Alternative medicine must get scientific validation for rational use
Article: WHO News story: 2004;82:635-636
16 August 2004 - Dear Colleague, I refer a recent News item in August 2004 WHO bulletin entitled by ‘New alternative medicine guide launched amidst increasing reports of adverse reactions’. It is really a public health concern both in developed and resource-poor countries, where the fake business with adulterated herbal medicine (a component of alternative medicine) is a major public health issue in many parts of the world (1-3). In fact there is no control by the governmental agencies of the countries, despite there are certain guideline from individual countries, very few are complying WHO guideline on alternative medicine. That, 80% of people in developing countries rely on alternative medicine, of those a significant proportion of population are experiencing an alarming danger due to impurities/adulterations herbal medicine mixed with allopathic drugs and sold over the counter or prescribed by practitioner of alternative medicine (4-5). Again, if we take a situation in India, we find that 53.3 % traditional-medicine practitioners (in India known as Ayurvedic physicians) are prescribing allopathic drugs without having the proper knowledge of allopathic drugs and medicament, which is creating lot of health hazards and economic burden to the community (6) . Report says 17.8% medically qualified physicians are prescribing herbal drugs without knowing the quality and contents of herbal medicine would be a concern (6). Many herbal products are not properly labelled, and do not contain an insert to explain the composition and etc relevant to the product. Unfortunately thousands of products are claiming several positive effects to cure a disease and disease conditions, which are evident in internet websites would be a concern to provide factual information.
Our concern, the member states would look into the matter to comply WHO guideline (7). But, problems are twofold; one is adulteration of herbal products with allopathic drugs; and the other is prescribing person.
Therefore, it would be a consideration if the herbal product is marketed as therapeutic agent; first it would need a scientific validation whether the products really have any positive effect to cure and reduce the severity of the disease. If yes, the next step would be clearance from the authority of drug control/administration, which would require a periodic monitoring by assessing the quality and efficacy. In fact, there are several effective herbal drugs would be used as a cost-efficient therapeutic product and we hope would be done only after scientific validation of the product like other allopathic pharmaceutical products.
Probably if we consider the one issue of scientific validation would control production of impure/adulterated herbal products (mix with allopathic drugs) and eventually could ensure the rational use of herbal products. That way we can restrict prescribing the herbal drugs only by a qualified physician/health-care provider including selling the approved product even over-the-counter. If it works, probably alternative medicine (herbal drugs) would have better position to cure and reduce the severity of certain diseases in cost-efficient approach to help millions in the world.
Hope, WHO would help in reducing the expense of death and disability due to aberrations in the discipline of alternative medicine, eventually, a strong framework convention to control such problem is essentially needful from the organization.
- Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-52.
- The ephedras. Lawrence review of natural products. In: Drug facts and comparisons. St. Louis: Facts and Comparisons, 1995.
- FDA warns against drug promotion of "herbal fen-phen." In: FDA Talk Paper. Rockville, Md.: Department of Health and Human Services, Food and Drug Administration, Nov. 6, 1997. Retrieved October 1998 from the World Wide Web: http://www.fda.gov/bbs/topics/ANSWERS/ANS00832.html.
- The Bulletin of the World Health Organization, August 2004, 82 (8):635
- C. R Choudhury. Traditional and complementary/alternative medicine: where does it stand? (a correspondence). National Medical Journal of India Vol 16. No 1, 2003 p 52.
- Choudhury A.D, Sudhakar K, Abdullah R, Holla A nd Choudhury C R. Pattern of drug-use in an Indian urban area: a questionnaire survey. Indian J Pharmaceutical Science 2002 Mar-Apr; 64(2): 124-8
Prof. Chitta Ranjan Choudhury. Coordinator, International Programme for Tropical Oral Health, Poole Hospital NHS Department of MF Surgery, & IHCS, Bournemouth University, Longfleet Road, Poole, Dorset BH15 2JB, England, UK. Professor & Director, Centre for Oral Disease Prevention & Control, Department of Oral Biology, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore 574 160, India. (email: Chitta_choudhury@yahoo.com)