36061 BiodiversityandHealthSymposiumConclusions andRecommendations' T he final half day of the Symposium conduit for indigenous knowledge to was designed to focus the attention of enter the policy debate and an participants on the implications for policy effective voice for local communities of information presented in previous in the decision process. Notes sessions and to collectively identify those areas of research that are most critical to To increase the effectiveness of furtherance of policy objectives. An healthcare as well as to alleviate important part of this was the invitation to poverty in the poorest parts of the traditional healers and other representa- world, participants recommended tives of indigenous peoples (seven of the urgent attention to three principles: Symposium participants) to express their 1.Success will only be achieved if needs and concerns before an interna- both biological diversity and cultural KI tional audience. Their collective response diversity are conserved., was an en-dorsement of the Symposium's 2.Leadership must come from aims and objectives and emphasized the indigenous peoples/(local communi- need to include more healers in the future ties) in the use of traditional knowl- and to support opportunities for Healers' edge for broader health benefits; Associations to hold in-ternational confer- 3.International cooperation and http://www.worldbank.org/afr/ik/default.htm ences. partnerships are necessary to ensure safety and quality of tradi- tional phytomedicines. General conclusions These principles reflect the central It was agreed that several of papers theme of the conference: collabora- offered a positive direc-tion for the future. tion to forge strategic partnerships. That is, a solution to many of our Many critical issues are unique to modern environmental and social specific locations and circumstances. problems in the developing coun-tries Effective action to address them will is the protection and promotion of require links between public and No. 92 biological and cultural diversity. May 2006 Specifically, the diversity of medicinal plants along with the knowledge of IK Notes reports periodically on traditional healers can effectively mitigate Indigenous Knowledge (IK) initiatives health, economic, and environmental in Sub-Saharan Africa and occassionally on such initiatives dilemmas incident to rapid globalization. outside the region. It is published by This consensus called attention to the the Africa region's Results and weakness of indigenous peoples' (and Learning Center as part of an local communities') voice in international evolving K partnership between the forums. The most important policy World Bank, communities, NGOs, development institutions, and objective to emerge from this convocation multilateral organizations. The views of specialists in natural medicine was expressed in this article are those of World Bank therefore a social one: With a commitment the authors and should not be to improve human and environmental attributed to the World Bank Group or its partners in this initiative. A health and well-being, governments and webpage on IK is available at: international aid agencies must provide a //www.worldbank.org/afr/ik 2 private sectors, urban and rural communities, de-eloped and and social safety net; developing countries, aboriginal peoples/(local communities) -- Traditional knowledge and the holders of that knowl- and their governments, the elderly and the young, as well edge merit respect and protection; as traditional and modern health practitioners. -- Ensure the participation of local (indigenous) peoples, Presentations demonstrated that research and indigenous specialists, including women and other members of the knowledge have made important contributions to the infor- lo-cal communities, in all activities related to biodiversity mation made available on medicinal plants and especially to and health; sustainable use and management. Nonetheless, an urgency Health to satisfy increasing consumer demand for natural products -- Formal recognition that traditional medicine has a role to and supplements threatens to overwhelm these efforts. To play in primary healthcare provision, especially for the ru- illus-trate, annual purchases in Canada exceed $4.5 billion, ral and urban poor; the United States $27 billion, and the international market is -- Validation of the safety and efficacy of traditional treat- over US $60 billion and growing at a rate of 7% per ments would improve general level of healthcare in annum. National and international policies are required to devel-oping countries; ensure sustainable resource development and equitable -- As well as a source of medicines, biodiversity is valu- division of costs and benefits. As a major source of knowl- able to human health for its environmental services, edge in this domain of medicinal plants and traditional bioindicator values, and therapeutic contribution to the healing, Canada has an important role to play in formulating over-all environment; policy. -- Link between health and diet needs greater emphasis. Participants unanimously welcomed the support of the Environment Cana-dian government, its international development -- Indigenous peoples'lands contain important biodiversity, agencies, researchers, and civil society to international including sources of medicinal plants; efforts includ-ing the Convention on Biological Diversity -- Maintenance of this biodiversity in our lands is important (CBD), WHO's Health for All and Good Agriculture and to