The Current Situation and Future Direction of Traditional and Complementary Medicine (T and CM) in Malaysian Health Care System

Abstract

Malaysia is a multiethnic-multicultural society situated in Southeast Asia. It consists of thirteen states and three federal territories. The total land mass of Malaysia is 329,847 square kilometers which is separated by South China Sea into two regions [1]. The major ethnic groups are Malay (50.4%), Chinese (23.7%) and Indians (7%). Since independence, the country has established a modern health care system, however; T&CM also built its roots in the health care system. In Malaysia, an estimated US$ 500 million is spent annually on traditional therapies, compared to only US$ 300 million on conventional therapies [2]. Malaysian traditional medicines are one of the most valuable and rich cultural heritage of Malaysian people which reflects a diverse culture and tradition. While encouraging and supporting the western health care system in each possible way, the Malaysian cabinet in 2006 approved the proposal to set up an integrated medicine program that incorporates selected T&CM practices such as Traditional Malay massage and acupuncture for chronic and post stroke management, herbal therapy as an adjuvant treatment for cancer and Malay postnatal care with an aim to ensure the safety and quality of T&CM for its consumers [3]. Currently, there are a total of ten hospitals with integrated medicine units providing a holistic approach towards enhancing health and quality of life. Both local and foreign traditional practitioners who wish to offer their services in Malaysia are required to register with the T&CM division under the Ministry of Health, Malaysia. The practitioners are bound to comply with the proposed guidelines in order to offer evidence based practices. The Standard Operating Procedure (SOP) to conduct T&CM services in the hospital set-up requires patients to be seen by the allopathic practitioners before seeking traditional therapies. However, at present T&CM treatment is given only as an outpatient. Ensuring safety, efficacy and quality of T&CM products is a core objective of World Health Organization (WHO) towards recognizing the role of T&CM in modern health care system. Research activities in Malaysian T&CM policy are focused to evidence based medicines. Clinical expertise, research evidence and patient’s values and preferences are identified as key components of evidence based practice [4]. An emphasis on evidence based practice is expected to help providers in evaluating clinical effectiveness of treatment while eliminating unsafe practices [5]. To date, several publications such as ‘Guidelines on Malay massage and postnatal care, acupuncture, reflexology’ and ‘Herbal therapies as an adjunct treatment for cancer’ have been developed and readily available for both traditional and conventional practitioners who intend to offer T&CM practices. Several initiatives have been taken to ensure professional development of traditional practitioners through education and training. Bachelor degree programs in Traditional Chinese Medicines (TCM), Malay medicine, homeopathy, Ayurveda and chiropractic are also offered by local institutes. At the same time, skill based diploma certificate programs namely in Malay massage, acupuncture, Islamic medicine, reflexology and aromatherapy are also offered.