INTRODUCTION

Studies over the past few decades have shown that there is a growing utilization of Complementary and
Alternative Medicine (CAM). Majority of these patients use more than one modality of CAM and
simultaneously also seek treatment from conventional medicine providers. Conventional Medical Systems
are recognizing this interest and demand and slowly we are seeing researches being done and more
interest being taken by conventional medicine in this area. It is therefore of little surprise that there is a
growing interest in learning more about CAM, which is also a part of the Pharmacy practice. Primary care
in rightful taking the lead on this.

This course module has been developed to help foster this interest and provide a basic understanding of
the various CAM modalities that are in popular use. You will learn to incorporate some of these principles
and knowledge in to your own practice habits, learn to critically appraise the growing literature in this field
and provide evidence based guidance to patients as they partake of CAM in their own care.

The term Complementary and alternative medicine is an umbrella term used to describe a range of health
systems, modalities and practices that may have little in common other than that they are practiced
alongside or as an alternative to mainstream medicine-(Ministerial advisory committee on Complementary
and alternative health July 2004).

Most Complementary and alternative medicine are based on similar philosophy and approach.
Complementary and alternative medicine has holistic approach to health care including the interactions
between physical, spiritual, social and psychological aspects.

There is increased awareness of complementary and alternative medicine among the general public.
Many of these products are readily available in supermarket or over the counter. Many individuals are
choosing to self-medicate without professional supervision. The World health organisation reported that
more than 70% of the world’s population uses non-conventional medicine.

For these reasons, you as the future Pharmacist are “ON CALL” and must be more aware of the principles
and overall aspects of CAM. This is for you to provide the needed assistance and help to patients utilizing
such practices.

With the knowledge gained from this course, better health provision shall be realized.

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 LESSON 1
Introduction to Integrative
Medicine

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Introduction to Integrative Medicine

Content at a Glance
 What is Integrative Medicine?
 The philosophy of integrative medicine
 Complementary and alternative medicine in pharmacy practice
 PITAHC (Philippine Institute of Traditional and Alternative Health Care) Guidelines (accreditation
and standards)
 RA 8432 – TAMA Act of 1997

Upon completion of this lesson, you should be able to:

 Discuss concepts and principles of Integrative Medicine
 Explain the principles of Integrative Medicine and Complementary and Alternative Medicine (CAM)
 Identify general applications of Integrative Medicine and Complementary and Alternative
Medicine in pharmacy practice and the integral role of the pharmacist in its implementation
 Discuss PITAHC and its Guidelines (accreditation and standards)

Integrative Medicine is a group of diverse medical and health care systems, practices, and products that
are not presently considered part of conventional/standard/mainstream medicine. It is an approach to
care that puts the patient at the center and addresses the full range of physical, emotional, mental, social,
spiritual and environmental influences that affect a person’s health. Employing a personalized strategy that
considers the patient’s unique conditions, needs and circumstances, it uses the most appropriate
interventions from an array of scientific disciplines to heal illness and disease and help people regain and
maintain optimum health. (Duke Integrative Medicine)

THE TRADITIONAL GOALS OF ALL MEDICINE ARE:

1. The prevention of disease and injury and promotion and maintenance of health.
2. The relief of pain and suffering caused by maladies.
3. The care and cure of those with a malady, and the care of those who cannot be cured.
4. The avoidance of premature death and the pursuit of a peaceful death.

Who we trust to our care, what we decide is the best treatment, how we evaluate success, and when we
look for alternatives depend on many factors. These factors include how one understands the nature of
health and disease, what is believed to have gone wrong and why, the type and strength of the evidence
supporting various treatments, and who is consulted when obtaining help.

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LET’S LEARN SOME MORE!

Integrative Medicine is health care that uses all appropriate therapeutic approaches. Combines
Mainstream Medical Therapies and CAM Therapies for which there is some High-Quality Scientific Evidence
of Safety and Effectiveness.” (Millstine, Denise, MD, Mayo Clinic, MSD Manual Professional Version)

It is an approach to care that puts the patient at the center and addresses the full range of physical,
emotional, mental, social, spiritual and environmental influences that affect a person’s health. Employing a
personalized strategy that considers the patient’s unique conditions, needs and circumstances, it uses the
most appropriate interventions from an array of scientific disciplines to heal illness and disease and help
people regain and maintain optimum health. (Duke Integrative Medicine)

Conventional Medicine/Standard Medicine/Mainstream Medicine is an approach to medicine that is

based on modern science, and that evaluates the human body, its disorders and medical treatments in
purely-biophysical or biochemical terms. Common treatment methods include drugs, radiation, and
surgery.

DEFINING PRINCIPLES AND PHILOSOPHY OF INTEGRATIVE MEDICINE

 The patient and practitioner are partners in the healing process.
 All factors that influence health, wellness and disease are taken into consideration, including body,
mind, spirit and community.
 Providers use all healing sciences to facilitate the body’s innate healing response.
 Effective interventions that are natural and less invasive are used whenever possible.
 Good medicine is based in good science. It is inquiry driven and open to new paradigms.
 Alongside the concept of treatment, the broader concepts of health promotion and the
prevention of illness are paramount.
 The care is personalized to best address the individual’s unique conditions, needs and
circumstances. Practitioners of integrative medicine exemplify its principles and commit themselves
to self-exploration and self-development.

