World Health Organization : The mandate of a specialized agency of the United Nations

PART III : A variety of activities

Chapter 3

TRADITIONAL MEDICINE

"For us who believe in physics, the distinction between the past, the present and the future  is just an illusion, although persistent"
Albert Einstein

3.1. Background and issues

When one is in charge of defining the concept of traditional medicine, one realises the complexity of such a task, as situations actually vary accordingly to countries and populations taken into consideration. Traditional medicine constitutes an extremely fascinating and attractive world under many points of view, and for a wide range of users in developing and developed countries. For example, traditional medicine may be either highly secretive, mystical and extremely localised, or codified and very well regulated. As a consequence, traditional medical knowledge may be passed on orally from generation to generation or may be openly taught in officially recognised universities.

However, the WHO has delineated a working definition of traditional medicine as "including diverse health practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness"[1].

Furthermore, traditional medicine therapies can be categorised as medication therapies, when they use herbal medicines, animal parts and/or minerals, and as non-medication therapies, if carried out mainly without the use of medication, as in the case of acupuncture or manual therapies[2].

The term traditional medicine is sometimes replaced by other terms, as complementary, alternative or non-conventional medicine. The different terminology is frequently used in countries where traditional medicine is practiced even though it is not part of the country's own tradition, or if it is not integrated into its dominant health care system. If allopathic medicine refers to the broad category of medical practice that is sometimes called Western medicine, biomedicine, scientific medicine or modern medicine, the adjective complementary, alternative and non-conventional refer to health care that is considered supplementary to allopathic medicine[3].

This categorisation depends on the health care system of the country taken into consideration. The WHO individuates basically three types of health system with the aim of describing the degree to which traditional medicine is an officially recognised element of health care[4]:

  • Integrative system: traditional medicine is officially recognised and incorporated into all areas of health care provision (health care delivery, education, training, regulation, insurance). This happens for example in China, Republic of Korea and Vietnam.
  • Inclusive system: traditional medicine is recognised, but it is not yet completely integrated into all aspects of health care. This system is typical of countries such as United Kingdom, USA, Canada, Norway, Germany, Australia, and also Nigeria, India, Ghana, Indonesia, Sri Lanka, Japan and United Arab Emirates.
  • Tolerant system: the national health care system is totally based on allopathic medicine. However some traditional medicine practice are tolerated by law. This is, for example, the case of Italy.

The most widespread systems of traditional medicine in the world are[5]:

  • Chinese medicine[6].

The earliest record of traditional medicine can be trace back to the 8th century B.C.. Diagnosis and treatment are based on a holistic view of the patient's symptoms, expressed in terms of the balance of yin and yang. Yin represents the earth, cold and femininity. Yang represents the sky, heat and masculinity. The actions of yin and yang influence the interactions of the five elements composing the universe: metal, wood, water, fire and earth. Practitioners of Chinese medicine seek to control the levels of yin and yang through 12 meridians, which bring energy to the body. Acupuncture, for example, that is one of the most widely used Chinese medicine practices, is based on the meridian theory[7]. Herbal medicines are also a consistent part of a such a traditional system[8].

Ayurveda's origin can be dated back even earlier, in the 10th century B.C.. However, its current form took shape between the 5th century B.C. and the 5th century A.D.. The term ayurveda is a Sanskrit term meaning 'science of life', and in fact, ayurveda is not only a system of medicine, but also a way of living. Ayurvedic philosophy is linked to sacred texts, the Vedas, and based on the theory of Panchmahabhutas. All objects and living bodies are composed of the five basic elements: earth, water, fire, air and sky. Furthermore, the environment is perceived as a macrocosm, and the individual as a microcosm, reciprocally acting on each other.

Ayurveda is widely practiced in South Asia, especially in Bangladesh, India, Nepal, Pakistan, and Sri Lanka.

  • Chiropractic.

Chiropractic was more recently founded at the end of the 19th century. The founder was a magnetic therapist practicing in Iowa, USA, named Daniel David Palmer. This therapy is based on an association between the spine and nervous system and on the self-healing properties of the human body. It diagnoses and treats mechanical disorders of the joints, muscles and ligaments of the body by manual adjustments.

