The Fifth Session of the Sixth Executive Committee (EC), the Seventh General Assembly (GA), and the First Session of the Seventh EC and 2009 World Acupuncture Congress of the World Federation of Acupuncture-Moxibustion societies (WFAS) were held at European parliament in Strasbourg, France on 3-7 November 2009.
New EC members for the year of 2009-2013were elected in the GA. The Seventh EC commenced and now consists of 49 members. Host countries for the future meetings were also approved.
In the Seventh EC, the Japan Society of Acupuncture and Moxibustion (JSAM) made a proposal regarding WFAS administrative duties. It consisted of eight items, and among them, the request for making the minutes of EC meetings was most important because WFAS EC meeting minutes have never been sent to the EC members except once, for the Bali, Indonesia meeting in 2006.
Papers regarding acupuncture education, legislation, traditional research and scientific research were also presented in the academic meeting.
JSAM will continue to support the enhancement of the academic level of WFAS and make any necessary proposals toward the further development of WFAS.

The WFAS University Cooperation Working Committee and WFAS Standard Working Committee were held during 2009 WFAS World Acupuncture Congress at European Parliament in Strasbourg, France on 6 November 2009. Publishing an International Textbook of Acupuncture and Moxibustion was proposed in the WFAS University Cooperation Working Committee. Also establishing Making WFAS standards on acupuncture needles, nomenclature and location of auricular points, manipulation of moxibustion, and manipulation of scalp acupuncture were discussed and proposed in the WFAS Standard Working Committee.

On this coming June 12, 2009, the 2nd JSAM International Symposium on Evidence-based Acupuncture on "Evidence of the Effectiveness of Acupuncture for Low Back Pain"is to be held in Saitama. We briefly outline the background and expected controversial points in this symposium.
There are three sessions including 1) Present status of RCT research on low back pain, 2) Treatment method for low back pain in China, Korea and Japan based on the database research, and 3) Sham acupuncture. When we assess the effectiveness of acupuncture for low back pain within the realm of Evidence-Based Medicine, the following discussions may be expected:
1) Therapeutic effect of sham needling -are we able to distinguish placebo effect?
2) Masking using sham needle -are we able to conduct double-blind trials on acupuncture?
3) Specific treatment technique -which factors contribute to "more effective acupuncture technique"?
Most of invited speakers are specialists who published their papers on RCT or sham needle in top medical journals in the world. We hope that issues, such as working together with other medical professionals and reflecting evidence to medical policies, to be tackled in the future for the development of acupuncture will become clearer in this symposium.

The very first session of the symposium on ‘cancer and acupuncture’ was held at the 53^rd Annual Conference of the Japan Society of Acupuncture and Moxibustion (JSAM). It suggested the efficacy and potential of acupuncture and moxibustion not only for cancer but also for cancer patients. This is the second session for further discussion. In recent years, acupuncture and moxibustion treatment for cancer patients has come to the world's attention, and many reports about its expediency and beneficial effect have been conducted in Japan and in the world. However, the adaptation range of acupuncture and moxibustion treatment for cancer is still limited because there is not enough evidence, so compilations of more sufficient case reports or research for presentation and effects in preventing relapse of cancer are required to prove its reliability. Acupuncture and moxibustion are used as one of the medical treatments directed at relieving symptoms and life-sustaining treatment in hospitals today. Earlier, frequent acupuncture treatment led to significant efficacy for cancer patients, and it is also reported that the number of lymphocytes increases in sequential acupuncture treatment but the number tends to return in a short time after cessation of treatment. Sequential autonomic immune therapy over a long term revealed several significant effects as follows; lymphocyte activation while the lymphocyte count remained, increase of cytokine (IL 12, IFNγ, TNFα, etc.) production and Th 1, Th 1/Th 2, immunostimulatory activity effect, reduction of tumor markers down to or close to normal, reduction or resolve of malignant neoplasm and recurrence prevention for unoperated cancer patients, QOL improvement with symptoms relief and life prolongation. In this seminar, it suggested that acupuncture and moxibustion are potential and appropriate treatments for cancer and further research in this field is required.

Unresolved problems remain in the clinical research methodology of acupuncture. In particular, the creation of placebo group in randomized controlled trial (RCT) is controversial: sham and / or minimal acupuncture may appear more powerful than placebo treatments in trials. Hence, in the future more emphasis should be placed on pragmatic RCTs, which compare typical treatment vs typical treatment plus acupuncture.
In order to more effectively integrate acupuncture therapy into modern Western medicine, evidence of efficacy, safety and cost-effectiveness should be clearly shown from both rational and clinical points of view. At the same time, we should reassess whether or not the present research methodology appropriately evaluates the essence of acupuncture therapy.

Acupuncture, which was originated and developed in the East Asian countries, has been globalized today. In Japan, acupuncture is more popular than the West, but lagging behind in terms of medical policy, research funding and evidence-based clinical research. Evidence-based approach such as randomized controlled trial has brought new developments in acupuncture research scene. On the other hand, clinical implication of acupuncture “system” seems to have been underestimated in evidence-based clinical research until recently.

The first Japan-Korea workshop on acupuncture and EBM was held on June 4, 2004 at Chiba in the 53rd annual scientific meeting of the JSAM. The purpose of this workshop was to exchange the experiences of clinical researches on acupuncture and moxibustion therapies, and to find out the issues and their solutions for developing the excellent clinical research to establish strong evidence. The final purpose was to develop aprotocol for the collaborative work between both countries.
Drs. Kawakita (JSAM) and Jang (KAMS) chaired the workshop. Three speakers from Japan (Drs Takahashi, Nabeta, and Tsukayama) and three Korean speakers (Drs Seo, Lee and Moon) presented their data on the clinical researches of acupuncture, moxibustion and bee-venom injection. After their paper presentations, various issues were discussed on their research methodology for establishing more strong evidence of acupuncture.We got interesting new findings and understood various issues for conducting clinical researches especially RCT.
Although we could not develop a protocol for the collaborative research in this workshop, it was very fruitful workshop as the first step for the future Japan-Korea collaborative clinical study. The most important product of this workshop was we could understand each other and we confirmed the necessity of the future collaborative clinical research on acupuncture.