WHO's First Traditional Medicine Summit

The WHO held its first summit dedicated to discussing traditional medicine. The two-day meeting, co-chaired by the Indian government, took place on August 17 in Gandhinagar, India. Last year, WHO established a global traditional medicine center in Jamnagar, India, which received funding of US$250 million from India. In 2019, the WHO added some traditional medicines to the International Classification of Diseases-11, the outline doctors use to diagnose diseases.

Shyama Kuruvilla, head of the Global Traditional Medicine Center and Summit, said traditional medicine was already used by billions of people, so WHO needed to explore how it could be incorporated into traditional healthcare and collaborate scientifically to gain a more complete understanding of its use. Many traditional medicine researchers agree, but some are unsure whether the summit will be productive.

"I'm afraid this conference will end up repeating the clichés and wishful thinking," said Edzard Ernst, an alternative medicine researcher at the University of Exeter in the United Kingdom, who has written several books questioning alternative medicine's claims.

Currently, WHO considers traditional and alternative medicine to include a broad range of disciplines such as Ayurveda, yoga, homeopathy and complementary therapies.

"For some people in some countries, this is their only source of health and wellbeing interventions or services," Kuruvilla said.

The summit will bring together participants from across WHO regions, indigenous communities, traditional medicine practitioners, and policy, data and science experts.

Kuruvilla said the WHO includes in its guidelines and policies only those interventions or systems that have been rigorously scientifically validated and proven effective through randomized controlled trials or systematic reviews, while for traditional medicine, this practice will continue. Kuruvilla also said there needs to be a global standard for the multibillion-dollar natural cosmetics and herbal medicine industry. For integrative interventions, such as yoga, researchers need to consider culture and context and develop a scientific approach, "which requires us to take a multidisciplinary research approach," she said.

Evidence-Based and Efficacy

Attendees will discuss how to gather evidence for traditional healing systems, said Lisa Susan Wieland, director of Cochrane Complementary Medicine at the University of Maryland School of Medicine in Baltimore and external advisor to the summit.

The quality and quantity of research in traditional medicine needs to be improved before firm conclusions can be drawn about its safety and efficacy, Wieland said. "A lot has changed in the past 15 years," she said. "Previously there wasn't enough high-quality research to determine what worked and what didn't, but now we're seeing more and better research in some traditional medicine."

The summit, which coincided with the 75th anniversary of WHO and India's independence, was organized by a panel of traditional medicine and public health experts from around the world. Some scientists worry this could lead to a blind promotion of traditional medicine. The panel that organized the summit published an editorial in the Journal of Ayurveda and Integrative Medicine that compared the "reductionist" approach of Western medicine (decomposing phenomena into their component parts) with the emphasis on "mind, body, and spiritual interconnection" with traditional medicine.

But GL Krishna, an Ayurvedic doctor in Bangalore, India and a proponent of evidence-based traditional medicine, believes this "reductionist" approach should form the basis of holistic care. "These systems were developed when evidence collection and evaluation methods were in their infancy. Therefore, careful evidence-based evaluation of these systems is needed," he said.

The Indian government has also expressed its support for traditional medicine .

According to Kishor Patwardhan, a researcher in Ayurvedic physiology at Banneres Hindu University in Varanasi, India, there is a need for research to demonstrate the clinical utility of traditional medicines. He hoped the summit would lead to "a solid roadmap to address the lack of credible evidence for Ayurvedic practices and the safety of products in the market".

Ricardo Ghelman, president of the Academic Federation of Integrative Health in Brazil and advisor to the summit, said the summit agenda will emphasize high-quality research and evidence mapping for a medical system that was once considered a fringe alternative medicine.

"This in no way means being weak on science," Kuruvilla said. "Practically, this means being very harsh on both conventional medicine and science, do we have the right approach to properly understand more complex phenomena?"

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https://doi.org/10.1038/d41586-023-02636-z