The World Health Organization (WHO) is halfway through implementing the WHO Traditional Medicine Strategy 2014–2023, and as a result published the WHO Global Report on Traditional and Complementary Medicine 2019.
I believe this report provides valuable information for policy-makers, health professionals and the public. I have hope that the contribution of T&CM (Traditional & Complementary Medicine) will be recognized as a fundamental aspect to maintaining our health and well-being.
The first section of this lengthy document, broken into eight parts, discusses national policy; national and state-level laws, or regulations; national programs; the national office for T&CM; the national expert committee; the national research institute; government and public research funding; and the national plan for integrating T&CM into health services. Although I will only discuss the first section in this month's issue, it is our goal to review the other sections in the future. To access the full report please visit: https://www.who.int/traditional-complementary-integrative-medicine/en/.
National Policy for T&CM
First, let's understand the definition of a national policy. The report states, "national policy should include a definition of the role of the government in the development of T&CM in the health care delivery system. Safety and efficacy may be stated as guiding principles, and the policy may also include vision and mission statements, as well as goals and objectives."1
The first milestone in this area happened between 1999 and 2005, when the number of Member States having a national policy doubled. The next time frame, 2005-2018, the number doubled again. The result—by 2018 a total of 98 countries, more than 50 percent of the 194 Member States, had adopted a national policy. Here is the current data captured during the most recent surveys conducted by WHO:
- South-East Asia region 91 percent
- African region 72 percent
- Eastern Mediterranean region 52 percent
- Western Pacific region 41 percent
- Region of the Americas 34 percent
- European region 28 percent
Laws & Regs
Gradually increasing since 1999, 109 Member States report having national laws or regulations for T&CM. For many Member States, national laws and regulations have been integrated into the national drug or medicine laws. However, for the U.S. the T&CM legal framework is the responsibility of each state.
National Programs for T&CM
Although many Member States reported having an exclusive program for T&CM, some have integrated their programs into long-term health plans. As of 2018, 79 out of the 194 Member States, or 40 percent, reported having a national program for T&CM. By region, South-East Asia reported the highest percentage of countries at 91 percent; the WHO African Region reported 72 percent; the Western Pacific Region 41 percent; the Region of the Americas 37 percent; the Eastern Mediterranean Region 19 percent; and the European Region 13 percent.
National Offices for T&CM
"Any government-sponsored office that is officially mandated and in charge of issues related to T&CM,"1 is defined as a national office for T&CM. Here is a breakdown of Member States (by region) with a national office:
- South-East Asia Region, 91 percent
- African Region, 83 percent
- Eastern Mediterranean Region, 62 percent
- Region of the Americas, 49 percent
- Western Pacific Region, 48 percent
- European Region, 28 percent
An "Expert" Committee
An expert committee is defined as "a group of experts convened by the national government for the purpose of reviewing and making policy and technical recommendations."1 As a percentage, the Member States in each WHO region that have an expert committee are as follows: South-East Asia Region, 91 percent; the African Region, 72 percent; the Eastern Mediterranean Region, 52 percent; the Western Pacific Region, 41 percent; the Region of the Americas, 34 percent; and the European Region, 28 percent.
National Research Institutes
This section states, "Many of the Member States reported that they did not have a national research institute for T&CM but that they had research policies relevant to T&CM research."1 Percentages for each WHO region who have national research institutes are as follows: South-East Asia Region, 64 percent; African Region, 62 percent; Eastern Mediterranean Region, 48 percent; Western Pacific Region, 33 percent; Region of the Americas, 26 percent; and the European Region, 21 percent.
Government & Public Research Funding
A new question, introduced in WHO's most recent survey/study, asked Member States "whether they had government or public research funding for T&CM and, if so, what was the yearly allocation from 2010 to 2016."1 Only 61 Member States, across six WHO regions, provided a voluntary reply to the update survey.
Of the 61 that responded, only 12 Member States – Benin, Brazil, Chile, China, Cuba, Democratic People's Republic of Korea, India, Mali, Oman, Peru, Thailand and the U.S. confirmed government funding. In the U.S., the National Institutes of Health (NIH) shared that $366 million was designated in 2016 to "Complementary and Alternative Medicine."
Integrating T&CM Into Healthcare Policy
Another new question asked in the update survey, "whether Member States had an existing national plan for integrating T&CM into their national health service delivery." Again, only 61 Member States, across six WHO regions, provided a voluntary reply to the update survey. Of the 61 respondent Member States, 13 (Benin, Bolivia, Brazil, Cuba, Democratic People's Republic of Korea, Ghana, Guatemala, Haiti, India, Mali, Mexico, Nicaragua and Thailand) confirmed a national plan for integration.
On another note, if you have comments or ideas please communicate them, so we can create a strong and unified profession.
Reference
- WHO Global Report on Traditional and Complementary 2019. Geneva: World Health Organization, 2019.
Click here for more information about Marilyn Allen, Editor-at-Large.