Traditional/complementary medicine: the way ahead.

The use of Traditional/Complementary Medicine (T/CM) is widespread in developing countries and is stea~.IY increasing across the developed world. \ The World Health Organisation (WHO) estimated that' In many countries, 80% or more of the po'p,ulation living in rural areas are cared for by traditional practitioners"'. About half the populations of\ieveloped countries regularly use T/CM. The \United States of America's expenditure on T/CM increased from $13 billion to $38 billion per year in 1990-7 2. The same trend is seen in Australia and in the United Kingdom. By 1993, it was estimated that Australians were spending almost twice as much on complementary medicines (CM) ($AU621 million yearly) than their contributions to pharmaceuticals. Recent government estimates revealed that each year 57% of Australians use some form of CM3. A survey in Southampton (with a population of (200,000) revealed that about 4 million pounds were spent a year on T/CM outside the National Health Service • At least 40% of general practices in the UK provide some complementary services5. In China, T/CM accounts for 30-50% of the total medicine consumption while in Hong Kong, 60% of the population has consulted TM practitioners at one time or another'. The Widespread and increasing use of T/CMin both developed and developing countries has raised significant issues of public health policy and has caused some measure of apprehension amongst those practising allopathic medicine. Many are peeved with the unsubstantiated claims made by T/CM practitioners especially with regards to the aspects of quality, safety and efficacy. Still, it is an undeniable fact that many of our patients are increasingly resorting to herbal remedies to cure their ailments. There are also an increasing number of western-trained doctors prescribing herbal remedies to their patients, albeit as adjunctive therapy. The number of publications on traditional medicine (TM) and herbal medicine research in leading peerreviewed medical journals is also gaining momentum. The resurging interest and importance of TM has prompted the National Centre for Complementary and Alternative Medicine (NCCAM), the Office of Dietary Supplements (ODS) and the American Association of Naturopathic Physicians together with the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) to organise a 3-day research workshop to review the current use of herbal remedies among patients with liver disease, examine the types of products used and