I write to inform you on the need to focus on the herbal medicine industry in your quest to tackle unemployment especially among graduates in Ghana. Let me first of all congratulate you on your election and inauguration as the 5th president of the 4th republic of Ghana. Policies such as one district one factory, Agriculture sector development, reduction/elimination of taxes, etc, as stated in your manifesto to tackle unemployment among the youth is highly commendable and will go a better way to address the identified problems in the country if implemented. I came across a portion in the NPP’s manifesto under the “HEALTH” segment which stated the need to integrate Traditional medicine into the health delivery system in Ghana. As it stands, Herbal medicine remains the only component of Traditional medicine that can be successfully integrated into the healthcare system as its practice is explicable with science just like other health disciplines.
Previous governments have contributed to the development of herbal medicine in their own capacities but these efforts have only gave the controlling powers of the herbal industry to indigenous herbal practitioners known as Traditional Medicine Practitioners (TMP’s) at the expense of professionally trained counterparts from the Kwame Nkrumah University of Science and Technology (KNUST), College of Integrated Medicine, Obuasi, and other private herbal schools. Evidence of this is seen with the recognition of the Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM) as the only legally mandated body in Ghana that liaises with Government and other organizations on herbal medicine issues and matters arising. There are limited opportunities for graduates in an industry controlled by indigenous practitioners. Mr President, the two main areas of herbal medicine industry exploited presently is clinical practice, and manufacturing (of medicines, herbal based alcoholic beverages, skin care products, etc). The rest involve the sale of products by way of wholesale and retail. Unfortunately the operators of these two major areas in the industry are indigenous people with no medical and pharmaceutical training and thus do not see the need to employ graduates. Most of them are business men with the sole intention of making profits and so heavily rely on advertisements through the media at the expense of the health of individuals. The most annoying part is that they control the activities of the few professionals in the industry, which is why the industry is still at the same spot although these professionals have also been in the system for long time. Mr President the problem at hand requires mainly policy and legal intervention to ensure that the needed systems are created within the herbal medicine industry to provide employment for not only professionally trained herbal medicine practitioners, but also for graduates in the field of Science, Social Sciences, Pharmacy, Nursing, and Medicine. The College of Integrative Medicine situated at Obuasi commenced the training of nurses and physician assistants solely for clinical herbal medicine practice years ago. Many graduates from the school just like those (Medical Herbalists) trained at the Kwame Nkrumah University of Science and Technology are unemployed.
An independent policy that gives direction to the clinical practice, manufacture, and regulation of herbal medicine professionally just like with pharmacy practice has to be either developed or the existing one reformed. “POLICY ON TRADITIONAL MEDICINE DEVELOPMENT IN GHANA”, a single document that puts together previous and present government’s policies regarding traditional medicine practice prior to the formal training of herbal medicine professionals, is the only available policy document that directs the Traditional and Alternative Medicine Directorate (TAMDI) on what to do with the herbal medicine practice. The policy document which lays out a plan to integrate traditional medicine into the main healthcare delivery system prioritises Traditional Medicine Practitioners (TMP’S) as the sole custodians although they are not professionally trained. Most of the provisions in the said document have been implemented with the exception of the integration. The reason for the failed integration is simple; TMP’s do not have medical training. All healthcare practitioners in the main health delivery system have a common medical foundation/training with which they are able to understand each other and work together as one unit in provision of quality care to people. On clinical herbal medicine practice, a reformed policy document should lay emphasis on the integration of herbal medicine practice by professionals like Medical Herbalists (M. H) and other trained herbal physicians and nurses, into the main healthcare delivery system in Ghana. Piloting of the services of Medical Herbalists in selected government hospitals have been in existence since 2012 but no efforts have been made to achieve full integration that will mandate all government and private hospitals have herbal clinics or units.
