<quote> New WHO guidelines to promote proper use of
alternative medicines Adverse drug reactions to alternative
medicines have more than doubled in three years
22 JUNE 2004 | GENEVA -- Since traditional, complementary
and alternative medicines remain largely unregulated,
consumers worldwide need to be informed and given the tools
to access appropriate, safe and effective treatment. To help
address this issue, the World Health Organization (WHO)
today releases a new set of guidelines for national health
authorities to develop context specific and reliable
information for consumer use of alternative medicines.
Up to 80% of developing country populations rely on
traditional medicine for their primary health care, due to
cultural tradition or lack of alternatives. In wealthy
countries, many people seek out various types of natural
remedies on the assumption that natural means safe.
However, as the use of traditional or alternative medicines
increases, so do reports of adverse reactions. In China, a
country where traditional therapies and products are widely
used in parallel with conventional medicine, there were 9
854 known reported cases of adverse drug reactions in 2002
alone, up from 4 000 between 1990 and 1999.
Many traditional/alternative medicine products are sold over
the counter. In a WHO survey of 142 countries, 99 responded
that most of these products could be bought without
prescription. In 39 countries, many traditional remedies
were used for self-medication, bought or prepared by
friends, acquaintances or the patient. These trends raise
concerns over the quality of the products used, their
therapeutic appropriateness for a given condition, and the
lack of medical follow-up.
â œWHO supports traditional and alternative medicines when
these have demonstrated benefits for the patient and minimal
risks,â ? said Dr LEE Jong-wook, Director-General of WHO. â
œBut as more people use these medicines, governments should
have the tools to ensure all stakeholders have the best
information about their benefits and their risks."
Accessible, easy to understand information is key to
guiding consumers in their choices. The guidelines
provide simple, easy to follow tips on issues to look out
for and a brief checklist of basic questions which may be
used to help facilitate proper use of traditional and
alternative medicine.
Advice is provided to government authorities on preparing
easy-to-access information and on working with the mass
media to sensitize and educate the population. In addition,
suggestions are given for several health system structures
and processes needed to promote proper use of traditional
and alternative medicines.
While the guidelines cannot compensate for poor products or
inappropriate practices, they can help governments educate
consumers on how to maximize the benefits and minimize the
risks of traditional medicines.
Alternative therapies - documented benefits and risks
Empirical and scientific evidence exists to support the
benefits of acupuncture, manual therapies and several
medicinal plants for chronic or mild conditions. For
instance, the effectiveness of acupuncture, a popular
treatment for relieving pain, has been demonstrated both
through numerous clinical trials and laboratory
experiments. As a result, 90% of pain clinics in the United
Kingdom and 70% in Germany include acupuncture as a form of
treatment. Equally, some medicinal plants have shown
efficacy for life-threatening conditions; medicine
combinations containing the Chinese herb Artemisia annua
are now considered amongst the most effective remedies
against malaria. However, there have been many cases of
consumers unknowingly using suspect or counterfeit
products; choosing inappropriate therapies in self-care; as
well as several reports of unintentional overdose.
Similarly, there have been reports of consumers being
injured by unqualified practitioners. For example, a study
performed by the National Research Institute on
Complementary and Alternative Medicine in Norway reported
cases of pneumothorax caused by unqualified acupuncturists.
In addition, there have been reports of paralysis caused by
unqualified manual therapists.
Another potential risk is that patients do not inform their
doctors about their use of traditional and complementary
medicines.
For instance, Ginkgo biloba is a popularly used herbal
medicine worldwide whose main function is to prevent
vascular disease and to increase blood circulation. The WHO
Uppsala Monitoring Centre reported some cases of excess
bleeding during a surgical operation. If the patient had
informed the doctor about the use of the medicine this could
have been avoided.
The development of the guidelines was carried out with the
financial and technical support of the Regional Government
of Lombardy, in collaboration with the State University of
Milan. The guidelines are based on evidence and experiences
collected from 102 countries representing all WHO regions.
RELATED LINKS
- WHO Guidelines: Developing Information on Proper Use of
Traditional, Complementary and Alternative Medicine [pdf
3.1Mb]
- Traditional medicine
- Medicinal plants WHO guidelines on developing consumer
information on proper use of traditional, complementary
and alternative medicines Summary of highlights
22 JUNE 2004 | GENEVA -- Policies governments could put in
place Make sure that sufficient information is provided to
consumers on the efficacy and safety of products as well as
contraindications Set up the right channels for consumers to
report adverse drug reactions and make those channels known
Organize communication campaigns to equip consumers with the
ability to discern the quality of the service they receive
Ensure that practitioners are appropriately qualified and
registered Encourage interaction between traditional and
conventional practitioners Provide insurance for non-
conventional therapies and products whose evidence base is
sound. Health system structures and processes that would
help promote better quality and safety Development of
quality standards and treatment guidelines to ensure
uniformity within a particular health system Standardization
of training and knowledge requirements for practitioners to
promote the credibility of traditional or alternative
practices and enhance consumer trust Collaboration between
conventional and traditional or complementary care providers
to improve results of treatment but also promote health
sector reform Organization of traditional or alternative
medicine practitioners to provide better structures for self-
control mechanisms Questions consumers should ask Is the
therapy suitable for his/her disease or condition? Does the
therapy have the potential to prevent, alleviate and/or cure
symptoms or in other ways contribute to improved health and
well-being for the consumer? Is the therapy or herbal
medicines provided by a qualified traditional medicine/
complementary and alternative medicine practitioner (TM/CAM)
or health care practitioner with adequate training
background, good skills and knowledge, preferably registered
and certified? Are the herbal medicinal products or
materials of assured quality and what are the
contraindications and precautions of the products or
materials? Are the therapies or herbal medicinal products
available at a competitive price? For more information
contact: Daniela Bagozzi Telephone: +41 22 791 4544 Email:
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Health Organization </quote>
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