the chest or side to relieve pain; fumes of heated bark shavings are sniffed to relieve pain. Infusion of male flowers (yellow in colour) taken as an anti-emetic

Analgesic, antiseptic, stomach ache, sarcoma, leprosy, and gonorrhoea

One of the favorite Samoan medicinal herbs, commonly used to treat inflammations, ‘ila’, ailments of babies, eye problems, and Ôghost sicknessÕ Leaf infusion occasionally used as a bath for haemorrhoids

Anti-emetic, anti-inflammatory, rubefacient; leaf infusion taken to treat food poisoning

Medicinal uses

Fiji, FSM, Palau, Niue, Samoa, Solomon Islands, Tonga, Tuvalu

FSM

Cook Islands, Fiji, FSM, Kiribati, Niue, Samoa, Solomon Islands, Tonga, Tuvalu

Used on most Pacific Islands

Cook Islands, Fiji, FSM, Niue, Samoa, Tonga

Abundant throughout the Pacific Islands

FSM, Palau

Cook Islands, Fiji, FSM, Niue, Samoa, Tonga

Kiribati, Samoa, Tonga

Pacific Island countries

908 Edgar J. DaSilva et al.

Palau – ukureralip; Yap – rurudai (island of FSM)

Phyllanthus amarus

Decoction of stem and leaves is consumed to treat arthritis, and to cure gonorrhoea and haemorrhoids

Leaves applied to the skin to treat arthritis, fever and rheumatism; bark infusion used to treat inflammations and rashes

Leaves, bark

Stem, leaves

Juice from crushed leaves used to treat stomach ache, ear infections and wound healing

Bark, leaves

Chuuk – kuruwen; Yap – bith (islands of FSM); Palau – abdel; Samoa – Tonga – loupata lau papata; Tonga – lepo, lepohina

Macaranga carolinensis

Ricinus communis

Leaves used to treat stomach ache of infants, and ailments believed to be caused by the unclosed fontanel (mavae ua) of babies (soft spot of the skull in infants)

Leaves

Bark or leaf infusion used to treat mouth infections, skin inflammations, and stomach ache

Cook Islands – tuitui pakarangi; Tonga – fiki

Bark, leaves

Jatropha curcas

Chuuk – efo00r (island of FSM); Palau – agoma; Samoa – masame; Tonga – malolo

Bark

Chuuk – ausus; Yap – bat (islands of FSM); Palau – ayas

Excoecaria agallocha

Glochidion ramiflorum

Bark or young leaves used to treat mouth infections in infants

Leaves, bark

Cook Islands – koka; Fiji – koka; Samoa – o’a; Tonga – koka; Vanuatu – koka

Bischofia javanica

Used as a laxative

Leaf infusion used to treat mouth infections in infants

Bark is used as an ingredient in decoctions for treating stomach ache

Leaves

Bark

Fruit pulp is used as purgative

Infusion of leaves or stems often taken as a purge; Milky juice of the plant is used in poultices of plant leaf to treat wounds (fractures) Crushed leaf juice is used as an anti-bilious and a wound cicatrizing agent; leaves are used to treat measles; crushed stem is used to treat wounds (fractures)

Anti-diarrhoeic; anti-(amoebic) dysentery agent

Cook Islands – tuitui; Fiji – lauci, sikeci; Samoa – lama; Tonga – tuitui

Euphorbiaceae Aleurites moluccana

Tonga – kanume

Ebenaceae Diospyros elliptica

Fruit

Stem, leaves

Chuuk – ruke; Namoluk – rokurok; Pohnpei – o¨mp; Satawal –raiwal; Ulithi – chawel; Woleai – chaiwel (islands of FSM)

Cook Islands – ‘ue

Milky latex

Bark, leaves

Palau – oriyemad; Tonga – fue’ae puaka

Samoa – talie; Tonga – telie

Cucurbitaceae Lagenaria siceraria

Ipomoea littoralis

Convolvulaceae Ipomoea indica

Terminalia samoensis

FSM, Palau

Fiji, Tonga

FSM, Palau, Samoa, Tonga

Cook Islands, Tonga

FSM, Palau, Samoa, Tonga

FSM, Palau

Cook Islands, Fiji, Niue, Samoa, Solomon Islands, Tonga, Vanuatu

Cook Islands, Fiji, Niue, Papua New Guinea, Samoa, Tonga

Tonga

Cook Islands

FSM

Fiji, Palau, Tonga

Samoa, Tonga

Medicinal plants in the Pacific Islands 909

Lythraceae Pemphis acidula

Geniostoma rupestre

Loganiaceae Fagraea berteroana

Ocimum tenuiflorum

Lamiaceae Ocimum basilicum

Hernandiaceae Hernandia nymphaeifolia

Bark

Bark

Cook Islands – ma’ame; Niue – sese; Samoa – taipoipo; Tonga – te’epilo’a

Chuuk – engi, Namoluk – chekis; Pohnpei – ngi (islands of FSM); Kiribati – te ngea; Tonga – ngingie; Tuvalu – gigie

Bark

To treat diarrhoea

Bark infusion used as a purge for stomach ache

Bark infusion often taken to treat improperly healed internal injuries (kafo)

Leaves and flowers along with turmeric used as an anti-diarrhoeic; antipyretic; expectorant, and as a cicatrizing agent; and also to treat bruises, sinusitis and fever

Leaves, flowers

Sacred Basil Satawal – taipwo; Ulithi – warong; Woleai – warung, Yap – lamar (islands of FSM)

Cook Islands – pua; Fiji – bua; Samoa – pua lulu; Tonga – oua tonga

A favourite medicinal herb used for urinary tract infections and as a remedy for headache

Anti-rheumatic, anti-bilious and embolic agent; used to treat swelling of joints, stomach ache, and to facilitate childbirth

Anti-bilious, anti-diarrhoeic agent fruits are used to make eye drops to relieve pain of itchy eyes

Leaves

Bark, leaves

Stem, bark, leaves, fruits,

Bark scrapings used to treat burns, and as an infusion to treat diarrhoea of infants

Root decoction mixed with coconut oil is spread onto prurigo – affected skin to relieve itch; to exterminate crab lice and ringworm

Bark infusion often used with mohoko (Cananga odorata) to treat stomach ache

Medicinal uses

Cook Islands – miri

Fiji – pipi; Kiribati – te bingibing; Samoa – piki; Tonga – puko; Tuvalu – puka

Ant – eenut; Chhuk – no¨t; Namoluk – net; Pingelap – rame´k; Pohnpei – inuk; Satawan – nu¨t (islands of FSM); Kiribati – te mao; Palau – gorai; Samoa – to’ito’i; Tonga – ngahu; Tuvalu – gasu

Bark

Cook Islands – i’l; Kiribati – te ibi; Samoa – ivi; Tonga – ivi

Inocarpus fagifer

Goodeniaceae Scaevola taccada

Root

Chuuk – wu´u´p; Yap – yubu (islands of FSM); Palau – dup dub

Derris elliptica

Plant part(s) used

Bark

Local Name (in italics) in Pacific Island states

Cook Islands – ‘atae; Fiji – drala dina; Chuuk – paar; Yap – raal (islands of FSM); Samoa – ngatae; Tonga – ngatae

Fabaceae Erythrina variegata

Botanical Name

Table 1. (Continued)

In some Pacific Islands

Cook Islands, Niue, Samoa, Tonga

Cook Islands, Fiji, Samoa, Tonga

Fiji, FSM, Samoa, Tonga

Cook Islands

Fiji, Kiribati, Samoa, Tonga

FSM, Kiribati, Palau, Samoa, Tonga, Tuvalu

Used in parts of Melanesia and Polynesia

FSM and Palau

Used in parts of Micronesia, Melanesia and Polynesia

Pacific Island countries

910 Edgar J. DaSilva et al.

Pisonia grandis

Root Inner bark, young leaves

Cook Islands – tiare moe

Kiribati – te buka; Palau – mesbesebe; Samoa – pu’avai; Tonga – puko; Tuvalu – pukavai

Young leaves and inner bark used as abortifacient

Infusion of grated root used for anal thrush in infants

Bark infusion is used to treat mouth infections, and abdominal aches and ailments

Bark

Cook Islands – la’ika; Fiji – kaviaka; Chuuk – faniap; Woleai – faliap; Yap – arifath (islands of FSM); Samoa – nonu fi’afi’; Tonga – fekika kai

Syzygium malaccense

Nyctaginaceae Mirabilis jalapa

Steam from boiling leaves inhaled for colds and congestion

Leaves

For gonorrhea, ten young leaves are mixed with ten young leaves of Piper betle and eaten raw

Fruits used in remedies for liver problems; inner bark infusion used for eye ailments

Bark infusion used to treat a baby cheek rash (palakea); milky sap used to treat boils; bark used in remedy for relapse sickness (kita)

Leaves commonly used in a steam bath for treating headache

Tonga – pulukamu

Leaves

Roots, bark fruits

Cook Islands – mati; Fiji – nunu; Chuuk – aaw; Woleai – giliao; Yap – aou (islands of FSM); Tonga – masi’ata

Palau – agaseel; Yap – arfath ni pan (island of FSM)

Leaves, bark

Cook Islands – kuru; Fiji – uto; Pohnpei – me´ynawe, Ulithi – maai; Yap – thow (islands of FSM); Palau – amudu; Samoa – ‘ulu; Tonga – mei

Leaves

Bark

Fiji – mulo mulo; Samoa – milo; Tonga – milo

Tonga – mo’ota

Used as an ecbolic, anti-diarrhoeic, and an anti-haemorrhagic; sap from bark used to treat eye ailments and stomach ache; running ears; young leaves with terminal buds used to relieve pain after childbirth; powdered terminal buds are used to treat ankle and wrist sprains

Young leaves, mucilage,

Cook Islands – ‘au; Fiji – vau; Chuuk – sapwo, Kosrae – lo; Pohnpei – kalau; Palau – aramal; Samoa – fau; Tonga – fau

Bark infusion used to treat mouth infections, stomach ailments, and diarrhoea in infants

Crushed leaves applied to boils, inflammations; leaf infusion used to treat postnatal relapse sickness (failele gau); an infusion of flowers with or without leaves is given as an anti-pyretic to babies; flower infusion reportedly used to induce abortion

Leaves

Cook Islands – kaute’enua; Yap – kokoris (island of FSM); Niue – kause; Samoa – ‘aute Samoa; Tuvalu – aute

Eucalyptus spp.

