Volume 7, Issue 1, February 2015, Pages 13–15
A Special Issue: Traditional and Integrative Approaches for Global Health
Opinion article
Building WHO's global Strategy for Traditional Medicine ☆
Abstract
Introduction
In
2012, WHO began the process for responding to the World Health Assembly
Resolution on Traditional Medicine WHA62.13 and upgrading the WHO
Traditional Medicine Strategy 2002–2005.
Methods
Over
the course of 18 months, the WHO developed a plan for developing the
Strategy, by inviting a number of experts from around the world to
contribute to the document. Four international collaborative meetings
were held in order to collate international views and opinions.
Results
Resulting
from these meetings and consultations, the WHO Traditional Medicine
Strategy 2014–2023 was subsequently published in the fall of 2013.
Conclusions
The
primary goal of the document was to provide strategic direction for
Member States as they move forward with regulatory and policy
development around traditional and complementary medicine (T&CM).
This article belongs to the Special Issue: T & G Health Issue.
Keywords
- Traditional Medicine;
- Complementary medicine;
- World Health Organization;
- WHO;
- International Health Policy
- ☆
- This article belongs to the Special Issue: T & G Health Issue.
- Corresponding author. Tel.:
+1 16047624743.
Introduction
The World Health Organization (WHO) recognizes that traditional and complementary medicine (T&CM), are a vital part of the global health care system. With this in mind, WHO recommends that governments harness the potential contribution of T&CM to health and wellness; and promote the safe and effective use of T&CM by regulating, researching and integrating products, practitioners and practice into health systems.In October 2013, WHO released the WHO Traditional Medicine Strategy 2014–2023 (the Strategy) [1] to provide guidance for countries as they work to manage priorities, regulations and governance of the T&CM field within their own jurisdiction. The new Strategy is an important follow-up to the WHO Traditional Medicine Strategy 2002–2005 [2] and responds to the World Health Assembly resolution on Traditional Medicine WHA62.13 [3].After the first Strategy proved to have a strong influence on how countries undertook regulation and oversight of Traditional Medicine (TM), the 2008 Beijing Congress on Traditional Medicine, which was attended by government representatives from more than 70 countries, identified the need for WHO to take a leading role in updating and expanding the original Strategy. Participants, who represented every WHO region, identified six priorities, known as the “Beijing Declaration”, and endorsed the development of a new global Strategy that would build on the successes of the previous Strategy and reflect the international situation in 2013 [4].In developing the new Strategy, WHO brought together and consulted with experts, Member States and other stakeholders across the six WHO regions to develop the strategic objectives, strategic directions and strategic actions for the new Strategy that will guide the T&CM sector from 2014–2023.The aim of the Strategy is to help member states “harness the potential contribution of TM to health, wellness and people-centred health care” and “promote the safe and effective use of TM by regulating, researching and integrating TM products, practitioners and practice into health systems, where appropriate” [5].Development of the Strategy
To ensure that the new Strategy presented a global perspective, WHO developed an iterative process that welcomed input and feedback from international representatives. The WHO hosted four international working group meetings of government representatives, academics and international experts to help craft the Strategy. To ensure the Strategy was current and reflected the needs of the community at large, comments were sought from organizations with official observer status with the WHO as well as more than 20 WHO Collaborating Centres in Traditional Medicine.T&CM is viewed very differently in every part of the world. In some regions – Africa, India and China for example – T&CM is widely used by the population. In North America, Europe and Australia, T&CM is more commonly referred to as complementary medicine, and is used in conjunction, or as an add-on to conventional medicine. In order to develop the Strategy, recognition of the different governance structures, national priorities and resources as well as attitudes towards T&CM had to be considered. In addition, WHO recently indicated that significant strategic planning for Member States must focus on the need for better universal health coverage (UHC) around the world. These factors played an important role in shaping a Strategy that could be supportive and useful in each unique region.Ultimately, WHO and experts from around the world, concluded that the 2014–2023 Strategy should help member states organize their activities in the following three strategic sectors: - •
- Build the knowledge base that will allow T&CM to be managed actively through appropriate national policies that understand and recognize the role and potential of T&CM.
- •
- Strengthen the quality assurance, safety, proper use and effectiveness of T&CM by regulating products, practices and practitioners through T&CM education and training, skills development, services and therapies.
- •
- Promote universal health coverage by integrating relevant T&CM services into health service delivery and self-health care by capitalizing on their potential contribution to improve health services and health outcomes, and by ensuring users are able to make informed choices about self-health care.
Contents of the Strategy
The WHO Traditional Medicine Strategy 2014–2023 is divided into five sections:
- 1)
- Section 1: An introduction that includes common terminologies, the role of traditional and complementary medicine (T&CM) around the world, information on how the WHO supports T&CM, background on how the Strategy was developed and a description of why this new Strategy is important.
