Introduction to Integrative Introduction to Integrative Medicine and Complementary Medicine and Complementary
and Alternative Medicine (CAM) and Alternative Medicine (CAM)
Jaime Z. Galvez Tan, MD, MPHJaime Z. Galvez Tan, MD, MPHProfessor, U.P. College of MedicineProfessor, U.P. College of Medicine
Head, Traditional and Integrative Medicine Clinic, UP-PGHHead, Traditional and Integrative Medicine Clinic, UP-PGH
Outline of PresentationOutline of PresentationHistorical Developments in CAMHistorical Developments in CAMDefinitions of CAMDefinitions of CAMGlobal Examples of CAMGlobal Examples of CAMConcepts of Health, Illness and WellnessConcepts of Health, Illness and WellnessRationale for Learning Filipino Traditional Rationale for Learning Filipino Traditional
Medicine and Integrative MedicineMedicine and Integrative MedicineChallenges to Health Institutions and Challenges to Health Institutions and
Health Sciences StudentsHealth Sciences Students
Historical Developments: GlobalHistorical Developments: Global World Health Organization (WHO): World Health Organization (WHO):
1978 Alma Ata Declaration on Primary 1978 Alma Ata Declaration on Primary Health Care (PHC): Integration of Health Care (PHC): Integration of Traditional Medicine in PHCTraditional Medicine in PHC
1999: US Congress established the 1999: US Congress established the National Center for Complementary National Center for Complementary and Alternative Medicine (NCCAM) in and Alternative Medicine (NCCAM) in the National Institutes of Health (NIH) the National Institutes of Health (NIH) Bethesda, Maryland.Bethesda, Maryland.
Philippine Experience in CAMPhilippine Experience in CAM
Mid-70’s: Private physicians Mid-70’s: Private physicians started training in started training in acupuncture in Chinaacupuncture in China
Early 1980’s: DOH Early 1980’s: DOH physicians trained physicians trained acupuncture in China; herbal acupuncture in China; herbal medicine production startedmedicine production started
1993-95: DOH established 1993-95: DOH established the Traditional Medicine Unit the Traditional Medicine Unit which promoted the use of which promoted the use of medicinal plants, medicinal plants, acupuncture and therapeutic acupuncture and therapeutic massagemassage
CAM Policy and Practice in the CAM Policy and Practice in the PhilippinesPhilippines
Republic Act 8433 established the Philippine Republic Act 8433 established the Philippine Institute for Traditional and Complementary Institute for Traditional and Complementary Health Care (PITAHC) in 1997 as an attached Health Care (PITAHC) in 1997 as an attached agency of the DOH.agency of the DOH.
Filipino physicians have organized the Philippine Filipino physicians have organized the Philippine Association of Medical Acupuncturists Inc Association of Medical Acupuncturists Inc (PAMAI) and the Philippine College for the (PAMAI) and the Philippine College for the Advancement of Medicine (PCAM) to promote Advancement of Medicine (PCAM) to promote the practice of CAM.the practice of CAM.
What is Complementary and What is Complementary and Alternative Medicine (CAM)? 1Alternative Medicine (CAM)? 1
Complementary and alternative medicine Complementary and alternative medicine is a group of diverse medical and health is a group of diverse medical and health care systems, practices, and products that care systems, practices, and products that are not presently considered to be part of are not presently considered to be part of conventional medicine (NCCAM-NIH).conventional medicine (NCCAM-NIH).
What is Complementary and What is Complementary and Alternative Medicine (CAM)? 2Alternative Medicine (CAM)? 2
CAM is a broad domain of healing CAM is a broad domain of healing resources that encompasses all health resources that encompasses all health systems, modalities and practice and their systems, modalities and practice and their accompanying theories and beliefs, other accompanying theories and beliefs, other than those intrinsic to the politically than those intrinsic to the politically dominant health systems of a particular dominant health systems of a particular society or culture in a given historical society or culture in a given historical period (Cochrane Collaboration).period (Cochrane Collaboration).
