Philippine Country Report
3rd Conference on Traditional Medicine in ASEAN Countries, October 31-November 2, 2011 Solo, Indonesia
Assistant Secretary Elmer G. Punzalan MD, FICS, MHA, MHSA Department of Health
On this present day, where modem Western medicine takes the lead in improving the quality of health of the Filipinos, many still cannot afford the privileges allopathic medicine has offered. This is the reason the Department of Health started the Traditional Medicine Program in 1992.
It was in 1997 that the approval of Republic Act No. 8423, also known as the Traditional and Alternative Medicine Act of 1997, created the Philippine Institute of Traditional and Alternative Health Care (PITAHC). The Institute is a government-owned and controlled corporation attached to the Department of Health that answers the present needs of the people on health care through the provision and delivery of traditional and alternative health care (TAHC) products, services, and technologies that have been proven safe, effective, and affordable. More importantly, we are mandated by law to accelerate the development of traditional and alternative health care and to integrate traditional and alternative medicine into the national health care delivery system.
The Traditional and Alternative Medicine Act tasks the institute the following:
- To encourage scientific researches on traditional and alternative health care systems (TAHC).
- To promote and advocate the use of traditional and alternative health care modalities which are proven safe, effective, and cost effective.
- To develop and coordinate skills training courses for various forms of TAHC modalities.
- To formulate standards, guidelines, and codes of ethical practice of TAHC modalities.
- To formulate policies for the protection of indigenous and natural health resources technology.
- To formulate policies to strengthen the role of TAHC delivery system and
- To promote traditional and alternative health care in international, national conventions, seminars, and meetings.
These objectives have a direct bearing in our programs and projects as well as to our partner TAHC practitioners and institutions. These also further strengthen our vision of “Traditional and alternative health care in the hands of the people”.
The interim organizational structure of PITAHC compliments the respective programs and special projects which were formulated based on the vision of PITAHC and its objectives.
Social Advocacy and Training Division
The division is responsible for the promotion and advocacy of traditional and alternative health care in the country. Among its regular activities include training on basic acupuncture for physicians, acupressure for common ailments, Tuina massage, and community-based herbal medicine preparation such as herbal soap, herbal ointment, and decoction.
The division also conducts regular orientation seminar series on different traditional and complimentary/alternative medicine to the different regions of the country, with special focus on the training of municipal health workers and community/village health workers, as they are the ones who are directly engaged in overseeing their community’s health.
The trainings in these communities have resulted not only in both health and economic benefits and accessibility of the needed health remedies, but also in positive attitudinal changes that is building of people’s confidence and self image. More importantly, it practically freed them from dependence on commercial drugs and demonstrated in the community’s ability to use and develop local resources to manage and solve their common non-complicated health problems.
In addition, we have established Zonal Centers for Traditional and Alternative Health Care in identified state universities and colleges (SUCs). These zonal centers serve as PITAHC’s arm in disseminating the benefits of traditional and alternative health care.
Standards and Accreditation Division
The division is responsible for formulating standards and guidelines for the practice of various forms of TAI IC modalities. In order to accelerate the practice of certain modalities, public review workshops focused on the draft competency standards, code of ethical practice, as well as accreditation system are being conducted. The institute has formalized through publication in the National Administrative Register, the competency standards, code of ethical practice and accreditation system for the practice of acupuncture and chiropractic. It is presently certifying acupuncturists and chiropractors and accrediting training programs, centers and clinics. Competency standards, code of ethical practice as well as accreditation system are currently being worked on for the practice of homeopathy, naturopathy, and hilot or Filipino traditional massage.
Moreover, the institute is also coordinating with a local government health insurance providers (e.g. PhiIHealth), in the hopes of allowing its members to avail of benefits when treated by acupuncture and other forms of TAHC modalities in the future.
Research and Development Division
The division is responsible for the conduct of priority TAHC research agenda that will have direct impact on public health care.
Research is more concentrated on herbal medicine through use of WHO guidelines for clinical research on herbal medicine. Four out of ten priority herbal plants that has undergone research is now listed in the Philippine National Drug Formulary and includes Lagundi (Vilex negundo), Sambong (Blumea balsamifera), Yerba buena (Mentha cordifolia) and Tsaang Gubat (Carmona retusa).
