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Conference Report

ORTHODOX AND HERBAL MEDICINE CONFERENCE
Theme: “Orthodox and Herbal Medicine: A Good Partnership for Quality Health Care Delivery”

28th October, 2010

Kama Conference Center Accra, Ghana

Table of Contents
About New Agenda Foundation ...........................................................................................................2 Acknowledgements ..............................................................................................................................3 List of Abbreviations ............................................................................................................................4 Executive Summary..............................................................................................................................5 1. Opening Ceremony.......................................................................................................................6 2. Plenary Sessions ...........................................................................................................................7 2.1. Session 1...............................................................................................................................7 2.1.1. The Role of Herbal Medicine: Prospects and Challenges. ...........................................7 2.1.2. The Missing Link between Orthodox and Alternative Medicine Practice ...................8 2.1.3. Codes, Standards and Ethics of Herbal Medicine Practice ..........................................9 2.1.4. General Discussions: Session 1 ....................................................................................9 2.2. Session 2.............................................................................................................................10 2.2.1. The Role of Orthodox and Traditional Medicine in Promoting Quality Health Care Delivery 10 2.2.2. Roles and Responsibilities of Key Health Institutions in Promoting Quality Health Care Delivery..............................................................................................................................11 2.2.3. General Discussions – Session 2 ................................................................................12 3. Way Forward ..............................................................................................................................12 4. Closing Remarks ........................................................................................................................13

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About New Agenda Foundation
New Agenda Foundation (NAF) is registered as a non-profit health, ICT and media organization.

Some of NAF’s key achievements include: A fundraising for Sheikh Osmanu Nuhu Sharubutu Educational Trust Fund (SONSETFUND) – 17th August, 2009 HIV & AIDS and Skin Conference – 28th – 29th October, 2009 Health Needs on GTV – 12th July – 13th October, 2010

NAF, since its formation, has been at the forefront of promoting quality health service delivery in Ghana by partnering and interacting with stakeholders in the health industry.

NAF ran a thirteen week TV programme on GTV dubbed “Health Needs” from 12th July to 13th October, 2010 where experts in the health industry were interviewed to find out the emerging trends in health technology as well as emerging diseases. Health Needs aired on Mondays 3:30pm. Since the programme engaged mainly practitioners from the herbal sector, NAF decided to organize a conference at the end of it all to bring all the stakeholders together for deliberations.

Contact Details: P. O. Box KB 891, Korle-Bu, Accra, Ghana.

E-mail: newagenda.foundation@gmail.com Phone: +233-242314805/ +233-246414414

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Acknowledgements
New Agenda Foundation is very grateful for the assistance of the following institutions and individuals who helped in various ways to make the conference a success. 1. CSIR-STEPRI 2. Ministry of Health 3. TAMP, Ministry of Health 4. TMPC 5. Prof. M.L.K. Mensah – Faculty of Pharmacy, KNUST 6. Mrs. Rose Omari – CSIR-STEPRI 7. Mr. Harrison Nimoh Agyemang –TMPC 8. Mr. Samuel Kwakwa – Coalition of NGOs in Health 9. Mr. Eugene Ansah Owusu Ampaw – TAMP, MOH 10. Miss Wendy Romaine – NAF Volunteer

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List of Abbreviations
CAM – Complementary and Alternative Medicine CSIR – Council for Scientific and Industrial Research CSRPM – Centre for Scientific and Research into Plant Medicine FDB – Food and Drugs Board GHAFTRAM – Ghana Federation of Traditional Medicine GHS – Ghana Health Service GMA – Ghana medical Association KNUST – Kwame Nkrumah University of Science and Technology MDC – Medical and Dental Council MOH – Ministry of Health NAF – New Agenda Foundation STEPRI – Science and Technology Policy Research Institute TAMP – Traditional Alternative Medicine Practice TCM – Traditional Chinese Medicine TMP – Traditional Medicine Practitioners TMPC – Traditional Medicine Practice Council WHO – World Health Organisation

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Executive Summary
The Orthodox and Herbal Medicine Conference was a one-day event to bring together the major stakeholders in the Health industry primarily to dialogue on how to ensure a good partnership between orthodox and herbal medicine practitioners and other non traditional players in the Health industry.

The theme for the event was “Orthodox and Herbal Medicine: A Good Partnership for Quality Health Care Delivery”

The Conference had 78 registered participants from across Ghana.

