(WP)TLRlICP/HRF/5.1I001lTLR
English only
Report series number: RS/2003/GE/45(CHN)
REPORT REGIONAL MEETING ON NETWORK FOR POLICY AND PROGRAMME DEVELOPMENT IN TRADITIONAL MEDICINE Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Shanghai, People's Republic of China 11-13 December 2003
Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines April 2004 WHOfWPRO LIBRARY
MANILA. PHILIPPINES
CONTENTS
SUMMARY .................................................................................................................................. I INTRODUCTION ........................................................................................................................ 3
1.1
Objectives ..................................................................................................................... 3
1.2 Pa.ticipants ................................................................................................................... 4
1.3 Organization ................................................................................................................. 4 1.4 Opening ceremony ........................................................................................................ 4 2. PROCEEDINGS ................................................................................................................... 5 2. I 2.2 2.3 2.4
Introduction: purpose of the meeting, procedures and expected outcomes ............... 5 Traditional medicine and the Western Pacific Region ................................................. 5 Country repOlts ............................................................................................................. 5 Lessons learned from experiences in implementing a national policy on traditional medicine ...................................................................................................................... 13 2.5 Overcoming challenges and difficulties in legislation and policy development on traditional medicine .................................................................................................... 14 2.6 Closing ceremony ....................................................................................................... 15
3.
CONCLUSIONS AND RECOMMENDATIONS .............................................................. 15 3.1 Conclusions ................................................................................................................ 15 3.2 Recommendations ...................................................................................................... 2 I ANNEXES: ANNEX I LIST OF PARTICIPANTS, TEMPORARY ADVISERS, OBSERVERS AND SECRETARIAT ...................................................... 23
ANNEX 2 - OPENING SPEECH OF DR SHIGERU OM I, REGIONAL DIRECTOR, WHO REGIONAL OFFICE FOR THE WESTERN PACIFIC ............... 27
SUMMARY
The Regional Meeting on Network for Policy and Programme Development took place in Shanghai, China from II to 13 December 2003. The main objectives ofthe meeting were: (I) (2) (3) (4) to review the national action for implementation of the Regional Strategy on Traditional Medicine; to identify the challenges and difficulties faced by Member States in implementing the regional strategy; to share experiences on legislation and policy development on traditional medicine; to propose proper approaches for legislation and pol icy/programme development with consideration of situation and status for individual countries; and to discuss the establishment ofa regional network for policy development and programme implementation on traditional medicine.
(5)
The meeting was attended by II palticipants from 10 countries of the Western Pacific Region, two temporary advisers and the responsible officer from the WHO Regional Office for the Western Pacific. Professor Li Zhen-Ji from China was elected Chairperson for the meeting. He served as Chairperson on II December 2003, after which Professor Shen Zhi-Xiang from China took over as Chairman from 12 to 13 December 2003. Dr Umadevi Ambihaipahar from Papua New Guinea was elected as the Vice-Chairperson, while the Rapporteurs were Mr Lee Young-Ho from the Republic of Korea and Dr Nor Shahidah Khairullah from Malaysia. Dr Yang Xiao-Du, Vice-Mayor of Shanghai, China welcomed all participants, temporary advisers. observers and guests present for this WHO Regional Meeting. Dr Zhang Jian-Zhong, Chairman of Administration Committee, Shanghai University of Traditional Chinese Medicine (SUTCM). conveyed his appreciation to WHO for conducting this meeting at SUTCM, and expressed hope that the relationships between SUTCM and WHO would be strengthened through this meeting. This was followed by the opening remarks of Dr Shigeru Omi, Regional Director of the WHO Regional Office for the Western Pacific, delivered by Dr Choi Seung-Hoon, Medical Officer, Traditional Medicine, WHO Regional Office for the Western Pacific. Country reports were presented covering country efforts on development of national policy on traditional medicine for the recent five years. lessons learnt in implementing the national policy and the challenges and difficulties faced in legislation and policy development. Future plans of each participating country were also discussed.
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The recommendations of the meeting are as follows: WHO should:
(\) make regular contacts to urge Member States, where national policies in traditional medicine are absent, for the development of national policies within the time-frame recommended in the Regional Strategy; (2) provide assistance and technical support to Member States to formulate, develop and review their respective national policies and action plans; (3) organize regular workshops, expert meetings and consultaneies to share experiences to develop national policies; (4) coordinate and facilitate the development of guidelines and standards of traditional medicine in the Member States; (5) work closely with Member States for proper use of traditional medicine through evidence-based research and health care; (6) provide a general framework to deal with issues relating to intellectual property management; and (7) co-ordinate the establishment of and maintain the Network for Traditional Medicine Policy and Programme (NTMP) to suppOtt the exchange and dissemination ofinfonnation, development and review of existing national policies, and training of personnel, Member States and areas should: (I) develop and review national policies and action plans on traditional medicine as part of the national health care system under the guidance and within the time-frame recommended in the Regional Strategy; (2) nominate an official representative and focal point for traditional medicine;
(3) participate actively in the NTMP to collaborate with WHO, other Member States and international organizations in the exchange of information for the development of national policies, training of personnel and the establishment of standards; (4) make appropriate reference to the findings of this regional meeting;
(5) give particular attention to issues and concerns related to the protection of intellectual property rights of medicinal plant products and traditional practices as well as to the conservation of biodiversity; and (6) provide regular repotts to WHO concerning the progress of policy development and implementation of traditional medicine policy, as appropriate,
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INTRODUCTION
In the Western Pacific Region. traditional medicine is still widely practised. The existing and ever increasing public demand on traditional medicine has led to a change in attitudes among governments in the Region towards traditional medicine. In order to ensure the proper use of traditional medicine and its possible integration into the mainstream of the health service system, more and more countries in the Region have developed or are in the process of developing their own national policy on traditional medicine in order to promote the proper use of traditional medicine and to protect the safety of the public. In October 1999, WHO Regional Office for the Western Pacific organized a Workshop on Development of National Policy on Traditional Medicine in Beijing for those countries in the Region who expressed a willingness to initiate efforts for policy development. The workshop highlighted the importance of having a national policy on traditional medicine and the significant role by governments in developing action plans for their own traditional medicine programmes. Since then, WHO has prepared the Regional Strategy for Traditional Medicine, which was adopted by the WHO Regional Committee for the Western Pacific during its 52"d Session held in Brunei Darussalam in September 200 I. The Regional Strategy for Traditional Medicine establishes a blueprint for the development of traditional medicine in the Region, which serves as a guide to national governments, WHO and other partners. The regional strategy also recommends that, where appropriate. Member States should use the regional strategy as a framework for the development of national traditional medicine programmes. During the meeting. country/area reports were presented by the representatives from 11 Member States and reviewed by the participants. Reviewing the conclusions and recommendations of Beijing Workshop, the difficulties in developing a national policy and programme on traditional medicine were identified and its solutions were proposed. The participants recommended that an appropriate national policy and programme should be developed by each Member State and a network for national policy and programme should be established and maintained for the dissemination of information, development and review of existing national policies and training of personnel. 1.1 Objectives (1) To review the national action for implementation of the Regional Strategy for Traditional Medicine. (2) To identify the challenges and difficulties faced by Member States in implementing the regional strategy. (3) To share experiences on legislation and policy development on traditional medicine.
