Traditional Medicine Systems in Countries Around the World

CHAPTER 1

OVERVIEW

1.1. TRADITIONAL MEDICINE SYSTEMS IN THE COUNTRY AND ABROAD

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1.1.1. Traditional medicine systems in countries around the world

According to WHO definition (2000): Traditional medicine is the whole body of knowledge, skills and practices based on the theories, beliefs and experiences inherent in different cultures, whether explained or not, but used to maintain health, as well as to prevent, diagnose, improve or treat physical or mental illness [96].

The legal status of TCM in each country is different [97]. In some countries, TCM is well managed, whereas in some countries, it is only mentioned as functional foods and oral treatment methods without permission [94]. However, in developing countries, the rate of people using TCM is very high with many valuable folk experiences [91].

1.1.1.1. Traditional medicine in health care in developed countries

One-third of Americans have used traditional medicine. In 1990, sales of traditional medicine were estimated at $1 billion. In 1989, 60% of the population of the Netherlands and Belgium and 74% of the population of the UK were satisfied with traditional medicine treatment [97].

One of the typical countries using Traditional Medicine in health care is China, a country with a long-standing Traditional Medicine tradition and has had a profound influence on the Traditional Medicine traditions of many other countries such as: Republic of Korea, Democratic People's Republic of Korea, Japan, Vietnam...[93].

+ In China: From 1949-1978, under the conditions of limited resources, along with the development of the preventive health system and the Chinese health insurance system, there was a movement of "barefoot" doctors volunteering to examine at community health facilities [74]. In addition, the state-run TCM hospital system was initially being built and consolidated, and put into operation in public health care. From 1978-2000, the Chinese health sector realized many new challenges, the emergence of chronic diseases, injuries, increased medical costs, and poor infrastructure; In that context, Chinese Traditional Medicine plays a leading role in the medical examination and treatment system, taking care of people's health, using traditional medicine, gradually becoming multidisciplinary, modernizing equipment in traditional medicine hospitals to effectively implement the policy of the Communist Party of China to combine traditional medicine and modern medicine, the Chinese health sector has many reforms such as: centralized fee management, building a medical legal framework, insurance mechanism. From 2000 to now, 85% of provinces have achieved the set goals, the traditional medicine system has developed strongly, looking at it in general, 80% of hospitals in China use traditional medicine in medical examination and treatment [80], [82]. Currently, more than

3,000 enterprises are engaged in TCM activities. In 2004, the Chinese traditional medicine industry earned 90 billion yuan (equivalent to 11.1 billion USD), with a total output value accounting for 26% of the entire Chinese pharmaceutical sector [74]. Nowadays, the issue of combining TCM with modern medicine is one of China's main policies. In which, modern medicine practitioners are further trained in TCM, traditional medicine practitioners are further trained in modern medicine, they participate in state health programs and are officially recognized [85]. In 1995, China had 2,522 TCM hospitals with

353,373 medical staff and 236,060 hospital beds. These hospitals have treated

200 million outpatients and 3 million inpatients a year. At the same time

95% of hospitals in China have TCM departments [81], [93].

- The 2005 Chinese Traditional Medicine Development Conference reported that: Chinese Traditional Medicine has been accepted by more than 120 countries and regions in the world. In the UK, more than 3,000 hospitals practicing Chinese Traditional Medicine have been opened. About 2.5 million British people spend a total of 90 million pounds annually to receive treatment with Chinese Traditional Medicine. In France, there are 2,600 hospitals practicing Chinese Traditional Medicine with 7,000 to 9,000 acupuncturists. Up to now, at least 40 countries have opened acupuncture schools. Up to now, over 50 medical contracts have been signed between China and other countries, including cooperation on Chinese Traditional Medicine. Traditional Chinese Medicine in general has gained legal status in many countries including Singapore, Malaysia, and Indonesia [74]. In China, the number of traditional Chinese medicine hospitals is 2,728, accounting for 13.5% of the total number of hospitals nationwide, with a total of 385,000 beds in traditional Chinese medicine hospitals, accounting for 12.6% of the total number of beds nationwide. In recent years, the investment level has continuously increased. In 2008, the investment budget exceeded 3.5 billion yuan, used to support many areas in the field of traditional Chinese medicine, including: treatment, education, scientific research, culture, construction of traditional Chinese medicine hospital facilities, etc. [74]. China currently has many large universities: Tianjin University of Traditional Chinese Medicine Hospital, Hospital of Traditional Chinese Medicine, Beijing Traditional Chinese Medicine Hospital, Xifan Hospital - Chinese Academy of Traditional Chinese Medicine, Wangjing Hospital - Chinese Academy of Traditional Chinese Medicine, Shanghai Traditional Chinese Medicine Hospital, Chengdu University of Traditional Chinese Medicine Hospital, Zhejiang Provincial Institute of Traditional Chinese Medicine, Guangdong Provincial Institute of Traditional Chinese Medicine, Gansu Provincial Institute of Traditional Chinese Medicine, among which there are some long-standing universities: Tianjin University of Traditional Chinese Medicine Hospital: established in 1954, is the unit that manages

