COOT WANG Traditional Medicine

Traditional Chinese medicine

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Traditional Chinese medicine (also known as TCM, simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōngyī) is a range of traditional medical practices originating in China that developed over several thousand years. The English phrase "TCM" was created in the 1950s by the PRC in order to export Chinese medicine; there is no equivalent phrase in Chinese. In fact, TCM is a modern compilation of traditional Chinese medicine. TCM practices include theories, diagnosis and treatments such as herbal medicine, acupuncture and massage; often Qigong is also strongly affiliated with TCM. TCM is a form of so-called Oriental medicine, which includes other traditional East Asian medical systems such as traditional Japanese and Korean medicine.

TCM theory asserts that processes of the human body are interrelated and in constant interaction with the environment. Signs of disharmony help the TCM practitioner to understand, treat and prevent illness and disease.

In the West, traditional Chinese medicine is considered alternative medicine. In mainland China and Taiwan, TCM is considered an integral part of the health care system. For example, TCM treatments may be prescribed to counter the side effects of chemotherapy, cravings and withdrawal symptoms of drug addicts, and a variety of chronic conditions.

TCM theory is based on a number of philosophical frameworks including the theory of Yin-yang, the Five Elements, the human body Meridian system, Zang Fu organ theory, and others. Diagnosis and treatment are conducted with reference to these concepts. TCM does not operate within the contemporary scientific paradigm, but some practitioners make efforts to bring practices into a biomedical and evidence-based medicine framework.

History of naturopathic medicine

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The term naturopathy was coined before 1900, by John Scheel, and used by Benedict Lust. Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp, who sent Lust to the United States to bring them Kneipp's methods. In 1905, Lust founded the American School of Naturopathy in New York, the first naturopathic college in the United States but "according to the New York Department of State, and the Florida Report to Governor Leroy Collins, it appears that this naturopathic school was never anything but a diploma mill". [2]. Lust took great strides in promoting the profession, culminating in passage of licensing laws in several states prior to 1935, including Arizona, California, Connecticut, Hawaii, Oregon, and Washington and the founding of several naturopathic colleges.

Naturopathic medicine went into decline, along with most other natural health professions, after the 1930s, with the discovery of penicillin and advent of synthetic drugs such as antibiotics and corticosteroids. In the post-war era, Lust's death, conflict between various schools of natural medicine (homeopathy, eclectics, physio-medicalism, herbalism, naturopathy, etc.), and the rise of medical technology were all contributing factors. In 1910, when the Carnegie Foundation for the Advancement of Teaching published the Flexner Report which criticized many aspects of medical education in various institutions (natural and conventional), it was mostly seen as an attack on low-quality natural medicine education. It caused many such programs to shut down and contributed to the popularity of conventional medicine.

Naturopathic medicine never completely ceased to exist, however, as there were always a few states in which licensing laws existed—though at one point there were virtually no schools. One of the most visible steps towards the profession's modern renewal was the opening in 1956 of the National College of Naturopathic Medicine in Portland, Oregon. This was the first of the modern naturopathic medical schools offering four-year naturopathic medical training with the intention of integrating science with naturopathic principles and practice.

Naturopathy In India

Naturopathy is very popular in India, and there are numerous naturopathic hospitals in the country. There are also many doctors trained in conventional medicine who have acquired naturopathy degrees so as to integrate the insights gained into their system of practice.[citation needed]

The Indian stream of naturopathy differs from the Western stream in many ways, particularly in their emphasis on strict vegetarianism and yoga.[citation needed]

Naturopathic physicians and traditional naturopaths

There are two groups in North America calling themselves "naturopaths" who have recently been engaged in legal battles. The term when originally coined by John Scheel, and popularized by Dr. Benedict Lust was to apply to those receiving an education in the basic medical sciences with an emphasis on natural therapies. This usage best describes modern day naturopathic physicians. In the absence of universal regulation of naturopathy, another group of practitioners (the so-called 'traditional naturopaths') has emerged.

Naturopathic Physicians

Naturopathic physicians in North America are primary care providers trained in conventional medical sciences, diagnosis and treatment, and are experts in natural therapeutics. Licensing and training requirements vary from state to state, but at least 14 states, the District of Columbia, and four Canadian provinces have formal licensing and educational requirements. [3][4] In these jurisdictions, Naturopathic Physicians must pass comprehensive board exams set by the North American Board of Naturopathic Examiners (NABNE)[5] after having completed academic and clinical training at a college certified by the Council on Naturopathic Medical Eductaion (CNME)[6].

