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Friday, 4 December 2015

The Globalization of Traditional Medicine in Northern Peru: From Shamanism to Molecules

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 [13].
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 [46]. 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].