Concluding our two-part series on Malaysia’s potential genetic gold mine of medicinal herbs.
LAST week, we met a team of scientists working to transform misai kucing, a local plant with a long history of traditional medicinal uses, into a cancer-fighting herbal extract. Yet this Penang-based team is an anomaly in the landscape of Malaysia’s herbal industry.
We are still a long way from producing anything more than general and medium-claim health supplements that offer “improved vitality”, “maintenance of good health”, or “promote healthy bones”.
For our herbal drug development industry to grow past infancy, it needs to overcome numerous challenges: from Asian superstitions and popular psychology to risk-averse corporations and a lack of coordination across institutions.
Gung-ho about herbs
Where would you look for the next big anti-cancer or hypertension drug?
Nature has provided us with the materials for plenty of revolutions: life-saving antibiotics, game-changing antimalarials, immunosuppressant drugs that enable us to perform organ transplants, anti-cancer drugs ... the list goes on.
Malaysia is one of the richest places on Earth in terms of biodiversity. It is home to about 12% of all plant species, and about 2,000 of those found locally are already known to possess medicinal qualities.
In 2010, the Government announced its intention to make the country a serious player in the high-value herbal products business.
The industry’s global market value had more than tripled in just eight years, hitting US$200bil (RM642bil) by 2008.
And it is expected to balloon to 20 times that amount over the next few decades, according to estimates by the World Bank (US$5tril, or RM16tril, by 2050).
This makes the herbal products industry a prime candidate to drive Malaysia’s emerging bioeconomy.
The Government made development of the herbal industry a priority under Entry Point Project 1 (EPP1) of Agriculture, one of 12 National Key Economic Areas.
Initially, the focus was on five plants known to Malay traditional medicine – tongkat ali, misai kucing, hempedu bumi, dukung anak and kacip fatimah.
Since then, six more – mengkudu, roselle, ginger, mas cotek, belalai gajah and pegaga – have been added to the list.
The ideal situation would be to replicate what happened with Korean Ginseng which, thanks to a careful government-coordinated research and marketing plan, is world renowned.
From roadside to store
Research is expensive, but necessary; it adds credibility so products can compete on the international market. First, there needs to be demand and support for such products on home ground – but the reality is that there couldn’t be a more difficult market to penetrate.
Tradition-minded South-East Asia tends to be very accepting of unregistered herbal medicines and products. Herbal remedies and supplements are ubiquitous, sold in street markets, shops and e-commerce sites, and bought by many.
The trade in unregistered supplements and medicine is booming – not surprising, considering that the region has historically been a confluence of Malay, Chinese and Ayurvedic traditional medicines. Culturally, communities maintain strong ties with traditional beliefs and practices; consulting traditional healers and witch doctors such as bomohs is not uncommon.
Culturally, there is little demand for oversight of the validity of product claims.
It is perhaps ironic that our ready acceptance of herbal medicines is, in fact, partly why it is so hard to drag the industry out of its infancy.
It all boils down to what makes sense as a financial investment.
This is how Prof Dr Ibrahim Jantan, a senior professor at Universiti Kebangsaan Malaysia who heads the university’s Natural Products Research Cluster, explains the psychology behind local investors: “Why should they spend on R&D when products already flooding the market are making so much money?”
It’s a toss-up – selling your product overseas may fetch a higher price, but generally, developed markets demand quality.
That’s where legal use of the label “clinically proven” really begins to matter, and that’s one of the goals EPP1 is striving for.
The problem is that R&D increases costs, so why bother with it if the sole objective is to make money, and there are many willing buyers in Asia?
A report published by the Global Science Advisory Council last year is telling. Entitled Public Research Assets Performance Evaluation: Unlocking Vast Potentials, Fast Tracking The Future, it notes that little is spent by industry, especially SMEs, on R&D.
This indicates that companies in Malaysia generally have a low rate of innovation, and little focus on product development. They want “ready-made” technologies from public research institutions without any cost.
As Ibrahim puts it: “What’s happening now is that generally, we are not coming up with our own products – we are trading products.”
Most countries do not regulate traditional medicine and health supplements.
Like so many of them, Malaysia has less stringent criteria for such products. These read like an abridged version of pharmaceutical product registration criteria.
Which makes sense, if the goal is to nurture growth within a fragile new industry with market incentives stacked against it.
The upshot is that products are evaluated based on their safety and quality, not their efficacy.
As it stands, the active ingredients of many herbal products are not even known.
This leads to a rather bizarre situation: there is no real way of measuring/testing a product to ensure it contains the appropriate dosages in standardised extracts to achieve its claims. Government seed funding encourages R&D and identification of the active ingredients, as well the concentrations required for efficacy.
There’s another reason why moving towards more clinically-backed products is important: safety.
Just because something has been consumed for hundreds of years doesn’t mean there are no chronic toxicity or side effects, Ibrahim points out.
After all, practitioners are more likely to only notice and make a clear connection between the consumption of a specific herb if the ensuing symptoms are acute.
This also applies to safe dosages: “Let’s say the herb is supposed to reduce blood pressure; the question is, does it reduce it to a therapeutic level?”
Either way, there is plenty of merchandise being sold, sometimes at exorbitant prices, to gullible consumers.
So improving standards within the industry will benefit both health and pocket.
The first step is to try and change consumer habits. Products approved by the Drug Control Authority (DCA) may not need to prove efficacy, but safety tests are needed to guard against harmful adulteration – a big problem in the vast market of illegal and unregistered herbal supplements and drugs.
Often the products are bogus; confiscations and tests have showed up poisons, heavy metals and slimming agents.
Prescription drugs such as paracetamol, antihistamines, steroids, anti-diabetics, and synthetic PDE-5 inhibitors (sex stimulants) have also been found, presumably as a deliberate action to produce some sort of therapeutic effect.
As the global herbal supplement industry continues to grow, standards and oversight measures are likely to come under closer scrutiny.
Science has shown that many herbs have a huge amount of medical potential, so the target should be to encourage a more science-based approach to the herbal industry, bringing it up to par with conventional medicines.
Public perception and trust in traditional medicines continue to fuel growth, despite widespread media reports about expensive supplements exposed for misleading claims.
It will be a huge challenge to convince local industry players to move away from the temptation to make a quick buck by scrimping on R&D costs, to simply manufacture low- and general-claim products.
With the wealth of promising local herbs, the prize for creating a “killer” scientifically-backed product could be big.
Six EPP1 champion companies have been partnered up with research institutions to bring local herbal products to market.
Only two of the six, however, have their eyes on the high-claim (disease risk reduction) products – Natureceuticals Sdn Bhd, with its anti-angiogenic Misai Kuching extract Canssufive, and Nova Laboratories Sdn Bhd, with its Hepar-P Capsule, a liver protection agent. The two hope to have completed clinical trials by 2017 and 2015 repsectively.
If their work does prove a success, they will be the first Malaysian companies to come up with high-claim herbal products.
For now, however, a better informed public and a crackdown on illegal products and misleading claims (that defy regulations like the Sale of Drugs Act), may go a long way to helping that cause.
Check if a herbal product is legitimate:
> Registered products are affixed with a hologram
> Cross-reference the product registration numbers against the National Pharmaceutical Control Bureau database (https://www.bpfk.gov.my/) by doing a QUEST search.