Posted on 30 March 2020
Dr Vivienne Lo from University College London, Professor Hugh MacPherson from the University of York, and Dr Aditi Bana from WHO in Geneva led the discussion.
The seminar is part of the Culture and Health series, a joint collaboration among WHO, the University of York, and the University of Exeter to engage academics and policymakers in discussions about the cultural and historical contexts of global health issues.
Dr Lo began the seminar by emphasising that much can be learned from traditional medicine, but that it must be evaluated in a way that is appropriate to how it is used. Traditional Chinese medicine is holistic and incorporates exercise, massage, and acupuncture. It depends on the skill of the doctor whose role is to prescribe therapies and artfully combine drugs in compound remedies that are specific to the patient. Treatment may change during the course of an individual’s recovery. Western medicine, in contrast, depends on standardisation and is usually reduced to its parts for analysis. Dr Lo asks whether we need to wait for evidence that would satisfy western medicine to advocate traditional Chinese medicine. In her words, it needs to be studied “on its own terms.”
Professor MacPherson presented a range of studies on the effectiveness of acupuncture for chronic pain. These included a meta-analysis published in 2018 that reviewed 39 trials involving over 20 thousand patients. It showed that acupuncture was more effective than no treatment or placebo effects in treating chronic pain. Professor MacPherson pointed out that this level of evidence is comparable to thousands of medical treatments that are supported by the NHS, but of which only half are known to be effective, according to a previous study by the British Medical Journal. If we require larger evidence to advocate acupuncture treatment, he said, we would need to wait to rely on big data, given that the scale of the effect of acupuncture is much smaller than, for example, opiates.
Dr Bana described WHO’s increasing work in traditional and complementary medicine (T&CM). The United Nations has recognised the role that T&CM could play in standard health care. In 2014, WHO launched a strategy to support countries in promoting T&CM use and in developing policies to regulate it and integrate it with standard health services. Since then most member nations have produced policies but are struggling to fund research that would add to the knowledge base for management policies. Nevertheless, ongoing T&CM activities at the WHO continue.
The Centre for Global Health Histories is indebted to our speakers for making the seminar possible. We also thank our fellow WHO and Exeter collaborators and remain grateful to the Wellcome Trust for its continual support.
Find the video recording here.
Event report by Alexandra Bradbury. MA, Medical History student, University of York.