Download Alternative medicine: challenges

Jennifer Orwa, PhD, OGW
Chief Research Officer, Kenya Medical Research
Institute, Center for Traditional Medicine and Drug
Research
Presentation at the KPA Nairobi Branch Annual
Scientific Conference, 21st May 2011 at 680 Hotel

The term “traditional medicine” refers to
practices and knowledge that existed before
the arrival of modern conventional medicine
which were used to promote, maintain and
restore health and well-being

In industrialized countries, adaptations of
traditional medicine are termed
“Complementary” or “Alternative”(CAM)

Worldwide, people developed
unique indigenous healing
traditions adapted and defined
by their culture, beliefs and
environment, which satisfied
the health needs of
communities over centuries.

In Western culture, alternative medicine is
any healing practice "that does not fall within
the realm of conventional medicine"

In some instances, it is based on historical
or cultural traditions, rather than a scientific
(e.g. evidence-based) basis

However critics to this definition exist
Richard Dawkins has stated that "there is no
alternative medicine
◦ There is only medicine that works and
medicine that doesn't work



Is frequently grouped with complementary
medicine which generally refers to the same
interventions when used in conjunction with
mainstream techniques, under the umbrella
term complementary and alternative
medicine, or CAM.
Some researchers in alternative medicine
oppose this grouping, preferring to
emphasize differences of approach, but
nevertheless use the term CAM, which has
become standard“

Although heterogeneous, the major CAM
systems have many common characteristics
including:
◦ a focus on individualizing treatments
◦ treating the whole person
◦ promoting self-care and self-healing, and
◦ recognizing the spiritual nature of each
individual

In addition, many CAM systems have
characteristics commonly found in mainstream
health care, such as
◦ a focus on good nutrition and preventive
practices

Unlike mainstream medicine
◦ CAM often lacks or has only limited
experimental and clinical study

Acupuncture
◦ the practice of inserting thin
needles into specific body
points to improve health and
well-being
◦ It originated in China more
than 2,000 years ago
Acupuncture needles

Acupuncture
◦ Research has shown that it reduces nausea
and vomiting after surgery and chemotherapy
◦ It can also relieve pain
◦ Researchers don't fully understand how
acupuncture works
 It might aid the activity of your body's pain-killing
chemicals
 It also might affect how you release chemicals
that regulate blood pressure and flow

Yoga

Herbs

Nutritional based
◦ Dietary supplements

Traditional Chinese medicine

Ayurveda

Meditation

Homeopathy

Hypnosis

herbal medicine

surgery

bone-setting

spinal manipulation and massage

Psychotherapy

psychiatry

preventive medicine

In the physical medicine
◦ herbal, animal, and mineral substances
may be used

In the metaphysical division of traditional
medicine
◦ Prayers, invocations, or incantations are
offered to some mysterious and powerful
forces

These are sold as:
◦ Tablets, Capsules
◦ Powders
◦ Teas
◦ Extracts
◦ Fresh or dried plants

International diversity:
◦ Traditional medicine practices have been
adopted in different cultures and regions
without the parallel advance of
international standards and methods for
evaluation

National policy and regulation:
◦ Not many countries have national policies
for traditional medicine
◦ Regulating traditional medicine products,
practices and practitioners is difficult due
to variations in definitions and
categorizations of traditional medicine
therapies

National policy and regulation:
◦ A single herbal product could be defined as
either a food, a dietary supplement or an
herbal medicine, depending on the country
◦ This disparity in regulations at the national
level has implications for international
access and distribution of products

Safety, effectiveness and quality:
◦ Scientific evidence from tests done to
evaluate the safety and effectiveness of
traditional medicine products and practices
is limited
◦ Requirements and methods for research
and evaluation are complex
◦ For example, it can be difficult to assess
the quality of finished herbal products

Safety, effectiveness and quality:
◦ The safety, effectiveness and quality of
finished herbal medicine products depend
on the quality of their source materials
(which can include hundreds of natural
constituents), and how elements are
handled through production processes

Knowledge and sustainability:
◦ Herbal materials for products are collected
from wild plant populations and cultivated
medicinal plants
◦ The expanding herbal product market could
drive over-harvesting of plants and
threaten biodiversity

Knowledge and sustainability:
◦ Poorly managed collection
and cultivation practices
could lead to the extinction
of endangered plant species
and the destruction of
natural resources
Prunus africana
with stripped bark

Patient safety and use:
◦ Many people believe that because
medicines are herbal (natural) or traditional
they are safe (or carry no risk for harm)
◦ However, traditional medicines and
practices can cause harmful, adverse
reactions if the product or therapy is of
poor quality, or it is taken inappropriately
or in conjunction with other medicines