In addition to addressing and handling the immediate health problem(s) as well as the deeper causes of
the disease or illness, integrative medicine strategies also focus on prevention and foster the development
of healthy behaviours and skills for effective self-care that patients can use throughout their lives.

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Differences Between Conventional and Integrative Medicine
Factor Conventional Medicine Integrative Medicine
A condition of physical, mental, and social Optimal balance, resilience, and integrity
Definition of
well-being and the absence of disease and of the body, mind, and spirit and their
health
other abnormalities interrelationships
Definition of Organ dysfunction, disordered biochemical Symptom and individual based:
illness processes, or undesirable symptoms Imbalance of body, mind, and spirit
Life processes that are based on known A free flowing energy that unites mind
Concept of life
physical laws and that involve physical and and body and is the underpinning of
force
biochemical events health (often called qi, pronounced "chi")
May involve more than physical
Understanding of Results only from physical processes in the processes in the brain*
consciousness brain
Can exert healing effects on the body
Any evidence-based intervention, including
Includes conventional medicine methods
drugs, surgery, radiation therapy, electrical
Method of in addition to evidence-informed natural
treatments, medical devices, physical
treatment healing practices and the patient's
therapy, exercise, and nutritional and lifestyle
inherent capacity for self-healing
interventions
Reliance on More flexible use of scientific evidence;
Stricter reliance on established principles of
scientific treatments often based on tradition
scientific evidence
evidence and/or lower quality scientific support
*Vithoulkas G, Muresanu DF: Conscience and consciousness: a definition. J Med Life. 15; 7(1): 104–108, 2014.

Complementary and Alternative Medicine (CAM) is a broad domain of healing resources that
encompasses all health systems, modalities, and practices and their accompanying theories and beliefs,
other than those intrinsic to the politically dominant health system of a particular society or culture in a
given historical period. CAM includes all such practices and ideas self-defined by their users as preventing
or treating illness or promoting health and well being (O’Connor et al 1997).

AKA: Faith Healing, Folk Medicine, Traditional Medicine, Holistic Medicine, Natural Medicine,
Unconventional Medicine, Unorthodox Medicine

“Complementary Medicine is Used Together With Conventional Medicine.”

“Alternative Medicine is Used in Place of Conventional Medicine.”

DEFINING PRINCIPLES AND PHILOSOPHY OF CAM

 Focuses on empowering the individual to accept responsibility for at least a part of the task of
recovery and future health maintenance
 Emphasizes sound nutrition as a core requirement for health
 Recommends a balanced lifestyle, adequate and appropriate exercise, rest, sleep and relaxation
as prerequisites for a state of good health
 Attempts to ensure detoxification and the efficacy of the organs and systems of the body
 Recognizes the importance of the musculoskeletal system as a potential source of interference with
nerve transmission and the body’s energy pathways, and as a reflection of the individuals internal
physical and emotional state
 Most importantly, treats the individual instead of his or her symptoms

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What is Holism/Holistic Medicine?
Holistic Medicine is an approach to medicine that aims to improve
the overall sense of bodily and emotional well-being of a person,
rather than just treat the symptoms of an illness. It addresses the
whole person – body, mind, and spirit.
 Concept focused on Relationships among all living things.
Therapeutic Encounters include:
 Enhancing Resistance to Illness
 Reducing aggravating behaviors
 Stress Management

Goal is optimal State of Wellness for each unique person.

CAM Practices and Classifications leading to HOLISTIC HEALTH

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According to Research:
CHARACTERISTICS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USERS
 The majority of individuals use CAM in conjunction with conventional medicine.
 CAM users tend to be women younger, well educated, higher income
 Suffering from chronic or recurring conditions
 People with back, neck, head, and joint pain or other such conditions
 Those with gastrointestinal disorders or sleeping problems
 Former smokers
 Up to 57% psychiatric patients use CAM, with the most frequent use being in depression and anxiety
------------------------

COMPLEMENTARY AND ALTERNATIVE MEDICINE IN PHARMACY PRACTICE

(Jeannette Y. Wick, RPh, MBA, FASCP,What is the Pharmacist's Role in Assessing CAM Use? Pharmacy Times)

Evidence indicates that the pharmacist's role should expand to include CAM. Literature published in the
last 15 years to determine exactly where pharmacists need to intervene is extensive. Here's what
researchers have concluded:

 Pharmacists have a professional responsibility to acknowledge and seek out information about
patients' CAM use.
 Pharmacists need to increase their knowledge base about CAM so they have a basic
understanding of what various products do and what their risks are.
 Pharmacists can and must help patients use CAM appropriately and safely.
 Pharmacists should have knowledge of when patients who use CAM experience adverse drug
events, and report them appropriately.
 Pharmacists need to educate patients about CAM and its potential benefits and risks.
 Pharmacists approach to CAM needs to be collaborative in nature, and they need to work with
health care professionals so that they are aware that the patient is taking CAM and it's
documented in the medical record.

These findings indicate that pharmacists’ professional responsibilities for CAM are not terribly different than
those for traditional medicines. Pharmacists who accept these responsibilities will need to look for resources
that can help them augment their traditional training with information focused directly on CAM.

