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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.
Source:
W.H.O Fact Sheet |