(4) To propose proper approaches for legislation and policy/programme development with consideration of situation and status for individual countries.
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(5) To discuss the establishment of a regional network for policy development and programme implementation on traditional medicine. 1.2 Participants
Eleven participants from 10 countries attended the meeting. The participants were policymakers, decision-makers and administrators of traditional medicine programme in their respective countries. Two temporal'y advisers frolll Australia and the Philippines were invited to provide their expertise during the meeting, and a WHO staff served as secretariat. The list of participants is attached as Annex I. 1.3 Organization
Professor Li Zhen-Ji fi'om China was elected as the Chairperson for the meeting. He served as Chairperson on II December 2003, after which Professor Shen Zhi-Xiang from China took over as Chairperson from 12 to 13 December 2003. Dr Umadevi Ambihaipahar from Papua New Guinea was elected as the Vice-Chairman, while the Rapporteurs were Mr Lee Young-Ho from the Republic of Korea and Dr Nor Shahidah Khairullah from Malaysia. 1.4 Opening ceremony
Professor Shen presided over the ceremony and introduced the distinguished guests and participants. Dr Zhang lian-Zhong, Chairman of Administration Committee, Shanghai University of Traditional Chinese Medicine (SUTCM). conveyed his appreciation to WHO for conducting this meeting at SUTCM, and expressed hope that the relationships between SUTCM and WHO would be strengthened through this meeting. He added a brief introduction about SUTCM and wished the outcomes of this meeting would contribute to the development oftradilionalmedicine in the Region. Professor Li Zhen-li, Deputy Director-General of State Administration of Traditional Chinese Medicine (SATCM) expressed his pleasure for the convening of the meeting and conveyed his support for continuous collaboration with WHO in the area of traditional medicine. Dr Yang Xiao-Du. Vice-Mayor of Shanghai, China welcomed all participants, temporary advisers, observers and guests. He also expressed his appreciation to WHO's partnership with Shanghai during the outbreak of severe acute respiratory syndrome (SARS), and stressed his strong will to support this meeting and the coming 55'" Session of the Regional Committee in September 2004 in Shanghai. This was followed by the opening remarks of Dr Shigeru Omi, Regional Director of the WHO Regional Office for the Western Pacific, which were delivered by Dr Choi Seung-Hoon, Medical Officer. Traditional Medicine. WHO Regional Office for the Western Pacific. He highlighted the importance of having a national policy on traditional medicine and the significant role played by governments in developing action plans for their own traditional medicine programmes, and stressed WHO's firm commitment to increasing its support to countries in having established an effective network for policy and programme development in traditional medicine. Dr Omi's opening remarks is attached as Annex 2.
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2. PROCEEDINGS
2.1
Introduction: purpose of the meeting, procedures and expected outcomes
Dr Choi outlined a proposed work schedule and recommended that because this was a follow-up meeting, discussion should be based on the document developed by the workshop held in Beijing, China in October 1999 entitled, Development ofNalional Policy on Tradilional Medicine. Likewise, the Regional Strategy for Traditional Medicine in the Western Pacific was also used as a reference document. Issues related to regulations, research and education were also mentioned. There were series of WHO meetings conducted in 2003 on these key issues, including the recent Forum on Harmonization of Herbal Medicines (FHH) meeting in Kunming, China. The working methods of the meeting include country presentations and plenary discussions, wherein the objectives of the meeting and country future plans were discussed. During the meeting, participants are expected to propose proper approaches for legislation and policy/programme development with consideration of situation and status for individual countries. The understanding of these proper approaches for policy/programme development would lead to the establishment ofa regional network for policy development and programme implementation in traditional medicine. 2.2 Traditional medicine and the Western Pacific Region
Dr Choi presented the background on the first meeting to develop a national policy on traditional medicine, which was held from II to 15 October 1999 in Beijing, China, and subsequent events that led to the present meeting. The first regional meeting was held among 18 participants from 17 countries in the Region. Consequently, the Regional Office came out with the publication entitled, Development ofNational Policy on Traditional Medicine. Among the main themes of this publication included the definition of traditional medicine (TRM) and its scope; WHO's supporting resolutions; the popUlation using TRM; reasons for broad use ofTRM being easy, effective, economical and safe; the preventive, curative and rehabilitative roles of TRM, and other general issues. Dr Choi also cited the Regional Strategy for Traditional Medicine in the Western Pacific Region for 2001-2010. 2.3 2.3.1 Country reports China
The Constitution of the People's Republic of China makes specific reference to the need to develop both modern and traditional Chinese medicines. In the mid-I 980s, the Regulations on the Management of Medical Facilities were established, which covers both traditional Chinese medicine (TCM) and Western medicine. In 1986, the State Council decided to set up the State Administration of Traditional Chinese Medicine (SATCM), and in 1988, the function was revised to add the management of pharmaceutical products. In 1997, the State Council's National
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Conference on Health Service reiterated that it attached equal importance to both TCM and modern medicine. The two systems are practised side by side at every level of the health care system. Since 1999, relevant administrative bylaws and regulations were promulgated to govern TCM, namely: the Law of the People's Republic of China on Medical Professional Practitioners; the Law on the Management of Pharmaceutical Products; the Administrative Regulations on the Conservation of Wild and Medicinal Resources; and the Regulations on the Protection of Diversity of Pharmaceutical Products ofTCM.
In October 2003, the Regulations on Traditional Chinese Medicine in the People's Republic of China were put into force, marking a significant milestone on the development and management ofTCM. Under the sponsorship and coordination of SA TCM, 150 regulations, technical standards and norms were developed concerning establishment ofTCM, medical and health care, training of personal, science and technology, external exchanges and cooperation, etc. At present, local policy development on TCM is also developed vigorously in 23 provinces, autonomous regions and municipalities. In 1999, Hong Kong (China) also adopted legislation on TCM to promote the health of the public and ensure the legitimate right ofTCM.
