Introduction

Since the ‘revival’ of complementary and alternative medicine (CAM) in the wake of the counterculture of the 1960s/1970s in Western societies (Cant and Sharma, 1999; Saks, 2015a), the issue of the governance of CAM has become a key area for sociological research. The continual acceptance of and/or contestation over CAM treatments and practices by multiple social actors have become too important to be dismissed. In this chapter, the term CAM governance is used thus in a broad sense to designate the various ways in which key actors have regulated CAM. Among these are:

• • the state and its different institutions;

• • supra-state agencies such as the World Health Organization (WHO);

• • professional bodies, CAM practitioners, medical doctors and other allied health care professionals;

• • health care corporations such as health insurance companies;

• • the lay public.

All have performed a key role in current CAM policy making in many Western countries.

Although sociological research on CAM governance has significantly increased, it remains mainly focused on single countries, rarely being compared internationally. Brazil and Portugal are two helpful examples to compare, for despite their close historical, political and cultural relations, which have spanned centuries, and although there are similarities in their health systems, they present differences in the way they have governed CAM. In this chapter, we compare recent modes of CAM governance in these two distinct yet historically, politically and culturally related countries. We investigate:

• • the extent to which CAM governance has changed over the past decades in the two countries;

• • the main modes of CAM governance in these same countries;

• • the implications of these modes of CAM governance for CAM professionals and for the public.

This chapter is based on a qualitative analysis of legislative and policy documents related to CAM in Brazil and Portugal since the late 1980s. The chapter first offers some theoretical reflections on the complexity of governing CAM in contemporary Western societies. It then analyses CAM's main modes of governance, focusing first on Brazil and then on Portugal. In both cases, the implications of CAM governance for CAM professionals and for the public are addressed. Finally, in the conclusion, CAM's recent modes of governance in Brazil and in Portugal and their implications for CAM professionals and the public are put into comparative perspective.