Traditional Medicine (TM) is the collection of skills and practices based on people’s life experiences or observations. With strong historical and cultural roots, it has long been used in health maintenance and in disease prevention and treatment. Thanks to the progress in modern science and civilization, TM has undergone, and is still undergoing an evolutionary process to “keep what’s good and remove what’s bad”.
TM has a long history. It is defined by the World Health Organization(WHO) as “the sum total of the knowledge, skill, and practices based on the 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 illness”.
In some countries or territories, TM or non-conventional medicine may be termed alternative or complementary medicine. The social development and changes in the spectrum of human diseases have resulted in the medicine’s paradigm shift from the biomedical to the biopsychosocial model. At the same time, population aging, advances in rehabilitation medicine and emerging contagious diseases brought new challenges and opportunities for TM. TM is found in almost every country in the world and the demand for its service is increasing. It has been used for thousands of years and has made great contributions to human health.
According to the newly released WHO Global Report on Traditional and Complementary Medicine 2019, as of 2018, 170 WHO Member States (88%) acknowledged their use of Traditional and Complementary Medicine (T&CM), 107 had a national office for T&CM, 98 had developed national policies on T&CM, 75 reported the presence of a national research institute for T&CM, and 109 reported the presence of a legal or regulatory framework for T&CM. In addition, 124 Member States had implemented regulations on herbal medicines, 45 reported the coverage of T&CM by health insurance [public and (or) private], and 34 included traditional or herbal medicines in their national essential medicines lists (NEMLs).
TM, with its availability and accessibility, is playing a key role in implementing the idea of people-centered health service and ensuring that all people have access to care. Thanks to the national policy of placing equal emphasis on Traditional Chinese Medicine (TCM) and Western Medicine in China, TCM is a key component in national healthcare system. It makes up 16.4% of the National Health Service and 23% of medical visits in grass-root medical institutions. The total output value of TCM pharmaceutical industry was approximately RMB 800 billion and the total value of international trade value reached $80 billion. Over 100 million Europeans are current users of T&CM, most (86%) Koreans have used traditional Korean Medicine at some point in their lives, and 76% of Singaporeans are regular users of TM. In the United States, more than 65% of the population use alternative and complementary medicine. In India, there are over 500,000 registered T&CM practitioners.
In Western countries, there has been an increasing demand for health service of TM, along with the rapid increase in chronic disease, intractable conditions and rehabilitation medicine. In some developing countries, TM plays a major role in primary healthcare service, and TM practitioners remain the sole or main health providers for people living in rural areas.
Globally, TM is playing a significant role in health maintenance as well as disease diagnosis and treatment. However, the current status of TM varies greatly from country to country due to the imbalance of economic-social development and differences in health system and policies. TM,as pointed out in the WHO Traditional Medicine Strategy 2014—2023, “is an important and often underestimated part of health services”. Despite the fact that more and more countries have launched laws or regulations on TM, not so many countries reported the integration of TM within national health care system. There is still a gap between TM practitioners, skills and products and medical doctors,technologies and pharmaceutical drugs. In addition, there are many challenges for TM in healthcare delivery, education, research and pharmaceutical industry to meet the demand for health maintenance as well as disease prevention and treatment.
In 2009, a new technical committee entitled “Traditional Chinese Medicine” (TCM) and coded“249” was established in the ISO family. It focuses on the TCM safety and quality. I was honored to serve as the secretary general and worked with the chairman Dr. David Graham (the former chairman of TGA, Australia) for 9 years. I’ve served as the chairman of ISO/TC 249 since 2019. The ISO/TC 249 offers a work platform for top experts in the field of TM. We are making every effort to develop TM and improve the TCM safety and quality.
We have organized two forums on world TM in Shanghai, once in 2017 and once in 2019.Inspired by the information exchanged among experts during the forum on the past, present and future challenges of TM, I came up with the idea of compiling a book entitled History, Present and Prospect of World Traditional Medicine which received a very positive feedback from TM scholars.
After over two years of hard work from senior experts in different countries, we are now ready to publish the first volume of the book, which involves Ayurveda, chiropractic, European Traditional Herbal Medicine, Ancient Greco-Arab and Islamic Herbal Medicine, Homeopathy, Japanese Kampo Medicine, Traditional Korean Medicine, Traditional Chinese Medicine and Traditional Thai Medicine.We hope this book can serve as a useful reference for TM regulators and practitioners and thus contribute to human health and global development of TM.
We will continue to gather more information on other types of T&CM across the world and then publish the second volume once the time is ripe.
Shen Yuandong
Institute of TCM International Standardization, Shanghai University of Traditional Chinese Medicine
April, 2022