Medicine in Malaysia,
Today
9 March, 2003
This article was published in the Sunday Star (Tuesday 11 March, 2003, 'Leave Healthcare to doctors') and in Malaysiakini.com (Monday 10 March, 2003, 'Dear Health Minister, don't waste time on unproven drugs'). It was written in response to the newspaper report "Seeking traditional medicine man" (The Star, 6 March, 2003) in which, the Health Minister of Malaysia appeared to be promoting traditional medicine at the expense of scientifically proven allopathic medicine. Subsequently, the article below prompted a reply from Datuk Dr. Ismail Merican, the Deputy Director General of Health of Malaysia, (Research & Technical Support), Kuala Lumpur, which was published in The Star (Saturday 15 March, 2003, 'Use of traditional medicine on the rise'). The comments made by the Deputy Director General are published below, after the article. To highlight the misinterpretation of the statistics by the Deputy Director general, another article was written by the author entitled 'Shocking Medical Statistics' and is posted as a separate article here.
Dear Mr. Chua Jui Meng, Health Minister of Malaysia
Medicine, like education, should not be a field where politicians like you, could play around with unproven policies and concepts. Medicine should be treated with respect and care, and all medical treatment should be based on scientifically researched techniques and drugs, which have undergone rigorous testing and surveys. We cannot rely on traditional medication and other form of supernatural healing process, where the only proof of efficacy is in its subjective relief of symptoms.
Taking Paracetamol, traditional medication or herbal tea, can relieve a fever. But do we know what is the cause of the fever? We might be able to relieve the symptom but we have not found the root cause of the illness in the first place. It could be a virus infection or a bacterial infection. It could be a tumour or some inflammatory disease. And if the cause is not found and treated, the fever, and other symptoms might arise again.
In my opinion, traditional medicine is just a case of simply turning a blind eye to the root cause of health problems in our country. As a Health Minister, in a fairly advanced country like Malaysia, you should not be promoting traditional medication at the expense of scientifically based medicine. To do so would be a disservice to the quality of health for all Malaysians. A person in your position should not be hiding behind the blanket of ignorance, and disregard the root cause of the health problems in Malaysia.
Instead of wasting time studying the benefits of traditional medicine and embarking on a project to identify (traditional medicine) practitioners who have successfully treated diseases locally (The Star, 6 March 2003 Article on 'Seeking traditional medicine man'), the Ministry of Health should look into their own backyard in Selangor and initiate a program to contain the current spread of dengue fever in that State.
Despite my opposition towards the current trend of elevating the rank of traditional medicine, I must agree that most of the drugs and medical practice we use today, originate from past cultures and traditions. However, these traditional drugs and techniques have been scientifically tested and proven to be effective. The medical community have accepted them as modern medicine after being reviewed by peers and published in medical journals.
If the Government is serious in bringing traditional medication into mainstream medicine, they should do it in an organized manner.
1. The Government should ensure that our forests are not raped and devirginated by logging, both illegal and legal. Tropical forests hold a lot of medicinal treasures, which are yet to be discovered.
2. Provide incentives and encouragement for our scientists to do more research on these topics, instead of allowing the brain drain syndrome in our country to continue.
3. Avoid making spontaneous statements about certain qualities of certain traditional medicinal product without first conducting a medical trial. Malaysians have a tendency to believe the utterances of leaders and so called 'medical profesionals' without questioning whether the data given has been proven significant statistically.
4. Educate the public about diseases and the mode of treatment available in this country and the world. People should be correctly informed that diseases like Diabetes Melitus and Hypertension are not curable at the moment, but only controllable. I have met patients with these diseases who told me that they have been cured after taking some herbs and other traditional medication. The Malaysian public nowadays tend to believe their relatives and friends more than they believe health care professionals who have spent years in medical school to get their degree.
