E-drug: NYT on WHO and traditional medicine
-------------------------------------------------------------------------
[ Copied as fair use. KM]
http://www.nytimes.com/2002/05/17/international/17MEDI.html?tntemail1
May 17, 2002
With Folk Medicine on Rise, Health Group Is Monitoring
By DONALD G. McNEIL Jr.
GENEVA, May 16 -- Assigning itself a Herculean task, the World Health
Organization took the first step today toward becoming the global watchdog
over unconventional medicine.
The organization, a branch of the United Nations, has long focused on
Western medicine, but it is looking closely at non-Western treatments,
because at least 80 percent of the people in the world's poorest countries
use them. Few of those countries can regulate their folk healers or share
their plant lore, which may be a miracle cure or a poison.
The group's mission to catalog and give information about such treatments
begins as they grow more popular in the West, and as the danger of some folk
remedies increases the numbers potentially at risk.
The treatments can be fatal. For example, the Chinese ma huang herb, which
contains ephedrine and helps breathing problems, caused heart attacks and
strokes among some Americans using it as a diet aid. Kavakava, a Pacific
Island anxiety-relieving tea, has poisoned the livers of those drinking a
concentrated form. Ginkgo biloba, which stimulates circulation, also
stimulates bleeding during surgery.
"We must act quickly to evaluate safety, efficacy, quality and
standardization," said Dr. Ebrahim Samba, the W.H.O.'s regional director for
Africa. Not only do patients need protecting, Dr. Samba said, but some
native medicinal plants with potentially lucrative new applications might,
too.
For example, artemisinin, a compound in a wormwood plant that has been used
as a fever remedy in China for 2,000 years, has become the world's most
effective new antimalaria drug. Sutherlandia frutescens, a South African
herbal tonic called cancerbush in English, is being tested on AIDS patients
to see if it helps them gain weight.
As defined by the W.H.O., folk medicine � sometimes called traditional and
alternative/complementary medicine � includes things from chiropractic care
and fad diets in Manhattan to porcupine quill injections in South Africa,
shamanistic trances in Siberia, Arabic unani medicine and faith-healing with
chicken guts in the Philippines.
Today, the Western-trained doctors who run the health organization
acknowledged that they were making a very modest beginning, on a budget of
$500,000, less than one-twentieth of 1 percent of the organization's $1.1
billion annual budget.
"We're not pushing to be the global anything � this isn't the black
helicopters," said Dr. Jonathan D. Quick, the organization's director of
essential medicines, joking about the conspiracy theory that a secret United
Nations army patrols the night skies in black helicopters. "There's no
W.H.O. policy that says, `You should regulate herbal medicine this way.'
We're just trying to get information out there."
But because it is the leading international health agency, its small
initiatives tend to grow in importance. A modest effort to identify
suppliers of cheap drug cocktails for AIDS and recommend dosages, for
instance, has led to substantial gains against the disease in Africa.
The group's ultimate goal is to catalog all folk remedies, making sure the
plants are saved in botanical gardens and the products patented country by
country. It also envisions writing common codes of ethics and training for
folk healers.
But for the moment, Dr. Quick's team is simply surveying the way different
countries train their practitioners and control their medicines. It is
compiling the existing studies and has published papers on 100 of the
roughly 5,000 medicinal plants that experts believe are in use.
Every study is expensive. Private ones now under way on ginkgo and St.
John's wort are costing $16 million and $5 million respectively, said Torkel
Falkenberg, of the Karolinska Institute in Sweden, who is an author of the
agency's strategy. Dr. Ossy Kasilo, the agency's specialist in African
remedies, said its first task was "to just undertake an inventory, then do
research on what works and what doesn't."
In China, where 95 percent of hospitals have folk medicine wards, treatments
are relatively advanced. But the practice is most prevalent in Africa, where
at least 80 percent of people use it, sometimes because it is the only
alternative. A W.H.O. survey found that while there was only one medical
doctor for every 50,000 people in Mozambique, there was a traditional healer
for every 200.
Africa is also the least regulated continent. Physicians in South Africa,
for example, angrily describe how their AIDS patients die of kidney failure
because a sangoma, a Zulu healer, has given them an enema containing an
essence made from powerful roots. Diseases are spread by injections done
with dirty razor blades or porcupine quills.
On the other hand, there are African remedies that seem to work on malaria,
sickle cell anemia, high blood pressure and some AIDS symptoms, Dr. Samba
said. "And for mental illness," he added, "traditional practitioners beat
psychiatrists hands down."
Most African healers learn their art by apprenticeship, so education is
inconsistent. But some African countries are taking the first step toward
regulation by creating healers' associations and offering courses on topics
like sanitary practices.
Folk practices are still common in the West, as well. For instance, in
France, where homeopathic medicine is popular, 75 percent say they have
tried alternative medicines, compared with 42 percent of Americans who
responded to a 1997 survey.
Dr. Quick of the W.H.O. said the field tended to divide into two poles,
"uninformed skeptics who don't believe in anything, and uncritical
enthusiasts who don't care about data."
"We want to convince the skeptics that some things work, and make the
enthusiasts more cautious because it can kill them."
--
To send a message to E-Drug, write to: e-drug@usa.healthnet.org
To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@usa.healthnet.org
Information and archives: http://www.healthnet.org/programs/edrug.html