WHO's programme: the approach will focus on the psychosocial and anthropological aspects of traditional medicine, on acupuncture and other healing methods, and on the claims made for herbs and medicinal plants

-----O's Progrannne on the psychosocial and aspects of traditional medicine, on acupuncture and other healing methods, and on the claims made for herbs and medicinal plants The approach will focus anthropological BY R. H. BANNERMAN I Traditional and indigenous sys-tems of medicine have persisted for many centuries, even in parts of the world where modern health care is readily available. The idea of mobilizing the manpower component of traditional medicine for purposes of primary health care, particu- larly in rural areas, has been gaining ground in many countries in recent years. An initial beginning was made with traditional birth attendants, because of the acute shortage of trained midwives. A meeting on the training and utiliza- tion of traditional birth attendants was held in 1972 at WHO headquarters in order to develop the kind of training programmes, research and studies that could improve the services of these work- ers in their respective communities. In 1974 a joint UNICEF/WHO study on alternative approaches to meeting basic health needs in developing countries recommended the mobilization and training of practitioners of traditional medicine, including traditional birth at- 16 tendants, for primary health care services. This was endorsed the following year by an Executive Board resolution and the idea was given support at the World Health Assembly in 1977, when a resolu- tion sponsored by several Third World Member States was passed by acclama- tion for the promotion and development of training and research in traditional medicine. Several Member States have already initiated training programmes for the traditional birth attendants, and orienta- tion courses and seminars for other health professionals. In 1976, WHO's Regional Committee for Africa had " Traditional Medicine and its Role in the Development of Health Services in Africa" as the topic for technical discussion . The Regional Committee for South-East Asia also adopted a resolution in the same year calling for the promotion of traditional and indigenous systems of medicine in the Region. This was followed by a semi- nar in Colombo, Sri Lanka, that made pragmatic recommendations about how to implement trammg, service and research programmes. June 1976 saw the foundation at WHO headquarters of a working group for the promotion and development of tradi- tional medicine. Its aim was to coordi- nate the various activities relating to the subject, and it prepared a programme with the following objectives: - to foster a realistic approach to tradi- tional medicine so as to promote and further contribute to health care; - to explore the merits of traditional medicine in the light of modern science so as to maximize useful and effective practices and discourage harmful ones ; - to promote the integration of proven valuable knowledge and skills in tradi- tional and modern medicine. High priority will be given to the devel- oping countries particularly with regard to primary health care within the context of the country's political structure, eco- nomic resources and development plans. Execution of the programme will be effected in close collaboration with the regional offices and, primarily, at the Dr. R. H. Bannerman (right ) , Secretary of WHO's Working Group on Traditional Medi- cine, is greeted by Chinese Vice-Premier Chi Teng-Kuei during the recent Study Tour on Traditional Medicine in Community Health Services in China (see page 23) (Photo WHO ) country level and with active community participation . The suggested approaches include the formulation of national health policies so as to contain provisions concerning traditional medicine and mechanisms of coordination, and better utilization of the useful elements of traditional medi- cine in the country's health care sys- tem. The administrative machinery needed to ensure effective planning, uti- lization and supervision of practitioners of traditional medicine will be reviewed within the context of the national health care delivery system. A questionnaire has already been designed for the collection of all avail- able information concerning practition- ers of traditional medicine, their training and services to the community. The ana- lysis of information collected, together with the results of surveys and research findings , will no doubt assist us all in the development of meaningful training pro- grammes for the various categories of practitioners of traditional medicine. Doctors, nurse/midwives, other health workers and students of health sciences will all be encouraged to undergo orien- tation in traditional medicine where ap- propriate. Multidisciplinary investigations into systems of traditional medicine will be encouraged, and special attention will be given to laboratory and clinical investi- gations for identifying effective remedies, comprising medicinal, plants, animal products and mineral substances. Inves- tigations will also be conducted into the psychosocial and anthropological as- pects of traditional medicine, as well as the mechanisms of acupuncture and other healing methods. Wherever possible, priority will be given to the promotion and development of useful local resources such as herbs for the production of medicinal substances; such action should effectively reduce the drug bills of many developing countries. Traditional healers and some modern physicians depend to a large extent on herbs and medicinal plants for treat- ment. The story of herbal medicines is a fascinating one- quinine, until recently, was the only cure for malaria ; morphia remains a most effective pain-reliever ; rauwolfia is still widely used for the control of hypertension and certain forms of psychiatric disorder, and herbal pre- parations have been used for many decades to treat rheumatoid arthritis . Recently, we have received serious claims that herbs are being used in China, tropical Africa and Central America for the control of diabetes mel- litus. All these claims have to be invest- igated scientifically and authenticated. There are clear indications of a major breakthrough in therapeutics and health care delivery, and those of us involved in the traditional medicine programme share fully the goal of our Director- General, that we should achieve total health care coverage for all people by the year 2000. • 17