Introduction
The essential role of traditional, complementary and integrative healthcare (TCIH) in achieving health and well-being and universal health coverage (UHC) is stated in the WHO Traditional Medicine Strategy: 2014–2023 (WHO TM Strategy) and in the Astana Declaration on Primary Health Care, with its corresponding operational framework.1 2 The role of TCIH for the achievement of health and well-being for all was reemphasised at the recent WHO Traditional Medicine Summit in India.3
As the World Health Assembly has decided to extend the current WHO TM Strategy until 2025 and for WHO to develop a new 10-year strategy,4 reflection on progress and the way forward is needed. To date, much of the focus on the implementation of the WHO TM Strategy has focused on the progress made by its member states,5 with less focus on stakeholders such as professional and patient organisations, educational institutions, researchers and practitioners. This might be attributed to the lack of clear reporting mechanism for stakeholders so far. We aim to assess progress in the WHO TM Strategy implementation, and to delineate a TCIH stakeholder perspective for the next WHO TM Strategy.
This paper is written from the perspective of the ‘People’s Declaration on Traditional, Complementary and Integrative Healthcare’ (https://tcih.org/), a worldwide coalition of over 300 professional and patient organisations, research centres and educational institutions (the authors are cofounders of this coalition). The coalition unites around the TCIH Declaration (see box 1 for highlights from the Declaration) and calls for respectful collaboration between traditional, complementary and biomedical practices.
Excerpt from ‘The People’s Declaration for Traditional, Complementary and Integrative Healthcare’, available online (https://tcih.org/)
The healthcare we desire
Focuses on the whole person, including physical, mental, social and spiritual dimensions.
Is patient-centred and supports self-healing and health creation.
Is participative and respects individual choices.
Is evidence-based by integrating clinical experience and patient values with the best available research information.
Respects cultural diversity and regional differences.
Is an integral part of community and planetary health.
Uses natural and sustainable resources that are respectful of the health of our planet.
Integrates traditional, complementary and biomedical practices in a supportive and collaborative manner.
Call to action
All countries
Ensure full access to traditional, complementary and integrative healthcare (TCIH) as part of the right to health for all.
Include TCIH into national health systems.
Provide accreditation of TCIH healthcare professionals in accordance with international training standards to ensure high-quality care.
Ensure access and safety of TCIH medicines through specific regulatory pathways.
Fund research on TCIH and disseminate reliable information on TCIH to the public.
All healthcare professionals
Foster respectful collaboration between all healthcare professions towards achieving a person-centred and holistic approach to healthcare.
All media and publications
Ensure accurate and fair reporting on TCIH.
Various terminologies are used in this field. WHO has defined ‘traditional medicine’ and ‘complementary medicine’ and merged these terms as T&CM.1 The WHO also uses the term ‘traditional, complementary and integrative medicine’ but has not yet defined ‘integrative medicine’ nor the broader umbrella term.6 For the purpose of this paper, we use the more inclusive term ‘traditional, complementary and integrative healthcare’ (TCIH) to refer to the respectful collaboration between various systems of healthcare and their health workers with the aim of offering a person-centred and holistic approach to health.
In this paper, we analyse progress and discuss future perspectives of the following three objectives of the WHO TM Strategy: research; regulation of TCIH practices, practitioners and products (we separate product regulation for convenience of the analysis); and integration into health systems to achieve UHC.1 We also reflect on the contribution of TCIH to address specific health challenges, an area that is missing in the current TM strategy. The scope of this paper includes traditional and complementary practices, that are or could suitably be part of regulated healthcare.
Progress in the implementation of the WHO TM Strategy was assessed based on the WHO’s 2019 and 2022 progress reports,7 8 WHO’s implementation report of the TM strategy,9 and the WHO’s T&CM publications since 2014, as available from its website. All identified outcomes and deliverables (publications, expert meetings) were plotted against the policy areas noted earlier and summarised in table 1. Progress at country level was drawn from the 2019 WHO Global Report on Traditional and Complementary Medicine, which is based on a country survey conducted in 2018, that is, halfway through the implementation of the 2014–2023 TM strategy5: key findings from this detailed survey are given in table 1 .