Myrtaceae Eugenia reinwardtiana

Ficus tinctoria

Moraceae Artocarpus altilis

Meliaceae Dysoxylum forsteri

Thespesia populnea

Hibiscus tiliaceus

Malvaceae Hibiscus rosasinensis

Kiribati, Palau, Samoa, Tonga, Tuvalu

Cook Islands

Used in most Pacific Islands

Tonga

FSM, Palau

Frequent use in some Pacific Islands

In many Pacific Islands

Tonga

Cook Islands, Fiji, Samoa, Solomon Islands, Tonga

Cook Islands, Fiji, FSM, Niue, Palau, Samoa, Tonga, Tuvalu

Cook Islands, Fiji, FSM, Niue, Samoa, Tuvalu

Medicinal plants in the Pacific Islands 911

Ancient medicinal plant once used to treat rashes (he’tube) but now replaced in their uses by Hydrocotyle asiatica (see above under Apiaceae) Bark infusion used to treat stomach ache, and crushed leaves to ease bruise pain Young fruit used to treat mouth infections of children; infusion of bark or leaves used to treat stomach ache; leaves applied to boils

Leaves

Bark, leaves

Leaves, fruits

Cook Islands – to’etupou; Niue – tono; Samoa – togo; Tonga – tono

Ant – mohosor; Chuuk – mosor; Pingelap – eles (islands of FSM); Palau – belou; Samoa – puapua; Tonga – puopua; Tuvalu – uli

Cook Islands – nono; Fiji – kura; Chhuk – nobur; Kosrae – noni; Pohnpei – nen; Yap – maglyel (islands of FSM); Kiribati – te non; Palau – ngel; Samoa – nonu; Tonga – nonu

Geophila repens

Guettarda speciosa

Morinda citrifolia

Bark infusion dripped into the mouth, nose, and eyes for treating Ôghost sicknessÕ (nightmares, dizziness)

Bark

Cook Islands – tiare maori; Niue – siale tafa; Samoa – pua Samoa; Tonga – siale Tonga

Gardenia taitensis

Bark (in conjunction with skin of betel nut and sprouts of Schizostachyum and coconut milk) is used to cure tuberculosis; a decoction of young leaves is drunk for syphilis

Leaf infusion given to a woman suffering from postnatal relapse sickness (failele gau)

Bark, leaves

Leaves

Kosrae – la

Bark decoction used to treat abdominal ailments (kahi)

Infusion of grated root taken for back and stomach aches, urinary tract infections; crushed leaves rubbed onto insect and poisonous fish stings, centipede bites, and skin inflammations

Root, leaves

Bark

Leaf infusion used to treat inflammations

Leaves along with coconut toddy is used to treat cough

Sap from crumpled young leaves used with minor wounds; for larger wounds, leaves of Vittaria incurvata are added and the pressed out juice is applied

Medicinal uses

Leaves

Samoa – toi; Tonga – toi

Samoa – ‘ava’ava aitu; Tonga – kavakava’ulie Cook islands – ‘ava; Fiji – yagona; Niue – ‘ava; Samoa – ‘ava

Leaves

Leaves

Plant part(s) used

Yap – gasmatz (island of FSM); Palau – kelmusu

Rubiaceae Aidia cochinchinensis

Colubrina asiatica

Rhamnaceae Alphitonia zizyphoides

Piper methysticum

Piperaceae Macropiper puberulum

Satawal – walima; Ulithi – walemokh; Woleai – walimog; Yap – walmog (islands of FSM)

Palau – emgurus

Oxalidaceae Averrhoa bilimbi

Papilionaceae Canavalia cathartica

Local Name (in italics) in Pacific Island states

Botanical Name

Table 1. (Continued)

Widely used in most Pacific Islands

Fiji, FSM, Palau, Samoa, Tonga, Tuvalu

Cook Islands, Niue, Samoa, Tonga

Cook Islands, Fiji, Niue, Samoa, Tonga , Tuvalu

FSM, Palau

FSM

Fiji, Samoa, Tonga

Wide use in many Pacific Islands

Samoa, Tonga

FSM

Cook Islands, Fiji, Niue, Palau, Samoa, Tonga

Pacific Island countries

912 Edgar J. DaSilva et al.

Bark

Leaves

Bark

Samoa – aloalo vao; Tonga – monomono’ahina

Niue – moea kula; Samoa – matalafi; Tonga – olavai

Niue – moea kula; Samoa – matalafi; Tonga – olavai

Mussaenda raiateensis

Psychotria insularum

Tarenna sambucina

Solanaceae Capsicum frutescens

Scrophulariaceae Limnophila fragrans

Santalum austracaledonicum Sapindaceae Pometia pinnata

Satawal – amuek; Ulithi – much; Woleai – mwech; Yap – debil (islands of FSM)

Leaves

Leaves

Bark

Fiji – dawa moli; Niue – tava; Samoa – tava

Cook Islands – mapua; Samoa – tamole vai

Plant

Sandalwood

Leaves

Niue – uhi; Samoa – usi; Tonga – uhi

Euodia hortensis Plant

Leaves

Kiribati – te aoranti; Samoa – moli’aina; Tonga – moli inu

Citrus sinensis

Fiji – yasi; Tonga – Ahi a’i

Fruits

Palau – depper; Samoa – moli tipolo; Tonga – lemani

Citrus limon

Santalaceae Santalum insulare

Fruits

Kiribati – te raim; Samoa – tipolo, moli tipolo; Tonga – laimi, moli laimi; Tuvalu – taim

Rutaceae Citrus aurantifolia

Leaves, fruits

Yap – bech (island of FSM); Palau – ereiroi

Mussaenda frondosa

Crushed leaf juice used to treat boils and inflammations (kulokula)

Leaf infusion used in treatment for haemorrhoids and wounds

Bark decoction used to treat abdominal ache and ailments (kahi); and given as an emetic to clear the throat of phlegm in mouth infections

Powdered wood in coconut oil used in body massage; wood scent used in head massage to relieve earaches or headaches, and treat skin infections Used in pharmaceutical and cosmetic preparations

Leaves (often with breadfruit bark) made into a decoction for treating relapse sickness (kita) Leaf infusion used to treat headache

Lemon juice mixed with eggs, milk or sugar used as cough and sore throat remedy

Lemon juice used in remedies for dysentery and a variety of other ailments

Decoction from bark is used to treat to treat children’s fever and stomach ache

Leaves of widely known plant whose leaves are used alternative or Ôghost medicinesÕ

Bark infusion used to treat breast-fed (fe’ea) baby affected by its mother whilst pregnant

Eight new green leaves and eight fruits are crushed together and taken together with a cup of water as an emetic; young fruit juice taken with water used to treat gonorrhoea

Fiji, FSM, Niue, Samoa, Solomon Islands, Tonga

Cook Islands, Samoa

Fiji, Niue, Samoa, Tonga

Vanuatu

Fiji, Tonga

Fiji, Niue, Samoa, Tonga

Cook Islands, Fiji, Kiribati, Niue, Samoa, Solomon Islands, Tonga

Palau, Samoa, Tonga

Kiribati, Samoa, Tonga, Tuvalu

Fiji, Niue, Samoa, Solomon Islands, Tonga

Fiji, Niue, Samoa, Tonga

Fiji, Samoa, Tonga

FSM, Palau

Medicinal plants in the Pacific Islands 913

Stem, leaves

Leaves

Cook Islands – rara; Yap – gillieui (island of FSM); Niue – lala sea; Samoa – namulega; Tonga – lala tahi

Vitex trifolia

Yap – sesemtenimen (island of FSM); Palau – perdakl

Leaves

Niue – aloalo; Samoa – aloalo; Tonga – volovalo; Tuvalu – aloalo

Premna serratifolia

Vitaceae Cayratia trifolia

Leaves

Cook Islands – tataramoa; Tonga – talatala; Samoa – latana

Lantana camara

Bark, fruits

Whole plant

Leaves

Chuuk – ansitfitnu; Pingelap – ne-kirri-r; Pohnpei – sau mwal; Satawal – afelefelegech; Ulithi – hafalfal; Woleai – gufalfal, hafalifal; Yap – yoyol (islands of FSM); Sonsorol – hafarefare (island of Palau) Cook Islands – ‘oronga, Fiji – roga; Samoa – soga; lausoga, Tonga – ‘olonga

Roots

Leaves

Cook Islands – poro, poroporo; Niue – polokai; Samoa – magalo; Tonga – polokai

Yap – rap (island of FSM); Palau – lap

Plant part(s) used

Local Name (in italics) in Pacific Island states

Butterfly pea Cook Islands – aloalo tai; Chuuk – apuech; Ifaluk – gabwi; Pingelap – ilau; Pohnpei – ula; Satawal – aupui; Ulithi – habwi; Woleai – gabwi; Yap – laruch (islands of FSM); Anguar (island in Palau) – kellel-lap-ni; Palau – umberet

Verbenaceae Clerodendrum inerme

Pipturus argenteus

Urticaceae Laportea ruderalis

Sterculiaceae Abroma augusta

Solanum americanum

Botanical Name

Table 1. (Continued)

Aphrodisiac

Leaf infusion used to treat mouth infections

Leaf infusion used to treat inflammations (kulokula)

Leaf sap applied along with one’s own saliva to fresh wounds to stop the bleeding

Crushed leaves used for wounds and punctures; and to treat ringworm

Ground plant is mixed with coconut oil is applied to boils; pounded plant is wrapped inside the membranous petiole base of the coconut and used as poultice for painful joints and swollen legs Bark commonly used as a tonic; fruits used as a mild laxative

Juice from roots crushed with leaves of Cayratia trifolia and copra are diluted with water and drunk as a potion to cure gonorrhoea; root sap is used as an aphrodisiac

Pounded or chewed leaves applied to wounds, cuts, and abrasions to promote healing; leaves often eaten or brewed into a tea remedy for coughs and sore throat; crushed leaves, with or without coconut oil, applied around boils

Medicinal uses

FSM, Palau

Cook Islands, Fiji, FSM, Niue, Samoa, Solomon Islands, Tonga

Niue, Samoa, Tonga, Tuvalu

Cook Islands, Samoa, Tonga

Cook Islands, FSM, Palau

Cook Islands, Fiji, Samoa, Tonga

FSM, Palau

FSM, Palau

Cook Islands, Niue, Samoa, Tonga

Pacific Island countries

914 Edgar J. DaSilva et al.

Leaves, stem

Leaves, bracts

Leaves

Giant Taro Chuuk – kka´; Ifaluk – file; Lamotrek – file; Ulithi – foleregion; Yap – lai (islands of FSM)

Giant Swamp Taro Chuuk – pwuna; Ifaluk – pulax; Lamotrek – bulokh; Satawal – pula; Ulithi – bwolokh; Woleai – bulag; Yap – lak’ (islands of FSM)

Yap – gumoy (island of FSM); Palau – toilal

Araceae Alocasia macrorrhiza

Cyrtosperma merkusii

Epipremnum carolinense

Cyperaceae Kyllinga nemoralis

Cocos nucifera

Arecaceae Areca catechu

Leaf sap used to treat burns, and sometimes taken to treat stomach ache

Leaves

Leaves

Ancient medicinal plant used to treat sprains and contusions, now used in remedies for wide variety of ailments

Water from ‘oviri nut often used as a liquid medium for medicines; oil from copra used in massage and as a purge; roots used in a variety of remedies Coconut cream commonly used in massage Water from a tender coconut is used as an anti-flatulent and anti-diarrhoeic agent; and as a galactagogue; young petioles of the red coconut variety is used for treatment of gonorrhoea

Root, bark, petiole, endosperm, oil

Coconut palm Cook Islands – niu; Fiji – niu; Chuuk – nu; Pohnpei – ni nih; Ulithi – lu (islands of FSM); Kiribati – ten e; Niue – niu; Palau – arius

Samoa – tuise; Tonga – pakopaka

Pounded buds along with buds of coconut are used to treat rheumatism and arthritis

Buds

Arecanut Palm

Juice from leaves crushed with those of Costus speciosus with coconut milk is taken as remedy for tuberculosis

Roasted leaves are placed onto bruises as an emollient Sap from bracts is used as remedy against intestinal parasites

For rat bite, crushed bud and leaves are applied to the affected part Sap from crushed stem is used as an aphrodisiac

