Alternative medicine and its challenges

1. Alternative medicine and its 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

2. Definitions • 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)

3. Definitions • 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.

4. Definition • 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 Dawkinshas stated that "there is no alternative medicine • There is only medicine that works and medicine that doesn't work

5. Alternative medicine • 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“

6. Alternative medicine • 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

7. Alternative medicine • 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

8. Examples of CAM • 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

9. Examples of CAM • 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

10. Examples of CAM • Yoga • Herbs • Nutritional based • Dietary supplements

11. Examples of CAM • Traditional Chinese medicine • Ayurveda • Meditation • Homeopathy • Hypnosis

12. Components of Traditional Medicine • herbal medicine • surgery • bone-setting • spinal manipulation and massage • Psychotherapy • psychiatry • preventive medicine

13. Traditional medicine in Africa • 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

14. Herbal Medicines • These are sold as: • Tablets, Capsules • Powders • Teas • Extracts • Fresh or dried plants

15. Challenges • International diversity: • Traditional medicine practices have been adopted in different cultures and regions without the parallel advance of international standards and methods for evaluation

16. Challenges • 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

17. Challenges • 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

18. Challenges • 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

19. Challenges • 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

20. Challenges • 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

21. Challenges • 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

22. Challenges • 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