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COVID-19: Madagascar solution stirs claims of local organic cure

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The search for homegrown solutions to the novel coronavirus (COVID-19) has gathered momentum. Despite opposition from the World Health Organisation (WHO), the Nigeria Centre for Disease Control (NCDC) and other agencies, traditional/ herbal cures are blazing the trail.

In fact, a herbal tonic from Madagascar has broken all the boundaries especially because the President of the country has sworn by it and instructed that it should be used to treat its citizens who contract the virus. Since then, other African countries, including Senegal and Nigeria, have joined the bandwagon. 

But what is interesting in the case of Nigeria is that a Federal Government who had rejected similar herbal drugs brought forward by its own scientists was now ready to receive such product from Madagascar. President Muhammadu Buhari had ordered the Presidential Task Force on COVID-19 to deploy the Madagascar herbal drug for the treatment of patients with COVID-19 in Nigeria but only after tests by the National Agency for Food and Drug Administration and Control (NAFDAC).

Nevertheless, after health workers in Nigeria including pharmacists, nurses and medical laboratory scientists and the House of Representatives kicked against the plan to import the herbal tonic – COVID-Organics (CVO) – from Madagascar, the Presidency seems to be making a U-turn. The Presidency last Thursday explained that it did not order for the herbal tonic from Madagascar, saying it was offered to the country.

The Minister of Health, Dr. Osagie Ehanire; the Director General of NAFDAC, Prof. Mojisola Christianah Adeyeye; and President/Chief Executive Officer, Bioresources Development Group, Prof. Maurice Iwu refused to comment on the issues at press time.

But the Minister had said during the PTF briefing last Monday that the plant used for the Madagascar herbal medicine grows in the country.He said the expected samples would be compared with the strain in Nigeria to ascertain its similarities.

“We understand that it is something called Artemisia annua, which also grows here. But we would like to get that sample and compare it with the strain here to know if they are exactly identical or similar and then see what properties it has. It will be subjected to analysis to find out what works in there and how it works and is used in getting a cure.

“All countries around the world are interested in finding a cure and we are not different; so we will look at all options, possibilities and promises that were made,” he said.

On May 4, the World Health Organisation (WHO) announced that it welcomes innovations around the world including repurposing drugs, traditional medicines and developing new therapies in the search for potential treatments for COVID-19.

A statement by the world health body read in part: “WHO recognises that traditional, complementary and alternative medicine has many benefits and Africa has a long history of traditional medicine and practitioners that play an important role in providing care to populations. Medicinal plants such as Artemisia annua are being considered as possible treatments for COVID-19 and should be tested for efficacy and adverse side effects. Africans deserve to use medicines tested to the same standards as people in the rest of the world. Even if therapies are derived from traditional practice, establishing their efficacy and safety through rigorous clinical trials is critical.

“WHO is working with research institutions to select traditional medicine products, which can be investigated for clinical efficacy and safety for COVID-19 treatment. In addition, the Organisation will continue to support countries as they explore the role of traditional health practitioners in prevention, control and early detection of the virus as well as case referral to health facilities.”

The invention of COVID Organics in Madagascar was, therefore, not a surprise to many observers in the health sector. What appears surprising is Nigeria’s interest in the herbal mixture given that it had maintained an indifferent posture to claims of herbal remedies to COVID-19 by some Nigerians.

A professor of Pharmacognosy and President and Chief Executive Officer (CEO) of Bioresources Development Group (BDG), Abuja, Prof. Maurice Iwu, had claimed that besides inhibiting the novel coronavirus (COVID-19), a drug patented by his company also stopped the growth of Ebola Virus Disease (EVD) and dengue fever.

Iwu, who is also the CEO of the International Centre for Ethnomedicine and Drug Development (InterCEDD), Nsukka, Enugu State, and Bioresources Institute of Nigeria, Umuna, Onu-Imo, Okigwe, Imo State, said his company had plans for clinical trial of the herbal-based COVID-19 drug at the NCDC isolation centre in Lagos or other suitable sites.

The former Chairman of the Independent National Electoral Commission (INEC), who recently spoke in an exclusive interview with The Guardian, said: “The clinical trials have not yet started. I said ‘trials’ because we anticipate sequence of trials as we are dealing with more than one product. Luckily, we already have a NAFDAC-listed product, which we want to subject to clinical evaluation against COVID-19. The clinical trial titled, ‘Efficacy and safety of IHP Detox Tea (a special blend of Andrographis paniculata, Garcinia kola and Psidium guajava) for treatment of Coronavirus disease 2019 (COVID-19): a pilot
placebo-controlled randomised trial,’ will be conducted by an independent research group, led by Vice Chancellor (VC) of Nnamdi Azikiwe University Awka, Anambra State. The study is planned to be carried out in the NCDC COVID-19 isolation site in Lagos or other suitable site.”

