WHO is particularly active in supporting development of TM in Africa, South-East Asia and the Western Pacific. This includes helping Member States to develop national policy and regulations, facilitating regional information exchange on these issues, and supporting efforts to ensure product safety, and availability of trained, qualified human resources.
As mentioned in Chapter 2 the WHO Regional Committee for Africa adopted a resolution, in 2000, on Promoting the Role of Traditional Medicine in Health Systems: a Strategy for the African Region.2 The resolution recognized the importance and potential of TM for the achievement of Health for All in the African Region, and recommended accelerated development of local production of traditional medicines. The resolution further urged Member States to translate the strategy into realistic national TM policies, backed up with appropriate legislation and plans for specific interventions at national and local levels, and to collaborate actively with all partners in its implementation and evaluation.
Concrete results as a result of development of the strategy are now beginning to be seen. They include legal frameworks for TM in 16 African countries.
In 1999 an AMRO working group reviewed the situation and use of TM (including national policy and regulation) in its region, and proposed two meetings - on regulation of herbal products and research into indigenous medicine. The Regional Meeting on Regulatory Aspects of Herbal Products - organized by WHO Headquarters and AMRO - was held in 2000 and analysed issues relating to national policy, economics, and regulation and registration of herbal products. Additionally, WHO guidelines for assessing the safety and efficacy of herbal medicines were introduced, and participants adopted a proposal on common requirements of registration of herbal products. The latter will facilitate further integration of TM into national health care systems in the Americas. Regulation and registration of herbal medicines, in particular, have been established in: Bolivia, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Peru and Venezuela. The second meeting, on research into indigenous medicine, was held in March 2001 in Guatemala.
"Health policy-makers worldwide are recognizing that traditional medicine and the use of herbal medicinal plants continue to be a strong part of a country's culture, history and beliefs, and that those practices in most parts ought to be analysed as being part of the country's health system."58
More than 12 Western European countries have established or revised their regulation on herbal medicines in accordance with the WHO Guidelines for Assessment of Herbal Medicines. WHO is increasingly active in advising European countries on regulation of TM/CAM and how to evaluate their safety and efficacy.
South East Asia
TM is widely used and respected throughout South-East Asia. In 1998, the South-East Asian Meeting of Ministers of Health recommended that this "rich heritage" and "important resource" be used more effectively in implementing primary health care in the countries of the region. In response, SEARO organized a regional consultation on development of traditional medicine, in the following year. The consultation focused on strengthening national TM programmes, and the role of TM expertise in improving district health systems. Additionally, information on national policy and regulations on TM was shared. SEARO continues to actively support individual countries in their efforts to develop national policy on TM and to integrate TM into their national health care systems.
In particular, WHO has supported the activities of the Department of Indian Systems of Medicine and Homeopathy, which was established within India's Ministry of Health and Family Welfare in 1995. During 1998 and 1999, the Department increased efforts to standardize and promote quality control of ayurvedic, unani, siddha and homeopathic medicines. It also finalized good manufacturing practice guidelines for ayurvedic medicines and promoted education in Indian TM.
The Western Pacific also has a rich TM heritage, which its countries are keen to optimize. At the 1997 and 1999 Meetings of Ministers of Health of the Western Pacific, participants iterated their full support for the wider application and development of TM in efforts to improve health status.
The Regional Office for the Western Pacific (WPRO) not only supports countries in drafting national TM policy and regulations, but also facilitates integration of TM into health service systems. For example, WHO helped draft legislation, signed on 8 December 1997, that created the Philippine Institute of Traditional and Alternative Healthcare. It also assisted Papua New Guinea in preparing a national TM policy that has since been incorporated into the country's 2001 - 2010 health plan. This policy identifies research into TM as a top priority. In Singapore, the Traditional Chinese Medicine Practitioners Act - incorporating a number of recommendations made by WPRO on regulation of practitioners - was passed by Parliament in 2000.
"More and more governments from countries and areas within the Region [WHO's Western Pacific Region] have shown a willingness to promote the proper use of traditional medicine and bring it into the formal health service system... There are now 14 countries and areas in the Region that have developed official government documents which recognize traditional medicine and its practice. This is in contrast to a few years ago, when only four countries (China, Japan, the Republic of Korea and Viet Nam) officially recognized the role of traditional medicine in formal health care systems."59
Meanwhile, full-time TM degree courses are being offered at universities in Australia, China, Hong Kong (China), Japan, the Republic of Korea and Vietnam, many of which have benefited from WPRO input.
Other WPRO activities have included development, in 1997, of Guidelines for the Appropriate Use of Herbal Medicine, to promote appropriate use of herbal medicines by countries in the region. The guidelines can be used to help formulate national policies and programmes on herbal medicines. Creation and implementation of national TM policies is in fact an area in which WPRO is becoming more and more involved. In 1999, a WHO workshop on developing national TM policies reviewed the role of TM in the Western Pacific and identified problems in drafting relevant government policy. In late 1999 a WHO consultation on TM and allopathic medicine examined how to harmonize the two types of health care to achieve maximum health impact. In 2000, a WHO regional workshop on TM practice and health sector development drafted an action plan on traditional medicine for the 20 Pacific Island countries.