health promotion as well as medical care; Collecting Prac-tices actions, WHO/IUCN/WWF Revised -- Medicinal plant conservation requires much more atten- Guidelines on the Conservation of Medicinal Plants and tion worldwide. programs, and the Global Strategy for Plant Conservation. Economy They also urged fur-ther support from the Canadian -- Commercial development of safe, efficacious, and government for international agreements and conventions afford-able phytomedicines could extend and improve toward a legal framework that will encourage conservation general healthcare in many countries; of biological and cultural diver-sity and sustainably manage -- Although it may not be adequately measured as part of resources. the formal economy, medicinal plants and the knowledge of their use make a significant contribution to productive activities. incomes. and well-being in developing coun- Background criteria for specific recommendations tries -- Notwithstanding these opportunities, local communities The health-environment-economy nexus produces a policy should have the right to control commercialization of their dilemma of longstanding. The emphasis on cultural diversity knowledge; in this Symposium introduces an important resource for -- Local communities have the right to equitable sharing of mit-igating the entire complex of problems. In coming to its the benefits arising from the use of their knowledge. recommendations respecting each of these four elements, the Symposium identified important values to be respected B. Objectives of policy (implications of the values and as well as specific policy objectives. principles) A. Values and principles that should be reflected in Cultural policies -- Formal recognition of traditional medicine in developing countries that rely on it for a majority of healthcare needs Cultures and explicit support for its continuance and augmentation; -- Recognize that traditional medicine is the people's -- Education and public awareness programs that choice and culturally acceptable (and accessible); acknowl-edge the contributions of traditional knowledge -- Culture represents an important source of health knowl- and bridge traditional and scientific research approaches; edge that is crucial to sustaining smallholder productivity -- Mechanisms to protect indigenous people's knowledge 3 as a property right. Recommendations for effective partnering Health care and promotion -- Acommitment to improve local healthcare using tradi- The following comments apply to all governments, but the tional means before considering commercialization of me- details reflect the Canadian context of the Symposium. dicinal plant products in global trade; Government agencies responsible for health, agriculture, -- Assistance to (rural) healers and birth attendants for environment, and overseas development assistance have all estab-lishing associations to express their collective needs shown leadership in their various capacities, but even more and concerns; could be accomplished if collaboration between parties -- Links between governments and traditional healers' were officially supported. This would permit greater asso-ciations to support integration of traditional and synergy of actions and efficient use of financial resources. modern medical practices; Specifically, an interdepartmental (Environment, Health, -- Financial and moral support to local NGOs (e.g., Agriculture, For-eign Affairs) agreement on the parameters TRAMIL, PROMETRA, (Eastern Africa Network on Me- of a national bio-diversity and health concept would give dicinal Plants and Traditional Medicine), et al.) that are Canada a more effective voice as global issues on this actively involved in assisting communities in the mainte- topic become more urgent. It is recommended that nance of traditional sources of healthcare; Canada's development agen-cies (CIDA and IDRC) --A"Consultative Group for Traditional Medicine Re- increase their efforts to encourage client (developing) search" (CGTMR) to focus on regional needs (analogous countries to embrace the values and adopt the policies to CGIAR). detailed above in developing their own na-tional policies for Ecosystem maintenance traditional medicine (and medicinal bio-diversity).As an -- A baseline inventory of ecosystems and threatened example, such actions would go far to implementing habi-tats (especially dry and semi-arid regions) that contain recommendations in African countries called for under the medicinal plants so that protection priorities can be estab- Declaration of the Period 2001--2010 as the Decade of lished; African Traditional Medicine. -- Harvesting guidelines for the sustainable collection of Furthermore, it is recommended that the Canadian wild medicinal plants; government incorporate the importance of biodiversity to -- The identification of sustainable propagation/cultivation human health in all relevant national policy frameworks and practices; pro-grams and that attention be given to working with client -- The development of new medicinal crops to avoid the (partner) countries to accomplish the following: threat to wild types; -- Increase global efforts to conserve medicinal plant bio- -- Establishment of genebanks and botanic gardens to pro- diversity and the traditional knowledge of their use in tect germplasm of native medicinal plant species; An global healthcare; evaluation of the conservation status of medicinal plants in -- Support R&D actions to evaluate and standardize tradi- all countries to provide a basis for protection and manage- tional