Leaves are used in the treatment of rheumatism and centipede bites

Leaves

Flowering plants: Monocotyledons Amaryllidaceae Hymenocallis littoralis Spider lily Chuuk – sip; Fais – ropig; Ifaluk – giop; Namoluk – kiop; Pohnpei – kiop; Puluwat – kiyopw; Satawal – lirio; Ulithi – mochingel spaiol; Woleai – giop; Yap – giup (islands of FSM); Sonsorol – kisop (island of Palau) Agavaceae Aloe vera Cook Islands – cactus; Tonga – aloe

Samoa, Tonga

Aboriginals credited with its introduction in to Papua New Guinea and the Solomon Islands, later into Fiji, Samoa, and Micronesia In use in all Pacific Islands

FSM, Palau

Widespread in Pacific region

Widespread in Pacific Islands

Tonga, Cook Islands

FSM, Palau

Medicinal plants in the Pacific Islands 915

Taccaceae Tacca leontopetaloides

Saccharum officinarum

Poaceae Cymbopogon citratus

Pandanacaceae Pandanus tectorius

Orchidaceae Nervilia palawensis

Root, tubers

Root starch taken internally to treat diarrhoea and dysentery, used as application to stop wounds bleeding; root starch mixed with coconut oil is used as a laxative, and as a skin ointment for sores and burns

Leaf ash mixed with coconut oil used to treat burns

Leaves

Chuuk – wow; Mokil – tu; Namoluk – uou; Pingelap – seu; Pohnpei – sehu; Puluwat – woow; Ulithi – ma¨kı¨l; Woleai – wo, wou (islands of FSM)

Chuuk – mwe´kumwe´k; Ifaluk – mogmog; Ulithi – mogmog; Yap – chabchab (islands of FSM)

Leaf decoction used to treat mouth infections

Juice from aerial root mixed with grated coconut and turmeric is used to treat sores; juice from young leaves with leaves of Messerschmidia argentea is used to stop vomiting in children; bark is used to treat thilfekh, pain in the chest

Pressed root juice is used to treat eye infections

Leaves

Roots, bark, young leaves

Root tubers

Stems or root sap used to treat thrush; sap from flower buds used to make a tonic Pulp of fruit applied to inflammations and rashes Juice of stem and leaves is drunk in treatment for gonorrhoea; the accumulated sap from cut stems is used for tuberculosis

Green juice from young leaves is diluted with water and used as an eye wash

For insect bite

Medicinal uses

Samoa – moegalo; Tonga – moengalo

Cook Islands – ‘ara; Fiji – vadra; Samoa – fasa, fala; Tonga – lau fala, fala

Palau – tirimofon

Stem, leaves

Musa sp.

Stem, roots

Leaves

Young plant (with leaves of Bulbophyllum)

Plant part(s) used

Fruit

Cultivar names vary with islands Cook Islands – meika; Fiji – vudi mai’a; Samoa – fa’i; Tonga – fusi

Yap – rich (island of FSM); Palau – asis

Wild Yam Fiji –sarau; Niue – hoi; Palau – belloi; Samoa – soi

Local Name (in italics) in Pacific Island states

Musa x paradisiaca

Musaceae Musa nana

Liliaceae Cordyline fruticosa

Dioscoreaceae Dioscorea bulbifera

Botanical Name

Table 1. (Continued)

Fiji, FSM, Niue, Samoa, Solomon Islands, Tonga, Tuvalu

FSM, Samoa

Samoa, Tonga

Cook Islands, Fiji,, Samoa, Tonga

Palau

Used in all Pacific Islands

Used in all Pacific Islands

Used in all Pacific Islands

FSM, Palau

Use in most Pacific Islands

Pacific Island countries

916 Edgar J. DaSilva et al.

a

Oak leaf fern Chuuk – sochin; Fais – chichi; Mokil – kamkam; Namoluk – chichi; Pingelap – kitiu; Pohnpei – kietu;Yap – gob (islands of FSM); Palau – aba a´b

Adapted from Defilipps et al. (1988) and Whistler (1994).

Polypodiaceae Polypodium scolopendria Fronds

Leaves

Rhizome

Cook Islands – ‘kapua’I’enua; Niue – poloi; Samoa – avapui; Tonga – angoango

Zingiber zerumbet

Kosrae – taime; Yap – gob (islands of FSM); Palau – dermulm

Rhizome

Yap – yoi (island of FSM); Samoa – fiu

Zingiber officianale

Ferns Marattiaceae Angiopteris evecta

Rhizome

Chuuk – a¨fa¨n; Ifaluk – angorlik; Pohnpei – ong; Ulithi – guchol; Yap – guchol (islands of FSM)

Zingiberaceae Curcuma longa

Infusion leaves are used to treat meselpikhI, a kind of cold believed to be caused by a magical influence; used for wound healing, to relieve pains after childbirth.

Used to counteract ptomaine poisoning

Infusion from grated rhizome used to treat stomach ache and internal ailments; grated rhizome mixed with kava taken for treating backaches Infusion of grated rhizome used to treat stomach ailments and mouth infections

Powdered rhizome applied often with root sap of Pandanus and grated coconut, to sores and rashes

FSM, Palau

FSM, Palau

Cook Islands, Fiji. Niue, Papua New Guinea, Samoa, Tonga

FSM, Samoa

FSM

Medicinal plants in the Pacific Islands 917

918

Edgar J. DaSilva et al. Pacific island medicinal plants and intellectual property rights

Figure 2. Frequency of usage of medicinal plants components in traditional medicinal practice.

descendents reveals the existence of traditional knowledge and a priceless heritage which has been bequeathed from generation to generation through unwritten pharmacopoeias in these two communities. Governmental foresight and action has ensured against loss of this heritage of bush medicine3 of national significance as the numbers of the descendents of these communities decrease and succumb to the customs, pressures, and vicissitudes of the globalizing occidental lifestyle. Rongoa Maori or Maori plant-based medicines have been researched as a resource for skin balms and essential oils. One such example is manuka (Tairawhiti Pharmaceuticals Ltd. 1999). An example of the value and appreciation of this accumulation of traditional knowledge is to be found in the posted injunction ‘Warning: Aboriginal people have expert knowledge about plants. Some of the plants listed here are poisonous unless treated properly’ carried in a museum information sheet concerning aboriginal plant use in current times (Museum Victoria 2001). Some traditional plants used in Aboriginal and Maori native plant-base medicine are listed in Table 3. There are elements of similarity in the philosophies underlying the practices of Aboriginal and Maori plantbased medicines. The aim of Aboriginal medicine was to protect, conserve and sustain Aboriginal human health resources through the use of medicinal plants and herbal remedies and to rid the body of evil spirit either through massage (mirimiri) or suction by either tribal men or women ‘doctors’. In the case of Rongoa herbal (Maori) medicine the medicinal doctors or tohunga played an intermediary role in spiritual prayers (karakia) to the gods (atua) since the spiritual dimension (taha wairua) occupied an anchoring role in the maintenance of the mental (hinengaro) and physical (tinana) wellness of a Maori being. Most health discomfort and illnesses like in ancient Indian culture resulted from a major deficiency in spiritual health (wairua).

3

A rather extensive bibliography of bush-foods, bush-medicines and aboriginal and traditional uses of Australian native plants has been prepared by the Australian National Botanical Gardens with the support of the Department of the Environment and Heritage, Australian Government (http://www.anbg.gov.au/bibliography/bushfood.html).

In the Pacific region the majority of the people still rely, like their ancestors did, directly on the rich biodiversity of Pacific plants for their food and medicine. There is an abundance of local knowledge and expertise pertaining to plant genetic resources that has been in use over a considerable period of time and which is in constant evolution and upgrading. Traditional knowledge is people’s awareness at the communal, rural and village levels of society of their natural plant capital and its bioeconomic and biomedical significance in the sustenance of the quality of their daily existence. In brief, traditional knowledge generated and accumulated through years of observation, practice and skills in accepting and rejecting plant species as food and medicine is traditional intellectual property. Traditional knowledge provides useful leads for scientific research. Examples are Leptospermum scoparium a source of the skin healthcare product manuka and the Madagascar periwinkle Catharanthus roseus, that yielded the anticancer agents vinblastine and vincristine. Global annual sales of products derived from tapping of genetic resources lie between US$ 500 and US$ 800 billion annually (Kate & Laird 2002). Furthermore, ‘sales of herbal medicine alone are estimated to have exceeded US$ 12.5 billion in 1994 and US$ 30 billion in 2000, with annual growth rates averaging between 5 and 15%, depending on the region’ (International Trade Forum 2001). Indeed, there is no doubt that such traditional knowledge, denied elsewhere as a constituent component comprising ancient and modern intellectual heritage, legacy and property is very valuable and therefore in need of safeguards against commercial and market forces. It is the indisputable key to identifying therapeutic principles within a plant whose pharmacological value can then be commercialized for international markets (Table 4). In the Pacific islands, access to traditional knowledge is unhindered and, more often than not, made available through the age-old principles of goodwill and trust. Biosearching resources of biodiversity for the development of education and knowledge have given way to bioprospecting for the advancement of pharmaceutical biodiversity and financial markets of new medicines for the curtailment and treatment of new diseases. As a consequence, and in comparison to the overall market earnings of the bioprospected product, ultimate returning benefits to the Pacific island communities are of a far lower order than that which would have resulted had access and benefit-sharing been negotiated within the framework of a mutually agreed-upon legal framework. ‘Bioprospecting is synonymous with exploitation’.4 Kava and Nonu are two well-known examples of products of medicinal plants that have been the subjects of bioprospecting research elsewhere in the northern 4

See UNESCO (2002) for details.

Helps lower cholesterol and prevents blood clots Rich in iodine Used to treat goitre Possesses mild laxative effect Rich in folic acid, and vitamins A, B1 and C Used as preventive medicine for heart disease Source of vitamin A; Used to treat intestines infested with worms

Good source of vitamins A, B2, C, iron, calcium and micronutrients; Used as a laxative and general body tonic Possesses calcium, iron, iodine, folicacid and alginates; used to prevent heart disease; and during pregnancy Used in lowering of cholesterol, inheart stroke treatment and against diarrhoea Rich in calcium, iron, iodine and vitamins A, B and C; Used as an anti-worm medicine; and in the healing of burns

Lumi karokaro (Fiji); Kirokiro (Vanuatu)

Limu kohu (Polynesia); limu moui (Tonga)

Nama (Fiji);Limu fu fua (Samoa, Tonga); Rimu kai (in Maori medicine) Limu tanga’u (Tonga)

Totoyava (Fiji)

Lumi yara (Fiji)

Rimu orna (Maori reserves)

Lumi vakalol (Fiji)

Rimu miti (Polynesia)

Acanthophora

Asparagopsis taxiformis

Caulerpa racemosa

Codium

Gracilaria

Halydroclathrus

Hypnea

Ulva

a

Adapted in part from Novaczek (2001).