Pharmacists can start by understanding the scope of the problem and defining CAM. It's especially
important to know what patients tend to use in specific geographic areas. In addition, pharmacists need
to ask patients about CAM use. If patients are using CAM, it's critical for pharmacists to ask them why, how
it's working, and if they're having any difficulties.

Pharmacists also need to acknowledge the many stakeholders in the CAM discussion. Pharmacists and
patients are obviously involved, but policymakers, regulators, professional organizations, academia,
traditional physicians, alternative practitioners, and the pharmaceutical/CAM industry are all involved as
well. We must work together to ensure the CAM is used responsibly and appropriately.

Appropriate evaluation must be done in order to assure safe and effective treatment modalities with
highest regard for the patient. Such evaluation is shown by the figure below.

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 Evaluation of CAM acceptability

Reading Material: Republic Act 8432

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 LESSON 2
Alternative Medical
System

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Alternative Medical System

Content at a Glance
 Homeopathic and Naturopathic Medicine
 Ayurvedic medicine
 Traditional Chinese Medicine

Upon completion of this lesson, you should be able to:

 Identify and compare the different alternative medical systems
 Differentiate the types of alternative medical systems
 Cite evidences on the use of Alternative Medical Systems

Alternative Medical Systems. Whereas the ancient Greeks postulated that health requires a balance of
vital humours, Asian cultures considered that health depends on the balance and flow of vital energies
through the body. This latter theory underlies the practice of acupuncture, for example, which asserts that
vital energy flow can be restored by placing needles at critical body points.

Alternative Medical Systems. An umbrella term for a number of practices beyond the scope of
conventional medicine. These forms of alternative medicine are built upon a complete system of ideas
and practice and may have evolved in Western or non-Western cultures.

Examples: Ayurveda, Chiropractic, Homeopathy, Naturopathic medicine, Osteopathy, and

Traditional Chinese medicine.

 Homeopathy
AKA homeopathic medicine is a medical system that was developed in Germany more than 200 years
ago.

It’s based on four tenets of unconventional theories:

1. Principle of Similars. “Like cures like”— similia similibus curentur -- the notion that a disease can
be cured by a substance that produces similar symptoms in healthy people.

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 Homeopathy (from the Greek "omeos" meaning similar and "pathos" meaning suffering).A
substance that can cause symptoms in a healthy person can stimulate self-healing in a person
presenting with a similar cluster of symptoms (both physical and emotional).

Example:
A patient suffering from seasonal allergies who presents with increased lacrimation,
irritating, burning nasal discharge, pain at the root of the nose, and a general feeling of
dullness may benefit from a homeopathic preparation of Allium cepa (onion) because it
produces a similar constellation of symptoms in healthy individuals.

Another patient with seasonal allergies characterized by irritating discharge from the
eyes and bland, non-irritating nasal discharge may benefit from a homeopathic
preparation of euphrasia (eyebright) because it produces similar symptoms in healthy
volunteers.

In the practice of Homeopathic Medicine, a detailed, comprehensive interview of the patient,

called the homeopathic case-taking, is undertaken to reveal the physical, psychological and
emotional characteristics and complaints of that individual. The homeopathic practitioner then
finds the homeopathic remedy whose materia medica (drug picture) is the most similar to that
of the patient’s characteristic totality. That homeopathic prescription (the similimum) is given to
the patient to stimulate his/her being to heal.

2. Principle of Proving. The German physician Dr. C. F. Samuel Hahnemann (1755-1843) first
codified this principle into a system of medicine. Starting with experiments (called “provings”)
on himself, Dr. Hahnemann administered medicinal substances to healthy volunteers (called
“provers”). Symptoms that developed in the provers while taking a specific substance, gave
the homeopathic “picture” of, and indications for that remedy. Over the years, by means of
provings, toxicological data, and clinical experience, the homeopathic drug pictures of over
2000 substances have been derived.

3. “Law of minimum dose”—the notion that the lower the dose of the medication, the greater its
effectiveness. Many homeopathic products are so diluted that no molecules of the original
substance remain.

HOW?
Homeopathic medicines are prepared through a series of dilutions, at each step of which
there is a vigorous agitation of the solution called succussion, until there is no detectible
chemical substance left. As paradoxical as it may seem, the higher the dilution, when
prepared in this dynamized way, the more potent the homeopathic remedy.

4. “Single Remedy” —the notion that disease is better managed by a single therapy to avoid
complications.
Most homeopathic practitioners prescribe one remedy at a time. The homeopathic remedy
has been proved by itself, producing its own unique drug picture. That remedy is matched
(prescribed) to the sick person having a similar picture. The results are observed, uncluttered by
the confusion of effects that might be produced if more than one medicine were given at the
same time.

Homeopathic products come from plants (such as red onion, arnica [mountain herb], poison ivy,
belladonna [deadly nightshade], and stinging nettle), minerals (such as white arsenic), or animals (such as
crushed whole bees). Homeopathic products are often made as sugar pellets to be placed under the
tongue; they may also be in other forms, such as ointments, gels, drops, creams, and tablets. Treatments
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are “individualized” or tailored to each person—it’s common for different people with the same condition
to receive different treatments.

