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Malaysia

Chronological development

Chronology of medical system development in Malaysia:

Year Chronology
Before 15th Century

Indigenous / traditional native medicine – practiced by Orang Asli of the Malay Peninsula (Negrito, Senoi & Proto-Malays) & Pribumi of Sabah and Sarawak [1].

During this period, traditional Malay medicine was strongly influenced by the animistic culture of Hindu-Buddhism from the sub-continent of India [2].These were the common forms of medical treatment. Survival and quality of life were dependent on traditional medicine.

15th Century Islam was introduced by traders and missionaries from India and Arab who came to Malacca, the maritime empire in that era. Islam created large influence on the traditional medical system. Among them was treatment by recitation of verses from the Quran [3].
19th Century

Traditional Chinese medicine started from 1800 onwards when the Chinese population began to increase rapidly in Penang and Singapore [1][3].Traditional Indian medicine commenced at the same time as the Chinese migrants flourished. Practiced mostly by Indians in the rubber estates, plantations and big cities [1][3].

Influx of modern medicine was taken up quickly for its ease and effectiveness – brought in by the colonial British [1][2].Complementary medicine started appearing into the scene [4].

20th Century till now

Modern medicine is the mainstream practice with traditional and complementary medicine treatments available as alternative.

1992 Registration of traditional medicine.
1996

T&CM Unit was formed in the Ministry of Health.

1997 Good Manufacturing Practice (GMP) was implemented for traditional medicine manufacturers.
1998 Formation of the T&CM Standing Committee.
1999 Formation of the five T&CM practitioner bodies.
2000 Formation of the Herbal Medicine Research Centre in the Institute for Medical Research.
2001 National Policy on Traditional and Complementary Medicine was launched [5].

2002

Formation of the National Committee in R & D on Herbal Medicine (NRDHM) [6].Global Information Hub on Integrated Medicine’s web portal was established [6].

2003 Formation of National Institute of Natural Product, Vaccine & Biological [6].

2004

Formation of Traditional and Complementary Medicine Division in the Ministry of Health.
2007

The first T&CM Unit was established in Kepala Batas Hospital, Pulau Pinang [7].Global Information Hub on Integrated Medicine, GlobinMed was officially launched.

2008

Launching of online registration for local T&CM practitioners.Establishment of Inspectorate and Enforcement Section at T&CM Division to organize enforcement activities on Traditional T&CM premises.

T&CM Unit established and started to operate in Sultan Ismail Hospital, Johor and Putrajaya Hospital, Wilayah Persekutuan Putrajaya.

2009

T&CM Unit establishment in 3 more site in Duchess of Kent, Sabah, Sultanah Nur Zahirah Hospital Kuala Terengganu and Sarawak General Hospital, Sarawak [8].

2010 The other 2 units of T&CM were established in Sarawak General Hospital, Sarawak, Port Dickson Hospital, Seremban, Negeri Sembilan, and Sultanah Bahiyah Hospital, Alor Setar, Kedah [9].
2011 Establishment of T&CM units in Sultanah Hajjah Kalsom Hospital, Cameroon Highland, Pahang and Raja Perempuan Zainab II Hospital, Kelantan [10].
2012 Establishment of T&CM units in Cheras Rehabilitation Centre, Kuala Lumpur [10].

Table 1: Chronological medical system development in Malaysia

Current Practice

  • Allopathic medicine is the main traditional medicine system currently in use in Malaysia.
  • Traditional and complementary medicine continues to be utilized for these years and is largely influenced by different ethnic backgrounds.
  • The Government of Malaysia recognizes the role played by traditional and complementary medicine and therefore supports its proper use, particularly as individual and community practice. Presently, the Ministry of Health Malaysia has initiated efforts to bring proven traditional and complementary medicine into mainstream healthcare services. The Ministry of Health has also established a Traditional and Complementary Medicine Division to support activities related to traditional complementary medicine.

Prevalence

  • Traditional Malay medicine (TMM), traditional Chinese medicine (TCM) and traditional Indian medicine (TIM), homeopathy and other complementary systems are among the biggest modalities being practiced.
  • In 2004, the Malaysian Ministry of Health conducted a study on the utilization of traditional and complementary medicine (T&CM) in local population. The survey showed that 55.6% of Malaysians have ever used any kind of T&CM in their lifetime was 69.4% (67.6% - 71.2%) [11]. In the past 12 months prior to the study, the prevalence was 55.6% (53.8% - 57.4%) [12]. The table below indicated that a big percentage of the population surveyed was using biologically-based therapy for health problem.