The goal of the conference was to promote dialogue and partnership between orthodox and alternative practitioners to ensure quality and affordable health care delivery. The conference consisted of an opening ceremony, two plenary sessions and discussions at the end of each session.

The conference created the platform for shared experiences among alternative medicine practitioners, mainly herbal practitioners, and policy makers by discussing how good practices could be encouraged and enforced.

The orthodox practitioners, i.e., Ghana Medical Association (GMA) and Medical and Dental Council (MDC) could not honour the invitation. It was decided at the end of the conference to continue to build bridges between the orthodox and alternative practitioners regardless and that the conference should be made a yearly event and to broaden the scope and participation by bringing on board other viable alternative medicine practitioners.

The conference was organized by New Agenda Foundation (NAF) in collaboration with the Ministry of Health (MOH), Department of Herbal Medicine - KNUST, Food and Drugs Board (FDB), Traditional Medicine Practice Council (TMPC), Council for Scientific and Industrial Research (CSIR), and Pharmacy Council.

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1. Opening Ceremony
The conference officially began with the arrival of the Guest of Honour in the person of the Honourable Deputy Minister of Health, Mr. Rojo Mettle Nunoo. The opening ceremony was started with a prayer by the President of the Council of Independent Churches, Apostle S. T. Doku. The representative for the Director-General of CSIR who was the Chairperson for the Opening Ceremony gave his remarks and in doing so commended NAF and its collaborators for holding such an important conference to enhance the health care delivery in Ghana. He noted that the special attention given by the conference to encourage partnership between the orthodox and herbal medicine practitioners is noteworthy. The Chairperson’s remarks were followed by a welcome address by Mr. Kwasi Boakye-Akyeampong, the Executive Director of New Agenda Foundation. He outlined the role the Foundation seeks to play in the promotion of quality health service delivery by helping to bring the key stakeholders to sit, dialogue, and share experiences. NAF plans to make this conference a yearly event.

Following the welcome address was a message of support from the Traditional Medicine Practice Council (TMPC) given by Mr. Harrison Nimoh Agyemang on behalf of TMPC.

Afterwards, the keynote address was given by the Honourable Deputy Minister of Health, Rojo Mettle Nunoo. The Deputy Minister commented that the Government of Ghana recognizes the difficulty in bringing both the orthodox and herbal practitioners together and mentioned the efforts of government in terms of policies to incorporate herbal medicine into mainstream medicine in Ghana. He however emphasized that the Herbal practitioners should be prepared to subject their work to rigorous scientific and clinical tests.

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2. Plenary Sessions
The conference was in two Plenary Sessions.

2.1. Session 1
Chairperson: Dr. Godfred Frempong - CSIR-STEPRI 2.1.1. The Role of Herbal Medicine: Prospects and Challenges. Speaker: Professor M.L.K. Mensah, KNUST

Professor Mensah’s presentation gave a general insight into herbal medicine as a global system of healthcare, established in traditional medicine or complementary and alternative medicine (CAM). He gave a general definition of medicine, and placed herbal medicine in the context of a valid health care system, with the goal of delivering safe and effective healthcare. He stressed that herbal medicines are the common denominator in several healthcare techniques including: Traditional Chinese Medicine (TCM), Ayurveda, Naturopathy, Osteopathy, etc. This makes herbal medicine the most popular form of traditional medicine practiced globally and a very lucrative business estimated to be worth several billion dollars. He indicated that herbal medicine has a scientific basis and in modern terms may be described as phytomedicine which has four basic rules with the same paradigm as orthodox/conventional medicine including: dose-response and efficacyconstituent relationships.

On the basis of the characteristics of phytomedicines, Professor Mensah hinted that there are challenges arising from lack of attention paid to procedure in the practice such as diagnosis, and to the products due to inadequate quality, safety and efficacy data. The paucity of comprehensive standards must be overcome to assure safety and effectiveness which serve as basis for evidence based practice. However, in the face of developments in science and technology prospects for its growth and development exist. These are supported by reports in the Cochrane review library that herbal therapies are generally not harmful.

In conclusion, he said that herbal medicine has great potential in both health and business aspects and called on all stakeholders to support the industry; science and technology must

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be applied as necessary tools for modernization of the practice and products.

