A deadly infectious disease of unknown etiology earlier referred to as ‘Wuhan pneumonia’ was reported in Wuhan city of China in December 2019, and by January 7, 2020, it was confirmed as a new type of coronavirus called “Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)”.
In February, 2020, the World Health Organization (WHO) named the pneumonia as Coronavirus Disease 2019 (COVID-19).
The sudden and rapid unexpected spread of COVID-19 from China to several other countries compelled the WHO to officially declare a global pandemic on March 11, 2020.
The reported cases continue to rise because of the rapid spread of SARS-CoV-2, but sadly, as of now, there are no approved specific antiviral drugs or vaccines available for its treatment. The general case treatment and prevention plans globally involve supportive care, hygienic practices, lifestyle modification and healthy diet.
The present clinical protocols for COVID-19 treatment in Ghana are solely orthodox and are yet to fully incorporate Ghanaian Herbal Medicine regimen.
It is expected that in the wake of COVID-19 pandemic, mandatory institutions, such as the Centre for Plant Medicine Research (CPMR), Traditional and Alternative Medicines Directorate (TAMD), and the Ghana, Food and Drugs Authority (FDA) as well as the Ghana Federation of Traditional Medicine (GHAFTRAM) and natural product drug discovery experts in research institutions across Ghana would team up to develop a concerted framework and suitable natural product remedies towards integration of Ghanaian Hebel Medicine into both current and future therapeutic options for the treatment of COVID-19.
Ethnobotanical and pharmacological studies on some indigenous medicinal plants (Alstonia boonei, Celtis mildbraedii, Acacia kameruneensis) have effectively been used to treat a plethora of viral infections such as common cold, pneumonia and measles in Ghana.
Unfortunately, the clinical application of these potential antiviral medicinal plants has not been sufficiently explored partly due to lack of standardized product development and reasonable scientific data on traditional formulations to support safety and efficacy in humans.
However, studies have demonstrated that these medicinal plants are capable of preventing or destroying viral replication.
The objective of this write up therefore is to start a national discourse on the development and use of standardized herbal medicines as complementary therapy in public health diseases including COVID-19.
For this purpose, the experience of China (home of traditional medicine) in the development of traditional medical practice and the therapeutic benefits of herbal medicines can inform a national strategic agenda towards the effective integration of GHM into the health delivery system.
The main treatment protocol for COVID-19 has been a supportive care package, which includes the combination of broad-spectrum antibiotics, antivirals, corticosteroids and convalescent plasma.
HIV protease inhibitors such as ritonavir and lopinavir have been used, and very often in combination with other appropriate antibiotics to treat COVID-19 patients.
A recent report revealed that favipiravir (Nucleoside anlog) has significant in vitro anti-SARS-CoV-2 activity, but the in vivo effect remains elusive.
Similarly, hydroxychloroquine/chloroquine, a potential broad-spectrum antiviral drug, demonstrated anti-SARS-CoV-2 activity. However, a preliminary study on its use on COVID-19 patients in the US revealed 16.4% higher death rate than in control patients.
The aforementioned data support the assertion by WHO that there is currently no specific recommended medicine for the treatment of COVID-19.
In this regard, there is a great opportunity for Ghana to explore the immense potential of GHM as a complementary therapy for COVID-19 patients.
There is no gainsaying the fact that some Ghanaians might have started using Ghanaian Herbal Medicine as treatment option for complaints consistent with COVID-19 symptoms with some success.
It is therefore time for researchers, herbal medical practitioners, regulators, other relevant scientists, the private sector and policy makers to come on board to valorize medicinal plant research in order to find local solutions with global impact for treatment of COVID-19 in Ghana.
This clarion call is underpinned by the success story of medicinal plant products utilization in the treatment of COVID-19 in China. Thus, the National Health Commission (NHC) of China reported that 60,107 confirmed COVID-19 patients (85.20 per cent of total) had been treated with Traditional Chinese Medicine (TCM) in February 2020.
There are sufficient biochemical differences that exist between the metabolism of bacterial and mammalian cells that enable selectivity to be achieved, leading to the early development of antibacterial agents, which are safe for clinical application.
Viruses, despite their apparent simplicity, present a challenging situation in anti-viral drug design efforts due to their replicative cycle. In this replicative cycle, viruses become physically and functionally incorporated into the host cells.
Consequently, it becomes very difficult to distinguish unique biochemical features of the pathogen from the host cell to serve as drug targets for selective activity.
The competitive advantage in using antiviral medicinal plants is enshrined in their multi-target and broad-spectrum activities which include attacking the viral components (envelop, nucleic acid and proteins) and viral life cycle (entry, replication, assembling and release).
These medicinal plants may also stimulate the defense mechanism of the host via their immunomodulation, antioxidant, anti-inflammatory and properties in destroying the deadly viruses.
There are sufficient scientific data to show that antiviral GHM possess such mechanistic features which can be unearthed to combat COVID-19. It is possible that some natural product scientists have already commenced investigations into the effect of GHM products or its components on SARS-CoV-2 in the laboratories.
The diverse research efforts towards COVID-19 should be brought to a common platform by policy makers and stakeholders in order to have a unified direction and purpose for optimal utilization of research funds, research infrastructure and social uptake of research.
This therefore places a call on the government to consider substantial research support to interdisciplinary research teams in terms of funds and material resources in its ‘COVID-19 combat plan’ for now and the future.
For a start, the government can dedicate 5 -20 per cent of the proceeds of the COVID-19 National Trust Fund to COVID-19 priority research needs and invite applications from local interdisciplinary research teams in collaboration with CMPR and FDA, Ghana.
In a couple of months, it is envisaged that outstanding indigenous polyherbal medicines suitable for clinical trials could be developed as antiviral agents for the treatment of COVID-19 patients.
By Dr. Caleb K. Firempong,
Medicinal Plant Biochemist, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, KNUST- Kumasi