The World Health Organisation Traditional Medicine Hoax
Saturday, November 08, 2008
The World Health Organisation is this weekend holding a Congress on Traditional Medicine to be held in Beijing, and will be evaluating how far governments around the world are following a previous WHO directive to integrate 'traditional' medicine concepts into their healthcare systems.According to the WHO, traditional medicines (TM) are defined as:
the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness.
The WHO also generously include what is called Complementary and Alternative Medicine as Traditional Medicines. The WHO appear to believe that real medicine can benefit from the integration of traditional beliefs, quackery and charlatanism and is actively lobbying governments to assist this process. This is an appalling state of affairs and deserves some closer examination.
Hold on, you might say. Are you not just being a while male western chauvinist, privileging my own cultural perspective in so readily dismissing TM? Are you not just thinking it all must be witchcraft and voodoo? No. I would strongly respond. Let us look at what the WHO are really promoting here. And, let's get a few things out of the way. Yes, there may well be effective treatments amongst the many indigenous medical traditions around the world. We could all quote examples of herbs that have found to useful in some areas. But, that is not to say that we should just take indigenous medicines at face value and assume that because we are told they work, they do. It is quite clear that many local healing beliefs have more cultural significance than medical substance. The same herb might be use for completely contradictory purposes amongst different cultures. We cannot assume that some cultures have tapped into ways of discovering medical knowledge that somehow depends on tradition, intuition or mysticism and not objective evidence and the scientific method. By looking at the prevalence of things like homeopathy within our own country, we can see that complex and far reaching healing beliefs can be sustained, with institutions, government support, research and university courses, without the slightest reason to believe that it is an effective medical approach.
So, back to the WHO. Their stance is that they should be promoting and strengthening something called traditional medicine throughout the world. The objectives of WHO are threefold:
- To facilitate integration of traditional medicine into the national health care system by assisting Member States to develop their own national policies on traditional medicine.
- To promote the proper use of traditional medicine by developing and providing international standards, technical guidelines and methodologies.
- To act as a clearing-house to facilitate information exchange in the field of traditional medicine
Tellingly, the acquisition of evidence to support the use of TM is not high on their priorities.
In 2002, the WHO published a review of its strategy with regards to TM. It is littered with CAM bias. It uses the term 'allopathy' to describe real medicine and so betrays a pro-CAM bias. Allopathy is a term invented by homeopaths as a term of abuse for healers that did not subscribe to their own philosophy. In a giveaway paragraph, the WHO say,
Allopathic medicine is based on Western culture. Practitioners therefore emphasize its scientific approach, and contend that it is both value-free and unmarked by cultural values.If I was an Indian medical researcher, I would find this very insulting. I would be quite capable of assessing evidence, collecting data and drawing rational conclusions without being part of 'western culture'. The statement is playing on a distasteful cultural relativism that assumes that somehow science is a western owned cultural phenomena and that other ways of knowing have equal validity.
Now, the WHO go on to describe TM as follows:
Their common basis is an holistic approach to life, equilibrium between the mind, body and their environment, and an emphasis on health rather than on disease. Generally, the practitioner focuses on the overall condition of the individual patient, rather than on the particular ailment or diseases from which he or she is suffering.
This is blatant pro-CAM propaganda ripped straight from the text books of any quack degree in a western university. First of all, it would be interesting to know how they know this? Are all indigenous healing beliefs holistic? - whatever that means. And are all 'western' medics not concerned about the patients total quality of life, their environment and their state of mind? It is insulting bullshit.
The report is full of such shallow minded nonsense. When discussing why there is little good evidence for many alternative therapies, the report says,
The reasons for the lack of research data are due not only to health care policies, but also to a lack of adequate or accepted research methodology for evaluating traditional medicine.