The reformed policy document should also lay emphasis on the inclusion of basic herbal medicine training in the syllabus of other health professionals like Medical Doctors, Nurses, Medical Laboratory Scientists, Sonographers, etc, for them to get the scientific basis on the nature of herbal medicines and how they work to clear all the misconceptions that has since prevented the acceptance and recommendation of herbal medicine services by these health professionals. Medical Herbalists and other professionals already have basic knowledge in Medical and Pharmaceutical Sciences as part of their training and as such are well positioned to work with the already mentioned health professions in the provision of quality health care to patients. An ideal herbal clinic as a department within a state owned health institution or hospital possesses an Out-patient-department, consulting rooms, records unit, and dispensary. Medical Herbalists are the doctors in charge of the consulting room by virtue of their formal training, meaning the other sections of the clinic will be run by Nurses, dispensing technicians, and record keepers thus creating several employment opportunities for graduates in these areas.
Mr President, the reformed policy document should give recognition to the professional body of Medical Herbalists known as THE GHANA ASSOCIATION OF MEDICAL HERBALISTS (GAMH) as the custodians of the clinical herbal medicine practice in Ghana instead of the GHAFTRAM (an indigenous body) as it is currently. This I believe will help instil faith in the profession and put the reckless activities of some of these local practitioners in check. An amendment should be made to the already available Traditional Medicine Practice Act 2000 (ACT 575) to hand over the controlling power of herbal medicine practice to the professionals and its body (GAMH). The TMP ACT led to the creation of the only available regulatory council known as Traditional Medicine Practice Council (TMPC) in 2010. TMPC with board membership for 5 indigenous practitioners and none for professional herbal practitioners (Medical Herbalists) currently regulates the activities of both professional and indigenous herbal medicine practitioners; as such there has been a loop hole with the practice therefore lots of charlatans are currently in the system holding practice licenses from this so called regulatory council. Professionals (Medical Herbalists) taking over control of the TMPC after amendment to the ACT 575 for instance will help ensure people qualified for the job are employed to serve public interest. A functioning private herbal clinic or hospital employs Medical herbalists, nurses, accountants, physiotherapists, dispensing technicians, Medical laboratory scientists, sonographers, security personnel, record keepers, managers for different branches, cleaners, IT personnel, Gym instructors, drivers, store keepers, among others. This will also help complement the work of the Food and Drugs Authority (FDA) in ensuring close monitoring of all herbal medicine practices, manufacturing and sale of products in herbal shops and pharmacies unlike the current situation where private gains is the order of the day by people (indigenous practitioners) tasked with monitoring as TMPC officials.
There should be a legal provision that mandates all privately owned herbal clinics, shops and hospitals register their facilities with professional licenses (Licenses of Medical Herbalists), so that Medical Herbalists who register these herbal facilities are held responsible by a higher authority (TMPC officers at the district, regional and national level of practice), just like with Pharmacy and the Medical profession. The district, regional and national offices of TMPC will create jobs for graduate social scientists as they will be needed for proper administrative works to help achieve the objectives of TMPC as a regulatory body of traditional medicine practice which herbal medicine falls under, unlike the current situation where indigenous practitioners and unqualified personnel are put in charge of these offices across the nation thus most of them appear non-functional. Mr President, I cannot talk about all the immense benefit this provisions if made will have on the country in terms of job creation for graduates. As it stands, most clinical herbal medicine facilities do not have professional medical herbalists to supervise their activities and as such they do not employ professionals or graduates to handle patient consultations, Nursing services, Laboratory services, dispensaries, physiotherapy services, etc. Some health facilities do not even possess important units that aid in diagnosis like medical laboratories, and ultrasound departments. In some cases these herbal centres rely on diagnostic machines (only meant to aid health professionals in diagnosis of diseases) as the main source of diagnoses and as such have misdiagnosed and extorted several people. In some cases, the people that handle the so called machines are not professionals and so are unable to interpret the results obtained. Also the quack people employed as physicians in their consulting rooms have no medical training and so are unable to make proper use of ultrasound, X-ray, and laboratory results in arriving at concrete diagnosis. Most of them are not able to utilize the past medical records of people who wish to seek alternative care for their chronic conditions at their facilities. The conditions of service of the few professionals that work with these centres is disheartening as owners of the facilities rely heavily on the media to attract clients by way of advertisements so therefore see no need for qualified health professionals. The contents of their adverts contradict the provisions stipulated in the FDA’s guidelines for advertisement and the Public Health ACT 2012. With full integration of traditional
