Over the past four decades, there has not been any significant organised research into the therapeutic efficacy and/or potential toxicity of purportedly medicinal Caribbean botanicals. Books published during the period and dealing with such plants were essentially compendia of ethnopharmacological information regarding uses, containing occasional crude modes of preparation of treatments and sparse data on chemical constituents. More recent publications have tended to consider the evidence-based legitimacy of a modest number of pharmacologically active plants. Currently, two of the most prominent organisations in this area are TRAMIL (the Program of Applied Research to Popular Medicine in the Caribbean) and the Caribbean Herbal Medicine Research Institute (CaHMRI). While TRAMIL's expressed main aim is to stimulate research that has the potential to educate physicians, pharmacologists, health personnel, and health programmes, its core research activity has been the conduct of ethnopharmacological disease-based surveys on the traditional medicinal uses of plants by the people in the Caribbean territories; TRAMIL is not involved in the conduct of clinical trials. A major objective of CaHMRI at the University of Trinidad and Tobago is claimed to be the provision of sound scientific information about medicinal plants and herbal remedies. However, CaHMRI's declared mission is the identification of local medicinal plants and isolation of their characteristic bioactive constituents, although an Internet posting states that it plans to test herbal medicinal extracts for their safety and efficacy through clinical trials. However, so far CaHMRI has not reported on any such activities. Cuba appears to be the only Caribbean territory to have made significant progress in advancing the status of herbal medicines from the folkloric domain. As part of its national natural and traditional medicine system, herbal medicine products are being manufactured by the State in pharmaceutical production laboratories.