By Josef A. Brinckmann

17-20, 2007, at the Putra World Trade Centre.

ICTMMM 2007 was co-located with the 6^th International Traditional / Complementary Medicine Conference (INTRACOM 2007), as well as the trade show Traditional & Complementary Medicine Exhibition (TCME 2007), with exhibitors of medicinal herbal products from Southeast Asian and the Middle Eastern countries. At the invitation of the Ministry of Health (MOH) Malaysia, I participated as a speaker and co-chair at ICTMMM 2007. As I participated only in the ICTMMM but not the INTRACOM, this review article is limited to the ICTMMM and the trade show.

The events were jointly organized by the Traditional and Complementary Medicine (T&CM) Division and the Institute for Medical Research of the MOH Malaysia. Events were supported by the following government ministries, universities, and organizations: the Inter Islamic Network in Tropical Medicine (INTROM), Ministry of Science, Technology and Innovation, Islamic Development Bank (IDB), Organization of the Islamic Conference (OIC) Standing Committee on Scientific and Technological Cooperation (COMSTECH), Traditional Medicine & Materia Medica Research Centre (TMRC) I.R. Iran, Shaheed Beheshti Medical Science University Iran, Islamic Organization for Medical Sciences (IOMS) Kuwait, Ministry of Higher Education, Malaysia Tourism Board, Malaysian Herbal Corporation (MHC), and 7 main associations recognized by the MOH in traditional and complementary medicine, such as the Federation of Malay Traditional Medicine of Malaysia, Federation of Chinese Physicians & Acupuncturists Association of Malaysia, and the Indian Traditional Medicine Organization of Malaysia, among others.

This was truly one of the better organized international congresses in which I have ever participated. It included very high quality presentations, genuine involvement from higher levels of governmental agencies, top-notch audio and visual technology, and speakers were kept on schedule. Symposium speakers were mainly from Malaysia, India, Indonesia, Iran, Singapore and Taiwan. There were also participants who traveled from Mauritius, Morocco, Pakistan, Philippines, P.R. China, Saudi Arabia, Syria, Sudan, and the United Arab Emirates (UAE), among other countries. Aside from the keynote address and the plenary session, ICTMMM and INTRACOM ran parallel symposia.

Plenary Sessions

The keynote address, “Holistic Medicine—The Optimal Relationship to Perfect Health,” was delivered by Tan Sri Datuk Dr. Hj.

Mohd Ismail Merican, director general of health, MOH Malaysia. Choi Seung-Hoon, OMD, PhD, regional advisor in Traditional Medicine, World Health Organization (WHO), Western Pacific Regional Office (WPRO), presented the first plenary session, “WHO Traditional Medicine Strategy and Activity.” Dr. Seung-Hoon elaborated on WHO’s various standardization projects in traditional medicine such as the development of international standard terminologies (IST) in traditional medicine, a new textbook on standardized acupuncture point locations, and evidence-based clinical practice guidelines in traditional medicine for 28 priority diseases. The 366-page WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region was published in June 2007.¹ Also discussed was the Western Pacific Region Index Medicus (WPRIM), a project of the WHO WPRO in collaboration with several institutions in its member states. This is the Region’s contribution to the Global Health Library (GHL) initiative. The project goal is the creation of an online index of medical and health journals published in member states of the WHO Western Pacific Region that can be accessed on the Internet, thereby ensuring global accessibility of medical and health research conducted in the region.

Plenary session 2 “Traditional and Complementary Medicine: Policy and Regulation in Malaysia” was delivered by Datuk Dr. Mukundan Sugunan Pillay, deputy director general of health, MOH Malaysia. Dr. Pillay discussed proposed legislation that is coming up for a vote, the “Traditional and Complementary Healthcare Practices Bill,” which aims to require the standardization of T&CM [note: this acronym does not refer to traditional Chinese medicine, i.e., TCM] practice, training, and education in order to ensure consumer safety with secondary aims of lowering regulatory costs to government and minimizing compliance costs. Recognized practitioner’s bodies for each group of T&CM practice now include those representing Traditional Malay Medicine, Traditional Chinese Medicine, Traditional Indian Medicine (Ayurveda, Siddha, and Unani), Homeopathy, and Complementary Therapies. Dr. Pillay discussed progress since the 2001 National Policy on Traditional / Complementary Medicine Malaysia,² which envisioned the integration of T&CM into the Malaysian healthcare system, such as three Malaysian hospitals in particular that will begin integration and partnerships with traditional medicine hospitals in both China and India, the launch of the GlobinMed for consumer education, and four guidelines booklets prepared by the National Committee for Research & Development in Herbal Medicine (NRDHM), MOH Malaysia: (1) Guidelines for Levels and Kinds of Evidence in Support of Claims for Therapeutic Products; (2) Guidelines for the Clinical Evaluation of T/ CM Interventions; (3) Guide to Intellectual Property Management; and (4) Guidelines for Standardisation, Safety and Clinical Evaluation of Herbal Medicinal Products. These NRDHM Guidelines can be purchased through the NRDHC Web site at http://www.nrdhm.org.

