Faculty of Agriculture and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107 2020, Lebanon.
BMC Complement Altern Med. 2011 Aug 28;11:71. doi: 10.1186/1472-6882-11-71.
The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure.
We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out.
There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products.
The current status quo with respect to the regulation of CAM products in Lebanon is not conducive to public safety, nor does it support the integration of CAM products into the healthcare system. The Ministry of Health indeed plays a dominant role in the regulation of these products through a combination of mixed and compulsory policy instruments. Yet, the proper implementation of these regulations requires political resolve coupled with the cooperation of all CAM stakeholders.
补充和替代医学（CAM）产品市场的监管是一个全球性的挑战。在东地中海地区（EMR），几乎没有研究考察或评估过 CAM 产品的监管政策。我们以黎巴嫩为例，调查了 EMR 国家中公共基础设施薄弱的国家对 CAM 产品的监管框架和适当监管及整合 CAM 产品的障碍。
我们采用了定性研究设计，对黎巴嫩 CAM 市场的利益相关者进行了一系列半结构化访谈。采用雪球抽样法来确定受访者；访谈一直持续到达到“饱和”点。共对 16 名决策者、专业协会代表、学术研究人员、CAM 产品进口商、政策制定者和媒体代表进行了访谈。对访谈进行了转录，并对脚本进行了主题分析。
所有利益相关者都一致认为，黎巴嫩 CAM 产品市场的监管需要加强。主题分析确定了一些障碍，这些障碍危及公众消费安全，并阻碍 CAM 疗法融入主流医学；包括：基础设施薄弱、监管不力、政策和政治无效、CAM 意识薄弱以及利益相关者之间的协调与合作不佳。在政策工具方面，由于用户和提供者对安全使用 CAM 产品的意识薄弱，利益相关者认为自愿工具（自我监管）无效。利益相关者建议更多地采用混合（提高公众意识和将 CAM 纳入医学和护理课程）和强制性（更严格的政府监管）政策工具的组合来监管 CAM 产品市场。
黎巴嫩目前对 CAM 产品的监管现状不利于公共安全，也不支持将 CAM 产品纳入医疗保健系统。卫生部确实通过混合和强制性政策工具的组合在这些产品的监管中发挥主导作用。然而，这些法规的正确实施需要政治决心以及所有 CAM 利益相关者的合作。
