PHARMAPACT, an acronym for Peoples Health Alliance Rejecting Medical Authoritarianism, Prejudice And Conspiratorial Tyranny, of which I am national co-ordinator, have recently formed a historic cross-cultural alliance (to be collectively known as HEALTH FREEDOM South Africa) with various health freedom and practitioner / service-provider organisations, including the ICC (Interim Co-ordinating Committee of Traditional Medical Practitioners of South Africa), and whose interests I intend to protect, and the Traditional Doctors, Herbalists, & Spiritualists Association of South Africa, of which I am a member and whose President has delegated me to represent their interests within the Legal Issues and Education work groups of the Centre for Traditional Medicines. We hereby formally protest the undemocratic nature of the structures of the Centre for Traditional Medicines, including the workgroups, which have not been called by public notice.

Much has been said about the so-called Listing System for all "natural health substances", as proposed by the now disgraced MCC hierarchy and supported, indeed driven, by financially and power-play vested interests both inside and outside of the industry. As national co-ordinator for PHARMAPACT, I have previously argued that the proposals are ill-considered, unconstitutional and illegal (MEDICINES CONTROL COUNCIL REGULATION OF ALL NATURAL HEALTH SUBSTANCES AS MEDICINES: ARGUMENT AGAINST ALLEGED LEGALITY (5598 words dated 3 Mar. 98). This paper is based hereon this insofar as traditional African substances and medicines are concerned and is intended to serve as legal notice to all Group members.

A further report (PHARMAPACT UPDATE: CHEERS AMID FEARS AS SOUTH AFRICAN HEALTH MINISTER SHUTS-DOWN MEDICINES CONTROL COUNCIL. 29 Mar. 98), is appended, so as to put the listing system into a proper global perspective, as is a further report (ARE YOU PAYING GOOD MONEY FOR NOTHING? Commercial Over-The-Counter Homoeopathy: Taxpayer Sponsored Health Fraud ! Jun.98), included to further expand on the reasons for apparent industry support for the Listing System. We use the word apparent, since many simply follow these unscrupulous leaders unquestioningly, and others are enticed by reward or are coerced by scaremongering of MCC retribution. Either way neither represents popular support.

Whilst we have no desire to bring African traditional healers and medicinal suppliers under any undue regulatory pressure, and we believe that earlier evidence, plus that of allopathic pharmaceutical iatrogenic and nosocomial morbidity and mortality, hold more than sufficient ammunition to defend PHARMAPACT's position that the MCC are acting illegally, the traditional African medicine regulatory double-standard, and especially our exposed evidence of MCC genocidal negligence and ethnopiracy, are issues we are morally compelled to protest, for reasons to be fully outlined shortly.

We are always impressed by how perceptive the general public are when they remark "but what about the traditional African herbs and muti-medicines? In the past, when the African tradition was apparently exempt from first the threat of registration and then the listing system, PHARMAPACT for many years challenged the MCC on the constitutionality of their actions. Specifically, Section 9 of the Constitution (Equality), subsection (3), clearly states that "The State may not unfairly discriminate directly or indirectly against anyone on one or more grounds, including ethnic origin or culture.

Significantly, subsection (5) moreover specifically states that "Discrimination on one or more grounds listed in subsection (3) is unfair, unless it is established that the discrimination is fair". The onus in this instance is thus uniquely on the party wishing to discriminate, and hence the MCC/MCA would have to take the initiative and convince the Constitutional Court that the discrimination in the circumstances at hand is fair, which is highly unlikely, given the facts to be presented herein. Let us raise various contentious issues and illustrate how the listings system would inappropriately address them.

In terms of "quality", the hygienic and contamination situation relating to the pavement on which these wares are displayed in the urban setting are of legitimate concern, being as they are, tainted with sputum, urine and faeces from animal and pedestrian traffic, plus a fair measure of vehicular combustion petrochemical deposits. We must however, be careful not to pursue purity to absurdity, as with the pharmaceutical manufacturing standards being insisted on for all natural health substances, which we insist ought logically to be maximally set at those for food standards which items are consumed in more significant quantities and arelikewise responsible for thousands of preventable deaths.

