new guidelines for alternative medicines use

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New guidelines to develop reliable information for consumer use of

alternative medicines

Wednesday, 23-Jun-2004 News-Medical.Net

Since traditional, complementary and alternative medicines remain

largely unregulated, consumers worldwide need to be informed and given

the tools to access appropriate, safe and effective treatment. To help

address this issue, the World Health Organization (WHO) today releases a

new set of guidelines for national health authorities to develop context

specific and reliable information for consumer use of alternative

medicines.

Up to 80% of developing country populations rely on traditional medicine

for their primary health care, due to cultural tradition or lack of

alternatives. In wealthy countries, many people seek out various types

of natural remedies on the assumption that natural means safe.

Summary highlights of WHO guidelines

However, as the use of traditional or alternative medicines increases,

so do reports of adverse reactions. In China, a country where

traditional therapies and products are widely used in parallel with

conventional medicine, there were 9 854 known reported cases of adverse

drug reactions in 2002 alone, up from 4 000 between 1990 and 1999.

Many traditional/alternative medicine products are sold over the

counter. In a WHO survey of 142 countries, 99 responded that most of

these products could be bought without prescription. In 39 countries,

many traditional remedies were used for self-medication, bought or

prepared by friends, acquaintances or the patient. These trends raise

concerns over the quality of the products used, their therapeutic

appropriateness for a given condition, and the lack of medical

follow-up.

“WHO supports traditional and alternative medicines when these have

demonstrated benefits for the patient and minimal risks,” said Dr LEE

Jong-wook, Director-General of WHO. “But as more people use these

medicines, governments should have the tools to ensure all stakeholders

have the best information about their benefits and their risks. "

Accessible, easy to understand information is key to guiding consumers

in their choices. The guidelines provide simple, easy to follow tips on

issues to look out for and a brief checklist of basic questions which

may be used to help facilitate proper use of traditional and alternative

medicine.

Advice is provided to government authorities on preparing easy-to-access

information and on working with the mass media to sensitize and educate

the population. In addition, suggestions are given for several health

system structures and processes needed to promote proper use of

traditional and alternative medicines.

While the guidelines cannot compensate for poor products or

inappropriate practices, they can help governments educate consumers on

how to maximize the benefits and minimize the risks of traditional

medicines.

Alternative therapies - documented benefits and risks

Empirical and scientific evidence exists to support the benefits of

acupuncture, manual therapies and several medicinal plants for chronic

or mild conditions. For instance, the effectiveness of acupuncture, a

popular treatment for relieving pain, has been demonstrated both through

numerous clinical trials and laboratory experiments. As a result, 90% of

pain clinics in the United Kingdom and 70% in Germany include

acupuncture as a form of treatment. Equally, some medicinal plants have

shown efficacy for life-threatening conditions; medicine combinations

containing the Chinese herb Artemisia annua are now considered amongst

the most effective remedies against malaria.

However, there have been many cases of consumers unknowingly using

suspect or counterfeit products; choosing inappropriate therapies in

self-care; as well as several reports of unintentional overdose.

Similarly, there have been reports of consumers being injured by

unqualified practitioners. For example, a study performed by the

National Research Institute on Complementary and Alternative Medicine in

Norway reported cases of pneumothorax caused by unqualified

acupuncturists. In addition, there have been reports of paralysis caused

by unqualified manual therapists.

Another potential risk is that patients do not inform their doctors

about their use of traditional and complementary medicines. For

instance, Ginkgo biloba is a popularly used herbal medicine worldwide

whose main function is to prevent vascular disease and to increase blood

circulation. The WHO Uppsala Monitoring Centre reported some cases of

excess bleeding during a surgical operation. If the patient had informed

the doctor about the use of the medicine this could have been avoided.

The development of the guidelines was carried out with the financial and

technical support of the Regional Government of Lombardy, in

collaboration with the State University of Milan. The guidelines are

based on evidence and experiences collected from 102 countries

representing all WHO regions.