‘Agbo jedi-jedi’ seems to be the most frequently used herbal medicine preparation, followed by ‘agbo-iba’ and Oroki herbal mixture. Family and friends reportedly influenced most users of herbal products to give them a try, and these herbal products were considered safe by the users of these herbal medicine preparations despite experiencing mild or moderate adverse effects.

Herbal Medicine Products
Herbal medicine products are a very significant part of “Traditional Medicine” (TM). Traditional Medicine has a broad range of characteristics and elements which earned it the working definition from the World Health Organization (WHO). Traditional medicines are diverse health practices, approaches, knowledge, and beliefs that incorporate plant, animal, and/ or mineral-based medicines, spiritual therapies, manual techniques, and exercises that are applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness. It is also known as “Complementary” or “Alternative” medicine (CAM).

Herbal medicines, also called botanical medicines or phytomedicines, refer to herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients. The plant materials include seeds, berries, roots, leaves, bark or flowers. Many drugs used in conventional medicine were originally derived from plants.

Over 60% of Nigerian households now depend on traditional medicine for primary health care, due to the pressing economic crunch.

Widespread Use Of Herbal Products
Despite the widespread use of herbal products among Nigerians and their reported benefits, they are not completely harmless. The indiscriminate, irresponsible, or non-regulated use of several herbal products may put the health of their users at risk of toxicity. Also, there is limited scientific evidence from studies done to evaluate the safety and effectiveness of traditional medicine products and practices. Adverse reactions have been reported to herbal medicines when used alone or concurrently with conventional or orthodox medicines.

Herbal medicine products use among adults without chronic illnesses is becoming quite high in Nigeria. Many users claim herbal medicine products are safe, cheap, effective, and beneficial. These users believe that herbal medicine products rarely produce adverse effects, a few experienced them mildly and moderately. Considering the magnitude of popularity of herbal medicine products among its users and their levels of ignorance of the potential toxicities, it is necessary to evaluate the safety, efficacy, and quality of these preparations and products which may involve clinical trial studies. Public enlightenment programme, in the form of health education about the safe use of herbal medicine products, maybe a useful means of minimizing the potential adverse effects

Despite the national diversity and adoption of Traditional Medicine in different cultures and regions, there is no parallel advance in national standards and methods for its evaluation. National policies and regulations also are lacking for Traditional Medicine products in many states and where these are available; it is difficult to fully regulate Traditional Medicine products, practices, and practitioners due to variations in definitions and categorizations of Traditional Medicine therapies. Lack of knowledge of how to sustain and preserve the plant populations and how to use them for medicinal purposes is a potential threat to Traditional Medicine sustenance.

Crippling Economic Policies Push Nigerians To Patronize Herbal Medicine Products To Meet Health Needs
Destiny Boma, the sole proprietor of a thriving ICT business in a major South Nigerian City of Port Harcourt, Rivers State started patronizing herbal medicine products three years ago as a cheaper alternative to modern healthcare service provision due to rising inflation which has set modern medicines above her budget.

Most Nigerians are desperately searching for ways to cut down on expenses and save on basic expenses including food. The country is experiencing double-digit inflation at the moment. Herbal medicine products have come in handy as one way, Nigerians to cut down expenses on modern healthcare provision and modern medicines, even though the sector is unregulated by health authorities and medical experts often warn about the risk of fake, even dangerous, remedies.

While being interviewed, Boma said outside a herbal kiosk selling an anti-malarial concoction in Port Harcourt, “My income can no longer accommodate rising hospital bills,”

An anti-malarial mix cost Boma 200 naira compared to the 2,500 Naira she would pay for treatment at the hospital.

Nigeria’s economy has been badly hit by falls in global oil prices and the pandemic, which slashed petroleum revenue, weakened the local naira, and helped keep inflation at around 17 percent.

Affordability Of Herbal Medicine Products
The economic squeeze of low oil prices plunged Nigeria into recession in 2016 and 2020, pushing an additional seven million into poverty in 2020 alone, according to the World Bank’s global poverty index.

Even before that, millions of Nigerians were living in poverty on less than a dollar a day

Herbal medicine products have a deep-rooted culture in Nigeria, especially in more traditional communities, but the drugs have become more popular in recent years even among Western-educated Nigerians like Boma.

Herbal medicine product stores and marketers promising a cure for all forms of illnesses, from common flu to diseases such as cancer and diabetes, are a common sight on the streets and markets.

Herbal medicine products marketers advertise their concoctions from loudspeakers atop old cars, while others push herbal mixture-filled wheelbarrows and carts through the streets.

When interviewed outside a herbal medicine products store in the Southern city of Aba, a two hours drive from Port Harcourt due to the terrible road conditions, Eberechi Godswill said “I have turned to herbs to treat ailments in my family due to the terrible economic situation,”

It required only “a fraction” of what he would spend in the hospital, said the 53-year-old mother of four as she held a plastic bag stuffed with anti-malarial herbs.

