The Organization acknowledges its indebtedness to the many experts who provided comments and advice during the preparation of these Guidelines on Basic Training and Safety in Acupuncture, including those who submitted comments through the WHO Regional Offices and the World Federation of Acupuncture and Moxibustion Societies (WFAS). In particular, thanks are due to those who reviewed the drafts at the WHO Consultation on Acupuncture at Cervia, Italy, in 1996, to Professor Zhu-Fan Xie, Honorary Director of the Institute of Integrated Medicine, First Hospital of Beijing Medical University, China, who drafted the guidelines, and to Dr Gordon Stott who edited the final draft. Appreciation is also extended to the Italian Ministry of Health and the Centre of Research in Bioclimatology, Biotechnologies and Natural Medicine of the State University of Milan (a WHO Collaborating Centre for Traditional Medicine), for their support and to the Japanese Hyogo Association of Acupuncture and Moxibustion and the Norwegian Acupuncture Association, for financial contribution for publication. Acupuncture is an important element of traditional Chinese medicine. It began to be used more than 2500 years ago, and its theory was already well developed at a very early time, as is shown in many of the Chinese classics. It was introduced to neighbouring countries in Asia in the 6th Century, being readily accepted, and by the early 16th Century it had reached Europe. Over the past two decades acupuncture has spread worldwide, which has encouraged the further development of this therapy, particularly through studies from modern medical perspectives and research methodologies. Many elements of traditional medicine are beneficial, and WHO encourages and supports countries to identify safe and effective remedies and practices for use in public and private health services. It has paid particular attention to supporting research in and the proper application of acupuncture and, in 1991, the Fortyfourth World Health Assembly urged Member States to introduce measures for its regulation and control (Resolution WHA44.34). With the increasing use of acupuncture, the need for a common language to facilitate communication in teaching, research, clinical practice and exchange of information had become pressing and, in 1989, WHO convened a Scientific Group which approved a Standard International Acupuncture Nomenclature which is being widely disseminated and applied. The Scientific Group also recommended that the Organization develop a series of statements and guidelines on acupuncture relating to basic training, safety in clinical practice, indications and contraindications, and clinical research. Guidelines for clinical research on acupuncture were issued by the WHO Regional Office for the Western Pacific in 1995. The present document consists of guidelines on basic training and safety in acupuncture. More than 50 international experts shared their knowledge and experience in their preparation. Basic training in acupuncture The guidelines cover basic requirements for training non-physician acupuncturists and physicians wishing to use acupuncture in their clinical work, and include a core syllabus. They are intended to assist national health authorities in setting standards and establishing official examinations, and also medical schools and institutions wishing to arrange training programmes. Guidelines on basic training and safety in acupuncture 2 Safety in acupuncture These guidelines are meant for hospitals, clinics and practitioners, and provide standards for safety in the clinical practice of acupuncture. Their purpose is to minimize the risk of infection and accidents, to alert acupuncturists to contraindications, and to advise on the management of complications occurring during treatment. Dr Xiaorui ZHANG Acting Team Coordinator Traditional Medicine Section I: Basic training in acupuncture 3 Section I: Basic training in acupuncture The increasing popularity in recent years of acupuncture as a form of therapy and the interest of some countries in introducing it into primary health care mean that national health authorities must ensure safety and competence in its use. In countries with a formal system of education in traditional medicine, and where acupuncture is firmly established as a normal component of health care, training may extend over several years at college level, and suitable mechanisms for supervision of its practitioners have been created. However, for other countries, where "modern Western medicine" forms the only basis of the national health system, the position is different and there may be no educational, professional or legislative framework to govern the practice of acupuncture. Making use of acupuncture in modern medical care means taking it out of its traditional context and