Among the most common conditions that people seek homeopathic treatment for are:
 asthma
 ear infections
 hay fever
 mental health conditions, such as depression, stress and anxiety
 allergies, such as food allergies
 dermatitis (an allergic skin condition)
 arthritis
 high blood pressure

There's no good-quality evidence that homeopathy is an effective treatment for these or any other health
conditions.

 Naturopathy
• Emphasizes restoring health rather than curing disease
• Diet, clinical nutrition, homeopathy, acupuncture, herbal medicine, hydrotherapy,
manipulation, physical therapy, therapeutic counseling, and pharmacology
• Several major naturopathic schools provide training, conferring the naturopathic doctor
(ND) degree

 Ayurveda (Ayurvedic medicine)

• Began thousands of years ago in India
• Aims to restore harmony by questioning, observing, touching, and classifying patients
 Ayurveda ‘the Science of Life’ is a holistic system of medicine from India, which evolved from
Brahma sages of Ancient India some 3000-5000 years ago. The principles and philosophy of
Ayurveda view man as a complex whole; including our external and internal environments. The
principles are derived from universal laws of nature that have changed little through time. With
subjective, objective, and intuitive approaches to gaining knowledge, incorporated with a deep
understanding of the unseen intelligence of the universe. The practices of Ayurveda have
withstood the test of time.
 Ayurveda defines life ‘Ayuh’ as the intelligent coordination of our four parts, the soul, the mind, the
senses, and the body, with the totality of nature and the cosmos. Health is not just a state of the
body. We interact with the seasons, planetary changes of the earth, and moon, other planets, as
well as orbiting relationships within our lives, our loved ones and friends, co-workers etc. We affect
and are affected by every other animate and inanimate thing in existence. Bringing all of this into
balance is the key to living healthy.

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 Salient Features of Ayurveda
There are several aspects of this system of medicine which distinguish it from other approaches to
health care:
1. Ayurveda describes three fundamental universal energies which regulate all natural
processes on both the macrocosmic and microcosmic levels. That is, the same energies
which produce effects in the various galaxies and star systems are operating at the level of
the human physiology--in our own physiology. These three universal energies are known as
the Tridosa.
2. Ayurveda is a complete medical system which recognizes that ultimately all intelligence
and wisdom flows from one Absolute source (Paramatma). Health manifests by the grace of
the Absolute, acting through the laws of Nature (Prakriti). Ayurveda assists Nature by
promoting harmony between the individual and Nature by living a life of balance
according to her laws.
3. It focuses on establishing and maintaining balance of the life energies within us, rather than
focusing on individual symptoms.
4. It recognizes the unique constitutional differences of all individuals and therefore
recommends different regimens for different types of people. Although two people may
appear to have the same outward symptoms, their energetic constitutions may be very
different and therefore call for very different remedies.
5. Finally, the ancient Ayurvedic physicians realized the need for preserving the alliance of the
mind and body and offers mankind tools for remembering and nurturing the subtler aspects
of our humanity. Ayurveda seeks to heal the fragmentation and disorder of the mind-body
complex and restore wholeness and harmony to all people.
6. To balance the elements and the doshas of the body and the senses, there are many
treatments, therapies, and exercises available. To balance the elements of the mind,
meditations, mantra, and exercises are often used. Massage and rasayana treatments,
along with visualization, pranic breathing, and other practices,allow personal access to
intuition, and the innate knowledge of the soul.
7. Ayurveda believes five basic elements Pancamahabhutas (space, air, fire, water and earth)
manifest in the human body as three basic humours known as tridosas (Vata, Pitta and
Kapha). These three govern creation, maintenance and destruction of bodily tissues as well
as the assimilation and elimination. Each person is born with a unique combination of these
dosas which decides their basic constitution called Prakruti. Understanding of each person's
Prakruti for deciding their personal diet and exercise pattern, supplements and medicinal
herbs, cleansing and rebuilding therapies that is right for them are among the chief
methods, Ayurveda employs for the maintenance and restoration of health.

Traditional Chinese Medicine (TCM)

• Emphasizes the proper balance of qi (pronounced “chi” – life force)
• Acupuncture, herbal medicine, massage, and qigong

TCM—also often referred to as “Eastern Medicine”—originated in ancient mainland China. It dates back
more than 2,500 years and has evolved and been perfected ever since. Even for those relying on modern
“Western Medicine” which is only a couple of hundred years old. However, there is likely a lot that can be
learned from TCM practices.
But what exactly is Traditional Chinese Medicine? An understanding of the premises of TCM starts with the
underlying philosophies.
Yin and Yang is the Basis of Traditional Chinese Medicine
Nature is the primary hallmark of TCM. The basic premise of TCM is that our bodies are a microcosm of our
surrounding world and universe. You have probably heard of “yin” and “yang” (or at least seen the
symbol).

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Yin and yang is the basis of Eastern science and TCM. It is the concept that opposing forces are actually
complimentary, essential, and need to exist in balance and harmony for optimal health.

Some examples are:

 light and dark
 positive and negative
 fire and water
 good and evil
 male and female
 expanding and contracting

Think about it this way. Shadows cannot exist without light. And the premise of many modern superhero
movies—good cannot exist without evil.

The basic underlying premise of yin and yang in TCM is these seemingly opposite forces need to exist in
balance and harmony. Harmony between yin and yang is thought to promote health. But imbalance is
thought to result in disease.

