FFrom herbalists in Africa collecting plants to use as poultices, to acupuncturists in China using needles to treat migraines, or Indian yogis practicing meditation, traditional remedies are increasingly proving effective and deserve more attention and research, according to World Health Organization official.
According to Dr Shyama Kuruvilla, head of the WHO Global Center for Traditional Medicine, the historical lack of evidence that has led many to reject traditional methods could change with increased investment and the use of modern technology.
Earlier this year, countries agreed that WHO should adopt new global strategy for traditional medicine for the next decade, which “seeks to leverage the potential contributions of TCIM [traditional, complementary and integrative medicine] evidence-based health and well-being.”
It includes plans to build a strong evidence base for the practice of traditional medicine, develop regulation of treatments and practitioners, and, where appropriate, integrate the practice into mainstream biomedical health care.
“It’s very interesting,” says Kuruvilla. “I'm not saying we know what works and what doesn't work at scale, but I think the opportunity is there. [to find out] right now.”
Traditional medicine, defined as systems of health and wellness that predate “biomedine,” comes in many forms, from herbal tea to the Indian Ayurvedic medical system.
Many of these centuries-old practices have “tremendous potential,” Kuruvilla says, and can now be explored in new ways using technologies including artificial intelligence, genomics and brain scanning.
Kuruvilla says Thailand is a good example of a country using traditional medicine, where researchers are observing and documenting traditional practices and conducting randomized trials to include herbal medicine in the country's list of essential medicines. In May, Thailand's Ministry of Health recommended doctors move from some biomedicines to traditional treatments for certain conditions, including muscle pain and constipation.
There have been some concerns that the WHO's strategy could create a loophole for non-scientific systems such as homeopathy to enter the mainstream, but Kuruvilla notes that homeopathy does not meet the WHO's definition of traditional medicine – it was only created in the late 18th century – and that there is not enough convincing evidence to support the practice.
But she says: “With all this – with biomedicine, homeopathy, traditional medicine – if the data changes, I think we have an obligation to be open to that.”
In some countries, homeopathy is used as a complementary medicine, “and it varies by country,” says Kuruvilla. “We, as WHO, must simply stick to the evidence.
“So I think that's our bottom line: Is it supported by good evidence, especially in terms of safety and effectiveness? And if it's not, then the WHO doesn't support it, whether it's biomedicine or traditional medicine.”
WHO polls suggest that in most countries, most traditional, complementary and integrative medicine services are not part of the formal health care system and are paid for by patients. They are less often subject to official quality control, but are extremely popular.
“Opting out was not an option because it would mean that everything happens without any guarantees,” says Kuruvilla, pointing to the growing trillion-dollar wellness industry, ranging from yoga studios to “nutraceuticals“
New techniques allow scientists to study traditional medicine “in a way that was not possible before,” Kuruvilla says. Genomics can lead to new insights into the properties of plants, and modern scanning equipment can detect changes in the brains of people who meditate.
“Meditation is all this 'woo-woo' stuff, but now seeing all these advances in neuroscience and showing changes in brain waves using functional magnetic resonance imaging that we couldn't do before – actually being able to trace the pathways that lead to changes in health outcomes – I think it's really, really exciting,” she says.
A new WHO strategic technical advisory group on traditional medicine was launched at a global summit in India this week. “This is a turning point for traditional medicine. It embodies cultural heritage and national health identity and increasingly represents a vital component of primary health care strategies,” Dr Yukiko Nakatani, WHO assistant director-general for health systems, access and data, said at the summit.
The idea, Kuruvilla suggests, is to “build a bridge” between traditional medicine and biomedicine. According to her, it is important to “find common ground.” “Demonstrating that the science can be reliable is really important, especially from a patient safety perspective.”
Traditional medicine has the potential to become a “treasure trove”, says Kuruvilla. She said the sheer number of people working in the field, including university-educated specialists accredited to work in clinics in China and India, could ease global labor shortages and make a “huge contribution” to universal health coverage.
In the context of aid cuts forcing countries to rethink healthcare provision, traditional medicine could be “a way for countries to become more self-reliant and then share those resources with each other.”
The risk of failing to invest, she said, means people can't safely access the type of healthcare they prefer, and “the world can't build on our shared heritage in ways that enable us to find new, holistic solutions for the health and well-being of people and the planet.”
