11/07/2018

Each year, the Fondation Pierre Fabre holds a conference to assess today’s knowledge and challenges in major global health matters. In 2018, the conference participants explored traditional healthcare practices and products and their place in the Global South’s healthcare systems. While there has been progress made in appreciation of traditional medicines, as encouraged by the WHO, many challenges remain to be addressed.

Speakers from Mali, Togo, Madagascar and France examined many different topics at the conference held on 2 October 2018, from the role traditional medicines have in patient care to research on local pharmacopoeias.

Traditional medicine is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health (…) or treatment of physical and mental illness. (…) For many millions of people, herbal medicines, traditional treatments, and traditional practitioners are the main source of health care, and sometimes the only source of care. This is care that is close to homes, accessible and affordable[1] [2].

Traditional medicines earn greater respect, but obstacles remain

The World Health Organization (WHO) sees traditional medicines (TM) as vectors to accessing healthcare and promoting good health and urges governments to integrate them into their national health systems and policies. It also promotes the safety, efficiency and quality of TM practices and products and their judicious, rational use. 

 

Roundtable Review: Insights on India and China

During the conference, Romain Simenel, an ethnologist at the French National Research Institute for Sustainable Development (IRD), explained that the recent commercial “boom” of Ayurveda, the traditional medicine of India, revolves around a “winning trio” of massage/diet/spirituality and an erudite image of medicine passed down by the Brahmins. The researcher, however, said that Ayurvedic knowledge is just as much based on the popular practices of marginalised tribes. Evelyne Micollier, anthropologist at the IRD, pointed out that, although international organisations often cite China as an example for having integrated traditional medicines into its public health system, there appears to be substantial abuse of these practices, so the country is now trying to “backtrack” by separating traditional Chinese medicine from the main healthcare system.

Member States have made substantial progress here: 69 countries had a TM policy in 2012 (versus just 25 in 1999) and 119 countries regulated herbal medicines (versus 65 in 2012). Nevertheless, problems remain, including a lack of research data and quality control mechanisms for traditional health products[1].

Discussing the challenges of traditional medicine

Throughout the day, the speakers shared their thoughts and experiences, helping to better qualify the dichotomy between traditional “soft”, “backward” medicinal practices and today’s conventional “chemical” medicine. Including these practices in training programmes for health professionals and when developing pharmacovigilance systems seems to be crucial to understanding patients’ needs and ensuring the safety of their treatments.

The discussions also shed light on the vast variety of healthcare practices around the world and clarified how they are changing in the face of today’s globalisation: the various forms of know-how are being transformed, borrowed and hybridised. It was therefore deemed important to ensure that promoting and respecting traditional medicines does cause them to be turned into “cultural globalisation products” and does not hinder development of conventional medicine, which would widen the inequalities in access to quality healthcare[3].

 

Traditional meets conventional
During this event, five speakers from African and Asian countries described a number of initiatives designed to promote and oversee the practices and tools of traditional medicines.
Rokia Sanogo, Professor of Pharmacognosy at the University of Bamako, presented the Department of Traditional Medicine (DMT) in Bamako, Mali, which is developing “Improved Traditional Medicines” using a combination of field surveys, laboratory tests and registration and production of medicines. Batomayena Bakoma, Professor of Pharmacognosy at the University of Lomé, showed how, in Togo, university traditional-medicine curricula can make future health professionals more aware of practices widely used by their future patients. Charles Andrianjara, Director of the Malagasy Institute of Applied Research in Madagascar, presented the results of pre-clinical work on two commonly used plant species for evaluation in treating sickle cell disease. Lastly, Bernard Fabre and Mathieu Leti of the Pierre Fabre Research Institute (IRPF) recounted their project collaboration with the Cambodian University of Health Sciences (USSC) to create a Cambodian pharmacopoeia that will help identify key species used in traditional Khmer medicine.

[1] WHO Traditional Medicine Strategy: 2014-2023. 2014. 
[2] Speech by WHO Director-General Dr Margaret Chan at the International Conference on Traditional Medicine for South-East Asian Countries, New Delhi, India, 12-14 February 2013.
[3] Dejouhanet L.: L’Ayurveda : Mondialisation d’une médecine traditionnelle indienne, Echo Geo n°10,