Neem & Global Healthcare

The natural world has consistently provided us with an astounding variety of powerful resources and to this day offers the foundation of innovation across global healthcare. Despite the impressive progress we have made in this sector with the advent of pharmaceuticals, where new medicines are synthesized based on knowledge of specific molecular targets, most prescribed medicines are still derived from natural compounds. Due to the remarkable uniformity of life, genetic diversity on the planet offers us a virtually endless supply of potential medicines for all kinds of diseases and conditions.

There is profound potential for creating solutions to many of mankind’s most significant challenges by using the compounds, designs and ideas found in nature. Neem is one such source of innovation.

All parts of the neem tree, and espe­cially the leaves, con­tain a wide range of med­i­c­i­nal benefits due to its anti­malar­ial, anti­fun­gal, antibac­te­r­ial, antivi­ral and anti­car­cino­genic prop­er­ties. With over 200 compounds proven to be effective against inflammation, infection, fever, skin disease and dental illness, neem is a solution to a variety of ailments. Over the past twenty years, several thousand papers have been pub­lished exploring the plant’s effectiveness as a natural medicine from major institutions such as the Mayo Clinic, the University of Oxford and the Massachusetts Institute of Technology.

An Important Solution to Antibiotic Resistance

One of the greatest threats to global health today, antibiotic resistance causes 700,000 deaths per year by comprising the effective prevention and treatment of an ever increasing range of infections. Allowed to continue unabated, this dangerous phenomenon is expected to cause 50 million deaths per year by 2050 and cost the world $100 trillion in lost economic output.

Despite half of the antibiotics prescribed today considered unnecessary by the US Center for Disease Control and Prevention, global antibiotic use is expected to see a 67% rise by 2030. The majority of antibiotic demand comes from agriculture, with 80% of the 150,000 metric tons of antibiotics made each year in the United States used exclusively for promoting growth and health in livestock, though their primary purpose is to fight disease for mankind. Resistance to synthetic antibiotics therefore spreads quickly between humans, animals and crops, with the situation compounded by the fact that no new classes of antibiotics have been discovered since 1980.

Alternative additives for livestock feed such as neem are taking center stage. With an ample amount of essential nutrients like protein, calcium, carotene and a host of other minerals required for healthy growth in livestock, neem is a very promising solution to the overuse of antibiotics in agriculture. Neem offers livestock enough nutrients and macro/micro minerals throughout the year and has even been recommended to replace up to 50% of soy feed to improve general nutrition and to reduce the use of medications for parasites, bacteria and fungi. With the ability to eradicate microbes that cause infections and disease in livestock, neem fights bacteria and alleviates the pressure of rising antibiotic resistance, while providing the nutrition necessary for healthy livestock.

Offering Protection Against the World’s Most Dangerous Animal

Neem has evolved from being a ‘traditional’ medicine to the subject of studies showing its effectiveness in reducing the transmission of mosquito-borne diseases, among other healthcare benefits. Neem has demonstrated anti-feedancy, fecundity suppression, ovicidal and larvidical activity, growth regulation and repellence against 600 different insect species (including mosquitoes). As opposed to synthetics, neem-based pesticides have multiple modes of action against insects, and therefore rarely induce resistance. Immune to resistance, entirely biodegradable and cost effective, organic insecticides such as neem are valuable solutions to this public health issue.

The Tiger Mosquito in particular presents a real challenge, acting as an effective conduit to humans for an assortment of viruses including yellow fever, encephalitis dengue and malaria, which together affect up to 200 million people every year.

Malaria is a killer responsible for up to 584,000 deaths worldwide every year. Although 3.3 billion people in 97 countries are at risk, developing regions of the world are the most affected. Finding a solution to malaria has therefore required practices that are cost effective and sustainable, which is why neem has been considered a viable option.

A study co-authored by MIT and detailed in the Malaria Journal shows how neem seeds, dried, ground into a coarse powder and then sprinkled onto known mosquito larvae breeding grounds resulted in 49% fewer adult females. As the study pointed out, targeting the larval phase of mosquitoes is cost effective with minimal environmental impact.

Neem leaf extract substantially increases the state of oxidation in red blood cells, preventing normal development of the malaria plasmodia [1]. An active ingredient in neem leaves, called Irodin A, is toxic to resistant strains of malaria, with 100 percent of the plasmodia dead in 72 hours with only a 1:20,000 ratio of active ingredients [2]. Two other compounds found in neem leaves called gedunin, a limonoid, and quercetin, a flavonoid, are at least as effective as quinine and chloroquine, the typical malaria prophylaxis drugs, against malaria [3]. Gedunin, an extract of neem bark, has also been found to be effective in treating malaria [4]. Antimalarial effects of neem appear to be greater in the body than on a petri dish, leading some to speculate that stimulation of the immune system is a major factor in neem’s effectiveness against malaria [5]. Neem also lowers the fever and increases the appetite, thereby strengthening the body, aiding in fighting the disease, parasites and speeding recovery [6].

Neem’s Future Uses in Medicine

Innovation is necessary in medicine to treat the variety of diseases that affect us every day, and renowned institutions such as the Mayo Clinic, Oxford University and the Massachusetts Institute of Technology are currently investigating the extensive health benefits of neem.

