Model of developing medicinal herbs and herbal medicine from the experience of some countries in the region

Posted date 18/09/2017

9.173 view

Posted date 18/09/2017

9.173 view

Associate Professor, Dr. Nguyen Thuong Dong

Modern medicine has only been around for about 100 years, so what did our ancestors use to treat their illnesses?... Since ancient times, people have learned from experience by observing which plants horses, cows or goats eat that are not poisonous, which plants will cure fever, stomachache or diarrhea... Like that, from generation to generation, they have summarized their experience in treating diseases, called folk medicine, each tribe has its own experience... Gradually, physicians have synthesized it into the experience of traditional medicine of each country. From there, theories and methods of diagnosis and treatment as well as a system of traditional medicine ingredients are formed.
In addition to traditional medicine and herbal medicines, Vietnam also produces a number of products in the form of health-beneficial functional foods such as: (1) Salamin from con bu and seaweed, which has the ability to inhibit epithelial, uterine and pericardial cancer cell lines; (2) Hasamin from sea cucumber, the active ingredient is holothurin B, which has the ability to inhibit KB, Hep-G ₂ and F ₁ cell lines; (3) Catosal from calcium alginate of brown algae, which has the effect of eliminating metals and preventing cancer development; (4) Omega-3/Omega-6 is a product of cooperation between the Vietnam Academy of Science and Technology and the Russian Federation, the main ingredients are essential fatty acids that have the effect of protecting the digestive tract, antihistamine, anti-oxidation, anti-mitosis, enhancing immunity, supporting the treatment of cancer and diabetes; (5) Malotus from the hibiscus plant, the main ingredient is malloapelta B, supports cancer treatment... In addition, there are many other popular functional products such as Gynostemma pentaphyllum tea, glucosamine...
Worldwide, of the total 1,184 new drugs registered from 1981 to June 2006, 54.06% were drugs of natural origin or synthetic drugs simulating the structure of natural compounds... From 1983 to 1989, of the total 170 patents, 100 were for natural compounds. In just two years (2005 to 2007), 79 natural compounds were approved for clinical trials.
Some natural compounds have high economic value such as: Vinblastin 1,000,000 USD/kg; Vincristin 2,000,000 USD/kg; Lappaconitin 1,100,000 USD/kg; Taxol 600,000 USD/kg; Campothecin 412,000 USD/kg… .
Medicinal plant resources of our country :
· By 2004, the country had 3,948 species of plants and large fungi, 52 species of seaweed, 408 species of animals and 75 minerals and minerals used as medicine. 314 monographs on medicinal materials have been compiled in the Pharmacopoeia.
· The whole country has 10,339,216 hectares of forest, of which: 1,906,753 hectares of special-use forests are planned into 164 areas including: 30 national parks, 58 nature reserves, 10 species conservation areas, 46 landscape protection areas and 20 scientific research forests.
· In addition, there are 4,254,886 hectares of protective forest, 4,148,607 hectares of production forest and 28,971 hectares of unplanned forest.

Current demand for medicinal herbs and supply capacity:
· Serving the pharmaceutical industry and functional food production: 20,986 tons (35%)
· Traditional medicine: 20,110 tons (34%). Export: 18,452% (31%)
Supply capacity: Natural exploitation: 12,100 tons (20%) , Cultivation: 15,606 tons (26%)
Imports: 31,841 tons (54%)
Areas still capable of exploitation (44 species ):

Ha Giang (Quan Ba, Vi Xuyen, Bac Quang)
Lao Cai (Bat Xat, Bao Thang, Van Ban)
Bac Kan (Cho Don, Nari)
Lai Chau (Sin Ho, Muong Te, Phong Tho)
Son La (Song Ma, Muong La)
Hoa Binh (Lac Son, Lac Thuy)
Cao Bang (Quang Hoa, Ha Lang, Bao Loc)
Lang Son (Bac Son, Trang Dinh, Loc Binh)
Quang Ninh (Ba Che, Van Don)
Thanh Hoa (Whole Western region)
Nghe An (Ky Son, Tuong Duong, Quy Hop)

