(2004; 109 pages)
1.1 The benefits of TM/CAM
TM/CAM therapies are generally available, affordable and commonly used in low- and middle-income countries. Surveys conducted by the WHO Roll Back Malaria Programme in 1998 showed that in Ghana, Mali, Nigeria and Zambia, more than 60% of children with high fever are treated at home with herbal medicines (5-8).
Many TM/CAM therapies are supported by empirical evidence on safety and effectiveness. Such evidence is usually based on sources such as traditional scriptures, pharmacopoeias and/or clinical experience collected over hundreds of years. An increasing number of scientific studies now support the use of certain TM/CAM therapies. The effectiveness of acupuncture, for example, a popular treatment for pain relief, has been demonstrated both through numerous clinical trials and laboratory experiments (9, 10). Another example is artemisinin, a new antimalarial medicine, which is purified from a traditionally used medicinal plant. Other examples of TM/CAM therapies with a research- derived evidence base are: St John’s Wort (Hypericum Perforatum) for mild depression; and Saw Palmetto (Serenoa Repens) for reducing symptoms of benign prostate hyperplasia (11, 12).
TM/CAM therapies may cause fewer adverse events than conventional therapies such as treatment with conventional medicines (pharmacotherapy). For example, a National Institutes of Health (NIH) panel issued a consensus statement on acupuncture stating that the incidence of adverse effects from acupuncture are extremely low and often lower than for conventional treatments (13).
Another reason why patients turn to TM/CAM for complementary care is the increasing cases of chronic and debilitating diseases for which there is no cure. Scientific studies of several TM/CAM therapies show that their use is effective, e.g. for HIV/AIDS and cancer patients (14, 15). As a result, UNAIDS is advocating collaboration with TM practitioners in AIDS prevention and care in sub-Saharan Africa (16).
The advantages of TM/CAM include its diversity and flexibility; its availability and affordability in many parts of the world; its widespread acceptance in low- and middle-income countries; its comparatively low cost; and the relatively low level of technological input required. As a result, TM/CAM therapies have the potential to contribute to a better health care system in many countries (2). However, there is a need for an increase in research to improve the evidence base as regards the efficacy of most TM/CAM therapies. Measures needed to facilitate research efforts include the legal recognition of TM/CAM, an increase in funding for research, the development of appropriate research methods for evaluating some TM/CAM therapies, and the development of systems for intellectual property rights protection (2).