Regarding safety and efficacy, it is appropriate to comparatively evaluate the relative risk from traditional African herbs and substances. Some 75% of the African population are estimated to use traditional herbs, usually in combinations. According to the database established by Noristan Laboratories over 20 years of research; of 350 plant extracts assayed, 79 % showed definite pharmacological activity, and 12 % definite toxic effects. (Hughson, L. Pharmaceutical & Cosmetic Review, Jul. / Aug. 1995)

Professors Folb and Schlebusch, past chairman and registrar of the MCC respectively, opinioned internationally a decade ago that "the issues of traditional medicines need to be addressed" ( Folb, P et al, J. Clin. Pharmacol. 1988: 28), yet apparently a moratorium exists iro. traditional medicines, in spite of Folb again writing, under the sub-heading Traditional drugs and indigenised pharmaceuticals, that "some give rise to serious adverse reactions, and others contain chemicals that have long term effects such as carcinogenicity and hepatoxicity" (Folb, P, SA Jour. Science, Vol. 85, Aug. 1989).

PHARMAPACT and its allies consider it ludicrous that the professors claim jurisdiction over exotic herbal and other natural health substances as medicines when it is clear that these are impacting positively on health and negatively on medical profits, but not to have jurisdiction when some of the indigenised medicines and eg. tobacco and other unregulated toxic pharmacological substances are impacting negatively on health and positively on medical profits, whilst hypocritically using public safety as a red herring to suppress public access to the former. Surely some serious reprioritisation is called for and the authoritories will have to face up to this dilemma.

Whilst there is little difference between an African medicinal and the exotics, all of which except for the former are currently the target of such vicious regulatory fervour by the MCC, the only difference we have identified, is that the latter have had their problematically toxic items excluded from international commerce for fear of litigation, whereas this process has not occurred with the indigenous substances but for a few bulk commercials. With current budget constraints, we cannot conceive of the listing system justifying the disproportionately high priority afforded it for relatively safe products, when urgent Toxics Lists and educational programmes are the only practical ways to truly act in the consumer's priority interest and save several thousand lives each year, not to mention untold suffering.

Whilst researching this report, we assumed that the morbidity and mortality incidence for South Africans using indigenous medicines would be minuscule, but we were stunned to uncover the shocking scientifically recorded and published clinical observation that "in South Africa, the major cause of death (from acute poisoning) among black (direct quote) South Africans are traditional medicines." To reassure the reader that this was not a typographical error, the editor, a Clinical Professor of Medical Toxicology, added in brackets "(about 50 % of deaths)". (Ellenhorn's Medical Toxicity: Diagnosis and Treatment of Human Poisoning, Williams & Wilkins, 2nd. Edn.1997). That this information escaped the MCC, is not acceptable, it is unforgivable.

Dr. P .H. Joubert, M.D., author of the internationally published article referenced in the above-mentioned textbook has, as Professor with the Dept. of Pharmacology & Therapeutics at the Medical University of South Africa (Medunsa) been responsible for most of the epidemiological work in the shamefully neglected field of local indigenised medical toxicology. In spite of Joubert (and others) relentlessly attempting for almost three decades to draw attention to this serious problem, practically nothing has been done to address this highly suspect apartheid oversight. Who needs a Third Force, when muti-medicine and a MCC blind eye to the problem will suffice?

In fact, some of Prof. Joubert's successors and the medical press have tried to play down the matter, eg. Dr. D.H Brand, is mentioned in an article which refers to follow-up work at Medunsa as suggesting that only a small percentage of overdose or poisoning occurs with traditional medicine. (Medical Chronical, Nov. / Dec.1993) The current department head, Prof W.J. du Plooy also plays down the statistics by interpreting them favourably (personal communication, 16 Feb.1998), which does nothing to speed a solution, but rather tends to bury the problem. Interestingly Du Plooy is a Medical Research Council funding recipient for "Traditional medicines as part of the national drug policy", so the authorities cannot plead ignorance as a result of claimed obscure research.