In implementing national policies, challenges and difficulties included insufficient financial support to conduct research and develop TCM, and limited recognition by some doctors of Western medicine of the role ofTCM in tile treatment of diseases. China's future plans, with reference to the Regulations on Traditional Chinese Medicine in the People's Republic of China, include the provinces formulating a plan of action for the implementation ofTCM regulations, and refining the existing criteria and standards ofTCM in terms of treatment, research, education and manufacture. 2.3.2 Hong Kong (China)
Article 138 of the Basic Law of Hong Kong Special Administrative Region provides that the Government shall formulate policies to develop Western and traditional Chinese medicine and improve medical and health services in both branches. In 1989, the Working Party on Chinese Medicine was created, followed by the Preparatory Committee on Chinese Medicine (PCCM) in 1995. In 1999, the Chinese Medicine Ordinance enacted by the Legislative Council made provisions for the registration of practitioners in Chinese medicine, the licensing of traders in Chinese medicine, the registration of proprietary Chinese medicine, and other related matters. The Chinese Medicine Council was established in September 1999. It is a statutory regulatory body responsible for devising and implementing the regulatory measures. Transitional arrangements were provided for registration ofTCM practitioners, licensing of Chinese medicine traders and registration of proprietary Chinese medicines taking into account the historical background, the standard of the Chinese Medicine Practitioners (CMPs), and the principle of not adversely affecting the livelihood ofCMPs.
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At present, there are about 3300 listed CMPs and about 4700 registered CMPs. They must comply with the code of practice and meet the requirements for continuing education for the purpose of renewing their certificate to practise. Chinese medicines are regulated through a licensing system for traders and a registration system for proprietary Chinese medicines (PCMs). So far, more than 6800 applications for trader's licenses have been received and are being processed. The registration of PCMs is planned to commence by the end of December 2003. On education, there are now three universities providing full-time undergraduate degree courses in TCM. As for service provision in the public sector, the aims are to support the practice of evidence-based medicine and clinical research as well as to facilitate the development of standards and models of interface between Chinese and Western medicine. The first phase of TCM service provision will be the establishment of three TCM clinics in public hospitals by the end of2003. In implementing national policies, challenges and difficulties included the reluctance of some practitioners and traders to accept the registration criteria and its cost implications, and concern for adequacy of infrastructure support.
2.3.3
The Lao People's Democratic Republic
The Research Jnstitute of Medicinal Plants (RIMP) was established in 1976, and a traditional medicine hospital was established in 1991. In 1995, the Minister of Health signed the National Lao Policy on Traditional Medicine, mentioning: (I) the promotion of the establishment of a traditional medicine network throughout the
country;
(2) the encouragement to healers applying their knowledge to solving health problems of Lao people; (3) the strengthening of infrastructure of the Traditional Medicine Research Center to
ensure its scienti fie research and support its network;
(4) the integration of the use of traditional medicine and medicinal plants with primary health care programme; (5) the encouragement of scientific research on TRM and medicinal plants for new medicament development; (6) (7) the protection of traditional healers' intellectual property rights (!PR); and the registration ofTRM healers.
In the past fi ve years, the Traditional Medicine Research Center (TMRC) has researched 670 traditional remedies and more than 870 medicinal plants, of which some have high medical value for malaria, tuberculosis, HIV / AIDS and diseases related to central nervous system. The Lao-Vietnam Friendship Traditional Diagnostic and Treatment Clinic was established in 200 I and more than 3000 patients have been treated.
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In implementing national policies, challenges and difficulties included the false perception of the Western medical doctors that TRM has fewer roles in the health care mainstream; the shortage of skilled staff on TRM; and the lack offunds to improve the infrastructures for scientific studies on TRM. A traditional medicine hospital, which has been under construction since mid-2002, will soon be inaugurated. This hospital will provide better health care to people in the six Northern Provinces, the most geographically and socioeconomically difficult areas. 2.3.4 Malaysia
A Standing Comminee on Traditional/Complementary Medicine was formed in 1988 to advise and assist the Ministry of Health in formulating policies and strategies for the monitoring of traditional/complementary medicine (T/CM). The Drug Control Authority is responsible for registration ofT/CM products. Licensing of traditional medicine importers has been implemented since 1999. The National Policy on Traditional/Complementary Medicine was officially launched in August 2001 and envisages that T/CM shall be an important component of the national health care system to achieve a holistic approach towards enhancing health and the quality of life. To achieve this, the mission entails to ensure the quality and safe use ofT/CM practices and products. It will coexist with the modern medicine and contribute towards enhancing the health and quality of all Malaysians. To encourage buy-in and ensure effective implementation of the T/CM policy and the advocated guidelines put forth by the Ministry of Health, all existing T/CM groups are categorized accordingly into umbrella bodies, namely Malay, Chinese, Indian, Complementary and Homeopathy. These national bodies, which are registered with the Registrar of Societies and appointed by the Minister of Health, register and self-regulate T/CM practitioners to ensure the compliance of standard codes of practice and conduct of certain modalities. TI,ree other high-level committees formed to assist in the implementation of the National Policy on T/CM include the T/CM Standing Committee chaired by the Deputy Director of Health (Research & Technical Support) with representatives from professional bodies, WHO, umbrella bodies and local universities. The T/CM Council is a higher body chaired by the Director-General of Health with nominated members from various stakeholders. It advises the T/CM Standing Committee on the direction and development ofT/CM in Malaysia. The National Committee on Research and Development in Herbal Medicine, which was approved by the Malaysian Government in 2002. ensures rigorous research and development in herbal medicine for safe, efficacious and quality herbal medicinal products by putting in place activities such as development of relevant guidelines, identification of training and infrastructure needs, creating harmonization among researchers as well as intersectional research collaboration. The Global Information Hub in Integrated Medicine was recently launched on 20 October 2003 to provide real-time information on the different modalities associated within T/CM to appropriate stakeholders including policy-makers, regulators, consumers, T/CM practitioners, researchers, health care professionals and the industry. In implementing national pol icies. challenges and difficulties have included: a lack of acceptability by mainstream medical practitioners of the valuable contributions made by T/CM in health care; the resistance among T/CM practitioners to adopt evidence-based practices; a lack of