What is Complementary and What is Complementary and Alternative Medicine (CAM)? 3Alternative Medicine (CAM)? 3
The scope of alternative health care The scope of alternative health care modalities as other forms of non-modalities as other forms of non-allopathic, occasionally non-indigenous or allopathic, occasionally non-indigenous or imported healing methods, though not imported healing methods, though not necessarily practiced for centuries nor necessarily practiced for centuries nor handed down from one generation to handed down from one generation to another. (PITAHC R.A. 8433)another. (PITAHC R.A. 8433)
Examples of CAM 1Examples of CAM 1 Traditional Chinese Medicine: yin-Traditional Chinese Medicine: yin-
yang; 5 element law; acupuncture, yang; 5 element law; acupuncture, acupressure, moxibustion, tuina, acupressure, moxibustion, tuina, medicinal plants, chi-gong, tai chi, medicinal plants, chi-gong, tai chi, animal and mineral medicineanimal and mineral medicine
Ayurveda: humours (vata-pita-Ayurveda: humours (vata-pita-kapha), yoga, meditation, fasting, kapha), yoga, meditation, fasting, purification, medicinal plants, purification, medicinal plants, aromatic oils, urine therapyaromatic oils, urine therapy
European: homeopathy, iridology, European: homeopathy, iridology, health spa, psychic healing, health spa, psychic healing, Swedish massage, orthomolecular, Swedish massage, orthomolecular, anthroposopy, macrobioticsanthroposopy, macrobiotics
Examples of CAM 2Examples of CAM 2 North American: chiropractic, North American: chiropractic,
osteopathy, prayer healing, osteopathy, prayer healing, nutraceuticals, music therapy, nutraceuticals, music therapy, color therapy, chelation, color therapy, chelation, biofeedback, native American biofeedback, native American medicinemedicine
Asian: reiki, shiatzu, Kampo Asian: reiki, shiatzu, Kampo medicine, reflexology, Zen medicine, reflexology, Zen meditation, Buddhist meditation, meditation, Buddhist meditation, Thai massage, Tibetan medicine, Thai massage, Tibetan medicine, kalimasadakalimasada
Examples of CAM 3Examples of CAM 3 Filipino: herbal medicines, hilot sa Filipino: herbal medicines, hilot sa
pilay, hilot sa panganganak, pilay, hilot sa panganganak, psychic surgery, biomagnetic psychic surgery, biomagnetic healing, pasma, usog, babaylan, healing, pasma, usog, babaylan, mumbaki, spiritual healing, mumbaki, spiritual healing, bentosa, tawas, hiyangbentosa, tawas, hiyang
Classification of CAM ModalitiesClassification of CAM Modalities Biological therapies: herbal medicine, Biological therapies: herbal medicine,
aromatherapy, dietary therapies aromatherapy, dietary therapies Manipulation therapies: acupuncture, massage, Manipulation therapies: acupuncture, massage,
reflexology, chiropractic, osteopathyreflexology, chiropractic, osteopathy Mind-Body interventions: meditation, hypnotherapy, Mind-Body interventions: meditation, hypnotherapy,
prayer, spiritual healing, imaging, visualizationprayer, spiritual healing, imaging, visualization Energy therapy: pranic healing, reiki, crystals, bio-Energy therapy: pranic healing, reiki, crystals, bio-
magnetic healingmagnetic healing Alternative systems: traditional Chinese medicine, Alternative systems: traditional Chinese medicine,
Ayurveda, Yunani-Tibb, naturopathy, homeopathyAyurveda, Yunani-Tibb, naturopathy, homeopathy
Concepts of Health, Well-Being, Concepts of Health, Well-Being, Wellness and IllnessWellness and Illness
Biomedical or Conventional Medicine Biomedical or Conventional Medicine Definition circa 1878-1978Definition circa 1878-1978
Health is the absence of disease.Health is the absence of disease.
Biomedicine is Disease-oriented; Understanding the Biomedicine is Disease-oriented; Understanding the person physically (anatomy, histology, biochemistry, person physically (anatomy, histology, biochemistry, physiology, pathology etc) physiology, pathology etc)
The Medical / Conventional Model –measuring The Medical / Conventional Model –measuring health by counting cases of diseases in populations health by counting cases of diseases in populations by incidence, prevalence, morbidity and mortality.by incidence, prevalence, morbidity and mortality.
W.H.O. Definition 1978W.H.O. Definition 1978
W.H.O. Definition of Health: It is a state of W.H.O. Definition of Health: It is a state of complete physical, mental and social well-complete physical, mental and social well-being and not merely the absence of being and not merely the absence of disease or infirmitydisease or infirmity
Filipino Traditional Medicine DefinitionFilipino Traditional Medicine Definition
Health and wellness is the state of Health and wellness is the state of harmony, balance and synergy between harmony, balance and synergy between humankind and the universe, between humankind and the universe, between humankind and the environment, between humankind and the environment, between and among humankind and within the and among humankind and within the human body, mind and soul.human body, mind and soul.
