Nov2012 eHealth conf on Dengue and Tawa-tawa

SYNTHESIS OF 9NOV2012 eHealth online conference on Dengue and Tawa-tawa:

Tawa-tawa (E.hirta) is a popular plant that has folkloric origins in the traditional medical management of dengue and other viral infections. This medicinal plant is found not only in the Philippines but in other parts of the world. It has gained attention due to our increasing problem of dengue. While we have evidence to show that the crude extract of E. hirta has shown improvement in platelet numbers and clinical laboratory measures such as bleeding time in animal models, the basic mechanism of improvement and accelerated healing is still not clear.

Research is currently on-going in SLMC, UST, UP-NIH, UERMMMCI and Xavier, some of which are done and published but some of them have not been published. Thus we urge them to publish their work. Among the institutions, SLMC provides the most number of basic, but very critical studies, with substantial research contributed by UST, Xavier and UP-NIH. UERMMMCI provides important observational studies in humans which can actually determine empirical toxicity based on historical data. Actually if we can only get as much data from past users and find the variation of preparations, we can reconstruct a dose response assessment, although limited. All of these are important for the development of the plant towards drug discovery. However, we must also appreciate that the depth of research would need to encompass the public health importance of the widespread use of the plant for dengue as well as the important aspects of pre-clinical and clinical trials -Phase 1, 2 and 3.

In the conference we note that the toxicity studies were limited and there has been substantial efficacy studies in animal models. The integration of these studies into one directed goal of producing a safe and effective product from nature rest upon the function of PCHRD-DOST. PITAHC as a legal entity needs to direct traditional medicine research and practice. PITAHC has the mandate to identify the public health gaps and set priorities for directed funding mechanisms.

In these settings, the marriage of policy and science is needed to move the system forward in a unified and harmonised manner, to produce results almost immediately perhaps. Most of our questions beg to know efficacy but the question is: How far can we push the “informal dosing” of Tawa-tawa that can help prevent an adverse event especially that we think the underserve use them the most? Should we not settle the issue of toxicity given that we are almost definite that there is empirical evidence of efficacy?

-Gemiliano D. Aligui, MD, MPH, PhD
(9 November 2012)