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For many Americans, the National Institutes of Health (NIH) is synonymous with breakthrough medical research that has decoded the human genome, developed technology to identify new epidemics like SARS, prevented crippling strokes, and contributed to the health and welfare of the public. To have been charged 5 years ago to bring this same level of rigor and integrity to the study of complementary and alternative medicine (CAM) was both a great challenge and a privilege for me. A challenge, because prior to the creation of the National Center for Complementary and Alternative Medicine (NCCAM), there was little credible research under way to determine whether popular CAM health practices were as safe and effective as promised. We had to inspire and build a whole new discipline within biomedical research to study CAM. And it was a privilege, because we were being entrusted with public resources to meet the task.
There are many ways to measure our progress to date.
- We can count the nearly 1.5 million people each year who visit this Web site as the leading portal for CAM information.
- Or the over 30,000 volunteers for the clinical research studies we fund.
- Or the hundreds of CAM research projects being conducted today in the Nation's most prestigious research institutions.
Five years ago, virtually none of these resources existed. Many questioned whether credible CAM research was possible, and whether well-trained scientists would even undertake it. Those doubts have virtually disappeared.
We can also measure our progress by how it has made a difference both at the kitchen table in millions of American homes and on the examining tables in physicians' offices.
- Five years ago, some 30 million Americans were supplementing their diets and their medications with herbal remedies, wondering whether they would help slow the relentless tide of aging, relieve arthritic pains, or prevent yet another common cold. NCCAM research has shown that not all of these herbal remedies work, that some can interfere with important life-saving drugs.
- NCCAM has funded model educational curricula for medical students, nurses, and physicians. The hundreds of scientific papers now emerging from the research projects we support are changing visits to the doctor. More than ever, physicians are asking women in menopause whether they are trying herbal supplements instead of hormones. They are asking whether patients with arthritis are using acupuncture or glucosamine. Health care providers and their patients are better equipped today to discuss health decisions that include CAM.
In 2004, we embark on a year of meetings that will generate a detailed strategic plan for our second 5 years. The plan will emerge from the shared vision of thought leaders in numerous disciplines, the experience of professional associations and patient advocates, and the input of visitors to this Web site. The goal of our strategic planning process is to lay out the priorities for our investments in research, research training, communication, and integration of conventional and CAM health care for the years to come.
Where can we have the greatest impact on medical science and human health? Which of the many CAM approaches is ready for large research studies, and which are ready for their first careful assessments? There will be some hard decisions to be made in the coming year. We can't do it all, but what we will do must continue to make a difference.
Stephen E. Straus, M.D.
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