Ha Tinh (Huong Son)
Quang Binh (Tuyen Hoa)
Thua Thien Hue (A - Roong)
Quang Nam (Phuoc Son, Tay Giang, Tra My)
Quang Ngai (Son Ha, Son Tay, Tra Bong)
Phu Yen (Song Hinh)
Kon Tum (Kong Plong, Dak To, Dakley)
Gia Lai (K. Bang, Kongchlo, Chu Prong)
Dak Lak (M. Drak, Krong Bong)
Dak Nong (The whole Dak Nong province)
Lam Dong (Di Linh, Lam Ha, Lac Duong)

Some traditional medicinal plant growing areas (56 plants ):

Mai Chau (Hoa Binh)
Moc Chau (Hoa Binh)
Mu Cang Chai (Son La)
Sin Ho (Lai Chau)
Mau Son (Lang Son)
Thong Nong (Cao Bang)
Pho Bang (Ha Giang)
Bac Ha (Lao Cai)
Sa Pa (Lao Cai)
Chiem Hoa (Tuyen Quang)
Quan Ba (Ha Giang)
Tam Duong (Vinh Phuc)
Van Giang (Hung Yen)

Thanh Tri (Hanoi)
Nghia Trai (Hung Yen)
Binh Minh (Hung Yen)
Nga Son (Thanh Hoa)
Yuy Hoa (Phu Yen)
Long Thanh (Dong Nai)
Tumorong (Kon Tum)
Ngoc Linh (Kon Tum)
Nam Tra My (Quang Nam)
EuKao (Dak Lak)
Dak Nong (Dak Nong)
Da Lat (Lam Dong)
Gia Loc (Hai Duong)

Some of the main medicinal plants grown: Artichoke, Chinese clematis, Chinese clematis, Turmeric, Cat's whiskers, Chrysanthemum, Coix, Cyperus, Scrophularia, Roselle, Basil, Ginger, Phyllanthus urinaria, Sophora japonica, Aloe vera, Artemisia vulgaris, Polyscias fruticosa, Chasteberry, Perilla fruticosa, Gac fruit, Noni, Lemon basil, Alisma orientalis, Mugwort, Perilla, Moneywort, Mint...
Some natural compounds that Vietnam has produced:

Rutin (Potato, Trichosanthes)
Berberine (Bitter Gold, Phellodendron)
Tetrahydropalmatine (Rotundin) (Rhodium)
Mangniferin (Mango leaves)
Stevioside (Sweet Grass)
Artemisinin (Artemisia vulgaris)
Curcumin (Turmeric)
Shikimic acid (Star anise)

Phytin (Rice bran)
D-Strophantin (Horny Goat Weed)
Diosgenin (Tiger beard, ginger root, imported Dioscorea species)
Terpineol (Turmeric Oil)
Menthol (Peppermint essential oil)
Eugenol (Basil Essential Oil)
Chitosan/glucosamine (Shrimp/Crab Shell)
β-carotene (Gac)

Vietnam also has the ability to produce a number of other natural compounds:

Taxol and baicalin from red pine

Vinblastine, vincristine from periwinkle
Zerumbon from ginger wind
Soybean Lecithin (2%)
Glutamic acid, isoflavonoids, phytosterols from soybeans
Malloapellta B from Boom

Indirubin and derivatives from cat indigo
Statin/lovastatin derivatives: by fermentation technology
Kangalait from Coix
Huperzine A from Lithopsacus
α, β - mangostin from mangosteen peel
John's worts from Hypericum perforatum

Some traditional medicinal plant areas have been formed:
Cinnamon (Yen Bai, Thanh Hoa, Quang Nam)
Hoi (Lang Son, Cao Bang, Quang Ninh, Bac Kan)
Sophora japonica (Thai Binh, Nam Dinh, Hung Yen, Nghe An, Thanh Hoa)
Melaleuca (Dong Thap Muoi, Moc Hoa, Tay Ninh, Thua Thien Hue)

Yellow Chrysanthemum (Hung Yen)
Moneywort (Bac Giang, Tay Ninh)
Yellow Artemisia (Hanoi, Vinh Phuc)
Roselle, periwinkle (Ninh Thuan, Binh Thuan)
Poplar (Lam Dong)
Gac (Hai Duong, Bac Giang)

