WHO Traditional Medicine Strategy and Activities “Standardization with Evidence-based Approaches”

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Traditional medicine (TRM)” is a comprehensive term used to refer both to TRM systems such as traditional Chinese medicine, Ayurvedic medicine and Unani medicine, and to various forms of indigenous medicine. In countries where the dominant health care system is based on western medicine, or where TRM has not been incorporated into the national health care system, TRM is often termed “alternative”, “complementary” or “non-conventional” medicine. Accordingly, TRM is used when referring to Africa, Latin America, South-East Asia, and/or the Western Pacific, whereas “complementary and alternative medicine” is used when referring to Europe and/or North America (and Australia). When referring in a general sense to all of these regions, the comprehensive TRM/CAM is used.

In definition, TRM is the knowledge, skills, and practices of holistic healthcare, recognized and accepted for its role in the maintenance of health and the treatment of diseases. It is based on indigenous theories, beliefs and experiences that are handed down from generation to generation.

There are a number of major challenges of TRM, which can be summarized as (1) varying degree with which it is recognized by governments; (2) lack of sound scientific evidence concerning the efficacy of many of its therapies; (3) difficulties relating to the protection of indigenous TRM knowledge; and (4) problems in ensuring its proper use.

To overcome the above-mentioned challenges, Western Pacific Regional Office (WPRO) has evolved our foci of plan as policy, regulations, standards, clinical practice, researches, education, and information under the theme of “Standardization with evidence-based approaches.”

The roles of standards in TRM are raising levels of quality, safety, reliability, efficiency, and interchangeability of TRM, and providing above benefits at an economical cost.

The main reasons of WHO's initiative on standardization come from its highest authoritative and reliable international organization in health issues and having wide experiences in international activities, while most of the Member States only have their respective initiatives and lack of experiences in the international cooperation in TRM.

In connection with the theme of “Standardization with evidence-based approaches”, WHO/WPRO are conducting a number of standardization projects in TRM such as terminologies, acupuncture point locations, TRM information including thesaurus, clinical ontology, classification and Western Pacific Regional Index Medicus, and evidence-based clinical practice guidelines in TRM for 28 priority diseases.

Developing international standard terminologies (IST) in TRM is the first step for the whole project of standardizations and, through two informal consultations and a Regional meeting; we have identified 3543 terms. WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region including Chinese terms with English translation and definition has been published in July 2007.

To standardize the acupuncture point locations, over the last 4 years, we have convened 11 consecutive meetings and successfully unified 92 controversial acupuncture point locations in Tsukuba, November 2006. WHO/WPRO published WHO Standard Acupuncture Point Locations in the Western Pacific Region in May 2008. There will be new textbook, charts, and model based upon newly standardized acupuncture point locations in the near future.

For promoting the proper use of TRM, developing the evidence-based clinical practice guidelines in TRM on priority diseases will be the core works. In selecting 28 priority diseases, there were four criteria used as basis, which can prove applying TRM is more efficacious, cost-effective, affordable and beneficial for the population than just simple use of western modern medicine.

Since the Declaration of Alma-Ata mentioned the role of traditional practitioners in the primary health care, WHO started to pay its attention to the TRM. Almost three decades later, the Prince of Wales delivered his keynote speech in the 59^th World Health Assembly with high appraisals on acupuncture and herbal medicine, and recommended the 193 Member States to integrate TRM into their public health systems and to promote har monization with western modern medicine. It shows how TRM rapidly and intensively has strived and innovated in recent decades.

WHO traditional medicine strategy and activities will secure the proper use of TRM aiming at “Health for All”, the goal of WHO.