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Traditional Medicine

傳統醫學

Key facts

? In some Asian ａｎｄ African countries, 80% of the population depend on traditional medicine fｏｒprimary health care.

? Herbal medicines are the most lucrative form of traditional medicine, generating billions of dollars in revenue.

? Traditional medicine can treat various infectious ａｎｄ chronic conditions: new antimalarial drugs were developed from the discovery ａｎｄ isolation of artemisinin from Artemisia annua L., a plant used in China fｏｒalmost 2000 years.

? Counterfeit, poｏｒquality, ｏｒadulterated herbal products in international markets are serious patient safety threats.

? More than 100 countries have regulations fｏｒherbal medicines.

Traditional medicine is the sum total of knowledge, skills ａｎｄ practices based on the theories, beliefs ａｎｄ experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve ｏｒtreat physical ａｎｄ mental illnesses.

Traditional medicine that has been adopted by other populations (outside its indigenous culture) is often termed alternative ｏｒcomplementary medicine.

Herbal medicines include herbs, herbal materials, herbal preparations, ａｎｄ finished herbal products that contain parts of plants ｏｒother plant materials as active ingredients.

Who uses traditional medicine?

In some Asian ａｎｄ African countries, 80% of the population depend on traditional medicine fｏｒprimary health care.

In many developed countries, 70% to 80% of the population has used some form of alternative ｏｒcomplementary medicine (e.g. acupuncture).

Herbal treatments are the most popular form of traditional medicine, ａｎｄ are highly lucrative in the international marketplace. Annual revenues in Western Europe reached US$ 5 billion in 2003-2004. In China sales of products totaled US$ 14 billion in 2005. Herbal medicine revenue in Brazil was US$ 160 million in 2007.

Challenges

Traditional medicine has been used in some communities fｏｒthousands of years. As traditional medicine practices are adopted by new populations there are challenges.

International diversity: Traditional medicine practices have been adopted in different cultures ａｎｄ regions without the parallel advance of international standards ａｎｄ methods fｏｒevaluation.

National policy ａｎｄ regulation: Not many countries have national policies for traditional medicine. Regulating traditional medicine products, practices and practitioners is difficult due to variations in definitions ａｎｄ categorizations of traditional medicine therapies. A single herbal product could be defined as either a food, a dietary supplement ｏｒan herbal medicine, depending on the country. This disparity in regulations at the national level has implications fｏｒinternational access ａｎｄ distribution of products.

Safety, effectiveness ａｎｄ quality: Scientific evidence from tests done to evaluate the safety ａｎｄ effectiveness of traditional medicine products ａｎｄ practices is limited. While evidence shows that acupuncture, some herbal medicines ａｎｄ some manual therapies (e.g. massage) are effective fｏｒspecific conditions, further study of products ａｎｄ practices is needed. Requirements ａｎｄ methods for research ａｎｄ evaluation are complex. Fｏｒexample, it can be difficult to assess the quality of finished herbal products. The safety, effectiveness ａｎｄ quality of finished herbal medicine products depend on the quality of their source materials (which can include hundreds of natural constituents), ａｎｄ how elements are handled through production processes.

Knowledge ａｎｄ sustainability: Herbal materials fｏｒproducts are collected from wild plant populations ａｎｄ cultivated medicinal plants. The expanding herbal product market could drive over-harvesting of plants ａｎｄ threaten biodiversity. Poorly managed collection ａｎｄ cultivation practices could lead to the extinction of endangered plant species ａｎｄ the destruction of natural resources. Efforts to preserve both plant populations ａｎｄ knowledge on how to use them fｏｒmedicinal purposes is needed to sustain traditional medicine.

Patient safety ａｎｄ use: Many people believe that because medicines are herbal (natural) ｏｒtraditional they are safe (ｏｒcarry no risk fｏｒharm). However, traditional medicines ａｎｄ practices can cause harmful, adverse reactions if the product or therapy is of poｏｒquality, ｏｒit is taken inappropriately ｏｒin conjunction with other medicines. Increased patient awareness about safe usage is important, as well as more training, collaboration ａｎｄ communication among providers of traditional ａｎｄ other medicines.

WHO response

WHO and its Member States cooperate to promote the use of traditional medicine for health care. The collaboration aims to:

? support ａｎｄ integrate traditional medicine into national health systems in combination with national policy ａｎｄ regulation fｏｒproducts, practices and providers to ensure safety ａｎｄ quality;

? ensure the use of safe, effective ａｎｄ quality products ａｎｄ practices, based on available evidence;

? acknowledge traditional medicine as part of primary health care, to increase access to care ａｎｄ preserve knowledge ａｎｄ resources; 

? ensure patient safety by upgrading the skills ａｎｄ knowledge of traditional medicine providers.

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