Traditional medicine is the sum total of the knowledge, skills and practices based on theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses. Traditional medicine has a long history, and while for many traditional medicinal products scientific, documented evidence of safety, efficacy and quality is scarce, these products have been "field-tested" for centuries by thousands of people; much empirical knowledge has thus been accumulated in communities and has been passed on by generations of healers. The World Health Organization therefore advocates a critical, but open-minded attitude to traditional medicines.

In some countries, the terms complementary medicine, alternative medicine or non-conventional medicine are used inter-changeably with traditional medicine. However, those terms refer to a broad set of health care practices that are not part of the country's own tradition and are not integrated into the dominant health care system.

Philosophical and practical differences

The main philosophy of western or allopathic medicine is that if the human body is struck by disease, a causative agent must be identified and dealt with in order to return the patient to good health. On the other hand, a common feature of most systems of traditional medicine is that they take a holistic approach towards the sick individual and treat disturbances on the physical, emotional and mental/spiritual levels, as well as in the environment, all at once.

Nevertheless, a distinction can be made between codified systems of traditional medicine and non-codified medicinal know-how, which includes the tribal and indigenous medicine found in many countries; this difference has implications in the context of intellectual property rights (see paragraph 6.3). The codified knowledge systems include for example Chinese traditional medicine, the Ayurvedic and Unani systems of medicine found in India, and homeopathy.

Furthermore, within traditional or complementary medicine, one can distinguish between procedure-based therapies, such as acupuncture, chiropractic therapy, osteopathy, manual and spiritual therapies etc, and medication-based therapies, using medicinal plants and herbs, but also minerals and animals or animal parts.

Herbal medicine: ingredients and methods

In herbal medicine, different parts of a plant can be used: the leaf, flower, seed, fruit, stem, wood, bark, roots, etc. Herbal materials furthermore include fresh juices, gums, fixed and essential oils, resins, dry powders. Herbal preparations are the basis for finished herbal products and may include comminuted or powdered herbal materials, extracts, tinctures and/or fatty oils of herbal materials. They are produced by well-known physical or biological processes, such as extraction, fractionation, purification and concentration, or by soaking or heating herbal materials in alcoholic beverages, in honey etc. But while the basic procedures are well-known, one should not overlook the fact that considerable skill and know-how may be required to carry them out correctly; for example, some plants contain highly poisonous ingredients, and care should be taken during the preparation process to destroy those. Finally, finished herbal products consist of herbal preparations made from one or more plants. They may also contain excipients, but no synthetic or allopathic medicines should have been added.

Figure 1 Some differences between allopathic and traditional or herbal medicines

Increasingly, countries are developing regulations regarding the registration of traditional medicine, in order to allow only products of which at least the safety and quality are proven on the market.

Access and sales

In many developing countries, a large part of the population, especially in rural areas, depends mainly or exclusively on traditional medicine for their primary health care. It has for example been reported that over 65% of the Indian population only has access to traditional systems of medicines. In Africa, 60 to 90% of the population use traditional medicine as their first line treatment.

In most Asian countries, even though allopathic medicine is available, traditional medicine is still very popular, for historic and cultural reasons. This is even the case in a highly developed country like Japan. Similarly, in other industrialized countries, the use of complementary and alternative medicine is increasing - in 1993, a landmark survey found that 1 in 3 adults in the US use some form of alternative medicine, and this seems to have increased since. As a result, in 2000, the world market for herbal medicines including raw materials- has been estimated at 43 billion US dollars (see also figure 2). Furthermore, it is interesting to note that, in the US, OTC sales of herbal medicines doubled between 1991 and 1994, and then again between 1994 and 1998. Similar steep increases in sales of herbal medicines have been reported in the EEC, while growth in sales was even fasterin China and Korea.

Figure 2 World market of herbal medicines

Source: Secretariat of the CBD, 2000.

Yet it is important to keep in mind that, while herbal medicines represent an alternative, an option, for people in industrialized countries, they often are the only alternative for large parts of the population in developing countries.