Traditional Naturopaths

Traditional naturopaths are guided by the same naturopathic philosophies and principles as board-licensed Naturopathic physicians and often prescribe similar treatments but do so as alternative or complimentary practitioners rather than as primary care providers. Some may voluntarily join a professional organization, but these organizations do not accredit educational programs in any meaningful way or license practitioners per se. The training programs for traditional naturopaths can vary greatly, are less rigorous and do not provide the same basic and clinical science education as naturopathic medical schools do. The professional organizations formed by traditional naturopaths are not recognized by the U.S. Government or any U.S. State or Territory.

Naturopathic medicine

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Naturopathic medicine (also known as naturopathy) is a school of medical philosophy and practice that seeks to improve health and treat disease chiefly by assisting the body's innate capacity to recover from illness and injury. Naturopathic practice may include a broad array of different modalities, including manual therapy, hydrotherapy, herbalism, acupuncture, counseling, environmental medicine, aromatherapy, nutritional counseling, homeopathy, and so on. Practitioners tend to emphasize a holistic approach to patient care. Naturopathy has its origins in a variety of world medicine practices, including the Ayurveda of India and Nature Cure of Europe. [1] It is today practiced in many countries around the world in one form or another, where it is subject to different standards of regulation and levels of acceptance.

Naturopathic practitioners prefer not to use invasive surgery, or most synthetic drugs, preferring "natural" remedies, for instance relatively unprocessed or whole medications, such as herbs and foods. Practitioners from accredited schools are trained to use diagnostic tests such as imaging and blood tests before deciding upon the full course of treatment. If the patient does not respond to these treatments, they are often referred to physicians who utilize standard medical care to treat the underlying disease or condition.

With only a few exceptions, most naturopathic treatments have not been tested for safety and efficacy utilizing scientific studies or clinical trials.[citation needed] There is a concern in the scientific and medical communities that these treatments are used to replace well-studied and tested medical procedures thereby endangering the health of the patient.

Islamic medicine

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In the history of medicine, Islamic medicine or Arabic medicine refers to medicine developed in the medieval Islamic civilisation and written in Arabic, the lingua franca of the Islamic civilization. Despite these names, a significant number of scientists during this period were not Arab. Some consider the label "Arab-Islamic" as historically inaccurate, arguing that this label does not appreciate the rich diversity of Eastern scholars who have contributed to science in this era.[1] Latin translations of Arabic medical works had a significant influence on the development of modern medicine.

The first encyclopedia of medicine in Arabic was Ali ibn Sahl Rabban al-Tabari's Firdous al-Hikmah ("Paradise of Wisdom"), written in seven parts, c. 860.

Razi (Rhazes) wrote the Comprehensive Book of Medicine in the 9th century. The Large Comprehensive was the most sought after of all his compositions, in which Rhazes recorded clinical cases of his own experience and provided very useful recordings of various diseases. The Comprehensive Book of Medicine, with its introduction of measles and smallpox, was very influential in Europe.

Ali ibn Abbas al-Majusi (Haly Abbas)'s Kitab Kamil as-sina'a at-tibbiyya ("Complete Book of the Medical Art"), c. 980, became better known as the Kitab al-Maliki ("Royal Book", Latin: Liber regalis) in honour of its royal patron 'Adud al-Dawla. In twenty sections, ten of theory and ten of practice, it was more systematic and concise than Razi's Hawi, but more practical than Avicenna's Canon, by which it was superseded. With many interpolations and substitutions, it served as the basis for the Pantegni (c. 1087) of Constantinus Africanus, the founding text of the Schola Medica Salernitana in Salerno.[12]

Abu al-Qasim al-Zahrawi (Abulcasis), regarded as the father of modern surgery,[13] contributed greatly to the discipline of medical surgery with his Kitab al-Tasrif ("Book of Concessions"), a 30-volume medical encyclopedia published in 1000, which was later translated to Latin and used in European medical schools for centuries. He invented numerous surgical instruments and described them in his al-Tasrif.

