Although Western medicine is the main form of health care in Singapore, TCM continues to enjoy considerable popularity, but its practice is confined to outpatient care. About 12% of daily outpatient attendance is estimated to be seen by TCM practitioners. At present, the government imposes minimal control on Chinese medicinal materials (CMM), and registration of herbal products is not required. The situation, however, will change when a system of listing Chinese proprietary medicinal products will be implemented. This control would include the issue of a product licence, an import licence, a wholesalers' licence and a manufacturers' licence including WHO GMP guidelines for herbal products. Legislation is being developed.
In July 1994, the Minister of Health appointed a Committee, headed by the Senior Minister of State for Health and Education, to review the practice of traditional Chinese medicine (TCM) and recommend measures to safeguard patients' interest and safety, and to enhance the standard of training of TCM practitioners. The Committee released its report in September 1995.
The enforcement activities currently carried out are targeted more towards safeguarding the public from toxic substances and the prevention of adulteration and exaggerated claims. As most raw herbs have low toxicity and herbs containing toxic substances are already controlled under the Poisons Act, the control of raw CMM (in terms of import, export, sale and distribution) can be maintained at the present level. For the control of Chinese proprietary medicines (CPM), the Committee recommends:
- Strengthening the control of CPM quality and safety standards. Control measures should be introduced gradually. For a start, a simplified system of product registration, generally referred to as "listing", should be implemented. This will involve the issuing of product licences for individual products and licensing local CPM manufacturers and importers/wholesalers.
- Establishing a CPM Advisory Committee under the Medicines Act to advise the Ministry of Health on the evaluation of CPM products and the granting of licences to manufacturers and importers/wholesalers. The members of the CPM Advisory Committee will be appointed by the Minister of Health and will include CMM experts.
- Setting up a CPM Listing Unit in the Ministry of Health. This unit will be responsible for processing applications for product listing and licensing of local CPM manufacturers, importers and wholesalers [127,143].