1. World Health Organization
20 November, 2018
WHO Traditional Medicine Strategy
Dr Zhang Qi
Traditional, Complementary and Integrative Medicine
Service Delivery and Safety

2. Overview of my presentation
Global situation in T&CM
WHO TM strategy
Implementation of the strategy

3. Demand and need to T&CM
Over 100 million Europeans are currently T&CM users, with one-fifth regularly using T&CM and preferring health care which includes T&CM . There are many more T&CM users in Africa, Asia, Australia and North America.
In Australia, of those randomly interviewed, 68.9% used at least one form of CAM in the past 12 months and 44.1% visited CAM practitioners.
In US, a national health survey in 2007 revealed that more than $34 billion is spent on CAM annually and almost 4 out of 10 adults had used CAM.
In China, according to the recent national survey data, 907 million visits to traditional Chinese medicine – 18% of all medical visits; 13.6 million traditional Chinese medicine inpatients – 16% of the total in all hospitals.
In India, There are registered Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy(AYUSH) practitioners and an estimated one million village-based, traditional AYUSH community health workers.

4. Demand and need to T&CM
An extensive number of patients with multiple sclerosis resort to complementary and alternative medicine treatments: prevalence of use ranges from 41 percent in Spain to 70 percent in Canada and 82 percent in Australia.
In China, the top five diseases for admission to traditional Chinese medicine hospitals: cerebrovascular accident, intervertebral disc displacement, haemorrhoids, ischaemic heart disease and essential hypertension.

5. Demand and need to T&CM
Nearly a quarter of all modern medicines are derived from natural products, many of which were first used in a traditional medicine context. TM is thus a resource for primary health care, but also for innovation and discovery.

6. World Health Organization
Progress since 2002 in T&CM
World Health Organization
20 November 2018

7. Regulation on practitioners in T&CM56
(43.5%) 17
(13%)
129

8. Education in T&CM
129
72 (56%)

9. Challenges in T&CM

10. Challenges
Progress relating to regulation on herbal medicines is moving faster, while regulation on TM practice and practitioners is advancing at a slower rate.
Member States where lack of knowledge in formulating national policy has led to a lack of regulations on TM practice and practitioners as well as a lack of integration of TM services into health service delivery and self-health care.

11. Member States & WHO

12. World Health Organization
HSS->UHC->SDG
20 November, 2018
SDG 3: Equitable health outcomes and wellbeing; Global public health security and resilient societies
SDG 1: No poverty
SDG 4: Quality Education
SDG 5: Gender Equality
SDG 16: Inclusive societies
SGD 8: Inclusive economic growth and decent jobs
SDGs
(Impact)
Achieve Universal Health Coverage
All people and communities receive the quality health services they need,
without financial hardship
UHC (Outcome)
Responsiveness Efficiency Fairness Quality Resilience
S e r v i c e D e l i v e r y
TCI
TCI
TCI
HSS
(Input/Output)
TCI
Workforce
Medical Products
Infrastructure
Information
F i n a n c i n g
TCI
G o v e r n a n c e
TCI
TCI

13. World Health Organization
20 November 2018
Universal Health coverage values and principles
T&CM
T&CM
T&CM 13 13

14. Health systems building blocks and outcomes
T&CM
T&CM
T&CM
T&CM
T&CM
T&CM

15. Why TCI can contribute to UHC and SDGs
SDG: Ensure healthy lives and promote wellbeing for all at all ages
T&CM close to cultural, social, economical, environmental and spiritual elements – sustainable development
Equity and universal access in health: T&CM is more available, accessible, acceptable and affordable
OTCs and non-medication interventions
Elderly care and healthy industry

16. Why TCI can contribute to UHC and SDGs
Increasing practice and requests to WHO for policy and technical support on integrative medicine and care:
To provide support on appropriate policy in the integration of T&CM into health services particularly in PHC.
To provide support on appropriate regulation in ensuring safety, quality and effective use of integrative practice in T&CM with conventional medicine.
To provide support on appropriate training for providers in integrative practice to ensure the safety and quality of its services.
To provide technical support on interactions of herbal medicines with other medicines as increasing use of herbal medicines with drugs.
To provide support on cost effectiveness in the integrative approaches.