For a long time, we have spent a lot of time developing plans for medicinal plant development, but there has not been any plan that can be applied in practice because of the lack of scientific basis. Therefore, we would like to introduce to our readers “Policies for medicinal plant development in China, Korea, Japan and India” for everyone to refer to.
China has developed a 350-page plan for medicinal plant development. China's plan consists of 5 parts: (1) Plan for developing raw material sources, including naturally grown raw materials and growing areas (2) Plan for the Chinese medicine production system (3) Plan for the business system and international cooperation (4) Plan for scientific research and technology development (5) Plan for training human resources and developing the traditional medicine medical examination and treatment system. Thus, it can be seen that China's plan closely links the development of raw material sources and output, in which international cooperation is also a measure to create output.
1.1. Planning for development of raw material resources
China currently has 12,807 medicinal herbs including 11,146 medicinal plant species, 1,581 medicinal animal species and 80 minerals. Currently, over 300 medicinal plant species are being grown in 600 regions, using about 100,000 hectares of land, with an annual yield of about 350,000 dry tons, creating jobs for 340,000 people who make a living by growing medicinal plants, meeting about 50% of the demand.
In the planning, China mainly focuses on 100 regions in 8 provinces: Hubei, Sichuan, Jilin, Yunnan, Ningxia, Shanxi, Guizhou and Guangxi. In 2015, 60 regions achieved GACP, providing enough domestic demand of 523,000 tons and 240,000 tons for export, of which 200,000 tons are raw medicinal materials.
1.2. Planning of traditional Chinese medicine production system.
Currently, China has 4,000 traditional Chinese medicine production establishments, producing about 4,000 types of drugs, in 30 different dosage forms, of which 1,500 establishments produce opium, with revenue reaching 54,327 billion yuan, accounting for 18% of the total industry revenue, and profit reaching 5,471 billion yuan, accounting for 31% of industrial profit, of which 16 companies have sales of over 1 billion.
In the planning, priority is given to developing 15 large-scale Chinese medicine industrial groups, 5 key groups with sales of over 5 billion yuan and 10 groups with sales of over 3 billion, concentrated in Beijing, Shanghai, Guangzhou, Yunnan, Sichuan, and Nanning such as the groups: Tongrengtang, Zhongxin, Tianxin, Yuannan, Baiyao, Nanjing medical company limited...
1.3. Business system planning and international system
Currently, China has 11,360 business establishments, 35,339 stores, 17 markets specializing in medicinal herbs, with total estimated sales of 110.3 billion yuan in 2010 (about 11 billion pounds), and 18.8 billion in 2015. China is exporting to 130 countries, with sales of 600 million USD, accounting for 3-5% of the world's sales of medicinal herbs and traditional medicines.
In the planning, the policy is to build large commercial centers aimed at export. China plans to establish 1 large commercial center in Hong Kong, 1-2 centers in Shanghai, classify 14 types of raw medicinal materials, prioritize domestic use, plan 100 top 1 medicinal materials, build price indexes for 500 Chinese medicines and semi-finished raw materials. China will focus on exporting in 10 countries, focusing on the EU, US, Korea and Japan. Export items are raw medicinal materials, Chinese medicines, functional foods for athletes, smart food and acupuncture tools.
Planning of the store system in the Traditional Medicine hospital: 20 stores specializing in trading Chinese medicine of corporations and 20 provincial-level Chinese medicine stores.
The International Conference focuses on introducing Chinese Traditional Medicine Law, policies, standards, coordination, technology transfer, export of Chinese medicine, cooperation in modernization of Chinese medicine, information exchange and training.
1.4. Planning for scientific research and technology development
Currently, China has 17 key laboratories or research centers on Chinese medicine, 90 regional or local research organizations with 110,000 scientific research staff, some of which have achieved GLP or GCP (good chemical practice), 37 types of Chinese medicine have won national gold medals, 120 types of pure chemicals have been isolated, 220 medicinal herbs have been developed as standards, 1,141 registration numbers have been granted for Chinese medicine, and medicinal herbs have successfully participated in the prevention of SARS and avian influenza.
In the Chinese planning, four goals must be achieved: (1) developing traditional Chinese medicine, (2) innovating technology, (3) modernizing traditional Chinese medicine in some areas, and (4) expanding international cooperation.
(a) The State invests in building two programs for the development of medicinal materials and Chinese medicine (short-term and long-term): (a.1) Program for the development of medicinal materials and Chinese medicine in the 5-year plan 2001-2005 (a.2) Program for the modernization of medicinal materials and Chinese medicine 2005-2010
The State invested in building 2-3 national key laboratories on Chinese medicine, 10 RD research centers, 20 regional centers, 10 Chinese medicine industrial establishments, building standards for 500 medicinal herbs and 500 types of tablets, controlling the chemical composition of 200 medicinal plants, developing 100 new medicines, of which 2-3 types reached "top medicine market in the World", 5 manufacturing corporations reached sales of 5 billion and 10 corporations reached 3 billion yuan, applying fingerprint technology to check quality, applying extraction technology using liquid CO2, ultrasound, resin membrane filtration and freeze-drying technology, 50 Chinese medicines reached national level products, 100 medicinal herbs reached top herbs`s in Chinese market
(b) Planning for innovation and industrialization of Chinese medicine: (b.1) The State invested 6.4 billion yuan in chemical screening research, verification of the use, clinical value and safety of Chinese medicine, and research on the drugs of the Miao ethnic group in Guangzhou and the Yun ethnic group in Yunnan. (b.2) Develop 95 national projects on industrialization of Chinese medicine with a total budget of 8.826 billion, of which the State supported 500 million yuan, to eliminate overlapping production and innovate extraction and preparation technology. The State provides price incentives and tax exemptions for Chinese medicine in the industrialization stage. (b.3) Training talents at the graduate and doctoral levels to serve industrialization. (b.4) Concentrating all means for growing and exporting Chinese medicine and medicinal materials
(c) Planning for training and development of the traditional medicine medical examination and treatment system: Currently, China has 2,682 traditional medicine medical examination and treatment facilities, 279,000 hospital beds, 29 traditional medicine universities, 50 traditional medicine training facilities, 100,000 college and secondary school students, 13 doctoral training facilities, 21 graduate training facilities . China plans in the direction of specialized training, talent training, combined with international cooperation, and has a policy of training talented bachelors.