Cladosiphon

Callophycus serratus

Health benefits and properties

Pacific name

Botanical generic or species name

Table 2. Medicinal sea plants of the Pacific Islands.a

Cook Islands, Fiji, Kiribati, Micronesia and Tonga Used as a folk medicine to treat gout

Cook Island, Fiji, Marshall Islands, Micronesia, Samoa, Solomon Islands, Tonga, Vanuatu Hypnea is currently being screened as a source of anti-tumour agents

Cook Island, Fiji, Marshall Islands, Micronesia, Samoa, Solomon Island sand Tonga

Different species reported in Cook Islands, Fiji, Micronesia, Samoa, Solomon Islands and Tonga

Found in all countries throughout the Pacific region; Bioactive compounds – a source of anti-tumour agents are known to be present in these algae, e.g. C. decortecatum

Found in all countries throughout the Pacific region Used as folk medicine for rheumatism in the Philippines Tonga Plants developed for exports to Japan and for potential foreign-exchange earnings

Fiji, Papua New Guinea, Samoa, Tonga

Kiribati, Micronesia, Samoa

Fiji, Tonga, Samoa, Solomon Islands, Kiribati, Micronesia,Vanuatu

Location and remarks

Medicinal plants in the Pacific Islands 919

Whole plant boiled

Leaves Leaves

Tarook

Be-al

Clematis microphylla

Eucalyptus camaldulensisi

Maori name

Botanical name

Leaves Plant Leaves

Bark, leaves Inner bark Leaves

Manono

Karamu

Koromiko

Manuka

Pohutukawa

Puriri

Coprosoma grandifolia

Coprosma robusta

Hebe salicifolia

Leptospermum scoparium

Metrosideros excelsa

Vitex lucens

Leaf infusions used as a sedative and for urinary problems; inner bark used in poultices for skin cuts and pains Infusion used to treat diarrhea and dysentery; Nectar from flowers is used to treat sore throats Infusion used to treat ulcers; and in steam baths to treat sore muscles and sprains

Decoction used for kidney troubles, bladder stoppage, and inflammation. Eases stomach ache and vomiting Leaf decoction used in treating ulcers, diarrhoea, dysentery, urinary problems sexually transmitted diseases

Infusion used tomake soothing tea tonic and for cleansing of sore eyes; leaves used externally for burns and boils Used as poulticesto help healing fractures and weak bones

Medicinal use

Crushed leaves and inhaled fortreatment of colds and coughs

Used to treat colds

Leaves used in aromatic steam bath for various illnesses; in treatment of diarrhoea

Leaf poultice to treat blisters and skin irritations

Infusion drunk to treat colds and used totreat skin complaints and infections

Used to treat indigestion Treatment of cuts and bites

Mixed with water to prepare a sweet drink;

Medicinal use

Also been used by New Zealand soldiers to treatgastric problems; used as a pack to treat baby skin sore Plant known to have strong antibacterial and antifungal properties Known also as New Zealand Christmas tree Also used in restoration planting

Used in Maori ceremonial culture

Known also as wineberry which used in winemaking Also known ‘knitbone’ plant

Remarks

Djab wurrung

Djadja wurrung

Lake Boga Gunditjmra Wemba Wemba Yorta Yorta Wimmera Djab wurrung Gunditjmara

Woi wurrung

Djab wurrung; Gunditjmara

Wotjobaluk; Plant extract containing essential oils used in skincare balm products for babies and adults

Djab wurrung Bungandit Gippsland Gunai/Kurnai

Gunditjmara

Used in Aboriginal language/region/clan area of

Adapted from Museum Victoria (2001) and from Rongoa Maori and other Maori Uses of Native Plants found in Aotea Harbour (www.aoteamoana.co.nz/native.html) and Tairawhiti Pharmaceuticals Ltd. (1999).

a

Leaves

Makomako

Aristotelia serrata

Maori traditional medicinal plants

Leaves

Poang-gurk

Mentha australis Plant part used

Oil

Tarrk

E. leucoxylon ‘connata’

Beeul Bial Biel Dharnya Mooerr Peeal Ta’art

Tunline Keeng Katwort Gadwud

Gukwonderuk

Carpobrotus rossii

Acacia pycnantha

Centipedia cunninghammi

Plant part used

Gum from plant and nectar from flowers; Bark Old plants

Aboriginal name

Karraank

Aboriginal traditional medicinal plants

Botanical name

Table 3. Aboriginal and Maori native medicinal plants.a

920 Edgar J. DaSilva et al.

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Medicinal plants in the Pacific Islands Table 4. Examples of traditional medicinal plants enriching allopathic medicine markets. Botanical name

Drug name

Common name

Plant part source used in treatment

Geographic origin

Cantharanthus roseus

Vinblastine

Rosy periwinkle

Whole plant used for certain cancers

Madagascar, but now grown worldwide

Citrullus colocynthis

Colocynthin(?)

Elaterin; Arabic name: Alhandal

Fruits used as source of purgative for stomach problems

In use in the Middle East since Biblical times

Pilocarpus jaborandi

Pilocarpine

Jaborandi

Leaves, roots used in treating glaucoma

Central and South America

Piper methysticum

Kwain

Kava Kava

Root drink used as Tranquilizer

Oceania

Salix alba

Salicin

White willow

Bark used asanalgesic

Europe

Rauwolfia serpentina

Reserpine

Indian snakeroot

Root bark used for circulatory disorders

Indomalesia

hemisphere (Grain & Kalpavriksh5 2002; Thorpe 2002) notwithstanding that current local Pacific products have been developed through the ingenuity of the indigenous people over several generations in hundreds and hundreds of years. Other described examples are the coral reef sponges from Papua New Guinea and the mamala trees (Homolanthus nutans). The Tuhoe tribe (the People of the Mist) of the Maori people has developed a repertoire of medicinal plants of significance that formally ‘recognizes Maori ownership of the knowledge, practical use and development of native plants used by the Tuhoe.’ In the event that any new drugs or treatments are developed and commercialized, the benefits will be shared: 40% will go to the Tuhoe representative body, another 40% will be awarded to a trust board for New Zealand’s Maori and Waikato University (the employer of the research investigator) will receive the remaining 20%. Finally, the research will specifically focus on developing treatments for chronic diseases affecting the Maori, such as diabetes, high blood pressure and asthma. This sets the project apart from the vast majority, which seek to profit from indigenous knowledge of medicinal plants without sharing financial or medical benefits (UNESCO 2002). A similar venture encompassing the sharing of financial returns is that of the University of the South Pacific, the governmental authority of Fiji, the local communities of nine villages in the Verata Tikina county on the island Viti Levu and the Strathclyde Institute for Drug Research, Scotland in the framework of a marine bioprospecting agreement (Prevost 2002). Financial returns from the analysis of the extracts from marine plants and organisms by the Scottish institute ‘on an equitable basis’ will ensure that the village 5 Kalpavriksh (KV) is a voluntary group that began working in 1979 on environmental education, research, campaigns, and direct action through a students’ campaign to save Delhi’s Ridge Forest area from encroachments and destruction. Since then Kalpavriksh has moved on to work on a number of local, national, and global issues. KV is registered under the Societies Registration Act of 1980 (No. S-17439). It is Delhi-based with an outreach unit in Pune.

communities as a whole will benefit in their efforts of conserving potential resources of plant and microbialderived therapeutic principles rather being peripheral beneficiaries. Such traditional knowledge exemplified by the traditional medical systems of the Ririo tribe of the Laura Island amongst the western Solomon Islands indicates that local practitioners of traditional medicine possessed ‘a sophisticated knowledge of human anatomy, disease states and medical treatments’ (Mozena 2001). The knowledge of traditional plants as practical and an inexpensive alternative with low-income communities (Compton 2001) can be likened to that knowledge used in the production of several varieties of rural cheese that are good examples of traditional-knowledgederived products. A major problem that the Pacific region has in protecting its genetic resources against exploitation is the lack of appropriate legal mechanisms to protect the rights of farmers and indigenous peoples. Apart from Papua New Guinea and Tonga that issued new intellectual property laws and regulations at the start of the millennium, patent laws in most Pacific island states have been carried over from the era of colonial relationships as transitional legal mechanisms into the national governance of the newly independent island states (Table 5). These mechanisms are now seemingly in need of updating given the advances made in the understanding and formulation of intellectual property rights in the past two to three decades (Forsyth 2003).6 Furthermore, no international patents have been taken out as protective measures to ensure proprietary rights of biotherapeutic and bioremedial principles present in traditional medicinal plants of the Pacific region. Several reasons have been advanced for this dysfunctional state experienced by

6

Deals with several issues of intellectual property laws – trademarks, copyright, patents, etc. in the South Pacific States; discusses also the history and rationale of intellectual property protection in the West and the South Pacific.

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Edgar J. DaSilva et al.

Table 5. National and international intellectual property right laws and policies by Pacific island countries. Pacific island States (also members of the Pacific Island Forum)

Cook Island

National activities

Party to International Environmental Agreements (+) as of December2003; and to Environmental strategies and issuance of State of Environment Reports

Patent laws and IPR activities

Biodiversity

New Zealand laws apply Fed. States of US Federal Laws Micronesia apply Fiji Enacted in 1879 with 7 updates to 1985 Kiribati Enactment of 1924 with 7 revisions up to 1977 Marshall Islands Adapted Trust Territory laws, acts of legislation and customary laws apply Nauru Patents Registration Act enacted in 1973 and amended in 1978 Niue New Zealand laws apply Palau US Federal Laws apply Papua New Guinea The Patents and Industrial Regulations 2000 approved by Legislative Council; and overseen by Intellectual Property Office of Papua New Guinea (IPOPNG) Samoa Patents Act, 1972 Solomon Islands Enactment of 1924 amended 1968 and 1978 Tonga New Industrial Property Act in effect from 2000 Tuvalu Patent law of 1924 amended in 1933; copyright act amended 1978 Vanuatu Enactment of 1924 Bill revised 1988

Climate change

Marine life conservation

Issuance of environmental Action plans

State of the art

+

+

1993

1993

+

+

1993

1993

+

+

1993

1991

+

+

1993

1994

+

+

1993

1991

+

+

+

+

+

1994

1994

+ +

+ +

+

1994 1990 (Forestry)

1994 1994

+ +

+ +

+

1993 1993

1993 1992

+

+

+

1993

1990

+

+

+

+

+

traditional knowledge holders (Grain & Kalpavriksh 2002; Pushpangadan7 2002; Thorpe 20028. However, interest in these issues exists (Table 6) as the Pacific States embark en route9 (Table 7) to safeguard7

Endangered species

Paper presented at Consultation Meeting of BIMST Countries on ‘Biodiversity Conservation and Sustainable Industrial Utilization of Medicinal Plant’ and Expert Group Meeting for the Establishment of Asia-Pacific Traditional Medicinal Network (APTMNET), Bangkok, Thailand, 20–22 May. 8 Listed amongst several other associated documents and study papers as background materials to the Report of the Commission on Intellectual Property Rights ‘Integrating Intellectual Property Rights and Development Policy’, November 2002 (2nd Edition). Publ. Commission on Intellectual Property Rights, c/o DFID, London, UK (www.iprcommission.org). 9 Examples of such interest are: (1) the Mataatua Declaration (June 1993) concerning the Human Genome Diversity project; (2) the Maori Congress of Indigenous Peoples (1993) concerning the patenting of life-forms.

1994

+

1988

ing their assets of traditional medicinal knowledge, their usage in cultural custom, ritual expression, and biodiversity resource management primarily for their own well-being and subsequently for their more well to do entrepreneurs and users elsewhere. Indeed, traditional knowledge of the environment and of the medicinal properties of plants with the accompanying philosophies and rituals mirrored in innovative practice, transmitted from generation to generation, has been the raison d’eˆtre of the cultural expressions and traits of indigenous peoples and tribes throughout the South Pacific long before the explorations of Charles de Brosses and Jules Se´bastien Ce´sar Dumont d’Urville.1 Thus, the conservation of indigenous and traditional knowledge through time has been and is a necessity (UNDP/CSOPP 2000) for the well-being of people in the industrialized societies of the Northern characterized by the industrializing communities of the South.