Astounding Sales Of Herbal Medicine Products
Herbalists say sales have soared and demand has increased from cash-strapped customers.

Abubakar Khalid, a herbalist in Kano’s Yakasai neighbourhood said, “The number of customers has increased four-fold because every day we attend to people from varying social backgrounds,”

Dr. Ibrahim Musa, of the Aminu Kano Teaching Hospital, Kano’s largest medical facility, blamed the trend on inflation with rising food costs sucking up earnings.

Nigerians usually pay for healthcare out of their pockets despite the emergence in recent years of health insurance for those with regular income.

“A lot of people don’t have enough money to buy medications,” said Dr. Musa, a consultant haematologist.

Nigeria’s healthcare system is one of the worst in the world, ranking 163 out of 191, according to the World Health Organization (WHO).

Public spending on healthcare stands at 3.89 percent of Nigeria’s $495 billion GDP, compared to 8.25 percent in South Africa with a population of 59 million, less than one-third of Nigeria’s, according to World Bank figures.

According to the Nigeria Medical Association (MNA) Nigeria has only 40,000 doctors for its 210 million population, a ratio of two doctors for every 10,000 people. The WHO standard is one doctor for every 600.

Fakes And Quacks Of Herbal Medicine Products
Nigeria imports 70 percent of its pharmaceutical needs. But a huge volume of fake and substandard drugs find their way into Nigeria’s market.

“People continue to lose faith in orthodox medications,” Dr. Musa said. “This makes them turn to herbal preparations which are much cheaper and readily available.”

But the business has been infiltrated by quacks who make unreasonable claims of cures for a quick profit, herbal marketers say.

In 2017, Mohammed Aliyu’s wife died from internal bleeding after drinking a herbal concoction she bought from a herbal medicine products marketer along their street in Kaduna.

“She stumbled into the house and lay on the floor vomiting blood. The bottle had no label, so we couldn’t trace the vendor,” he said.

In December 2021 Nigeria’s foremost drug and food watchdog, NAFDAC warned Nigerians against using herbal concoctions due to poor storage which exposes the medications to bacteria.

Adnan Mu’azzam Haido, a Medical Doctor in Kano, said one major downside of herbal medicine products is the “one-cure-for-all ailments” trend as well as claims of cures for diseases considered incurable but manageable, such as AIDS, cancer, and diabetes.

Dr. Ibrahim Musa, of the Aminu Kano Teaching Hospital, further stated, “People have lost faith in the healthcare system and we need to win them back. We can only do that if we strengthen the healthcare system through universal access, universal coverage and quality.”

Call To Standardize Herbal Medicine Products In Line With Global Standards
Dr. Isaac Ayodele, the CEO, Ayodele Herbal Farm have joined voices to call for the standardization of Nigerian herbal medicine products to global health standards.

Dr. Ayodele, who holds a Doctor of Science degree in Public Health, said that herbal formulae must aim at transforming the concept of herbal medicine products, which was before regarded as a fetish, unhygienic and primitive. Herbal medicine products, also called botanical medicine or phytomedicine, refer to the use of plant seeds, berries, roots, leaves, bark, or flowers for medicinal purposes — a practice that he said was accepted internationally.

He explained that practitioners of herbal medicine and users need a new information order aimed at placing herbal medicine in its proper perspective in Africa and beyond.

He further described his farm’s activities, by saying, “Within 20 years, we have transformed the concept of herbal products, herbal farm, and herbal health care into a great brand, such as the allopathic medicine that can be used safely by people of all races, religion, sex, and socio-economic status. On our farm, we cultivate both foreign and local herbs through which we strive to improve the health and well-being of our numerous clients at home and abroad.”

He noted that in order to make for quality assurance, herbal drug manufacturers must use organic medicinal plants.

“This guarantees the safety, standardisation, and hygiene of products,” he said.

He also said that in order to make such products acceptable to national and international audiences, they must be formulated and produced by professionals in herbal medicine.

He said that to this end, his organisation engaged in regular clinical trials of products in order to ensure their efficacy.

He assured that herbal capsules and teas had been tested and proved to be effective in the treatment of erectile dysfunction and low libido, weight loss, potbelly remedy, detoxification, and improvement of digestion, as well as for fighting high sugar levels in the blood.

Explaining the place of herbal medicine in modern medical practice, Ayodele noted, “Precisely, we may have the advance technology now and modern medicines, but we cannot change the fact that the old remedy is still popular.”

Summary
Though Herbal medicine products have become quite popular among Nigerian households most people appear to be ignorant of their potential adverse effects. It may be necessary to evaluate the safety, efficacy, and quality of herbal medicine products through periodic clinical trial studies. Public enlightenment programme about the safe use of herbal medicine products may be necessary as a means of minimizing the potential adverse effects.

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