**9. Challenges of contemporary herbal medicine practice in Africa**

Traditional medicines are increasingly being used outside the confines of traditional cultures and far beyond geographical areas without proper knowledge of their use and the underlying principles [8]. They are therefore practiced in ways that deviate from the traditional norm of practice within the specific traditional setting. Such deviations include the method of extraction—where highly efficient and sophisticated technological tools are frequently used for extracting medicinal plants and then reformulating the extract into a final product. Such an approach is entirely different from the hitherto traditional approaches of macerating the plant materials either dried or fresh often in boiling water to produce decoctions, which are then administered. This traditional approach therefore tends to make the herbal medicine safe since potentially toxic compounds are not extracted due to the inherent inefficiency in the aqueous extraction method (preparation of the decoction). Also, doses employed in contemporary practice often tend to be different from the traditional doses, which were systematically established over several years of practice and proven to be safe. Besides, herbal medicines are used for non-traditional indications in recent years. A typical example is the use of herbal medicines for relieving constipation but abused as an abortifacient by the youth due to its induced contractive effect on smooth muscles such as the endometrial muscles. The concomitant use of traditional medicines with other types of medicines is quite outside the traditional context and has become a matter of particular safety concern [8].

Another challenge posed to the practice is the lack of appropriate foundational knowledge in traditional medicine practice and the herbal medicines used to treat diseases. This is a common occurrence among many contemporary practitioners, especially those in urban and cosmopolitan areas. The work of such practitioners is based on information gathered from indirect sources such as the Internet or from reading books and therefore lacking in specific knowledge. These 'neo-herbalists' most often lack the expertise and basic principles necessary for the use of herbal medicines. Their practice may therefore not be entirely safe and can put patrons at risk of adverse reactions.

Besides, documented knowledge about medicinal plants and their uses within cultural settings rarely contains information on potential toxicity of the plants. This is because many ethnopharmacologists tend to focus more on the therapeutic property of the plants and hence do not inventory their toxicological information. This failure to document and contextualize potential toxicity of plants in the perspective of local healing traditions and healing practitioners' methods and approaches to treatment does not promote the safe use of medicinal plants outside the boundaries of the cultures where the medicinal plants are used.