Again, bullshit. The scientific method is quite capable of evaluating health claims, no mater what the source. Admittedly, some techniques lend themselves more readily to testing. Homeopathy, with their little sugar pills, is straightforward. Acupuncture needs a little more thought as it is quite hard to produce a good sham therapy. People tend to know if you stick a needle in them. The reason that such research methodology is not accepted by practitioners of alternative medicine is that is shows their techniques are indistinguishable from placebo treatments. The evidence collated over the past decade has been enormously unfavourable to most alternative medicines.
So, what is going on here. There may well be a number of factors. Firstly, it might be worth noting that the current Director-General of the WHO is a candidate put forward by the Chinese government, Dr Margaret Chan. She has extensive experience in government support and regulation of alternative medicine. Chinese medicine is not quite so traditional as we might be led to believe. Chairman Mao is credited with inventing what we now know as Traditional Chinese Medicine as he cynically provided his population with cheap medical services after the revolution. When diplomatic relations with the West were resumed, delegates were shown patients undergoing surgery using acupuncture as an anaesthetic. These displays are now know to be hoaxes where the patient was heavily sedated and had large amounts of local anaesthetic applied. (The BBC were quite recently taken in by this again).
But more worryingly, the conference in Beijing contains its own clues to distortion. In a Reuters news report we are told,
Revenue from traditional medicine in Europe reached more than 3 billion euros ($3.82 billion) from 2003 to 2004, according to Zhang Xiaorui, WHO coordinator on traditional medicine. The number for China was $8 billion, she said.
Yes. Vested interests appear to playing a huge role. At the conference, several groups have set up satellite symposia. The International Pharmaceutical Federation, a group representing 'pharmaceutical scientists ' is promoting 'self medication' of traditional, alternative and complementary medicines. The Ministry of Health of China and the State Administration of Traditional Medicine of China is also sponsoring a symposium on acupuncture that is organised by the World Federation of Acupuncture and Moxibustion Societies. The World Federation of Chiropractic is also in on the act with their own lobby. There is nothing non-western and traditional about chiropractic. It is a deluded and rather nasty cult like practice that aggressively lobbies for government regulation.
Behind this appears to be a justification from the WHO that it is right to promote TM because it is so widespread. They claim that,
- In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
- In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
- WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
- In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
- In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
- 70% of the population in Canada have used complementary medicine at least once.
- In Germany, 90% of the population have used a natural remedy at some point in their life.
This is nothing but an argument from popularity. Just because something is popular does not mean that it is right. In fact it is disgraceful. Most people in India or Africa that use traditional medicine do so because they have no choice. And here is the heart of the problem. The United Nations should not be encouraging the of unproven, discredited and absurd treatments, just because they are 'popular'. They should be ensuring that governments make available effective and affordable treatments for all their populations.
The stance of the WHO and the United Nations here is shameful and unethical. They are pandering to local nationalistic irrational beliefs, commercial interests and a vague relativism. In doing so, they are promoting practices that will be a massive distraction and a waste of precious resources for those wishing to provide safe, effective and affordable treatments to the most vulnerable people of the world.
Babies in Kenyan slums do not need homeopathy to protect them against malaria. Thousands of them die every year. They need nets for their beds and mosquito control. South African people with HIV do not need Vitamin C and traditional medicine. They need cheap generic anti-retrovirals. Schistosomiasis devastates lives of 200 million and it is easily treatable with a single dose of the drug praziquantel. (The 'traditional' therapy, myrrh, fails.) TB kills thousands and can be treated with drugs. Clean water prevents cholera. Vaccinations prevent polio.
The prevalence of TM is not something that should be encouraged by the WHO but something that should be a world-wide cause for alarm and action. In India where the government actively encourages homeopathy, the WHO should be alerting the world to the plight of hundreds of millions of people denied access to effective medical treatment and subjected to exploitative quackery in the name of political expediency. In South Africa, the Mbeki government advocated the use of traditional medicines at the expense of 'colonial' drugs for the treatment of HIV. It has been estimated that 300,000 people died as a result and it allowed western quacks, such as Matthias Rath, to use the rhetoric of traditional medication to promote his useless vitamin pills as an AIDS cure.
