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NEWS ARCHIVES (2)
WHO LAUNCHES THE FIRST GLOBAL STRATEGY
ON TRADITIONAL AND ALTERNATIVE MEDICINE
Traditional medicine is becoming more popular in the
north and up to 80% of people in the south use it as part of primary
health care. The situation has given rise to concerns among health
practitioners and consumers on the issue of safety, above all, but also
on questions of policy, regulation, evidence, biodiversity and
preservation and protection of traditional knowledge.
The World Health Organization (WHO)
has released a
global plan to address those issues. The strategy provides a framework
for policy to assist countries to regulate traditional or
complementary/alternative medicine (TM/CAM) to make its use safer, more
accessible to their populations and sustainable.
"About 80% of the people in Africa use traditional
medicine. It is for this reason that we must act quickly to evaluate its
safety, efficacy, quality and standardization – to protect our heritage
and to preserve our traditional knowledge. We must also institutionalize
and integrate it into our national health systems." says Ebrahim Samba,
WHO’s Regional Director for Africa.
In wealthy countries, growing numbers of patients
rely on alternative medicine for preventive or palliative care. In
France, 75% of the population has used complementary medicine at least
once; in Germany, 77% of pain clinics provide acupuncture; and in the
United Kingdom, expenditure on complementary or alternative medicine
stands at US$ 2300 million per year.
But problems may arise out of incorrect use of traditional therapies.
For instance, the herb Ma Huang (ephedra) is traditionally used in China
to treat short-term respiratory congestion. In the United States, the
herb was marketed as a dietary aid, whose long-term use led to at least
a dozen deaths, heart attacks and strokes. In Belgium, at least
70 people required renal transplant or dialysis for interstitial
fibrosis of the kidney after taking the wrong herb from the
Aristolochiaceae family, again as a dietary aid.
"Traditional or complementary medicine is victim of
both uncritical enthusiasts and uninformed skeptics," explains Dr
Yasuhiro Suzuki, WHO Executive Director for Health Technology and
Pharmaceuticals. "This strategy is intended to tap into its real
potential for people’s health and well-being, while minimizing the risks
of unproven or misused remedies."
In developing countries, where more than one-third of
the population lacks access to essential medicines, the provision of
safe and effective TM/CAM therapies could become a critical tool to
increase access to health care. But while traditional medicine has been
fully integrated into the health systems of China, North and South Korea
and Viet Nam, many countries have not collected and standardized
evidence on this type of health care.
The global market for traditional therapies stands at
US$ 60 billion a year and is steadily growing. In addition to the
patient safety issue and the threat to knowledge and biodiversity, there
is also the risk that further commercialization through unregulated use
will make these therapies unaffordable to many who rely on them as their
primary source of health care. For this reason policies on the
protection of indigenous or traditional knowledge are necessary.
About 25% of modern medicines are descended from
plants first used traditionally. The efficacy of acupuncture in
relieving pain and nausea has been well established. Randomized
controlled trials also offer convincing evidence that therapies such as
hypnosis and relaxation techniques can alleviate anxiety, panic
disorders and insomnia. Other studies have shown that yoga can reduce
asthma attacks while tai ji techniques can help the elderly reduce their
fear of falls.
As well as addressing chronic conditions, TM can also
impact on infectious diseases. In Africa, North America and Europe,
three out of four people living with HIV/AIDS use some form of
traditional or complementary treatment for various symptoms and
conditions. In South Africa, the Medical Research Council is conducting
studies on the plant Sutherlandia microphylla’s efficacy in
treating AIDS patients. Traditionally used as a tonic, this plant may
increase energy, appetite and body mass in people living with HIV.
The Chinese herbal remedy Artemisia annua,
used for almost 2000 years, has recently been found to be effective
against resistant malaria and could give hope of preventing many of the
800 000 deaths among children from severe malaria each year.
The WHO TM/CAM strategy aims to assist countries to:
- develop national policies on the evaluation and regulation of
TM/CAM practices;
- create a stronger evidence base on the safety, efficacy and
quality of the TM/CAM products and practices;
- ensure availability and affordability of TM/CAM, including
essential herbal medicines;
- promote therapeutically sound use of TM/CAM by providers and
consumers.
The strategy, a working document for adaptation and
regional implementation, and more information on TM/CAM can be accessed
on:
http://www.who.int/medicines/organization/trm/orgtrmmain.shtml
For
more information, contact Daniella Bagozzi, Information Officer,
Communications, Health Technology and Pharmeuticals, WHO, Geneva. Tel.
(+41 22) 791 4544; mobile (+41) 079 475 54 90; E-mail:
bagozzid@who.int.
All WHO Press Releases, Fact Sheets and Features as well as other
information on this subject can be obtained on Internet on the WHO home
page
http://www.who.int/
UN Official Calls African AIDS Summit Historic,
Urges Concrete Action
Decision taken during the summit on AIDS held in Abuja
(Nigeria) at the end of April (2001) will amount to nothing unless they are
translated to action in order to save the continent from the AIDS pandemic,
according to a senior official of the UN agency for AIDS.
The Summit attracted more than a dozen presidents and
representatives of more than 40 countries. After two days of
deliberation, preceded by a ministerial and technical session to prepare the
Declaration and Action Plan, the leaders agreed to make the fight against
HIV/AIDS their highest priority and to allocate more resources to strengthen
their health systems and fight the disease, as well as other related
infectious diseases like malaria and tuberculosis.
The UN official, Peter Piot, Executive Director of UNAIDS,
described the Summit as "historic", especially within the context of
Africa's response to the pandemic which has left the continent with 24.5
million of the 36 million people infected with AIDS world-wide.