2.1.2. The Missing Link between Orthodox and Alternative Medicine Practice Speaker: Mr. David Nii Amankwa Addo, CEO, Good Life Natural Health Institute.

Mr Addo opened his presentation by acknowledging that there is indeed a vital link between orthodox medicine and complementary and alternative medicine (CAM) practice. What, in his opinion, is missing is about the central theme concerning health and well-being and this can be addressed from the position of the “whole person “. There is a powerful link between the mind, body and spirit, on one side, and health and disease, on the other. He opines that the body and mind have an innate capability for self repair and this he said can be supported and enhanced by appropriate conventional (orthodox) as well as complementary or alternative (CAM) therapies. Mr Addo mentioned that there should be a considered and systemic change (shift) from a disease oriented, doctor and technology centred model into a health oriented patient centred approach that understands and empowers the integration of body, mind, spirit and social (society) or community in health care. He mentioned a 2005 WHO publication that stated that the leading causes of illness in the world were chronic diseases; strokes, cancers, diabetes, depression, high cholesterol and added “chronic digestion problems” as from his observation from private practice. He asserted that most chronic diseases are lifestyle based –for instance, eating habits; high proteins, acid foods, refined food, high calorie foods, high fat, greasy foods, etc. He however acknowledged that there are cases where patients are genetically predisposed to such diseases. Mr Addo mentioned that while we take advantage of all the advances in modern science with regard to detecting diseases early, understanding genetic underpinnings and or using precise and targeted surgical interventions, we also need medicine that understands the natural mechanisms of health that is part of the human body as well as practitioners who 8 2010

know how to put these modalities into use to help prevent illness or reverse and assist persons to recover from their chronic disease states. He concluded by admonishing the need to move from the position of addressing the symptoms to giving due consideration to the whole person and said, “this is the only way by which we can begin to bridge the gap”.

2.1.3. Codes, Standards and Ethics of Herbal Medicine Practice Speaker: Mr. Harrison Nimoh Agyemang, Traditional Medicine Council (TMPC) on Behalf of Mr F. K. Hlortsi, Registrar, TMPC.

The presentation of Mr. F.K. Hlortsi-Akakpo, the Registrar of TMPC was made by Mr. Harrison Nimoh Agyemang on behalf of the Council. The presentation addressed the following; objectives, scope of work of TMPC, Traditional Medicine Practitioners - TMP’s relationship with the public, TMP’s relation to colleague Practioners, TMP’s relations to patients, and TMP’s relations to their chosen profession.

Mr. Nimoh emphasized the importance of TMPs in health care delivery and urged the practitioners to familiarise themselves with and adhere to the codes and ethics of their profession which require them to do everything right in the course of their practice in order not to fall foul of the law. He said this will help weed out the fake ones among them, win public confidence, and also attract government’s support and cooperation.

2.1.4. General Discussions: Session 1 Some of the issues that came up during discussions were: Recent arrests of members of mostly herbal practitioners has put some fear into their members as a result they would have been happy if the FDB had been present to answer some questions They appealed to the government through the Deputy Minister of Health to assist them by ensuring that the impediments put their way in the form of exorbitant fees and cumbersome approval processes are eliminated.

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They feel they also contribute to the economy in the form of employment and therefore need to be encouraged. They also seek to be recognized by the GMA as part of the health care delivery system The government should encourage and create more opportunities for graduates of the Herbal Medicine programme at KNUST The Deputy Minister assured them that the government is prepared to work with them but they should also be prepared to follow the rules and regulations because health care is about life and the government would not compromise on standards. For instance, if they are willing to subject their preparations to rigorous scientific and clinical testing like orthodox drugs go through then they would have all the support from government. He mentioned that the government is not just sitting idle but taking proactive measures by encouraging the formation of supporting institutions like TMPC and TAMP as self regulatory bodies for their particular practice. There are also training programmes, workshops and conferences the government is supporting to help them improve and to enhance public confidence.

2.2. Session 2
Chairperson: Dr Margaret Price, HIV & AIDS Consultant 2.2.1. The Role of Orthodox and Traditional Medicine in Promoting Quality Health Care Delivery Speaker: Mr. Stephen Osafo-Mensah, Senior Research Scientist, Center for Scientific Research into Plant Medicine, Mampong-Akwapim.