923

Medicinal plants in the Pacific Islands Table 6. Membership in Regional Bodies and UN Agencies vis-a`-vis medicinal plant programs. Pacific state

Cook Islands Fed. States of Micronesia Fijid Kiribati Marshall Islands Papua New Guinea Palau Nauru Niue Samoaf Solomon Islands Tonga Tuvalu Vanuatuh

Regional Agencyi

International or UN bodyj

SPARTECA

SPCa

SPF

ACP

+ + + + + + + + + + + + + +

+ + + + + + + + + + + + + +

+ + + + + + + + + + + + + +

+ + + + + + + + + + + + + +

APEC

+

FAO

WHOb

+

+

+ + + + + + + + +

+ + + + + + + + + +

+

+

WTO (TRIPS) + + ±e + ± }g + } ± }

c

UNESCO

+ + + + + + + + + + + + + +

a

Following a workshop on nature conservation (1969) and a new program for the conservation of nature (1973) of SPC (then based in Noumea, New Caledonia) evolved into the South Pacific Regional Environment Program (SPREP) in 1982 that was relocated to Apia, Samoa. SPREP became officially autonomous in 1995. Members of SPREP are: American Samoa, Australia, Cook Islands, Federated States of Micronesia, Fiji, France, French Polynesia, Guam, Kiribati, Marshall Islands, Nauru, New Caledonia, New Zealand, Niue, Northern Mariana Islands, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, United States of America, Vanuatu and Wallis and Futuna. In 1999/ 2000 the SPC and SPREP with other national and international bodies established the South Pacific Regional Initiative on Forest Genetic Resources (SPRIG) and in which medicinal plant species of economic significance are addressed (FAO 2000). b Collates data on 102 plants with medical applications in the South Pacific (WHO 1998b). c 1. None of the Pacific island states are party to the IP related treaties below: –International Convention for the Protection of New varieties of Plants (UPOV Convention)) as of January 15, 2004) –Paris Convention for the Protection of Industrial Property (as of March 2, 2004); –Patent Cooperation Treaty (as of January 15, 2004 ); –Budapest treaty on the International Recognition of the Deposit of Microorganisms for the Purposes of Patent Procedure (as of February 23, 2004). 2. Pacific Island states party to Traditional knowledge-related treaties are as: –UNESCO Convention concerning the Protection of the World Cultural and Natural Heritage (as of November 23, 2003) are: Fiji, Kiribati, Marshall Islands, Micronesia-Federated States, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Vanuatu; –None of the Pacific island states are party to the FAO International Treaty on Plant Genetic Resources for Food and Agriculture. d Proposes Draft Sustainable Development Bill (Grain & Kalpavriksh 2002). e Applicant. f Institutes and proposes domestic laws as: Intellectual Property Rights Law, 1998; Village Fono Act, 1990; Draft Environment Bill of 1999/ 2000; and Proposal on Access to Genetic Resources Regulations (Grain & Kalpavriksh 2002). g Observer. h Revision of Environment Act (Grain & Kalpavriksh 2002). i Regional Agency: (1) SPARTECA ¼ South Pacific Regional Trade and Economic Cooperation Agreement; (2) SPC ¼ South Pacific Commission; (3) SPF ¼ South Pacific Forum. j International or UN body: (1) ACP ¼ Africa, Caribbean and Pacific bloc that came into being following the adoption of the Lome´ Convention in Togo, 1975; that are members (2) APEC ¼ Asia-Pacific Economic Cooperation bloc that came into being following foundation meeting in Canberra, Australia, 1989; (3) WHO ¼ World Health Organization; (4) WTO (TRIPS) ¼ World Trade Organization (TradeRelated aspects of Intellectual Property Rights); (5) UNESCO ¼ United Nations Educational Scientific and Cultural Organization.

For the Western Pacific region there are 12 WHO Collaborating Centres for Traditional Medicine. Whereas two of these are Universities in Nanking and Shanghai, five are institutes of science and research in medicinal plants and acupuncture in Beijing. Out of the remaining five institutes, two each are based in Japan and the Republic of Korea, and one in Vietnam (WHO 2002). Perhaps by the end of the decade one will be established for the region of the South Pacific to address the needs for preservation and conservation of medicinal plant germplasm resources in the region and to provide the much needed training opportunities for the assessment of traditional medicinal applications and safety considerations in daily use.

Safety The safety and appropriateness of medicinal herbs and plants is always an issue of concern amongst medical and health professionals. Whereas there is wide acceptance of traditional plant medicine as an important complementary component of therapeutic practice, the use of plant and herbal remedies on the other hand has been questioned. Some of these concerns are the absence of scientific rigour in traditional medicine in determining the degree of effectiveness and toxicity of the remedies compared to that which is applied more strictly with allopathic medicine; the presence of substances other than that of the traditional remedy

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Edgar J. DaSilva et al.

Table 7. National Activities. Country

Activity

Remarks

Cook Islands

Proposes Pacific Gene Bank to preserve rareplant seeds and safeguards against extinction and loss of plants of economic significance Use of traditional medicine in hospitals not accepted

In: Country Report: FAO Technical Conference on Plant Genetic Resources, Leipzig 1996, p. 25 In: Report of Workshop on ‘Development of National Policy on Traditional Medicine, 11–15 October, 1999, WPRO, publ. Manila, 2000, p. 67

Fiji

WAINIMATE (see Box 3) dealing with traditional medicinal therapies engaged in drafting legislation to cover efficacy of herbal products, licensing of healers, safety,and protection of intellectual property rights of healers

In : Report of Workshop on ‘Development of National Policy on Traditional Medicine, 11–15 October, 1999, WPRO, publ. Manila, 2000, p. 67

Kiribati

68 species of the plant flora of Kiribati are issue for medicinal and ceremonial purposes inclusive of housing facilities Establishment of the Maurin Kiribati Federation

In: Kiribati State of the Environment report, ed Wilson, C., South Pacific Regional Environment Program/UNDP, Apia, p. 46 An association of traditional healers (Botaki ni Unimwane) that consults regularly with medical doctors (Ministry of Health Policy 1999–2002)a In collaboration with Ministry of Health

Establishment Medicinal nursery gardens. Concept of green health and recognition of traditional healers supported Nauru

Traditional medicine used by 60% of the population

In: WHO Regional Strategy for Traditional Medicine in the Western Pacific (2002); Manila 40 p.

Papua New Guinea

Working on national policy for access and benefit-sharing for the protection of genetic resources initiated Traditional medicine remains a form of practice not within the formal health system. Proven traditional medicines considered in National Drug Policy; Policy concerning proper use of traditional medicine to be covered in the new National health Plan (2001–2010).

Parliament approval necessary.

Local enterprise developed by Siaosi-Tinielu family ventures into export market with nonu products of medicinal and nutraceutical significance Amongst a flora of over 700 recorded plants – ferns (245 species) and flowering plants (500 species) there are some 150 traditional medicinal plants The Medical Practitioner’ Act does not permit practicing medicines a traditional healer

In: International Trade Forum Issue No. 3: (2001) LDCS – Jump Starting Trade

Solomon Islands

140 local medicinal plants and 159 ornamental plants are encountered in the usage of indigenous plant species

In: Country Report: FAO Technical Conference on Plant Genetic Resources, Leipzig 1996, p. 25

Tonga

Some 35 plant families have been identified to possess medicinal properties The number of medicinal plants are estimated at 198

In: Global Ethnomedicinal Information Retrieval System (GEIRS) – www.cieer.org/geirs/index.html

Vanuatu

Accounted for 8% of the export supplies of medicinal plants from the LDCS during 1995–1998 after Sudan (37%) and the Congo (16%)

In: Discussion Document – Product Profile: Medicinal Plants, p. 14. Business Sector Round Table, Third United Nations Conference on the Least Developed Countries, International Trade Centre, Brussels, May 16, 2001

Samoa

In: Report of Workshop on ‘Development of National Policy on Traditional Medicine, 11-15 October, 1999, WPRO, publ. Manila, 2000, p. 67

In: Western Samoa State of the Environment report, ed.Taule’alo T., SPREP/UNDP, Apia, p. 76 In: Report of Workshop on ‘Development of National Policy on Traditional Medicine, 11–15 October, 1999, WPRO, publ. Manila, 2000, p. 67

a Interactions with the medical fraternity on the efficacy and safety of medicinal plants to cure major health problems in Pacific Islands is either non-existent or very limited. Currently, modern healthcare and traditional medicinal system in the Pacific Islands simply coexist, users are free to choose between the two or to simultaneously benefit from both systems.

that could be injurious to health; and the absence of standardized quality control measures (Kang-Yum & Oransky 1992; Catlin et a1. 1993; Drew & Myers 1997). The key difference is that a pharmaceutical medicine is composed of a single compound whereas a

traditional medicinal product is a mix of the remedying principle accompanied by other biochemical entities. The use of traditional medicine in the Pacific island states is an indisputable component of the islanders’

925

Medicinal plants in the Pacific Islands Box 2. Trade in some biotech domains between Pacific Island states and Australia. Export earnings (AU$)a

Country

Product

Cook Islands

–Cosmoceutical preparations for skin healthcare 564

Export diversificationb Nonu fruit exports in varying forms; ‘cut flowers’ exports planned

–Fruit and vegetable juices –Marine and plant-based ornamentals

4584 5498

Fiji

–Manioc and similar root and tubers –Products from Cocos nucifera

2615 1713

Vanilla exports in exploration stage

Kiribati

–Mollusc and other aquatic invertebrates

62,525

Seaweed being exported on a trial basis

Marshall Islands

–Oilcakes and vegetable fat or oil residues

87,692

New initiative

Papua NewGuinea

–Oilcakes and vegetable fat or oil residues

3666

Developing produce form organic markets;vanilla exports inexploration stage

–Crustaceans and other aquatic invertebrates

3964

Nauru

–Fruit and vegetable juices

6800

Samoa

–Manioc and similar roots and tubers –Products from Cocos nucifera –Fruit and vegetable juices

34,830 131,683 20,873

Nonu fruit exported in varying forms; vanilla exports in exploration stage

Solomon Islands

–Oilcakes and vegetable fat or oil residues

34,607

Development of indigenous nuts and fruit

–Products from Cocos nucifera –Crustaceans

10,670 57,936

Tonga

–Manioc and similar roots and tubers –Medicinal seaweeds and vegetable products –Products from Cocos nucifera –Marine and plant-based ornamentals

11,160 109,294 124,000 24,000

Well-defined entrepreneurial export product strategy; Cyclic typhoons influence volume of medicinal and vegetable products in export markets

Vanuatu

–Manioc and similar roots and tubers –Medicinal seaweeds other vegetable products –Oilcakes and vegetable fat or oil residues –Crustaceans

82,565 35,913 562,500 50,531

Vanilla exports in exploration stage

a

Extracted from Trade Performance between Individual (Pacific) countries and Australia, In: Pacific Outlook, January–September, 2003 (www.sptc.gov.au/pdf/online_11.12-2003.pdf). b See FAO-SAPA (1999).

