Safety and Efficacy of Medicinal Plants Used to Manufacture Herbal Products with Regulatory Approval in Uganda: A Cross-Sectional Study

Bruhan Kaggwa; Henry Kyeyune; Edson Ireeta Munanura; Godwin Anywar; Stephen Lutoti; Jacqueline Aber; Lynn K Bagoloire; Anke Weisheit; Casim Umba Tolo; Pakoyo Fadhiru Kamba; Patrick Engeu Ogwang

doi:10.1155/2022/1304839

Safety and Efficacy of Medicinal Plants Used to Manufacture Herbal Products with Regulatory Approval in Uganda: A Cross-Sectional Study

Evid Based Complement Alternat Med. 2022 Apr 13:2022:1304839. doi: 10.1155/2022/1304839. eCollection 2022.

Authors

Affiliations

¹ Mbarara University of Science and Technology, Pharm-Bio Technology and Traditional Medicine Center (PHARMBIOTRAC), P.O. Box 1410, Mbarara, Uganda.
² Makerere University, College of Health Sciences, Department of Pharmacy, P.O. Box 7062, Kampala, Uganda.
³ Makerere University, Department of Plant Sciences, Microbiology and Biotechnology, P.O. Box 7062, Kampala, Uganda.
⁴ Makerere University, College of Health Sciences, School of Medicine, Clinical Epidemiology Unit, P.O. Box 7072, Kampala, Uganda.

Abstract

Introduction: The Uganda National Drug Authority requires phytochemical screening, freedom from microbial contamination, and evidence of safety and efficacy of the constituent plants to register herbal products. Since Uganda has no pharmacopeia, safety, efficacy, and plant processing information are not readily available. We documented the plant materials used to manufacture products in Uganda and established evidence of their safety and efficacy and availability of monographs.

Methods: The NDA register of herbal products was reviewed, and a product list was extracted. The herbal products were purchased from local pharmacies, and their labels were studied to identify plant ingredients and drug use. Literature was reviewed to document evidence of the safety and efficacy of the plant materials concerning manufacturer's claims. Also, the WHO and available African Pharmacopeia were searched to establish the availability of the plant monographs.

Results: Of the 84 NDA-registered local products, only 18 were obtained from the market; 82% were indicated for respiratory tract disorders. Thirty-three plant materials were listed with Eucalyptus globulus Labill, being the commonest. Several in vitro and in vivo studies demonstrate efficacy, thus supporting the use of the selected plant species for empirical treatment as stated on the product label. While most plants were safe, some species such as Albizia coriaria Oliv. had dose-dependent toxicities that cannot be predicted in combinations. The WHO, African Pharmacopoeia, and West African Herbal Pharmacopoeia had only 16 plant monographs of the 33 plants of interest. Nevertheless, Aloe vera (L.) Burm.f., Azadirachta indica A.Juss., Zingiber officinale Roscoe, and Allium sativum L. monographs were published by all three pharmacopoeias.

Conclusions: Preclinical evidence of safety and efficacy exists in the literature for most of the plants used to manufacture registered herbal products in Uganda. More specific bioassays and clinical trials are required for the products to provide conclusive evidence of safety and toxicity. Monographs are urgently needed for the Ugandan plants.