Avicenna (Ibn Sina), a Hanbali and Mu'tazili philosopher and doctor in the early 11th century, was another influential figure. He is regarded as the father of modern medicine,[14] and one of the greatest thinkers and medical scholars in history. His medical encyclopedia, The Canon of Medicine (c. 1020), remained a standard textbook in Europe for centuries, up until the renewal of the Muslim tradition of scientific medicine. He also wrote The Book of Healing (actually a more general encyclopedia of science and philosophy), which became another popular textbook in Europe. Among other things, Avicenna's contributions to medicine include the introduction of systematic experimentation and quantification into the study of physiology,[15] the discovery of the contagious nature of infectious diseases, the introduction of quarantine to limit the spread of contagious diseases, the introduction of experimental medicine, evidence-based medicine, clinical trials,[16] randomized controlled trials,[17][18] efficacy tests,[19][20] clinical pharmacology,[21] risk factor analysis, and the idea of a syndrome in the diagnosis of specific diseases,[22] the first descriptions on bacteria and viral organisms,[23] the distinction of mediastinitis from pleurisy, the contagious nature of phthisis and tuberculosis, the distribution of diseases by water and soil, and the first careful descriptions of skin troubles, sexually transmitted diseases, perversions, and nervous ailments,[8] as well the use of ice to treat fevers, and the separation of medicine from pharmacology, which was important to the development of the pharmaceutical sciences.[24]

Abū Rayhān al-Bīrūnī's Kitab-al-Saidana was an extensive medical encyclopedia which synthesized Islamic medicine with Indian medicine. His medical investigations included one of the earliest descriptions on Siamese twins.[25]

Ibn al-Nafis (1213-1288) wrote Al-Shamil fi al-Tibb (The Comprehensive Book on Medicine), a voluminous medical encyclopedia that was originally planned to comprise 300 volumes, but he was only able to complete 80 volumes as a result of his death in 1288. However, even in its incomplete state, the book is one of the largest known medical encyclopedias in history, though only a small portion of The Comprehensive Book on Medicine has survived. During his lifetime, The Comprehensive Book on Medicine had eventually replaced Ibn Sina's The Canon of Medicine as a medical authority in the medieval Islamic world. Arabic biographers from the 13th onwards considered Ibn al-Nafis the greatest physician in history, some referring to him as "the second Ibn Sina", and others considering him even greater than Ibn Sina.[26]

Hospitals at Byzantium

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An important contribution of Byzantium is arguably the fact that it was the first Empire in which dedicated medical establishments - usually set up by individual Churches or the State, which parallel modern Hospitals in many way, flourished. Although similar establishments existed in Ancient Greece and Rome, they differed in that they were usually either institutions for Military use, or places were citizens went to die in a more peaceful way. Medical Institutions of this sort were common in Imperial Cities such as Constantinople and later Thessaloniki.

The first hospital was built by Basil of Caesarea in the late fourth century, and although these Institutions flourished, it was only throughout the 8th and 9th Centuries that they began to appear in Provincial Towns as well as Cities, (although Justinian's subsidization of private physicians to work publicly for six months of the year can be seen as the real breakthrough point). Byzantine Medicine was entirely based around Hospitals or walk-in dispensaries which formed part of the Hospital complex, there was a dedicated hierarchy including the Chief Physician (archiatroi), professional nurses (hypourgoi) and the orderlies (hyperetai).

Doctors themselves were well trained and most likely attended the University of Constantinople as Medicine had become a truly scholarly subject by the period of Byzantium (despite the prominence of the great physicians of antiquity, its status as a Science was greatly improved through its application in formal education (particularly in the University of Constantinople). This rigidity through professionalism (similar to the professionalism exhibited in the Byzantine Civil Service) bears many hallmarks of today's modern Hospitals, and comparisons are nearly always made by modern Scholars studying this particular field. Thus, we know that in the twelfth century, Constantinople had two well organized hospitals staffed by medical specialists (including women doctors), with special wards for various types of diseases and systematic methods of treatment.

Background of Byzantine medicine

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Arguably the first Byzantine Physician was the author of the Vienna Dioscurides manuscript, created for the daughter of Emperor Olybrius around 515. Like most Byzantine physicians, he drew his material from ancient authorities such as Galen and Hippocrates, though this is not to say that Byzantine Physicians did not make corrections to the 'fathers of Medicine' or make original contributions. Oribasius, perhaps the greatest Byzantine compiler of medical knowledge, frequently made revisions noting where older methods had been incorrect. Several of his works, along with many other Byzantine physicians, were translated into Latin, and eventually, during the Enlightenment and Age of Reason, into English and French.

