Quick Links to Global News in Traditional, Alternative, and Integrative Health and Medicine for January 2015

This monthly Global Integrator features highlights on developments in traditional medicine and alternative and integrative health during a 1-month period. Here are 32 selections from India, Gambia, Vietnam, indigenous Canada, South Africa, Nigeria, Ethiopia, and elsewhere for the month of January 2015.

  • A professor speaking to the Nigerian Academy of Sciences makes the case for why Nigeria must develop medicine from natural sources.
  • A 400-year-old Xuan Duong Clinic run by a 16th-generation Vietnamese healer who mixes Western and traditional medicine is the subject of this feature: “Treating diseases and saving patients by combining Western and traditional Vietnamese medicine while honoring the traditional art of healing is the motto.”
  • In late-January meetings with Nguyen Hoang Son, deputy director of the Traditional Medicine Administration in Vietnam, traditional healers signed an oath to not use rhino horn medicinally.
  • Leading British herbal agencies are now among the 140 organizations and businesses endorsing the Botanical Adulterants Program led by 3 US not-for-profit entities.
  • In South Africa, the Herbal Drugs Research Unit at Tshwane University of Technology will begin looking into the healing properties of the country’s indigenous plants. They estimate that there are 200,000 traditional healers in the country.
  • This widely linked article from Indian Country media in the United States speaks to scientific findings that support traditional healing agents in used by indigenous peoples there.
  • The Ethiopian Ministry of Culture and Tourism in collaboration with Jimma University organized a conference on “Ethiopian Traditional Medicine: Underutilized/Threatened Heritage and its Prospects” January 16-17, 2015. See photo of participants.
  • Kirkland & Ellis is acting for Hong Kong’s China Traditional Chinese Medicine in a proposed $1.3-billion purchase of the largest manufacturer of concentrated traditional Chinese medicine granules in China.
  • The major British indexed medical journal The Lancet included this thoughtful article urging collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine for mental illness.
  • Plans for major study on Ayurveda’s potential led by author Deepak Chopra, MD, received attention from multiple media.
  • The cleverly titled “T(ha)ime Machine: Global Trends Turn Back to Thai Wisdom,” hosted by the Office of Knowledge Management and Development at Royal Paragon Hall, sought to draw attention to the nation’s traditional medicine traditions.
  • The crossover issues of healthcare integration and colonialism is the subject of this posting on the indigenous Canadian child who died recently after her parents chose to forego Western methods.
  • British Member of Parliament David Tredinnick is keeping up his call for the government to explore contributions of complementary medicine practitioners as a partial solution to the medical crisis there.
  • In Gambia, President Yahya Jammeh gave “high priority to traditional medicine” as he called for its full acceptance and integration into the delivery system while also calling for a crackdown on healers who oversell their services. The government is reiterating its 2009 ban on advertising of traditional medicines or any other forms of medicine “especially on the radio.”
  • Also in Gambia, before the end of 2015 the government, in collaboration with its Traditional Healers Association (TRAHAS), will host a World Summit of Natural Medicine Practitioners in Banjul in collaboration with the West African Health Organization.
  • A delegation of Russian military doctors visited Chinese doctors to explore integration of these methods in care of their soldiers. Russian Defense Minister Sergey Shoygu had previously expressed interest in establishing a Center of Traditional Chinese Medicine in Moscow.
  • In the city of Saurimo, Angola, a 2-day meeting was held to promote natural products “used in treating endemic diseases.” The event was promoted by the Provincial Directorate of Culture in Lunda Sul and the provincial governor, Cândida Narciso, pictured, attended.
  • In Karachi, conservative Pakistani president Mamnoon Hussain urged “practitioners as well as proponents of alternative medicine to focus towards scientific research as well standardisation of education and training in homoeopathy” and traditional practices.
  • In India, a crackdown on “two types of quacks—one kind is Siddha, Ayurveda and unani doctors who prescribe allopathic medicines or administer injections. And then there are those who claim to be traditional medicine practitioners but do not possess a registration number or educational qualifications.”
  • In Ghana, the National vice chair of the Ghana Federation of Traditional Medicine Practitioners (GHAFTRAM), Sheikh Amen Bonsu, has “urged the members to make sure that their medicines are prepared under strict hygienic conditions.”
  • Insurance payments for complementary and alternative medicine practices are under assault following a leaked government report.
  • A new goods and services tax in Malaysia may end up shutting down up to a third (1800) of the 6000 “Chinese medicine halls” in that country due to challenges in meeting computerization and other requirements.
  • The central government of India has announced that it will financially support a new Ayurvedic clinical research center on 50 acres in Kerala to help “scientifically validate traditional systems of healing.” The center will include a strong biotech unit. The government’s goal is to expand the already robust market for Ayurvedic medicine 5-fold by 2020.
  • Apparently, the Indian complex will also include India’s first center for the interdisciplinary study of medicine, the Amrita Institute for Integrated Medicine and Research Center.
  • A “reverse pharmacology process” is being explored in Palau for use of medicinal plants for diabetes and other nonpharmacological diseases following publication of a major study.
  • The use of deer antler therapy is being viewed as a potential growth area for medical tourism in Kazakhstan. The “wellness or health tourism” potential is said to be “from traditional cures like kumyss therapy, mineral and other water treatments and traditional medicine treatments including deer antler therapy.”
  • An excellent overview of the Indian government’s plans with its AYUSH department and the globalization of Ayurveda is here. Recent action in India has stimulated this reflection on the AYUSH department and the global movement for “integrative medicine” with the Arizona Center for Integrative Medicine (United States) referenced.
  • This article in Forbes speaks to the efforts in China to make a demarcation between those traditional medicines that can be added to food and those that cannot. This is in a country where food is definitely viewed as medicine.
  • Members of the Zimbabwe National Traditional Healers Association (Zinatha) are taking on “vendors who have flooded the streets selling the so called herbs for curing various ailments” calling them a danger to public health “as they are neither traditional healers nor herbalists.”
  • One of Shanghai’s 157 “intangible cultural traditions” was celebrated in the Chinese Global Times: the TCM practice of orthopedics.
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Indian Minister for AYUSH, Shripad Naik, on the Role of Traditional Medicine in Cancer Care