The solution to so many terrible illnesses in the developing world are fairly straightforward. What is missing is political will and stability, education and fairly modest funding. The trillions that the West is now spending on bailing out banks is fantastically more than what is required to save the lives of millions from preventable illnesses. And while this is ignored, the United Nations is pandering to nationalistic nonsense, quackery and charlatanism that will benefit the deluded and fraudulent and kill hundreds of thousands unnecessarily.
The only more shocking thing is that this will go completely unreported in the world's news.
Labels: WHO, World Health organisation
posted by Le Canard Noir at
11:03 PM
28 Comments:
Shocking stuff Andy, but not entirely unexpected. WHO, like all UN bodies, is a political body not a scientific or medical organisation with a commitment to evidence. As long as politicians feel there are votes or influence to be gained by pandering to prejudices and populism over healthcare then they will and WHO will suffer the consequences.
The same thing is happening in the EU with the relentless lobbying of CAM bodies and daft MEPs, like Kathy Sinnott who buys into almost every conspiracy theory and lie put out by fringe CAM organisations. In fact the EU have already showed that they do not understand science by making the claim that "Scientific research must focus on finding alternative methods to animal testing" - most basic biological research is impossible without animal models and reagents.
Thanks for an interesting article, LCN. The statements by WHO are preposterous and, as you say, written by a quack.
The big question is what can we do about it?
Its odd that 30,000 people complained about that Ross and Brand Incident yet I can't see similar numbers over this fiasco. Even though many will die because of this.
This is depressing.
Just WHO in hell do they think they are?
BillyJoe
"The United Nations should not be encouraging the of unproven, discredited and absurd treatments, just because they are 'popular'. They should be ensuring that governments make available effective and affordable treatments for all their populations."
hurrah, nail hit squarely on head. in particular it is the use of TM/CAM in place of actual medicine that may well be causing unnecessary suffering amongst those who need real 'Western' medicine the most.
cracking post!
peterd102: not sure it is odd, after all Africans dying because of bullshit promoted by the United Nations is nowhere near as important, relevant or interesting as an overpaid buffoon making a total tit of himself on radio...
Grr. I used to think the WHO was pretty good and worthy.
Not sure what can be done about this though?
Smart Bombs said...
Grr. I used to think the WHO was pretty good and worthy.
They do do a lot of good things (eg vaccinations), but they have certainly blotted their copybook with this nonsense.
In Ghana, Mali et al the first response to malaria is traditional medicine. That sentence need quite a few qualifiers. It is the first response only by those who do not have the means or access to Western Medicine. I am surprised that Mbeki is not on this panel, he needs a job now and his aids experience make him an ideal candidate. Beetroot, garlic and the rape of a virgin to cure aids.
I am very saddened by these statements from the WHO, which discredit them and cannot reflect the views of the majority of their scientific advisors. Zeno is absolutely right about vaccination, and the WHO have been equally good on sanitation / food safety. Reflecting my own interests, I would add that they have also done sterling and well substantiated work in the critical nexus of health, diet and lifestyle. The '02 WHO - FAO expert consultation report 'Diet, Nutrition and the Prevention of Chronic Diseases' is a landmark; unavoidably fuzzy in places, but it remains one of the best summaries of the near-current state of research. I worry that the CAM / indigenous medicine guff will undermine the diet & nutrition story, as this clearly has the potential to form the basis of a very cost-effective segment of healthcare.
Yet another excellent posting LCN.
I am not sure I should read the Quackometer because every time I do my blood pressure goes through the roof. However, the alternative (ignorance and complacency) is even worse so I shall persevere.
I really cannot cope with the stupidity of the TM/CAM school which alleges that the “””practitioner focuses on the overall condition of the individual patient, rather than on the particular ailment or diseases from which he or she is suffering”””.
So the usual “holistic”, “whole body” nonsense.
Surely that is arrant nonsense.