repertoire of customs and habits that contribute to their well-being and maintenance of good health. As a result, rather than wane, the use of traditional medicine in current times has increased, particularly in the west Pacific region. Moreover, it is being integrated by medical doctors and hospitals into their daily practices concerning health care. Such a development has been mirrored in the growing preference and resort to medicinal plant use in the northern hemisphere that is marked by the high monetary cost of pharmaceutical healthcare medicines and products. Home gardens or traditional domestic herbaria are now becoming storehouses of valuable information on the occurrence, preservation and use of traditional medicinal plants. In Fiji, some 40% of the reported 183 medicinal plant species in use are cultivated in home gardens (Clarke & Thaman 1995) and in Kiribati and Tonga, some 75% of all reported are cultivated for use in home gardens. In Nauru some 28% of reported medicinal plants are now protected in home gardens whereas conservation of young medicinal plants seedlings in home gardens in Tuvalu has been initiated. In Samoa, several Polynesian

introductions of medicinal plants have been made (Imo & Cable 1995). The most significant finding is that of Homolanthus nutans that is reported to contain prostratin and ‘to have activity against the AIDS/HIV virus’ (Cox & Balik 1994). In summary, the guiding and motivating principle throughout the history of the people of Micronesia, Melanesia and Polynesia and their voyage into current times has been an unshakeable faith in the healing properties of their medicinal plants. Thus, there is an urgent need for the rational use of traditional medicine with oversight mechanisms in order to conserve, preserve and protect public safety. Such a need is inherently coupled to the availability and proven evidence on the safety and efficacy of traditional medicine. Mindful of these developments, WHO through its office in Manila embarked upon a policy of promoting the sound use of traditional medicine that involves the following elements: (1) framing national and regional policies; (2) enhancing the safety, efficacy and quality of traditional medicinal practices and products; (3) ensuring access to and use of safe

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Edgar J. DaSilva et al.

Box 3. Women and medicinal plants in the Pacific region. Country Program

Duration (and sponsors) Goal-oriented activities

Fiji: EcoWoman Project 1997–1999/(CIDA)

Fiji: Wainimate (NGO – Women’s Association for Natural Medicinal Therapy)b

a

1998–2002 (WWF, the University of the South Pacific, Fiji, and Pacific Peoples’ Partnership)

Achievements

Lessons learnt

Transfer scientific knowledge from women professionals in science to rural counterparts –Build network infrastructure for program delivery on traditional medicine –Imbed ‘carry on capacity’ once project concluded

Cooperation group with Wainimate (see below) to develop Fiji’s Biodiversity Strategy and Action Plan

Ongoing activities Need to be more Widespread Throughout the Country

–Record occurrence and promote safe use of traditional medicinal practices; and protect against loss, misuse and piracy of healers’ know-how of traditional medicinal plantsthrough thematic activities: (1)‘Save plants that save lives’ and (2) ‘Affordable Healthcare for All by the Year 2000’

–Issuance of news letter ‘Wainuibuka’ –Issuance of traditional medicine handbook – ‘Na Vola ni Wai Vakaviti’ for use by healers in the Fijian islands –Conduction of workshops in Fiji, Kiribati (with healers’ group – Te Maurin Kiribati) that has developed the ETEN Medicinal Plants garden) and Vanuatu; and business visits to Niue and Tuvalu –Conduction of workshop in the Solomon Islands fortrainers –WAINIMATE project displayed at EXPO 2002

Participation of Professional women Scientists and rural women healers is high with growing awareness of traditional and modern healing systems; potential for new income for rural women results from establishment of ‘kura’ (Morinda citrifolia)plantations; more needs to be done to protect against exploitation of traditional cures and loss of traditional knowledge possessed by the aged generation

a The South Pacific People’s Foundation (SPPF) functioned as the Canadian Executive Agency; the Pacific Island Nation Partner was the South Pacific Action Committee for Human Ecology and Environment (SPACHEE). b Part extraction form the Once and Future Action Network (OFAN) in Science and Technology, Pacific Edition, December, 2000, p. 3 (www.wigsat/org.ofan/res/OFANewsPacific.do).

procedures of application; and (4) promoting rational, standardized and quality use of traditional medicine (WHO 2003a). To that end, much needed guidelines (GACP) concerning the cultivation and collection of medicinal plants and some post-harvest operations that are necessary for the safety and efficacy of medicinal herbs have been issued (WHO 2003b). The guidelines focus on: • ensuring the quality of medicinal plant materials used as a source for herbal medicines for purposes of improving the quality, safety and efficacy of marketoriented remedial products; • promoting the formulation and use of national and regional GACP guidelines through dissemination of GACP monographs that instruct on the safe and efficient use of medicinal plants and herbal medicines; and • encouraging and monitoring cultivation and collection procedures of medicinal plants of good quality that contributes to the conservation of medicinal plants and to the management of the environment.

Trade considerations – Green pharmaceuticals10 Different forms of trade with medicinal plants exist given that there are local, national, regional and international demands for such medicines. Demands are either for a group or mix of traditional medicinal plants or simply for a single species that has near miraculous health-restoring powers as well as for other agricultural products (FAOSAPA 1999). In essence, the trade sectors of medicinal plants in the Pacific region conform to those described for different markets (Cunningham 1996). As concerns international trade, the Pacific island countries on account of their small size, isolation in ocean space, non-diversified market economies and exposure to climatic change and natural disasters – significant factors that contribute to the damage of their export supplies of medicinal plants and subsequent foreign-exchange earnings and vulnerability in interre10 The use of the term ‘green pharmaceuticals’ relates to the natural occurrence of medicinal plants and not to genetically modified medicinal plants nor to those obtained through gene farming.

927

Medicinal plants in the Pacific Islands gional trade, cannot compete internationally with the major supplying countries like India, China, etc. (Tewari 2000). Exports of Mozuku seaweed from Kiribati and Tonga are examples that have been victim to the forces of cyclones and typhoons. Products of trade that may have a medicinal plant origin are provided in Box 2. In global trade assessments of medicinal plants ‘a substantial part of this trade is not recorded and official trade statistics either do not identify the plants individually, or do not separate their medicinal usage from further usage such as ‘perfumes, essential oils, culinary herbs, insecticides, fungicides, etc.’(International Trade Centre 2001). The world’s natural product market may soon benefit from research being conducted by the Universities of Papua New Guinea and Utah in the framework of the International Cooperative Biodiversity Groups (ICBG) ‘Conservation and Sustainable Use of Biodiversity in Papua New Guinea’ project.11 The focus of research is on the occurrence of biological and chemical therapeutics for use in the conservation of local and international human health resources. Collection and establishment of an inventory of ethnomedicinal plants, assessment of the economic value of natural products is being conducted by the University of Papua New Guinea and the National Forest Research Institute prior to the development of intellectual property rights legislation. Tobia (2004) reports that some 250 plant samples and over 120 marine invertebrates have been processed to date for the detection of remedial principles against a variety of diseases. The production of kava by The Pacific island states of the Federated States of Micronesia, Fiji, Samoa, Tonga, and Vanuatu is a success story with Vanuatu having a principal role in the domain of trade (Lebot 2001).12 Traditional markets for kava exports in the USA and Europe, especially in France, Germany and Spain, showed a downturn in 1999 as a result of misuse of the name ‘kava’. Furthermore, in late 2001, restriction ‘of the sale of kava-containing food and medicinal products’ resulted from some cases of adverse reactions reportedly associated with use of kava (Piper methysticum). The negative trade impact on the foreign-exchange earnings of Fiji, Samoa, Tonga and Vanuatu have been catastrophic as a result of bans and recalls of kava products in Australia, Canada, France, Germany, Italy, New Zealand, Singapore, Switzerland, the UK, and issuance of warning notices in the USA. In response, an in-depth investigation into the restrictions EU Member States have placed on kava products has been initiated in developing ‘a strategic action plan to rebut the ban on 11

A project – The International Cooperative Biodiversity Groups (ICBG) Program is a unique effort by six components of the National Institutes of Health (NIH), the Biological Sciences Directorate of the National Science Foundation (NSF) and the Foreign Agriculture Service of the USDA that focuses on the interdependent issues of drug discovery, biodiversity conservation, and sustainable economic growth. 12 Presentation at Regional Workshop on ‘Constraints, Challenges and Prospects for the Commodity-Based Development and Diversification in the Pacific Island Economies’, August 18–20, 2001, Nadi, Fiji. Author can be reached at CIRAD, Post Mail Bag, Port Vila, Vanuatu.

kava in most European states’ to counteract the negative economic impact of the restrictions in force (Gruenwald et al. 2003).13 Likewise the international market for noni, obtained from Morinda citrifolia is under threat (KeithRead 2002). Incidentally, kava is amongst the 10 listed phytomedicines discovered by indigenous people (Borges et al. 1999). Moreover, Piper methysticum has been identified as a conservation priority amongst 14 medicinal plants that are either endangered or on account of their recent popularity (Hamilton & Schmitt 2000) and, in Oceania, two plants – Nesogenes rotensis and Osmoxylon mariannens – were named as ‘imperilled species’ that do not often ‘receive the recognition they deserve’… plants are an integral part of a healthy environment. They provide cultural and economic benefits that range from ornamental and medicinal uses to shelter and food for native wildlife.’ (Saipan Tribune 2004). International trade in traditional medicinal plants is on the increase, nothwithstanding the concerns expressed in relation to their availability and safety aspects. This increase is fuelled by the search for new therapeutics to combat the onslaught of new and emerging diseases and the shortfall in antibiotic efficacy should organisms become more and more drug-resistant. However, as such trade increases there is a need to address especially the issue of safety. There is also need particularly in the Pacific island states, many of which are amongst the least developed countries, to safeguard their market earnings from medicinal plants. Discouraging and banning random and indiscriminate collection would ensure their long-term availability, manageable harvesting in the combat against their becoming endangered or extinct. Furthermore, as is the case with the whole range of nutraceuticals there is need, perhaps, of an international legal instrument that provides certification and standardization of sustainable traditional medicinal market products. Such a measure would address the concerns of safety, environmental management of medicinal crop yields and the unethical purchase of street medicines of doubtful plant origin. The WHO guidelines (WHO 2003b) on good agricultural and collection practices would help national trade authorities in market practices. The development of a resource base in national medicinal parks would go a long way to strengthening national initiatives concerning the cultivation of traditional medicinal plants. Such resource bases could then serve as a foundation to provide for research and education in the rational use of medicinal plants, in the establishment of local quality 13

The Pacific Islands Forum Secretariat, Suva, Fiji, on behalf of the negatively affected South Pacific Member States requested the Centre for the Development of Enterprise (CDE), Brussels, Belgium – an institution of the ACP (see14) bloc and the European Union established within the framework of the Cotonou Agreement in 2000, for assistance in relation to the negative impact on The South Pacific Member States resulting from European bans on kava import products. CDE then engaged the Phytopharm Consulting of Berlin, Germany (www.phytopharm.org) to perform the ‘in-depth investigation into EU Member States Market Restrictions on Kava Products’.

