Traditional and Complementary Medicine: Where Are We?-Juniper Publishers

Juniper Publishers
As physical fitness and healthy diet not very easy to obtain and maintain, interest in Traditional and Complementary Medicine (TCM) is growing wider day by day. There are lots of synonym terms globally, but Turkish Ministry of Health accepts TCM officially. National Center for Complementary and Integrative Health (NCCIH) divides TCM approaches into two main groups [1]:
I. Natural products
II. Mind and body practices
Among natural products there are herbs, vitamins and minerals or dietary supplements. These are the most common approaches in USA as well as the other countries [2]. In the second group, there are yoga, chiropractice, acupuncture, etc. Besides these two groups, there are also some other practices such as homeopathy, nathuropathy and ayurveda.
World Health Organization (WHO) promotes the interventions that both improves the quality and standardization and also facilitates the integration to health care systems [3]. WHO reports that in 80% of member countries acupuncture is used and covered by health insurance in 13% of them? In some member countries. TCM is the first line of health care, where in others, is complementary to the health care approaches because of the historical and cultural effects. Especially for physical fitness, dietary supplements, lifestyle changes, chronic conditions and cancer care, TCM is used very common all over the world [2]. Despite the widespread use of TCM, physicians underestimate the TCM use by their patients [4].
In WHO Traditional Medicine Strategy Report 2014-2023, the goals were indicated as to support Member States in:
1. Harnessing the potential contribution of TCM to health, wellness and people-centered health care.
2. Promoting safe and effective use of TCM through the regulation, evaluation and integration of TCM products, practices and practitioners into health systems, as appropriate [3].
In this report, key strategies were mentioned as:
1) To build the knowledge base for active management of TCM through appropriate national policies.
2) To strengthen quality assurance, safety, proper use and effectiveness of TCM by regulating TCM products, practices and practitioners.
3) To promote universal health coverage by integrating TCM services into health care service delivery and self-health care.
For the second strategy WHO suggests the countries to recognize the importance of regulations: Education and Training. According to this report in 2012: 119 member countries reported that they have TCM policy and 69 members had TCM regulations on herbal products. 39 members were with TCM education at university level. In most countries, health insurance does not cover TCM modalities, which means a huge amount of money out-of-pocket spending on TCM [5]. Other important issues about TCM are education/ training, safety and quality. Still in many countries, legislation, policy and educational issues cannot be solved or in progress.

Turkey’s Status

In Turkey, which is one of the TCM use is very common, national policy and legislation are being established [6,7]. Although TCM Administrative Regulations were published by this Ministry in 2014 [8], Turkey is better far from many countries regarding policy and regulations [9]. Legislation on drugs was begin so long ago, but after European Union harmonized standards, it gets accelerated [10-12]. A department was established attached to the Ministry of health (Department of Traditional and Complementary Medical Applications), and as the interest in plant-origin-products increased, a Herbal Committee to registrate the herbal medicines was founded [13]. After Regulation on Pharmaceutical and Medicinal Products was published in 2003 [14], Regulation on Traditional Plant Medical Products was published in 2010 [15]. Besides, on March 9th 2019, Regulation on Clinical Researches of the Traditional and Complementary Medical Applications came into force [16].
By all these regulations, administration places, administrative people, administration criteria, administration and research rules were edited and being under control of the Ministry. Therefore, quality also can be obtained by interoperability. Although there are some efforts, health insurance coverage issue is still unresolved.
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