17. Primary health care and TCI
Activities on 40th anniversary of Alma Ata Declaration
The role of PHC in achieving UHC and SDGs
The role of TCI in PHC
The role of WHO TM strategy and relevant WHA resolutions

18. WHO TM Strategy 2014-2023: Goals
Harnessing the potential contribution of T&CM to health, wellness, people- centred health care and universal health coverage
Promoting safe and effective use of T&CM through the regulation, research and integration of T&CM products, practices and practitioners into the health system, as appropriate

19. WHO TM Strategy 2014-2023: Objectives and directions
Build knowledge base for management through policies
Strengthen quality assurance, safety, proper use and effectiveness by regulation
Promote universal health coverage by integration
understand and recognize role and potential, build country profile
strengthen knowledge base, build evidence and sustain resources
capitalize on potential contribution to improve
health services and health outcomes
informed choice about self-health care
products: monitoring, enforcement, harmonization
practices and practitioners: education &training, skills development, services and therapies

20. Implementation of WHO TM Strategy: Indicators for monitoring
a national/
provincial T&CM policy
consumer education project/program for self-health care using T&CM
increased governmental/
public research funding on T&CM
Member States reporting
WHO
national plan/
program/
approach for integrating T&CM service into national health service delivery
national regulation for T&CM products
national/
provincial regulation for T&CM practice
national/provincial regulation/
registration for T&CM practitioners

21. WHA Resolution on Traditional Medicine
WHA67.18 adopted in May 2014 urges Member States :
To adapt, adopt and implement, where appropriate, the WHO strategy as a basis for national T&CM programmes or work plans
To develop and implement working plans to integrate TM into health services particularly primary health care services
To report to WHO on progress in implementing the strategy

22. WHA Resolution on Traditional Medicine
WHA67.18 requests the Director-General of WHO:
To facilitate Member States’ implementation of the WHO strategy, supporting their formulation of knowledge-based national policies, standards and regulations, and strengthening national capacity building
To provide policy guidance to Member States on how to integrate T&CM services within health care systems
To provide technical guidance in ensuring safety, quality and effectiveness of T&CM services

23. WHA Resolution on integrated, people-centred health services(2016)
Title: Strengthening integrated, people-centred health services
Urges WHO Member States to integrate where appropriate traditional and complementary medicine and modern health systems, based on national context and knowledge-based policies, while assuring the safety, quality and effectiveness of health services and taking into account a holistic approach to health

24. Promote the contribution through : Leadership-Integration and Q&S
Support MS in their efforts in providing more health care choices to meet people’s needs and demands
Review and identify the existing models of appropriate integration in MS particularly in PHC to support IPCHS, UHC, SDGs and to report good practices
Quality improvement and safety of traditional, complementary and integrative medicine(TCI) services (starting in acupuncture) - keep the world safe and “do no harm”
Quality and safety on herbal medicines
Qualified TCI practitioners

25. Promote the contribution through : Standards, norms and technical documents
A series of Benchmarks for practice in TCI:
Benchmarks for practice in Acupuncture and in Cupping
Benchmarks for practice in Ayurveda
Benchmarks for practice in Panchakarma
Benchmarks for practice in Tuina
Benchmarks for practice in Unani

26. Promote the contribution through: Traditional Medicine Chapter (Module 1)
Purpose: enable traditional medicine health services to count and be counted internationally.
Nature and scope: the chapter in its current form refers to disorders and patterns which originated in ancient Chinese medicine and are commonly used in China, Japan, Korea, Australia, America, Europe and elsewhere around the world.
It will be the case for creating a common language for this part of TM diagnosis and strengthening the integrative approach for improving people’s health. WHO EB progress report agreed and consensus reached in Tokyo ICD congress in Will be launched in June 2018.

27. Integration of T&CM into national health systems
Conventional medicine
Traditional and
complementary/ alternative
medicine
Integrative medicine
The patients and the public will be benefited from accessing more choices.