“It may interest you that one of the plants that yielded the active compound has been clinically evaluated in several studies. In one of the published reports, Andrographis has been clinically evaluated about 33 times in full blown clinical trials.”

On the constituents of his product, Iwu said: “We actually patented three active compounds: Andrographolide from Andrographis panicultata, Akiluvir (from Garcinia kola) and Alstonine from Picralima nitida seeds. I am really surprised at your question because the whole idea of a patent is full disclosure. We had screened thousands of plant extracts for various biological activities. Many of them including black seed oil, neem, lemon grass, citrus leaves and peel, turmeric, many other spices and herbs, etc. showed some antiviral activity but these three compounds exhibited remarkable antiviral activities and significantly inhibited the growth of Severe Active Respiratory Syndrome (SARS) coronavirus in laboratory studies,” he added.

Also, a professor of Pharmacognosy at the Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Prof. Olukemi Odukoya, who also recommended some herbal remedies for the virus, explained that when COVID-19 infects a cell, it hijacks the existing molecular machinery to create long chains of proteins required by the virus to generate even more copies of itself.

“These long viral proteins, however, only become functional when cut into smaller pieces by proteases. Thus, coronavirus proteases like that of COVID-19’s, play an integral role in propagating the virus. Similar to a lock and its key, the protease’s activity is triggered by the binding of molecules to specific points on the protease called active sites. The binding of a substrate effectively switches the protease on, allowing it to cut the long viral protein strands into smaller chains. The protease’s activity can also be blocked by molecules called inhibitors. When an inhibitor attaches to an active site, it prevents the binding of substrates—stopping the action of the protease altogether. Therefore, finding an inhibitor for COVID-19’s protease may be the first step to beating the epidemic.”

According to her, the proteinase activities for all coronaviruses include papain-like proteinase (PLP).“Papain, also known as papaya proteinase I, is a cysteine protease enzyme present in papaya (Carica papaya). Papaya has natural inhibitors complexed to papain as recorded by Monti et al., 2004.

Can this block the proteinase activities of COVID-19’s protease and be the key to lockdown the activity of the virus naturally? “The enzyme papain has been found helpful in lowering inflammation and Papaya contributes to a healthy immune system by increasing resistance to coughs and colds because of its vitamin A and C contents. Carica papaya constituents exhibit alkaline combination,” he added.

She added: “Garlic, Ginger, Capsicum and Xylopia are used in Traditional Medicine because they are rich in polyphenols and have high antioxidant capacity. In addition, these spices have antimicrobial activity. Using these spices together potentiates activity synergistically. Rosella (Zobo) as well as Spondias (Spondias mombin) have high levels of Vitamin C and will render the COVID-19 spike proteins less active.”

Amid the Madagascar solution and claims of herbal cure by Nigerians, medical doctors under the aegis of the Nigerian Medical Association (NMA) and other health professionals seem not amused.

President, NMA, Dr. Francis Adedayo Faduyile, told journalists yesterday: “The acceptance of the herbal remedy from Madagascar, Covid Organics, by the Federal Government is an act of pulling all stops in search of remedial interventions in protecting the lives of our citizens. We appreciate the concerns of our colleagues in the Pharmaceutical Society of Nigeria (PSN) and bemoan the situation where Nigeria appears to be lagging and not leading the Black race’s response against the pandemic. NMA insists that the herbal mixture undergoes due diligence based on scientific methods before authorising its use in the polity while urging the government to leapfrog the revitalisation of research and production activities of our pharmaceutical industries.”

Pharmacists under the aegis of Pharmaceutical Society of Nigeria (PSN) and other health workers under the umbrella of Joint Health Sector Union (JOHESU) also provided reasons the Federal Government should not import COVID-19 herbal tonic from Madagascar.

JOHESU is the umbrella body of all health workers in Nigeria excluding medical doctors. President, PSN, Mazi Sam Ohuabunwa, said importing herbal tonic from Madagascar “is thoroughly disgraceful.” He argued: “Nigeria has about 174 universities (43 federal, 52 state and 79 private), 20 Faculties of Pharmacy and about 69 federal-funded research Institutes including National Institute for Pharmaceutical Research and Development (NIPRD), Abuja, and the National Institute for Medical Research (NIMR), Yaba, while Madagascar has only six universities, one Faculty of Pharmacy and nine research centres.

