Evid Based Complement Alternat Med. 2013; 2013: 291903.
Published online 2013 Dec 28. doi: 10.1155/2013/291903
PMCID: PMC3888705
Abstract
Northern
Peru represents the center of the Andean “health axis,” with roots
going back to traditional practices of Cupisnique culture (1000 BC). For
more than a decade of research, semistructured interviews were
conducted with healers, collectors, and sellers of medicinal plants. In
addition, bioassays were carried out to evaluate the efficacy and
toxicity of plants found. Most of the 510 species encountered were
native to Peru (83%). Fifty percent of the plants used in colonial times
have disappeared from the pharmacopoeia. Market vendors specialized
either on common and exotic plants, plants for common ailments, and
plants only used by healers or on plants with magical purposes. Over 974
preparations with up to 29 different ingredients were used to treat 164
health conditions. Almost 65% of the medicinal plants were applied in
these mixtures. Antibacterial activity was confirmed in most plants used
for infections. Twenty-four percent of the aqueous extracts and 76% of
the ethanolic extracts showed toxicity. Traditional preparation methods
take this into account when choosing the appropriate solvent for the
preparation of a remedy. The increasing demand for medicinal species did
not increase the cultivation of medicinal plants. Most species are wild
collected, causing doubts about the sustainability of trade.
1. Introduction
Traditional
medicine is used globally and has a rapidly growing economic
importance. In developing countries, traditional medicine is often the
only accessible and affordable treatment available. In Uganda, for
instance, the ratio of traditional practitioners to the population is
between 1 : 200 and 1 : 400, while the availability of Western doctors
is typically 1 : 20,000 or less. Moreover, doctors are mostly located in
cities and other urban areas and are therefore inaccessible to rural
populations. In Africa, up to 80% of the population uses Traditional
Medicine as the primary healthcare system. In Latin America, the WHO
Regional Office for the Americas (AMRO/PAHO) reports that 71% of the
population in Chile and 40% of the population in Colombia have used
Traditional Medicine. In many Asian countries, Traditional Medicine is
widely used, even though Western medicine is often readily available. In
Japan, 60–70% of allopathic doctors prescribe traditional medicines for
their patients. In China, Traditional Medicine accounts for about 40%
of all healthcare and is used to treat roughly 200 million patients
annually. The number of visits to providers of complementary-alternative
medicine (CAM) now exceeds by far the number of visits to all primary
care physicians in the US [1–3].
Complementary-Alternative
Medicine is becoming more and more popular in many developed countries.
Forty-eight percent of the population in Australia, 70% in Canada, 42%
in the US, 38% in Belgium, and 75% in France have used
Complementary-Alternative Medicine at least once [4–6]. A survey of 610 Swiss doctors showed that 46% had used some form of CAM, mainly homeopathy and acupuncture [7]. In the United Kingdom, almost 40% of all general allopathic practitioners offer some form of CAM referral or access [8].
In the US, a national survey reported the use of at least 1 of 16
alternative therapies increased from 34% in 1990 to 42% in 1997 [9, 10].
The
expenses for the use of Traditional and Complementary-Alternative
Medicine are exponentially growing in many parts of the world. In
Malaysia, an estimated US $500 million is spent annually on Traditional
Medicine, compared to about US $300 million on allopathic medicine. The
1997 out-of-pocket Complementary-Alternative Medicine expenditure was
estimated at US $2,700 million in the USA. In Australia, Canada, and the
United Kingdom, annual Complementary-Alternative Medicine expenditure
is estimated at US $80 million, US $2,400 million, and US $2300 million,
respectively. The world market for herbal medicines based on
traditional knowledge was estimated at US $60,000 million in the late
1990s [11]. A decade later, it was around US $60 billion [12] with estimates for 2015 at US $90 billion [13].
The sales of herbs and herbal nutritional supplements in the US
increased to 101% between May 1996 and May 1998. The most popular herbal
products included Ginseng (Ginkgo biloba), Garlic (Allium sativum), Echinacea spp., and St. John's wort (Hypericum perforatum) [11].