T&CM Categories

% of sample population citing usage of T/CM for health problems
Biologically-based therapy (e.g. herbs, vitamins supplement) 88.9
Manipulative & body-based (e.g. massage, reflexology, chiropractic) 27.0
Mind-body medicine (e.g. hypnosis, prayer, meditation, yoga, taichi) 11.1

Whole medical system (e.g. acupuncture, ayurveda, homeopathy, Chinese medicine)

1.9

 

 

 

 

 

Table 2: Utilization of T&CM by the Malaysian population based on categories [11]

Administration

Official Body

Traditional and Complementary Medicine Division (T&CM Division)

Contact

Traditional & Complementary Medicine Division
Ministry of Health
Block E
Jalan Cenderasari
50590 Kuala Lumpur
Malaysia
Contact No: +603 2698 5077
Fax No      : +603 2691 1259
 
Email        : This email address is being protected from spambots. You need JavaScript enabled to view it.
                  This email address is being protected from spambots. You need JavaScript enabled to view it.
Website    : http://tcm.moh.gov.my
 
State Branches
Penang

Traditional and Complementary Medicine Branch Office,
Penang State Health Department,
Kompleks Kesihatan Butterworth,
Jalan Pantai,
12000 Butterworth.
PENANG
Tel : 604-3233 531
Fax: 604-3233 540

Terengganu

Traditional and Complementary Medicine Branch Office,
Terengganu State Health Department,
Tingkat 8, Menara Yayasan Islam,
Jalan Sultan Omar,
20300 Kuala Terengganu,
TERENGGANU
Tel: 609-622 2627
Fax: 609-622 7486

 Johor


Traditional and Complementary Medicine Branch Office
Johore State Health Department,
9-01, Tingkat 9,
Menara MSC, Cyber Port,
Jalan Bukit Meldrum
80300 JOHOR.
Tel: 607-221 1787
Fax: 607-221 2787

Sarawak


Traditional and Complementary Medicine Branch Office
Sarawak State Health Department,
N0. 23, Lot 2366 Block 10,
Tingkat 1 & 2, Kucing Central Land,
Bormill Estate,
93200 Kuching.
SARAWAK
Tel: 6082-233 346 (GL) / 349 (DL)
Fax: 6082-233 341

Sabah

Traditional and Complementary Medicine Branch Office
Sabah StateFax: Health Department,
LOT D9.7, Tingkat 9, Blok D,
Bangunan KWSP,
88598, Kota Kinabalu,
SABAH
Tel: 6088-265 960 / 6088-252 798
Fax: 088-211 277 / 088-253 072

 Table 3: Contact details of T&CM Branch Offices [13]

Main therapies

There are 6 practitioner bodies that represent each major T&CM modalities in Malaysia. The roles of these bodies are to assist the T&CM Division on [14]:

  1. Registration and self-regulation of T&CM practitioners through the compliance of standard codes of practices and conduct of identified modalities.
  2. Development of training curriculum and establishment of training centers.
  3. Various activities organized by society or organization related to T&CM.
  4. Development of database for practitioners, clients and other bodies which are related to T&CM.
  5. Improvement of technical cooperation and strategic alliance within government agencies and private sectors in T&CM.
  6. Investigation of complaints against practice, premises and advertisement.
  7. Promotion of T&CM health tourism.
 tncm practitioner bodies
 
GAPERA : Gabungan Pertubuhan Pengamal Perubatan Melayu Malaysia
MCMA : Malaysian Chinese Medical Associations
FCPMDAM : Federation of Chinese Physicians and Medicine-Dealers Association of Malaysia
FCPAAM : Federation of Chinese Physicians & Acupuncturists Association of Malaysia
PEPTIM : Malaysian Association of Traditional Indian Medicine

MPHM

: Malaysian Homeopathic Medical Council

FCNMAM

: Federation of Complementary & Natural Medical Associations, Malaysia
DARUSSYIFA’ : Persatuan Kebajikan dan Pengubatan Islam Darussyifa’
 
Diagram 1: Eight professional bodies assigned by Ministry of Health, Malaysia
 

Policy & Regulations

The Malaysian Government is gradually and consistently working on regulating and controlling T&CM through policies, acts and guidelines in order to ensure its safety and effectiveness.

Policy

  • The Malaysia's National Policy [15] on Traditional and Complementary Medicine was launched in 2001.
  • The vision of the policy: "Integration of Traditional and Complementary Medicine (T&CM) into the Malaysian Healthcare System".
  • The mission is to "ensure quality and safe use of T&CM practices and products to attain optimal potential in healthcare delivery".
  • The Policy Statements are:
  1. Promotion of proper T&CM practice in accordance with standard ethics particularly in the primary healthcare delivery system.

  2. Establishment of appropriate education and training of T&CM practitioners

  3. Adherence to acceptable standards of safety and quality for products and practice

  4. Facilitation of the development of responsible advertisement with relevant agencies

  5. Establishment of strong research and development activities in T&CM.

  6. Promotion and advocacy of T&CM

  7. Facilitation of the development and protection of intellectual property rights related to T&CM knowledge, culture and biological resources.

