Prof. Maurice Iwu invites you to consider that our ideas of medicine are never fixed in time, and never complete. There have always existed multiple healing disciplines. He asks you to consider that the food you eat has great potential to heal you.
Prof Iwu is a professor and practitioner of pharmacognosy. His expertise is in herbal medicine, and has expert knowledge on the active chemical components of medicinal plants and their healing potential.
He hails from a community of healers. In honor of the healing waters in his hometown of Umuezeala-Umukabia, Ehime Mbano – Imo State, his parents named him Okwara Dibia (Son of the great healers). HIs community in Umuezeala is known to produce healers with great knowledge and skill and claim he was reincarnated from the great healing waters of Umuezeala.
Dr Iwu studied at the University of Bradford, England, receiving a Master’s degree in Pharmacy in 1976, and a Ph.D. in 1978. He was the World Health Organisation’S (WHO) Visiting Scholar to Dyson Perrins Laboratory, University of Oxford (1980). In 1999 he won the International Prize for Ethnobiology. He was a Professor of Pharmacognosy at the University of Nigeria, Nsukka between 1984–1993.
Between 1996–2002 he was President of the International Society of ethnobiology and is currently a member and ex-President of the Nigerian Society of Pharmacognosy. He is currently a member of the American Society of Tropical Medicine and Hygiene and a Member of the International Society for Medicinal Plant Research. He was the Executive Director, Bioresources Development and Conservation Program and a Senior Research Associate at the Division of Experimental Therapeutics of Walter Reed Army Institute of Research, Washington D.C. He has published more than 100 research articles and is the author of four books.
Dr. Iwu currently leads the Imo state response to COVID-19. My father encouraged me to reach out. I am in St Catherines, Canada. We connect over WhatsApp. Our conversations ranged from COVID-19, traditional knowledge systems, and the healing potential of the food we eat. He speaks with the confidence and defiance of a roar. The interview has been edited for brevity and clarity.
Before we get deep into the conversation, I want to talk about language, power, and knowledge production. We can easily run over words like western medicine, herbal medicine, and Indigenous knowledge. Healing strikes me as something that humans would have needed to figure out very early in our evolution. What types of healing are there? Is there a form of healing that should be valued, or prioritized over the other?
I am glad you started from this viewpoint. People confuse healing with treatment. Every human society has a way of attempting to heal. Some are successful at it, and some are not.
There are various forms of healing. Pharamco is based on the activity of plants, and compounds and their active ingredients. It is a totally different ball game. This is just one aspect of healing. Healing means restoring to its original form, or curing a deviation, or curing an ailment. It is so broad-based. Sometimes non-medical approaches can lead to good healing. For example, people in Africa use spirit possession to reach the transcendental state and restore back what was broken. If you use the broken pot concept, maybe you can understand healing better. If you put a broken pot back together, and you fix it up with glue, you can still see the fractures on the pot.
There is a difference between treatment and healing. In some cultures, they say only God heals. You can treat, you can provide medication, but the actual healing is actually a spiritual dimension. This is one thing we should not lose sight of. In the Yoruba system, there is a whole epistemological concept around healing that arises from incantations, songs, dances and so on.
In the Latin American context, the keyote psychedelic plants they use is a form of healing. They did not use it as they do now in the West. It was used as a spiritual exercise aimed primarily at healing. They believed when they were in that trance they were able to conjure the spirits of their forefathers.
There is a whole spectrum of healing practices that many cultures have developed. One insignificant aspect, the restoration of health through medication, seemed to have overshadowed more fundamental ways of healing. At some stage, medicine began to focus mainly on diseases rather than restoring the balance of a person.
Thankfully, people have begun to ask themselves, what is actually medicine? And they are now talking about transcendental medicine, now talking about holistic medicine. People are now saying the best way to treat is to let the body be straightened, and that is the best way to heal, and the body can actually treat itself.