What then are the facts?

Prof. Joubert in his earliest work (that we know of), undertook a retrospective comparative epidemiological study of acute poisonings at the teaching hospitals of the Orange Free State, 1970-1976, which revealed that among whites, medical drug poisonings predominated, whilst priorities among the developing black community, (direct quote), were prevention of pesticide, paraffin, carbon monoxide (indoor fires) and traditional medicine poisonings . (Joubert, P. H., "Toxicology units in developing countries: different priorities?" J Toxicol Clin Toxicol 1982 Jul; 19(5))

In a subsequent project covering 1981-1982 at Ga-Rankuwa Hospital, Pretoria, it was determined that whilst 18 % of all acute poisonings were due to traditional medicines, 86.58 % of all deaths from acute poisoning were as a result of poisoning with traditional medicines and it was concluded that "Traditional toxicology services (as found in developed countries), primarily geared towards the management of cases of drug poisoning, are inappropriate to the needs of developing communities." (Joubert P, Sebata B, "The role of prospective epidemiology in the establishment of a toxicology service for a developing community." S Afr Med J 1982 Nov 27; 62(23))

In a continuing project covering 1981-1985, also at Ga-Rankuwa Hospital, it was once again determined that the main causes were paraffin (59 %), but with low mortality (2.1 %), whilst poisoning with traditional medicine resulted in a high mortality of 15.2 % and accounted for 51.7% of all deaths, which were always accidental. Vomiting, diarrhea, and abdominal pains were the most frequently encountered symptoms, while lungs, liver and central nervous system were commonly affected. The traditional healer was the main source (83.4 %), while 11.3 % was bought from African medicine shops. (Venter C. P., Joubert P. H. " Aspects of poisoning with traditional medicines in southern Africa", Biomed Environ Sci 1988 Dec; 1(4))

The main paper under analysis as referenced in the above-mentioned textbook is Prof. Joubert's "Poisoning admissions of black South Africans" (J Toxicol Clin Toxicol 1990; 28(1)), also dealing with acute poisoning admissions to Ga-Rankuwa Hospital, from which we summarise as follows: Overall the major causes of mortality were traditional medicines, responsible for 51.7 % and kerosine (paraffin) for 26.7 % of the deaths that occurred.

When differentiated into fatal childhood poisonings, 72.7 % were attributed to paraffin. When differentiated into adult poisonings, the commonest cause of acute poisonings was traditional medicines at 44 % (followed by pesticides). Of the patients who died, 62 % were diagnosed as poisoning by traditional medicines, and 12.5 % each for medical drugs and pesticides. There were no cases of deliberate self-poisoning with traditional medicines.

It was Prof. Joubert's conclusion that the main issues were the extremely high mortality, and that if the poisonings due to traditional medicines could be eliminated, the overall mortality rate would decrease by + 50 %. The abstract conclusion was that the prevention of paraffin poisoning and poisoning by traditional medicines merits high priority in the health care of the indigenous population of South Africa. (Joubert P.H., Poisoning admissions of black South Africans, J Toxicol Clin Toxicol, 1990; 28(1))

Further vindicating Prof. Joubert's concerns, in spite of counter-propoganda, are the statistical conclusions reached by Dr. E Osuch, Joubert's current successor who extended his work as a thesis ("Toxicological aspects of some traditional medicines used by patients admitted to Ga-Rankuwa Hospital") covering the subsequent period 1987-1992, claiming "more than half of all acute poisoning deaths." Even more recently Dr. Osuch et al have stated that "A large percentage of acute poisonings in black (direct quotation) South Africans is due to traditional medicines." (Foukardis G, Munting G, Osuch E, J Ethnopharmacol 1994 Feb;41(3)).