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mutual respect and understanding due to misunderstandings of each other's philosophy of practice; a lack of adequate manpower with expertise and knowledge in TICM to initiate a comprehensive education programme; the difficulty in instilling awareness among grass-roots consumers ai>ollt the potential adverse effects of some TICM services and produCl~ due to strong . cultural beliefs; a lack of coordination, harmonization, and collaboration in herbal medicine research and development among researchers; and a lack of oversight among TICM practitioners regarding the impOltance of quality products to ensure safety. The future of Malaysian T/CM is its incremental integration into the mainstream health care system; a dedicated institute for evidence-based TCM research; the formation of a TICM division within the Ministry of Health to look at practice, products and training; and the launching of the T/CM Act. 2.3.5 Mongolia
In 1990, the government prioritized the development of Mongolian TRM. In 1990, a Traditional Medicine Department was set up in the Mongolian Traditional Medical School of Health Science University. In 1996, the government announced its support for incorporation of remedies used by TRM into the mainstream health service system. In 1999, a Resolution of the State Great Khural Parliament was approved on strategies to develop TRM hospitals, training of TRM manpower and for production of medicinal drugs meeting good manufacturing practices (GMP) requirements. In 2000, the Ministry of Health developed "The National Policy on Developing Mongolian Traditional Medicine up to Year 2005." As o[year 2002,262 traditional medical doctors are working in both state and private traditional medical hospitals, and there are 1.1 traditional medical doctors per 10 000 people, surpassing modern medical doctors. Out ofthe 7600 hospital beds in general hospitals in Mongolia, 606 beds are assigned to traditional medicine, of which 338 (56%) are in state hospitals and 269 (44%) are in private medical hospitals. Since 1989, the Mongolian Traditional Medical School of Health Science University has offered a six-year training course, each year admitting 20 to 25 students for study of traditional Mongolian medicine. As of 2003, 1558 doctors were trained in traditional medicine, out of which 558 have a bachelor degree in Mongolian Traditional Medicine. The remaining J000 Western medicine doctors completed either a one-year resident course, a two-year masters degree or a three-year PhD in traditional Mongolian medicine. There are two private medical colleges called "Manba Datsan" Traditional Medical College and "Monos" Medical College, each offering a five-year curriculum. In research, Ia new types of herbal medicines have been registered in the Ministry of Health. In implementing national policies, challenges and difficulties have included the difficulty in studying traditional medicine "secrets" using modern, Western scientific methods as well as difficulty in combining both Mongolian traditional medicine and Western medicine in clinical practice.
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2.3.6
Papua New Guinea
In 1999, the Department of Health recognized the importance ofTRM by cre.ating an Officer-in-Charge in TRM to facilitate and sustain its national health progral~me, glVIn~ particular attention to the use ofTRM as complementary therapy to the.officlal allopathic system. In 1999, the Department of Health supported a national workshop drafting (he. TRM ?rogr~mme in the "National Health Plan for 200 1-20 I0", which was approved by the Parliament s National Executive Council in 200 I. Since 2000, a National Task Force has been established to implement the general policies on TRM programmes. In 2001, ajoint effOit between the University of Papua New Guinea and the Department of Health on TRM research and policy development was started. In November 200 I, a national workshop was held for local TRM practitioners, academe and researchers, and government agencies, wherein a consensus was recommended on (I) The Concept of Scope and Role ofTRM in Papua New Guinea: and (2) Traditional Medicine - The Way Forward in a New Era. A pre-survey information-gathering 011 botanical identification, ethnographic description, pictorial records, herbarium specimens, biological activities and chemical constituents of600 medicinal plants in 19 provinces was done, leading to the draft manuscript on "Medicinal Plants of Papua New Guinea", which is now ready for WHO publication. In December 2002, the Department of Health prepared an electronic database on medicinal plants, which includes (I) prescription database. (2) chemistry database. (3) photo-image database. and (4) practitioners' database. In 2003. a national group composed of traditional healers, environment conservation sectors, government medical officers and academic researchers was created to a draft "Detailed Policy Document on TRM". In implementing national policies, challenges and difficulties included: insufficient documentation in TRM; a lack of relevant coordinated research on herbal medicines and therapeutic benefits; a lack ofpublic information about TRM; a lack of knowledge, acceptance and low priority 011 TRM by some orticials of the Department of Health; as well as a lack of understanding and cooperation among traditional healers and medical officers and other professional health workers. In addition, there is a lack of manpower, technical and financial support for research, regulation, education and clinical services. There is also a need to have a national legislation on TRM. "The Electronic Database on Medicinal Plants of Papua New Guinea" will be officially launched soon. By March 2004. a National Workshop on Traditional Medicine will be held to formalize specific policy documents andTRM legislation issues. In addition, Papua New Guinea will create the formation ofTRM practitioners' network; the developments of training modules in primary health care for TRM practitioners; the evaluation and selection of I 0-20 medicinal plants and remedies for home and self-health care and the international collaboration to improve knowledge and skills on TRM for medical officers and students.