  8. Conservations of plants and animals for progress of T&CM development with participation of all relevant agencies

  9. Enhancement of international technical co-operation and exchanges relevant to T&CM.

Guideline

  • The T&CM Division was developed six (6) Practice Guidelines [13]
    • T&CM Practice Guidelines on Acupuncture, 2007 (reviewed on 2009)
    • T&CM Practice Guidelines on Malay Massage, 2008 (reviewed 2009)
    • Standard operating procedures for T&CM units, 2007 (reviewed 2009)
    • T&CM Practice Guidelines on Malay Postnatal Care (2009)
    • T&CM Practice Guidelines on Herbal Therapy as an Adjunct Treatment for Cancer (2009) 
  • The T&CM Division was developed 4 Good Practice Guidelines [13]:
    • Good Practice Guideline on Acupuncture, 2010
    • Good Practice Guideline on Malay massage, 2010
    • Good Practice Guideline on Reflexology, 2011
    • Garis Panduan Perkhidmatan Spa, 2011

Regulation

  • In the effort of integrating the T&CM into the national healthcare system, the Ministry is formulating the T&CM Bill. 
  • Acts related to T&CM Products:
    • Control of Drug and Cosmetic Regulation, 1984
    • Poison Act 1952
    • Sale of Drug Act 1952
    • Advertisement and Sale Act 1956
    • Protection of Wild Life 1972

Overview of T&CM Control in Malaysia

In summary, Malaysia concentrates on 4 main areas of T&CM i.e. product, practices, training and research.

tcm CONTROLLING BODY

Diagram 2: The controlling body for specific areas within the Ministry of Health Malaysia [4]

Facilities

Untill 2013, eleven (11) government hospitals have been incorporate several modalities in the day to day service [10]. In the meantime, these T&CM units offered only traditional Malay Massage, Acupuncture, Herbal Medicine, Malay postnatal massage and Shirodhara [10].

  • Kepala Batas Hospital, Pulau Pinang (2007)
  • Putarajaya Hospital, Wilayah Persekutuan Putrajaya (2008)
  • Sultan Ismail Hospital, Johor Bahru (2008)
  • Duchess of Kent, Sabah [2009]
  • Sultanah Nur Zahirah Hospital, Kuala Terengganu (2009)
  • Sarawak General Hospital (2009)
  • Port Dickson Hospital, Seremban (2010)
  • Sultanah Bahiyah Hospital, Alor Setar, Kedah (2010)
  • Sultanah Hajjah Kalsom, Cameroon Highland, Pahang (2011)
  • Raja Perempuan Zainab II Hospital, Kelantan (2011)
  • Cheras Rehabilitation Hospital, Kuala Lumpur (2012)

For the moment in the private sector, there are only three (3) hospitals that practices parallel integrated medicine namely for Traditional Chinese Medicine. The hospitals are Putra Hospital in Malacca, Tung Shin Hospital in Kuala Lumpur and Lam Wah Ee Hospital in Penang.

Insurance coverage

Currently, there is no insurance coverage for any T&CM modalities in Malaysia.

Research Institute/s

The National Committee for R&D in Herbal Medicines was set up in 2001 to develop, monitor and coordinate strategic master plan for research and development of herbal medicine in Malaysia. The committee has published 4 guidelines:

  • Guidelines for levels and kinds of evidence to support claims for therapeutic products
  • Guidelines for the clinical evaluation of T&CM interventions
  • Guide to Intellectual Property Rights Management
  • Guidelines for standardization of herbal medicinal products

Among the important research institutes are:

  • The National Institutes of Health namely the Institute for Medical Research (IMR), National Institute for Natural Products and Vaccinology, Institute for Health System Research
  • Forest Research Institute Malaysia (FRIM)
  • Malaysian Agricultural Research and Development Institute (MARDI)
  • The universities e.g. University Malaya, University Science of Malaysia (USM), University Putra Malaysia (UPM), The National University of Malaysia and others

 

Training & Education

At present, Malaysia is establishing the education program in T&CM together with the Ministry of Higher Education. It has been established that such courses have to be registered with the ‘Jabatan Pendidikan Negara’ (National Education Division) and the program need to be approved by Malaysian Qualification Agency (MQA). Subsequent to Workshop on Development of Standards and Criteria organized by T&CM Division, they successfully form  T&CM programmes for both diploma and degree levels (Table 3).
 
TCM malaysia educational programme
Table 4: T&CM educational programmes in Malaysia [13]
 
The development of standard and criteria is prioritized based on practices which have industrial demand and sufficient documentation of their effectiveness. Some of the objectives of the workshop include a preview of the qualities required to meet the standard and criteria in order to fulfill the format set by the ‘Bahagian Jaminan Kualiti’ (Quality Assurance Division) and ‘Jabatan Pengajian Tinggi’ (Department of Higher Learning) to certify higher-level learning; to obtain consensus to develop syllabus for T&CM learning fields, to ensure that the T&CM learning programs are of international standards.  
 