You can be fit as a fiddle and get an infectious illness which has nothing to do with your overall condition but which specifically requires proper medical intervention. Of course your general level of health might be important in terms of your ability to combat the illness (I am mindful of Lance Armstrong and his fight against cancer) but the specific illness still needs specific targeted medical intervention.
The statistics used in the claims to justify this are nonsense as well and you have accurately skewered many of them.
Just because “””In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once” hardly lends it credence. I have used pixy dust twice (for allergy and headache) and in both cases it was worse than useless – admittedly I was taking the piss as I knew a headache from an impacted wisdom tooth could not possibly be cured by nothing – and it wasn’t. . So presumably I would count in those statistics (not that they asked me!).
Bear in mind that there will be much Boolean overlap in those numbers with the people who genuinely believe dog created life, the universe and everything in 6 days. So maybe not the most credible audience.
As ever with these charlatans the statistics are used in a totally meaningless way, designed to evade, avoid and obfuscate. The assertion that “””In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM””” is a prime example. The real number of interest is how many people use only CAM to cure HIV/AIDS (as Scary Mary claims to do) as opposed to how many use some CAM (including things like smoking dope, St Johns Wort etc) in addition to their retrovirals and other medicines.
ALl of the references to CAM in Africa etc allude to poverty and not the efficacy of CAM. people with nothing will probably always clutch at whatever straws are available.
Whist looking for something else entirely I found the following in the James Lind library. Is this the same organisation - the initials seem similar.
“”"”"” The World Health Organization has proposed solutions to address the problem of unidentifiable research and publication (or dissemination) bias: First, it is establishing standards for the registration and exchange of data for the registration of trials.
Secondly, it is proposing registration of research protocols in databases that fulfill the above standards, before patient recruitment starts.
Finally, it is proposing the implementation of an open access portal (www.who.int/ictrp), which collates the data of all registers, allowing people to learn about coming, ongoing and finished research protocols.
We must all support the lead given by the World Health Organisation to reduce reporting biases by requiring registration of all fair tests of treatments at inception, and by insisting that their results should be published.”"”"”"”"
All of you, in your entire life, have never seen a hospital of Traditional Chinese Medicine (TCM). That by the way has a history of evolution dating thousands of years (nothing to do with Mao Tse Dong).
Some of their TCM hospital are better equiped with high tech diag machines than many of our facilities here in the U.S.
TCM is very effective clinically and scientifically speaking. As a matter of facts, some of the best chemotherapy drugs used worldwide today, are symply Chinese medicne or direct derivatives of it. Even the most effective malaria treatment now a day is Artemisinin or its multiple modified forms such as arthemeter, which derive from artemisia annua (used in Chinese medicine since ancient times). I suggest you take a tour to a modern TCM hospital in China, or perhaps undergo some education on that respect, before making misleading statements.
Don't you respect your selves. A knowledgeable person on that field will think that you are better represented by a mirrored duck.
A. Lin, MD
Oncologist
All of you, in your entire life, have never seen a hospital of Traditional Chinese Medicine (TCM). That by the way has a history of evolution dating thousands of years (nothing to do with Mao Tse Dong).
Some of their TCM hospital are better equiped with high tech diag machines than many of our facilities here in the U.S.
TCM is very effective clinically and scientifically speaking. As a matter of facts, some of the best chemotherapy drugs used worldwide today, are symply Chinese medicne or direct derivatives of it. Even the most effective malaria treatment now a day is Artemisinin or its multiple modified forms such as arthemeter, which derive from artemisia annua (used in Chinese medicine since ancient times). I suggest you take a tour to a modern TCM hospital in China, or perhaps undergo some education on that respect, before making misleading statements.
Don't you respect your selves. A knowledgeable person on that field will think that you are better represented by a mirrored duck.
A. Lin, MD
Oncologist
A Lin - I think you have entirely missed the point of what I have written. Yes, some herbs have found to be effective for various things. But your example of Artemisinin is interesting. It has undergone trials and is producing standardised doses, purities and an evidence base for safety and efficacy. By definition, it can no longer be counted as 'traditional medicine' since no traditional medicine undergoes this process. TM is used on a 'belief' basis from local traditions.