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2.3.7
The Philippines
III 1992, the Traditional Medicine Programme was started in the Department of Health. And in 1997. the Traditional and Alternative Medicine Act (TAMA) was signed by the President of the Philippines and the Congress, stating the policy of the State to improve the quality and delivery of health care services to (he Filipino people through the development of traditional and alternative health care and its integration into the national health care delivery system. The act also created the Philippine Institute of Traditiollal & Alternative Health Care (PITAHC). Since 2000. community-based training on herbal medicines has been teaching the public (0 be self-reliant, government herbal processing plants have been rehabilitated for production of affordable herbal medicines. and traditional and alternative health care have been integrated into the health sciences curriculum. There was also the creation of a national policy, Executive Order 247, on the regulation of access to biological and genetic resources in the Philippines. Since October 2003, data have been collected on practitioners, associations, organizations and diseases addressed by the different TRM modalities. for inclusion in a national database. A website is now available for public information. In December 2003, the first quarterly newsletter of PIT AHC was approved for publication. In implementing national policies. challenges and difficulties included weak advocacy, poor coordination of government regulation agencies and stakeholders, and no integration of different groups and organizations practising alternative medicine. A National Nutritional Campaign for the well-being of school children, which is based on a new paradigm of health, will be launched by January 2004. There will also be the establishment of well-being clinics to act as models for government and private institutions; the establishment of an extensive library. including books. audio-visual compact discs on alternative therapies, by first quarter of2004; guidelines on licensing of natural herbal products; a code of ethics for acupuncture. massage, chelation therapy, homeopathy, chiropractic massage and iridology; and a national clinical research database of all significant cases and testimonials submitted by practitioners in traditional medicine. 2.3.8 The Republic of Korea
In 1952, the National Medical Law recognized both modern and TRM. Since 1987, the National Health Insurance System has included TRM. In June 1993, the Oriental Medicine Division was founded and later expanded to the Oriental Medicine Bureau in 1996. The Korean Institute of Oriental Medicine was established in 1994, and in 1996 a Clinical Research Centre for Oriental Medicine was established. Since 1998, standardization requirements on traditional medicines have been expanded to all of the 514 items registered in the Official Traditional Medicines List. The criteria have been established for the maximum allowance of heavy metals and residual agricultural chemicals in the traditional medicines so that harmful medicines may not be imported, manufactured or distributed. The government set up the Oriental Medical Specialist Systems in 1999 to specialize and advance the clinical practices of traditional medicine. In August 2003, "Traditional Medicine and
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Pharmaceutics Promotion Act" was legislated. This Act aims to formulate an institutiOl~al basis for the promotion and development of traditional medicine and pharmacy 111 the Republic of Korea. In an effort to enhance the country's technology and its industrialization of traditional . medicine, the government is investing 208.7 billion Won for research and dev~lopment (2010 Project) from 1998 to 2010 in five fields, such as cerebral diseases and 1I1ternal secretions. Since 1999, public-health traditional medicine doctors have been sent to the health centres located
in rural areas. In implementing national policies, challenges and difficulties included the pote~tial . conflict between TRM and Western Inedicine practitioners as well as financial constramts III research and development projects. For 2004, the number of public healtll traditional medical will be increased from 750 to 1000 and the and the number of health centres will climb from 137 to 173 to include small and medium-sized cities. Changing the educational system from a six-year medical college course to "4+4 graduate medical school system" is being considered. The National Health Insurance coverage on traditional medicine is quite limited, so the scope of the insurance is going to be expanded for the people's wider accesS to traditional medicine. There will be the activation of a cooperative medical service with the expectation of creating a new model of medicine in Korea. 2.3.9 Singapore
In 1994, the Ministry of Health appointed a committee headed by the Senior Minister of Health and Education to review the practice ofTCM and recommend measures to safeguard patients' interests and safety. In November 1995, a Traditional Chinese Medicine Unit was established; it was later renamed, in 2000, as Traditional and Complementary Medicine Branch. In 1996, self-regulation mechanisms were started for listing TCM practitioners, upgrading the standard of practitioners' training. In 1999, the regulation on Chinese Medicine Materials (CMM) started focusing on Chinese Proprietary Medicines (CPM). In November 2000, a Traditional Chinese Medicine Practitioners Act was passed. Registration of TCM practitioners started in 200 I, with the implementation of relevant legislations and the establishment of the TCM Practitioners Board. The registration ofTCM practitioners was conducted in two stages, The registration of acupuncturists under transitional arrangement, which was completed in 2001, was followed in 200 I by the registration ofTCM physicians. The registration under transitional arrangement will be complete by the end of2003. For CMM, the registration ofCPM was implemented over a three-year period and completed in 200 I. All impol1ers, wholesalers, local manufacturers and assemblers were licensed, and more than 8000 CPM products were registered. In implementing national policies, challenges and difficulties included the registration of practitioners with varied background on TCM practice, The Singapore government will be upgrading the TCM practice in terms of training, standards of practice and the registration of herbal dispensers.
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2.3.10
Viet Nam
The official position ofTRM in the medical system is based on a statement by President Ho Chi Minh in 1955, that being, Viet Nam should "inherit valuable experiences from traditional medicine and at the same time study the possibility of combining TRM with modern medicine in order to establish our own medicine". In 1980, the constitutions called for the integration ofTRM and modern medicine.
In November 2003, for the first time, the Prime Minister signed and promulgated a "National Policy on TRM from the year 2003 to 2010". There are five research institutes and 49 provincial hospitals ofTRM; 80% of general hospitals at the central or provincial level have a TRM department or team. Thirty per cent of the village medical stations are using TRM for diagnostics and treatment, and there are over 10 000 private TRM clinic establishments. Viet Nam has produced a solid cadre ofTRM physicians who have mastered the knowledge of TRM combined with modern medicine, including three professors, 12 associate professors, 35 doctorates, more than 100 graduates with masters degrees, more than 100 Grade-II Hospital Specialists, more than 500 Grade-I Hospital Specialists, more than 2000 doctors in general TRM, and 5000 middle-ranking officers. In addition, there were 3850 medicinal plant species, 406 animal species, 70 mineral classes investigated and classified in the Materia Medica. In 2001, the essential medicines listed by the Minister of Health included 184 semi-finalized products, 90 finished products and 60 medicinal plant products. In implementing national policies, challenges and difficulties included the unequal development of organization system ofTRM; the lack and backwardness of equipment; the lack of staff, especially officers-in-Iead and community staff; the lack of scientific research work in the field ofTRM; the need for the combination ofTRM and modern medicine be strengthened; the weak management ofTRM; and the spontaneous cultivation and development of Materia Medica. As stated in the "National Policy on TRM from the year 2003 to 2010", the future plans of the Viet Nam government are to complete a system of organizing and controlling TRM at all levels; to perfect a system of establishment for examination and treatment by TRM; to increase TRM to occupy 30% of medicine circulated in the market; to set up medicinal plant gardens in all medical levels from centre to region; to perform the solutions and policies on management, manpower; to modernize varying forms of services listed in the Materia Medica; and to guarantee finances and promote international cooperation. 2.4 Lessons learned from experiences in implementing a national policy on traditional
medici lie Dr Alfonso Lagaya introduced the formulation of a national policy as done by strategists among top-level public health planners and even strategists among businessmen and military planners. Quoting the work of Han Hyun-Woo's Effectiveness o/Traditional Medicine Policy Formulation as presented at the International Symposium on Traditional Medicine in Kobe, Japan in September 2000, policy formulation starts with a policy issue wherein a policy agenda is set, e.g. health problems in society. Focusing on disease, disability and death, the gathering of data through the country's mortality incidences, morbidity incidences and demography and disease structure may provide a picture of health issues for that particular country. The country's current
