Complementary Medicine Complementary Medicine integrated in Healthcare.integrated in Healthcare.
The WHO Collaborating Centre The WHO Collaborating Centre and the Lombardy Region case.and the Lombardy Region case.
Maurizio ItalianoMaurizio ItalianoDulcamara International School of Classical HomeopathyDulcamara International School of Classical Homeopathy
CSOA School of HomeopathyCSOA School of Homeopathy
The Centre for Research in Medical Bioclimatology, The Centre for Research in Medical Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityBiotechnologies, and Natural Medicines of Milan University
WHO Collaborating Centre for Traditional MedicineWHO Collaborating Centre for Traditional Medicine
EHFG Workshop - October 5, 2005
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Centre for Research in Medical The Centre for Research in Medical Bioclimatology, Biotechnologies, and Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityNatural Medicines of Milan University
WHO Collaborating Centre for Traditional WHO Collaborating Centre for Traditional MedicineMedicine
• Founded on 31 March 1969 Founded on 31 March 1969 (Rector’s Decree No. 37683)(Rector’s Decree No. 37683)
• Directed by Prof. Umberto Solimene - Directed by Prof. Umberto Solimene - Chair of Medical Therapy and Thermal Chair of Medical Therapy and Thermal MedicineMedicine
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Centre for Research in Medical The Centre for Research in Medical Bioclimatology, Biotechnologies, and Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityNatural Medicines of Milan University
WHO Collaborating Centre for Traditional WHO Collaborating Centre for Traditional MedicineMedicine
Aims:Aims:• Promoting development of experimental Promoting development of experimental
studies and research in studies and research in BioclimatologyBioclimatology, , Biomedical technologies and Biomedical technologies and CAMCAM
• Promoting the knowledge and diffusion of Promoting the knowledge and diffusion of advanced trends in advanced trends in BioclimatologyBioclimatology
• Encourage studies and research in Encourage studies and research in CAM CAM areasareas respecting their methodology and respecting their methodology and patternspatterns
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Centre for Research in Medical The Centre for Research in Medical Bioclimatology, Biotechnologies, and Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityNatural Medicines of Milan University
WHO Collaborating Centre for Traditional WHO Collaborating Centre for Traditional MedicineMedicine
Staff notes:Staff notes:
• The Centre takes also advantage of help The Centre takes also advantage of help and support from the scientific and and support from the scientific and technical staff at the Human Anatomy technical staff at the Human Anatomy Dept. of Milan University. One of the most Dept. of Milan University. One of the most advanced in Europe.advanced in Europe.
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Centre for Research in Medical The Centre for Research in Medical Bioclimatology, Biotechnologies, and Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityNatural Medicines of Milan University
WHO Collaborating Centre for Traditional WHO Collaborating Centre for Traditional MedicineMedicine
Activities:Activities:• ScientificScientific
– National and International Research protocols National and International Research protocols in the mentioned areasin the mentioned areas
• EducationalEducational– Training and Specialization graduate Courses Training and Specialization graduate Courses
for medical practicionersfor medical practicioners
• OrganizationalOrganizational– Workshops, Symposia, and ConventionsWorkshops, Symposia, and Conventions
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Centre for Research in Medical The Centre for Research in Medical Bioclimatology, Biotechnologies, and Bioclimatology, Biotechnologies, and Natural Medicines of Milan UniversityNatural Medicines of Milan University
WHO Collaborating Centre for Traditional WHO Collaborating Centre for Traditional MedicineMedicine
WHO:WHO:
• The The World Health OrganizationWorld Health Organization based in based in
Geneva, has acknowledged the Centre as Geneva, has acknowledged the Centre as
unique Collaborating Facility in Europe in unique Collaborating Facility in Europe in
the area of the area of Traditional MedicineTraditional Medicine (Thermal (Thermal
medicine, Acupuncture, Phytotherapy, medicine, Acupuncture, Phytotherapy,
Homeopathy, Ayurvedic medicine, etc.)Homeopathy, Ayurvedic medicine, etc.)
