Participants in WHO Workshop on Consumer Education about TCAM
OP/ED: Making choices between treatments or practitioners without solid comparative information. Using products of unknown quality, safety and efficacy from Internet websites or local drug sellers. These are some of the many challenges we face as consumers of traditional, complementary and alternative medicine (TCAM). I recently participated in a WHO workshop in Macao SAR, China, on consumer education and TCAM.
The three-day workshop was arranged by World Health Organization and Macao Health Bureau, which also provided funding.Some 40 participants from 30 countries participated. I was invited as WHO advisor and local trainer.
The WHO has been active in this area for some time.
Several Improvements Since 2005
Comparing the responses of Member States to the two WHO global surveys (2005 and 2012) about TCAM, improvements have been made in the general country indicators. For example, the number of Member States providing high-level TCAM education has increased from only a few to 39, representing 30 percent. And the number of Member States reporting a national research institute for TCAM has increased from 58 in 2005 to 73 in 2012. These indicators may be translated into increased safety for the consumer using TCAM.
In general, more countries accept the contribution that TCAM can make. Governments and consumers are looking beyond herbals to consider other TCAM practices and practitioners and whether they should be integrated into health services.
Pros and Cons of Self Care
The need for the 2004 guidelines was prompted by the growing international trend on the use of TCAM for self-care. But already then, there were an increasing number of reports of incorrect use, including overdoses, unknowing use of suspect or counterfeit herbal medicines, and unintentional injuries caused by unqualified practitioners.
One reason for these problems is the widespread misconception that natural equals safe, and that therefore e.g. herbals are safe. While there is a grain of truth in this idea – albeit only for certain treatments and specific contexts – it is certainly not true (and actually dangerous) as a general statement. Nature provides examples of many powerful poisons for example.
We Must be Health Literate
So more self-care is something we should applaud. But only if we are both self-reliant and “health literate”. The term health literacy refers to the cognitive and social skills we as individuals need to acquire or possess in order to access, understand and use health information constructively. And health literacy is in turn crucial to empowerment.
So self care without health literacy and real empowerment can have negative consequences. We might unwittingly take interacting herbals and ordinary medicines together, and cause ourselves or our loved ones harm. Or spend our precious money on unqualified practitioners or useless treatments. Hence the need for intensified consumer information.
Involving Consumers Crucial
However, crucially, as a WHO officer working in patient safety observed at the Macao meeting, consumers must be engaged and involved, not “talked down to” as ignorant people to be passively “educated”.
In patient safety work, this approach – where patients themselves work as global ambassadors for patient safety – is proving very successful. Read more about the approach “Patients for Patient Safety” here. http://www.who.int/patientsafety/patients_for_patient/statement/en/
The Macao workshop resulted in a series of recommendations and priorities for action for WHO and Member States to consider. It is too early to list these here, as they must are still being finally edited by the workshop organizers. But when they do become official, I will write again.
However, I can safely reveal one important recommendation, highlighting the importance of gaining political support and commitment for the cause of consumer involvement and education and all the related issues needed to strengthen the situation of the consumer in this area.
David Finer
Health Journalist
Health Communications Specialist