“Nigeria has some of the best scientists (pharmaceutical, medical, biochemical, biological etc.) in the world who have done so much work on natural and herbal medicines.

“Nigeria has developed a pharmacopeia of natural and herbal products and has one of the richest flora and fauna – potent sources of phytomedicines.

“Since the outbreak of the COVID-19, a number of them have raised their voices that they have herbal and natural products that can be used to treat or manage COVID-19. Some have patents. Many herbal companies and producers have announced specifically that they have herbal formulations that can do what this ‘invention’ from Madagascar can do.”
   
Ohuabunwa added: “While in principle we would not mind the Nigerian government importing any new drug that is proven to cure COVID-19 or indeed any other disease for which we have neither the capacity nor the technology to produce locally, we are totally appalled that Nigeria is about to spend scarce foreign exchange to import ‘Coal into Newcastle’. Even if we are not going to pay for this, it is thoroughly disgraceful that a country that should be the leader of Africa, with the largest Gross Domestic Product (GDP) will allow itself to be dragged this low.

He noted that pharmacists had raised their voices severally that the Federal Government should review these claims and put them through clinical evaluation, as most of the producers could not afford to conduct clinical trials. He said they had recommended that a portion of the nearly N25 billion donated/allocated for the COVID-19 pandemic should be dedicated for local research and development, but the government has remained essentially silent, only waiting to participate in the World Health Organisation (WHO) sponsored or mandated trials.

“We have been told that Nigeria is participating in the WHO solidarity trial, but nothing on trying our own inventions and formulations,” the pharmacist said.
   
Ohuabunwa added: “Now, we want to import COVID Organics from Madagascar to try. Why are we like this? If the world can supply us synthetic and chemically-sophisticated medicines, which we apparently lack the technology to produce, why must we wait for the world to supply us herbal formulations, which we can easily make and which we have similar products.”
   
“We urge our government to save Nigerian pharmaceutical scientists and other scientists from the shame of having our country import and try herbal remedies which God has given us in abundance and some of which our grandfathers and grandmothers have used for ages. Let us try our own local formulations before we try COVID Organics or any other imported remedy. Every well-meaning nation has been in a race to find cures, remedies and other medical supplies used for COVID-19, while we seem to wait for other nations to solve our problems. There is much talk but little action.
   
“This dependency mentality needs to change and now is the time. We must seize this opportunity to look inwards, build confidence in our abilities, competences and re-orientate our national economic philosophy from import dependency to export driven. And Nigeria can beat India and China in the production and export of herbal products if anyone is willing to lead us down this path.”

   
Chairman, JOHESU, Comrade Bio Joy Josiah, told The Guardian: “Ordinarily, one will wonder why the FG will start with a Madagascan herbal tonic. It is better to make further enquiries on this matter for informed decision-making.

“We have an emergency on our hands right now. Naturally, people want anything that brings a remedy at reasonable cost. Our attitude should be to allow any remedy that has successfully passed through due process of the scientific evaluations/protocol at National Agency for Food and Drug Administration and Control (NAFDAC) be used at this time. So, whether it is a Somalian, Chadian or Nigerien tonic would not really matter for as long as it brings relief without adverse reactions or other negative consequences to a consumer.”
   
Asked if he recommends herbal remedies for COVID-19, Josiah said: “Our pharmacist members give the impression that all drugs are basically of natural origin. We are a nation blessed with trees, leaves, barks, roots and the like, so it will be delightful to witness the use of herbal preparations in the health system.

“In the last few weeks, I have read claims of all sorts, including those of a former Acting Vice Chancellor of a first generation university and accomplished pharmacist, which all insinuate that they have herbal remedies for COVID-19. I will volunteer to be the foremost promoter and marketer for any such product provided that there is scientific validation and endorsement from NAFDAC, which is statutorily mandated to carry out such functions.”

On Prof. Iwu’s claim, the JOHESU Chairman said: “It is still in the same realm as the last insight I provided. Iwu’s claim was one of those I referred to earlier. Iwu is an internationally acclaimed researcher, so he is more familiar with this terrain than I am. Science is about facts and not magic like some will like to relegate it to become. It is on this note that I am encouraging all researchers in herbal medicine to subject their formulations to clinical trials for eventual registration for use.”


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