Department of Parasitology, WRAIR

Landscapes, Medicines and Healing

Maurice M. IwuExecutive Director, BDCP

To Heal is to Restore Order Physical treatment with

medicines and body manipulations

Psychosomatic interventions as in mental illness

Spiritual interventions among the religious

Healing is a journey

From disorder to order State of illness to good health

Could be voluntary i.e. participatory Or forced, i.e. by a benevolent leader or escort In most cases the desired outcome is achieved But not always …

Understanding the Nature of Things

What is the nature of the Human Person?

What is Disease to an African Healer?

What is the meaning of Life in the African Cosmology ?

What is Man?

A holistic being that is related to all that is terrestrial, extra-terrestrial

and cosmogenic

Five Elements of the Self

The Physical: biological and the bioenergetic, bio-luminescent and biomagnetic body

The Inner Mind: rubbish bin of modern medicine The Morale: seat of religious experiences The Soul: our true self/ capable of multiple forms The Spirit

Dimensions of Human Spirituality

Level - 1: ancestors

Level - 2: ethereal beings or life spirits that govern the world

Level-3: morphic resonance or collective memory

Level-4: a group of 256 well-known, well codified and well classified spirits – “Fa”, “Ifa” or “ofo”.

Level-5: The Spirit

Sickness or Disease is defined as lack of balance between the different aspects of

self, the spiritual entities and the environment.

Healing Elements or Healing Tools

The Spirit Entities The Healer The patient The Healing Objects: plants, minerals, animals

etc.

The African Healer’s World There are several realities of existence or worlds There is a spiritual component in all living things and

existence is often a product of negotiated order between beings.

Certain events are preordained or determined at completely different sphere of existence far from where it becomes manifest.

There is no physical limitation to the power of the human spirit.

Communal Healing or Group Therapy

NDEPP

Collective healing through ceremonies and cleansing rituals

Restores harmony between families, communities and societies

Example is the Ndeep at Yoff – Mame Ndiarre is the healing divinity.

African Millennium for Science and Technology

Landscape and Healing

The importance of place and specificity of cultural context when investigating

health care beliefs and practices.

Therapeutic landscapesThese are places, settings,

situations, locales, and milieus that encompass both the physical and

psychological environments associated with treatment or

healing, and the maintenance of health and well-being.

Sacred Therapeutic Landscapes

Places, settings, situations, locales, and milieus that provide platform for

communion with the spirits and the sacred. Its sacrality derives from a recognition and acceptance of the

landscape as spiritual meeting place between different entities involved in

healing .

High Mountain Climatotherapy

reduced partial pressure of oxygen, intensified sun radiation, low temperatures, and lower water vapor content in the inhaled

air – XXXXXXX

Apparently harmless to permanent inhabitants buy biotropic to temporary residents

Global Epidemiological Status of Malaria

Over 90 Countries / Territories Affected Over 2020 Million Persons at Risk (36% of

World’s Population) 1.5-2.7 Million Deaths Per Year 300-500 Million Clinical Cases Per Year Increase in the Prevalence and Severity of

Multiple Drug Resistance

WHERE WE ARE TODAY:WHERE WE ARE TODAY:HUMAN LEISHMANIASISHUMAN LEISHMANIASIS

Endemic to 88 countries, 350 million at risk, 12 million infected, annual incidence 2-3 million

Pentavalent antimonial resistance widespread

Subclinical infections >30 years Opportunistic infection with HIV. No FDA approved drug exists No chemoprophylaxis exists

Department of Parasitology, WRAIR

Emerging Infectious Diseases

Thirty (30) New Diseases Have Emerged in the Past 20 Years - WHO 1996

Globalization of Some Old Diseases

Global Intervention Efforts

Vaccine Development

Rational Drug Development: Single Chemical Entities

Herbal Medicines: including phytomedicines

Nutritional Aides

Drug Development Choices Phytomedicines

– Quicker to market– Low safety problems

New Chemical Entities– Good acceptance– IND possibility– Industry support

Rational Design – New chemotypes – External support

Department of Parasitology, WRAIR

bringing ancient wisdom to life

ETHNOMEDICINE

Classification of Ethnomedicine

The personalistic systems where supernatural causes ascribed to angry deities, ghosts, ancestors and witches predominate, and

The naturalistic systems where illness is explained in impersonal, systemic terms.

