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Long read: Traditional Medicine, Aboriginal Health & Big Pharma.


Eucalyptus tree in the Outback

Exploring the natural world for medicine is nothing new, humans have been experimenting with plants and animals to keep them healthy for tens of thousands of years. As one of the world's oldest surviving cultures, Australia's Indigenous people have a profound connection with the land and have amassed an in-depth knowledge of their native flora and fauna. This powerful traditional knowledge is derived from generations of observation and it has been a crucial factor in the longstanding survival of Australia's Aboriginal tribes.

Many communities worldwide, not just indigenous communities, still rely on natural products for both medicinal and cultural purposes. Traditional medicine continues to play an essential role in health care and it is estimated to be used by 60% of the world's population.

The Aboriginal people of Australia have always been careful stewards of their lands, and this has been essential in preserving the delicate and diverse eco-systems throughout their country. They have known for millennia that their health and well-being depend on their local plant and animal communities and have celebrated, protected and preserved them.

Australia is one of the world's 17 mega-diverse countries, 84% of its plants are found nowhere else in the world. The immense landmass (7.7 million km2) stretches from tropical regions in the north, an arid desert interior to temperate areas in the south. It is home to an incredible diversity of plants and animals, not to mention teeming life in its coastal and inland waters.


Bush Tucker

Australia’s incredible natural resources have fed and cured Aboriginal people for countless generations, and a healthy diet from bush tucker was perhaps the most important way to preserve health amongst the tribes. Here are a few examples:

The Billy goat plum, or Kakadu plum, (Terminalia ferdinandiana) is the world’s richest source of Vitamin C. It is found in woodlands of the Northern Territory and Western Australia and contains 50 times the Vitamin C of oranges. It was a major source in those areas it grew and essential in maintaining general health.

The small berries of the Kangaroo apple (Solanum laciniatum and Solanum aviculare) contain phytochemicals called phenols, which are beneficial antioxidants shown to protect against heart disease, stroke and cancer. The small, egg-shaped fruits also contain tryptophan which helps keep skin and hair healthy. It has now been discovered that this versatile plant contains a steroid which is important to the production of cortisone, which decreases swelling and inflammation in your body.

Witchetty grubs (Endoxyla leucomochla) are a famous source of bush tucker. They are high in protein and fat, as well as valuable sources of vitamin B1 and the essential minerals potassium, magnesium and zinc. They also had a medicinal use, the grubs were crushed into a paste, placed on burns and covered with a bandage to seal and soothe the skin. Little wonder that they have been so widely celebrated in Aboriginal art.

This barely scratches the surface. Edible fruits, nuts, seeds, spices and leaves combined with meat, fish and insects, provided, and to some extent continue to provide excellent nutrition. Many of these bush tucker ingredients have even made it to the mainstream, although we’re yet to see the grubs on our supermarket shelves!


The Witchetty Grub (Sputnikcccp / CC BY-SA (http://creativecommons.org/licenses/by-sa/3.0/)

Indigenous Medicine

If people in Indigenous communities did fall sick, they used plants to treat symptoms and return them to health. Some were crushed, heated and applied to the skin. Other treatments were boiled and inhaled, and occasionally drunk. There were also saps, directly smeared on the skin, and barks that were smoked or burned.

The Bundjalung Aboriginal people from the coast of New South Wales crushed tea-tree (Melaleuca alternifolia) leaves to brew a tea for throat ailments. In the 1920s, scientific experiments proved that the tea-tree oil’s antiseptic properties were far stronger than modern antiseptics of the time. It has become a staple in households around the world, as has Eucalyptus oil, which Aboriginal people extracted from leaves to use to treat body pains and fevers and chills. Today the oil is used commercially in mouthwash, throat lozenges and cough suppressants.


Goat's foot (Ipomoea pes-caprae) was crushed into a poultice for pain relief from stingray and stonefish stings suffered by Aboriginal fishermen from northern Australia and parts of New South Wales. Considerable trial and error must have been involved in the discovery that the bright orange desert mushroom (Pycnoporus sp.) can soothe a sore mouth or lips, it has been known to be a natural teething ring. Snake vine (Tinospora smilacina) was used in Central Australia to treat headaches, rheumatoid arthritis and other inflammatory-related ailments.