(J.Z. Galvez Tan from interviews with hundreds of traditional healers)(J.Z. Galvez Tan from interviews with hundreds of traditional healers)
Integrative or Holistic MedicineIntegrative or Holistic MedicineHealth and wellness is the state of Health and wellness is the state of
complete physical, mental, social, spiritual, complete physical, mental, social, spiritual, emotional and environmental well-being.emotional and environmental well-being.
Quality of life and quality of daily living is Quality of life and quality of daily living is primordial.primordial.
It is the fusion of the best of Asian and It is the fusion of the best of Asian and Filipino Traditional Medicine with the best Filipino Traditional Medicine with the best of North American and European Medicineof North American and European Medicine
Six Dimensions of Health, Wellness Six Dimensions of Health, Wellness and Well-Beingand Well-Being
Physical
Mental
Spiritual
Emotional
Social
Environmental
Six Dimensions of Health, Wellness Six Dimensions of Health, Wellness and Well-Beingand Well-Being
Body
Mind
Soul
Heart
Hands
Feet
Six Dimensions of National Health, Six Dimensions of National Health, Wellness and Well-BeingWellness and Well-Being
Political
Cultural
Economic
Social
Environmental
Security
Why Filipino Traditional Why Filipino Traditional Medicine and Integrative Medicine and Integrative
Medicine and Complementary Medicine and Complementary Medicine in Medical and Health Medicine in Medical and Health
Sciences Education?Sciences Education?
Why Study Filipino Traditional Why Study Filipino Traditional Medicine? #1Medicine? #1
Cultural and ethnolinguistic competency of the Cultural and ethnolinguistic competency of the Filipino Physicians, Nurses, Dentists and other Filipino Physicians, Nurses, Dentists and other Health ProfessionalsHealth Professionals
W.H.O. recommendation of integration of Traditional W.H.O. recommendation of integration of Traditional Medicine in Medical and Health Sciences Education Medicine in Medical and Health Sciences Education and Primary Health Care since 1978and Primary Health Care since 1978
World Health Assembly resolutions since 1981 called World Health Assembly resolutions since 1981 called upon member-states to integrate Traditional upon member-states to integrate Traditional Medicine in their health care systemsMedicine in their health care systems
Why Study Filipino Traditional Why Study Filipino Traditional Medicine? #2Medicine? #2
Filipino Physicians and Filipino Health Professionals Filipino Physicians and Filipino Health Professionals who manifest the rich heritage, self-respect and who manifest the rich heritage, self-respect and uniquely Filipino character and identity of more than uniquely Filipino character and identity of more than thousand year old healing traditions of our country, thousand year old healing traditions of our country, are truly able to express the genuine Filipino soul in are truly able to express the genuine Filipino soul in their health care practicetheir health care practice
Philippine government policies and laws supportive Philippine government policies and laws supportive through the Philippine Institute of Traditional and through the Philippine Institute of Traditional and Alternative Health Care (PITAHC, Republic Act 8433, Alternative Health Care (PITAHC, Republic Act 8433, 1997)1997)
Why Integrative and Complementary Why Integrative and Complementary Medicine in the Medical and Health Medicine in the Medical and Health
Sciences Curricula?Sciences Curricula? Evidence Based Medicine already being applied in Evidence Based Medicine already being applied in
Complimentary and Alternative MedicineComplimentary and Alternative Medicine NIH Bethesda actively promoting through the National NIH Bethesda actively promoting through the National
Center for Complementary and Alternative MedicineCenter for Complementary and Alternative Medicine North American, European and Asian Medical and North American, European and Asian Medical and
Health Sciences Schools already incorporating Health Sciences Schools already incorporating Integrative Medicine and Complementary and Integrative Medicine and Complementary and Alternative MedicineAlternative Medicine
Patients already inquiring if not requesting their Patients already inquiring if not requesting their physicians and health care professionals for physicians and health care professionals for complementary and alternative medicinecomplementary and alternative medicine
Global Uses of Medicinal PlantsGlobal Uses of Medicinal Plants
Phytomedicines and phytochemicalsPhytomedicines and phytochemicalsNutraceuticalsNutraceuticalsPersonal Care Products and CosmeticsPersonal Care Products and CosmeticsSpa Health and Spa MedicineSpa Health and Spa MedicineCulinary: Flavors and spicesCulinary: Flavors and spicesFragrance and perfumerFragrance and perfumerBio-pesticidesBio-pesticides
Challenges to the Research Challenges to the Research Community and Business Community and Business
SectorSector
1. Majority of Philippine medicinal plants 1. Majority of Philippine medicinal plants with centuries of ethnomedical history, with centuries of ethnomedical history, remain untapped.remain untapped.