Homeopathy was first mentioned by Hippocrates (462-377 B.C.), but it was a German physician, Hahnemann (1755-1843), who established homeopathy's basic principles, among which the most important is 'simila similibus curentur'. The founder wrote that "in order to radically heal a certain kind of chronic infections, it is necessary to find remedies which normally cause in the human body a similar disease, as much similar as possible"[11]. Basically this means that a substance, which absorbed in a certain quantity in a healthy person may cause a disease, may also cure it if taken in a different dose. Other principles are direction of cure, principle of single remedy, the theory of minimum diluted dose, and the theory of chronic diseases[12].

Homeopathy is widely diffuse in Europe, as well as in Asia and in North America. It has also been integrated in the systems of many countries, including India, Mexico, Pakistan, Sri Lanka, and the United Kingdom.

Unani is based on Hippocrates' theory of the four bodily humours: blood, phlegm, yellow bile, and black bile. Galen (131-210 A.D.), Rhazes (850-925 A.D.) and Avicenna (980-1037 A.D.) heavily influenced unani's foundation and formed its structure. Unani is therefore Greek medicine which developed throughout the Arabic civilisation. It draws from the traditional systems of medicine of China, Egypt, India, Iraq, Persia, and the Syrian Arabi Republic. It is also called Arabic medicine.

The use of traditional medicine in the prevention, diagnosis and treatment of an extensive range of diseases, has been increasing, overall in the last 20 years, both in developing (Figure 1) and developed countries (Figure 2).

Figure 1: Use of traditional medicine for primary health care is extensive in some developing countries

Source: WHO Traditional Medicine Strategy 2002-2005, p. 9

Figure 2: Percentage of population which has used traditional medicine at least once in selected developed countries

Source: WHO Traditional Medicine Strategy 2002-2005, p.11

The reasons for such a popularity are different accordingly to the countries taken into consideration.

In developing countries, traditional medicine is considered more accessible and affordable than allopathic medicine. To give an example, 80% of the population in Africa uses traditional medicine[14]. According to a survey by the US Agency for International Development, in Sub-Saharan Africa, traditional practitioners outnumber allopathic practitioners by 100 to 1[15]. Furthermore, allopathic practitioners are usually located in cities or other urban areas. Traditional medicine, then, becomes for rural population the only source of health care[16].

Traditional medicine sometimes also constitutes the only affordable source of health care. This is why herbal medicines are mainly used to cure malaria (Artemisia annua), and are also used to obtain symptomatic relief and to manage opportunistic infections in patients affected by HIV/AIDS[17].

In developed countries, traditional medicine is perceived as a diverse approach to ill-health. Traditional medicine is based on "the needs of individuals. Different people may receive different treatments even if, according to modern medicine, they suffer from the same disease. Traditional medicine is based on a belief that each individual has his or her own constitution and social circumstances which result in different reactions to 'causes of disease' and 'treatment'"[18]. For this reason, the increasing use of traditional medicine arises from the dissatisfaction caused by the allopathic medicine approach.

Moreover, as we have previously seen, noncommunicable diseases have been tremendously growing in developed countries. Even if allopathic medicine provides the patients with multiple treatments and technologies, this approach has not been sufficiently effective. For many patients, traditional medicine sometime offers gentler means to manage such diseases, to improve the quality of life of persons living with chronic diseases, as well as for the ageing population[19].

3.2. The action taken by the WHO

The increasing diffusion of the use of traditional medicine in the world has been asking for the World Health Organization's intervention. Member states' requests insistently reach WHO every day. Member states want assistance from WHO in formulating national policy and regulatory frameworks about traditional medicine; in ensuring the safety, efficacy and quality of the practices; in guaranteeing the access to such treatments and in assuring their rational use[20].

Dr Samba, WHO's Regional Director for Africa, comments that if 80% of the people in Africa really uses traditional medicine, "we must move quickly to evaluate its safety, efficacy, quality and standardisation – to protect our heritage and to preserve our traditional knowledge. We must also institutionalise and integrate it into our national health systems"[21].