BDCP - Herbal Product Plan

STRATEGY

WHAT?Whole herbs, standardized extracts

phytomedicines, formulation

WHO?Through a wholly owned

subsidiary (AXXON Biopharm.)

HOW?Establish local base/ Partnerships/ SBA

ETHNOBOTANICAL SURVEY Record folk use of plants Survey conducted by a

physician/botanist/sociologist team Vouchers collected after interview

ETHNOMEDICAL ANALYSIS Determination of disease being treated Level of equivalence in diagnosis by

traditional/modern medicine Apply expanded diagnostic criteria

CLINICAL OUTCOME EVALUATION Leads are de-replicated Safety is determined in animals Appropriate dosage formulation Clear end-point determined

Ethnomedical Team

PhysicianPhysician

Traditional HealerTraditional Healer

EthnobotanistEthnobotanist

Data - Collection Forms

New Realities of Global Economy The Trans-National Nature of Capital, Industry

and Labor

Changing Waves of the Biotechnology Sector

Recognition of Exclusion (or Discrimination) and Not Exploitation as the New Threat on Equity and Sustainable Development

Garcinia kola Seeds

Respiratory tract infectious

Anti-inflammatory

Antiviral

Tonic

mAU

2 4 6 8 10 12 14 16 18

0

2.5

5

7.5

10

12.5

15

17.5

20

Time (min)

standard

Hangover tonic1

2

4

Electropherograms of Hangover tonic preparation and a standard containing Kolaflavanone, GB1 and GB2

1. Kolaflavanone, R1 = OCH3, R2 = H2. GB1, R1 = OH, R2 = H4. GB2, R1 = R2 = OH

O

O

OH

OH

HO

O

O

HO

OH

R2

R1

3 4 5 6 7 8 9

0

5

10

15

20

Time (min)

mAU

Electropherograms of Hepa-Vital tea and a standard containing Kolaflavanone, GB1 and GB2

standard

Hepa-Vital tea

1

24

Aframomum danielli & related Spp. Seeds and rhizome used

as antifungal agents

Showed good activity against Leishmaniasis spp.

COE for Opportunistic fungal infections

Chasmanthera depedens

Chasmanthera dependens Leaves used as topical

antifungal paste

Showed good activity against malaria & Leishmaniasis spp.

COE for opportunistic fungal infections

Lead compounds being developed

Cryptolepis sanguinoleta Used for malaria treatment

Positive clinical outcome

In vitro and in vivo activity against Plasmodium spp

Cryptolepine isolated as most active compound

N+

N

HCryptolepine

N+

N

OOCH3

Sanguinoletine

N

S

Cl

Cl-Cl-

M-3

Alkaloids of Cryptolepis sanguinoleta

Enantia chlorantha Used for treatment of malaria & liver diseases

Positive clinical outcome for both diseases

Good in vitro activity against Plasmodium spp but poor in vivo activity or inactive

Palmatine and related protoberberines isolated as the active compound

O

O

OCH3

OCH3

Berberine

H3CO

H3CO

OCH3

OCH3

Palmatine

Protoberberines from Enantia chlorantha

* Optimization studies has shown that high lipophilicity caused by modification of the substituents appears to

increase biological activity.

* Preparation of structurally related non-quarternary salts with antimalarial activity.

* Testing of Enantine and other non-protoberberine alakaloids found in the same plant for antimalarial activity

Dracaena mannii

Very positive clinical outcome studies

In vitro activity against Leishmaniasis spp.

