32991 Sri Lanka's Ministry of Indigenous Systems of Medicine A yurveda1 and other traditional agreed that a section on indigenous systems of health care have been medicine should be included in its used for over two thousand years in Sri National Health Policy ­ conse- Lanka. Indigenous systems such as quently, a National Policy on Sri Ayurveda are based on the country's Lankan Systems of Indigenous Notes cultural, social, economic, and religious Medicines was developed by the characteristics. In addition, Sri Lankans Ministry of Indigenous Medicine. utilizing knowledge of these indigenous The Ministry maintains that the "Sri systems of medicine were the first in the Lankan Traditional System of Medi- world to develop the concept of a cine,Ayurveda, Siddha, Unani or hospital and established a highly scien- similar therapeutic techniques, healing tific public healthcare system2. Over systems, healthcare procedures KI the last two centuries, colonialism and practiced with proper approval in Sri industrialization have undermined the Lanka and recognized by another value and use of traditional medicine in country or at (the)international level Sri Lanka. The Sri Lankan healthcare are (sic) accepted as an alternate or system has since been largely based on complementary system of medicine Western medicine and this has become based on natural and holistic theo- popularized as the primary source of ries4." http://www.worldbank.org/afr/ik/default.htm medicine and treatment through both the public and private healthcare systems. Despite this trend, traditional medicine Footnotes 1 continues to be popular among local Sri Ayruveda is one of the oldest docu- Lankan citizens for treating and curing mented forms of medicine, Shroff (2002) - it originated in India and spread to Sri illnesses. Traditional medicine is gener- Lanka through the Silk Route. ally practiced informally without the 2Ministry of Indigenous Medicine Draft national healthcare system's support. Report 2004 pg. 2 Considering the recognition and value 3Developed in October 2000 that traditional medicine still receives in 4Ministry of Indigenous Medicines 2005 No. 83 Sri Lanka, a Ministry of Indigenous August 2005 Systems of Medicine was established in Sri Lanka3 to validate traditional medici- IK Notes reports periodically on nal practices and facilitate access to Indigenous Knowledge (IK) initiatives traditional medicines alongside modern in Sub-Saharan Africa and medical treatments. Sri Lanka presents occassionally on such initiatives outside the region. It is published by a unique case study since it is the first the Africa region's Knowledge and country to create an Ministry entirely Learning Center as part of an devoted to the indigenous systems of evolving K partnership between the medicine. World Bank, communities, NGOs, development institutions, and multilateral organizations. The views World Bank expressed in this article are those of Ministry of Indigenous Systems of the authors and should not be Medicine attributed to the World Bank Group or its partners in this initiative. A The Sri Lankan government, recognizing webpage on IK is available at //www.worldbank.org/afr/ik the value of these traditional medicines 2 The national policy on indigenous medicines cites its vision in doing this is attempting to create national pride in the use to be: of traditional medicines and hopes to give citizens morale, ·"A healthy and prosperous nation for contributing to the self-respect, and trust for their country's medicines. development of the country through Indigenous Systems of Medicine (ISM)5." Their mission is to: Policies 3.4, 3.18, 3.23, 3.24 ·"Achieve the quality of life by contributing to physical, The Ministry presents four policies with regard to Intellec- mental, social, economic and spiritual well-being of the tual Property Rights (IPR). First, it notes that a National people of Sri Lanka by adopting professional excellence in Indigenous Systems of Medicine (ISM)6." Council for Indigenous Systems of Medicine will be established and include advisory, investigatory and supervi- Their goal includes: sory groups to monitor legal activities with indigenous ·"Improving health status of the Sri Lankan people through systems of medicine. Second, it is developing legal mecha- best practices of traditional, indigenous and other knowl- nisms to obtain benefits from the commercialization of edge systems while preserving the identity and strength- traditional medicines. Third, institutional structures will be ening the role and contribution of the Indigenous Systems of Medicine (ISM) in the National Healthcare system7." strengthened, through legal reforms, for the conservation, management, development, and regulation of indigenous systems of medicine. Finally, a social security system will be created to protect the social, economic and personal Objectives of the Ministry welfare of traditional medical practitioners and communi- The objectives include expanding, restructuring, and ties where indigenous systems of medicine are practiced. strengthening both government and private health care services to include traditional medicines in their health programs. In addition, they plan to enhance community Policy 3.7 and society participation in the healthcare process so that In the area of education, the Ministry is planning to launch local citizens have a voice and can contribute ideas to the a joint program with the Ministry of Education to include healthcare system. It also plans to strengthen research indigenous knowledge systems and practices in the formal