Traditional medicine and its contributions to science, health equity and sustainability

The ‘Bull World Health Organ’ has just published a theme issue on ‘Traditional Medicine’. Here are some extracts  from the accompanying editorial that I thought were remarkable:

The World Health Organization’s (WHO) new Global traditional medicine strategy 2025–2034 aims to advance the contribution of evidence-based traditional, complementary and integrative medicine to the highest attainable standard of health and well-being…

Traditional medicine is the primary or preferred care for billions of people worldwide. Analysis of 71 nationally representative surveys shows its wide spread use for hypertension, diabetes and hypercholesterolemia, often alongside conventional care. The clinical potential is considerable …

However, challenges remain; for instance, while acupuncture is recommended for migraine, many guidelines show methodological and procedural gaps.

Traditional medicine is increasingly used in the health, wellness and bioeconomy sectors. Nonetheless, an analysis revealed that less than 1% of global health research funding is dedicated to traditional medicine, an inequity that undermines efforts to build the required evidence base.

Traditional medicine is more than a collection of therapies; it represents a worldview in which health is harmony within and between individuals, communities and ecosystems. Restoring this balance is a scientific, rights-based and sustainability imperative.

I think these lines (there are several other issues as well, and I recommend reading the full article) require a few comments.

The WHO aim to “advance the contribution of evidence-based traditional, complementary and integrative medicine” seems laudable, yet it also raises concerns: once any form of medicine is “evidence-based”, it is not “traditional, complementary and integrative”. Then it is by definition EBM, evidence-based medicine! Thus, the entire premise of the WHO Global traditional medicine strategy 2025–2034 makes no sense.

The fact that “traditional medicine is the primary or preferred care for billions of people worldwide” does not necessarily mean that its “clinical potential is considerable”. More likely it means that billions have to rely on obsolete forms of medicine from the dark ages because they cannot afford effective treatments. This is far from an opportunity; it is a challenge for us to improve this inhuman situation.

The fact that “acupuncture is recommended for migraine”, while the evidence for this (and almost all similar) recommendations are not supported by sound evidence, amounts to a scandal. One would have hoped that, instead of promoting unproven ‘traditional medicine’, an urgent task of the WHO would be to warn people of bogus and often dangerous claims that are ubiquitous in this sector.

The fact that “1% of global health research funding is dedicated to traditional medicine” might look unfair at first glance. But global health research funding is in the range of US$ 200 billion per year. Thus 1% would amount to 2 billion, and I suggest that one could do plenty of good research with this money. Instead, the sector tends to waste its funds on lousy pseudo-research, as anyone interested can confirm by reading this blog. Why does the WHO not point this out and take measures to stop pseudo-science in the realm of ‘traditional medicine’? Do they really think that offensive ideological platitudes such as “restoring balance is a scientific, rights-based and sustainability imperative” cuts the mustard?

My recommendation to the WHO is as simple as it is important: if you want to create meaningful articles, documents or strategies on ‘traditional medicine’ (or indeed any other subject), don’t charge biased proponents with the task but recruit a few well-informed critical thinkers as well.