Of further interest in Dr Osuch's thesis is that 24 different plants tended to recur as causes of these hospital admissions, in our view presenting a golden opportunity for the authorities to educate suppliers and users regarding dose, precautionaries, early poisoning symptoms etc., an opportunity squandered by all concerned, especially the MCC, via TRAMED, and the responsibility rather being borne by PHARMAPACT, at least to initiate the necessary reform, via this and future efforts. We are trying to prepare a toxics short-list list, but are not receiving the co-operation of the authorities in this regard. In the meantime it appears that the main killer in the Transvaal is Urginea sanguinea, previous reference) and in Kwazulu/Natal, Callilepsis laureata. References for the latter are as follows:

• (Byrant A, Zulu Medicine and Medicine Men, Centaur, 1966)(without doubt a virulent poison)
• (Seedat Y, Hitchcock P, S Afr Med J Jul 31;45(30))(acute renal failure)
• (Wainwright J, Schonland M, Candy H, S Afr J Med 1977 Aug 13;52(8))(found to cause fatal liver necrosis, widely used as a herbal medicine, nephrotoxic, hypoglycaemic, hepatoxic)
• (Watson A, Coovadia H, Bhoola K, S Afr Med J 1979 Feb 24;55(8))(administration of Impila (Zulu for health) is common, the practice can and does cause poisoning, hepatic and renal tubular necrosis, hypoglycaemia, alteration of consciousness, hepatic and renal dysfunction)
• (Veale D, S Afr Pharm J 1987 (54))(fatal if ingested in small quantities, confusion, vomiting, diarrhoea, convulsions, hypoglycaemia and liver and kidney failure)
• (Dehrmann F, Bye S, Dutton M, J Ethnopharmacol 1991 Sept; 34(2-3))(used extensively as a medicament, nephrotoxic).

Shockingly little or nothing has been done about this unacceptable situation, least of all by those who over the period that this information has been directly available to them and who have been directing MCC policy under the shallow guise (at least to us), repeated ad nauseam, of being the custodians of public safety from toxic medicines and insisting that they have been empowered to control all substances fitting their enacted definition of a medicine. The new transitional authority assumes legal responsibility.

We are presently engaged in ongoing culpability investigations and the processing of criminal charges of gross dereliction of public duty and genocide against Professors Schlebusch and especially Folb and in the latter's case, a further enquiry into ethnopiracy, since Folb has directorship at the University of Cape Town of the Dept. of Pharmacology, the World Health Organisation Collaborating Centre for Drug Policy (WHOCCDP); and the Traditional Medicines Programme (TRAMED) and is in a better position than anyone to be aware of these shocking circumstances, and especially as chairman of the MCC, to be doing something meaningful about them. Further collaborators will be held as accessories after the fact.

In addition to TRAMED, is a Research Group for Traditional Medicines which is also a joint venture between the MRC, the Department of Pharmacology at UCT and the School of Pharmacy of the University of the Western Cape, which is also engaged in ethnopiracy testing of plant extracts at UCT, according to Dan Ncayiyana, Deputy Chancellor of UCT, "to isolate active compounds to develop new drugs." (Electronic Mail & Guardian, 19 Oct., 1997) It is no surprise that the person preferred by the MCC to take over as Chairman of the MCC in June was vice chairman, Professor P. Eagles, Director of the UWC School of Pharmacy, who is currently expanding on Folb's ethnopiracy operation. Criminal charges will be pursued.

Instead of using the 60,000 entries TRAMED database available to the WHOCCDP to "monitor all adverse reactions to medicines in South Africa and investigate national problems of drug toxicity, recommend policy in this regard and encourage the rational and safe use of medicines, including traditional medicines" (as claimed on it's websites), the combined facilities are "presently engaged in large amounts of research based upon the extraction and isolation of active compounds from plants used by traditional healers in the treatment of disease." Gilbert Matsabisa (MCC/ CMC) is busy with "ethnopharmacology in drug development" at the UCT Pharmacology Dept.

Nigel Gericke, a medical practitioner who is a member of the CMC (& Afr. Trad. Med. sub-committee)(sponsored by Pharmacare Ltd), and was the founder of TRAMED whilst working as phytomedicines development manager for S A Druggists states in his CV that he continues to serve as consultant to TRAMED on a voluntary basis, including ongoing research into side-effects and the development of a traditional medicines formulary to encourage the safe use of indigenous medicinal plants, and the development of a database, including toxicology. Criminal charges will soon be brought to bear.

