World Health Organization WHO – Long-term Support of the Development of CAM
The World Health Organization (WHO) is a UN agency with its headquarters in Geneva. It is an important public health authority. It is comprised of 194 member states, including the Czech Republic.
“The World Health Organization’s main duties include preparing health care policies and consulting member states depending on their needs. WHO further supports nations in preparing national health care strategies, monitors health indicators among populations as well as indicators assessing individual countries’ healthcare systems. It also develops and tests new technologies and procedures aimed at handling diseases and health care management.” (41)
The World Health Assembly (WHA) is the supreme decision-making body within the WHO. It is comprised of representatives of the 194 member states and gathers once a year. The Executive Board, which is comprised of 32 health care experts, executes the WHA’s decisions and strategies and gathers twice a year. (42)
WHO has been engaged in complementary and alternative medicine for a long time. The first WHA resolution on this matter dates back to the 1970s. The Program “Traditional, complementary and integrative medicine” is one of WHO’s long-term projects.
Since the beginning of the 21st century, WHO has published a series of important documents on traditional, complementary and alternative medicine (TM/CAM). The most important are the following:
1) Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review (2001)
2) WHO Traditional Medicine Strategy 2002–2005 (2002)
3) WHO Traditional Medicine Strategy 2014–2023 (2013)
In all of its documents, WHO expresses strong support for TM/CAM both in developing countries and in highly developed states. It emphasizes that TM/CAM has a significant positive potential in both cases and can be beneficial to patients. However, extensive, high-quality research must first be carried out in order to substantially develop the knowledge base. A relevant legal framework for TM/CAM will then be created based on this knowledge and will be integrated into the standard health care systems.
The document The legal status of traditional medicine, complementary/alternative medicine: a worldwide review (43) (2001) is the result of intensive work spanning ten years. It provides information concerning the TM/CAM situation in 123 countries. Unfortunately, the Czech Republic is among the countries for which reliable data could not be obtained. The material points out that TM/CAM has been used increasingly both in developing and in highly developed countries. However, many countries (in 2001) did not have national policies and relevant legislations to regulate this health care sector. The safety, quality and effectiveness of these therapies and products was thus not ensured, which subsequently prevented them from being integrated into the health care system. The document includes information on TM/CAM utilization rates, legal regulations for general practitioners and products, health insurance in relation to TM/CAM, and further education among TM/CAM-certified general practitioners in 123 countries.
The document discusses the empirically verified efficacy of TM/CAM:
“Traditional and complementary/alternative medicine has demonstrated efficacy in areas such as mental health, disease prevention, treatment of non-communicable diseases, and improvement of the quality of life for persons living with chronic diseases as well as for the ageing population. Although further research, clinical trials, and evaluations are needed, traditional and complementary/alternative medicine has shown great potential to meet a broad spectrum of health care needs.” (44)
The already cited WHO Traditional Medicine Strategy 2002–2005 (45) from 2002 is another important document aiming to map the development of the TM/CAM situation in the member states.
This document drew attention to the steep increase in popularity of TM/CAM in both developing and highly developed countries. It also pointed out the growing efforts of individual governments to provide legal clarifications for TM/CAM and to legalize and regulate it in the interest of the patient. The document further mentions the growing public financing of research and development in this area. At the same time, it pointed out the current lack of reliable, high-quality research on the effects of individual therapies and medicaments used by TM/CAM.
This material was followed up 11 years later by the most recent strategic WHO document. The WHO Traditional Medicine Strategy 2014-2023 (46) was published in 2013 and emphasizes the significant positive potential of CAM on the current national health care systems.
The worldwide development of CAM and further related facts are summarized in the document as follows:
1) Continuously use of TM/CAM (member states should enable their citizens to make informed choices)
2) The growing financial importance of TM/CAM (the possibility to reduce healthcare costs)
3) The globality of TM/CAM (global use of local products requires international cooperation to ensure safety)
4) The uneven levels of accreditation and control of TM/CAM, and varying levels of education among TM/CAM practitioners (a particularly serious issue in the globalized world)
5) The significant progress of TM /CAM research and its development since 2002
6) The urgency of protecting the rights of local communities (taking into account the growing popularity of TM)
7) The need for better integration into healthcare systems (47)
The WHO Traditional Medicine Strategy 2014–2023 states that, since 2002, further significant advancement has been made regarding the approach of national health policies to TM/CAM worldwide. It describes the increasingly successfully and scientifically verified studies of TM/CAM therapies and the subsequent legal regulations regarding safe and efficient practices. However, it also sets out priority tasks and challenges to be addressed by 202348: Selected passages of this extensive document are available on page 90.
WHO’s approach to CAM is also illustrated by the statement from the WHO director-general Margaret Chan MD on the relationship between the conventional medicine and TM/CAM:
“The two systems of traditional and Western medicine need not clash. Within the context of primary health care, they can blend together in a beneficial harmony, using the best features of each system, and compensating for certain weaknesses in each. This is not something that will happen all by itself. Deliberate policy decisions have to be made. But it can be done successfully.” (49)
Figure 12 – The World Health Organization’s (WHO) recommendations for national health care policy-makers concerning traditional, complementary and alternative medicine (T&CM). Author of the diagram – KoS.