With over 200 compounds found to be effective against inflammation and infection, fever, skin disease and dental illness, neem is a clinically proven antimicrobial that is active against a variety of viruses.

Reducing Insulin Requirements for Diabetics

One person dies from diabetes every seven seconds. 387 million people are living with the illness today, with an increase of 205 million expected by 2035. In 2014 diabetes expenditure reached $612 billion, making the illness responsible for $1 out of every $9 spent on healthcare [7].

Neem delays the coagulation of blood, which calms erratic heart beats, hence, reduces potential heart diseases and high blood pressure. For non-ketonic and insulin-sensitive diabetic patients, neem leaf extracts can reduce their insulin requirements by 30-50% [8].

Showing Clear Antiretroviral Activity

35 million people were living with HIV in 2013; with an estimated 39 million people having died from AIDS related causes in the last century [9]. Although the number of HIV infections has dropped by 21% since 1997, it is still prevalent in developing regions such as Africa where between 15-28% of the population are living with the infection [10].

Neem leaves show clear antiretroviral activity in humans suffering with AIDS.  Exhibiting significant improvements in CD4T cell levels, reduced levels of anaemia and an average weight gain of six pounds, the examined HIV/AIDS patients in several clinical trials showed signs of recovery and did not experience any adverse effects from the treatment [11]. The US National Institute of Health confirmed that neem extracts have been able to kill the AIDS virus in vitro[12]. Patents have been granted for these specific extracts as an alternative natural AIDS treatment [13].

Sensitizing Cancerous Cells to Radiotherapy

Cancer is the cause of one in every eight deaths worldwide and is rapidly becoming a global pandemic. The cancer burden is expected to increase to 21.7 million cases and 13 million deaths per year in 2030.

Various compounds found in neem bark, leaves, seeds and seed oil have been used to combat cancerous cells with no registered side effects. Instead of targeting the cancer cells directly, the protein – Neem Leaf Glycoprotein (NLGP) – modulates cells that are responsible for providing immunity to the body present within the tumor environment and its peripheral system. Neem extracts have also been shown to sensitize cancer cells to immunotherapy and radiotherapy, and enhance the efficacy of chemotherapeutic agents. In-vitro studies by the Memorial Sloane Kettering Cancer Center have also demonstrated neem’s ability to inhibit cancer cell growth [14].

The Department of Biochemistry and Microbiology from Rochester’s Mayo Clinic has been researching neem since 2013, and researchers are currently engaged in preclinical evaluation of neem’s ability to inhibit prostate cancer tumor growth in mice.

In the latest breakthrough for cancer research and treatment, the Department of Pharmacology at the NUS Yong Loo Lin School of Medicine in Singapore found that nimbolide, a bioactive compound found in neem, may be capable of not only shrinking prostate tumors by nearly 70%, but also capable of suppressing metastasis, or the rapid growth of cancer cells, by nearly 50% when taken in controlled doses over a relatively short period [15].

Nimbolide has also being evaluated as a potential treatment for the highly lethal pancreatic cancer. With one of the highest mortality rates (94% of patients die within the first five years of diagnosis), the cancer grows quickly and there are currently no effective treatments available. Initial tests from the Texas University of Health Sciences have shown that nimbolide was able to reduce the migration and invasion capabilities of pancreatic cancer cells by 70%, without harming healthy cells. Nimbolide treatments also induced cancer cell death, causing the size and number of pancreatic cancer cell colonies to drop by 80%.

[1] Etkin, Nina L. A Hausa Herbal Pharmacopoeia: Biomedical Evaluation of Commonly Used Plant Medicines." Journal of Ethnopharmacology 4.1 (1981)
[2] Conrick, John. Neem: The Ultimate Herb. Lotus Press (2001)
[3] Badam, L., et al. In vitro Antimalarial Activity of Neem (Azadirachta indica A. Juss) Leaf and Seed Extracts." Indian Journal of Malariology 24.2 (1987)
[4] Bray, D. H., et al. Plants as Sources of Antimalarial Drugs. Activity of Meliaceae Plants and their Constituent Limonoids." Phytotherapy Research 4.1 (1990)
[5] Pathak, G. P., et al. Neem (Azadirachta Indica): Traditional Medicine for House-Hold Remedy Against Various Human and Animal Ailments: Review (2013)
[6] Abatan, Matthew O., and Modupe J. Makinde. Screening Azadirachta indica and Pisum sativum for Possible Antimalarial Activities. Journal of ethnopharmacology 17.1 (1986)
[7] International Diabetes Foundation, Diabetes – Facts and Figures (2015).
[8] Tiwari, Ruchi. Neem and its Potential for Safeguarding Health of Animals and Humans (2014)
[9] World Health Organization, 10 Facts on HIV/AIDS (2014)
[10] HIV Aware, What Everyone Should Know about HIV (2015)
[11] Federation of American Societies for Experimental Biology, Seeking HIV Treatment Clues in the Neem Tree (2012).
[12] The Guardian, Neem – Nature’s Pharmacy (2002)
[13] Anyaehie, Ugochukwu. Medicinal Properties of Fractionated Neem Leef Extract (2009)
[14] Memorial Slaone Kettering Cancer Center, Integrative Medicine – Neem (2014)
[15] National University of Singapore - Consumption of a bioactive compound from Neem plant could significantly suppress development of prostate cancer.