By Samuel Opio
On August 25, Dr Sheila Ndyanabangi, the principal medical officer in the Ministry of health passed on after a relentless battle with cancer.
A few days later, Rotarians across the country held their annual cancer run to fundraise for the procurement of a linear accelerator to be installed at Nsambya hospital.
The total cost of the linear accelerator is estimated at sh18 billion. A linear accelerator provides high energy beams which can be irradiated on various body parts to treat cancer. This is indeed a great step .However, there will be need to ensure adequate maintenance to minimize downtime that can be as high as 25% for linear accelerators considering their heavy reliance on western technology.
In light of challenges with Western technological approaches, there is need to critically look at cancer treatment from a more local perspective and develop home grown solutions. Uganda is blessed with a lot of flora and fauna and ranks among the top ten most biodiverse countries in the world. More than 18,783 plant and animal species have been recorded to date. Among these species, a large number have been scientifically proven to have medicinal properties and have already been used to develop modern medicines .
Prunus Africana ,locally known as ngwabuzito in Luganda has been shown to have proven efficacy in the treatment of cancer and dubbed, the ‘wonder cancer drug’. Its bark is currently exported to European countries where it is used by pharmaceutical companies to make drugs for the treatment of prostrate cancer. It is however shocking, that whereas the bark which is the source of raw materials for this drug grows naturally within Uganda, the manufactured drug comes not only at a cost way out of reach of many Ugandans but remains unavailable in many pharmacies and drug outlets.
Another set of widely used cancer drugs are Vincristine and Vinblastine. Both are extracts of the periwinkle plant botanically known as Catharanthus roseus. Its purple beautiful flowers can be found in many Ugandan homes. The drug extracted out of it is administered as an injection. However, it remains expensive and out of reach of many including those that have its flowers growing in their backyards. Paclitaxel, another cancer drug derived from the bark of the pacific yew tree is used in the treatment of breast, lung, cervical, ovarian and skin cancer.
The drug hit annual sales of $ 2.1 billion dollars in the early 2000s and is among the most prescribed cancer drugs administered as an intravenous injection. It was discovered after screening more than 35,000 plants and mainly grows in North America and parts of Africa.
A dose costs over $ 1,000 dollars. Similar to it is another drug, etoposide sourced from the may apple tree and used in the treatment of ovarian cancer, various blood cancers and lung cancer.
The list is endless! However, in summary,75% of anticancer medicines in use are sourced from natural products or those related to them. By the year 2,000, 57% of all clinical trials for the development of new cancer drugs were either natural products or their derivatives.
Uganda’s rich biodiversity of plants makes it a strategic location for screening of potential medicines for treating cancer. These drug candidates can then be further developed into suitable drug formulations that can undergo various laboratory and clinical tests to establish their safety and efficacy in the treatment of various cancers. However, all this is limited by the lack of drug research institutes.
Whereas there are many research institutes such as Uganda Virus research institute, Natural chemotherapeutic research institute, Uganda industrial research institute, National agricultural research institutes none is designed to have an in-depth focus on drug discovery and development to a level of commercialization. The human resources are available with more than 2,000 pharmacists in country.
Scaling up efforts to develop new drugs for cancer from our rich biodiversity can help lower the burden of cancer which is humongous and out of reach of many. This includes the middle class who have the flowers used to make the cancer drugs at their backyard but lack the treatment to cure the disease on their front yard. There is no better time to establish the Uganda National drug research institute than now!
The writer is a Pharmacist, Secretary, Pharmaceutical society of Uganda and a private herbal medicine researcher.