928 control measures and the recognition of womens’ labour force as a significant factor in the establishment of small-scale entrepreneurial ventures. Gender Women, the mainstay of rural and village households in the Pacific region, like those in Africa, the Arab States, Asia, Latin America and the Caribbean, are the guarantors and transmitters of traditional knowledge concerning the use of medicinal plants for the healthy well-being of their families. Village women occupy an important role in the use of plant medicinal resources. Time-honoured practices handed down from mother to daughter through several generations in the sowing, harvesting and use of traditional medicinal plants contribute to their preservation and availability in village markets. However, in the Pacific islands, where the majority of traditional healers are women, the women’s labour force cannot compare in scope and range of activities as those in Asia, Africa and Latin America. This is due to lack of opportunities in rural environments for furthering the little formal education since childhood and restrictions to fulfil their customary domestic duties and responsibilities. Nevertheless, women the world over occupy a unique role as instinctive agents of change and innovation in bridging the gaps between the practice of customary green health science with the modern advances in the sustenance of the health and well-being of their families. Recent initiatives focus on empowering and enabling women to engage in ‘participatory democracy’ by bringing an understanding of science and the issues of intellectual property rights concerning Pacific island availability and use of traditional medicinal plants (Box 3). Notwithstanding its abundance, the underutilized resource of seaweeds constitutes another avenue of income generation for rural and entrepreneurial women in the Pacific region (Novaczek 2003). Seaweeds have been harnessed elsewhere for their medicinal value and as a source of micronutrients and cosmoceuticals. Following a series of workshops supported by UNDP at the University of the South Pacific, women desirous of engaging in the development of small enterprises have taken pioneering steps. A small successful business providing seaweed-based cosmetics, tonics and other health-related preparations exists in Suva, Fiji. In Papua New Guinea a similar herbal venture has been opened and in Vanuatu, natural therapy clinics in Port Vila and Santo are testimony to the innovative skills of women that are breaking out of the confinement of established gender roles that restrict them to the drudgery of domestic chores and habits.

Kava and nonu Amongst the medicinal plants of the Pacific the two most widely used species and well-known exports of

Edgar J. DaSilva et al. virtually worldwide economic significance are kava and nonu – traditional medicines that may include the use of the root, stem, bark, leaves, flower, rhizomes or whole plant for treatment (Figure 2). Recent developments, however, have diminished the attraction of foreignexchange earnings and trade of these two Pacific medicinal plants with financial losses being particularly severe in the case of kava. Such losses as in the case of kava arise from the onslaught of dieback disease due to cucumber mosaic virus (Davis et al. 1996). Severe losses of planting material reported in Fiji, Tonga and Vanuatu contribute to the economic vulnerability of these Pacific states. To contain these losses, the technique of tissue-culture has been preferred by the Plant Protection Services of the SPC in building up stocks of disease-free kava-plantlets in Fiji. A similar approach has been made with nonu that is susceptible to attack by insects at the Papua New Guinea University of Technology (Anon 2004).

Kava Piper methysticum, a shrub belonging to the pepper family Piperaceae (Table 1) and the psychoactive beverage made from it are both known by the name kava (Rudgley 2000). Awa, Waka, Lawena, Sakau, Yaqona are other common names in use in Fiji and elsewhere in the Pacific region for kava which is offered at traditional social gatherings, and in cultural and religious ceremonies (Lebot et al. 1997) and which spread westwards to Papua New Guinea and Micronesia and eastwards into Fiji and Polynesia from the group of islands in eastern Melanesia – Vanuatu that is considered the centre of distribution. Of the known 118 cultivars of kava, 80 occur in this archipelago. Interest in kava has extended beyond the Pacific Rim into the industrialized world on account of its many beneficial qualities that help to reduce stress and induce a state of relaxation. In the Federated States Micronesia (FSM), the island of Pohnpei is the major market where sakau bars are a common sight all along the island. Local consumption alone could amount to about US$10 million annually. Sakau is being exported from the FSM to nearby islands with Ponapean populations, Guam and the Commonwealth of Northern Mariana Islands. Fresh extracts of kava are also sold in the local markets in Micronesia.14 In the 1990s the kava industry and market in the Pacific islands was 14 Sales of kava were banned by the government of the Federated States of Micronesia (FSM) in a bid to stop a cholera outbreak in mid2000. Kava known as sakau is stronger and thicker than that found elsewhere in the Pacific. It is prepared by mixing beaten kava roots with water. The drink sakau itself does contain the organism Vibrio cholerae. However, the danger is in the unsafe preparation of the drink, the roots being beaten on old stone blocks (Micronesia bans Kava Sales in bid to combat cholera, International News, Agence France Presse (English), May 18, 2000, Auckland, NZ).

Medicinal plants in the Pacific Islands

929

Table 8. Worldwide responses to kava products from the Pacific region.a Country Developed World Germany

Year

Remarks

1998 2001

Two cases of hepatotoxicity reported Bundesinstitut fu¨r Arzneimittel und Medizinprodukt (BfArM or Federal Institute for Drugs and Medical Devices) issues notice of withdrawal of marketing authorizations for kava-containing productsb June: registrations of German manufacturers of kava preparations inclusive of food and medicinal products and also homeopathic medicines cancelled; October: German Federal Institute for Risk Assessment warns consumers not to use kava products Following a meeting in Berlin, April 2 between the German Health Ministry and IKEC (acting on behalf of the Pacific Islands States) agreement is reached on that

2002

2004

(1) research would first focus on the safety of kava prior to a discussion of its efficacy; (2) a re-evaluation of the safety of kava within the next six months would be made As a consequence Deputy Health Minister for Germany calls on IKEC and independent experts in pharmacology and toxicology to jointly determine the designmodality for the generation of new data Switzerland

2000 2001

Kava marketers notified by government authorities on safety concerns relating to use of kava Following conclusion of Safety Drug Control use of kava extracts suspended and withdrawn

Australia

2002

February: Attention of healthcare personnel and consumers through respective Therapeutics Goods Association (TGA) alerts drawn to emerging and increasing number of international reports linking kavamedicine use with hepatotoxicity Consumers recommended to discontinue use of kava and to desist from use of unsupervised prescription drugs. Consultation with a doctor emphasized prior to use of kava-containing medicines August: TGA issues voluntary recall of all kava-containing medicines N.B. There are 84 medicines containing extracts from the kava plant on The TGA Register

Belgium

2001

Belgian Health authority announces (i) requirement of additional labelling on kava products and (ii) distribution by pharmacies and health stores be done with care

Austria

2002

Follows German ban of July 2002 though no case of illness reported

Canada

2002

January: Health Canada announces safety assessment survey of kava and advices consumers to refrain from using kava products August: Stop-sale order issued following report of illness in four cases

France

2002

French Agency for the Safety of Health Products suspends for one-year all products containing kava. Public advised to stop usage of kava products

Ireland

2002

Irish Medicines Board institutes voluntary withdrawal of all kava containing products

Malta

2002

Following evaluation of growing scientific information on the health effects of kava on humans, Food Safety Commission prohibits kava extracts from local markets

Netherlands

2002 2003

Government authorities ban the sale of kava-based products Commodities Law (Herbal Preparations) Decree amended so that herbal preparations are not to contain any material derived wholly or partially from kava

New Caledonia

2002

Sale of kava-based products in pharmacies banned Health and Social Department; traditional kava preparations served in nakamalsc and products such askava sweets and instant kava sold in supermarkets not covered by the ban;

New Zealand

2002

Food Standards Australian and New Zealand (FSANZ) authority warns consumers of possible ill-effects of kava-containing dietary supplements; (FSANZ) issues proposal (i) to retain prohibition on kava ingredients in foods but not in dietary supplements covered by NZ government regulations; (ii) to keep labelling statements concerning public health In addition to above warnings and considerations, FSANZ proposes to: (1) operate in conjunction with the National Code of Kava Management; and (2) amend the definition of kava; and (3) retain the labelling statements concerning public health (see also Gruenwald 2004)

2003 2004

UK (see also Wales)

2001 2002 2003 2004

Medicines Control Agency (MCA) requests marketing community to withdraw on voluntary basis all kava products their toxicity evaluation MCA concludes safety assessment and issues ban on medicinal products containing kava In mid-January order banning sale of kava-based products becomeseffective with foreseen review after two years Following a meeting in London, April 2 between UK Medicines and Healthcare ProductsRegulatory Agency (MHRA) and the IKEC, the MHRA expresses interest in the German approach – the creation of new data, dialoguing on the issue in question and re-consideration of the results of all new research

930

Edgar J. DaSilva et al.

Table 8. (Continued) Country

Year

Remarks

USA

2001

Food and Drug Administration (FDA) calls on healthcare professionals to report adverseevents linking kava use with liver toxicity Report from Centres for Disease Control and Prevention reports on two cases of liverassociated with kavadietary productsd FDA continues to draw attention of consumers and healthcare providers to potential risks concerning use of kava-based products

2002

Wales

2002 2003 2004

Developing countries Brazil

2002

Malaysia

2002

Singapore

2002

South Africa

2002 2003

Through the Welsh Statutory Instrument 2002 No.3157 (W.293) The Kava-kava in Foods (Wales) Regulations 2002, that came into force on 9 January, 2003,the sale of food consisting of or containing was prohibited As a result of the case brought by the National Association of Health Stores (NAHS) against the UK Government, The National Assembly or Wales reversed its ban thatcame into force on end October 2003 London High Court in January rejects NAHS case re: UK Government re-consideration of its ban on kava

Brazilian National Agency of Sanitary Monitoring (ANVISA) requires specific labelling for medicinal products containing kava. This measure is to restrict indiscriminate usage of such products without medical evaluation The Drugs Control Authority (DCA) suspends the registration of all kava products until safety concerns answered; requires registered holders of kava-products to provide detailed information on their products and methods of preparation: cancels registration of 9 out of 13 kava-containing registered products in Malaysia Singapore Health Sciences Authority (HSA)voluntary withdraws all kava-containing products from Singaporean markets and proceeds to prohibit importation of kava and its constituents under the Poisons Act; violation of the prohibition order punishable by fines up to US$10,000 and imprisonment up to two years. Medicines Control Council of South Africa issues recall of all dietary supplements, medicines and preparations Issues gazetted notice conveying MCC decision all kava-containing Medicines, dietary supplements and preparations are a serious health risk

International International Kava Executive Council

2003

Explores ways to re-establish the trade between EU Member Sates and the South Pacific countries in first ever European-South Pacific Stakeholders’ consultations(Brussels, Belgium, August)