What the WHO is proposing is that unproven, disproven, unscientific, and implausible treatments are integrated into real medicine. This is absurd and a criminal waste of resources and focus. People will die as a result.
You are just plain wrong about TCM. Most of what people think of traditional chinese medicine is a largely modern invention or re-invention. Acupuncture as we know is is only a few hundred years old. Originally it used blades and was much closer to blood letting. The use of needles was a much later invention. In the west people think reflexology and ear candling is part of Chinese medicine (Shops in the UK advertise these things) Reflexology and ear candling are 20th century inventions. When acupuncture is subjected to proper review - it does abysmally. When herbs are closely examined. Most of them do very poorly and show wide variations in safety standards.
Thanks for the article LCN. Very interesting.
I disagree, with your response to Lin, to some extent.
Relabling artemisin from TM to western... Indigenous/traditional medicine does to some extent undergo what we call 'scientific rigour'. As much as you call the use of TM a belief. Of course its not done in the entirely unbiased and objective scientific labs (excuse the sarcasm..), but is instead tested via trial and error over generations - thus use over time, trial & error act as their trials. Which in a sense is no different from 'western science'..
Not saying that all TM/CAM are reliable substitutes for western medicines, just that one should always be careful about dismissing other peoples beliefs... After all the 'science' that everyone talks about tends to take a very western slant.
the world was flat before....
Err yeah so a bit of rambling!
Cheers!
I completely disagree with you. The last sentence is my biggest gripe. In what sense is science taking a 'western slant'? Now I would agree that science funding can often be applied to subjects that have western interests - e.g. funding for cancer research rather than malaria research.
But science does not take a slant as to what it true and what is false. Science does not ignore eastern concepts of, say, chi because it is 'western'. Chi is unscientific because there is no body of evidence to suggest that chi exists or plays any role in human health. It is a pseudo-religious/scientific concept.
My point is exactly that we have to be cautious of other people's health beliefs simply because there are so many good reasons why they can be wrong.
On what grounds would you object to a cultures health beliefs? Say the Western African beliefs, that albino peoples body parts can be used in healing rituals? Why should the WHO not respect these beliefs?Why not just take their word for it that this is a good use of albino people? No, some standards must apply universally - whether they be ethical or through the use of objective evidence.
science is not an entity in itself, its derived from human observation. I was simply stating that although the purpose of science is to find 'the truth'. Who decides what the truth actually is.. Knowledge, beliefs, paradigms they change over time. That doesn't mean to say that current scientific knowledge is not functional, its just that people have an angle before they even broach a subject (based on societal etc factors) and especially in relation to TM/CAM which often incorporates environmental, social and spiritual aspects which are hard to prove scienfically (and directly) as necessary for better health. Even the word 'health' has a broad set of meanings, which differ from group to group and person to person. Most western people will describe health as mind and body, but when you look at more diverse groups you may find that people don't differentiate between my health and your health, or my health and the health of the land..
Thats why I'm saying that although science may be the way to prove western methods of health, care has to be taking when applying it to other cultures/people.
Obviously using albino body parts or similar muti killings in South Africa, at least to me, completely contradict the purpose of medacine, because it involves harming someone...
I don't think it has to be an all or nothing. Why polarise it?! This is a positive move to accept that current western approaches and beliefs are not the only 'valid' methods to addressing health problems.
This is exactly the sort of sloppy thinking that is a clear danger to people when considering health choices. 'Western' science does not dictate what truth is - it is the only reliable method we have for discovering truth.
Perhaps you would like to have your relativist, post-modern discussion of truth with the Kenyan parents of a child who has died of malaria? In what sense is this child's death in some way relative to what the culture might believe about health, the land and evidence?
Malaria can be prevented and treated in a number of different ways. How we know which methods work and which do not is discoverable by applying the scientific method. It saves lives. Trusting in traditional local knowledge is much less reliable and in some cases downright dangerous and abhorent.