Is Western medicine an intelligent system of nomenclature? What we understand as western medicine was not invented in the West. It was a long process of historical exchange and made up of generations of sharing from Indians, Chinese, North Africans, and Mediterians cultures. It was crystallized in what is now known as Western Europe and exported through colonization, and is still being redefined, and moulded by all the world’s peoples. This is probably the greatest human group assignment! Is Western medicine the right word to use to understand modern medicine? How do you understand the categories of medicine as we have come to know it?
There is nothing Western about modern orthordox medicine. It is the summation of all modern man has come to glean about how plants, how compounds, how chemicals interact with the human body. That is not to say that other traditional societies do not have their own components of modern medicine.
Modern medicine should not be appropriated by any one culture. You can see, it is really something that the modern man has put together from all these centuries of healthcare. For any one culture to appropriate it to themselves, that is really epistemological nonsense. It makes no sense at all. Most of the elements in Western medicine came from China, a lot of it came from India, and Egypt, and some parts of Southern Africa and West-Central Africa.
There is nothing western about medicine. It is a sum total of our various contributions that have come up together, that has been crystallized into a form of treatment that a group now wants to appropriate. Look at vaccination for example. Vaccination has its origins in Africa, where people used scarification to impact immunity amongst various diseases. After a time, it became so modernized that people thought it was alien and something new. No, it is not new at all.
A significant amount of medical knowledge production happens in Universities and research facilities in western Europe, North America, and many of their international satellites in universities and campuses around the world. India and China have also emerged as dominant players in this field. There is a critique that because of the west’s cultural hegemony on medicine, it does not include or legitimize diverse forms of healing, so other forms are seen as unintelligent. And it does not seek to improve itself by continuing to learn from multiple cultural perspectives. What assumptions are made about modern medicine? What are its strengths, and what are some of its limitations? How have they been exposed with the emergence of COVID-19?
What happened is actually a self-imposed reductionist framework. We have been made to believe that everything that is foreign is better. This is not only in medicine, but it is all over in terms of human development. It is more a psychological issue. There is nothing at all that should cause the kind of dichotomy that we are having now. The Chinese that were forced to toe the line of Western medicine still practice their own medicines. The Indian Ayurvedic medicine is still practiced side by side with modern orthodox medicine. This kind of combination of traditional and orthodox is still happening in Africa, but not to the same extent.
Because our medical system was intertwined with our religious system, it became that you were not a good Christian if you looked to traditional healing. In Africa, food and medicine is interchangeable. They have known that from time. And there no other time that has come into practice than this covid 19 era. Now, people are struggling to understand why we are doing better with the Coronavirus than other parts of the world. We had a situation whereby in August/ September the death rate was about 6 percent, in the US, but around Africa, the highest was around 2percent.
People could not fathom that. If it was because of the heat, then it shouldn’t have happened in Egypt. If it was Because of our so-called backwardness then other countries who are also backward should have had the same experience as us. People are struggling to understand the success. We are struggling now to persuade the world that we do not need the vaccine. It is like you see a fish in the water, and you say “poor fish, the fish is drowning” and you pluck it out of the water, thinking like you are doing the fish some good.
Look at Canada, every year, you have to take the flu vaccine, we don’t need the flu vaccine here. We are not saying that those vaccines don’t work, they do work. They are not dangerous, we are not talking about efficacy, that is a totally different dimension. But if something is going well, why break it. The problem is, they are trying to define humanity in their own terms. This they have done for centuries.
Why is it that when we talk about the nominal value for high blood we use that average for the Caucasian? When you talk about the blood sugar level, we talk about what happens to them, but they are not the majority of the human population. But this is a struggle that nobody can help us with. There are certain things we can not adapt, we can not cut and paste. We have to evolve and develop it ourselves. We do not have to reinvent the wheel, but we also do not always have to follow the example of the west. And medicine is one place in which we can lead.
There is no reason for us to accept the description of how others describe our medicine. It is based on us to give it the value we prescribe. It is how we value our own medical system that counts most. We have to convince ourselves first and believe in ourselves. If we believe in ourselves, we may have a way forward.
I want to challenge your statement about COVID-19 and the need for vaccination. Earlier you had said, China uses both systems, Indian uses both systems, in the Igbo, Nigeria, and African context, why is it an either-or, why can’t we use both?