Activity against cutaneous Leishmaniasis

Active substance problematic for rodent studies

THE BDCP APPROACH

1. Capacity building through the organization of traditional healers and enhancement of their associations, establishment of ethnobotanical database of medicinal and aromatic plants.

2. Establishment of a sui generis system of compensation through the Fund for Integrated Rural Development and Traditional Medicine (FIRD-TM).

3. Advocacy for legislation on regulation and standardization of traditional medicine in Nigeria and other African countries .

4. Establishment of the International Centre for Ethnomedicine and Drug Development (InterCEDD), a full service research facility to enhance local capacity to conduct integrated research for drug development, and commercialization of potentially useful natural products.

Integration of Goals

ConservationDrug Development

Economic

Developm

entICBG

African ICBG(International Cooperative Biodiversity Group)

Large integrated program with the core requirement to identify new drug candidates from

natural products.

Funded by U.S. –NIH, NSF, USDA, USAID

WALTER REED ARMY INSTITUTE OF RESEARCH - AFRICA ICBG

BUILT ON THE FOUNDATION OF A SUCCESSFUL DRUG DEVELOPMENT PROGRAM

A. Virtual Drug Company - Multidisciplinary StaffB. Rich in Tropical Diseases ExpertiseC. Not Profit DrivenD. Interactive With W.H.O., Academia, Industry

West and Central Africa ICBGObjectives

1-Establish and maintain inventory of species used in traditional medicine.

2-Identify lead compounds for the treatment of human diseases.3-Establish and maintain study plots for long-term assessment of

rainforest ecological dynamics.4-Conduct economic value assessment of major species in the host

country and the study area.5-Train scientists and technicians from participating countries in

various aspects of drug development, plant research and biodiversity conservation.

Department of Parasitology, WRAIR

Project Background

Korup Forest: access bridge Cameroon

Field Camp: Korup Forest, CameroonField Camp: Korup Forest, Cameroon

Collaborating Institutions Walter Reed Army Inst. of Research, Wash.D.C.

Pace University University of Pittsburgh Southern Research Institute University of Minnesota University of Florida Florida State University University of Utah

Smithsonian Institution, Wash. D.C. Smithsonian Tropical Research Institute, Smithsonian Man and the Biosphere Program

Bioresources Development and Conservation Program (BDCP), Nigeria and Cameroon

University of Dschang, Cameroon University of Buea, Cameroon International Center for Ethnomedicine and Drug

Development Nsukka Nigeria. University of Jos, Nigeria Biodiversity Support Program (c/o WWF)

Active Investigators: 64

Department of Parasitology, WRAIR

Drug Development LeadsDISEASES SAMPLES LAB. ACTIVITY% LEADS

TESTED

Malaria 500 WRAIR 343 (69%) 20Leishmania 130 WRAIR 52 (40%) 6Cytotoxicity 20 U of Utah 16 (80%)* 5Viral 30 SRI 16 (53%) 2Trypanosomiasis 27 PACE 13 (48%) 3Trichomonas 25 PACE 10 (40%) 7O.I.: Cryptosporidium 22 NIAID 7 (31%) 2Toxoplasmosis 22 NIAID 6 (27%) 2

Acknowledgements Dr. Brian Schuster Prof. Elijah Sokomba Prof. Paul Akubue Dr. Chris O. Okunji Prof. Francis Okwuasaba

Prof. Louis Barrows Prof. Simon Efange Dr. Chioma Obijiofor

Prof. Cyrus Bacchi Dr. Chike Onyechere Dr. Joan Jackson Prof. Johnson Ayafor Dr. Angela Duncan Dr. David Skanchy Dr. Claire Wirmum

Thank You !!!

Bioresources Development and Conservation Programme (BDCP)

Phone: Nigeria: (234)-42-253905U.S.A.: (301) 962-6201

Email: bdcp@bioresources.orgwww.bioresources.org