Reducing excess mortality, morbidity and disability, especially in poor and marginalized populations is one of WHO's strategic directions for 2002 - 2005.60 Since TM is a highly accessible and afford-able form of health care in many low-income countries, WHO is promoting its inclusion - where proven save and effective - in plans for improving health status.
At the same time, global population ageing is bringing greater incidence of chronic disease and TM/CAM offer a potential means for managing such disease. Indeed, in developed countries, more and more people are using TM/CAM - in combination with or instead of allopathic medicine - to help relieve chronic pain and/or to improve quality of life.
But several objectives must be attained to ensure optimal use of TM/CAM. At the same time, WHO's resources are limited and its efforts must be directed towards securing the greatest public health gains for the greatest number. Specific objectives in TM/CAM for 2002 - 2005 are accordingly to support countries to:
• integrate TM/CAM with national health care systems, as appropriate,j by developing and implementing national TM/CAM policies and programmes
• promote the safety, efficacy and quality of TM/CAM by expanding the knowledge-base on TM/CAM, and by providing guidance on regulatory and quality assurance standards
• increase the availability and affordability of TM/CAM, as appropriate, with an emphasis on access for poor populations
• promote therapeutically sound use of appropriate TM/CAM by providers and consumers.
j "Appropriate" is taken to refer to TM/CAM health care that does not cost more and which is no less safe and efficacious than recommended allopathic care for the disease or health problem.
Each of these objectives incorporates two or three components, with expected out-comes (Table 13). A critical indicator has also been included for each objective and will be used to help evaluate WHO's work in this area. Additionally, several surveys relating to TM/CAM policy, and regulation and use of TM/CAM, will be carried out in cooperation with Member States and NGOs to assess progress.
Over the next four years, WHO will make the first two objectives - development and implementation of national TM/CAM policies, and promoting the safety, efficacy and quality of TM/CAM - a priority. This will include work on regulation of herbal and other TM/CAM products. It will also include focusing on strengthening research methodologies, and on increasing the quality, quantity and accessibility of clinical evidence to support claims for TM/CAM effectiveness.
"The wealth of accumulated clinical experience and knowledge within traditional medicine deserves to be acknowledged and combined with methodologically sound research into the extent and limitations of traditional practice. Patients, governments, traditional practitioners and practitioners of modern medicine all stand to benefit from evidence-based practice of traditional medicine. The support of the scientific community and practitioners of modern medicine will be needed if traditional medicine is to be brought into mainstream health services."61