Problems have also arisen in the past from the improper use of traditional medicine. For example, in 1996, in Belgium, more than 50 people suffered kidney failure after taking a herbal preparation which contained Aristolochia fangchi (a toxic plant) instead of Stephania tetranda or Magnolia officinalis[22].

Within the WHO, the structure entitled of responding to such challenges is the Traditional Medicine Team, in the Essential Drugs and Medicine Policies Department[23], Health and Pharmaceuticals Cluster[24]. The basic objectives of the Traditional Medicine Team are: to facilitate integration of traditional medicine into the national health care system by assisting member states to develop their own national policies on traditional medicine; to promote the proper use of traditional medicine by developing and providing international standards, technical guidelines and methodologies; to study the potential usefulness of traditional medicine including evaluation of practices and examination of the safety and efficacy of remedies; to act as a clearing-house to facilitate information exchange in the field of traditional medicine; to educate and inform the general practices about proven traditional health practices[25].

One of the highest achievement of the Traditional Medicine Team's work has been the formulation of the first five-year strategy for traditional medicine, namely 'WHO Traditional Medicine Strategy 2002-2005'[26] issued in May 2002. For the release of the document, the Traditional Medicine Team has received the contribution from numerous member states and partners, such as organisations of the UN system, international organisations, nongovernmental organisations and global and national professional associations[27].

The strategy has four main objectives:

  • Policy: to integrate relevant aspects of traditional medicine within national health care systems by framing national traditional medicine policies and implementing programmes;
  • Safety, efficacy and quality: to promote the safety, efficacy and quality of traditional medicine practices by providing guidance on regulatory and quality assurance standards;
  • Access: to increase access to, and affordability of, traditional medicine;
  • Rational use: to promote rational use of traditional medicine[28].

Source: WHO Traditional Medicine Strategy 2002-2005, p. 45

Concerning the implementation of such objectives, the strategy proposes:

  • Policy.

A policy is "a commitment to a goal and a guide to action"[29]. Even if only 25 of WHO's 192 member states (as of 2000) have developed national policies on traditional medicine[30], they are actually necessary tools in order to define the role of traditional medicine in the health care system, and its good employ. In general, such policy should cover a range of issues, such as: the definition of the government's role in developing traditional medicine in the health-care delivery system; provisions for safety and quality assurance; provisions for education and training; provisions for research and development; and also consideration of intellectual property issues[31].

A useful document in this sense, collecting data about legal frameworks worldwide, was issued in 2001 regarding to the 'Legal status of traditional medicine and complementary/alternative medicine'[32].

  • Safety, efficacy, quality.

Differently from allopathic medicine that has developed mainly within the Western culture, traditional medicine has rather been influenced by different cultures and historical conditions. Furthermore, its common basis being a holistic approach to life, traditional medicine takes into account multiple and various factors. Its nature, therefore, renders it difficult to be evaluated, since there are no common standards and methods to do so[33].

WHO's task consists, then, in assuring safety, efficacy and quality of traditional medicine through increasing the knowledge about the various practices, and developing norms, standards and guidelines. An example are the regulation of herbal medicine[34], and the 'Guidelines on basic training and safety in acupuncture'[35]. Another initiative should be the adoption of a national expert committee. For example, in the African Region, 21 out of 46 countries have institutes carrying out research in traditional medicine[36].

  • Access.

To guarantee access to traditional medicine means to ensure its equitable availability and affordability, with a particular attention to the poorest population[37]. In low-income countries, the need of inexpensive and effective treatments for common diseases is very high. Yet one-third, and sometimes even a half of the population of these countries, lack regular access to essential drugs. Traditional medicine are, in comparison, much more available and affordable than allopathic medicine[38].

With the purpose of increasing the access to traditional medicine, first, reliable indicators to accurately measure levels of access – both financial and geographic – to it must be developed; and, secondly, the safest and most effective therapies must be identified, to provide a sound basis for efforts to promote it[39].