No. Institutions Courses offered

1

Southern College, Skudai

  • University Foundation for Degree Programme (Traditional Chinese Medicine)

  • Bachelor Degree of Traditional Chinese Medicine 4 + 1 in collaboration with Xiamen University, China

2

Tunku Abdul Rahman University (Sungai Long Campus)

  • Bachelor of Traditional Chinese Medicine  (Hons)

3

INTI International University College

  • Bachelor of Traditional Chinese Medicine  (Hons)

4

Cyberjaya University College of Medical Sciences (CUCMS)

  • Bachelor of Homeopathy

5

Management and Science University (MSU)

  • Bachelor of Traditional Chinese Medicine  (Hons)

  • Diploma in Traditional Chinese Medicine

6

International Medical Unversity (IMU)

  • Bachelor of Science (Hons) Chinese Medicine

  • Bachelor of Science (Hons) Chiropractic

7

Malacca College of Complementary Medicine

  • Diploma in Natural Medicine

Table 5: Institution providing T&CM courses in Malaysia; adapted from Traditional and Complementary Programme in Malaysia [13]

The T&CM Division has been conducting a series of introductory lectures to both the allopathic (including MOH staffs) and T&CM practitioners. The former offers a peek into the various T&CM modalities available, their principles and benefits during a series of monthly short seminars after which the attendees are awarded Continuous Medical Education (CME) points. In order to ensure T&CM practitioners go through a proper education and training, T&CM Division conducted siries of Anatomy and Physiology Courses [16]. In addition, T&CM Division senior officers have been visiting major hospitals nationwide as guest speakers to give preview of the Goverment’s policies pertaining to T&CM in the country.

Links

References

  1. Muzaffar Desmond Tate, Khoo Kay Kim, Selvamany Gabriel. History of Medicine in Malaysia – The Foundation Years. Malaysia: Academy of Medicine of Malaysia; 2005. Pg 1-33.
  2. Dentan, RK. “Disreputable magicians’, the dark destroyer, and the trickster lord: Reflections on Semai religion and a possible common religious base in South and Southeast Asia. Asian Anthropology. 2002; Vol 1: 153 – 194.
  3. World Health Organization. Legal Status of Traditional Medicine and Complementary /Alternative Medicine: A Worldwide Review. Geneva: WHO; 2001. Pg. 160-163.
  4. Jaafar Lassa. Traditional & Complementary Medicine in Malaysia. Presentation at 2006 Governmental Forum on Traditional Medicine (2006 GFTRM). Beijing, 2006.
  5. World Health Organization. National Policy on Traditional Medicine and Regulation of Herbal Medicine. Geneva: WHO; 2005.
  6. Traditional and Complementary Medicine, MO. History of T/CM Division. Buletin BPTK. 2006 Sept - Dec;1(1).
  7. Mahani, M. Integrated Hospital & T&CM Unit.Buletin BPTK@KKM. 2009 Jan – Jun;05(26).
  8. Mohd., H.M.Z., 3 New Integrated Hospitals Near You!. Buletin BPTK@KKM. 2009 Julai – Dec; 06(5).
  9. Radzuan, M.B. New Units of T&CM (Alor Setar and Port Dickson). Buletin BPTK@KKM. 2010 Jan – Jun;07(4).
  10. Traditional and Complementary Medicine Division, MOH. Evolution of traditional and complementary medicine: in the Malaysian public healthcare system. Malaysia: Traditional and Complementary Medicine Division; 2013.
  11. Siti, Z. M., et al. (2009). Use of traditional and complementary medicine in Malaysia: a baseline study. Complementary Therapies in Medicine. 17(5-6): 292-299.
  12. Tahir Aris, Azman A.H., Sondi S., Zakiah Ismail et. al. The utilisation of traditional & complementary medicine in the Malaysian population – a community based survey. Journal of Health Management. 2006. Suppl.:76.
  13. Traditional and Complementary Medicine Division, MOH. Traditional complementary medicine programme in Malaysia. . Malaysia: Traditional and Complementary Medicine Division; 2011.
  14. Traditional and Complementary Medicine Division. [homepage on the internet]. [cited 2011 Jan 5]. Available from: http://tcm.moh.gov.my/v4/pdf/TOR.pdf
  15. Ministry of Health Malaysia. National Policy of Traditional and Complementary Medicine. 2nd Revision. Malaysia: Traditional and Complementary Medicine Division ;2007.
  16. Traditional and Complementary Medicine Division, MOH. Bulletin BPTK@KKM. 2008; 4.

 

 Update: 17 March 2015