Another Byzantine treatise, that of the thirteenth century Nicholas Myrepsos, remained the principal pharmaceutical code of the Parisian medical faculty until 1651, while the Byzantine tract of Demetrios Pepagomenos (thirteenth century) on gout was translated and published in Latin by the great post-Byzantine humanist, Marcus Musurus, in Venice in 1517. Ergo it could be argued that previous misrepresentations about Byzantium being simply a 'carrier' of Ancient Medical knowledge to the Renaissance are completely factually wrong. It is already known for example that a late twelfth century Latin physician at Salerno (Roger of Salerno), was influenced by the treatises of the Byzantine doctors Aetius and Alexander of Tralles as well as Paul of Aegina.

The last great Byzantine Physician was Actuarius, who lived in the early 14th Century in Constantinople. His works on Urine laid much of the foundation for later study in that field. However, from the latter 12th Century to the end in 1453, there is very little outpouring in medical knowledge, largely due to the turmoil the Empire was facing on both fronts, following its resurrection after the Latin Empire and the dwindling population of Constantinople due to plague and war. Nevertheless, Byzantine medicine is extremely important both in terms of new discoveries made in that period (at a time when Western Europe was in turmoil), the careful protecting of Ancient Greek and Roman knowledge through compendiums as well as the revision of it and finally, the effect it had in transferring knowledge to both Renaissance Italy and Arabia.

Byzantine medicine

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Byzantine medicine is the medicine practiced in the Byzantine Empire from about 400 AD to 1453 AD. It drew largely on Ancient Greek and Roman knowledge. However, Medicine was also one of the few sciences in which the Byzantines improved on their Greco-Roman predecessors. As a result, Byzantine Medicine had a significant influence on Islamic medicine and the Western rebirth of Medicine during the Renaissance.

Byzantine physicians often compiled and standardized medical knowledge into textbooks. These books tended to be elaborately decorated with many fine illustrations, highlighting the particular ailment. The Medical Compendium in Seven Books, written by the leading physician Paul of Aegina, is of particular importance. The compendium was written in the late seventh century and remained in use as a standard textbook for 800 years.

Late antiquity witnessed a revolution in the medical scene and many sources mention hospitals in passing (although their own history in the Military sense can be drawn back to Imperial Rome and beyond). Constantinople doubtless was the center of such activities in the Middle Ages, owing to its geographical position, wealth and accumulated knowledge.

Medical education

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Increasing numbers of medical colleges have started offering courses in alternative medicine. For example, the University of Arizona College of Medicine offers a program in Integrative Medicine under the leadership of Dr. Andrew Weil which trains physicians in various branches of alternative medicine which "...neither rejects conventional medicine, nor embraces alternative practices uncritically."[10] In three separate research surveys that surveyed 729 schools in the United States (125 medical schools offering an MD degree, 25 medical schools offering a Doctor of Osteopathy degree, and 585 schools offering a nursing degree), 60% of the standard medical schools, 95% of osteopathic medical schools and 84.8% of the nursing schools teach some form of CAM.[11][12][13] Accredited Naturopathic colleges and universities are increasing in number and popularity in the U.S.A. They offer the most complete medical training in complimentary medicines that is available today[citation needed]. See Naturopathic medicine.

In Britain, no conventional medical schools offer courses that teach the clinical practice of alternative medicine. However, alternative medicine is taught in several unconventional schools as part of their curriculum. Teaching is based mostly on theory and understanding of alternative medicine, with emphasis on being able to communicate with alternative medicine specialists. To obtain competence in practicing clinical alternative medicine, qualifications must be obtained from individual medical societies. The student must have graduated and be a qualified doctor. The British Medical Acupuncture Society, which offers medical acupuncture certificates to doctors, is one such example, as is the College of Naturopathic Medicine UK and Ireland.

Contemporary use of alternative medicine

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Many people utilize mainstream medicine for diagnosis and basic information, while turning to alternatives for what they believe to be health-enhancing measures. However, studies indicate that a majority of people use alternative approaches in conjunction with conventional medicine.