Whilst not disagreeing with your argument and accepting the fact that some traditionally used herbs can form the basis of effective medicines, eg aspirin, what influence do you think the well documented placebo effect has on the acceptance of TM in both the developed and the developing world? I'm sure a recuperative holiday taking the waters at some luxurious German spa or at the Dead Sea as prescribed by the German Health Service would improve my feelings of well being with a possible consequential improvement in my health
I wonder why people here mostly seem so deeply angry, unhappy, grumpy and stressed about all this?
is this grumpyclub.com?
grumpy club?
it doesn't seem that to me
hard opinion forum that is only partially scientific - it is that...
Triple blind trials are not the only way to prove something is efficacious and the facts that many scientific champions neglect include the many, many failures of well tested medicines that cause pain, hardship, and sometimes death.
The biggest recent shout against Homeopathy has been that the prophylaxis of malariinum puts peoples lives at risk by allowing them to falsely believe they are protected when they are not - those who shout loudest have never produced a case, to my knowledge, of someone who has contracted malaria from such a practice - I have done this: visited Accra, Ghana, and been bitten by mosquitoes but been OK - as have the hundreds of homeopathic practitioners who have visited high risk Asian areas...
whereas there is plenty of evidence of people contracting malaria despite taking the Larium type of treatment - that also caused fitting and a rushed return from their travels in several clients of my acquaintance.
the facts are often uncomfortable - for all sides in these arguments - remember those that don't suit your argument as well as those that do.
those who shout loudest have never produced a case, to my knowledge, of someone who has contracted malaria from such a practice
Show me a homeopathic clinic in Ghana, Kenya or Southern Africa that publishes follow up figures, monitoring reports and adverse reaction rates.
Oh, and five seconds googling reveals ...
http://whatstheharm.net/newsarchive/JanezaPodgorsek.html
Five more seconds googling reveals five cases...
http://www3.interscience.wiley.com/cgi-bin/fulltext/119957193/PDFSTART
The problem is that homeopaths are so convinced of their mumbo jumbo they feel no need to address follow up. Most African victims of homeopathy will go unrecorded. Utterly immoral.
And a French woman...
http://findarticles.com/p/articles/mi_m0999/is_7271_321/ai_67708490
This article. liberally sprinkled with the word "quack" is a typical fundamentalist denialist piece attempting to depict the WHO as acting under predominantly political motives.
It is the anti-Homeopathists who are guilty of that consistently - apparently science is not good enough them or else they don't have the science to refute it.
Just to set the record straight, in 2005 Prince Charles made a pro CAM speech before the WHO. In what was in my opinion, the utilization of a scientific journal for purposes of retaliation, the Lancet produced its famous "End of Homeopathy" issue not long after the speech. One of the anti-Homeopathy meta analysis articles in that issue became famous for asserting that its meta-analysis showed Homeopathy no better than placebo. Criticized from the start for the articles's faulty and arcane methodology, a reconstruction of the meta-analysis was done recently and an article published in the Journal of Clinical Epidemeology and in other journals completely refuting the famous Lancet meta-analysis and holding it up as the scientific rubbish that it was.
http://www.innovations-report.de/html/berichte/studien/evidence_homeo...
"Due to a lack of funding, there are a limited number of homeopathic
studies. As a result, it is quite possible to interpret homeopathic
data selectively and unfavourably, which is what appears to have been
done in the Lancet paper. If we assume that homeopathy does not work
for just one condition (Arnica for post-exercise muscle stiffness), or
alter the definition of 'larger trial', the results are positive. The
comparison with conventional medicine was meaningless: the original
110 trials were matched, but matching was lost after the trials were
reduced to 8 in one group and 6 in the other. Interestingly, the
quality of homeopathic trials was better than conventional trials."