In early November 2014, Indian Prime Minister Naredra Modi appointed Shri Shripad Naik as India’s Minister of State. His responsibilities span both the traditional healing department, AYUSH, and Health & Family Welfare. In two state bulletins in early February 2015, Naik made public some of his views. In a World Cancer Day symposium talk in New Delhi, he took two tacks. First, he urged practitioners “to not only advise the treatment of patients with drugs, but also have the concept of modulating the life-style, dietary regimen, seasonal regimen and behavior to prevent and cure the diseases.” He asserted that these traditional approaches can be curative.

Naik added an integrative twist. Another “important area to be explored” is “integration of AYUSH with conventional healthcare system to reduce the side effects of chemotherapy, radiotherapy and to prevent the recurrence and metastasis and improve the quality of life of cancer patients.” A separate bulletin underscored Naik’s belief that “a scientific eye and mind is required to explore the value from the vast knowledge base of AYUSH for healthcare of cancer patients.” He offered a global view of cancer management that needs help: “It must be understood that stand alone modern medicine may not be sufficient to meet health needs of the society ailing with this dreaded disease.”

Comment: Naik is in leadership amidst a robust period for traditional medicines in India. Just 2 months before his appointment, Modi elevated AYUSH to its own independent ministry. The 6-month-old independent ministry has “as a part of its mandate to propagate the Indian systems of medicine globally.” Two days before the new ministry was celebrated, India announced an agreement with Bangladesh. The goal: create “a structured frame work for cooperation between the two countries for the promotion of Indian traditional systems of medicine and homeopathy in Bangladesh.” Similar memoranda of understanding (MoU) are in place with Malaysia, Trinidad and Tobago, and Hungary with others in consideration in Serbia and Nepal. (A memorandum with the Chinese State Administration of Traditional Chinese Medicine (SATCM) has expired.)

Naik’s view that India’s traditional medicine tradition must be explored “to cure” cancer effects runs contrary to thinking in the research establishment in the United States. The cofounder of the Society for Integrative Oncology, Bernie Cassileth, PhD, recently declared in an ASCO Post article entitled Long and Winding Road to Modern Integrative Oncology that the only value for non-conventional treatments is to diminish side-effects and assist with quality of life. Similarly, in a February 10, 2015, press conference, the director of the US National Institutes of Health National Center for Complementary and Integrative Health, Josephine Briggs, MD, essentially declared that natural agents have a lack of curative power for not just cancer but any significant condition. Briggs limited their value to “symptom management and promotion of health.”

Notably, Briggs and Naik are talking apples and oranges here. While the NCCIH tends to reduce its research questions to exploration of one therapy at a time, Naik speaks to AYUSH’s full court press of a whole-person, multifaceted system of traditional medical care. Here’s hoping that such research finds sufficient funding and excellent methodologists.

“Justified Traditional Medicine”: Establishing “Ethical Alternative Medicine Practice” in Zanzibar

The transition from the way traditional healthcare providers have worked in villages for centuries to the modern era is captured in this opinion piece in All Africa. Entitled “Tanzania: Why Traditional Healers Must Be Registered,” the story opens with the plight of traditional healer Omar Ali Mpendu from Ruifiji. He reportedly “came to the Isles three months ago and had a good reception from people in Makunduchi village, about 70 kilometers from the Stone Town. The community leaders of Mtende, Nganani, and Kijini said Mr Mpendu was good since his arrival in the village, winning praise from the local villagers.”

