International Kava Alliance

Kava has become the subject of much debate wordwide.

By Joerg Gruenwald

As in the U.S., an international alliance is being established around the world to protect kava as a traditional drink in the Pacific and herbal medicine in the Western World. Recently kava was the main topic at a conference organized by the Commonwealth, Pacific Herbs Business Forum. Held in late February, 80 international specialists and local growers of pacific herbs in Vanuatu (South Pacific) attended the conference. At the end of the conference, the participants agreed that the governments of kava exporting countries take steps to implement actions for the recovery and development of the agricultural sector. This is important for the economies and farmers in kava exporting countries.

Participants also noted that kava has been consumed for many hundreds of years in amounts that greatly exceed the dosage in herbal medicines and no pattern of liver disease has ever been linkedto kava consumption. The forum suggested the European health authorities examine the current actions against kava products. They also asked the World Health Organization (WHO) to convene an expert panel to examine the scientific evidence concerning the alleged adverse effects of kava.

These requests were presented to a meeting of Forum Economic Ministers held in Sydney, Australia, February 27-28, as well as to the Commonwealth Heads of Government meeting (CHOGM) in Brisbane, Australia, afterwards.

The situation in Germany will not lead to a ban of kava, or a withdrawal of all products, as has happened in countries such as Great Britain, France, Austria and Ireland, even though Germany started the hysteria. Kava in Germany is regulated as a drug and in about 80 % of all usages it is prescribed by physicians and reimbursed by the health insurance system for anxiety treatment. The plan of the pharmacovigilance unit of the health authorities in Germany is to recommend to the government that kava become a prescription only medicine. For the present market, this would not result in a major change, since most patients already get kava from their doctors.

But the decision to make kava a prescription only product has not been finalized and the industry and the associations as well as academia are fighting to keep kava an OTC product because the available data does not justify a change in the present situation.

In a recent article in the leading journal for pharmacists DAZ (Deutsche Apotheker Zeitung), Professor Dieter Loew, a well respected pharmacologist concludes that the present judgment on kava was not justifiable or understandable. The positive effects of kava are very well clinically documented and the risks are low, known and can be calculated.

In a second article by Dr. Matthias Schmidt and professor Adolf Narstedt from the University of Muenster, the author concluded that individual cases presented by the German health authorities were practically ripped apart. German health authorities quote the extreme example of the patient who died of liver failure. In this case it was documented that the patient had an alcohol abuse problem lasting many years and the liver was damaged for a long time before the patient started to take kava.

Further, the analysis of the individual 36 cases revealed that only one case had a probability of a causal relation to kava in the proposed dosage. All other 35 cases had no relation to kava as there was a causal relation to other medications or the relation could not be properly evaluated. The authors also concluded that a possible ban of kava would, in fact, increase the danger of liver toxicity, since the patients must be treated with other chemical drugs, which have liver toxicity risks 112 – 265 times higher than that for kava.NW