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health care delivery system is then analysed for gaps in implementation, coupled with an analysis of political. economic and sociocultural factors. One common issue experienced by most countries in implementing a national policy on traditional medicine is the high cost of health care products and services beyond the reach of the majority. The integration ofTRM services and products is one of the most widely accepted solutions. Because of constraints in resources such as finances, manpower, technology, equipments and supplies, a wise public health strategist would never promote and create national policies involving all modalities at the same time. In developing a strategy. a review of the available TRM services and products of relevance is warranted, followed by some of the best strategic practices namely: stakeholder (beneficiaries and competitors) listing and political mapping; stakeholders' analysis of their strengths, weakness, opportunities and threats (SWOT); strategic options; strategic decisions and implementation; and evaluation and control. In analysing their opportunities, countries that seek to attain a national TRM policy should take into account assistance provided by WHO and 14 countries and areas in the Western Pacific Region that have developed official government documents and have recognized traditional medici ne and its practice. Once a strong national policy is attained, the above strategic steps may still be used for policy implementation. The above suggested steps are intended with the creation of a national policy as the immediate goal, while taking into consideration its ultimate health effects, economic effects and social effects of the people. 2.5 Overcoming challenges and difficulties in legislation and policy development on traditional medicine
Professor Charlie Changli Xue summarized the common challenges and difficulties experienced by member countries and areas in legislation and policy development on traditional medicine. The most common issue is the lack of country-specific definitions of traditional medicine that reOect the specific scope of practice of traditional medicine modalities in individual countries and areas (i.e. the situation in South-East Asian countries and areas is significantly different than other South PacifIC areas). Professor Xue also mentioned his experience working as a WHO consultant in Brunei Darussalam in 2003. There, the public in large tended to believe that acupuncture and herbal medicines were more mainstream. Instead, what was believed to be traditionall11edicines were Indonesian herbal medicine, BOl11oh (a spiritual healing method), etc. Thus, the public tended to be more interested in the theoretical basis of these therapeutic approaches. Other challenges and difficult issues included understanding the public usage of these modalities; collecting reliable information on traditional medicine professionals; developing an effective communication mechanism between the traditional medicine profession and the public, government as well as other health care professions; addressing concerns on quality and safety of herball11edicines; knowledge in infection control for acupuncture and other
- 15-
manipulative therapies; developing educational programmes and standards; assuring quality of traditional medicine educalion; and addressing issues related to research methodologies in traditional medicine research and mechanisms in dealing with public complaints concerning traditional medicine practice. The legislation for Chinese medicine in Victoria, Australia was used as an example to illustrate approaches / strategies that may address these issues. It was concluded that a network-including leading regulators and academia-would be useful for promoting legislation and policy development in traditional medicine in the Western Pacific Region. 2.6 Closing ceremony
The closing ceremony was held in the morning of 13 December 2003. Dr Choi thanked all the participants. the two temporary advisers, the Chairperson and Vice-Chairperson and the Rapporteurs and observers for their contributions to this meeting. Professor Shen Zhi-Xiang, Chairperson, expressed his appreciation to Dr Choi for his organization of the meeting and thanked Shanghai University of Traditional Chinese Medicine for hosting the meeting and oITering kind hospitality to the meeting attendees. On behalf orthe participants, Dr Constance Chan from Hong Kong (China) and Dr Southavong from the Lao People's Democratic Republic thanked WHO and Shanghai University of Traditional Chinese Medicine for organizing and hosting the meeting and expressed their appreciation of the excellent opportunity to exchange and discuss issues related to national policy and programme development in traditional medicine in the Western Pacific Region. 3. CONCLUSIONS AND RECOMMENDATIONS
3.1
Conclusions
The participants of the meeting recognized the need to review the publication entitled, Development a/National Policy OIl Traditional Medicine, and that slight modifications have been proposed on various issues covered by the publication, after due consideration was given to developments and achievements made since the meeting in Beijing in 1999. However, it was agreed that the definition of traditional medicine did not need to be changed. 3.1.1 Scope of traditional medicine The practice of traditional medicine includes: • • • • herbal and natural products; acupuncture: massage/manipulation; heat therapy;
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• • • • • 3.1.2
dietary therapy; exercise therapy; spiritual therapy; mental therapy; and other indigenous healing modalities. Role of traditional medicine
Traditional medicine is believed to have a promotive, preventive, curative and rehabilitative role with varying emphasis in different countries/areas. It can be the main form of health care, or an integrated component of the mainstream health care, or an alternative or complementary component to the main fonn of health care in the countries in the Region. 3.1.3 Acceptance of traditional medicine by the public Traditional medicine is accepted by the public because it's: • effective;
• • • • • 3.1.4
accessible; culturally believed and acceptable; relatively safe with few adverse effects; preventive and health enhancing; and cost-effective and affordable. Role of government in the field of traditional medicine
Because traditional medicine continues to playa significant role in health care in many countries and has been reappearing in others, governments should give traditional medicine appropriate recognition to improve the image and standard of the practitioners by ensuring the provision of safe and effective practice. This can be done through policy changes, regulations, registration, improving training and research of traditional medicine. The roles of the government are considered to be the following: • • • policy-maker; legislalor; regulator;
- 17 -
• • • •
developer of referral systems, structures and facilities for traditional medicine; developer of repository of databases; maintainer of registry/directory of practitioners; and enabler, in areas of: • insurance,
• • • 3.1.5
training and education, product research and development, and regulation of practice.
Need for a national policy on traditional medicine A national policy on traditional medicine is needed for the following reasons: • The use oftraditionalmedioine is widespread in some countries and is the only available form of health care system in others. It will assess and define the role of traditional medicine in health care delivery systems.
•
•
Government commitment is needed to ensure the direction, action and provision of financial and other resources. It will ensure the promotion of safety, efficacy and quality of traditional medicines.
•
• .• 3.1.6
It could assist in the control of the increase of medical expenditures. Traditional medicine could be an alternative and cost-effective form of health care. Steps for development of a national policy
The government is the leading body for development of a national policy on traditional medicine. Development of a national policy may consist of the following steps: (I) system-wide review to collect and disseminate information to enable the government to understand and appreciate the role oftraditional medicine in the community; (2) identifying a national focal point or management body devoted to traditional medicine (e.g. the ministry of health);
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(3)
organizing an advisory committee or task force comprising: champions of traditional medicine; stake holders; lay people; and local and foreign experts (including traditional medicine practitioners, pharmacists, botanists, academics. medical doctors. lawyers. environmental and conservation departments, etc.);
(4)
conducting a thorough situational analysis to provide information and make recommendations to the government in order to make an informed policy decision; providing a draft policy statement;
(5) (6)
organizing nationwide workshops and national consultations involving stakeholders, inCluding the government. the public, practitioners (e.g. doctors, pharmacists, pharmacologists. traditional health practitioners) and other relevant organizations;
(7) getting approval/endorsement from relevant government authority, and, if applicable. legislation to support the national policy; (8) (9)
developing a strategic plan; allocating funds; implementing national policy; and evaluating and monitoring.