Korea's pharmaceutical development policy
The Chosun Korea Oriental Medicine Association (AKOM) was established in 1945, the first Oriental university was established in 1947, AKOM was included in the medical law in 1951. In 1973, the National Medical Law recognized Traditional Medicine Hospitals. In 1988, the Association of Traditional Medicine Hospitals (KOMHA) was established. In 1993, there was a debate about whether the processing of oriental medicine belongs to Western pharmacists or Oriental medicine pharmacists.
Currently, HQ has 12,705 doctors of Oriental Medicine, 11 universities with 750 students, 131 hospitals with 7,714 beds, 7,499 clinics with 519 beds. HQ plans to have 13,675 doctors, 395 pharmacists, 1,848 pharmacists and 27,000 physicians in 2002. Oriental Medicine universities include: Kyung Hee (Soul), Wonkwang (Jeonbuk), Dongkuk (Gyungbuk), Kyungsan (Daegu), Daejeon (Daejon), Dongui (Busan)...
Processed product sales reached 27 million USD in 1999, herbal medicine sales reached 22.7 million USD in 1999. HQ built 4 large herbal and medicinal herb business centers in: Kyungdong, Daegu, Jeonju and Geumsan, 75 business stores, 99 herbal and medicinal herb import and export establishments. Planned 326 clinics, 312 pharmacies. Some large corporations such as Samsung also invested in this field.
On November 23, 1996, HQ established the Department of Traditional Medicine Development - HQ, the department has 2 departments: Policy Team and Oriental Medicine Development Team HQ. By 2003, HQ had produced 514 herbal medicines, of which 130 were listed in the Pharmacopoeia, 384 were listed in the Herbal Pharmacopoeia of HQ and about 2000 types of raw materials used to make medicines. In 2001, HQ exported 1,152,329,000 USD.
India's Pharmaceutical Development Policy
The Indian traditional medicine system has two branches: folk medicine and classical medicine (Classical stream). The folk medicine branch is divided into two small branches: folk medicine of the village elders system and folk medicine of the Tibetan people. Tibetan medicine alone uses 8,000 medicinal plant species, Unani medicine 700 species, Siddha medicine 800 species, Ayurveda medicine 900 species, while modern medicine only uses 30 species. Indian medicinal herbs are mainly exported to the US, Japan, and Europe, in 1995 reaching sales of 53.219 million USD, an average annual increase of 10%.
In 2000, India established the National Medicinal Plants Commission, and each state has its own sub-state commission. These commissions are responsible for regulating all matters related to medicinal plant development, including formulating national policies and strategies for the development, processing, and marketing of medicinal plants and herbs. The National Commission is chaired by the Minister of Health and Family Affairs, and its ex-officio members include the Director General of the Department of Health Systems and Homoeopathy, the Department of Science and Technology, Agriculture and Cooperation, and the Ministry of Tibetan Affairs. Four nominated members are experts in ethnobotany, pharmaceutical industry, commerce and patents, four nominated members are from the fields of health organizations, NGOs, medicinal plant cultivation and pharmaceutical industry, two nominated members represent the medicinal plant development cooperative association, and one nominated member represents a research institute.
The Commission has four main tasks: (1) to encourage the cultivation of certain medicinal plants as strengths (2) to support states on the quality, safety and efficacy of medicinal herbs (3) to develop policies to ensure effective use including harvesting, processing, transportation and preservation (4) to select 32 medicinal plants for development based on domestic and export needs, which may change annually.