Interestingly, in late 1995, at the request of professor Folb, a study was made by Gericke and recommendations made for the development of a South African approach, yet ironically no urgent regulatory action is being imposed on this sector, which by far represents the major, if not sole risk to public safety from hatural health substances against which the MCC claim to be acting when witch-hunting the international natural health substance traditions. Don't these people care about the deaths of thousands of Africans? Apparently not ! Folb and his gestapo were instead confiscating innocuous substances including, believe it or not, yoghurt acidophilus concentrateand, garlic, parsley and celery. Civil suite will be instituted iro. material damages borne.

Dr. Gericke in the meantime developed his own commercial range of ethnopirated indigenous medicines (Healer's Choice brand) and with his senior at SAD, Bosch van Oudtshoorn, co-authored a new book (Medicinal Plants of South Africa, Briza, 1997)(developed from the TRAMED database, to which it gives no acknowledgement, nor to the traditional healers). Most curiously and irresponsibly this book does not provide an iota of toxicological data for any of the 132 plants featured, in spite of significant toxicities, as if none existed, though the publishers briefly provide the standard indemnity. Civil suite will be brought to bear.

A shockingly similar situation inexplicably exists with the recently published South African Traditional Healer's Primary Healthcare Handbook (UCT, 1997)(Sponsored by Smithcline Beechham Pharmaceuticals), also a product of the TRAMED Project, which, although it provides short token precautionaries for the toxics among the 55 plants featured, simply does not do justice in addressing the enormous problem of acute poisonings and fatalities arising from traditional African medicines. We have to question and protest the deliberate exclusion of an educational toxics list.

Some 3000 plants are in use, 10 % in major use, and of which the most toxic or those responsible for most of the serious poisonings and fatalities are not even featured or identified in these two publications, especially curious considering that they both have their genesis under Professor Folb's directorship and against the claimed public interest, much of which is hypocritically repeated by Folb in the first paragraph of his forward to the manual.

The authorities having no excuse to plead ignorance in defence of their callous inaction in the face of so much innocent human suffering and loss of life, since this is the claimed primary responsibility of the Medicines Control Council, and the traditional African healers and sellers of herbal medicine are not directly to blame. Charges of culpable homocide will be brought against participants.

Why have these "downright dangerous drugs" not been given toxicological precautionaries at every opportunity as with the exotics and called-up to protect consumers? # Many of these substances cross our borders from as far afield as Mozambique, Malawi, Swaziland and Tanzania, so why are the MCC not similarly instructing the Customs officials to embargo these medicinal drugs at point of entry? # Why are MCC inspectors not exercising their functions within the arena of the African herbal / muti shops and markets? Are our African citizens not entitled to equal protection under Act 101, or is apartheid still alive and well amidst a sinister apartheid plot to poison the unsuspecting African traditionalist, now awkwardly come back to nest?

The bottom line is :

For the "listing system" to be implemented, it will have to include the African traditional medicines, or face constitutional challenges, criminal charges and civil action against the enforcing authority. If on the other hand, the African traditionals are forced into the listing system, it will involve the expropriation of a 2 billion rand market from thousands of people who have traditionally earned their sustenance this way, severely restrict free public access to and escalate the cost of these substances to the very people who rely on them most and whom the authorities falsely purport to serve. With an election at hand, the Government cannot afford such confrontational controversy.

Stuart Thomson (National Co-ordinator, PHARMAPACT)

Formal Representative, Traditional Doctors, Herbalists and Spiritual Healers Association of South Africa.

Contact details and more information:

Peoples Health Alliance Rejecting Medical Authoritarianism, Prejudice, And Conspiratorial Tyranny

(Fax and phone 04457-7765)

(E-Mail : PHARMAPACT@hotmail.com)

(Website address; https://www.angelfire.com/biz/pharmapact

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