Qi—or Life Force—is an Important Concept in Traditional Chinese Medicine

Qi (pronounced “Chee”), is generally defined as the vital energy that flows through the bodies of every
living thing. The literal translation from the Chinese characters means “molded by the energy of the
nature”. The Chinese believed that Qi permeated everything and linked their bodies’ to the surrounding
environment.

The concept of Qi is deeply rooted in Traditional Chinese Medicine. The concept was first noted in the
oldest TCM scriptures, aptly named the ‘Internal Scripture.’ The concept is that vital energy circulates
through our bodies in pathways referred to as meridians. Symptoms or overt illnesses are believed to be the
result of blocked, disrupted, or unbalanced Qi moving through our meridians.

A properly flowing Qi is believed to be responsible for many aspects of

health. Thus, a major focus of TCM practices is often targeted at unblocking
and allowing our Qi to properly circulate throughout our bodies.

There are Four Types of Qi

As mentioned above Qi is the energy that is moving throughout our bodies
and the world around us. But there can be other energies that can affect
our circulating life force. Early Chinese philosophers and other Eastern
practitioners built on this notion of Qi. They further postulated there were
sub-fractions of Qi.

Generally speaking, the major subcategories of Qi became:

 Inborn Qi—related to genetics and cellular makeup
 Pectoral Qi—related to metabolism and consists external factors like air and food
 Nutritive Qi—related to diet and other nutritive factors
 Protective Qi—related to protection from the outside world or immune health

Together these various Qi are said to form interdependent networks in the body and affect:
 Mental health
 Emotions
 Internal organ function
 Sensory organ function
 Heart health
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  Skeletal and connective tissue
 Body fluids
 Aging

Thus, a basic premise of TCM is that a properly flowing and well interconnected Qi is essential for optimal
health. This concept has been recently embraced by Western medical science. Systems biology is the
study of complex biological systems and the networks that connect them.

These connections can be through nerve conduction, hormones, signaling molecules, electrical impulses,
or even external cues like day and night. It is also the appreciation that a single input (diet, exercise,
medicines, stress etc.) does not just affect one cell, or one organ, or even one biological system. Rather, an
input can have very wide-reaching effects on our physiology—a concept that has been appreciated by
TCM for 1000s of years.

Healthy Qi is Incorporated into Many Aspects of Eastern Philosophies

The concept of energy moving around and through every aspect of ourselves and life around us has
permeated into many aspects of early Eastern cultures; many of which, have become relatively
mainstream—or at least heard about—in more modern Western civilizations.

These major aspects include:

 Feng Shui—the concept of harmonizing energy in the placement and arrangement of physical
objects in a space. This careful balancing of Qi through a space can affect health, wealth, and
vigor of the occupants.
 Qigong—the concept of balancing Qi through coordinated movement, awareness, rhythmic
breathing, and meditative states. It is utilized during exercise, healing, and training for martial arts.
 Martial arts—related to Qigong, this concept is known as Neijing. It often involves slow,
choreographed movements, and visualization to both learn a martial art and to focus internal Qi
force to achieve great feats of strength.
 Medicine—a number of medical practices can be used to help realign Qi. These can include
herbology, acupuncture, moxibustion, and reflexology.
 Parenthood—for many centuries birth has been thought to be the result of the coming together
and intertwining of the Qi from a male and female. In TCM, this is referred to as joining energy or the
joining of essences.

There are Five Elements Represented in Traditional Chinese Medicine

Another important philosophy in Eastern Medicine is what is known as the “Five Phases” or “Five Elements”.
Symbolically these five elements represent all phenomena, including the stages of human life, and explain
the functioning of the body and how it changes during health or disease.

The five elements—or phases—of TCM include and philosophically represent:

 Fire—a time brimming with flowering and brimming with energy.
 Earth—a time of transition as in the changing of seasons.
 Wood—a time of growth (think about trees sprouting in the spring).
 Metal—a time of harvesting and collecting.
 Water—a time of stillness and retreat.

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 AN ACT CREATING THE PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE
(PITAHC) TO ACCELERATE THE DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN
THE PHILIPPINES, PROVIDING FOR A TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT
FUND AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in Congress

assembled:

Section 1. Short Title. – This Act shall be known as the “Traditional and Alternative Medicine Act
(TAMA) of 1997.”

ARTICLE I
GUIDING PRINCIPLES

Section 2. Declaration of Policy. – It is hereby declared the policy of the State to improve the
quality and delivery of health care services to the Filipino people through the development of
traditional and alternative health care and its integration into the national health care delivery
system.

It shall also be the policy of the State to seek a legally workable basis by which indigenous
societies would own their knowledge of traditional medicine. When such knowledge is used by
outsiders, the indigenous societies can require the permitted users to acknowledge its source
and can demand a share of any financial return that may come from its authorized commercial
use.