Mr. Osafo Mensah’s presentation centered on five key areas namely; Traditional medicine in Ghana, Concept of disease in traditional medicine, Concepts of herbal medicine, and the role TMP can play in the total health care delivery system.

Tracing the origin of tradition medicine to the pre-colonial era he recounted the immense benefits traditional medicine has brought to our health care delivery system. He highlighted the challenges facing the herbal industry and called on the government to put in place 10 2010

mechanisms that would ensure a good partnership between orthodox and herbal medicine practitioners.

He also urged herbal medicine practitioners to be mindful of their work and make sure that in the course of their duty they do the right thing by abiding by all the necessary regulations and codes governing the industry.

2.2.2. Roles and Responsibilities of Key Health Institutions in Promoting Quality Health Care Delivery Speaker: Mrs. Susanna Larbi Wumbee, Ghana Health Service

The presentation discussed key issues like definition of quality health care, key health institutions, roles and responsibilities of key institutions, challenges and , way forward.

She emphasise that quality health care requires safe interventions, meeting clients’ needs, having unique management practices, strong leadership and teamwork, and finally impacting positively on morbidity, disability and mortality. In doing all these the

presentation revealed that certain attributes are also required to make quality health care attainable. These are access to service, clean environment, safety, good health outcomes, good staff attitude, prudent use of resources, adherence to performance standards and qualified and competent staff. Key health institutions mentioned included to help achieve this are Ministry of Health, Ghana Health Service, Teaching Hospitals, Quasi Health Institutions, Traditional Medicine, Health Development Partners, etc

In spite of the numerous challenges like shortage of health staff, poor staff attitude, lack of logistics and equipment, the presentation called for the implementation of incentive packages, customer care programmes for staff, data quality audit for reliable data, and also instituting an award scheme to reward hard working staff.

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2.2.3. General Discussions – Session 2 Following are some of the key issues raised by participants: Fees charged by FDB is too high and thus gives practitioners the incentive to circumvent the process The process involved in certifying drugs is also too cumbersome The TMPs called on the government to come to their aid and put in place proper mechanisms to help them carry out their legal business. An appeal was made to the regulatory bodies like TMPC, MOH, and FDB to organize periodic training programmes for the practitioners to enhance their knowledge and practice. Herbal medicine has both health and business potential therefore all stakeholders should support the industry. The following, among others, are some of the potentials discussed: o Employment opportunities o Foreign income earner o Positive effect on balance of trade by way of reducing the amount of drugs we import o Offer cheaper alternative to healthcare

3. Way Forward
At the closing of the conference it was obvious that all the participants were in accord about the need to get the orthodox and herbal medicine practitioners to collaborate and complement each other in the delivery of quality health care. And for this to happen, it requires some effort from government through policies and programmes by the Ministry of Health and other key regulatory institutions like the Food and Drugs Board.

The following points are therefore to be communicated to all stakeholders to form a basis of measurement of progress when the conference convenes again next year. 1. It is important to integrate alternative medicine into the mainstream medicine 2. Periodic training and workshops should be organized for herbal practitioners 3. Government must provide financial and technical support for the herbal industry 12 2010

4. The various regulatory bodies must put proper measures in place to enhance the development of alternative medicine 5. Quack practitioners must be made to face the full rigors of the law 6. FDB should review its relationship with TMPs 7. Efforts should be made to bring GMA, MDC, Pharmacy Council to work with TMPC 8. A conference to bring all stakeholders on the table to discuss issues pertaining to the integration of orthodox and alternative or complementary medicine should be made an annual affair.

4. Closing Remarks
The closing remarks were given by Kwasi Boakye-Akyeampong (Executive Director, NAF) and Atta Kwaku Boadi (Programmes Director, NAF). They both thanked the speakers, collaborators, planning committee members, participants, and volunteers for their part in making the programme a success. They also emphasized that every effort would be made to make this event an annual affair and promised to get all the stakeholders on board in subsequent years.

They admonished practitioners not to be discouraged by the challenges and rather see themselves as pioneers and pace-setters who would have to chart a cause for future generations of practitioners. Practitioners were also to continue to seek for improvement and encourage the adoption of industry best practices as a way of gaining public confidence and collaborate with institutions like TMPC and TAMP. NAF believes with the introduction of a degree programme in Herbal Medicine at KNUST, it is hoped gradually, the public will give the practice the respect and recognition it deserves.

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