HerbalEGram: Volume 8, Number 1, January 2011
WHO Developing New Traditional Medicine Classification
The World Health Organization (WHO) recently announced a new
project that could bring greater respect and more widespread recognition to
traditional medicine* systems across the world. With the goal of easing and
encouraging the use of traditional medicine in clinical, epidemiological, and statistical settings, WHO’s International
Classification of Traditional Medicine (ICTM) will provide a harmonized
traditional medicine evidence base with stated terminologies and classifications for diagnoses and
interventions.1
In a
recent press release, WHO said the ICTM is in part a response to the increasing
worldwide usage of traditional medicine while classification and terminology
tools remain sparse. The classification will initially include information on
practices and customs in China, Japan, and the Republic of Korea, and will use
an interactive, online platform that traditional medicine users can use to
document terms and concepts with which they are familiar. Joining other
significant activities like the 1978 Alma Alta Declaration and the recent 2008 Beijing
Declaration,2 the ICTM further illustrates WHO’s dedication to aiding traditional medicine’s
globalization and integration into worldwide healthcare.
A
few of the expected outcomes that WHO has for the ICTM include the production
of data that can be used to objectively evaluate traditional medicine’s
benefits, safety, use, spending, and trends; as well as the ability to study
traditional medicine’s role in disease prevention and treatment. Additionally,
one accepted classification system will allow all countries throughout the
world to base their monitoring of traditional medicine on the same set of data.
“The ICTM may have wide impact on both traditional and
allopathic practitioners, as well as hospital administrators, insurance
companies, and policy makers,” said Ryan
Abbott, director of research and project management for Nova Worldwide
Consulting and a former member of WHO’s traditional medicine team (e-mail,
January 8, 2011). Abbott noted that this impact will likely be greater in countries such as the United States
where no comparable domestic classifications exist, as opposed to some Asian
countries that already have standardized, domestic versions of traditional
medicine disease classifications. “International standards should improve
communication between [sic] providers in different nations, and endorsement by
WHO still carries significant weight,” he continued.
“The ICTM may
have a legitimizing effect for traditional healthcare practitioners and
practices that are still looked down upon by allopathic providers,” said Abbott. “The use of traditional medicine in developed
countries such as the United States is significant, both in the number of
people using traditional medicine and in the out-of-pocket costs they are
willing to pay for traditional products and services. This initiative
potentially represents an important step toward greater integration of
traditional and allopathic medicine.”
ICTM
will join similar WHO classifications, such as the International Classification
of Diseases (ICD),3
which are meant to provide a consensual, meaningful, and useful classification
framework and language for governments, healthcare providers, and consumers.4 ICD, for example, is used to “classify diseases and other health problems
recorded on many types of health and vital records, including death
certificates and health records.”5 These informational records are stored and retrieved for clinical, epidemiological,
and quality purposes, and are also used by countries around the world to form
their mortality and morbidity statistics.
“Inclusion in the
WHO Family of International Classifications, a very conventional tool of
mainstream medical care, would be a powerful endorsement of traditional
medicine,” said Abbott.
Additional
impacts of the ICTM, according to Abbott, might include greater insurance
reimbursement for traditional providers and services and creating a more
scientific approach to traditional medicine by having answers to such questions
as how many patients have particular traditional diseases, which receive a
certain therapy, what are their outcomes, etc. “It may also help generate data
on drug-herb interactions, which is an area where data is sorely lacking,” he
continued. “Better data in this area may help patients avoid adverse effects,
and may also improve conventional reluctance on the part of physicians to
combine [conventional pharmaceutical] drugs and herbs.”
While the
positive effects of the ICTM are broad and significant, the potential for
challenges and negative effects exists as well. “Traditional medical practices
tend to be characterized by a highly individualized approach to treatment,
which may be difficult to reduce into simple or standardized terms,” said Abbott.
“Also, it will be challenging to translate traditional medical concepts into
terminology the mainstream medical community can understand and work with.”
Additional integration disadvantages include the possibility of traditional
medicine’s facing some of the same problems as mainstream medicine, such as the
modern role of billing and insurance that some consider to be a constraint on
clinical practice and physician autonomy.
Though
just announced by WHO in December 2010,
the first meeting discussing the project took place in May of 2010.6 The ICTM is currently being drafted and WHO hopes for it to be completed in
time for approval voting at the May 2014 World Health General Assembly.
*Traditional
medicine refers the practice of historical and indigenous systems of medicine
and is distinguished from modern conventional, mainstream, orthodox, standard-practice,
or sometimes, “allopathic” medicine, which is sometimes referred to erroneously
within the conventional medical profession as “traditional medicine.”
—Lindsay Stafford
References
4. The WHO Family
of International Classifications. World Health Organization website. Available
at: www.who.int/classifications/en/.
Accessed December 29, 2010.
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