It should also be considered that traditional practitioners live at the community level, making traditional medicine extremely available. For this reason, "the role of traditional practitioners should be recognized and cooperation between them and community health-workers should be strengthened"[40].

Other issues are the protection of traditional knowledge, which has been increasingly appropriated, adapted and patented by scientists and industry, and sustainable use of natural resources, which sometimes are being wastefully exploited[41]. A method which can be adopted to protect traditional medicine is to create national inventory of medicinal plants to ensure that knowledge is correctly and continuously used over generations. An example is the survey among traditional practitioners conducted by the Ministry of Health of Cote d'Ivoire that recorded more than 2000 traditionally use plants[42]. The sustainable use of medical plants is, for example, improved by the project of the Traditional Medicine Team relatively to 'Good Sourcing Practice for Medicinal Plant'[43].

  • Rational use.

To guarantee rational use of medicines means generally to ensure sound and cost-effective use of drugs by health professionals and consumers[44]. Regarding to traditional medicine, in particular, rational use has many aspects: proper use of good-quality products; good communication between traditional medicine providers; provision of scientific information and guidance for the public[45].

There are various challenges the WHO should face. With respect to education and training, the WHO should ensure that knowledge, qualification and training of traditional medicine providers are adequate. In addition, the WHO should also make traditional medicine and allopathic practitioners understand and appreciate the complementarity of the two different approaches[46].

Furthermore, the proper use of good quality products also contributes to guarantee rational use of traditional medicine.

Another element is to provide consumers with the necessary information in order to raise awareness of safe and appropriate use of traditional medicines.

WHO's interventions should therefore be targeted both to providers and consumers. The WHO should work for increasing the capacity of traditional providers to use traditional medicine properly, and to increase the capacity of consumers to make informed decisions about traditional medicine[47].

3.3.Traditional medicine and WHO's mandate

Once analysed the fascinating world of traditional medicine and, in particular, the role of the Traditional Medicine Team within the WHO, this last section is aimed at understanding once more why the Organization is engaged in such an activity. It is again a question on WHO's mandate.

First of all, what has traditional medicine to do with the development promoted by the Millennium Development Goals? Traditional medicine, as previously said, is on a wide range used by the poorest population of the world in developing countries. The reasons are its accessibility and affordability in comparison with allopathic medicine. Therefore, with no doubt, a correct use of such therapies and practices would be able to lead to the development of those people. Moreover, traditional medicine can properly be used in case of communicable diseases such as malaria and HIV, and in maternal health through traditional birth attendance. On this perspective, such a WHO activity responds to the fifth and sixth Millennium Development Goals[48].

Secondly, traditional medicine seems to be perfectly in accordance with the definition of health given by the WHO Constitution, and it fits with the strategic objective of 'Health for All'.

Traditional medicine is based on "a holistic approach to life, equilibrium between the mind, body and their environment, and an emphasis on health rather than on disease"[49]. Such a unique vision, which is not at all common in the Western 'scientific' approach to health, is in the pathway designed by the constitutional definition of health, which goes beyond the mere absence of disease and introduces a state of complete physical, mental and social well-being.

Moreover, the use of traditional medicine as a response to primary health care needs, above all in the poorest population, makes it one of the most useful means to reach the Health for All objective. The achievement of such an objective requires the employment of all the resources available in the world at any kind of level. Within this category, traditional medicine is absolutely a resource which should not be wasted and rather properly utilised[50]. Dr Mahler wrote in the introduction to a book on traditional medicine, that in order to achieve the Health for All goal, "il faudra employer tous les moyens utiles et mobiliser toutes les ressources possibles. Parmi ces moyens et ces ressources figurent divers types de pratiques indigènes et de praticiens et d'accoucheuses traditionnels"[51].

Furthermore, one does not have to forget that traditional medicine also plays a role in developed countries were people are mostly affected by noncommunicable diseases and, in particular, by chronic illnesses. For its holistic approach to health, it also highlights the importance of prevention, and of maintaining a certain style of life avoiding risk factors. From this point of view, traditional medicine can contribute to improve the quality of life of those who suffer from minor illness or from certain incurable diseases. The reference, with this perspective, is to more than one of the strategic direction of the corporate strategy.