(10)
(II) 3.1.6
Contents of a national policy
In general. the national policy should include a definition of the government's role in the development of traditional medicine in the health care delivery system. Safety efficacy and quality should be stated as the guiding principles. The policy should also include vision and mission as well as goals and objectives of the traditional medicine policy. Vision The vision of tile government on traditional medicine could include the following points: Definition of traditional medicine An individual country may wish to give its own definition of traditional medicine as related to its cultural, social and economic values.
•
Contribution of traditional medicine in health care system
" II
I' I I,
I
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The government should address the likely contribution of traditional medicine to the health care delivery system of the country. Benefits of traditional medicine The government should explain the benefits of traditional medicine for the society and the economy of the country. Positioning and interface between traditional medicine and Western medicine in health care system. Mission
A mission is a general statement that defines tasks and functions to be performed by the government and its designated agency. A government should define its mission according to the particular needs of the country. A mission could include the following points: • promotion of the proper use of traditional medicine particularly in PHC delivery system; the government's responsibility for the traditional medicine programme; need for new legislation or expansion of laws already existing in the country, taking into account the existing international conventions; regulation of traditional medicine practitioners, provision of infrastructure as far as applicable, development of code of ethics and practice for practitioners; education and training of practitioners; regulation of raw materials, semi-finalized and finished products; acceptable standards of safety and quality; consideration on potential coverage by state health insurance; capacity-building of traditional medicine human resources in order to strengthen expertise of government in traditional medicine; conservation of plants and allimals (conventions of biodiversity and endangered species); sustainable practice: promotion and advocacy (dissemination of information inside and outside governments); research and development;
• •
•
• • • • •
•
• •
•
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• • 3.1.7
international technical cooperation and exchange; and monitoring and evaluation of implementation of the national policy on traditional medicine. Difficulties in developing a national policy and programme in traditional medicine
The following difficulties could exist: • • • • lack of political will; lack of understanding of the role of traditional medicine; resistance to change: reluctance/non-cooperation by practitioners and manufacturers to government intervention in traditional medicine; financial constraints; difficulty in reaching a consensus in accreditation of practitioners; lack of qualified manpower within and outside government; shortage of personnel in government to ensure sustainability of traditional medicine; and lack of coordination among governmental agencies Proposed solutions Solutions for existing difficulties mentioned above can consist in: • advocacy by education and information dissemination to raise public awareness on traditional medicine; open discussions and consultations; convincing the government of long-term financial benefits of traditional medicine; allowing practice of both systems of medicine to complement each other (where applicable); introducing traditional medicine curricula to the Western system (where applicable); introducing education and training to traditional health practitioners;
• • • •
• 3.1.8
• • •
• •
,
'
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•
convincing other health care providers that traditional medicine policy is not to compete with them but to complement the existing health care; mobilizing financial resources (plan of action, lobby in budget proposals); a transition period/grace period given to practitioners and manufacturers (phase by phase through consultations; government incentives) before regulation is introduced; working out a credible system of accreditation. developing professional organizations (associations of traditional medicine practitioners ); capacity/capability-building (intercountry exchange programmes/technical cooperation ); liaison with WHO. other international organization and other countries; and collaborate with nongovernmental organizations as long as government takes a leading role to ensure capacity-building and sustainable development.
• •
• •
•
• •
3.2
Recommendations
The participants of the workshop provided the following general recommendations to WHO and its Member States. WHO should: (I)
regularly urge Member States, where national policies in traditional medicine are absent, to develop national policies within the time-frame recommended in the Regional Strategy;
(2) provide assistance and technical support to Member States to formulate, develop and review their respective national policies and action plans; (3) organize regular workshops, expert meetings and consultancies to share experiences to develop national policies: (4) coordinate and facilitate the development of guidelines and standards of traditional medicine in the Member States; (5) work closely with Member States for proper use of traditional medicine through evidence-based research and health care; (6) provide a general framework to deal with issues relating to intellectual property management; and
- 22-
(7) coordinate the establishment of and maintain the Network for Traditional Medicine Policy and Programme (NTMP) to support the exchange and dissemination of information, development and review of existing national policies, and training of personnel. Member States and areas should: (I) develop and review national policies and action plans on traditional medicine as part of the national health care system under the guidance and within the time-frame recommended in the Regional Strategy; (2) nominate an official representative and focal point for traditional medicine;
(3) participate actively in the NTMP to collaborate with WHO, other Member States and international organizations in the exchange of infoonation for the development of national policies, training of personnel and the establishment of standards; (4) make appropriate reference to the findings of this regional meeting;
(5) give particular attention to issues and concerns related to the protection of intellectual property rights of medicinal plant products and traditional practices as well as to the conservation of biodiversity; and (6) provide regular reports to WHO concerning the progress of policy development and implementation of traditional medicine policy, as appropriate.