WHO

2003

October: Advisory Committee on Safety of Medicinal Plantse recommends: (1) Pharmacovigilance in herbal medicines (2) Obtaining data /assessments from countries reporting adverse reactions arising from the use of kava-based medicines and inclusive of literature reviews (3) Re-evaluation of all data following compilation of all available data on kava-products and their safety by the WHO Collaborating Centre for International Drug Monitoringbased in Uppsala, Sweden (4) Extraction and analysis procedures used for all kava preparations be the subject ofof further research preferably at the PhD level

a Adapted from (i) Gruenwald et al. (2003) (ii) Pharmaceuticals: Restriction in Use and Availability, WHO Document: WHO/EDM/QSM/ 2003.5, prepared in within the context of the United Nations Publication ‘Consolidated List of Products whose Consumption and/or Sale have been Banned, Withdrawn, Severely Restricted or Not Approved by Governments’, April 2003, 21 pp., and available from Marketing and Dissemination, WHO, Geneva, Switzerland (iii) FSANZ Proposal P256 – Review of Kava (Standards O10/2.6.3) Final Assessment Report, 17 March, 100 pp. (www.foodstandards.gov). b (1) The National Association of Health Stores (NAHS) in the UK points out that many European countries have banned kava products without notifying the European Commission in accordance with European directive 98/. In: WHO to investigate Ban on kava Herb by Hasslberger, J. December 5, 2003 (www.newmediaexplorer.org). (2) In 2002 favourable opinion issued by EU Scientific Committee in compliance with EU regulation 258/97 and based on assessment extensive toxicity and allergenicity data. In: poster presented by Hermann, M (International Potato Centre, Lima, Peru) at Workshop on Underutilized Plant Species, Leipzig, Germany May 6–8, 2003. (www.newmediaexplorer.org). (3) New EU ‘Medicine’ Definition: Difficult Times for Natural Cures and Prevention in EU Directive 2004/27/EC of March 31, 2004 that defines a medicinal (necessitating registration as a pharmaceutical drug) as: (a) Any substance or combination of substances presented as having properties for treating or preventing disease in human beings; (b) Any substance or combination of substances which may be used in or administered to human beings wither with a view to restoring, correcting or modifying physiological functions by exerting a pharmacological, immunological or metabolic action, or to making a medical diagnosis (www.newmediaexplorer.org). c A nakamal, widespread throughout New Caledonia and Vanuatu, with its calm and dimly lit ambience is a traditional place where kava is prepared, served, and consumed with the onset of dusk. Once identified as the house of men, the nakamal, has now evolved into a central meeting place for men folk and their families from all walks of life that wish to relax and escape from the pressures and stresses of daily work routine. d The Morbidity and Mortality Weekly Report (MMWR) 2002. Hepatic Toxicity Possibly Associated with Kava-containing Products – United States, Germany, and Switzerland, 1999–2002, MMWR Vol. 51: 1065–1067 from the Centres for Disease Control and Prevention presents data for two cases in the USA and summarizes the European situation (see also JAMA. 2003, 289: 36–37). e Recommendations from the first meeting of the Advisory Committee on Safety of Medicinal Products, 20–22 October 20034, WHO, Geneva (www.who.int/medicine/organization/paredl/WAD-safety.doc); see also WHO, 1998, p. 145.

931

Medicinal plants in the Pacific Islands Box 4. Family-owned ‘noni’ enterprises. Country

Product

Remarks

Category listed

Further details at

Cook Islands

100% Organic Noni juice

No additives or preservatives

Health

http://www.noninz.com/

Fiji

100% Pure and Organic Noni Juice

Family owned and Health and medicinal managed company based no additives or preservatives

Samoa

100% Organic Noni juice

Family owned and managed Organic Certified by www.nonusamoa.com enterprise (International International Federation Trade Centre, 2001). of Agricultural Movements (IFOAM)

widely estimated to have grown to a value of US$ 200 million. This medicinal plant that originates from a wild progenitor Piper wichmannii has been the focus of concern for the Pacific region on account of the considerable economic losses in trade (Gruenwald et al. 2003) and of safe consumption for human health (Table 8). The reporting of liver toxicity of kava especially in Germany and Switzerland triggered a virtual worldwide chain reaction that was crippling and detrimental to several Pacific island economies. Once flourishing markets of kava nutraceuticals and food supplements and exports from Fiji, Samoa, Tonga and Vanuatu were virtually destroyed overnight, upsetting self-sustaining rural enterprises and livelihoods and adding to an increase in the vulnerability of oncethriving communities that were using traditional medicines and practices that through the passage of time had sustained the well-being of their peoples through several centuries and successive generations. As a result of the action initiated by several South Pacific governmental and scientific bodies,15 the fact-finding Gruenwald report (see foot note13) and its proposed strategic action plan to counteract the debilitating impact of the ban, the convening of a kava-stakeholders’ meeting (Gruenwald 2004), and the deliberations of the WHO Advisory Committee on Safety Medicinal Products, have led the World Health Organization (WHO) to review the safety of herbal kava.

Nonu Morinda citrifolia, commonly known as noni or nin and one of the most widely used medicinal plants in Polynesia prior to European use, is widely popular in current times (Dixon et al. 1999). Moreover, it is an apt example of the varied ways used in plant medicinal preparations by different cultures. For example, noni fruit juice products, available with or without pasteurization, are processed and prepared either through 15 Pacific Island Forum Secretariat (PIFS); Fiji Kava Council, Samoa Association of Manufacturers and Exporters, Tonga Lava Council and Vanuatu Kava Exporters Association.

www.estermaria.com/

fermentation or through drip extraction or the squeezing of fresh fruits (Box 4). More than 200 commercial entities sell and distribute noni products worldwide as a contemporary medicine. However, in some cases use as a medicine has been contested, thus necessitating the need for constant clinical monitoring for impurities and additives. The methods of use and preparation of these medicinal products are now being challenged by health authorities in some countries on account of the absence of standardized procedures for preparation and quality control. Regulatory action against noni juice in the USA was successfully terminated in 1998 through a multistate agreement by the Attorneys-General of Arizona, California, New Jersey and Texas who had contested the claims made in promotional material concerning remedial actions in relation to a variety of illnesses.16 In relation to unpasteurized and ‘all other unprocessed packaged fruit and vegetable juices,’ the US Food and Drug Administration now requires that these products carry a warning label or sign by the autumn of 1999 indicating that such products ‘can be the cause of serious illness in children, the elderly and persons with weakened immune systems’ (see also Mueller et al. 2000). The Finnish National Food Administration16 in 1998 banned the sale of noni juice until such time that the mandatory required brochure in conjunction with sales as well as other promotional had been corrected in 16 (a) New Warning Labels and Regulatory Action against Tahitian Noni. In: Nutrition Forum, November 1998, ed. Vaughn, L; publ. Prometheus Books, Essex, UK, ISSN 1093-4545 (www.hutch.demon.co.uk/nutrition/). (b) Decision (E 27/216/98) of November 26, 1998, the National Food Administration Temporary ban on sales of NONI fruit juice from Tahiti (National Food Agency Finland, Press Release: November 23/30, 1998) (www.elintarvikevirasto.fi/valvonat/p3222.html). (c) Communication from the UK Advisory Committee on Novel Foods and Processes to the European Commission: View of Noni Juice, Food Standards Agency, 13 December 2001 (www.foodstandards.gov.uk/science/ouradvisors/novelfood/acnfppapers/noni-juice). (d) Opinion of the Scientific Committee on ‘Food on Tahitian Noni Juice’ Document SCF/CS?NF?DOS?18.ADD.2.Final, 11 December, p 13, publ. European Commission – Health & Consumer Protection Directorate General (Directorate C – Scientific Opinions, C2 – Management of Scientific Committees; scientific cooperation and networks), Brussels, Belgium.

932 accordance with the Finnish Food Act and its legislated regulations. And in 2000, the Belgian Competent Authority concluding that information provided ‘concerning probable place of the novel food in the diet and its level of use were not sufficient’ issued an unfavourable opinion – a view that was heard by the UK Competent Authority.16 Following completion of consultations between European Commission (EC) Member States, the EC Scientific Committee on Food (SCF) expressed an opinion16 that noni juice is acceptable as a novel food given that toxicity data showed no cause for concern. Furthermore, following pasteurization, the product was microbiologically safe.

Conclusion The Pacific region, an oceanic blanket of some 165.384 million km2 of the planet’s surface, is home to nearly 9 million people who have descended from a succession of ancestors starting with early Asian, Austronesian and Melanesian settlers several thousands of years that were followed by implantations of 16th century European explorers, 18th century entrepreneurial fishing and trading communities, 19th century empire-building powers of the northern hemisphere that culminated in the emergence of the early 20th century indigenous people-settler dominated states. The region is thus a natural treasury of numerous cultures, cultural legacies, languages, social customs, and a wealth of floral and faunal biodiversity that is a resource base of alternative, folkloric and traditional plant-based medicines. Verbal pharmacopoeias of varied philosophies and practices in traditional medicine have been transmitted from generations to generations and are still in the contemporary practice of Aboriginal and Maori medicine. The therapeutic use of medicinal plants elsewhere in the Pacific regions for the maintenance and sustenance of human health resources has found favour with occidental lifestyles as an alternative to the rising costs of patented drugs in conventional medicine and health practice, the efficiency of which, at times, is weakened by the phenomenon of microbial drug resistance. The role of women, especially in the least developed countries in which families cannot afford the steep expenses of allopathic medicines, is vital. Mindful of the crucial role of women using medicinal plants for family and communal well-being, several UN agencies, and particularly WHO, have endorsed the undeniable value of traditional medicinal knowledge in the conservation of human health. Efforts to formulate national policies that embrace the efficient and safe use of traditional medicine, that evaluate and regularize traditional practices, and that fosters consultations between traditional and modern health practitioners attract national and international endorsement and commercial interest and support. In recent times, safety issues regarding the use of medicinal plants in the technically advanced societies

Edgar J. DaSilva et al. have come to the fore arousing concern and controversy (Moulds & Malani 2003). Use of traditional medicines such as kava by generations of native populations through several centuries has been brought into doubt on the ground of health concerns arising from biosafety issues – lack of quality control, liver toxicity, and lack of use of standard methods of preparation and application. Another complicating factor is inaccurate or misleading product labelling that apart from damaging the medicinal plant market also puts into disrepute and doubt the time-honoured proven reputation of the herb as a medicinal plant. Linked to such doubt are the issues of economic significance and global markets wherein the galloping growth of the medicinal kava and nonu plant products compete with those of allopathic therapeutics (Blumentahl 2002). The Gruenwald Report (Gruenwald et al. 2003) in its scientific evaluation found in favour of the use of kava based on over two thousand years of traditional use. Furthermore, withdrawal of authorization for market was unjustified on the basis of insufficient and unconvincing data concerning liver toxicity. The formulation of a strategic action plan focusing on revocation of the ban and instituting market re-introductions of kava is a necessary step in re-establishing the once mutually beneficial trade between the European and Pacific countries. Another vital issue is whether traders, producers and devastated kava-using medicinal enterprises in Fiji, Samoa, Tonga and Vanuatu are entitled to financial compensation through appropriate international mechanisms to meet their economic losses coming from a ban unjustified to some and valid for others. Medicinal plants, the oldest known health care products, play a vital role in the maintenance of human health worldwide and especially in the developing world (Hoareau & DaSilva 1999; McNeill Jr. 2004). Their importance is linked to the availability and use of traditional intellectual property that has sustained the well-being of ancestral generations over several hundred years. The discovery of anticancer compounds and other therapeutics of plant-origin (Table 4) is justification not only for such traditional use but also for the pursuit of pharmacological research and drug development to combat emergent and new diseases which threaten families and that erode national human health resources. References Anon, 2004 Noni fruit and coconut oil studies kick off. The Reporter, April 23–29, ed. Lahies, C. p. 6. Public Relations Unit, PNG University of Technology, PM Bag Lane 411, Papua New Guinea. Blumenthal, M. 2002 Kava safety questioned due to case reports of liver toxicity. HerbalGram 55, 26–32. Borges, J.R., Carlson, T.J.S., Chinnock, J.A., King, S.R., Meza, E.N. & Moran, K. 1999 Issues in the commercialization of medicinal plants. HerbalGram 47, 46–51. Catlin, D.H., Sekera, M. & Adelman, D.C. 1993 Erythroderma associated with the ingestion of an herbal product. Western Journal of Medicine 159, 491–493.

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