There was also some complexity to treatments. Sandpaper Fig and Stinking Passion Flower (Ficus opposita) / (Passiflora foetida) were used in combination by northern coastal communities to relieve itching. The rough leaves of the sandpaper fig were crushed and soaked in water, then rubbed on the itch until it bled. The pulped fruit of the stinking passionflower was then smeared on to the affected area.


Discoveries from Indigenous knowledge continue to the present day, in the last decade, leaves from the Emu Bush (Eremophila sp.) were found to have the same strength as some established antibiotics. Northern Territory tribes used the leaves to treat sores, cuts and wounds, but now South Australian scientists plan to use the plant for sterilising implants, such as artificial hips. Although modern pharmaceutical science has come a long way from its ancient roots, nature and the knowledge of indigenous communities continue to be a vital source of new compounds and inspiration.

Eremophila alternifolia (Melburnian / CC BY-SA (http://creativecommons.org/licenses/by-sa/3.0/))

Traditional Medicine meets Modern Pharma

Traditional medicine is defined as:


'The overall body of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether they can be explained or not. These might be used to maintain health as well as prevent, diagnose, improve or treat physical and mental illness'
The World Health Organization (WHO)


There is very little written documentation on the traditional medicinal practices of Australia's Indigenous people without a written language. Detailed information about plant sources, collection times, methods and preparations, has been preserved through songs and dances passed through the generations. Today, unfortunately, this knowledge that has been passed down from one generation to the next as oral lore is rapidly being lost.

In Australia, a greater awareness of this issue has resulted in initiatives across the states and territories to preserve and document local indigenous medicinal knowledge. At the forefront of this movement was the Northern Territory, where, in the 1980s, the government and the Commonwealth jointly funded the compilation of 'Traditional Bush Medicines', an Aboriginal Pharmacopoeia of the Northern Territory.

Meanwhile, modern medicine is becoming short of new treatments. New drugs take years of research and development at enormous cost and rising drug resistance has rendered many essential life-saving drugs ineffective. These circumstances have led to a growing appreciation of traditional medicine by ethnopharmacologists, pharmacists, chemists, botanists and anthropologists. Changing consumer demand with an increasing emphasis on healthy living and concerns over the side-effects of mainstream drugs has also played a part.

This has led scientists and pharmaceutical companies to increasingly search out the medical knowledge of Indigenous populations for new drug sources. Unsurprisingly, this has not been straightforward, and it has led to questions about how to ensure that the communities where this knowledge was developed, also benefit from passing on what they have learned.


Big Business

The modern pharmaceutical industry began with local apothecaries that expanded from their traditional role of distributing botanical cures to wholesale manufacture. Intentional drug discovery from plants began in 1803 with the isolation of morphine from opium by the German apothecary assistant Friedrich Sertürner. He named the compound after the Greek god of dreams, Morpheus. This was the start of an enormous global industry. In 2018, global spending on prescription drugs reached $1.2 trillion dollars. (Statista)

Given the sheer scale of the numbers involved, the economic value of Indigenous medicine is now recognised. However, the disparity between the earnings and benefits to particularly western companies, and to the communities from where the knowledge was discovered, is stark.

This inequality is by no means a problem unique to Australian Aborigines. In 2015, in India, steps were taken by the government to protect local treatments from the "bio-prospecting" of natural remedies by companies abroad. Traditional practitioners of yoga, considered traditional medicine, have sought to protect the 1500 asanas and exercises of their ancient texts from exploitation by western brands.

It is a complex situation, but western law provides few avenues for protecting indigenous knowledge systems. The World Intellectual Property Organization (WIPO) has begun to develop a legal instrument to protect traditional medical knowledge and intellectual property, but the first substantive measure was the addition of The Nagoya Protocol was added to the Convention on Biological Diversity in October 2014.


These new obligations were ratified by 123 parties and the EU. They force countries to ensure that:

'Anyone under their jurisdiction who benefits from traditional knowledge has obtained prior informed consent and negotiated a fair and equitable deal to share those benefits.'
The Nagoya Protocol, Convention on Biological Diversity

At last, steps are being taken to protect Indigenous intellectual property, but there is still a long way to go.