The healer’s problem: the Zanzibar Traditional and Alternative Medicine Council (ZTAMC), established under the Zanzibar 2008 policy on traditional medicine, requires a license to practice, which Mpendu couldn’t produce. The secretary of ZTAMC intervened. His decision to shut down Ali Mpendu’s practice was supported by Mohammed Saleh Jidawi, MD, from the Ministry of Health. Saleh Jidawi stated that “the need to publicly acknowledge and monitor the practicing traditional healers and protect the public wellbeing is among the priority of the health sector.” The author underscores that the Minister “recognizes the importance of natural therapy practitioners, and his ministry would continue to cooperate with them in upgrading to provide education and to research.” Reference is made to the importance of incorporating “healings that are in accordance with religious faith.” The strategy is “promoting access to justified traditional medicine care to all in need.”

For context, the author references the World Health Organization (WHO) definition of traditional medicine as “the health practices, approaches, knowledge and beliefs incorporating plant-, animal-, and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose, and prevent illnesses or maintain wellbeing.”

Comment: The piece is a balanced look at the way the movement for “integrative health” and interprofessionalism is framed in a nation where NGO-based medicine meets traditional practices. One healer who supports the growing dialogue with the government on traditional medicine regulation speaks to how “people need to know and understand the developed medicines from the west, and also the ‘African and Arabic magic’ therapy.” Interesting to think of “Justified Traditional Medicine” as a goal, even as “Evidence-Based Medicine” or, more truthfully, “Evidence Informed Practice” dominate the scene in the U.S. and Europe. The writer notes that a related area of incipient regulation is midwifery. Minister of Health Jidawi describes an integrative birth care ideal: “Traditional birth attendants play significant role in home deliveries where more than 50 per cent of birth occurs. With such a background there is an unequivocal need to ensure close collaboration and regulation between modern and alternative medicine practitioners.”

British Agency’s Thumbs-up to Midwifery Provokes Positive New York Times Article

Women with uncomplicated pregnancies (roughly 45%) are better off in the hands of midwives than of hospital doctors during birth. This is according to new guidelines by the British National Institute for Health and Care Excellence. The agency has advised healthy women that it is safer to have their babies at home, or in a birth center, than in a hospital. The reason: in a hospital, there is a greater chance of surgical intervention and therefore infection. Hospital birth was also found to increase costs: hospital births $2500, birth center births $2200, and homebirth $1500.

These recommendations “reversed a generation of guidance on childbirth” according to a December 3, 2014, New York Times article: “British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies.” The Times piece concludes with a quote from the clinical practice director at the British agency: “Yes, [hospital birth] is a very expensive way to deliver healthy babies to healthy women.” He adds: “Saving money is not a crime.” The article notes that “the findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them.”

Comment: Great to see these data jump the Atlantic. The Times article was notable for downplaying the national treasure midwives are considered in the Netherlands. Midwives on bikes, working their own neighborhoods, are the backbone of the best birth outcomes in any Western country. Cost may yet trump the power of the obstetricians in the United States. One day, hopefully, policy makers will understand that the ultimate cost savings will come when more mothers learn that the whole medical apparatus is not a requirement for them to have a baby. Side note: The state of Washington is the closest in the United States to have imagined that the United States should follow a similar evidence-based path. See Homebirth Midwives and the Hospital Goliath: Evidence Builds for Disruptive Innovation, the most commented upon article I have ever written for The Huffington Post. (Thanks to William Wulsin, ND, LAc, MPA, MPH, for the link to the Times piece.)

 

American Botanical Council Takes on International Partners to Help Heal an Industry Shadow via Adulterants Program

The end-of-2014 statement from the American Botanical Council (ABC) highlights international developments with its exemplary partnership to address one of the industry’s most intransigent problems. The program is the internationally-reaching Botanical Adulterants Program that ABC has worked to expand in recent years with two partners: the American Herbal Pharmacopoeia and the University of Mississippi’s National Center for Natural Products Research (NCNPR). The program’s already expansive set of endorsers recently received additional participation from the world’s largest medicinal plant research group, the Society for Medicinal Plant and Natural product Research (GA) and also from the International Alliance on Dietary/Food Supplement Associations (IADSA). In addition, two exceptional professionals are now working on the initiative. One is international regulatory expert Michael Smith, BPharm, ND, and the other is product chemist John Cardellina, PhD. Smith, a senior fellow at the Samueli Institute, has led regulatory initiatives in Canada and Australia. He was a top consultant to the World Health Organization’s Traditional Medicines Strategy 2014-2023.

