WHO launches the first global strategy on traditional and alternative medicine
16 May 2002 - Traditional medicine is becoming more popular in the north and up to 80% of people in the south use it as part of primary health care. The situation has given rise to concerns among health practitioners and consumers on the issue of safety, above all, but also on questions of policy, regulation, evidence, biodiversity and preservation and protection of traditional knowledge.
The World Health Organization (WHO) today releases a global plan to address those issues. The strategy provides a framework for policy to assist countries to regulate traditional or complementary/alternative medicine (TM/CAM) to make its use safer, more accessible to their populations and sustainable.
"About 80% of the people in Africa use traditional medicine. It is for this reason that we must act quickly to evaluate its safety, efficacy, quality and standardization – to protect our heritage and to preserve our traditional knowledge. We must also institutionalize and integrate it into our national health systems." says Ebrahim Samba, WHO’s Regional Director for Africa.
In wealthy countries, growing numbers of patients rely on alternative medicine for preventive or palliative care. In France, 75% of the population has used complementary medicine at least once; in Germany, 77% of pain clinics provide acupuncture; and in the United Kingdom, expenditure on complementary or alternative medicine stands at US$ 2300 million per year.
But problems may arise out of incorrect use of traditional therapies. For instance, the herb Ma Huang (ephedra) is traditionally used in China to treat short-term respiratory congestion. In the United States, the herb was marketed as a dietary aid, whose long-term use 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 the wrong herb from the Aristolochiaceae family, again as a dietary aid.
"Traditional or complementary medicine is victim of both uncritical enthusiasts and uninformed skeptics," explains Dr Yasuhiro Suzuki, WHO Executive Director for Health Technology and Pharmaceuticals. "This strategy is intended to tap into its real potential for people’s health and well-being, while minimizing the risks of unproven or misused remedies."
In developing countries, where more than one-third of the population lacks access to essential medicines, the provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care. But while traditional medicine has been fully integrated into the health systems of China, North and South Korea and Viet Nam, many countries have not collected and standardized evidence on this type of health care.
The global market for traditional therapies stands at US$ 60 billion a year and is steadily growing. In addition to the patient safety issue and the threat to knowledge and biodiversity, there is also the risk that further commercialization through unregulated use will make these therapies unaffordable to many who rely on them as their primary source of health care. For this reason policies on the protection of indigenous or traditional knowledge are necessary.
About 25% of modern medicines are descended from plants first used traditionally. The efficacy of acupuncture in relieving pain and nausea has been well established. Randomized controlled trials also offer convincing evidence that therapies such as hypnosis and relaxation techniques can alleviate anxiety, panic disorders and insomnia. Other studies have shown that yoga can reduce asthma attacks while tai ji techniques can help the elderly reduce their fear of falls.
As well as addressing chronic conditions, TM can also impact on infectious diseases. In Africa, North America and Europe, three out of four people living with HIV/AIDS use some form of traditional or complementary treatment for various symptoms and conditions. In South Africa, the Medical Research Council is conducting studies on the plant Sutherlandia microphylla’s efficacy in treating AIDS patients. Traditionally used as a tonic, this plant may increase energy, appetite and body mass in people living with HIV.
The Chinese herbal remedy Artemisia annua, used for almost 2000 years, has recently been found to be effective against resistant malaria and could give hope of preventing many of the 800 000 deaths among children from severe malaria each year.
The WHO TM/CAM strategy aims 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 TM/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.
The strategy, a working document for adaptation and regional implementation, and more information on TM/CAM can be accessed on: http://www.who.int/medicines/organization/trm/orgtrmmain.shtml