Japan's policy on development of medicinal materials and herbs
After China, Japan is a country that uses many natural products and is very interested in the quality of medicinal herbs and traditional medicine. Japanese traditional medicine is called Kampo medicine. Many Kampo medicines have been allowed by the Ministry of Health to be researched and modernized, such as: Sho-Saiko-To to treat cirrhosis, viral hepatitis, liver cancer and HIV-AID's in capsule form or Hochu-Ekki-To to fight depression. Recently, scientists at Toyama University have successfully researched anti-metastatic drugs for liver, stomach and lung cancer from curcumin. The Ministry of Health has allowed research to convert all Kampo medicines into standard extract form, so that patients do not have to boil the medicine, but only need to mix the standard extracts that have been proven to have similar effects, in a glass of warm water and drink.
Functional foods are also trusted by the Japanese because they believe that they are good for health, reducing the effects of toxins and radiation. Japanese women are very interested in protecting their skin, know how to press the Ken-Ryo, Sei-mei, Indo, Ei-fu acupoints... and drink perilla leaf water, apply burdock cream, wash their hair with cherry blossom water to have beautiful skin, black hair... The government's policy is to encourage the use of natural products but is very concerned about quality, especially the production conditions of the business system, which provides natural products to the market for users.
Proposing a model for developing medicinal herbs in Vietnam
Our country has abundant natural resources, plants and trees grow all year round, 54 ethnic groups have a lot of experience in using medicinal herbs to treat diseases and take care of their health, our State always encourages the development of medicinal herbs, but the state management of this field has not yet met the development requirements. In the 60s of the last century, the Ministry of Health established the Department of Medicinal Herbs and the activities of this Department have brought many great results. Since the Department of Medicinal Herbs no longer exists, the management of medicinal herbs has been transferred to the Department of Drug Administration, the work of medicinal herbs has still been operating well, in the 80s and 90s we were successful in researching and producing Artemisinin, enterprises still export many medicinal herbs, semi-finished products and medicinal herbs to Eastern European countries and Japan...
In the mid-90s, the management of medicinal materials was transferred to the Department of Traditional Medicine. Because the main task of the Department was to manage the system of hospitals treating with traditional medicine, the staff of the Department were mainly doctors from the provinces doing management work, so it was inevitable that there were limitations. After the renovation, our country fell into a period of serious shortage of treatment drugs, so the management of the pharmaceutical industry was only concerned with expanding the system of importing modern medicine, investing in the quality testing system with limited funding provided by the state, so it was inevitable that there was a lack of investment in the development of medicinal materials. To build a good plan, it is necessary to first have measures to gather a number of cadres with experience in this specialized field, understanding medicinal plants, understanding many narrow characteristics of medicinal plants such as: ecology, the ability to apply biotechnology in developing medicinal plants, ethnopharmacology, ethnobotany, the work of developing and conserving medicinal plants, phytochemistry of medicinal plants, pharmacy... especially having enough information on the experience of developing medicinal materials of countries with similar conditions to Vietnam.
