Filipino, Flora, Folklore and Pharmacies

What are some features of the people of the philippines?

• Over 7000 islands with over 180 languages

• Approximately 115 million people spanning 300,000 km

• Previously under Spanish and American colonization

• Officially recognized as an independent country in 1946

~110 major indigenous groups in the Philippines with ~150 languages, and ~17 million people

How is the Philippines a biodiversity hotspot?

• One of 15 countries identified as Mega diverse

~ 5000 endemic species bordering marine ecosystems

~ 13,500 plant species, ~3500 are indigenous

• Mostly tropical or subtropical forests, mountainous regions

What is the historic drug use policy in the Philippines?

• A “War on Drugs” has been established under former President Rodrigo Duterte which is still ongoing

• Extrajudicial killings are allowed if death is linked to drug dispersal or use

• Cannabis possession = 12-20 years in prison for <300g or longer for more!!

• Violence was not only allowed but promoted!

What is the current drug use policy in the Philippines?

• Former president implicated in the war on drugs own daughter is now Vice President of the Philippines; and the president is the son of another former president

• Bongbong Marcos has promoted a “bloodless” anti drug policy, not in support of Duterte's violence

• EX president Duterte has been recently been sent to International Criminal Court at the age of 79

What is traditional medicine?

It is the sum of total knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness

What is ethnobotany?

A sector of botany that relies on indigenously-informed plant identification, foraging and cultivation in use as food, medicine and shelter

Approximately 25% of drugs used in conventional medicine have been in some way associated in some way with plant products

Who are the traditional knowledge keepers in the Philippines?

• Babaylans

• Albularyos

• Hilots

• Mangluluops

• ManghihilasWh

Who are the Babaylans?

• Second in command to the datus during pre-colonial times

• Role came through spiritual possession, had a spirit familiar

• Functioned as warriors, healers, record keepers, priestesses and sages

• Generally female but transgender, male or non binary babaylans existed

• They were ostracized post-spanish colonization

Who are the Alburlarygos?

• Adapted from the Spanish term herbolario

• Contemporary to Babaylans

• General practitioner, counsellor

• Cupping, herbal concoctions, bone alignment

• Mostly present in rural areas

How has interest persisted for traditional medicine?

• Local knowledge

• Availability of resources

• Anecdotal evidence

• Distrust of modern healthcare

What is the poverty rate in the philipines?

Among 10 members in the Association of Southeast Asian Nations the Philippines has the highest income inequality

– 55.09% of the population earns less than P380 PHP ($9.24 CAD/day)

• 57% or more exist near or below the poverty line

What does wealth disparity look for medicine in the philipines?

A single trip to the doctor can cost between P500-1500

• 1 TCAM health practitioner to 300 Filipinos

• 1 doctor to >26,000 Filipinos

Over 80% of commonly prescribed medication costs more than a single income of the lowest paid government worker

= Widespread use of traditional medicines

What were the results on use of traditional medicines by filipinos?

164 participants on their use of traditional medicines

• 68.5% from rural, 51.5% from urban

• Significant factors include how many years they have live in a district and if they are from a rural or urban community

What is the flora de filipinas?

A landmark botanical atlas illustrating Filipino medicinal plants in detail along with their uses; also included folklore insights

What is the plant of war: Tungkod Pari; Cordyline fruticosa used for?

• Roots were used for diarrhea treatment

• The Ifugao tribe planted these near rice plantations to drive evil spirits away and for ritualistic use

What is the Java Plum: Duhat: Syzygium jambolanum used for?

• Leaves can be smoked as a tobacco alternative

• Wounds can be cleaned with a bark reduction

• Trees are the hiding spots of Engkanto (elves) and Pugats

• Are used as offerings to Mandurugoas (vampires) so they would not harm a family

• Low glycemic index; it helps convert carbs to energy and regulates blood sugar levels

What is Tuli?

A male rite of passage in the philipines

• Traditionally performed by a manunuli: boys around 8-12 years of age undergo a German cut circumcision

• Boys are told to chew bayabas leaves during the procedure with the chewed mixture applied afterwards to stop the bleeding

What are the active ingredients of Guava // Babyas: Psidium guajava?

Quercetin and Rutin: Antioxidants interact with free radicals that are produced during oxidation

Quercetin = acts as a spasmolytic and as an antioxidant

Rutin = exhibits high free radical scavenging activity

How does Babyas function as a microbial?

• Have polyphenols that have been shown to inhibit various microorganisms

• Tannins can chelate extracellular iron, pass through bacterial cell walls and interfere with metabolism, disrupt cell membranes and inhibit cell wall synthesis

• Phenols have been shown to interact with ergosterol; a component of fungal cell walls

• Aqueous extracts are more effective than methanol or acetone extracts

How does Babyas disrupt biofilms?

• Bacterial biofilms are more resistant to treatment

• Guava leaf extract has been shown to disrupt quorum sensing dependent biofilms growth

• Alpha-copaene binds CviR

Howis Babyas used in wound healing?

• Antioxidants quench free radicals incurred by damaged cells and produce angiogenesis

• Triterpenes facilitating wound closing by inhibition of proinflammatory components such as interleukin-6 and upregulating anti-inflammatory cytokines like interleukin-10

How much was the Philippines spending in 1970 on pharmaceuticals?