Edzard Ernst wrote in the Medical Journal of Australia that "about half the general population in developed countries use complementary and alternative medicine (CAM)."[4] A survey released in May 2004 by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, 36% of Americans used some form of alternative therapy in the past 12 months, 50% in a lifetime — a category that included yoga, meditation, herbal treatments and the Atkins diet.[5] If prayer was counted as an alternative therapy, the figure rose to 62.1%. 25% of people who use CAM do so because a medical professional suggested it.[6] Another study suggests a similar figure of 40%.[7] A British telephone survey by the BBC of 1209 adults in 1998 shows that around 20% of adults in Britain had used alternative medicine in the past 12 months.[citation needed]

The use of alternative medicine appears to be increasing. A 1998 study showed that the use of alternative medicine had risen from 33.8% in 1990 to 42.1% in 1997.[8] In the United Kingdom, a 2000 report ordered by the House of Lords suggested that "...limited data seem to support the idea that CAM use in the United Kingdom is high and is increasing.

Regulation Traditional Medicine

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Jurisdiction differs concerning which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled health service or reimbursed by a private health medical insurance company.

In article 34 (Specific legal obligations) of the General Comment No. 14 (2000) on The right to the highest attainable standard of health of the Committee on Economic, Social and Cultural Rights (United Nations), it is stated that

Obligations to respect (the right to health) include a State's obligation to refrain from prohibiting or impeding traditional preventive care, healing practices and medicines, from marketing unsafe drugs and from applying coercive medical treatments [2]

A number of alternative medicine advocates disagree with the restrictions of government agencies that approve medical treatments (such as the American Food and Drug Administration) and the agencies' adherence to experimental evaluation methods. They claim that this impedes those seeking to bring useful and effective treatments and approaches to the public, and protest that their contributions and discoveries are unfairly dismissed, overlooked or suppressed. Alternative medicine providers often argue that health fraud should be dealt with appropriately when it occurs.

In India, which is the home of several alternative systems of medicines, Ayurveda, Siddha, Unani, and Homeopathy are licenced by the government, despite lack of reputable scientific evidence. Naturopathy will also be licensed soon because several Universities now offer bachelors degrees in it. Other activities connected with AM/CM, such as Panchakarma and massage therapy related to Ayurveda are also licenced by the government now. Research into and licensing of these activities is carried out by the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH).

Alternative medicine

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has been defined as "therapeutic or preventive health care practices, such as homeopathy, naturopathy, chiropractic, and herbal medicine, that do not follow generally accepted medical methods and may not have a scientific explanation for their effectiveness."[1]

Alternative medicine practices are often based in belief systems not derived from modern science. Alternative medicines may therefore incorporate spiritual, metaphysical, or religious underpinnings, untested practices, pre-modern medical traditions, or newly developed approaches to healing. If an alternative medical approach, initially untested, is subsequently shown to be safe and effective, it may then be adopted by conventional practitioners and no longer considered "alternative".

"Alternative medicine" is often categorized together with complementary medicine using the umbrella term Complementary and alternative medicine or CAM.

Traditional medicine from Wiki

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The term traditional medicine describes medical knowledge systems, which developed over centuries within various societies before the era of modern medicine; traditional medicines include practices such as herbal medicine, Ayurvedic medicine, Unani medicine, acupuncture, traditional Chinese medicine, South African Muti, Yoruba Ifá, as well as other medical knowledge and practices all over the globe.

WHO defines Traditional Medicine as "the health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being"[1].

Countries in Africa, Asia and Latin America use traditional medicine to help meet some of their primary health care needs. For example, in Africa, up to 80% of the population uses traditional medicine for primary health care. The WHO, however, also notes that its use is spreading in popularity in industrialized countries. For example, in the United States, 158 million adults use complementary medicine (a field which incorporates traditional medicine but is broader in scope).[1]

The WHO also notes, though, that "inappropriate use of traditional medicines or practices can have negative or dangerous effects" and that "further research is needed to ascertain the efficacy and safety" of several of the practices and medicinal plants used by traditional medicine systems.[1]

Core disciplines which study traditional medicine include ethnomedicine, ethnobotany, and medical anthropology.

Traditional medicine from WHO

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What is traditional medicine?

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.

Countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. In industralized countries, adaptations of traditional medicine are termed “Complementary“ or “Alternative” (CAM).
Increasing use and popularity

TM has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries.

* In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
* In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
* WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
* In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
* In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
* 70% of the population in Canada have used complementary medicine at least once.
* In Germany, 90% of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10 800.
* In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US $17 billion was spent on traditional remedies in 2000.
* In the United Kingdom, annual expenditure on alternative medicine is US$ 230 million.
* The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily.