A fascinating plenary lecture entitled “Global Trends in Use and Regulation of Natural Healthcare” was delivered by Professor Gerard C. Bodeker, MD, EdD, University of Oxford Medical School (UK) and Mailman School of Public Health, Columbia University (New York). Dr. Bodeker emphasized that the focus of research on T&CM should not be limited only to evidence of safety, efficacy, and quality, but also to include the study of poverty alleviation and positive economic benefit in rural, local, and indigenous communities; for example, in cases where T&CM practices are taught to women heads of households who manage village medicinal herb gardens and herbal medicine-making in order to take responsibility for common ailments in their families and villages. Dr. Bodeker also stressed that the aims of social equity expressed in Malaysia’s Ninth Plan should be viewed just as importantly as current efforts in the areas of standardization of medicinal herbal products and clinical practices and development of biotechnology, among other activities. A new book edited by Dr. Bodeker and Gemma Burford was also introduced during this plenary titled, Traditional, Complementary and Alternative Medicine: Policy and Public Health Perspective.³ The 472-page book was published in January 2007 by Imperial College Press and is promoted as the first book to address public health issues in traditional, complementary and alternative medicine (TCAM) and features access to data from the WHO Global Atlas on trends in the TCAM sector worldwide.

Other plenary lectures included the following: (1) “Translating Science to Traditional and Complementary Practice” by Professor Bushan Parwardhan, chief of academics, Interdisciplinary School of Health Sciences, University of Pune (India), (2) “A Scientific Insight on Evidence Based Research in Ayurveda: An Appraisal of Some Clinical Studies” by Dr. G.S. Lavekar, director of Central Council for Research in Ayurveda & Siddha (CCRAS) Dept. of Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homeopathy (AYUSH), Ministry of Health & Family Welfare (India), and (3) “The International Standard for Sustainable Wild Collection of Medicinal and Aromatic Plants (ISSC-MAP)” presented by this author.

Symposium Sessions

As there were nearly 60 speakers between the INTRACOM and ICTMMM parallel symposia, as well as parallel workshops, this brief article cannot provide a review of all sessions of interest, and there were many. On day three of the Congress, I was honored to co-chair an extraordinarily interesting symposium with Prof. Dr. Farzaneh Naghibi, associate professor at the Shaheed Behesthi University of Medical Sciences, School of Pharmacy Traditional Medicine & Materia Medica Research Centre” in Tehran, Iran. (At the Closing Ceremony on day 4, Dr. Farzaneh was also presented with the ICTMMM Best Scientist Award for her contribution in research and active participation in ICTMMM since its inception. She coauthored several poster presentations including “Cytotoxic activity of some medicinal plants from Iran,” “Antimalarial activity of some medicinal plants from Iran,” “Qualitative and quantitative analysis of some brands of valerian pharmaceutical products,” “Quantitative analysis of 18 ß-glycyrrhetinic acid in Glycyrrhiza glabra extract by HPLC,” and “Purification of apigenin by preparative TLC.”) This was a session on herbal information technology and an initiative for information sharing that featured presentations on the (1) Global Information Hub on Integrated Medicine (GlobinMed): Malaysia’s Initiative, by Dr. Ami Fazlin Syed Mohamed, project manager and secretariat for GlobinMed and Dr. Zakiah Ismail, medical officer, head of Herbal Medicine Research Centre (HMRC) of the Institute for Medical Research (IMR) (Malaysia): http://www.globinmed.com;

(2) Islamic Network for Tropical Medicine (INTROM): Positioning Its Role for Information Sharing, by Dr. Amal Nasir Mustaffa, Executive Director of INTROM (Malaysia): http://www.imr.gov. my/affi/introm.htm, and (3) Asia-Pacific Traditional Medicine and Herbal Technology Network (APTMNET): Smart Partnership Amongst Member Countries, by Ms. Chen Suthing, Chief Engineer, APTMNET (China): http://www.apctt-tm.net.

Dr. Ami’s presentation, on behalf of the GlobinMed project team, outlined the 9 areas of focus: (1) conservation; (2) intellectual property rights (IPR) and patent database of herbal substances; (3) medicinal herbal products information (consumer level and professional level); (4) policy, laws and regulations on T&CM; (5) research and publication; (6) safety of herbs and T&CM; (7) herbal trade and business (Malaysian and global perspectives); (8) T&CM modalities; and (9) training and education on T&CM. The GlobinMed project is a vast undertaking that upholds the vision of promoting and enhancing the practice of T&CM towards the establishment of integrated medicine together with conventional medicine, through global communication and education with the availability of valid, up-to-date and comprehensive information. It is a Web portal that compiles information on the aforementioned 9 areas of focus. The idea for GlobinMed was conceived during the 12^th Commonwealth Health Minister’s meeting in Barbados (1998) upon agreement that the scattered information on T&CM should be compiled, evaluated, and centralized for easy access. Malaysia spearheaded the initiative based on strong commitment of its government and the availability of the Multimedia Super Corridor (MSC Malaysia information available at: http://www.msc.com.my). The specific objectives of GlobinMed are as follows:

1. To develop a state-of-the art information resource on T&CM and integrated medicine, which is supported by advanced interactive technologies that is simple, easy and interactive, in tandem with consumer demand, and commercially viable and sustainable;

2. To establish a global electronic information resource that covers policy, practice, research, trade, education, safety, conservation and IPR of T&CM;

3. To promote the generation and dissemination of T&CM information that is validated, up-to-date, widely available and evidence-based to the global consumers;

4. To provide a specialized information service of T&CM information to consumers and professionals;

Malaysia’s policy is to welcome strategic partnerships, especially in the development of the educational content, and the MOH believes that it is a strategic win-win situation because GlobinMed is a globalized “one-stop” center for information related to integrated medicine.

Also in this information technology session, Ms. Chen’s concise presentation on partnership of member countries in the APTMNET provided background on the framework and objectives as well as database development. The four objectives of APTMNET are as follows:

1. To promote cooperation among member countries of Asian-Pacific Centre for Transfer of Technology (APCTT) on sustainable utilization and biodiversity conservation, R&D and processing of traditional medicine, quality control and standardization of traditional medicine production, protection of Intellectual Property on traditional medicine;

2. To promote sharing and dissemination of information on traditional medicine among member countries of APCTT;

3. To promote technology transfer as well as exchange of experts and organizing relevant training programs among member countries of APCTT;

4. To promote the technical and industrial cooperation among enterprises (SMEs) and R&D institutions in the Asia-Pacific region.

There are 14 APCTT member countries (Bangladesh, China, India, Indonesia, Iran, Korea, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam), each responsible for the construction of the nodal station in that country. APCTT will promote information exchange, organization of training, and academic seminars among member countries. The nodal stations are expected to adopt the uniform standards of framework agreed to by all participating countries for nodal Web site establishment. All sites will be bilingual in the native language as well as English. Each member will be responsible for the English translation of their content. During the subsequent Q&A period, there were requests to clarify the differences and/or overlaps between the GlobinMed and APTMNET information portals, respectively. It is the view of the spokespersons for both projects that each offers distinctly different services, that they are complementary and not competitive, and that each are participants in the other’s activities. This clarification was also to be addressed further at a subsequent event that took place in the week immediately following the ICTMMM 2007. The 2007 Asia-Pacific Traditional Medicine Network (APTMnet) Forum, organized by the MOH Malaysia IMR took place July 23-24, 2007, in Kuala Lumpur. More information on the outcome of the APTMnet Forum is available by contacting Dr. Zakiah Ismail, Herbal Medicine Research Centre (HMRC), Institute for Medical Research (IMR), Jalan Pahang, 50588 Kuala Lumpur, Malaysia, e-mail: zakiah@imr.gov.my.

Poster Presentations

In addition to the aforementioned posters co-authored by Dr. Farzaneh, there were a total of 113 posters presented. The majority of other posters were also presented by researchers from Iran. Posters presented by Malaysian researchers included, among others, a clinical study on the effect of ketum leaf (Mitragyna speciosa, Rubiaceae) on drug addicts,⁴ and several studies investigating new uses for, as well as acute and subacute toxicity of, the Malaysian medicinal plant tongkat ali root (Eurycoma longifolia, Simaroubaceae),^5,6,7,8 traditionally used for fever, medication after birth, boils, wounds, ulcers, syphilis and bleeding gums,⁹ and also more widely used as a male aphrodisiac.¹⁰

The Trade Show

The TCME 2007 encompassed 68 exhibition booths, and approximately 2,100 visitors attended the trade show. The exhibitor profile included manufacturers and marketers of bee products, botanical raw materials and extracts, cocoa, coffee, dietary supplements, essential oils, herbal medicinal finished products, natural edible pigments, organic foods and beverages, and organic health ingredients. There were also booths by purveyors of traditional medicine practice. In addition to suppliers of ingredients and finished products, other exhibitors included professional associations representing practitioners of traditional medicine, traditional medicine schools, and governmental agencies relevant to the trade. One of the largest exhibition booths, situated at the hall entrance, was the GlobinMed booth with numerous computer terminals set up for attendees to test out the new Web site and ask any questions of the GlobinMed team. University Malaysia Pahang also exhibited and provided abstracts of various herbal research projects including “Preparation of standardized essential oil from Gaharu (Aquilaria malaccensis, Thymelaeaceae),” “Antiinflammatory oil from Halia Bara (Zingiber officinale var. rubrum, Zingiberaceae),” and “Environmental friendly product from Patchouli (Pogostemon cablin, Lamiaceae) biomass,” among others.

Josef Brinckmann is the vice president of research and development at Traditional Medicinals, Inc. in Sebastopol, California; a consultant on market intelligence for medicinal plants and extracts for the International Trade Centre (ITC) of the United Nations in Geneva, Switzerland; editor of ITC’s quarterly Market News Service for Medicinal Plants & Extracts; and a member of the Advisory Board of the American Botanical Council.