WHO Traditional Medicine Strategy: 2002-2005
(2002; 70 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentAcknowledgements
View the documentAcronyms, abbreviations and WHO Regions
Open this folder and view contentsKey points: WHO Traditional Medicine Strategy 2002 - 2005
Close this folderChapter One: Global review
View the document1.1 What is traditional medicine? Towards a working definition
View the document1.2 Broad use and appeal
View the document1.3 Expenditure
View the document1.4 Accounting for use and increasing interest
View the document1.5 Responding to the popularity of TM/CAM
Open this folder and view contentsChapter Two: Challenges
Open this folder and view contentsChapter Three: The current role of WHO
Open this folder and view contentsChapter Four: International and national resources for traditional medicine
Open this folder and view contentsChapter Five: Strategy and plan of action 2002 - 2005
View the documentAnnex One: List of WHO Collaborating Centres for Traditional Medicine
Open this folder and view contentsAnnex Two: Selected WHO publications and documents on traditional medicine
View the documentReferences
View the documentBack Cover
 

1.1 What is traditional medicine? Towards a working definition

There are many TM systems, including traditional Chinese medicine, Indian ayurveda and Arabic unani medicine. A variety of indigenous TM systems have also been developed throughout history by Asian, African, Arabic, Native American, Oceanic, Central and South American and other cultures. Influenced by factors such as history, personal attitudes and philosophy, their practice may vary greatly from country to country and from region to region. Needless to say, their theory and application often differ significantly from those of allopathic medicine (Box 1).

Depending on the therapies involved, TM/CAM therapies can be categorized as medication therapies - if they use herbal medicines,d animal parts and/or minerals - or non-medication therapies - if carried out primarily without using medication, as in the case of acupuncture, manual therapies, qigong, tai ji, thermal therapy, yoga, and other physical, mental, spiritual and mind - body therapies.

d Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations thereof.

Box 1

WHAT IS TRADITIONAL MEDICINE?

Traditional medicine may be codified, regulated, taught openly and practised widely and systematically, and benefit from thousands of years of experience.

Conversely, it may be highly secretive, mystical and extremely localized, with knowledge of its practices passed on orally. It may be based on salient physical symptoms or perceived supernatural forces.

Clearly, at global level, traditional medicine eludes precise definition or description, containing as it does diverse and sometimes conflicting characteristics and viewpoints. But a working definition is nevertheless useful. For WHO such a definition must of necessity be comprehensive and inclusive.

WHO therefore defines traditional medicine as including diverse health practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness.

Complementary and alternative medicine

The terms "complementary" and "alternative" (and sometimes also "non-conventional" or "parallel") are used to refer to a broad set of health care practices that are not part of a country's own tradition, or not integrated into its dominant health care system.

Acupuncture is a traditional Chinese medicine therapy. But many European countries define it and traditional Chinese medicine in general as CAM, because they do not form part of their own health care traditions. Similarly, since homeopathy and chiropractic systems were developed in Europe in the 18th Century, after the introduction of allopathic medicine, they are not categorized as TM systems nor incorporated into the dominant modes of health care in Europe. Instead, they are regarded as a form of CAM.e

"To speak of "alternative" medicine is... like talking about foreigners - both terms are vaguely pejorative and refer to large, heterogeneous categories defined by what they are not rather than by what they are."1

e Accordingly, in this document, “traditional medicine” is used when referring to Africa, Latin America, South-East Asia, and/or the Western Pacific, whereas “complementary and alternative medicine” is used when referring to Europe and/or North America (and Australia). When referring in a general sense to all of these regions, the comprehensive TM/CAM is used.

Some common TM/CAM therapies, described in the 1999 British Medical Journal series on CAM, are shown in Table 1. The table is by no means exhaustive, and new branches of established disciplines are being developed continually.

Incorporation of TM/CAM into national health care systems

WHO has defined three types of health system to describe the degree to which TM/CAM is an officially recognized element of health care.

In an integrative system, TM/CAM is officially recognized and incorporated into all areas of health care provision. This means that: TM/CAM is included in the relevant country's national drug policy; providers and products are registered and regulated; TM/CAM therapies are available at hospitals and clinics (both public and private); treatment with TM/CAM is reimbursed under health insurance; relevant research is undertaken; and education in TM/CAM is available. Worldwide, only China, the Democratic People's Republic of Korea, the Republic of Korea and Viet Nam can be considered to have attained an integrative system (Table 2).

Table 1 Commonly used TM/CAM therapies and therapeutic techniques

 

Chinese medicine

Ayurveda

Unani

Naturopathy

Osteopathy

Homeopathy

Chiropractic

Others

Herbal medicines

a

Acupuncture/acupressure

     

   

b

Manual therapies

Tuinac

 

Shiatsud

Spiritual therapies

     

Hypnosis, healing, meditation

Exercises

Qigonge

Yoga

 

Relaxation

       

- commonly uses this therapy/therapeutic technique

- sometimes uses this therapy/therapeutic technique

- uses therapeutic touch


a for example, many informal TM systems in Africa and Latin America use herbal medicines.

b for example, in Thailand, some commonly used TM therapies incorporate acupuncture and acupressure.

c type of manual therapy used in traditional Chinese medicine.

d refers to manual therapy of Japanese origin in which pressure is applied with thumbs, palms, etc., to certain points of the body.

e component of traditional Chinese medicine that combines movement, meditation and regulation of breathing to enhance the flow of vital energy (qi) in the body to improve circulation and enhance immune function.

An inclusive system recognizes TM/CAM, but has not yet fully integrated it into all aspects of health care, be this health care delivery, education and training, or regulation. TM/CAM might not be available at all health care levels, health insurance might not cover treatment with TM/CAM, official education in TM/CAM might not be avail-able at university level, and regulation of TM/CAM providers and products might be lacking or only partial. That said, work on policy, regulation, practice, health insurance coverage, research and education will be under way. Countries operating an inclusive system include developing countries such as Equatorial Guinea, Nigeria and Mali which have a national TM/CAM policy, but little or no regulation of TM/CAM products, and developed countries such as Canada and the United Kingdom which do not offer significant university-level education in TM/CAM, but which are making concerted efforts to ensure the quality and safety of TM/CAM. Ultimately, countries operating an inclusive system can be expected to attain an integrative system (Table 3).

In countries with a tolerant system, the national health care system is based entirely on allopathic medicine, but some TM/CAM practices are tolerated by law.

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