5. The Government should have tighter control over traditional medicinal products, which are sold openly to the public. It is an irony that the Ministry of Health places strict control over the availability and sale of modern medicine, but on the other hand does not have any control whatsoever over these traditional medicinal products. Potions claiming to cure all diseases are being sold everywhere and Malaysians are taken in by their claims. On the other hand, life saving procedures such as live donor organ transplants are being discouraged.
Health care should be left to health care professionals. After years of training, I am sure medical doctors are capable of diagnosing a disease and treating it. After all, it is the doctor who has direct contact with the patient. It is also the doctor who examines the patient as a whole and comes to a diagnosis based on proper examining techniques. Policy makers and traditional healers should not attempt to break this sacred bond between the doctor and the patient.
Mr. Chua Jui Meng. With all due respect, salutations and felicitations, I call upon your good self and your friends in the world of traditional medicine, to step back and let medical professionals carry on with their work.
Thank you.
Health Care Monitor
The response to the article above by Datuk Dr. Ismail Merican, the Deputy Director General of Health is listed below.
USE OF TRADITIONAL MEDICINE ON THE RISE
I REFER to the letter, “Leave healthcare to doctors” (The Star, March 11).
Among other things, Health Care Monitor said “traditional medicine is just a case of simply turning a blind eye to the root cause of health problems in our country” and that “the medical community has accepted them as modern medicine after being reviewed by peers and published in medical journals”.
The writer also stated “the Health Minister should not be promoting traditional medicine at the expense of scientifically based medicine”.
It is obvious the writer needs to be updated on the impact and influence of traditional and complementary medicine (TCM) in our daily lives and efforts by the Health Ministry in addressing this issue head-on.
Whether we like it or not, the use of TCM worldwide has catapulted over the last decade or so. Nearly 80% of the world population use some form of traditional medicine and, globally, the usage of herbal medicines increases at a rate of 10-20% annually.
Although Western (modern) medicine has contributed tremendously to healthcare development, the practice of traditional medicine involving different ethnicity, cultures, beliefs and experiences still prevails.
Some US$32bil (RM121.6bil) of sales of pharmaceuticals worldwide are attributed to traditional medicines.
In 1997 nearly one third of Americans used herbal products and herbal medicine sales in the US reached an estimated US$3.24bil (RM12.3bil).
In the same year, Malaysians spent about RM2bil on herbal products. It is interesting to note that while each American spent about RM45 on herbals, each Malaysian spent RM91, which is twice as much, taking into account populations of 273 million and 22 million respectively.
The ministry is mindful of the issues of quality and safety of products and practice of TCM practitioners and has, therefore, set up the National Standing Committee for TCM comprising representatives from the Malaysian Medical Association, World Health Organisation, the ministry and the five umbrella bodies (Malay, Chinese, Indian, complementary and homoeopathy).
The committee has contributed towards the National Policy of TCM, encouraged self-regulation, put in mechanisms for formal training and many more, while waiting for the new TCM Act to be established.
This Act will set another milestone towards ensuring quality, safe and effective TCM practices and products.
The Cabinet recently approved the formation of the National Committee for Research and Development on Herbal Medicines (NRDHM) to systematically coordinate and integrate the various research and development activities on herbal medicine conducted by the country’s various research institutions
The NRDHM will soon launch several guidelines to ensure that clinical trials conducted in Malaysia conform to international standards.
The Food and Drugs Authority in the US, a highly respected and formidable regulatory agency in the world has commended Malaysia for her “sophisticated and comprehensive” approach to herbal medicine research.
I urge Health Care Monitor not to turn a blind eye to TCM, given its increasing popularity and not to link it with “the root cause of health problems in our country”.
We are working very hard to put in the science in the art of TCM in this country. Modern medicine as it stands can never be challenged because of its fundamental scientific basis.
There is, however, room for TCM provided it is practised according to the high quality and standards laid down by the ministry.
DATUK DR ISMAIL MERICAN,
Deputy Director General of Health of Malaysia
(Research & Technical Support)
Kuala Lumpur.
The reply to Dr. Ismail's letter is found in the article entitled ' Shocking Medical Statistics'.
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