As the use of herbal medicine continues to grow, within the next 50 years it will have replaced conventional medicine as the primary means of treatment, Dr. Nyoman Kertia, a professor at Gadjah Mada University’s School of Medicine in Yogyakarta, has predicted.
“We need only to learn from the herbal knowledge handed down by our forbearers, rather than from that of other nations. I want to delve further into the efficacy of herbal drugs and develop them for human health,” said the 53-year-old father of five from Bali.
According to him, the time-honored ancestral tradition and the example set by Indonesians today who enjoy good health through herbal drug consumption should never be overlooked. It also means that the development of herbal formulas needn’t be done from scratch.
“The empirical evidence for being healthy by ingesting jamu [herbal medicine] and other such concoctions needs only to be followed up with scientific research,” he said.
Because little scientific research has been done on herbal medicines, such treatments are relegated to a secondary role as most people rely on conventional or chemical medicines. “Some doctors or hospitals have often been allergic to giving out herbal drugs for fear of being seen as unscientific by the public,” said Nyoman.
Nevertheless, the popularity of herbal medicines, he said, was increasing. As chairman of the herbal medicine team at Yogyakarta’s Dr. Sardjito General Hospital since 2008, Nyoman indicated that herbal drugs were being prescribed more frequently now, mostly for chronic ailments like heart disease and certain types of cancer, due to their lower costs.
“They’ve been used as a complement to conventional drugs. In fact, some herbs are also used to heal diseases just like modern medicines do, but without the side-effects. Such herbs have been subjected to clinical tests and are verified phyto-pharmaceuticals,” said Nyoman, who was a researcher of Indonesian herbal drugs with the Food and Drug Control Agency from 2004 to 2006. He also previously studied acupuncture in China and rheumatism in Australia, and in 1999 he was named best researcher by the Indonesian Rheumatologists Association.
Herbal drugs are grouped in two categories, jamu and phyto-pharmaceuticals, which are those that have already been scientifically tested for efficacy and healing capability.
Sadly, most of the thousands of herbal raw materials in Indonesia are processed into jamu, while only six have been standardized into phyto-pharmaceuticals. These six are effective for treating various disorders like diarrhea, rheumatism, high cholesterol, erectile dysfunction and hypertension.
“The development of phyto-pharmaceutical herbs has been slow because each takes three to five years to study and costs billions of rupiah. Government allocations to this health sector are too small, totaling just Rp 250 million (US$21,750) to 300 million per province, thus making it hard to promote more herbs to this category,” Nyoman said.
The current dominance of jamu in herbal drug production has indeed made physicians wary of prescribing these medicines. However, Nyoman noted that in 2012 there were 2,720 herbal prescriptions issued to hospital patients nationwide.
“It was a really heartening development, showing that doctors had become less averse to prescribing herbal drugs. Hopefully, this will inspire other physicians in their herbal treatments,” he said, adding the materials most frequently used in common herbal medicines were extracts of white teak, pare (fruit of a shrub, Momordica charabtia), seledri (celery), pegagan (pennywort), kunyit (turmeric), mengkudu (Morinda citrifolia), jinten (caraway seeds), temulawak (white turmeric), ginger and ceplukan (cut-leaf ground cherry).
Herbal drugs are also prescribed for patients with internal diseases and skin conditions, as well as for tooth, mouth and childhood ailments. But they are still most prescribed for cancer and disorders related to aging. “The herbs are prescribed by specialists rather than general practitioners, and this tendency is increasing,” he said.
The medical circles already turning to the use of herbal drugs are now affiliated with the Association of Doctors for Eastern Medicine Promotion (PDPKT) and the Indonesian Herbal Medical Doctors Association (PDHMI).
Indonesia has over 7,000 medicinal herbs, 283 of which are used for natural or herbal drug manufacturing. “Ironically, we still import 96 percent of our herbal drug raw materials, which is a very tragic fact,” said Nyoman.
Admitting that he wasn’t sure how the quality of Indonesian herbs compared with imported ones, he was convinced that local products should be at least equal in quality to those from India, China, the Middle East and other countries.
“Those from other nations are better promoted so they appear to be superior. Indonesian herbal drugs still lack promotional efforts,” said Nyoman.
Therefore, he hoped the government would get involved in the promotion of local herbal medicines and issue a regulation to protect the public from the influx of foreign products so that consumers could critically and wisely make their choices.
Indonesian herbal drugs were accepted by three hospitals in 2005, which have since prescribed these medicines. The number rose to 18 hospitals in 2009, and now there are 54 scattered over eight provinces. In other countries, over half of their hospitals have applied herbal complementary therapy.