Section 3. Objectives. – The objectives of this Act are as follows:

(a) To encourage scientific research on and develop traditional and alternative health
care systems that have direct impact on public health care;

(b) To promote and advocate the use of traditional, alternative, preventive and curative
health care modalities that have been proven safe, effective, cost effective and
consistent with government standards on medical practice;

(c) To develop and coordinate skills training courses for various forms of traditional and
alternative health care modalities;

(d) To formulate standards, guidelines and codes of ethical practice appropriate for the
practice of traditional and alternative health care as well as in the manufacture, quality
control and marketing of different traditional and alternative health care materials,
natural and organic products, for approval and adoption by the appropriate
government agencies;

(e) To formulate policies for the protection of indigenous and natural health resources
and technology from unwarranted exploitation, for approval and adoption by the
appropriate government agencies;

(f) To formulate policies to strengthen the role of traditional and alternative health care
delivery system; and
 (g) To promote traditional and alternative health care in international and national
conventions, seminars and meetings in coordination with the Department of Tourism,
Duty Free Philippines, Incorporated, Philippine Convention and Visitors Corporation and
other tourism-related agencies as well as non-government organizations and local
government units.

ARTICLE II
DEFINITION OF TERMS

Section 4. Definition of Terms. – As used in this Act, the following terms shall mean:

(a) “Traditional and alternative health care” – the sum total of knowledge, skills and
practices on health care, other than those embodied in biomedicine, used in the
prevention, diagnosis and elimination of physical or mental disorder.

(b) “Traditional medicine” – the sum total of knowledge, skills, and practice on health
care, not necessarily explicable in the context of modern, scientific philosophical
framework, but recognized by the people to help maintain and improve their health
towards the wholeness of their being, the community and society, and their interrelations
based on culture, history, heritage, and consciousness.

(c) “Biomedicine” – that discipline of medical care advocating therapy with remedies
that produce effects differing from those of the diseases treated. It is also called
“allopathy”,”western medicine”, “orthodox medicine”, or “cosmopolitan medicine”.

(d) “Alternative health care modalities” – other forms of non-allopathic, occasionally

non-indigenous or imported healing methods, though not necessarily practiced for
centuries nor handed down from one generation to another. Some alternative health
care modalities include reflexology, acupressure, chiropractics, nutritional therapy, and
other similar methods.

(e) “Herbal medicines” – finished, labelled, medicinal products that contain as active
ingredient/s serial or underground part/s of plant or other materials or combination
thereof, whether in the crude state or as plant preparations.

Plant material includes juices, gums, fatty oils, essential oils, and other substances of this
nature. Herbal medicines, however, may contain excipients in addition to the active
ingredient(s). Medicines containing plant material(s) combined with chemically-defined
active substances, including chemically-defined, isolated constituents of plants, are not
considered to be herbal medicines.

(f) “Natural product” – those foods that grow spontaneously in nature whether or not
they are tended by man. It also refers to foods that have been prepared from grains,
vegetables, fruits, nuts, meats, fish, eggs, honey, raw milk, and the like, without the use or
addition of additives, preservatives, artificial colors and flavors, or manufactured
chemicals of any sort after harvest or slaughter.

(g) “Manufacture” – any and all operations involved in the production, including
preparation, propagation, processing, formulating, filling, packing, repacking, altering,
ornamenting, finishing, or otherwise changing the container, wrapper, or labelling of a
consumer product in the furtherance of the distribution of the same from the original
 place of manufacture to the person who makes the final delivery or sale to the ultimate
consumer.

(h) “Traditional healers” – the relatively old, highly respected people with a profound
knowledge of traditional remedies.

(i) “Intellectual property rights” – is the legal basis by which the indigenous communities
exercise their rights to have access to, protect, control over their cultural knowledge and
product, including, but not limited to, traditional medicines, and includes the right to
receive compensation for it.

ARTICLE III
THE PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE

Section 5. Philippine Institute of Traditional and Alternative Health Care. – There is hereby
established a body corporate to be known as the Philippine Institute of Traditional and
Alternative Health Care, hereinafter referred to as the Institute. The Institute shall be attached to
the Department of Health. Its principal flag office shall be in Metro Manila, but it may establish
other branches or offices elsewhere in the Philippines as may be necessary or proper for the
accomplishment of its purposes and objectives.

Section 6. Powers and Functions. – In furtherance of its purposes and objectives, the Institute shall
have the following powers and functions:

(a) To plan and carry out research and development activities in the areas of traditional
and alternative health care and its ultimate integration into the national health care
delivery system;

(b) To verify, package and transfer economically viable technologies in the field of
traditional and alternative health care, giving emphasis on the social engineering
aspects necessary for group endeavor;

(c) To provide the data base or policy formulation that will stimulate and sustain
production, marketing and consumption of traditional and alternative health care
products;

(d) To organize and develop continuing training programs for physicians, nurses,
pharmacists, physical therapists, and other professional health workers and students, as
well as scientists, research managers and extension workers in the field of traditional and
alternative health care;

(e) To formulate policies that would create public awareness through educational
activities, conventions, seminars, conferences, and the like by focusing on the promotion
of healthy living for preventing diseases, thereby uplifting the health care industry;

(f) To acquire or obtain from any governmental authority whether national or local,
foreign or domestic, or from any person, corporation, partnership, association or other
entity, such charters, franchises, licenses, rights, privileges, assistance, financial or
otherwise, and concessions as are conducive to and necessary or proper for the
attainment of its purposes and objectives;
(g) To receive and acquire from any person and/or government and private entities,
whether foreign or domestic, grants, donations and contributions consisting of such
properties, real or personal, including funds and valuable effects or things, as may be
useful, necessary or proper to carry out its purposes and objectives and administer the
same in accordance with the terms of such grants, donations and contributions,
consistent with its purposes and objectives;