~ $22 million USD

but this was unsustainable, as most of the public could not afford the drugs

What is NIRPROMP?

The National Integrated Research Program On Medicinal Plants

Established in 1974 as a collaboration between University of the Philippines Manila (UPM) and the Department of Science and Technology (DOST) government branch

Associated with Dr Nelia Cortes-Maramba

What are the goals of NIRPROMP?

Discover new drugs from plants

Develop drugs in various dosages to establish an autonomous Filipino pharmaceutical industry

Generate a new source of revenue via cash crops

What is the appeal of traditional medicine in the philipines?

• Drugs are expensive and intensive to make

• Traditional knowledge may help to streamline the process

• Herbal medicine is valued at 216 billion USD

How did NIRPROMP conduct its ethnobotanical surveys?

• 1700 albularyos were interviewed by NIRPROMP researchers between 1977 and 1982

• 1500 plants of medicinal value were identified and NIRPROMP was able to identify 480 of them as medically beneficial through studies

What group introduced much of NIRPROMPs initial backlash?

The Philippines Medical Association in 1979

How did the NIRPROMP pushback to initial backlash?

They continued to examine the medicinal plants identified for:

Safety, Efficacy, Quality, Availability of raw material, and propagation studies of the raw herbs

10 were chosen to focus onWh

Why was Lagundi selected?

Selected for further investigation as respiratory illness was identified as one of the symptoms in Filipino population that would be easiest to treat as an antitussive (cough suppressant)

What are the main bioactive compounds in Lagundi?

4 main bioactive components from leaf extracts: chrysoplenol-D, casticin, luteolin, isoorientin

• Compounds were found to work synergistically together and performed weakly alone

What are the flavonoids found in Langundi?

• Chyrosoplenol-D: a muscle relaxant

• Casticin, luteolin, isoorientin function as anti-histimines

• Leukotriene inhibitors

• Langundinin: a recently discovered iridoid; a deterrent involved with plant defense

How does Lagundi act as a mucolytic and a bronchodilator?

• Flavonoids bind to polymers and fibrins to dissolve sticky mucus in the lungs

• Bronchodilation occurs via the inhibition of phosphodiesterase and calcium channels by flavonoids and tannins

• Extracts also show mast cell stabilization and antineosinophilic activity

What were the results of the clinical trial with lagundi?

• In 1980 clinical studies ensued

• 119 participants that had a cough were screened and given either lagundi or a placebo

• Patients improved with lagundi without side effects

What is the chronology of the development of the lagundi tablet?

In 1993: NIRPROMP develops a tablet; leaves are dried and processed into a tablet form

In 1995: The department of Health releases a list of endorsed medicinal plants: the top 10 promising plant pupils

In 1996:The Bureau of Food and Drugs approves the Lagundi tablets for commercial production as medicinal tablets for cough, cold and asthma

What award did the Langundi tablet receieve?

The Filipino pharmaceutical company Pascual Laboratories submitted the lagundi medication to the 1997 International Exhibition of Inventions, New Techniques and Products in Geneva, Switzerland and won the silver certificate for R&D

How was the Langundi tablet patented?

In 1999 the patent for lagundi medication was filed for and after further development into the characterization of the plant, the utility model was approved in 2001

• A utility model is essentially a less restrictive patent

Patents for the cough syrup were able to be completed

Intellectual property (IP) was officially managed and owned by the Government

Under the utility model agreement, the licensee pay an upfront fee for the product: royalties are pad based on gross revenues

What is the Information transfer act?

In 2009 it was declared that technology developed with government funds must be completely transferred to establishments like universities to evolve the work into useful products and services

The government then formally transferred the lagundi cough syrup to UPM for future research and development, licensing and commercialization

This act allowed the university to attain 60% of the royalties from the developed products (40% before the act) and 40% for the government

What does the filipino pharmacy market look like today?

• Filipinos are paying: 4X more for generic drugs and up to 22X more for branded drugs

• From a 2010 survey of 600 respondents, only 15 people stated that they can afford the medication prescribed to them

What is biopiracy?

The exploitation of indigenous resources for commercialization without due acknowledgement of source materials

What are 2 examples of biopiracy from the philipines?

1. The Philippines loses around 8.1 million USD annually in royalties for a single pharmaceutical product derived from Philippine genetic resources that was patented by a foreign company.

→ Erythromycin was developed from a Filipino soil microorganism

2. Bitter gourd // Ampalaya : Momordica Charantia

• Patented by a New Jersey pharmaceutical company to treat diabetes

• Research into developing new drugs from plants is slow and not well funded

What is the TAMA?

 the Traditional and Alternative Medicine Act (TAMA)

• Established in 1997 to encourage research on developing traditional medicine for widespread market use

• Includes standardization, advocacy, and protection of resources

• Created the Philippine Institute of Traditional and Alternative Health Care (PITAHC)

What is acess and benefit sharing?

It was founded in 2021 and focused on gaining prior informed consent from parties and establishing mutually agreed terms to ensure equitable access and benefit to genetic resources and their benefits

→ First instance in 2023 between Herbanext Laboratories, the Ayta people and the banaba species for diabetes