The largest scale of traditional Chinese medicine, established earliest in Tianjin. With a total area of over 80,000m2 , 1,300 beds, the number of patients admitted daily remains at over 1,700 people. The number of patients visiting daily is over 7,000 people, the number of patients visiting annually for the past 20 years has been over 1 million people. The annual bed utilization rate has been over 100% for the past 15 years. The operating model includes a general department: There are 35 technical departments

surgical, clinical, 103 specialized clinics, 24 inpatient wards [74].

+ Japan: With a history of traditional medicine of over 1,400 years, it is considered the country with the highest rate of people using traditional medicine in the world today. Japanese traditional medicine doctors are a combination of Chinese traditional medicine and Japanese folk medicine, commonly known as Kampo. Kampo is trained as follows: after graduating from medical school (6 years) and practicing for 3 years at medical facilities, then studying 3 more years of traditional medicine to become Kampoo. From 1974 to 1989, the use of traditional medicine in Japan increased 15 times while that of modern medicine increased only 2.6 times. At least 65% of doctors in Japan confirmed that they used a combination of traditional medicine and modern medicine at the same time [88]. The reason for this is that Kampoo does not cause reactions or side effects, and Kampoo medicine also meets the spiritual and mental factors of the Japanese people [88]. A Kampoo prescription intended for use in patients must go through two phases: in phase 1 all patients are given the drug and those who respond to the drug are selected, and in phase 2 a randomized clinical trial with a control group including patients who respond to the drug is conducted on and evaluates the drug's effects [10], [84]. Kampoo is not part of the state system but is encouraged to develop and Japan is the country with the highest rate of people using TCM in the world [85].

+ Republic of Korea: In this country, most public and private medical facilities operate for profit. The expansion of private medical facilities has led to inefficiencies in the public health system, overuse of necessary services, concentration of doctors in large cities, and an imbalance between high medical costs and low cost benefits. In the Republic of Korea, traditional medicine is very developed and has an equal status with modern medicine. However, in recent years, traditional medicine has tended to shrink due to the payment system for modern medicine being more generous and preferential [90].

+ Southeast Asia: The World Health Organization's global strategy focuses on the important role of T/CAM in protecting, improving and preventing the best and most widespread health. WHO encourages all ASEAN members to support T/CAM and continue to evaluate and formulate national policies with appropriate structures, moving towards the most appropriate practice and use of T/CAM and in line with the health care system, especially beneficial to health, socio-economic and commercial [86], [87], [89], [98], [100]. Indonesia, Malaysia, especially Thailand... are also countries with a tradition of using T/CAM to protect, care for and improve health [85]. From 1950 to 1980, T/CAM in Thailand was almost completely paralyzed due to overemphasis on modern medicine. This has affected the quality of primary health care (PHC) in Thailand. Since 1980, the Thai government and health sector have urgently established a policy to develop herbal medicines nationwide, conducted surveys on medicinal plants, pharmaceutical research, and gradually introduced traditional medicine into the national health system to serve the people's health care work [91]. Brunei Darussalam began to establish T/CAM - Department of Traditional Medicine - Ministry of Health on May 26, 2008, focusing on integrating T/CAM into health care services [87]. From December 23, 2002

By February 4, 2005, 8 traditional medicine experts from the Central Hospital of Traditional Medicine - Vietnam had come to the Traditional Medicine Research Center - Lao Ministry of Health to conduct clinical research on traditional medicine. During this time, the experts cured more than 5,000 patients with traditional medicine. The Lao Ministry of Health has planned to cooperate with the Vietnamese Ministry of Health to provide postgraduate training and short training courses on traditional medicine treatment methods [10].