It is important to find the harmony between the two, but right now it is either-or. What I find very distressing is that people go to Nigerian traditional medicine only when all hope is lost. Traditional healers only have the bad cases, they are like the referral hospital. But people don’t take it from the word go.
There are some places in Mali, Ghana, some parts of Southern Africa, Zimbabwe, where the two of them are practicing together. There are some doctors who trained in the Western way but are practicing with the two. There are several examples where physicians are using plant-based remedies in the Orthodox medical practice.
In parts of Borno state in North Eastern Nigeria, there is what they call Kayansaya, it is an ingredient used for making teas. Those repertoires form a whole system of medical knowledge so that those people using in those areas, you can see a sophistication in the way they practice their medicine.
In the Fulani and Hausa tradition, there is a whole pharmacology that they use. Yoruba medicine is Agbo medicine. As you travel across Africa, I am amazed at the richness of knowledge our people have, and yet, we are late into developing them into global remedies because of the peculiarities of the pharmaceutical industry, otherwise, we have a lot to sing about.
What opportunities exist in this field of research, what is being done on the African continent and her diasporas to facilitate research and discovery?
We are breaking the ground slowly, it has taken a long time, but steady progress has been made. We have a program called African Regional Standards Organisation. The goal is to standardize African Traditional Medicine (ATM). We have been able to lay a solid foundation and publish official monograms and standards on key concepts – what do we mean by AfTM, the mode of practice, why is it that we are different from others. There are many social science epistemological issues, but we have delved into them to produce some definite statements for them. They are now adopted by the African Union. That is why we now say African Traditional Knowledge instead of all the other words we used to use.
Then we have delved into producing modern standards for African pharmacopeia. We have pharmacopeia for modern standards for just about 15 plants because of the rigour that goes into developing them. I wrote a book about 20 years ago called the handbook for African traditional medicinal plants. We then published another book called functional foods of Africa. This year we published another one called healing plants of Nigeria.
If we do not publish these books ourselves, if we don’t bring them out in the forefront, no one will take us seriously because they would want to interrogate what we have said and see the veracity of our statements. The other element is that, if we do not use it, we lose it.
We established a long time ago a company called Bio resources development and conservation program. Then it grew into a BioResource development group, because we now have commercial arms. We teamed up with other people to acquire what was Pfizer Nigeria, it’s now called NEIMETH where we are into the regular pharmaceutical business. Our pride is the fact that we now have International Centre for Ethnomedicine & Drug Discovery (InterCEDD) health products. It is a laboratory we established in Nsukka Nigeria.
The laboratory is a standard ethnobotanical drug development laboratory where research ranges from botany to the full-scale development of medical drug products. We have 23 formulations now that are market-based. Even things like bitter kola, we now have it in capsules. We are also subjecting all our products to modern medicine clinical trials.
Research in this area is expensive, it is tedious, but if we don’t do it, no one will do it for us. To make money we take a binary approach. As a pharmaceutical company, we compete with other countries around the world, we do painkillers, and antibiotics like everybody, but we also have these InterCedd products, which is where our heart is.
The biggest thing that has happened in this area is the convergence between these systems: biotechnology, information technology, and artificial intelligence. Mathematical models are being developed to make the traditional healers more effective. We then have in our hands the ability to tailor the product to what we want to. The African traditional model is coming up gradually, steadily, we are not there yet, we are far from where we want to be, but it is coming up.
Can you speak to me specifically about the results from plant-based medicines and therapeutics? Is there any systematic research on patient outcomes? Are there any research activities done to develop therapeutics to manage covid-19?
Across the continent, there are so many African drugs that have made it to the clinics. One of the clinical trials we are so happy with is with a product called symphlerol. But we are doing what you may call translational medicine. Synferols is a product that is made from virgin coconut oil that we distilled out without using heat. We mix the virgin coconut oil with a product called ocimum gratissimum.
