TRADITIONAL HERBALISTS WARNED

Following reports of contaminated and ineffective herbal medicine, the Ugandan Ministry of Health (MoH) has issued a warning to traditional herbalists. Concerns center on contamination with dangerous microbes and heavy metals, which has led to health risks and undermined the efficacy of the products. 

The National Drug Authority (NDA) had noted poor hygiene in handling and processing herbal remedies. A 2021 study found that 62.9% of herbal medicines in East Africa were contaminated with microbes from faecal pollution, including E. coli, Salmonella spp., and Shigella spp, hence poor hygiene practices.

Additionally, many herbalists lack knowledge of good manufacturing practices (GMP). The use of contaminated materials or improper drying and storage leads to the growth of bacteria and fungi, which degrade the quality of the medicine lacking standardized production.

 Furthermore, herbal medicines are also contaminated by toxic heavy metals like lead, mercury, and arsenic, which are absorbed by plants from polluted soil and water during cultivation, thus a contaminated environment poses danger.

Health risks for consumers include:

• Disease transmission: The presence of bacteria like Salmonella and E. coli causes severe gastrointestinal and respiratory issues, including dysentery and pneumonia.
• Organ damage: High levels of heavy metals have been linked to cancers and chronic toxicity of the heart, lungs, and kidneys.
• Reduced effectiveness: Inaccurate formulas, adulteration with other substances, and microbial degradation could reduce or nullify the intended therapeutic effects of the medicine, leaving underlying illnesses untreated.
• Drug interactions: The potency of herbal medicines could also be unpredictable and might cause adverse reactions when combined with conventional medicines. Contaminants or undisclosed ingredient, such as corticosteroids or other conventional drugs, causes harmful drug-herb interactions. 
• Toxic side effects: Some herbs also cause severe toxicity, including catastrophic liver and kidney damage.
• Chronic illness: Regular consumption of herbal medicines contaminated with heavy metals, such as lead and cadmium, has been linked to long-term health issues like cancer.
• Infections: Pathogenic bacteria like Salmonella spp. and E. coli, which have been found in high numbers in tested products, can cause dangerous infections. 

Actions and recommendations

The Ministry of Health and the National Drug Authority (NDA) are working to regulate the herbal medicine industry and protect the public. In 2024, an NDA official noted that while hundreds of herbal products were “notified,” meaning they were recognized by the authority, limitations in post-market surveillance mean that product quality was not always guaranteed. 

Recommendations for herbalists

• Improving hygiene in all stages of production, from harvesting and preparation to packaging and storage.
• Seeking training on and implement good manufacturing practices (GMP) to ensure safety and consistency.
• Registering products with the National Drug Authority to ensure they are formally evaluated and recognized. 

Recommendations for consumers

• Buy from certified sources: Purchase herbal products only from licensed pharmacies and approved outlets to avoid uncertified and potentially harmful products.
• Verify products: The NDA maintains a website with a list of all notified herbal products. Consumers can use this resource to verify products before purchasing.
• Consult a professional: Do not self-prescribe. Seek advice from a qualified healthcare professional, including a reputable herbalist, to ensure safe and appropriate use.
• Report adverse effects: The government encourages consumers to report any adverse reactions or complications from using herbal medicines.