Conditions for Effective Collaboration between Modern and Traditional Medicine NotesKI I n spite of the scientific advances challenges and problems of accessibil- made by modern medicine, 75­80 ity to modern health care, there is a percent of the population turn to tra- tendency to try and integrate tradi- ditional medicine for health care. This tional medicine into modern health medicine has evolved with the history systems. The Health for All objective, of mankind, and traditional knowledge to which traditional medicine could is a popular asset that is integrated contribute, is still a topical question, into the socio-medical environment. and health authorities are increasingly http://www.worldbank.org/afr/ik/default.htm The OAU expressed a real interest in challenged about the role traditional the subject of traditional medicine dur- medicine could play in improving the ing the first symposium on medicinal health of the people. As the financial plants and African pharmacopoeia held affordability of modern drugs is a prob- in Dakar in 1968. The 1978 Alma Ata lem, improved traditional drugs Declaration recognizes the role of tra- (MTAs) offer an interesting alternative ditional medicine and traditional heal- for these mostly destitute populations. ers in achieving the Health for All ob- Yet, the strategic orientations and jective. In 1977, WHO launched the programmes of traditional medicine do No. 65 Traditional Medicine Programme and not always have an important place in February 2004 adopted a resolution inviting inter- ested member states to pay appropri- IK Notes reports periodically on Indigenous Knowledge (IK) initiatives ate attention to the use of traditional in Sub-Saharan Africa and occasionally health systems. on such initiatives outside the Region. It is published by the Africa Region's Knowledge and Learning Center as part of an evolving IK partnership Integration between the World Bank, communi- ties, NGOs, development institutions The difference between modern and and multilateral organizations. The traditional medicine practitioners lies views expressed in this article are World Bank those of the authors and should not be not only in their way of thinking, but attributed to the World Bank Group also and especially in their perceptions or its partners in this initiative. A webpage on IK is available at // of man and health. The concepts they www.worldbank.org/afr/ik/ use are often different. Due to the default.htm 2 overall health policies. As a consequence, health workers do tory analyses. These clinical experimentation centres may not know the principal traditional healers in their districts well serve to validate the pharmacological studies (efficacy and are not always informed about government policies on and safety) on improved traditional drugs which have to be traditional medicine. prepared in the appropriate galenic formulation. Community centres of appropriate technology, which are equipped and have operating means, can be used for manu- Areas of collaboration facturing and packaging these drugs for a regular supply of There are real opportunities for traditional medicine to con- medicinal plants. Through the training of traditional healers, tribute to the improvement of health. The promotion of tra- it will be possible to avoid practices dangerous to people's ditional medicine can be achieved through, among other health and to rationalize their practice. Traditional healers things, the control and sensitisation of traditional healers. need to be identified and organized in associations in order Collaboration can be achieved through relevant institutions to have a reliable basis for collaboration. and the reference universities, and also through government health facilities, where herbalists can sell medicinal plants Joining forces that can facilitate their contacts with the modern health sys- tem. Combined health centres where traditional healers, The WHO regional strategy aims at helping member coun- doctors, and/or head nurses work together allow for a combi- tries to optimize the use of traditional medicine in order to nation of the two medicines. The patients in these facilities achieve health for all. It is based on a number of principles, benefit from traditional consultations supported by labora- among which are advocacy, the official recognition of tradi- tional medicine by the states, its institutionalisation, and the IK Notes building of partnerships. Interventions in this area consist in formulating policies, strengthening capacities and promot- ing research and development. Ministries of Health should would be of interest to: collaborate with the other sectors, consumer groups, non- governmental organizations, traditional healers' associa- Name tions, and training institutions to make the most of tradi- Institution tional medicine. Taboos have to be lifted and a frank and sincere dialogue framework established for discussions between the profes- Address sionals of the two sectors which have ignored each other for a long time. Social sciences should better study the socio- cultural background of traditional healers for a better under- standing of the concept of traditional medicine, which would help strengthen this collaboration. Letters, comments, and requests for publications The practice of traditional medicine should be regulated should be addressed to: in order to improve its efficiency and reinforce its accep- tance. The requirements to be met by medicinal plant pro- Editor: IK Notes Knowledge and Learning Center ducers for marketing their products should be clearly stated. Africa Region, World Bank The plants that are registered should have the required qual- 1818 H Street, N.W., Mailstop J8-811 Washington, D.C. 20433 ity and efficacy, and proof of safety must be established for E-mail: pmohan@worldbank.org some plants which, used over time, can cause chronic tox- aemia. Their galenic formulations should be improved. The setting up of scientific committees made up of experts to 3 review new drug applications is critical. It will also be neces- ˇ Finalizing the inventories of the growing areas of the prin- sary to produce monographs on the different plants. The cipal medicinal plants used by traditional healers studies on medicinal plants conducted in various countries ˇ Creating botanical gardens for self-sufficiency and the will help to strengthen the scientific and medical bases of preservation of medicinal plants traditional medicine. ˇ Setting up a regulatory mechanism to authorize the mar- keting of improved traditional drugs ˇ Ensuring appropriate communication between the differ- Priority activities ent players. The role that traditional medicine could play in solving pub- lic health problems has not yet been sufficiently explored. WHO member states at the 50th Session of the Regional The priority activities to be undertaken in this regard can be Committee held in September 2000 adopted a strategy on summarized as follows: the promotion of the role of traditional medicine. The in- ˇ Knowing the distribution of traditional healers through struments for supporting the countries in the censuses institutionalisation and integration of traditional medicine ˇ Organizing traditional healers into associations in modern health systems are being developed. ˇ Informing and sensitising traditional healers for collabora- WHO is also supporting scientific studies on the efficacy, tion with public health authorities safety, and quality of the plant based drugs used to treat ma- ˇ Informing traditional healers about priority diseases laria, HIV/AIDS and sickle cell anaemia, among other dis- ˇ Better informing and sensitising regional and district eases. Recommendations were made to the countries to cre- medical officers about the strategic orientations regarding ate the institutional and structural framework needed for the traditional medicine development of traditional medicine. ˇ Regulating the practice of traditional medicine This article was written by Dr. Mamadou Ngom -- WHO Office/Senegal -- and was first published by PROMETRA in its magazine, Médécine Verte No. 17, July ­ September 2003. This version is a translation of the original. For more information, please contact Dr. Eric Gbodossou: Erick@refer.sn 4