Mr President, also on manufacturing of herbal medicines, the Public Health ACT 2012 clearly directs supervision of drug/manufacturing units by qualified person approved by the Food and Drugs Authority (FDA) as having specialist knowledge in the article to be manufactured, and the conditions under which the manufacture is to be carried on (Standard Operating Procedures) specified in the Guidelines(Good Manufacturing Procedure) of the FDA to ensure that the article will be of good quality and safe to use. The FDA currently needs assistance from the practice regulatory body TMPC just like it relies on the Pharmacy Council most of the time to help supervise pharmaceutical manufacturing units before its site inspection period. There is the need to enforce the usage of a formidable Herbal Pharmacopeia to guide the preparation of the Standard Operating Procedures (S. O.P) for the manufacturing, dosing, packaging and quality control of all herbal medicines for use locally or for exportation. A pharmacopeia is a publication containing a list of medicinal drugs/plants, acceptable procedure and conditions for their preparation in different dosage forms, quality control processes, information on packaging, preservative usage etc, and is usually the property of the state. Mr President, Ghana does not own a Pharmacopoeia for the Pharmaceutical industry but rather relies on that of Britain (B.P) and United State (U.S.P). It however has one for the Herbal industry called the Ghana Herbal Pharmacopeia with the latest edition revised by the Late Prof Kofi Annan, former Head of Department for Herbal Medicine, and former Dean of the Faculty of Pharmacy, KNUST, in consultation with the appropriate bodies like research institutions, etc. It is sad that most of the herbal manufacturing industries (mostly owned by indigenous practitioners) do not have in their possession a Standard Operating Procedure and other relevant systems. Miraculously they most of the time pass FDA’s site inspections. Bribery and corruption has become the order of the day.
Mr President, just like the clinical herbal practice, a functioning herbal manufacturing unit/factory with proper supervision by herbal medicine experts employs quality control personnel (usually graduates with science background), production manager, supply chain /procurement officers, accountants, production staff ( Senior high school levers, and tertiary graduates), engineers (electrical, mechanical, etc), operators of distribution vans, ware house supervisors, store room keepers, Cultivators of medicinal plants, etc. There are several herbal manufacturing industries (both medicinal and herbal based alcoholic) currently in the country with few job opportunities as a result of greed, and lack of close supervision. There is no practice without medicines and these medicines are produced with medicinal plants. By law, every herbal centre should have medicinal farms to grow the various plants they utilize or better still should rely on cultivators of medicinal plants for supply instead of the overreliance on plants growing in the wild. Over reliance on plants growing in the wild for preparation of various herbal medicines/products have led to adulteration in recent times, as continuous availability of such plants is not assured with high public demand.
Medicinal farms are needed to ensure continuous availability of consistent high quality efficacious herbal medicines and comparable responses from the same dose administered at any given time. Establishment and running of these farms especially in the northern part of the country requires continuous irrigation so I hereby plead with you to include them in the ONE VILLAGE ONE DAM policy. Medicinal plants cultivation/medicinal farms will create jobs for graduates in the field of agriculture and botany. The economy of Ghana will also enjoy foreign exchange from exportation of raw or partly processed cultivated medicinal plants yearly just like with China and India. Plants remain major sources of pharmaceutical drugs therefore medicinal plant cultivation and processing is important. Mr President, the lack of processing plants to isolate and concentrate components of medicinal plants used in various pharmaceuticals/drugs remains a big challenge therefore most pharmaceutical companies have had to import isolated plant concentrates at high exchange rates from countries like UK, India, Germany, U. S, etc despite having enough experts in that field by way of postgraduate research studies in plant medicine and pharmacy.
In conclusion, the herbal industry is growing at a faster rate without the needed systems/structures for graduates job creation and effectiveness thus its opportunities have not been fully exploited. We cannot continue to say HERBAL MEDICINE IS THE FUTURE whiles our actions today does not put us in a position to later enjoy the benefits from the herbal industry in the future. I will be grateful if my concerns are seriously considered, verified by way of investigations, and implemented for job creation and the betterment of our economy and country as a whole.