Green Health in Guatemala - How can we build mutual trust 2 and partnerships for developing local medicines’ evidence-3 base and potential?

18 The implementation of access and benefit-sharing (ABS) protocols and especially the Nagoya 19 Protocol has created new hurdles for collaborations around Indigenous Traditional Knowledge and 20 international collaborations. Overall, these frameworks push for the development of novel 21 collaborative North-South agendas in order to improve the fair distribution of benefits. The Green 22 Health project (Guatemala) aims to implement a culturally pertinent and mutually accepted 23 framework for sustainable use, access and benefit-sharing (ABS) of traditional medicinal plants. It 24 involves developing a consensus among indigenous groups, government officials, industry, and 25 academia. We describe steps undertaken to design and implement an intercultural transdisciplinary 26 process that promotes trust building and advances herbal medicine research in a respectful and 27 innovative way. This involves joint definition of goals and methods. The consortium co-researched 28 Q’eqchi’ Maya traditional medicine, collected voucher specimens of medicinal plants with 29 traditional healers, identified their taxa, and later developed a literature-based evaluation 30 identifying species for potential product development. No samples for further research and 31 development are collected. By applying the emic-etic concept, the project was able to understand 32 the main drivers of each stakeholder and the associated obstacles for reaching an ABS agreement. 33 This results in the emergence of potential new drivers for developing evidence-based herbal medicine from the perspective of academia, policy and cooperation and grass-roots indigenous 35 movements.

138 Transdisciplinarity (TD) has emerged as an approach to research that transcends disciplinary 139 (academic) boundaries but that, nonetheless, is able to incorporate state-of-the-art interdisciplinary what is perceived to be the common good." We see here an acknowledgement for uncertainty and a 153 recognition that the collaborative process will not be static but rather subjected to constant change.
154 This is perhaps one of the most important characteristics of the transdisciplinary approach in the 155 Green Health project.

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In TD, mutual learning among participants is a key concept referring to the process of "exchange, 157 generation and integration of existing or newly developing knowledge in different parts of science and 158 society" (Scholz, 2011:8  Guatemala's genetic resources, including derivatives, and for the associated traditional knowledge.

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Part of this process included 26 "Regional Dialogue" sessions, held across the country to understand 331 the concerns of indigenous and other local communities.

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The proposed law would have its own institutional framework through the creation of a state entity,  where there are conditions generating gaps between the goal and observed reality (as shown in Figure   415 2). For each negative condition, specific tools were developed by the team to apply within the TD 416 process as modulators of change. 417

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No plant material has been or will be exported from Guatemala as a part of this project.

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We excluded additional species if they were either endangered or well-known for being toxic. This is 680 the case for Aristolochia tonduzii O.C. Schmid, as the entire genus Aristolochia is of major toxicological 681 concern, due to the presence of aristolochic acid derivatives (Michl et

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The industrial partner then carried out a further study of the information available to assess the 721 commercial potential of the remaining species. From that list, 12 species were first removed because 722 they exhibited too many activities; such a variety of properties would make it unlikely to be able to 723 develop a product treat a specific human disease or condition, without other side-effects. Secondly, a 724 further 15 species were excluded because the reported activities would be unlikely to translate into a 725 high value commercial application.

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That analysis led to a shortlist of four species with a potential for further research and development.

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As an example, Phalaris canariensis L. is traditionally used for "blood in urine"/prostate treatment, 728 which is certainly a condition that could have a commercial potential. Kchaou   and resources in developing a reflexive and respectful participatory process that builds mutual trust.

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Most importantly, however, future stakeholders, for example, from industry need to seriously 804 incorporate the desired benefits from the emic views of indigenous communities.

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Without overcoming the regulatory problems, our project, however, remains theoretical in its efforts 806 to develop an actual ABS contract between industry and indigenous peoples in Guatemala. In a wider 807 context, the project also highlights that the national implementation of the NP and associated 808 international agreements will impact not only on a country's global competitiveness, but also directly 809 on what opportunities exist for local stakeholders, including the indigenous groups. The 810 implementation of the NP differs among Central American countries, and this has resulted in some 811 countries developing their bioeconomies faster than others. Overall, while we have proof that 812 incorporating emic drivers and views make potential ABS agreements more socially robust, these need 813 to meet at the middle with etic views of scientifically robust, clear, legal frameworks that reduce 814 uncertainty for all stakeholders involved.
815 Table 1: Overarching aims and interested as presented by the indigenous, governmental, industrial 1054 and academic partners.

Interests of academic Partners
To advance knowledge on ethnopharmacology and ethnobotany of the Q'eqchi Generate a basic evidence-base for advancing herbal medicine research.
Case study for safety use of most used plants.
To increase the repository of medicinal spp. at the UVG herbarium.
To develop a case study for ABS understanding role of science partners.
To develop intercultural transdisciplinary methods for building N-S partnerships

Indigenous Council
To increase information on the plants used by the Ajilonel, particularly their safety and ability to be reproduced outside of the forest.
To develop a plant nursery and seed repository of medicinal plant species.
To create an agreement with local government officials for the creation of a protected area.
To discuss potential income generation strategies with foreign partners, for the development of the Council's families.

CONAP (Government partner)
To develop the first case study on how to create an ABS format for negotiating agreements between indigenous peoples and a foreign institution.
To develop tools and manuals for the replicability of the experience with other indigenous groups.
To generate evidence for CONAP's use on further advancing the negotiation of regulatory frameworks.

Interests of industry partner
To gain access to information on indigenous plant use for evaluating potential commercial uses.
To develop the first ABS agreement with an indigenous group and a partner from industry, as a step to advance clear policy and regulatory frameworks.