The future is natural medicine. Is Bangladesh ready for it?

The use of natural medicines and supplements has surged over the past three decades. As per World Health Organisation, around 80% of the global population use herbal products for their primary healthcare. It is to be noted that this primary healthcare is grounded on applied, scientifically proven and socially acceptable methods and is readily accessible and affordable in the current social context. 

There are different opinions regarding the history of natural medicines; nevertheless, ancient Chinese and Egyptian texts mention many medical uses for plants dating back to 3000 BC. Also, the oldest documented evidence of medicinal plants' usage for preparation of drugs has been found to be approximately 5,000 years old on a Sumerian clay slab from Nagpur. In that time period, medicinal plants and their parts were used as healing elements based on experience and belief with very limited scientific evidence to back it up. 
 
The history of modern natural medicine started in the early 19th century. Natural medicine became advanced and popular as scientists discovered the extraction process of right ingredients, removal of impurities, mechanism of action against disease and clinical evidence. This advancement helped the mainstream pharmaceuticals also, as 25% of their raw materials come from botanical sources.  
 
In view of the philosophy behind natural medicine origin, it is broadly subdivided into a few categories like-herbal, unani and ayurvedic. 

The herbal medicine concept describes the art or practice of using herbs and herbal preparations to maintain health and to prevent, alleviate or cure disease. It is worth mentioning that herb is defined as commonly available plants that are used for flavoring and garnishing food, for medicinal purposes or for fragrances.
 
Unani medicine is an ancient Greek treatment approach based on the qualities of four temperaments and four humors. Unani medicine recognises the mental, emotional, spiritual and physical causes of illness or health and believes that each individual should take responsibility for their own well-being. They also focus on eliminating toxic agents through sweating, bath, massage, vomiting and exercise.
 
Ayurveda is a 3000-year-old concept originated in India. It follows that this universe is made up of air, water, fire, earth and ether. These five key components are represented in the human body. The Ayurvedic system of medicine believes that each individual possesses a unique combination of these and an imbalance in these five elements, in turn, causes an imbalance which gives rise to diseases.
 
The latest concept of natural medicines is nutraceuticals. A food/part of food that offers medical/health benefits, including prevention and treatment of disease. In the US, nutraceuticals are out of the regulatory category; they are controlled as dietary supplements and food additives by the Food and Drug Administration.
 
According to market research consulting firm Statistics, the global natural medicine market is expected to reach $87billion with a compounded annual growth rate of 9.9%. This growth rate is double compared to mainstream pharmaceuticals. 
 
In this market, the European Union has the highest 30% share followed by Asia and North America with 26% and 20% share respectively. In Germany, there are over 600 plant-based medicines that are commonly prescribed by doctors. In the US, people are starting to turn away from big pharmaceutical companies and return to natural medicine.

Figure: Region-wise market distribution (%) of natural medicines

Historically, the natural medicine market of Bangladesh was mostly served by not so well reputed companies with conventional offerings, which, in turn, were not well accepted by the specialist doctors due to the perception of poor quality of natural medicine. Recently, the mainstream pharmaceutical companies are concentrating on this market with modern approaches and drawing attention from every corner. 

Among the top companies are Square, Incepta, Renata, Radiant, UniMed UniHealth, Acme, Drug International, IBN Sina who have already launched many exciting natural products and a few other companies are preparing themselves to join. Currently, the natural medicine units of different pharmaceutical companies are offering more than 70 natural generics in the market with an estimated yearly sales volume of Tk 475 Cr. 

Based on the present trend, the market is expected to reach Tk 1000 Cr per year by the end of 2024. In view of the global demands, a few Bangladeshi companies are preparing themselves for exporting their natural products.

India is the 2nd largest exporter of medicinal plants in the world after China; with more than 6,000 medicinal plants. Moreover, India and China, combined, produce more than 70% of the total global demand for natural products.

In China, herbal medicine accounts for 40% of all healthcare delivered and about 200 million patients are covered by it per annum. 48% of the population in Australia, 38% in Belgium and 75% in France prefer herbal products. 70% of all doctors in France and Germany regularly prescribe natural medicine.

There are a lot of driving factors behind the growth of natural medicines such as minimum side effects, scientific evidence, increasing number of ageing population who love nature, waiver from various legal barriers unlike pharmaceutical products, eco/bio friendly appeal, involvement of top companies, advancement in the science of extraction, purification and identification mechanisms of natural medicine, establishment of modern dosage forms;  and increasing number of qualified practitioners. 

Therefore, the top pharmaceutical companies who are yet to launch natural products need to come forward with natural medicines targeting both local and global markets.  

The author is a pharmacist and a former consultant at The World Bank. 
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.