activities to ensure the quality of service and products school curriculum. The purpose of this integration is to pertaining to indigenous systems of medicine. The last popularize Sri Lankan human values, lifestyle, and life point above also reflects the Ministry's effort to validate vision associated with traditional medicines to school the safety and effectiveness of traditional medicines using modern medical guidelines8. children and the community. Introducing indigenous knowledge into the school curricu- lum is extremely important. When Sri Lankan children attend formal schools they may feel a cultural disconnect, Policies of the Ministry with regard to indigenous knowledge, from the material The Ministry has written 30 policies to implement its taught in the curriculum. As stated in the policy, Sri objectives and accomplish its mission. These cover all Lankan indigenous systems of medicine should be valued areas including the use of technology, creating databases, and reinforced in school as "scientific10." When indigenous legal protection, and addressing issues of preservation and knowledge is taught alongside material in school curricu- conservation related to traditional medicines. The govern- lum, students respect their indigenous knowledge and tend ment has established these policies to align with interna- tional IPR guidelines and to protect the country's indig- Footnotes enous systems of medicines. This section details select 5Ministry of Indigenous Medicines 2005 policies set out by the Ministry and is followed by a brief 6 Ministry of Indigenous Medicines 2005 discussion of each policy. 7Ministry of Indigenous Medicines 2005 8International Traditional Medicine guidelines are set by the World Health Organization Policy 3.1 9Ministry of Indigenous Medicines Draft Report 2005 pg. 9 10According to modern or Western Science Systems. Western, The Ministry plans to create a flag and song depicting the Modern or Conventional Science is science/ Knowledge of "historical pride, heritage, haughtiness (sic) and respect9" European origin which contributes to current day global Science regarding indigenous systems of medicines. The Ministry Standards 3 to utilize and disseminate it later in their lives. The way forward Indigenous knowledge can also help increase atten- dance and retention in schools. It can be equated to the Sri Lanka has taken an important local and global step with the establishment of a Ministry of Indigenous Systems of prior knowledge students bring with them to the class- Medicine and has set up a model from which other coun- room and can help students connect to the content taught tries can hopefully learn and possibly adapt similar strate- through the formal school curriculum and standards. Sri gies into their own health systems. Many other countries, Lankanstudents,whomayfrequentlyuseindigenous such as Ethiopia, Uganda, and Tanzania, have valuable systems of medicine at home, are more likely to relate to knowledge of traditional medicines. Many of the communi- and understand the relevance of school material when this ties in these countries have also participated in scientific practice is publicly acknowledged. In addition, students and clinical trials regarding the use of traditional medicine maybetteridentifywiththeeducationtheyarereceiving to help treat infectious diseases such as HIV-AIDS. A and this may lead to higher student retention in school. South-South knowledge exchange program can facilitate other countries to develop their own Ministry of Indigenous Systems of Medicine. Policy 3.14 The Africa Region Knowledge and Learning unit of the World Bank has created such opportunities for knowledge Lastly, with regard to quality assurance a systematic exchanges between countries to take place. For instance, method will be institutionalized for the quality assurance of the division has hosted two East Africa ­ South Asia study indigenous systems of medicine's products and processes tours. In these study tours, 20 development practitioners aligned with national and global requirements. from Ethiopia, Kenya, and Uganda, along with Bank staff, The World Health Organization (WHO) has set global visited development projects in India, Sri Lanka, and guidelines towards evaluating the safety and efficacy of Bangladesh. The 20 development practitioners visited traditional medicines. These guidelines are quite extensive successful projects in the areas of health, agriculture, and and include the evaluation of traditional medicines accord- informatics. The knowledge exchange between the ing to their environment and the contexts in which they are development practitioners has resulted in African develop- being used. They have also published numerous research ment practitioners beginning to implement similar projects documents from 1989-2004 covering areas of clinical in their respective countries. research in traditional medicine, the conservation of medicinal plants, and creating collaborations between traditional healers and modern medical doctors. For instance, the WHO guidelines for methodologies on research and evaluation of traditional medicine (2000) articulates a strategy to improve and promote the proper use and development of traditional medicine. The Sri Lankan Ministry of Indigenous Systems of Medicine is planning to follow similar guidelines. This IK Note was written by Deepa Srikantaiah, Consultant, Africa Region, World Bank and is based on the Sri Lankan Ministry of Indigenous Medicine Policy Report. For more information, e-mail dsrikantaiah@worldbank.org or sprakash@worldbank.org.