Regulate medicinal products in Lesotho

THIS article is in response to a piece written by ‘Malintle Matlakeng and her subsequent invitation for comments regarding an article she wrote titled Ngakas do more harm in fighting against Aids (Lesotho Times, December 1-7 2011).
I Dr Teboho Bulane, as an expert in the field of integrative medicine, plus my tireless efforts to help our nation, am strongly persuaded to share the following: First of all, in this particular case you have raised, the fundamental problem is not the title doctor (ngaka). The source of the problem is lack of regulation and registration of medicinal products in Lesotho. It must be well noted that testimonies about any product are not scientific proofs that a product is effective and safe.
Globally, there is an exponential increase in the use of complementary medicines in the form of herbal medicines and nutriceutical products. According to WHO World Medicines Situation 2011 Report, 70 to 95 percent of the world’s population relies on complementary medicines for primary health care in developing countries like Lesotho. Following the epidemic of HIV/Aids, the UNADIS 2011 Report stated that two out of three of people living with HIV/Aids infections in the developing countries like Lesotho rely on complementary medicines for symptomatic relief and management of opportunistic. It was found that there are three primary reasons people living with HIV/Aids opt to use complementary medical treatments namely:  A dangerously rough notion that a natural product is safe and effective.  Immune system boosting  General well-being. According to Peltzer and his associates (2008), 90 percent of the people living with HIV/Aids do not indicate to healthcare providers that they use herbal therapies. These facts draw attention to a sober reconsideration of the current HIV/Aids management approach. Clearly, a combination of the best of orthodox and complementary medical treatments for the betterment of the patient’s health (integrative medicine) is globally becoming more and more imperative. On the other hand, the inappropriate combination of orthodox medical treatments with complementary medical treatments can result in the following:  Reduced HIV/Aids and TB treatment effects  Increased chances of HIV/Aids and TB treatment toxicity Life-threatening adverse drug reactions Escalation of public health costs. The Upplase Monitoring Centre of the World Health Organisation (WHO) 2011 Report sheds more light on the deadly possibilities of the results of the inappropriate combination of both orthodox and complementary medical treatments. The Upplase Monitoring Centre of the World Health Organisation 2011 reported 12 679 interaction cases where only herbal substances were involved and 21 951 cases which included both herbal and non-herbal substances.
The report further stated that there were 3 389 reported critical cases for adverse drug reactions on herbal drugs. Four possibilities are highly the causative of the above.  There is a serious lack of trained and qualified healthcare providers in the field of complementary and integrative medicine. There is a lack of public education to report adverse reactions when using complementary medicines in any form. Patients are reluctant to provide information regarding their use of complementary medical products to their healthcare professionals.The problem also exists because of the absence of regulation and registration of medicinal products (therapeutic substances), particularly in Lesotho.
It is imperative to share with our people that because of lack of regulation and registration of any therapeutic substances, that is any medicinal products being chemicals, herbals and nutricueticals in Lesotho, the problem you have observed runs deeper than that. To reveal the few, according to our 2011 research findings, 1 929 medicines were studied. The percentage ratio between complementary medicines and conventional medicines was 46 percent to 53.7 percent, respectively.
31.55 percent of complementary medicines were registered from their country of origin while 68.45 percent were not registered from their country of origin. 70.39 percent of conventional medicines were registered from their country of origin while 29.61 percent were not registered from their country of origin. Percentage ratio between complementary medicines and conventional medicines in the supermarket was 92 percent to 8 percent respectively. 41.92 percent of complementary medicines in the supermarkets were registered from their country of origin while 58.08 percent were not registered from their country of origin. The above results revealed that 68.45 percent of over-the-counter medicines in the pharmacies their safety, efficacy and quality is questionable. 29.61 percent of the prescribed medicines in the pharmacies and by extension, even the ones in private doctors, private and government hospitals their safety, efficacy and quality is questionable. The results further indicated that 58.08 percent of the complementary medicines in the supermarket their safety, efficacy and quality is questionable.

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