2.The Philippine herbal industry is still in 2.The Philippine herbal industry is still in the early developmental stage and its the early developmental stage and its potential has not been fully exploited.potential has not been fully exploited.
3. Lack of collaboration among research 3. Lack of collaboration among research institutions, private sector and academeinstitutions, private sector and academe
More Challenges to the More Challenges to the Research Community & Research Community &
Business SectorBusiness Sector 4.Lack of investments in research and 4.Lack of investments in research and
development, raw material production, post development, raw material production, post harvest processing and herbal manufacturing.harvest processing and herbal manufacturing.
5.Low level of scientific technology in herbal 5.Low level of scientific technology in herbal medicine research and manufacture among medicine research and manufacture among small and medium enterprises.small and medium enterprises.
6. No standardized procedures in local 6. No standardized procedures in local manufacture of most herbal products.manufacture of most herbal products.
More Challenges to the More Challenges to the Research Community and Research Community and
Business SectorBusiness Sector7. Need for market and government 7. Need for market and government
incentives like the ones given to rice, corn, incentives like the ones given to rice, corn, coconut, sugar, bananas, pineapples and coconut, sugar, bananas, pineapples and mangoes.mangoes.
Challenges to Expanding the Challenges to Expanding the MarketMarket
Raw material production Raw material production Quality processing and production Quality processing and production Attitude of “Competition is good” versus Attitude of “Competition is good” versus
crab mentality crab mentality Investments in research and development Investments in research and development Regulatory frameworkRegulatory frameworkWildlife Act of 2002Wildlife Act of 2002Market and government incentivesMarket and government incentives
Most Marketable Medicinal Most Marketable Medicinal PlantsPlants
1.1. Lagundi (Vitex negundo)Lagundi (Vitex negundo)2.2. Sambong (Blumea balsamifera)Sambong (Blumea balsamifera)3.3. Ampalaya (Momordica charantia)Ampalaya (Momordica charantia)4.4. Herba buena (Mentha cordifolia)Herba buena (Mentha cordifolia)5.5. Tsaang Gubat (Carmina retusa)Tsaang Gubat (Carmina retusa)6.6. Malunggay (Moringa olifera)Malunggay (Moringa olifera)7.7. Balbas pusa (Orthosiphon aristatus)Balbas pusa (Orthosiphon aristatus)8.8. Banaba (Lagerstroema speciosa)Banaba (Lagerstroema speciosa)9.9. Takip-Kuhol (Centella asiatica)Takip-Kuhol (Centella asiatica)10.10. Saluyot (Corchorus olitorius)Saluyot (Corchorus olitorius)11.11. Pansit-pansitan (Peperonia pellucida)Pansit-pansitan (Peperonia pellucida)12.12. Akapulko (Cassia alata)Akapulko (Cassia alata)
The Future of Complementary The Future of Complementary and Alternative Medicine and and Alternative Medicine and
Integrative Medicine in the Integrative Medicine in the PhilippinesPhilippines
The Future is Good!The Future is Good!The Future is Great!The Future is Great!
Philippines - The Heart of AsiaPhilippines - The Heart of AsiaPhilippines - Islands of Wellness and the Philippines - Islands of Wellness and the
Center of Health and Wellness in AsiaCenter of Health and Wellness in AsiaPhilippines - The Global Capital for Tropical Philippines - The Global Capital for Tropical
Medicinal PlantsMedicinal PlantsThe Filipino Hilot Traditional Massage - a The Filipino Hilot Traditional Massage - a
brand name in all spas of the world in the brand name in all spas of the world in the next 5 yearsnext 5 years
Philippine Health Care - the Best of Asia Philippine Health Care - the Best of Asia with the Best of Europe and North Americawith the Best of Europe and North America
Maraming Salamat Po!Maraming Salamat Po!Thank You Very Much!Thank You Very Much!
Jaime Z. Galvez Tan M.D., M.P.H.Jaime Z. Galvez Tan M.D., M.P.H.Mobile: 0928 507 4479Mobile: 0928 507 4479
E-mail: [email protected]: [email protected]