It is used to treat peptic ulcers without the heavy antibiotics that people use. We contacted Nnamdi Azikiwe University in Awka to assist with research. The director of the university was also a pharmacognosist, and they conducted trials that were independent of us. The results were published in some of the most prestigious journals in the field of peptic ulcer medicine.
The second one is the IHP Detox tea. It is a product that is made up of three plants. Andrographis, Bitter Cola, and guava leaves. The government of Thailand recently approved the use of a Andrographis Paniculata to treat early stages of Covid-19. The tea is combined in a way that we are able to treat them and release the acid concentrate without any extraction. They are still in the plant, but are used in a way that when you put it in hot water they dissociate and become part of the tea. The only drawback is that it is very bitter.
In 2014, when we had the ebola crisis, we tested it on the virus, and also the coronavirus. People were surprised that when this SARS COVS2 virus emerged, we told the nigerian government we had the cure. They said “you are mad, this thing just came out”. We were convinced we had a cure that it was not a new coronavirus, but it was a second coming of the old one. It took the WHO 4 months to agree that what we had was a second coming. If we didn’t have confidence in ourselves, we would have lost that chance.
You are saying when the WHO announced their findings, they confirmed the findings you made earlier?
Precisely. We had already patented the compounds in 2014/ 2015 and you can not patent a compound against a disease that does not exist. People thought we were crazy and met us with the typical African cynicism. They said this virus that just emerged in Nigeria six weeks ago, how can you say you have the cure for it?
Luckily some people believe us, and we had dramatic success stories. Some people had underlying health conditions and became impacted by coronavirus. In the west, it was like passing a death sentence, but here, we were able to manage them by using the ISD detox tea. And it was totally inexpensive. I was working with people on the front line, I was using it morning and night.
The idea here wasn’t to make money, we kept the price the same way, like normal tea. We also taught people how to make it on their own. Nigeria and the rest of west Africa had success stories, and nobody was singing our praise.
How did these clinical trials fit into the Global thinking around Coronavirus? DId you submit them internationally for peer review?
The peer-review will be when the studies are complete. Our studies went right from the clinic to use. From a medical point of view, these are anecdotal until they are proven by clinical trial. The clinical trials are currently ongoing.
But that is a problem we have here in Africa. Madagascar had a cure, but because we did not put a lot of modern science in it. Through the process of industrial manufacturing, they then must have lost potency. Secondly, the dose they were using must have been low. Now the initial work they did in Madagascar has been confirmed by a Chinese and an Indian study. Because of Pharmacoeconomics, everyone’s attention is on the vaccine. Cheaper alternatives will not make that much money for pharmaceutical companies.
Your work has not come without criticism. Central to the critique is the question of knowledge ownership. As these plants are cultivated to make modern medicine, there is a possibility to change the nature of the plant on the ground, and when those changes happen on scale there is the potential for these plants to be wiped out and replaced with new strands. In addition, local people who use these plants in their day to day lives begin to have limited access to them. How do you think about ownership, the need for scale, and the need for profit?
I think you raised a very good and very big question. Those are the challenges we must face, we can not run away from them. I have a fundamental belief which shapes our whole conduct. One, there has to be a holistic approach. Everyone has to benefit. From the traditional healer to the village where the plant grows from, to the industrialist. It has to be a win-win. If it is not a win-win, then something will be lost.
I was awarded a prestigious prize in 1999 for the way I have been able to use intellectual property rights as a method of conserving and adding value to traditional medicinal plants. It was so fundamental and unique that the world intellectual property organization did a case study on us. The title was creating value in traditional medicine.
The fact is us using it to make medicine does not prevent the community from using it to do what it has always done. We have a product that can be used to manage schizophrenia. It has not yet been concluded in clinical trials. We went back to the traditional healer who gave us the idea to tell him about dosage, how to preserve it, how it can be cultivated. The product is not yet in the market. You can see, he has not been exploited. He contributed to a team and so on.
