WHO strategy for Traditional and alternative medicine

[Guest guest]

LAUNCHES THE FIRST GLOBAL STRATEGY ON TRADITIONAL AND ALTERNATIVE

MEDICINE

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