The goal of the planning is to “build a number of medicinal plant development areas, cultivate and exploit a number of medicinal plants (56 cultivated plants and 44 plants that can still be exploited) to annually supply about 60,000 tons of dry medicinal plants, serving domestic demand and export. Modernize the technology of processing and producing medicinal plants, build a number of active ingredient extraction facilities, reaching 20% of active ingredients for medicinal use by 2030”.
In the planning of planting areas, we should base on traditional planting areas, planning each area of about 500 hectares, so that there are enough 15,000 hectares, because the productivity of each hectare is about 3 tons/year, so each year we have about 45,000 tons of medicinal herbs planted, plus about 12,000 tons of natural exploitation (10% of the total medicinal plant reserves that can still be exploited, to avoid the risk of extinction) and about 3,000 tons of medicinal herbs planted in areas not included in the planning. In the Northwest region, you should choose: Mai Chau, Moc Chau, Sin Ho, in the Northeast region, you should choose Thong Nong, Pho Bang, Quan Ba, Bac Ha, Sa Pa, in the Red River Delta region, you should choose: Tan Yen, Viet Yen, Van Giang, Gia Loc, Tam Duong, Thanh Tri, in the North Central region, you should choose: Son Ba Muoi, Nga Son, Muong Long, in the South Central region, you should choose Tuy Hoa, in the Central Highlands region, you should choose: Tumorong, Eukao, Ngoc Linh, Nam Tra My, Daknong and Da Lat, and in the South region, you should choose Long Thanh, Bay Nui, Thong Nhat, Tri Ton.
The medicinal plant production system also needs planning, it should not be considered that planning in the pharmaceutical industry system is enough, because they must be attached to the responsibility of regularly consuming the amount of raw materials produced by the growing areas and avoiding overlapping production. Currently, the whole country has about 300 traditional medicine production facilities, we should focus on investing in experienced facilities such as: Traphaco, OPC, Mediplantex, TU 2 Pharmaceuticals, Thien Duoc, DOMESCO, Daphaco, Thanh Hoa, VIME 2, Fitopharma, Nam Ha, Phuc Hung, Thai Duong..., encourage companies to invest in high technologies such as extraction by liquefied gas, ultrasound...

Invest in building 2 opium processing factories in Hanoi and Ho Chi Minh City, 3 "standard extract" factories in Van Giang, Long Thanh and Dong Thap, providing high-quality medicinal herbs for manufacturing factories. Build 3 trading centers for medicinal herbs and traditional medicine with enough space and conditions to ensure quality in Ninh Hiep, Lang Son and Ho Chi Minh City, combined with re-planning the distribution system.
The State needs to invest in programs to improve the scientific content of medicinal products, modernize industrial production, strive to extract 200 active ingredients by 2030, produce 30 national products of medicinal origin, build and upgrade 500 medicinal standards in the Vietnamese pharmaceutical industry. To achieve that, it is necessary to build 2 research and development programs and industrialize production and projects: research and development of new drugs, ensuring safety, high-standard production, conservation of medicinal plants and knowledge of medicinal plant use, and screening research on chemical composition and biological effects.
In addition, it is necessary to plan a human resource training system and a traditional medicine medical examination and treatment system, build 2 traditional medicine academies, about 5 doctoral and graduate training facilities and 3 laboratories meeting GLP and GCP standards, striving that by 2030 we will regulate the expiry date for all medicinal herbs and 100% of medicinal plant growing areas will meet GACP.

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