(h) To serve as the coordinating center of a national network of traditional and

alternative health care stations located in the different regions of the country;

(i) To formulate a code of ethics and standards for the practice of traditional and
alternative health care modalities for approval and adoption by the appropriate
professional and government agencies;

(j) To formulate standards and guidelines for the manufacture, marketing and quality
control of different traditional and alternative health care materials and products for
approval and adoption by the Bureau of Food and Drugs;

(k) To coordinate with other institutions and agencies involved in the research on herbal
medicines;

(1) To adopt and use a corporate seal;

(m) To sue and be sued in its corporate name;

(n) To succeed by its corporate name;

(o) To adopt its bylaws and promulgate such rules and regulations as may be necessary
or proper to implement this Act, and to amend or repeal the same from time to time;

(p) To enter into, make and execute contracts and agreements of any kind or nature;

(q) To borrow, raise or obtain funds, or to enter into any financial or credit arrangement in
order to support or carry out its research programs, finance its capital and operating
expenses, subject to pertinent laws governing public debts and expenditure;

(r) To invest in, purchase or otherwise acquire, own, hold, use, mortgage, pledge,
encumber, sell, assign, convey, exchange, or otherwise deal in real and/or personal
properties of whatever kind and nature, or any interest therein, including shares of stock,
bonds, notes, securities and other evidences of indebtedness of natural or juridical
persons, whether domestic or foreign and whether government or private;

(s) To exercise all the powers of a corporation under the General Corporation Law,
insofar as such powers are not in violation of the provisions of this Act; and

(t) To exercise such other powers and functions, and perform other acts as may be
necessary, proper or incidental to the attainment of its purposes and objectives.
Section 7. Board of Trustees. – The corporate powers of the Institute shall be exercised, and all its
business, activities and properties shall be controlled by a Board of Trustees, hereinafter referred
to as the Board.

(a) Composition. – The Board shall be composed of the following:

Secretary of Health – ex-officio chairman

Permanent representatives of the following government offices:

Department of Science and Technology;

Department of Environment and Natural Resources;

Department of Agriculture;

Department of Education, Culture and Sports; and

Commission on Higher Education.

Representatives of the following industries/sectors:

One (1) physician who is engaged in the practice of traditional and alternative
health care;

One (1) member from a duly recognized academe/research institution engaged

in traditional and alternative health care research;

One (1) traditional and alternative health care practitioner who is not a physician;

One (1) biomedical/allopathietwestem medical practitioner preferably from the

Philippine Medical Association;

One (1) member from the natural food industry and/or organic food industry; and

One (1) member from an environmental sector organization,

The six (6) members representing the abovementioned sectors/industries shall be

appointed by the President of the Philippines upon recommendation of the
Secretary of Health.

Of the appointive members, two (2) members shall have a term of three (3) years;
the second two (2) members shall have a term of three (3) years; and, the third
two (2) members shall each have a term of one (1) year.

Any member appointed to a vacancy shall serve only for the unexpired term of
the member whom he/she succeeded.

(b) Meetings and quorum. – The Board shall meet regularly at least once a month or as
often as the exigencies of the service demand. The presence of at least six (6) members
 shall constitute a quorum, and the majority vote of the members present, there being a
quorum, shall be necessary for the adoption of any resolution, decision, or any other act
of the Board.

(c) Allowances and per diems. – The members of the Board shall receive a per them for
every meeting actually attended subject to the pertinent budgetary laws, rules and
regulations on compensation, honoraria and allowances.

Section 8. Powers and Functions of the Board. – The Board shall exercise the following powers
and functions:

(a) To define and approve the programs, plans, policies, procedures and guidelines for
the Institute in accordance with its purposes and objectives, and to control the
management, operation and administration of the Institute;

(b) To approve the Institute’s organizational structure, staffing pattern, operating and
capital expenditure, and financial budgets prepared in accordance with the corporate
plan of the Institute;

(c) To approve salary ranges, benefits and privileges, bonuses and other terms and
conditions of service for all officers and employees of the Institute, upon
recommendation of the Director General and consistent with the salary standardization
and other laws;

(d) To appoint, transfer, promote, suspend, remove or otherwise discipline any

subordinate officer or employee of the Institute, upon recommendation of the Director
General;

(e) To create such committee or committees and appoint the members thereof, as may
be necessary or proper for the management of the Institute or the attainment of its
purposes and objectives;

(f) To determine the research priorities of the Institute consistent with the framework of its
purposes and objectives and in coordination with other government agencies; and

(g) To exercise such other powers and functions and perform such other acts as may be
necessary or proper for the attainment of the purposes and objectives of the Institute, or
as may be delegated by the Secretary of Health.

Section 9. Director General and Other Officers. – The Institute shall be headed by a Director
General who shall be appointed by the President of the Philippines upon recommendation of
the Secretary of Health. The Director General shall have a term of six (6) years.

The Director General shall be assisted by such Deputy Director General(s) and program
managers/coordinators as the Board may determine to carry out the purposes and objectives of
this Act.