Modern Health Challenges for Aboriginal people

So, with thousands of years of traditional medical knowledge, Aboriginal Australians must be among the healthiest in the world, right? Sadly, this is not the case. Many Indigenous Australians experience poorer health than other Australians, often dying at much younger ages.

'Indigenous Australians are more likely than non-Indigenous Australians to have respiratory diseases, mental health problems, cardiovascular disease, diabetes and chronic kidney disease. There is also a high occurrence of certain diseases that are now almost unknown in the non-Indigenous population, notably trachoma (a bacterial infection of the eye) and rheumatic heart disease.'
Healthdirect.gov.au

Substance use plays a significant role in the gap between Indigenous and non-Indigenous Australians when it comes to life expectancy and health. Alcohol, tobacco and illicit substances are a large problem in Indigenous communities, however, they also are widely used by all Australians. The root cause of many of the contemporary health issues experienced by Aboriginal communities is inequality as a result of the legacy of colonisation.

Throughout Australia, programs are emerging to tackle the chronic inequality that leads to such poor health outcomes for many Aboriginal people. Government and state interventions continue to be insufficient, so many small organisations have attempted to fill a very large gap. The Arts Centre Movement is at the forefront of efforts to recognise the harm that has been done to Aboriginal tribes and alongside acting as a focus for creative activity, they work with other organisations to help coordinate health and education programs within communities.

One such organisation is Purple House. They offer remote dialysis, social support, care services and support a bush medicine business. It is entirely Indigenous-run and owned. They opened their first dialysis clinic in Kintore in 2004, however as of 2019 they now run 19 remote clinics and a mobile dialysis unit called the Purple Truck. The effect of their work has been impressive - Central Australia has gone from having the worst to the best survival rates for dialysis in Australia.

Around the world, to some degree or another, we have all benefited from the traditional medical knowledge of Indigenous communities, including that of Aboriginal Australians. However, it is very unlikely they have received any benefit in kind. Simply put, we are in their debt. Although organisation such as Purple house do receive some state support, the Northern Territory and Commonwealth Government offer partial funding for their programs, much of their income is supported by philanthropic and self-generated funds.

Facing such serious issues, of course, there is never enough to help everyone. This is why Aboriginal Art UK will try to help in a small way. When we can open our doors again, each year we will raffle a painting with the proceeds going to Purple House and we will endeavour to do more over the coming months and years, It is a small gesture in the face of a very significant problem, but we hope you will be able to support our effort to help. To find out more about their work, please visit https://www.purplehouse.org.au/.




References:


Traditional Australian Aboriginal medicinal plants: an untapped resource for novel therapeutic compounds? Future Med. Chem. (2013). Locher, Semple & Simpson

10 Aboriginal Bush Medicines, by Marina Kamenev, February 8, 2011.

https://www.australiangeographic.com.au/topics/history-culture/2011/02/top-10-aboriginal-bush-medicines/

India moves to protect traditional medicines from foreign patents, by Randeep Ramesh, 22 Feb 2009.

https://www.theguardian.com/world/2009/feb/22/india-protect-traditional-medicines

Traditional medicine for modern times: Facts and figures. By: Andrea Rinaldi, Priya Shetty.

https://www.scidev.net/global/medicine/feature/traditional-medicine-modern-times-facts-figures.html?_


Biodiversity and health, WHO.

https://www.who.int/news-room/fact-sheets/detail/biodiversity-and-health

Biodiversity, drug discovery, and the future of global health: Introducing the biodiversity to biomedicine consortium, a call to action. US National Library of Medicine National Institutes of Health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735771/

The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015. Australian Institute of Health and Welfare, 2015

https://www.aihw.gov.au/reports/indigenous-health-welfare/indigenous-health-welfare-2015/contents/table-of-contents

Medicine Spending Worldwide. Statista, 2015 https://www.statista.com/statistics/280572/medicine-spending-worldwide/

Indigenous Health. heathdirect.gov.au

https://www.healthdirect.gov.au/indigenous-health


ABORIGINAL ART UK

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© Nadia Phillips 2020