Accessible and affordable in developing countries
In developing countries, broad use of TM is often attributable to its accessibility and affordability. In Uganda, for instance, the ratio of TM practitionersc to population is between 1:200 and 1:400. This contrasts starkly with the availability of allopathic practitioners, for which the ratio is typically 1:20 000 or less. Moreover, distribution of such personnel may be uneven, with most being found in cities or other urban areas, and therefore difficult for rural populations to access. TM is sometimes also the only affordable source of health care - especially for the world's poorest patients. In Ghana, Kenya and Mali, research has shown that a course of pyrimethamine/sulfadoxine antimalarials can cost several dollars. Yet per capita out-of-pocket health expenditure in Ghana and Kenya amounts to only around US$ 6 per year. Conversely, herbal medicines for treating malaria are consider-ably cheaper and may sometimes even be paid for in kind and/or according to the "wealth" of the client.
c TM practitioners are generally understood to be traditional healers, bone setters, herbalists, etc. TM providers include both TM practitioners and allopathic medicine professionals such as doctors, dentists and nurses who provide TM/CAM therapies to their patients - e.g. many medical doctors also use acupuncture to treat their patients.
TM is also highly popular in many developing countries because it is firmly embedded within wider belief systems.
An alternative approach to health care in developed countries
In many developed countries popular use of CAM is fuelled by concern about the adverse effects of chemical drugs, questioning of the approaches and assumptions of allopathic medicine, and greater public access to health information.
At the same time, longer life expectancy has brought with it increased risks of developing chronic, debilitating diseases such as heart disease, cancer, diabetes and mental disorders. For many patients, CAM appears to offer gentler means of managing such diseases than does allopathic medicine.