As way back as 1998, we set up a trust fund for Integrated Rural Development and Traditional Medicine, and the first chairman of the fund was a traditional ruler from Oweri. Government agencies were also part of this fund. We have been able to go to villages and ask them what they want, and based on the needs we provide. Who are we to dictate to them what their value system is? We don’t even need to have a full drug for them to benefit from our work. Traditional knowledge research and rural development must be tied together. That is why we created the first strategic action plan for biodiversity conservation in Nigeria.
How did you develop your understanding of these Indigenous processes of healing, how have you refined your knowledge about them over time?
I come from Umuezeala-Umukabia in Imo state. We are a place that is traditional. We have very powerful traditional healers. We had many doctors who were involved in divination. As far as my people are concerned, there is a river called Okwara Dibia, as far as my people are concerned, I reincarnated from there.
And so, being a healer does not surprise them. But I am a catholic. I am a night of St. Gregory The Great, and a night of Saint Mulumba. No one can say because I am involved in the practice of traditional African medicine I am not involved in divination. In the beginning, people used to say how can a whole professor be dabbling into the occult? It is not, it is just based in our own system of knowledge.
We are able to prove that you can be catholic, and also that you practice traditional African medicine. One of the books I published, I mentioned, the healing Foods of Nigeria, I collaborated with a reverend father from Edo State in Nigeria. He was more interested in healing, I was more interested in science. With this system of knowledge, we are trying to train the world that knowledge does not belong to any other group. You can have a situation where it becomes a synthesis.
Luckily, modern medicine now embraced an idea they now call one health. Because of COVID-19, we have seen all health is the same. Whether you are talking about the environment, or natural health, or people’s health, they are all related. You can’t take a person out of their environment and expect them to be healthy.
Through your studies, is there something you have discovered that you did not expect to see, or something you were hoping to see, and have been disapproved of?
It happens all the time! One of the things I learnt early in my profession is not to have a preconceived idea of what will work. I try to have a theoretical basis for what I should do, but I am not dogmatic about it.
A very good example is this example I mentioned earlier about virgin coconut oil. I could not believe how an oil that did not have any medical alkaloids – no strong compounds in it can have such an outcome associated with it.
Another example is the bitter leaf. When you remove the bitter component, the undigested part happens to be more medical! How can you have an effect from nothing? No drug has been absorbed by the body.
The same phenomena I saw with alstonine a drug for schizophrenia. It does not cross the blood-brain barrier from what we observe, yet it has an effect on the brain so you ask yourself, what is it that is working here, there must be some intelligent network in the body that does not need a physical connection. THERE MUST Be a communication system that is wireless
We are now beginning to understand the microbiology in the stomach. It is a whole colony and ecosystem of its own. Now people are realizing that most of the diseases we suffer have the origins in the stomach. When I was younger, my parents used to take us routinely for deworming. Routinely we go for cleansing of the stomach, routinely they give us medicine that supposed to purge you. It looks so nonsensical based on pathology, but now, modern science has been able to realize that there is some sense in what we were saying.
Finally, what baffles me, is how different people are. You wonder the risk we take when we take medicine based on commonality of effect. It is amazing how we are still able to have the common result. In African cosmology, you can’t use the same medicine for everybody, yet modern medicine has been able to achieve that.
We are not saying that traditional medicine is better or superior. We are just saying that it is different. It also has a longer history of sustainability and safety and is based on more superior science. The onus is on us to prove to the world that we have something that works. The onus is on us to market this idea and to ensure we leave this as an earlier Heirloom to generations yet unborn.
You can find more of Dr. Iwu’s work at
Food as medicine; functional foods of Africa. ( CRC Press)
Healing Plants of Nigeria: Ethnomedicine and Therapeutic Applications
Handbook of African Medicine
Resources:
See http://www.edmonds-institute.org/outofafrica.pdf (May 15, 2011)
See http://www.edmonds-institute.org/mystery.html (May 15, 2011)
See http://www.edmonds-institute.org/mystery.html (May 15, 2011)
Konadu, K. (2007) Indigenous Medicine and Knowledge in African Society New York: Routledge p. 60
UNEP (2003) “Traditional Lifestyles and Biodiversity Use” Prepared for the Secretariat of the Conventions on Biological Diversity June 2003