To summarise, traditional medicine can be employed on a variety of different fronts: it is actually used in developing and developed countries, and for treating both communicable and noncommunicable diseases. This characteristic elevates traditional medicine to a universal level that makes it object of interest of an international organisation as WHO.

Nevertheless, the structure within the WHO, aimed at supporting the enormous possibility of employment of traditional medicine, shows a paradox. Despite the huge amount of work which could be done within this context in order to collect precious fruits, the Traditional Medicine Team is tied up by a ridiculous budget which does not even allow it to hire the needed personnel.

The budget of the Essential Medicines Department: access, quality and rational use is very little in comparison with that one of the previous analysed activities, and it does not seem to be dramatically increasing (Table 1).

Table 1: Resources

US$ thousand All funds WHO regular budget Other sources
2000-1 2002-3 2004-5 2000-1 2002-3 2004-5 2000-1 2002-3 2004-5
TOTAL 37,078 42,063 52,506 10,078 11,063 18,006 27,000 31,000 34,500

Traditional medicine ends up being, also on a global level[52], not understood and not fully exploited in all its possibilities.


 

[1] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 7

[2] ibid.

[3]Legal status of traditional medicine and complementary/alternative medicine, Document WHO/EDM/TRM/2001.2, WHO, Geneva, 2001, p. 1

[4] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, pp. 8-9

[5] The short description of these system is taken from Legal status of traditional medicine and complementary/alternative medicine, Document WHO/EDM/TRM/2001.2, WHO, Geneva, 2001, pp. 2-3. For further information, see Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983; Cabieses F., Apuntes de Medicina Tradicional, Tomo I, Diselpesa, Lima, 1993; O.M.S., Il ruolo delle medicine tradizionali nel sistema sanitario, Edizioni di RED, Como, 1984

[6] For complete information, see Pei, W., Médecine Chinoise traditionnelle, in Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983, pp. 68-74

[7] Minelli, E., Le cinque vie dell'agopuntura, Gemma Editco, Verona, 2002

[8] Regulatory situation of herbal medicines, Document WHO/TRM/98.1, WHO, Geneva, 1998

[9] For complete information, see Kurup, P.N.V., L'Ayurveda, in Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983, pp. 51-60

[10] For complete information, see Vithoulkas, G., Homéopathie, in Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983, pp. 107-112

[11] Hahnemann, F.S., quoted in Canova, F., Omeopatia: un comparto dallo sviluppo duraturo o un fenomeno di moda?, Dissertation for the Faculty of Economics, University Bocconi, academic year 1992-3, p. 7

[12] For further information about the principles of homeopathy, see Canova, F., Omeopatia: un comparto dallo sviluppo duraturo o un fenomeno di moda?, Dissertation for the Faculty of Economics, University Bocconi, 1992-3, p. 7

[13] For complete information, see Said, H.M., Le système Unani de santé et de soins médicaux, in Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983, pp. 61-67

[14] Traditional medicine in the African region. An initial situation analysis (1998-1999), Harare, WHO Regional Office for Africa, 2000

[15] Vongo, R., Local production and dispensing of herbal antimalarials, A report from the First International Meeting of the Research Initiative on Traditional Anti-Malarials, Moshi, Tanzania, 8-11 December 1999

[16] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 13

[17] For this reason UNAIDS is advocating collaboration with traditional medicine practitioners in Sub-Saharan Africa, see Collaboration with traditional healers in AIDS prevention and care in Sub-Saharan Africa: a comparative case study using INAIDS best practice criteria, UNAIDS, Geneva, 1999

[18] Report: technical briefing on traditional medicine, Forty-ninth Regional Committee Meeting, Manila, Philippines, 18 September 1998

[19] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 14

[20] ibid., pp. 19-27

[21] WHO launches the first global strategy on traditional and alternative medicine, Press Release WHO/38, 16 May 2002

