WHO Traditional Medicine Strategy: 2002-2005
(2002; 70 pages) [French] [Spanish] Voir le document au format PDF
Table des matières
Afficher le documentAcknowledgements
Afficher le documentAcronyms, abbreviations and WHO Regions
Ouvrir ce répertoire et afficher son contenuKey points: WHO Traditional Medicine Strategy 2002 - 2005
Fermer ce répertoireChapter One: Global review
Afficher le document1.1 What is traditional medicine? Towards a working definition
Afficher le document1.2 Broad use and appeal
Afficher le document1.3 Expenditure
Afficher le document1.4 Accounting for use and increasing interest
Afficher le document1.5 Responding to the popularity of TM/CAM
Ouvrir ce répertoire et afficher son contenuChapter Two: Challenges
Ouvrir ce répertoire et afficher son contenuChapter Three: The current role of WHO
Ouvrir ce répertoire et afficher son contenuChapter Four: International and national resources for traditional medicine
Ouvrir ce répertoire et afficher son contenuChapter Five: Strategy and plan of action 2002 - 2005
Afficher le documentAnnex One: List of WHO Collaborating Centres for Traditional Medicine
Ouvrir ce répertoire et afficher son contenuAnnex Two: Selected WHO publications and documents on traditional medicine
Afficher le documentReferences
Afficher le documentBack Cover
 

1.2 Broad use and appeal

In many developing countries - as often stated in government reports - the majority of the population continues to use TM to meet its primary health care needs (Figure 1). Similarly, the resolution on Promoting the Role of Traditional Medicine in Health Systems: A Strategy for the African Region, adopted by the 50th WHO Regional Committee for the African Region in August 2000, states that about 80% of the population of African Member States use TM to help meet health care needs.2 This includes use of traditional birth attendants (TBAs). In fact, recognizing the contribution that TBAs can make to primary health care, a number of African countries have initiated training programmes to improve TBAs' skills and primary health care knowledge (Figure 2). Some of these countries also provide training in TM for pharmacists, doctors and nurses.


Figure 1. Use of TM for primary health care is extensive in some developing countries

Sources: compiled from government reports to World Health Organization.


Figure 2. African countries with health care training programmes for traditional birth attendants

Source: World Health Organization, 2000.3

Table 2 Examples of countries with an integrative approach to TM/CAM

 

National policy on TM/CAM

TM/CAM unit or department within ministry of health

Regulation of herbal products and herbal products industry

Human TM resources

Practice at all levels including public hospitals (i.e. if practised in public hospitals, TM/CAM are integrated into national health system)

Health insurance coverage for treatment and products

TM/CAM national research institutes

Official education at university level that covers both TM and AM for doctors, pharmacists and nurses

China

1949 constitution contains policy on TM

State Administration of Traditional and Complementary Medicine (TCM)

Regulation - Yes

TCM doctors

525 000

TCM hospitals

2 500

Full

170 national and state research institutes

30 TCM universities

     

Pharmacopoeia includes herbs

TCM/AM doctors

10 000

TCM/AM hospitals

39

   

3 TM colleges for minority groups

     

List of essential drugs

TCM pharmacists

83 000

Total beds

35 000

   

51 medical technology schools of TCM

     

includes herbal medicines

TCM associate doctors

72 000

TM hospitals for minority groups

127

     
     

Manufacturers

600

AM pharmacists

55 000

       
     

Herbal farmers

340 000

           

Republic of Korea

National TM policy 1969

Oriental Medicine Bureau

Regulation - Yes

Oriental doctors

9 914

107 oriental medical hospitals and 6 590 local oriental medical clinics

Full

1 national research institute

11 oriental medicine universities

     

Pharmacopoeia includes herbs

Acupuncturists

4 500

       

Viet Nam

National TM policy 1955

Department of TM

Regulation - Yes

TM doctors

25 500

48 hospitals with TM department

Full

3 national research institutes

TM faculty in 3 medical colleges,

     

List of essential drugs includes herbal medicines

Acupuncturists

20 000

     

2 medical technology schools of TM

     

State manufacturers

2

TM practitioners

5 000

       

Sources: compiled from government reports to World Health Organization.