References
Lüdtke R, Rutten ALB. The conclusion on the effectiveness of
homeopathy highly depend on the set of analysed trials. Journal of
Clinical Epidemiology, 2008. doi: 10.1016/j.jclinepi.2008.06.015
Rutten ALB, Stolper CF. The 2005 meta-analysis of homeopathy:
analysis
of postpublication data. Homeopathy, 2008. doi:10.1016/j.homp.
2008.09.008.
That's just one example.
You want more? - like an anti-Homeopathy letter circulated in Britain apparently written on stationary with an official looking NHS logo - except unauthorized by the NHS who issued a disavowal.
Oh yes however tenuous is the science behind Homeopathy, the antis seem to need more "ammunition" against it.
I wonder why. Is there the possibility to be considered, looming over all the frantic denialisms, that it works?
Dr. Lin is quite correct, the vast majority of those who make the criticisms against TCM, including the author of the article, have not a clue as to what it is all about.
The only "hoax" is them pretending to know what they are talking about.
Regarding Artemesia (Qing Hao in Chinese I think), the herb was certified some time ago for its effectiveness against Malaria by the WHO. It previously had been used for this purpose by the Chinese for centuries.
As one of the people who has been directly involved in the development of artemisinin based therapy for treating malaria, I just wanted to set the record straight on the use of herbal Artemisinin for treating malaria and its origins.
It was indeed known from old times that an aqueous extract, i.e. a tea, of a plant called Artemisia Annua, could be used for lowering fever. However, the extension of its use to the treatment of malaria has only taken place during the 1960’s after research performed in China.
At the time, a war was going on in Vietnam and one of the main problems for the Vietcong was not the US soldiers on the ground, but the lack of proper medication against malaria, as quinine or other products could not be shipped to them as they were under Western control. The Vietcong asked Mao to help them and several hundred Chinese researchers started investigating whether they could find an alternative. After a considerable search, they found that a petroleum ether extract, so not the aqueous extract, of the herb Artemisia Annua showed antimalarial activity. Further research showed that this action was due to one single compound, called artemisinin and this substance was subsequently extracted and purified.
Even so, the extracted artemisin itself has a very poor solubility and therefore bioavailability and it was further chemically modified to other derivatives like artesunate, artemether and arteether.
In the early 1990’s the existence of this product was revealed to the west at a WHO conference on malaria held in China. This was a major breakthrough, as the malaria parasite had developed resistance against most known Western drugs. Therefore, several pharmaceutical companies, Sanofi, Roche & Novartis then started the full clinical development of the product. The reason for going through the whole process of toxicological and clinical research was to be able to clearly define the safety and to find the proper dose and administration regime for the compounds.
In the early 1990’s some companies started marketing the product in Asia as a monotherapy of about 100 mg artesunate daily for a duration of 7 days. This treatment in itself is very effective, but as most people feel better quickly there are not many patients that take the pills for the full duration, so to shorten therapy length and to prevent resistance from building up, it was then decided by WHO, to state that artesunate and artemether are only to be used in combination with other drugs like lumefantrine, sulfadoxine or amodiaquine.
This lead to new toxicological and clinical research and finally around 1998, and a clinical program including up to 4 000 patients, the first combination therapy artemether-lumefantrine was launched by Novartis, this was later followed by other combinations like artesunate-sulfadoxine-pyrimethamine and artesunate-amodiaquine.
These fixed dose therapies, in which an artemisinin derivate is combined with another chemical western based drug molecule are nowadays the only recognized and formally approved artemisinin combination therapies (ACT) as endorsed by WHO for the treatment of malaria.
In conclusion, although the origin of ACT therapy certainly is to be found in Traditional Medicine, because off the chemical modifications and purifactions performed after extracting a single clearly defined substance from the herb, the combination with western synthetic drugs, and the clinical research programs that went into it before its acceptance by the WHO and other health authorities, I feel it would be hard pressed to use the current ACT treatment as an example of the effectivity of Traditional Medicine or herbal medicine.
Post a Comment
Links to this post:
Create a Link
<< Home