[22] Traditional medicine, Report by the Secretariat, Document EB111/9

[23] Essential Drugs and Medicine Policies Department, see www.who.int/medicines

[24] Health Technology and Pharmaceuticals: 2002-2003 Strategy, Document WHO/HTP/01.02, WHO, Geneva, 2001

[25] Traditional Medicine Team, see www. who.int/medicines/organization/trm/orgtrmobject.shtml

[26] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002

[27] Among the UN agencies, FAO and WIPO; among international organisations, EU, WB and WTO; among the nongovernmental organisations, the Ford Foundation, PRO. ME. TRA (Association for the Promotion of Traditional Medicine), WWF; among the global and national professional associations, the World Federation of Chiropractic, the Liga Medicorum Homeophatica Internationalis, the Islamic Organization for Medical Sciences. For complete information, see WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, pp. 35-41

[28] Traditional medicine, Report by the Secretariat, Document EB111/9

[29] WHO medicines strategy 2000-2003, see www.who.int/medicines/strategy/stmission.shtml

[30] National policy on traditional medicine and alternative/complementary medicine,

see www.who.int/m/topics/national_policy_traditional_&_alternative_…/index.htm

[31] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 21

[32] Legal status of traditional medicine and complementary/alternative medicine, Document WHO/EDM/TRM/2001.2, WHO, Geneva, 2001

[33] From a conversation with one of the members of the Traditional Medicine Team.

[34] Regulatory situation of herbal medicines, Document WHO/TRM/98.1, WHO, Geneva, 1998. Furthermore, to update the situation of the herbal medicine regulation, WHO regions have been recently working to organise workshops on the topic. During my internship, I took part to the drafting of the Guidelines for a Workshop on Herbal Medicines in the African Region.

[35] Guidelines on basic training and safety in acupuncture, Document WHO/EDM/TRM/99.1, WHO, Geneva, 1999

[36] Traditional medicine, Report by the Secretariat, Document EB111/9

[37] WHO medicines strategy 2000-2003, see www.who.int/medicines/strategy/stmission.shtml

[38] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 24.

In particular, see the study on cost-effectiveness of complementary and alternative medicine conducted in Peru. The conclusion was that of nine selected mild and chronic pathologies, the direct costs incurred in using such medicine were lower than those for conventional therapy, and that its efficacy was higher, with fewer side-effects. Traditional medicine, Report by the Secretariat, Document EB111/9

[39] Traditional medicine – Growing needs and potential, WHO Policy Perspectives on Medicines, WHO, Geneva, No. 2, May 2002

[40] Traditional medicine, Report by the Secretariat, Document EB111/9

[41] Traditional medicine – Growing needs and potential, WHO Policy Perspectives on Medicines, WHO, Geneva, No. 2, May 2002

[42] Traditional medicine, Report by the Secretariat, Document EB111/9

[43] During my internship, I had the possibility to take part to the WHO Working Group on Good Sourcing Practice, held in Geneva, on 29-30 October 2002.

[44] WHO medicines strategy 2000-2003, see www.who.int/medicines/strategy/stmission.shtml

[45] Traditional medicine – Growing needs and potential, WHO Policy Perspectives on Medicines, WHO, Geneva, No. 2, May 2002

[46] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002, p. 26

[47]ibid., p. 48

[48] Improve maternal health and combat HIV/AIDS, malaria and other diseases.

See www.un.org/millenniumgoals

[49] WHO Traditional Medicine Strategy 2002-2005, Document WHO/EDM/TRM/2002.1, WHO, Geneva, 2002., p. 21

[50] The impression I had during my internship was to be in front of a prosperous and vital reality which had to be properly organise. This is why the activity of the TRM Team is mainly normative. On the contrary, many other activities of the WHO are aimed at inventing new methods, practices, techniques starting from nothing in order to achieve certain objectives.

[51] Bannerman, R.H., Burton, J., Wen-chieh, C., Médecine traditionnelle et couverture des soins de santé, WHO, Geneva, 1983, p. 7

[52] The attacks moved against traditional medicine, or in a pejorative sense 'alternative medicine', in Italy are well known. However, the Lombardy Region has just started a collaboration with the TRM Team.

 

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Edited by Aldo Campana,