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The neem tree has been called "the village pharmacy" because its bark, leaves, sap, fruit, seeds, and twigs have so many diverse uses in the traditional medicine of India. This member of the mahogany family has been used medicinally for at least 4,000 years and is held in such esteem that Indian poets called it Sarva Roga Nivarini, meaning "the One That Can Cure All Ailments." Mohandas Gandhi encouraged scientific investigation of the neem tree as part of his program to revitalize Indian traditions, which eventually let to more than 2,000 research papers and intense commercial interest.
At least 50 patents have been filed on neem and neem-based products in the United States for control of insects in food and ornamental crops. However, the Indian government and many nongovernmental organizations have united to overthrow some patents of this type, which they regard as "folk-wisdom piracy." One fear is that if neem is patented, indigenous people who already use it will lose the right to continue to do so. Another point is the fundamental question: Who owns the genetic diversity of plants? The nations where the plants come from or the transnational corporations that pay for the research into those plants? Although this area of international law is rapidly evolving, a patent on the spice turmeric has already been overturned, and neem may follow soon.
At least 100 bioactive substances have been found in neem, including nimbidin, azadiracthins, and other triterpenoids and limonoids. Although the scientific evidence for all of neem's uses in healthcare remains preliminary, the intense interest in the plant will eventually lead to proper double-blind, placebo-controlled trials . (For information on why such studies are so important, see Why Does This Database Rely on Double-blind Studies? )
Because of the numerous parts of the neem tree used, and the many different ways these can be prepared, the only advice we can give at this time is to follow the directions on the label of the neem product you purchase.