Table 3. Examples of countries with an inclusive approach to TM/CAM

 

National policy on TM/CAM

TM/CAM unit or department within ministry of health

Regulation of TM or herbal products or of both TM and herbal products

TM/CAM practised at all levels including public hospitals (i.e. if practised in public hospitals, TM/CAM are integrated into national health system)

Health insurance coverage for treatment and products

TM/CAM research institute at national or university level

Official education at university level, covering both TM + AM for doctors, pharmacists and nurses

India

Yes

Yes

Both

Yes in some hospitals

No

Yes

Yes

Sri Lanka

Yes

Yes

Both

No

No

No

No

Indonesia

Yes

Yes

Both

Yes, in some state hospitals

No

Yes

No

Japan

No

No

Both

Yes, in some state hospitals

Yes

Yes, in some prefectures

No

Australia

No

Yes, in some states

Herbal products

Yes, in some state hospitals

Partial

No

Yes

United Arab Emirates

No

No

Both

Yes, in some state hospitals

No

Yes

No

Germany

No

No

Both

Yes, in some state hospitals

Partial

Yes

No

Norway

Yes

Staff in charge

Both

Yes, in some state hospitals

Partial

Yes, in one state university

No

United Kingdom

Yes

No

Both

Yes, in some state hospitals

Partial

No

No, in preparation

Canada

Yes

Yes

Both

Yes, in some state hospitals

Partial

Yes, in some state universities

No

USA

No

No

Both

Yes, in some state hospitals

Partial

Yes, NCCAM and in some state universities

No

Ghana

Yes

Yes

Both

No

No

Yes

No

Nigeria

Yes

Yes

Both

Yes

No

Yes

No

Sources: compiled from government reports to World Health Organization.

In many Asian countries TM continues to be widely used, even though allopathic medicine is often readily available. In Japan, 60 - 70% of allopathic doctors prescribe kampo medicines for their patients. In Malaysia, traditional forms of Malay, Chinese and Indian medicine are used extensively. In China, TM accounts for around 40% of all health care delivered, and is used to treat roughly 200 million patients annually.4 For Latin America, the WHO Regional Office for the Americas (AMRO/PAHO) reports that 71% of the population in Chile and 40% of the population in Colombia have used TM.5

In many developed countries, certain CAM therapies are very popular. Various government and non-government reports (Figure 3) state that the percentage of the population that has used CAM is 46% in Australia, 49% in France and 70% in Canada.6,7,8 A survey of 610 Swiss doctors showed that 46% had used some form of CAM, mainly homeopathy and acupuncture. This is comparable to the CAM figure for the Swiss population as a whole.9 In the United Kingdom, almost 40% of all general allopathic practitioners offer some form of CAM referral or access.10 In the USA, a national survey reported in the Journal of the American Medical Association indicated that use of at least 1 of 16 alternative therapies during the previous year increased from 34% in 1990 to 42% in 1997.13 The number of visits to CAM providers now exceeds by far the number of visits to all primary care physicians in the US.


Figure 3. Percentage of population which has used CAM at least once in selected developed countries

Sources: Fisher P & Ward A, 1999; Health Canada, 2001, World Health Organization, 1998.7,8,6


Figure 4. Countries where acupuncture is practised by allopathic doctors only, or by both allopathic doctors and acupuncturists

Sources: World Federation of Acupuncture-Moxibustion Societies, 2000; World Health Organization, in press.11,12

Acupuncture is especially popular. Originating in China, it is now used in at least 78 countries and practised not only by acupuncturists, but also by allopathic practitioners (Figure 4). According to the World Federation of Acupuncture-Moxibustion Societies, there are at least 50 000 acupuncturists in Asia. In Europe, there are an estimated 15 000 acupuncturists, including allopathic doctors who also practise as acupuncturists. In Belgium, 74% of acupuncture treatment is administered by allopathic doctors. In Germany, 77% of pain clinics provide acupuncture. In the United Kingdom, 46% of allopathic doctors either recommend patients for acupuncture treatment or treat their patients with acupuncture themselves. The USA has 12 000 licensed acupuncturists - the practice of acupuncture is legal in 38 states and six states are developing acupuncture practice policies.11,14,15

Table 4. Increase in sales of the most popular herbal products in the USA 1997 - 1998

Herb

Sales in US$ million

% increase in sales

 

1997

1998

 

Total herbal supplements

292

587

101

Echinacea

33

64

96

Garlic

66

81

24

Ginkgo biloba

52

126

143

Ginseng

76

96

26

St. John's wort

1

103

102

Other herbs

64

118

85

Source: data from Scanner Data, FDM, Inc., USA.18

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