Botanica 2012: Integrating Plant-based Medicine

Next week, Trinity College in Dublin, Ireland will host Botanica 2012, “an international celebration of plant therapies and clinical aromatherapy.” The inaugural conference, which will host a diverse group of speakers from around the world, is intended to foster collaboration and knowledge sharing, but is also meant to provide a forum for the promotion of plant-based medicine (phytotherapy) and to “raise the profile of evidence-based integrated clinical aromatherapy interventions.” [1] Researchers will present a variety of topics, from the results of aromatherapy on patients with dementia in France to the effects of herbs and aromatherapy used to treat World Trade Center rescue personnel after September 11, 2001. The conference program ends with a day of workshops that offer equally wide-ranging subject matter, from the acupressure application of aromatherapy for gynecological symptoms, to introductory gemmotherapy—described as “plant stem cell medicine” for its use of embryonic phytotissues.[2]

Though known as complementary and alternative medicine (CAM) in Europe and the US, traditional or plant-based medicine is the mainstream in much of the “developing” world, and the World Health Organization estimates that 80% of the population in Africa and Asia depends on traditional medicine for primary health care.[3] It is based in knowledge that is often passed down from mentor to student; and the evidence of its efficacy is thousands of years of now predictable outcomes. In our Western medical systems, entrenched in the use of chemotherapies (that is, chemical or pharmaceutical intervention), CAM practitioners around the globe are increasingly seeking to consolidate evidence-based knowledge as a counterbalance to the perception that pharmaceutical interventions are more legitimate or safer because they undergo standardized testing.

In Europe, the use of CAM by medical doctors is quite prevalent; a majority of European countries have some kind of national legislation in place to regulate the most commonly used therapies, and insurance systems—both nationalized and privatized—largely cover such treatments.[4] A 2010 report by a European alliance of CAM organizations noted that 65% of Europeans use CAM therapies. In Germany alone, 15,000 medical doctors have also been trained in naturopathic medicine, and 70% of general practitioners say they prefer to prescribe herbal medicines.[5]

In the United States, the regulation of CAM therapies exists only at the state level, if at all, and CAM remains relatively dis-integrated from the mainstream American medical system. In fact, the National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative therapies as “those not considered part of conventional medicine as practiced by medical doctors, doctors of osteopathy, and allied health professionals.”[6] A branch of the National Institutes of Health, the NCCAM aims to apply the conventional model of “rigorous scientific investigation”[7] to CAM therapies, and American insurance companies cite a lack of such investigation as a primary reason for non-coverage of CAM therapies, along with “minimal cost-effectiveness research and the absence of practice standards.”[8] The implication is that conventional medicine is better researched and better standardized, but a 2005 Institute of Medicine report “stressed the application of uniform rules for testing…of all therapies (both CAM and non-CAM),” wherein the “ultimate goal is to create a comprehensive, evidence-based health care system with an unbiased approach to diverse experiences of health and healing.”[9]

A trend toward regulating these therapies predictably has supporters and detractors in both the conventional and alternative medical worlds. There are many CAM practitioners who fear the “village herbalist” will be lost amid efforts to standardize types of care that are intended to be uniquely individualized; and some medical doctors, skeptical of CAM, argue that research on these therapies unjustifiably legitimizes them. On the other hand, some CAM practitioners feel that the integration of these therapies into a more pluralistic healthcare model realistically demands a move toward more conventionally scientific systems of evidence collection, and many want this research to be driven by the CAM community in a bottom-up approach that circumvents any top-down standardization that may otherwise be imposed by the conventional medical community. Like so many professions and practices that face increasing regulation, the debate over CAM regulation is bound to continue, taking on new forms over time. Conferences like Botanica 2012 offer participants with diverse experience and backgrounds the chance to share not only evidence-based knowledge on plant-based therapies, but also to evaluate and discuss the place of CAM practices in the global healthcare debate and to strategize on appropriate paths toward better integration of these therapies into widely varying healthcare systems.


[1] Botanica 2012, http://botanica2012.com/

[2] Botanica 2012, Programme, http://botanica2012.com/programme/

[3] World Health Organization, Media Centre, “Traditional Medicine,” Fact sheet No. 134 (December 2008) http://www.who.int/mediacentre/factsheets/fs134/en/

[4] The Regulatory Status of Complementary and Alternative Medicine for Medical Doctors in Europe (The CAMDOC Alliance, January 2010), http://www.camdoc.eu/Pdf/CAMDOCRegulatoryStatus8_10.pdf

[5] Ibid., p. 18.

[6] National Center for Complementary and Alternative Medicine, Health Info, “What is CAM?” http://nccam.nih.gov/health/whatiscam

[7] National Center for Complementary and Alternative Medicine, About NCCAM, “NCCAM At a Glance: Mission and Vision,” http://nccam.nih.gov/about/ataglance

[8] David Nemer, MD Candidate (Harvard Medical School, 2013),”Complementary and Alternative Medicine in the United States,” November 15, 2010, p. 4, http://improvehealthcare.org/wp-content/uploads/2011/08/1-4-1-PB.pdf

[9] Ibid., p. 6.