+ Currently, there is almost no research topic in the world that has provided specific research on human resources for developing traditional medicine as well as the need for continuous training for staff working in traditional medicine. However, in the traditional medicine development strategy for 2002-2005, the World Health Organization continues to affirm the role and value of traditional medicine in primary health care for the people. The Western Pacific Traditional Medicine Strategy (2011-2020) has taken into account the challenges and trends of the region as well as the global strategic context. The strategy has noted that the direction of each country and territory will depend on the needs, capacity, priorities, current health policies, regulations, strategies, resources, culture and history of that country. The objectives of the strategy include [99]:

- Bring traditional medicine into the national health system.

- Promote the safe and effective use of traditional medicine.

- Increase opportunities for safe and effective use of traditional medicine.

- Promote the protection and sustainable use of traditional medicine resources.

- Strengthen cooperation in building and sharing knowledge and skills

practice traditional medicine

1.1.1.2. Traditional medicine in health care in other continents

African and Latin American countries, especially the tribes here, have long known how to make remedies from available plants in their habitat to prevent and treat common diseases in their communities.

According to the results of some studies in Australia, 48.5% of the population uses at least one type of traditional medicine treatment, and practicing doctors have recommended people to use herbs - one of ten alternative therapies (acupuncture, hypnosis, meditation, spinal manipulation, aerobics, yoga, homeopathy, herbs, massage, and flower smelling) [95]. The government has had policies to popularize this alternative method to the whole community [83], [92].

In the 2002-2005 Traditional Medicine Development Strategy, the World Health Organization continued to affirm the role and value of Traditional Medicine in primary health care for the people [94]. The World Health Organization (WHO) has actively and made efforts to support activities to develop Traditional Medicine resources in countries through training courses for traditional medicine practitioners in Laos, Mongolia, the Philippines and the Western Pacific island countries. The goal is to use trained traditional medicine practitioners to educate health or provide primary health care services using traditional medicine [90], [81]. Enhance the research capacity of traditional medicine in countries through organizing regional workshops, training courses and scholarships for training experts [90].

1.1.2. Traditional Medicine System in Health Care in Vietnam

1.1.2.1. Traditional Medicine System in Vietnam before the August Revolution

The founder of traditional medicine is the great physician Zen master Tue Tinh (14th century), who was honored by our people as the "Saint of traditional medicine". He put forward the view that "traditional medicine treats traditional people" in disease prevention and treatment. This is a view that is both scientific, humane, and humanistic, and also demonstrates the will of independence.

independence, self-reliance, national pride and the intellectual potential of the Vietnamese people in disease prevention and treatment. Tue Tinh clearly realized that Vietnamese people living in their country must be influenced by the soil, climate, drinking water, plants, animals and all kinds of animals available right there. To help people easily understand and remember the methods of treating diseases with traditional medicine, Tue Tinh compiled a book in verse to propagate traditional medicine. The poem on traditional medicine has 630 ingredients written in the national language. The first part of the book "Nam Duoc Than Hieu" has 400 ingredients written in Chinese characters, 82 of which have Vietnamese names... to popularize the experience of using traditional medicine in disease prevention and treatment for the people [67] [56].

During the Le Dynasty, there was a great physician named Hai Thuong Lan Ong - real name Le Huu Trac (1724-1791) who was a great physician of our country. In addition to his dedicated and talented treatment, he also compiled the "Hai Thuong Y Tong Tam Linh" book consisting of 28 volumes and 66 books, including books specializing in medicinal herbs and traditional medicine prescriptions such as: "Duoc Pham Vang Yeu", "Y Phuong Hai Hoi", "Linh Nam Ban Thao". The book is considered an encyclopedia of Vietnamese traditional medicine [57] [66] [14].

During the Tay Son Dynasty (1789-1802): physician Nguyen Hoanh from Thanh Hoa compiled a collection of traditional Vietnamese medicine with over 500 local herbs and plants and 130 medicinal minerals and animals with simple uses according to folk experience [67].

Under the Nguyen Dynasty (1802-1945): when there was an epidemic, the Imperial Medical Institute invited local physicians to participate in fighting the epidemic. The organization of the Imperial Medical Institute also specifically regulated the methods of providing medicine (preparation, inspection, packaging, decoction... of the Five Medicines Department) [67], [66].

Under the French colonial period (1884-1945): due to the influence of the "Westernization" movement in Eastern countries in general and Vietnam in particular, the colonial and semi-colonial regimes suppressed the traditional medicine industry, but mainly only occurred in urban areas.

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