A leading initiative of the adulterants program is the development of Laboratory Guidance Documents to “provide summaries and evaluations of existing analytical methods for determining authenticity and detection of adulteration of herbs already covered in the Botanical Adulterants Program.” The program’s first such document, on the herb skullcap, is about to be released. ABC anticipates that the adulterants program “will be picking up even more steam in 2015.”

Comment: This program is to the herb industry what the US Institute of Health Improvement’s (IHI) “100,000 Lives Campaign” was to the US medical delivery system. Each calls attention to an ugly shadow that many in each industry would consider just the kind of dirty laundry to not air in public. The IHI campaign responded to a 1999 report from the Institute of Medicine of the US National Academy of Sciences that found medical errors accountable for 98,000 deaths.

While death and product adulteration as outcomes are hardly of the same order of magnitude, from a public relations perspective each may be viewed as carrying similar weight within the respective industry. ABC and its partners are calling attention to both intentional and unintentional “errors” in the makeup of herbal products that can influence both their usefulness to consumers and their safety. Good for the IHI on the former. Good for ABC and ABC’s partners on the latter. The botanical industry is international. Notably, the ABC end-of-year statement also boasted that it has “added 10 new international experts to the ABC Advisory Board (and we’re planning on adding more).” Alignment of interest note: I serve on the ABC Advisory Board.

Naturopathic Group Announces 2016 Barcelona Conference as Field Moves Toward W.H.O. Status

Logo for ICNMThe 3rd International Congress on Naturopathic Medicine has been announced for Barcelona, July 1-3, 2016. The event, while young, boasts 140 Supporting Partners. Organizers suggest that over 50 nations will be represented totaling 500 delegates. The deadline for submissions is June 1, 2015. The conference has in the past been a key organizing site for the World Naturopathic Federation (WNF) which, among other things, is a strategy for the field to formally work with the World Health Organization (W.H.O.). That group is now functioning with an Interim-Committee. (See photo.)

Comment:  I was curious on hearing of the first ICNM conference in 2013 to see how well it would be attended. The link in time to the desire of many in the naturopathic field to gain W.H.O. status proved fortuitous for the ICNM; similarly, the ICNM has been good for the WNF aspirants. I was interested to see North America’s Consortium of Academic Health Centers for Integrative Medicine (now the Academic Consortium for Integrative Medicine and Health) on the list of nominal “Supporting Partners.” The site does not say what constitutes sponsorship.  It’s early: the ICNM site is yet in formation with its organizing team and chair not yet noted.

Notably absent among the 140 is the American Association of Naturopathic Physicians (AANP), the organization the represents the naturopathic profession in the United States. A query to AANP netted a reply that they’d just received a request and are processing it. However, many of the schools associated with the AANP in Canada and the United States are among those listed, as is the Naturopathic Medical Student Association. Meantime, the AANP’s commitment to the WNF, led for the AANP by Tabatha Parker, ND – a WNF interim-committee member – and AANP past-president Michael Cronin, ND, is evident in this article and video. One of the interesting dances in that act for the W.H.O. is how to knit together many of the organizations on the ICNM site into a more formal relationship: the “naturopaths” of India, the “heilpraktikers” of Germany, and the “naturopathic physicians,” subsets of whom have broad prescribing rights. Curious how this process with two thus far mutually supportive, but separate, conference and organization, will continue going forward.

Pakistan Government Challenges Acupuncturists to Set Regulations for Legalization

Photo of Saira Afzal Tarar According to this recent article, Pakistan’s Minister for National Health Services, Regulation and Coordination, Saira Afzal Tarar told attendees of a January 25, 2015 conference, ACU-CAM 2015, that the government is going to establish a Federal Health Commission to legalize acupuncture and some other natural modes of treatment. To do so puts a challenge to the country’s acupuncturists:  “The acupuncturists should give a programme to convince the health authorities to introduce this mode of treatment in hospitals of Punjab.” Suggested was “an institution on the lines of College of Physicians and Surgeons Pakistan (CPSP) for proper recognition of their qualifications and degrees.” The regulation is paired with a separate initiative to said to seeks to “eradicate quacks” from the country. The article states there are already 25,000 acupuncturists practicing in Pakistan. The conference was organized by the by Mir Khalil-ur-Rahman Memorial Society together with the Iffat Anwar School of Acupuncture and Complementary Medicine.

Comment:  Interesting associations for the birth of acupuncture. The memorial society is addressing injustice and imbalance in society and health minister Tarar is a ”conservative and feminist.” The proposed regulation will align with recommendations of the World Health Organization’s 2014-2023 strategic plan for traditional medicine.  The stated number of presently illegal but already practicing acupuncturists seems high given its present illegality. For reference, there are approximately 30,000 licensed in the United States where regulation dates back nearly a half-century. Notable among the faculty is Shahzad Anwar, MD who gained a specialization in pain medicine from Harvard University and medical acupuncture in China.