II II
"
)' , I
J
- 23 ANNEX I
LIST OF PARTICIPANTS, TEMPORARY ADVISERS AND SECRETARIAT
1. PARTICIPANTS
CHINA, PEOPLE'S REPUBLIC OF
Professor Li Zhen-Ji Deputy Director General State Administration of Traditional Chinese Medicine No. 13 Baijiazhuangdongli Chaoyang District Beij ing 100026 People's Republic of China Tel. no.: 86 1065953924 FAX: 861065911268 Professor Shen Zhi-Xiang Director-General Department of International Cooperation State Administration of Traditional Chinese Medicine No. 13 Baijiazhuangdongli Chaoyang District Beijing 100026 People's Republic of China Tel. no.: 8610659 11264 FAX: 86 1065911268 E-mail: shenzhixiang@natcm.gov.cn
HONG KONG (CHINA)
Dr Constance Chan HOIl-Yee Assistant Director Traditional Chinese Medicine Department of Health Wu Chung House 17'" and 21" Floors 213 Queen's Road East Wanchai Hong Kong Tel. no.: (852) 21265100 FAX: (852)21239566;21265100 E-mail: constance_chan@dh.gov.hk
LAO PEOPLE'S DEMOCRATIC REPUBLIC
Dr Bounhong Southavong Traditional Medicine Research Center Ministry of Health Vientiane
Lao People's Democratic Republic Tel. no.: (856) 21 31 5693 FAX: (856)21312353 E-mail: bsouthavong@hotmail.com
- 24 Annex I
MALAYSIA
Dr Nor Shahidah Khairullah Director National Institute for Natural Products and Vaccinology Secretary National Committee for Research and Development in Herbal Medicine clo Virology Unit Infectiolls Disease Research Centre Institute for Medical Research Jalan Pahang 50588 Kuala Lumpur Malaysia Tel. no.: (603) 2693 5070/40402345 FAX: (603) 26936323 E-mail: norshahidah@imr.gov.my Dr Namral Tumurbaatar General Specialist on Traditional Medicine Ministry of Health President of School of Traditional Medicine Health Science University P.O. Box 495 Ulaanbaatar 36 Mongolia Tel. no.: 976 II 343013; 99286896 (mobile) FAX: 976 II 343013 E-mail: tumurbaatar@nmum.edu.mn Dr Umadevi Ambihaipahar Officer-in-Charge of Traditional Medicine and Principal Advisor of Mental Health Services Department of Health P. O. Box 807 Waigani Port Moresby Papua New Guinea Tel. no.: (675) 3232993 FAX: (675) 323 2992 Ms Graciela Eleazar Officer-in-Charge Philippine Institute of Traditional and Alternative Health Care Unit 2402, Atlanta Centre 31 Annapolis Street Greenhills, San Juan Metro Manila Philippines Tel. no.: (63-2) 727 7621 FAX: (63-2) 727 6199
MONGOLIA
PAPUA NEW GUINEA
PHILIPPINES
- 25 Annex I
REPUBLIC OF KOREA
Mr Lee Young-Ho Director Oriental Medicine Policy Division Ministry of Health and Welfare Seoul Republic of Korea Tel. no.: 822503 7535 FAX: 8225037584 E-mail: youngholee@mohw.go.kr Ms l'Ig Peck Hiang Deputy Head Traditional Chinese Medicine Traditional and Complementary Medicine Branch Ministry of Health I 6 Co liege Road Singapore 169854 Tel. no.: 656236 1948 FAX: 656236 1948 E-mail: chuo_ng_peckJliang@moh.gov.sg Professor Ch" Quoc Truong Director National Institute for Traditional Medicine and Deputy-Director Department of Traditional Medicine Ministry of Health HaNoi VietNam Tel. no.: 8449432442 FAX: 844 822 9353 E-mail: truongcq@yahoo.com
SINGAPORE
VIETNAM
2. TEMPORARY ADVISERS
Dr Alfonso T. Lagaya Office of the Secretary of Health Department of Health San Lazaro Compound Manila Philippines Tel. no.: 09163525778 E-mail: alagaya@aimonline.org
- 26 Annex I
Associate Professor Charlie Xue Head The Chinese Medicine Unit RMIT University P.O. Box 71 Bundoora, Victoria 3083 Australia Tel. no.: 6 J3 99257745 FAX: 613-99257178 E-mail: charlie.xue@rmit.edu.au
3. SECRETARIAT Dr Choi Seung-Hoon Medical Officer, Traditional Medicine WHO Regional Office for the Western Pacific P.O. Box 2932 1000 Manila Philippines Tel. no.: (632) 528 9844 FAX: (632) 521 1036 E-mail: chois@wpro.who.int
- 27 ANNEX 2
OPENING SPEECH OF DR SHIGERU OMI REGIONAL DffiECTOR, WHO REGIONAL OFFICE FOR THE WESTERN PACIFIC DURING THE REGIONAL MEETING ON NETWORK POLICY AND PROGRAMME DEVELOPMENT IN THADITIONAL MEDICINE 11 DECEMUEH 2003, SHANGHAI, CHINA (DELIVERED BY DR CIIOI SEUNG-1l00N, MEDICAL OFFICER, TRADITIONAL MEDICINE, WIIO REGIONAL OFFICE FOR THEW ESTERN PACIFIC) HONOURABLE YANG XIAO-DU, VICE-MAYOR OF SHANGHAI, PROFESSOR LI ZHENJI, DEPUTY DIRECTOR-GENERAL OF STATE ADMINISTRATION OF TRADITIONAL CHINESE MEDICINE, DISTINGUISHED PARTICIPANTS, LADIES AND GENTLEMEN, I am very pleased to welcome you all to this workshop on traditional medicine. On behalf of the World Health Organization, I would like to express my sincere appreciation to the Government of Chin a for hosling this very important meeting. I would also like to give our he8l1feilihanks 10 Ihe Siale Adminislralion ofTradilional Chinese Medicine and to the Shanghai University orTradilional Chinese Medicine for organizing this meeting. Traditional medicine has been practised for hundreds of years. It was the only available method of health care in this part of the world before Western medicine was introduced to Asia. Traditionalmcdicinc has contributed greatly to maintaining human health and to combatting various diseases. Even now. in spite of the widespread introduction of modern medicine in the Region, traditional medicine still plays a role in many countries. This increasing use oflradilionalmedicine is also raising the interest of govern men Is. In October 1999, the WHO Regional Office for the Western Pacific convened the Workshop on Development of National Policy on Traditional Medicine, which was held in Beijing, China. The workshop highlighted the importance of having a national policy on traditional medicine and the significant role played by governments in developing action plans for their own traditional medicine programmes. Since then. WHO has prepared the Regional Strategy for Traditional Medicine. This strategy identified four broad needs which countries face in the practice of traditional medicine in the Region. They are: • • political supp0l1; appropriate standards for traditional medicine;
• •
an evidence-based approach: and conservation of indigenous health resources.
The Regional Strategy was endorsed by the WHO Regional Committee during its 52"d session held in Brunei Darussalam in September 200 I.
- 28 Annex 2
It has been four years since the Workshop on Development of National Policy on Traditional Medicine was held in Beijing, China, and it is only fitting that China again host the regional meeting for policy-makers, decision-makers and administrators of traditional medicine programmes from selected cOllntries in the Region.
A major task of this meeting is to discuss the establishment of a regional network for policy development and programme implementation in traditional medicine. We would like to see that through this meeting, policy-makers, decision-makers and administrators of traditional medicine programmes will be able to work together closely to share information, expertise and resources. This way we may be able to achieve more when we meet again next time. Through the organization of!his meeting, WHO remains committed to increasing its support to countries in having established an effective network for policy and programme development in traditional medicine. With these few words, I wish you all a successful meeting and an enjoyable stay in Shanghai! Thank you.