Safety and efficacy issues

Scientific evidence from randomized clinical trials is only strong for many uses of acupuncture, some herbal medicines and for some of the manual therapies. Further research is needed to ascertain the efficacy and safety of several other practices and medicinal plants.

Unregulated or inappropriate use of traditional medicines and practices can have negative or dangerous effects.

For instance, the herb “Ma Huang” (Ephedra) is traditionally used in China to treat respiratory congestion. In the United States, the herb was marketed as a dietary aid, whose over dosage led to at least a dozen deaths, heart attacks and strokes.

In Belgium, at least 70 people required renal transplant or dialysis for interstitial fibrosis of the kidney after taking a herbal preparation made from the wrong species of plant as slimming treatment.
Biodiversity and sustainability

In addition to patient safety issues, there is the risk that a growing herbal market and its great commercial benefit might pose a threat to biodiversity through the over harvesting of the raw material for herbal medicines and other natural health care products. These practices, if not controlled, may lead to the extinction of endangered species and the destruction of natural habitats and resources.

Another related issue is that at present, the requirements for protection provided under international standards for patent law and by most national conventional patent laws are inadequate to protect traditional knowledge and biodiversity.
Tried and tested methods and products

* 25% of modern medicines are made from plants first used traditionally.
* Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia.
* Yoga can reduce asthma attacks while Tai Ji techniques can help the elderly reduce their fear of falls.
* TM can also have impact on infectious diseases. For example, the Chinese herbal remedy Artemisia annua, used in China for almost 2000 years has been found to be effective against resistant malaria and could create a breakthrough in preventing almost one million deaths annually, most of them children, from severe malaria.
* In South Africa, the Medical Research Council is conducting studies on the efficacy of the plant Sutherlandia Microphylla in treating AIDS patients. Traditionally used as a tonic, this plant may increase energy, appetite and body mass in people living with HIV.

WHO efforts in promoting safe, effective and affordable traditional medicine

The World Health Organization launched its first ever comprehensive traditional medicine strategy in 2002. The strategy is designed to assist countries to:

* Develop national policies on the evaluation and regulation of TM/CAM practices;
* Create a stronger evidence base on the safety, efficacy and quality of the TAM/CAM products and practices;
* Ensure availability and affordability of TM/CAM including essential herbal medicines;
* Promote therapeutically sound use of TM/CAM by providers and consumers;
* Document traditional medicines and remedies.

At present, WHO is supporting clinical studies on antimalarials in three African countries; the studies are revealing good potential for herbal antimalarials.

Other collaboration is taking place with Burkina Faso, the Democratic Republic of the Congo, Ghana, Mali, Nigeria, Kenya, Uganda, and Zimbabwe in the research and evaluation of herbal treatments for HIV/ AIDS, malaria, sickle cell anaemia and Diabetes Mellitus.

In Tanzania, WHO, in collaboration with China, is providing technical support to the government for the production of antimalarials derived from the Chinese herb Artemisia annua. Local production of the medicine will bring the price of one dose down from US $6 or $7 to a more affordable $2.

In 2003, WHO support has so far facilitated the development and introduction of traditional and alternative health care curricula in seven tertiary education institutions in the Philippines.

Training workshops on the use of traditional medicines for selected diseases and disorders have also been organized in China, Mongolia and Vietnam.
Priorities for promoting the use of traditional medicines

Over one-third of the population in developing countries lack access to essential medicines. The provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care.

While China, the Democratic People’s Republic of Korea, the Republic of Korea and Vietnam have fully integrated traditional medicine into their health care systems, many countries are yet to collect and integrate standardized evidence on this type of health care.

70 countries have a national regulation on herbal medicines but the legislative control of medicinal plants has not evolved around a structured model. This is because medicinal products or herbs are defined differently in different countries and diverse approaches have been adopted with regard to licensing, dispensing, manufacturing and trading.

The limited scientific evidence about TM/CAM’s safety and efficacy as well as other considerations make it important for governments to:

* Formulate national policy and regulation for the proper use of TM/CAM and its integration into national health care systems in line with the provisions of the WHO strategies on Traditional Medicines;
* Establish regulatory mechanisms to control the safety and quality of products and of TM/CAM practice;
* Create awareness about safe and effective TM/CAM therapies among the public and consumers;
* Cultivate and conserve medicinal plants to ensure their sustainable use.