Pharm. Sam Etatuvie is the director general of the Nigerian Natural Medicine Development Agency (NNMDA). During a recent courtesy visit to Pharmanews office in Maryland, Lagos, Etatuvie spoke on the agency’s plan to introduce new locally made insecticide-treated bed nets with herbal extracts, noting that this will help tackle the challenge of mosquito resistance to treated nets made with pyrethoids. He also spoke on the agency’s efforts to collaborate with dedicated scientists and entrepreneurs to deepen the development of herbal medicines in the country. Excerpts:
Some Nigerian researchers recently discovered that malaria-causing mosquitoes are now resistant to Long Lasting Treated Nets and some insecticides, leading to serious concerns in some parts of the country. As an agency that focuses on natural medicine development, is there any herbal alternative that could be used to tackle this challenge?
One of our critical areas in drug development in terms of products development is that of malaria eradication, but we look more at vector control. To this extent, we developed a mosquito repellant, using pure extracts from medicinal plants indigenous to Nigeria. It is one of those things that we will soon put into the market. The common mosquito repellant is Odomos, which contains DDT and other components.
The other area we also looking at is how we can incorporate these extracts into the mosquito treated nets, because if you look at the existing ones, they are made of pyrethoids; but pyrethoids is not very effective in this clime. We have our own extracts that people have used for a very long time to scare away mosquitoes. Thus, we are working to put these extracts into the nets and it will give us a better result and also prevent this resistance war.
When is this new mosquito repellant likely to be available?
It is already in progress. We are actually waiting for NAFDAC listing. We exhibited it at the last Technology and Innovation Ministry Conference that was held in April 2017. It can be easily rubbed on the body and it has good fragrance, and can be used for little children. The good thing is that it is also useful in animal care. For those that have dogs and other pets at home, they can apply it to scare away flies.
Few weeks back, a bill for an act to provide for establishment of complementary and alternative medicine (CAM), with the aim of integrating CAM into the nation’s healthcare system, passed the third reading at the National Assembly. Can you briefly explain the merits of this bill to the healthcare system and are there inputs from your agency in this bill?
First of all, there is no input from our agency in the bill. There is always this semantics of alternative, complementary, and the WHO calls it CAM (complementary alternative medicine). If you look at our mandate, it’s basically looking at our indigenous healthcare systems; but if you look at the CAM itself, you are looking at other forms of treatment like osteopathy, allopathic medicine and acupuncture from Asian countries.
There is the Nigerian Council of Physicians of Natural Medicine (NCPNM) headed By Bishop Atilade. They are osteopaths who have studied outside the shores of the country on this area of medicine; they are the people behind the CAM bill. They have a representation in the Nigeria medical and Dental Council. Thus, those treatments are alternative to the ones we have here; that is, to our indigenous medicines. In fact, they are available in some hospitals now, in forms of acupuncture, naturopathic and so on.
However, naturopathy is the closest to what the agency is doing. Thus, the NCPNM is responsible for the CAM, not NNMDA. We have got no problem with the bill, because if other countries have developed their own indigenous products to the level of WHO approval, then it’s a plus for them and availability of variety for Nigerians to choose which method is best for their body chemistry.
Will this not slow down the development of our indigenous herbal medicines? If the National Assembly is pushing for the adoption of natural medicines from other countries, how and when will ours be developed?
There is time for everything. That was why the government established NNMDA, and we are not working in isolation. NNMDA is in partnership with NIPRID in some areas; so the work has been complementary.
In those days, when we started, we did some major works together. For instance, we did a UNESCO project together, and so on. So, there is no fear in that if people have a health challenge, it is getting a solution that is more important to everybody than how the solution came.
We are concerned with the result. If you have a challenge with your bones and an acupuncturist can use his needle and tools to solve the problem, that is fine. I think it is better to create opportunity for alternatives in our healthcare delivery system, rather than having one method of care delivery.
How far has the agency gone in assisting scientists who want to embark on production of herbal medicines?
We have done documentation of all the research works and findings on all Nigerian scientists on medicinal plants. If you are a curious scientist and you really want to formulate herbal medicine, we have that information for you. All you need do is to study them. We know the plants that have been worked on and the result, then what you need to do.
There are also herbal pharmacopeias in this country; we actually attempted to develop Nigeria herbal pharmacopeias. There is the West African Pharmacopeia, and even Ghana has her own pharmacopeia. So, if you have access to this pharmacopeia and to our own documentation, it gives you real opportunity of where to look for a particular disease state. I believe that, as entrepreneurs, we should be able to look at what is existing, what we need and the best alternative for us.
I also want to emphasise the fact that NAFDAC has made it easier for many entrepreneurs. If you want to do your formulation, you need to intimate NAFDAC about it, and they come to your facility to do the inspection and tell you two or more best ways to go about it. Then you proceed for the listing of the product and once this is done, it can last for two years. At the expiration of these two years, you can put in for another two years before the product can be taken for clinical trials abroad for additional studies.
Clinical trials are expensive but we are working with ADCPN to see how best we can reduce the cost and other ethical issues that are related to them. For me, those are the areas I want to direct everybody’s attention to. There is a lot of information out there; you can pick any medicinal plant, from the root to the leaf, to the flower and whatever it contains and how we can meet up.
Is there any plan to digitalise your materials for proper accessibility and durability?
We have what they call the Digital Virtual Library. If you come to the agency, the library is divided into two sections – the digital library and the physical library. Our documentation, in most cases, we try to have it in soft copy, as we are working on it. Our target for all users is to be able to buy e-copies of books through our website; and we shall ensure the website is in good order before the end of July.
Are there things you are going to do to encourage patronage from the pharmaceutical industry?
I think a lot of partnership is important and like I said, I want to meet the PMG-MAN to discuss some of the plans I have with them. There are lots of individual entrepreneurs, who have already indicated their interest. For instance, the Association of Incubation Entrepreneurs – some of their members have under done our trainings and we linked them up to another agency, which is the Nigerian Board for Technology Incubation.
Every state, except for one or two, has an incubation centre – what they call Technology Incubation Centre (TIC). In Lagos, it is at Agege.
So, if we train an entrepreneur and his product has a lot of prospects, we link them up with the TIC, then the TIC will give them a space to start. Once you commence, you have a shade for your facilities – generator, water, opportunity to work as a group and to talk to the Bank of Industries or the Bank of Agriculture as a group, for financial assistance.
But the formal sector – that is, the real manufacturers – know more than me about the challenges of manufacturing products. I believe that’s why they are also finding it difficult to come into natural medicine development at the moment; they are really into either importing finished products or almost finished products, as well as raw materials for pharmaceuticals
I think now, when we have this so called recession, is a good time to do what is called backward integration. This is the best time we can push people. From my own experience, the bio diversity of this country is much better than the one in India and China. So, if we do good work, we should be able to have better quality products.
The cancer scourge is on the rise generally. Has the agency identified any treatment potentials in any indigenous plant?
We thought about it but a lot of people are working in that area. No need for spending limited resources to embark on a duplicated project. Even bitter leaf has been shown to help manage cancer. A lot of people have done good work. We are thinking of prostrate cancer, actually, and we have taken some steps to work with some organisations in Abuja; but we have not concluded the arrangement.
There is somebody in Sapele, Delta State, that we have just discussed with, who has a herbal product on the management of prostate cancer. He wrote to the Ministry of Health and the ministry directed us to have some discussion with him, which I just did about a few weeks ago. By the time it’s a candidate product we can work with, it will be a great relief to patients, and that will be another step forward.