- 2)
- Section 2: An outline of the global progress that has taken place in TM policy and regulations, practices and education and research since publication of the WHO Traditional Medicine Strategy 2002–2005.
- 3)
- Section 3: An analysis of the current global picture for T&CM including the continuing demand, how it is used, progress in regulation, importance of universal health coverage and the integration of T&CM (including opportunities and challenges).
- 4)
- Section 4: A clear description of strategic objectives, strategic directions, and strategic actions. This section is the most important section of the document and outlines the future steps recommended by the numerous advisors and experts throughout the course of developing the document. This section is described in more detail below.
- 5)
- Section 5: An overview of the important aspects of the Strategy and suggestions on how it can be implemented and measured.
What is different in the new Strategy?
The World Health Organization Traditional Medicine Strategy 2014–2023
contains many of the same themes as the former Strategy, however, the
Strategy also acknowledges that many advances have occurred in the past
decade in T&CM. Rather than focusing on the past, the Strategy is
intended to set the tone for increased changes in the decade to come.
Section
4 is the pivotal section for Member States and includes the strategic
objectives, directions and actions. This is a new approach that provides
distinct and specific actions that Member States can take to strengthen
their T&CM sector. The challenge for those developing the Strategy,
and for those who will implement it, is that each country's view of
T&CM is unique and distinct, and that will influence the feasibility
of making significant change in the next decade.
There are some specific areas in which the new Strategy stands apart from the last one. These include the following:
- •
- Stronger recognition of complementary medicine, as well as traditional medicine (TM). This Strategy recognizes that many therapies and products that are considered TM medicine in one part of the world are being used internationally as complementary medicines.
- •
- The Strategy exists as a living document.Unlike the first Strategy which had a five year life span, the new Strategy is intended to be spread over a full decade. This more dynamic approach allows for the Strategy to grow and evolve, reflecting changes in the sector. In addition, the Strategy.
- a.
- identifies the need for ongoing monitoring and adaptations.
- b.
- provides a reasonable time frame in which to accomplish the goals and objectives.
- c.
- provides a structured way for parts of the sector to become more involved and potentially ‘own’ the document itself.
- •
- Recognition of the importance of self-care.Reflecting changing attitudes and the global market for traditional and complementary medicinal products such as dietary supplements and herbal medicines, as well as the growth in popularity of such practices as yoga, one of the three strategic directions (4.3) focuses exclusively on self-care. Specifically, this direction notes that consumers must play a central role in determining what products or practices they wish to take or not take.
- •
- Increased focus on regulation.More Member States are regulating the practice of T&CM and therapeutic products used since the introduction of the WHO Traditional Medicine Strategy 2002–2005. Regulation is identified as a specific strategic direction and is considered to be a key step in ensuring the quality assurance, safety, proper use and effectiveness of T&CM practices, products and practitioners.
- •
- A more inclusionary and comprehensive approach.Since 2002, the WHO has developed guidelines, policies, and protocols dealing with herbal medicines and traditional medicinal products in topics ranging from Good Manufacturing Practices (GMP) to adverse event reporting. Building from this strong base, in this Strategy there is increased attention to how products and therapies are used. The new Strategy actively identifies collaboration with all groups including industry and consumers as being key to its success. Though the WHO is not a governmental agency and cannot directly address individual sectors, it can encourage member states in how to engage all the relevant constituents.
Conclusion
The WHO Traditional Medicine Strategy 2014–2023
reflects on the global priorities for T&CM and suggests the steps
needed to deliver on these priorities. In essence, the Strategy is a
roadmap for work on T&CM. This Strategy is the primary document on
T&CM that reflects the current global situation. It is a living
document with an evaluation planned halfway through its 10-year
lifespan.
One of the most
important ways in which this Strategy can be used is by engaging
governments, both domestically and internationally. Though the Strategy
does not come with associated resources, it may prove to be a useful
tool to support applications for funding to both government and
non-government agencies. Some countries very actively support T&CM
while others do not, and the use of this document may aid international
initiatives and provide a cohesive link into the work of the WHO. The
ultimate hope is that individuals engaged or interested in T&CM will
recognize WHO's interest in the field, and will value WHO's support for
a long-term plan that supports evidence informed T&CM around the
world. Given the increased attention by the WHO to the importance
healthy lifestyles as a means of combating the global epidemic in
non-communicable diseases, this Strategy provides a good opportunity for
the T&CM sector to play a more central role in addressing important
health-care priorities globally and in particular in combating the
global epidemic in non-communicable diseases and promoting self
healthcare.
Conflict of interest
The
authors of this article were members of the technical drafting team
that developed the WHO Traditional Medicine Strategy 2014–2023.
Acknowledgements
The
authors of this article were members of the technical drafting team
that developed the WHO Traditional Medicine Strategy 2014–2023. We
gratefully acknowledge the additional members of the drafting team, Dr.
Zhang Qi and Dr. Xiaorui Zhang.
References
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