Background information

Traditional medical practices brought by Indian and Chinese traders and migrants complemented, but did not replace, the indigenous medical system in Malaysia. The introduction of Islam by Indians and Arabs, on the other hand, led to major changes in the traditional medical system. Among them was treatment by recitation of verses from the Koran.

The diversity in medical systems in Malaysia reflects the diverse population of Malay, Chinese, Indian, and indigenous heritage. In addition to allopathic medicine, the major systems of medicine practised in Malaysia include ayurveda, siddha, unani, traditional Chinese medicine, and traditional systems of medicine, such as that provided by traditional medicine practitioners, spiritualists, bonesetters, traditional birth attendants, and others who use home remedies. Medical options also include homeopathy, naturopathy, reflexology, aromatherapy, and chiropractic.

Traditional Malay medical practices can be traced mainly to Indonesia. These medical practices are especially popular among Malay in rural areas and rely on practical experience and observation handed down orally and in writing from generation to generation. Medical treatment may include reciting incantations over water and giving it to the patient to drink, administering herbs internally or externally, giving amulets, and prescribing special baths, with lime flowers or holy water, for example. More than one of these options may be used and more than one traditional medicine practitioner may be called upon.

Chinese traditional medicine is believed to have been introduced into Malaysia by Chinese migrants working in the tin mines. These migrants brought herbal medicines as well as other forms of treatment, including acupuncture. Chinese medical practitioners hold high status and are known as sinseh. Today, traditional Chinese medicine is also used in urban centres.

Siddha, ayurveda, and unani - all traditional Indian medical systems - are practised in Malaysia. The majority of medicines used in these systems are of vegetable, mineral, and animal origin. Herbal preparations and herbal products are imported from India as medical tablets, oils, ointments, metals, mineral concoctions, and herbal powders.

Statistics

The 1996 National Health & Morbidity Survey II found that 2.3% of the people sampled consulted a traditional or complementary/alternative medical practitioner and 3.8% used both allopathic medicine and traditional Chinese medicine. Although no statistics are available, traditional medicine is mainly practised by providers of traditional medicine, whereas allopathic medical providers practise complementary/alternative medicine as well as allopathic medicine.

In Malaysia, sales of traditional and complementary/alternative medicines are estimated to be 1000 million Malaysian ringgit annually, compared with a market of 900 million Malaysian ringgit for allopathic pharmaceuticals.

There are 12 chiropractors practising in Malaysia (45).

Regulatory situation

The official health care system adopted and implemented by the Malaysian Government is an allopathic one. Subsection 1 of Section 34 of the Medical Act of 1971 contains the following broad general exemption (253):

Subject to the provisions of subsection 2 and regulations made under this Act, nothing in this Act shall be deemed to affect the right of any person, not being a person taking or using any name, title, addition or description calculated to induce any person to believe that he is qualified to practise medicine or surgery according to modern scientific methods, to practise systems of therapeutics or surgery according to purely Malay, Chinese, Indian or other native methods, and to demand and recover reasonable charges in respect of such practice.

Subsection 2 limits the treatment of eye diseases to practitioners of allopathic medicine. Likewise, the Poisons Ordinance of 1952 restricts the use of certain substances to practitioners of allopathic medicine.

The Midwives (Registration) Regulations of 1971 (254) legalize the practice of eligible traditional birth attendants. Subsection 2 of Section 11 of the Regulations permits midwifery to be practised by the following:

Any person untrained in the practice of midwifery, who within four years of the commencement of [the Midwives Act of 1966] satisfies the Registrar that such person has during a period of two years immediately preceding application for registration... attended to women during childbirth.

There are no other laws affecting traditional medical practice in Malaysia; however, there are a number of laws that regulate the production and sale of traditional medicines. These are the Poison Act of 1952, Sale of Drug Act of 1952, Advertisement and Sale Act of 1956, and the Control of Drugs and Cosmetics Regulations of 1984. Since 1992, traditional medicine products have been registered (255).

The Drug Control Authority is responsible for product registration, including quality and safety. Every manufacturer of traditional medicine is required to comply with good manufacturing practices, and importers are required to comply with good storage practices. All homeopathic medicines have to be registered with the National Pharmaceutical and Drug Control Board (53).

In the past, the Government has taken a neutral stand on the practice of traditional Chinese medicine. However, in recognition of the current and potential contribution of traditional and complementary/alternative medicine to health care, the Government is now considering bringing traditional Chinese medicine into the official health care system (255). The Ministry of Health has set up the Steering Committee on Complementary Medicine with a multisectoral membership to advise and assist the Minister in formulating policies and strategies for monitoring the practice of traditional Chinese medicine in the country.

A national policy is being drafted on traditional Chinese medicine to encourage established practitioners to form their own self-regulatory bodies. These bodies will enable a system of official recognition of member-practitioners. To ensure that the qualifications of practitioners are recognized and can be accredited for formal registration, the bodies are required to set formal standards, including training, for their own practices. They are also encouraged to update the skills and knowledge of their members. The Unit of Traditional Chinese Medicine has been established at the Primary Health Care Section, Family Health Development Division, Ministry of Health. It will be responsible for monitoring and facilitating the implementation of the Ministry's policies as well as strengthening national and international collaboration.

There is no chiropractic law.

Education and training

Recently, the umbrella body for traditional Chinese medicine has issued a Practice Approval Certificate for practitioners who have taken its courses or courses from a recognized university. This certificate is needed for a Business License Certificate.

Homeopathy will be introduced as a discipline at the newly established Faculty of Biomedicine (53).

Insurance coverage

Neither national healthcare insurance nor private insurance covers traditional Chinese medicine in Malaysia.