The division has collaborated with the National Institute for Health of the University of the Philippines for the researches Documentation of Philippine Traditional Knowledge and Practices in Health and Formulation of Guidelines on Herbal Products that will Harmonize the Regulations of the Food and Drug Administration with the Traditional and Alternative Medicines Act. Moreover, the institute collaborated with the Research and Biotechnology Division of the St. Luke’s Medical Center for the research Screening of Indigenous Bioresources for Antiviral Activity: Phase I Cellular and Molecular Assays using a Dengue Virus In Vitro Model.
In addition, product development is currently being conducted on Psidium guajava for use as antiseptic and feminine wash.
Herbal Processing Plants
The Institute has four herbal processing plants strategically located all over the country. Originally set up as research centers for herbal medicine, the herbal processing plants are responsible for the production of the different herbal products being marketed by the Institute. They produce the following: 1. Lagundi (Vilex negundo)tablet and syrup; 2. Sambong (Blumea balsamifera) tablet; 3. Tsaang gubat (Carmona retusa) tablet: 4. Herbal soaps: and 5. Herbal teas.
A study was also conducted by the Research and Development Division concerning Industrial Hygiene/Environmental Monitoring Assessment of PITAHC, DOH Herbal Processing Plants to improve herbal plant operations.
Apart from the activities above, the institute accommodates students for on-the-job trainings and internship programs, assists in student researches, and hosts annual plant visits or tours to students. To further support our activities, the institute is constructing its own four-storey building which is located side by side with the East A venue Medical Center, a tertiary hospital that is dedicated to the practice of allopathic medicine. PITAHC will offer within this new structure, traditional and alternative health care therapies like acupuncture, massage, and other alternative health care modalities.
Current Issues in the Development of TM in the Philippines
A study by Paul Kadetz (2010), doctoral candidate from the University of Oxford, for the WHO-Western Pacific Region Country Report, on the State of Traditional, Complementary, and Alternative Medicine in the Philippines, cited a number of issues that include the following:
- Partial implementation of TAHC regulation due to shared enforcement responsibilities between PITAHC, the lead agency responsible for the promotion of TAHC, Department of Health, and the Food and Drug Administration.
- Need for an increased promotion of public awareness of, and access to, Traditional Medicine/Complimentary and Alternative Medicine (TM/CAM).
- Limited funding for trainings at the municipal and local levels due to a decentralized form of health care system.
- Need to conduct cost-effectiveness and cost-benefit analysis for TM/CAM concerning the benefits of TM/CAM in poverty alleviation and health service delivery improvement.
- Irregular monitoring of TM/CAM practices and practitioners due to limited incentives for certified practitioners and accredited clinics and training centers.
- Limited financial, educational or temporal resources to monitor and regulate standardization at the local level.
- Minimum priority in government funding for research and infrequent public educational programs for research findings.
- Need to formalize intellectual property rights for traditional knowledge and
- Need to focus on cultural integrity (i.e. keeping cultural integrity intact from potential compromises in the standardization of practice) in the implementation of TAMA.
Future Plans and Programs
The Institute is proposing to build its activities for the next one to two years by adopting significant recommendations in the work of Kadetz (2010), which is also in accordance with our commitment to the World Health Organization – Western Pacific Regional Office (WHO-WPRO):
- Revise the Traditional and Medicine Act to strengthen TM/CAM regulation.
- Communicate and cooperate with the different levels of local health care as well as create a more formal referral network between TM/CAM practitioners and biomedical practitioners.
- Allocate funding for TM/CAM at the local level.
- Improve PITAHC database especially concerning inclusiveness of information regarding all local practices and practitioners.
- Collaborate with national and private health insurance providers in the creation of benefits and incentives for TM/CAM patients and practitioners, respectively.
- Create a committee or working group to facilitate the formulation of guidelines or minimum safety requirements for TM/CAM practices that cannot be standardized (e.g. faith healing, panic healing).
- Identify measures to expedite funds for TM/CAM research.
- Improve documentation of indigenous traditional know ledge on health care practices.
- Provide an avenue (i.e. conduct of forums and/or public hearing, etc.) for TM/CAM practitioners to take an active role in the integration process of TM/CAM in the communities and to determine the kind of integration that would be most sustainable in their respective localities.
With these projects and activities, as well as the present cooperation among ASEAN countries, we hope to attain our objective soon and carry out our mission that is to “Uphold the right of every Filipino to better health through the provision of safe, beneficial, affordable, and culturally acceptable traditional and alternative health care products, services, and technologies”.