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
ISTAT Survey on the use of CAM by the Italian population
0
1
2
3
4
5
6
7
8
9
1991 1994 1999
AcupunctureHomeopathyPhytotherapy
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Three Important StepsThree Important Steps
• First StepFirst Step– Years 2000-2002Years 2000-2002
• Second StepSecond Step– Years 2002-2004Years 2002-2004
• Third StepThird Step– Years 2003-2006Years 2003-2006
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
First StepFirst StepYears 2000-2002Years 2000-2002
D.G.R n. VI/48041 - 4 February 2000:
“Observation and evaluation of therapeutic procedures of CAM”
TARGETS:TARGETS:• TO MONITORTO MONITOR the existing services and
providers of CAM• TO VERIFYTO VERIFY therapeutic potential through
observational studies, in order to achieve a preliminary evaluation of the efficacy of CAM in certain areas of pathology
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
OUTCOMEOUTCOME
• 134134 projects presentedpresented and reviewedreviewed
• 9999 projects approvedapproved and submittedsubmitted to
experimental evaluation
• 4242 projects completedcompleted
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Second StepSecond StepYears 2002-2004Years 2002-2004
CAM included in the Regional Community
Health Plan amongst the innovative projects
TARGET:TARGET:
• TO MANAGETO MANAGE the integration process
between conventional and non conventional
medicine
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Informational leafletInformational leaflet
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
WHY?WHY?
Main principlesprinciples outlined in the Plan applicable
to CAM:
• Freedom of ChoiceFreedom of Choice
• Safety of care and consumer protectionSafety of care and consumer protection
• Developing and monitoring the expertise Developing and monitoring the expertise and skills of providersand skills of providers
• Proper use of medicineProper use of medicine
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Main principles outlined in the WHO Main principles outlined in the WHO Traditional Medicine StrategyTraditional Medicine Strategy
• QualityQuality
• EfficacyEfficacy
• SafetySafety
• Rational use by Rational use by Consumers and Consumers and ProvidersProviders
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Third StepThird StepYears 2003-2006Years 2003-2006
D.G.R n. VII/13235 - 9 June 2003:
“Quadriennal Cooperation Plan with WHO on evaluation and use of CAM”
TARGET:TARGET:
• TO CONTINUETO CONTINUE observational studies in the field of CAM
• TO PROMOTE TO PROMOTE clinical trials clinical trials in the field of CAM
• TO COLLABORATETO COLLABORATE with WHO to implement the Memorandum of Understanding that provides a quadrennial cooperation plan relating to CAM
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Memorandum of Understanding between The Memorandum of Understanding between WHO and the Regional Government of WHO and the Regional Government of Lombardy was signed on 15 July 2003Lombardy was signed on 15 July 2003
TARGETS:• The Regional Government of Lombardy
collaborates with WHO to promote safetysafety, qualityquality, efficacyefficacy and rational userational use of CAM by Consumers and Providers in order to protect citizens’ health
• To develop a set of guidelinesguidelines addressed both to providers and consumers in order to assure safetysafety, qualityquality and efficacyefficacy of CAM therapies and products and to outline minimal standards standards of trainingof training for providers
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
The Memorandum of Understanding is based The Memorandum of Understanding is based on 3 main Projects:on 3 main Projects:
1. Promotion of rational userational use of CAM by consumers
2. Promotion of correct practicecorrect practice of CAM therapies by providers
3. Promotion of the quality and safetyquality and safety of herbal medicines, including homeopathic products
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Excerption of Activities in Collaboration with Excerption of Activities in Collaboration with WHO:WHO:
• 1-3 December 2003:• WHO Consultation on Proper Use of TRM/CAM by WHO Consultation on Proper Use of TRM/CAM by
ConsumersConsumers
• 5-7 December 2003:• 1st Working Group on the Efficacy of Homeopathy1st Working Group on the Efficacy of Homeopathy
• 19-21 March 2004:• 2nd Working Group on the Efficacy of Homeopathy2nd Working Group on the Efficacy of Homeopathy
• 12-14 July 2004:• WHO Consultation on Contaminants and Residues WHO Consultation on Contaminants and Residues
in Herbal Medicinesin Herbal Medicines
• 2-4 December 2004:• WHO Consultation on ChiropracticWHO Consultation on Chiropractic
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Lombardy Region Activities:Lombardy Region Activities:• 4 December 2003:
• Roundtable about CAM and consumer protectionRoundtable about CAM and consumer protection
• 14 May 2004:• International Congress about CAM researches in International Congress about CAM researches in
Lombardy RegionLombardy Region
• 29 June 2004:• Roundtable about the WHO guidelines on the Roundtable about the WHO guidelines on the
development of information about CAMdevelopment of information about CAM
• 26 November 2004:• Workshop for the media about Consumer informationWorkshop for the media about Consumer information
• 20 January 2005:• Training course for medical doctors about the proper Training course for medical doctors about the proper
use of CAM by Consumersuse of CAM by Consumers
M. Italiano - WHO Collaborating Centre for Traditional Medicine - Milan
Suggested areas to increase stability Suggested areas to increase stability of CAMof CAM
• Stronger design of Epistemological basisStronger design of Epistemological basis
• Development of Basic and Clinical Development of Basic and Clinical
ResearchResearch
• CUSTOMER SATISFACTIONCUSTOMER SATISFACTION