"Meeting like this are political meetings, and the way
that one can work with it is that they are useful to hold governments
accountable. And so far as we are concerned, a year from now, we will
say, okay these are (the) number of commitments, where are we in each
individual country and continentally," said Piot to Panafrican News
Agency.
"That's the significance of these king of statement
(the Summit Declaration). Otherwise they are not worth more than the
paper they are printed on," continued Piot. "Of course, the
challenge is that the words, great words are now translated into action, after
the Summit."
Piot has also expressed concern at the attention focused on
anti-AIDS drugs, especially in the past few months and during South Africa
successful battle against the big pharmaceutical companies opposed to the
country's resort to the use of generic drugs to treat infected people.
"The better job we do on prevention, the less people
will need treatment. And so we have to continue to intensify
prevention...while at the same time building up the treatment. We have
to do both. It is not we have a choice," Piot said.
Piot warned however against compulsory testing of people for
the AIDS virus so as not to drive people underground, especially against the
growing practice, in some countries, demanding HIV-free certificates from
couples seeking to get married in churches or those seeking employment.
Source: Panafrican News Agency (Dakar)
Racial &
Ethnic Gap Seen In Medical School Promotions
Despite gaining ground in medical school admission or
acceptance, minority physicians in position of medical school faculty are less
likely to be promoted compared with white faculty. That is what came out a
new study published in JAMA (2000;284:1085-1092).
" In 1980-1981, 2.6% of newly appointed assistant
professors were underrepresented minorities (URMs) including black, Mexican
American, Puerto Rican, Native American and Native Alaskan, 10.3% were Asian or
Pacific Islander (API) and 1.9% were other Hispanics," wrote Ernest Moy,
MD, and colleagues at the Association of American Medical Colleges, in Washington, D.C.
By the 1996-1997 calendar year, these number rose: 4.6% of
newly appointed assistant professors were URMs, 13.8% were APIs, and 2.1% were
other Hispanics. A much smaller increase was noted among associate
professor appointments over the same period.
"Although these increases indicate steady improvement in
the representation of minority faculty, they suggest that medical schools have
ben more successful at recruiting minority junior faculty and less successful at
helping minority junior faculty achieve senior rank," wrote Dr. Moy in the
study.
The authors of the study reviewed over a 17-year period
official rosters of medical schools faculty and tracked the promotions of more
than 33,000 assistant professors and more than 16,000 associate professors. The
following troubling trends were found:
- Only half of the minority faculty members who became
assistant or associate professors in 1980-1981 had been promoted after 17
years of follow-up;
- Minority faculty members in particular face many barriers
to advancement (relative risk, 0.68 for assistant professors and 0.81 for
associate professors);
- Minority faculty, in general, are affiliated with
departments and medical schools with lower promotions rates and are less
likely to be on tenure tracks or to receive National Institute of Health
awards;
- Minority faculty and API faculty are more likely to be
women.
Source: JAMA ( 2000;284:1085-1092)
CLINTON
SIGNS MINORITY HEALTH BILL
President Clinton
on Nov. 22, 2000 signed into law a bill creating a center at the National Institutes
of Health to study health disparities among the country's minority
populations.
The center (National Center on Minority Health
and Health Disparities) will coordinate research to identify areas where NIH
studies into minority health problems are insufficient.
" It is unacceptable that African American
men have a higher overall cancer incidence and infant mortality rates than any
other racial or ethnic group; Hispanic and Native Americans suffer much
greater rates of diabetes and Asian American and Pacific Islanders are
afflicted with extraordinary high levels of cancer of the liver," Clinton
said.
The new law authorizes more than $150 million
for the new center, increases funding for research on race and health
disparities at the Agency for Healthcare Research and Quality and creates a
new program to attract health disparity researchers. (Source: AP)
Ed. Foot Note: This law is the end result
of fights led at different levels by prominent African Americans individuals
and organizations to ensure fairness in the American healthcare system (more
on that below).
LEGISLATING FAIRNESS IN
HEALTHCARE
The U.S. Surgeon General David Satcher testified last May
2000 before
Congress about the need of improving the quality of health care for
minorities. Satcher ended his testimony by reminding the
committee of the premise on which the U.S. Public Health Service was founded
in 1798 -- "to the extent we care for those most vulnerable among
us, we do most to promote and protect the health of the nation.
NMA SEES BLACK HEALTH
PROBLEMS AS CRUCIAL CIVIL RIGHTS ISSUES
Rodney G
Hood, M.D., the new president of the National Medical Association (NMA), said
fighting racism will be the first priority of his new administration in order
to eliminate racial disparities in the American health care.
"I have definitely worked out an agenda to raise the question of racial
disparities as well as the impact that racism has on the cost of those
disparities," Hood told The Medical Herald. Dr.
Hood was talking after the 99th convention of the NMA held this year (2000) in
Washington, DC.
The NMA was
founded in 1895 as an organization serving the interests of African Americans
physicians and patients in the US. Hood, 54, a San Diego internist
called racism and racial disparities his No. 1 focus as NMA
President.
According to Dr. Hood, the disparities take the form of
inadequate treatment for deadly diseases such as cardiovascular diseases,
cancer, HIV/AIDS. During his declaration, the new NMA president
referred to articles which were published in the New England Journal
of Medicine clearly pointing out that racism affects the health outcomes
of African Americans. He said educating people about those disparities was
important. Increasing the number of African Americans entering medicine and
the health field was also necessary, stated Dr Hook whose statements were
echoed by several NMA key members also concerned about the shortage
of black physicians and the progressive elimination of affirmative action.
"The new
stance by the NMA to focus on discrimination marks a dramatic departure for
the conservative organization", wrote The Medical Herald.
SOURCE: American Journal of
Public Health 2000;90:1436-1443.
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