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
 

1.5 Responding to the popularity of TM/CAM

Governments are responding to the growing use of TM/CAM. Several countries are currently developing regulations for the practice of chiropractic, while 24 countries already have such regulations (Figure 7). Others are working to regulate herbal medicines - the number of WHO Member States with regulations related to herbal medicines increased from 52 in 1994 to 64 in 2000 (Figure 8). In 2000 alone, regulations on herbal medicines were developed by Australia, Canada, Madagascar, Nigeria and the USA. (WHO assisted both Madagascar and Nigeria in developing its regulations.) In some countries, structures, budget and training in TM/CAM are growing steadily (Table 5).


Figure 7. Chiropractic laws are now widespread

Source: reported by World Federation of Chiropractic and World Chiropractic Alliance in 2000.39,40

The growing number of national TM re-search institutes in developing countries is also a sign of the growing importance of TM. In fact, most developing countries now have national TM research institutes. Notable examples are found in China, Ghana, the Democratic People's Republic of Korea, the Republic of Korea, India, Mali, Madagascar, Nigeria, Thailand, Indonesia, the Lao People's Democratic Republic, Sri Lanka and Viet Nam. (See also Figure 9.)

Meanwhile, in developing countries, responses to the popularity of CAM are becoming more and more extensive. In 1995, the Norwegian Parliament examined how CAM could best be incorporated into the Norwegian health service. This included Countries with legislation on chiropractic Countries with legislation on chiropractic pending consideration of: certification for professional training and education in CAM, and documenting CAM treatments. In 1997, the Ministry of Health and Social Affairs established a committee to look at various aspects of CAM. Its report proposed repeal of the Act Relating to Quackery, and creation of a registration system for CAM providers. It also proposed allocating funds over a five-year period, to increase know-ledge of CAM, and promote cooperation between CAM providers and Norway's health care system.42 This last was followed up at international level in 1999 by the Memorandum of Understanding on Cooperation in Health signed by the Ministers of Health of the People's Republic of China and Norway. The agreement seeks to promote health and health services in both countries, focusing on TM/CAM and development, regulation and organization of hospitals.


Figure 8. More and more countries are regulating herbal medicines

Source: World Health Organization, 199841and data collected by World Health Organization during period 1999 - 2001.


Figure 9. Many African countries have institutes that carry out TM research

Source: World Health Organization, 2000.3

Table 5. A growing number of African countries have established structures, budget and training in TM

Country

A legal framework for TM

A national management or coordination body

Association(s) of traditional practitioners

Directory of traditional practitioners

National budget allocation for TM

Angola

 

 

Botswana

   

   

Burkina Faso

   

Cameroon

   

 

Côte d'Ivoire

 

Dem. Rep. of the Congo

     

Equatorial Guinea

   

Eritrea

       

Ethiopia

 

 

Gambia

     

 

Ghana

 

Lesotho

 

Madagascar

 

Malawi

 

   

Mali

Mauritania

   

   

Mozambique

 

   

Namibia

   

Niger

 

Nigeria

     

Rwanda

 

Sao Tome & Principe

   

Senegal

   

 

Zambia

 

Zimbabwe

 

Source: World Health Organization, 2000.3

CAM provision and use has also been officially reviewed in the United Kingdom, following growing concerns about its safety. Currently - with the exception of osteopathy and chiropractic, which are protected by statute - anyone can practise CAM without any training. In 1999, the House of Lords requested the Committee on Science and Technology to make a survey of this type of health care. The committee recommended creation of a central mechanism (funded by government and charitable resources) to coordinate, advise and oversee training on research into CAM. Secondly, it suggested that the National Health Service Research and Development Directorate, and the Medical Research Council, dedicate research funding to create centres of excellence for CAM research, using the US National Center for Complementary and Alternative Medicine (see next page) as a model.16

Increased CAM training and education opportunities in the United Kingdom also reflect increased interest in this type of health care. Training in acupuncture, for example, is provided in more and more academic settings. And CAM courses are also being offered to medical students, although they tend to provide an academic introduction only, rather than teach specific clinical skills. The proportion of medical schools in the United Kingdom offering such courses rose from 10% to 40% between 1995 and 1997.43 In the USA, a large number of medical schools now have elective classes and CAM seminars.44

In developed countries, funding and establishment of CAM research and research units at sites of research excellence is likewise increasing. In the United Kingdom, the National Health Service recently funded two trials of acupunture for treating chronic pain, while in Germany, a centre for CAM research at the Technische Universität in Munich has produced a series of important systematic reviews.43

In the USA, in 1992, US Congress established the Office for Alternative Medicine in the National Institutes of Health (see http://nccam.nih/gov/). The mandate of this Office was extended in 1999, with the Office becoming the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM has received progressive budget increases - by 2000, its budget had risen to US$ 68.4 million (Figure 10). Concurrently in 2000, the White House set up the White House Commission on Alternative Medicine. Created by an executive order on 8 March 2000, the Commission is charged with developing a set of legislative and administrative recommendations to maximize the benefits of CAM for the general public. It has ten members, including senators and experts.


Figure 10. CAM funding is increasing significantly in the USA

Source: National Center for Complementary and Alternative Medicine, 2000.45

The USA also has a large number of units for CAM research, based at research institutions such as the University of Maryland, Columbia University in New York, Harvard University in Massachusetts, and the Memorial Sloan-Kettering Cancer Center in New York.43

International activity in TM/CAM is also becoming more prominent. The European Union (EU) recently completed a COST (European Cooperation in the field of Scientific and Technical research) project on "unconventional medicine". And in a 1999 EU Parliamentary Assembly (entitled A European Approach to Non-conventional Medicines), Member States were called upon to promote official recognition of CAM in medical faculties, to encourage its use in hospitals, and to encourage allopathic doctors to study CAM at university level.46 Also in Europe, the European Agency for the Evaluation of Medicinal Products (EMEA) works on the quality, safety and efficacy of herbal medicinal products. An Ad Hoc Working Group on Herbal Medicinal Products was established by the EMEA in 1997. (See also Chapter 4).

More recently, the Abuja Declaration on Roll Back Malaria, signed by the African heads of state and governments of 53 countries in 2000, recognized the important contribution that TM makes to fighting malaria. The Declaration includes a request to governments to ensure the effectiveness of such treatment, and to make it available and accessible to the poorest groups in communities.

 

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