phytomedicines in order to promote their safe, ef- ment. fective, and affordable use; Economic development -- Establish effective regulatory systems for registration -- Government recognition that traditional medicine and and quality assurance of phytomedicines; me-dicinal plants in a culturally acceptable healthcare -- Establish sustainable commercial enterprises for local system offer significant economic benefits; phytomedicine production that offer new income alterna- -- Commitment by governments to maintain and augment tives. These should be linked to the specific socio-cultural a traditional system background, resource potential, and the technological ca- -- Commitment by government to implement, where pabilities of each country; and neces-sary, constraints on commercialization and export -- Work with the World Trade Organization (WTO), the of tradi-tional knowledge to protect both biological and World Intellectual Property Organization (WIPO), and cultural diversity; other relevant organizations to identify a process that ef- -- Explicit provision, where cultivation is a response to fectively regulates the international trade of medicinal enhanced appreciation of medicinal plants, to compensate plant species and protects local communities as well as for the displacement of collectors (generally women and the individual country's resources and rights. landless peoples) from their accustomed source of liveli- hood. 4 Focusing future research to the policy objectives and -- Development of new medicinal crops to avoid the threat recommendations to wild types and satisfy human needs (Agriculture and Health); The Symposium and its output of reports and recommenda- -- The potential social and biological impact of marketing tions reflect the understanding and values of researchers and trade (local, regional, and international) on the re- and practitioners whose expertise lies primarily in the fields source-base and people's livelihoods (Environment, of biological sciences and health care. We are conscious Agriculture, Trade, and Finance); that further action on our recommendations depends on a -- Identification of appropriate mechanisms to improve and favor-able response from controllers of budgets and that ensure equity in access to, and benefit from, medicinal these in turn depend on a compliant political environment. It plant resources; is there-fore important for us as a research community to -- Analysis of factors and challenges for policy develop- focus our attention on possible sources of resistance to ment, harmonization, and implementation in developing what we con-sider desirable policy directions and to countries; encourage the kinds of research that will lend greater -- Identification of opportunities for community-based pro- precision and higher value to policy goals. cessing of plant materials, quality development, and mar- The following are some of the research projects which keting; Sym-posium participants identified as important input to -- Identification of key considerations in/for integrating tra- formula-tion of an integrated biodiversity and health policy. ditional medicine and use of medicinal plants in public Such research would benefit from a multi-sector partner- health care sector; ship be-tween Health,Agriculture and Environment, and -- Assessment of factors and policies that determine and Trade. constrain household dietary diversity and nutritional sta- -- Socio-economic assessments of volumes and values of tus. and the opportunities to enhance it: harvested medicinal plants for optimizing opportunities in -- Identification of mechanisms to resolve potential market supply and demand (Health, Trade, and Finance); conflicts between local level access and benefit sharing -- Inventory of medicinal plants that identifies threatened priorities, and national/international interests. species, threatened ecosystems, and threatened habitats (especially dry and semi-arid regions) (Environment and In submitting this list along with our report and recommen- Health); dations, we especially solicit the attention and advice of -- Information required for recovery actions aimed at decision-makers and their advisors on any potential resis- threat-ened species; tance to the plans and policy objectives outlined. There are -- Data required for effective, in situ and ex situ protec- alos some specific relevant questions. For example: Are tion; there important additions to the list? Is there a ranking of -- Harvesting guidelines for the sustainable collection of them that will promote greater likelihood of success in the wild medicinal plants (Environment and Health); overall enterprise? -- Identification of sustainable propagation/cultivation prac-tices and opportunities (Agriculture and Health); -- Estimate of social impact of cultivation on collectors (generally women and landless peoples); This IK Note was written by John Lambert, and prepared in collaboration with discussion leaders T. Johns, N. Turner, E. Dickenson, R. Martes, F. Gasengayire, J. Thor Arnason, and K. Wilde. It is excerpted from the Biodiversity and Health Symposium: Conclusions and Recommendations, Proceedings of the International Symposium, Biodiversity & Health: Focusing Research to Policy, Ottawa, Canada, October 25-28, 2003. The original paper was edited by J.T. Arnason, P.M. Catling, E. Small, P.T. Dang, and J.D.H. Lambert, as published by.NRC Research Press, Ottawa, Ontario. pp. 135-138. For more information or if you have questions, please contact Philippe Rasoanaivo at jlambert@,worldbank.org.