Section 10. Powers, Functions and Duties of the Director General. – The Director General shall
have the following powers, functions and duties:
 (a) To exercise overall supervision and direction over the implementation of all research
and development programs of the Institute, and to supervise and direct the
management, operation and administration of the Institute;

(b) To execute contracts, including the deeds that may incur obligations, acquire and
dispose of assets and deliver documents on behalf of the Institute, within the limits of
authority delegated to him by the Board;

(c) To implement and enforce policies, decisions, orders, rules and regulations adopted
by the Board;

(d) To submit to the Board an annual report of the Institute;

(e) To submit to the Board an annual budget and such supplemental budget as may be
necessary for its consideration and approval; and

(f) To exercise such other powers and functions and perform such other duties as may be
authorized by the Board.

Section 11. Government Agency Support and Coordination. – The Institute may, for the purpose
of its research and development activities, obtain and secure the services of scholars, scientists
and technical personnel of any unit of the Department of Health and other agencies of the
Philippine Government. Such personnel may be paid honoraria as may be fixed and authorized
by the Board following the usual government rules and regulations governing honoraria and
allowances. The Institute shall also assist, cooperate and coordinate with other government
agencies, such as the Bureau of Food and Drugs of the Department of Health and the Philippine
Council for Health Research and Development of the Department of Science and Technology
for the implementation of the purposes and objectives of this Act.

ARTICLE IV
PROMOTION OF TRADITIONAL AND ALTERNATIVE HEALTH CARE

Section 12. Traditional and Alternative Health Care Advocacy and Research Program. – The
Institute shall promulgate a nationwide campaign to boost support for the realization of the
objectives of this Act. It shall encourage the participation of non-government organizations in
traditional and alternative health care and health-related projects. The Institute shall also
formulate and implement a research program on the indigenous Philippine traditional health
care practices performed by “traditional healers” using scientific research methodologies.

Section 13. Standards for the Manufacture, Marketing and Quality Control of Traditional
Medicine. – The Institute, in collaboration with the Bureau of Food and Drugs, shall formulate
standards and guidelines for the manufacture, quality control and marketing of different
traditional and alternative health care materials and products.

Section 14. Incentives for the Manufacturers of Traditional and Alternative Health Care
Products. – Manufacturers of traditional and alternative health care products like herbal
medicinal plants shall enjoy such exemptions, deductions and other tax incentives as may be
provided for under the Omnibus Investment Code, as amended.

Section 15. Traditional and Alternative Health Care Development Fund. – To implement the
provisions of this Act, there is hereby created a Traditional and Alternative Health Care
Development Fund which shall be used exclusively for the programs and projects of the Institute,
in the amount of Fifty million pesos (P50,000,000,00) for the first year, Seventy-five million pesos
(P75,000,000.00) for the second year, and One hundred million pesos (P100,000,000.00) for the
third year from the earnings of Duty Free Philippines: Provided, That not more than fifteen
percent (15%) of said fund shall be used for administrative costs of the Institute.

Thereafter, such amount as may be necessary to fund the continued implementation of this Act
shall be included in the annual General Appropriations Act.

ARTICLE V
TRANSITORY PROVISIONS

Section 16. Appointment of Board Members. – Within thirty (30) days from the date of effectivity
of this Act, the President of the Philippines shall appoint the members of the Board as well as the
Director General and Deputy Director General(s).

Section 17. Transfer of Functions of the Traditional Medivine Unit. – Upon the establishment of the
Institute, the functions, personnel and assets of the Traditional Medicine Unit and all the
pharmaceutical and herbal processing plants of the Department of Health shall be transferred
to the Institute without need of conveyance, transfer of assignment.

For the year, during which this Act was approved, the unexpended portion of the budget of the
offices, agencies and units merged shall be utilized for establishing the Institute and initiating its
operations, including the formulation of the rules and regulations necessary for the
implementation of this Act.

Incumbent officials and employees of the affected offices shall continue to exercise their
respective functions, duties and responsibilities with the corresponding benefits and privileges. To
the greatest extent possible and in accordance with existing laws, all employees of the affected
offices, agencies and units shall be absorbed by the Institute.

ARTICLE VI
MISCELLANEOUS PROVISIONS

Section 18. Oversight Function. – The Institute shall submit to Congress an annual
accomplishment report which shall include the status of its priority researches and operation. In
the exercise of its oversight functions, Congress may inquire into the programs of the Institute.

Section 19. Implementing Rules and Regulations. – Within thirty (30) days from the completion of
their appointments, the Board shall convene and, in collaboration with the Department of
Health – Traditional Medicine Unit, formulate the rules and regulations necessary for the
implementation of this Act. Said rules and regulations shall be issued within one hundred eighty
(180) days from the date of the Board’s initial meeting and shall take effect upon publication in
a newspaper of general circulation.

Section 20. Repealing Clause. – All laws, decrees, executive orders, and other laws including
their implementing rules and regulations inconsistent with the provisions of this Act are hereby
amended, repealed or modified accordingly.

Section 21. Separability Clause. – If any provision of this Act is declared unconstitutional or invalid,
other provisions thereof which are not affected thereby shall continue in full force and effect.
Section 22. Effectivity. – This Act shall take effect fifteen (15) days following its publication in the
Official Gazette or in at least two (2) newspapers of general circulation.

Approved: December 9, 1997

Source: http://lawphil.net/statutes/repacts/ra1997/ra_8423_1997.html