Intended for healthcare professionals

Education And Debate

Lessons on integration from the developing world's experienceTraditional medicine

BMJ 2001; 322 doi: (Published 20 January 2001) Cite this as: BMJ 2001;322:164

Lessons on integration from the developing world's experience

  1. Gerard Bodeker (, chair
  1. Commonwealth Working Group on Traditional and Complementary Health Systems, Green College, University of Oxford, Oxford OX2 6HG

    It is now recognised that about half the population of industrialised countries regularly use complementary medicine. Higher education, higher income, and poor health are predictors of its use.1 This growth in consumer demand and availability of services for complementary medicine has outpaced the development of policy by governments and health professions.

    As Western governments grapple with policy issues entailed in integrating complementary medicine into national health services, many developing countries have long since addressed these issues. Their experience constitutes a valuable, although largely unexplored, pool of policy data.

    Summary points

    Integration works best when based on self regulation in relation to standards of practice and training

    This needs to be matched by a central or regional system for drug control and evaluation and maintenance of good manufacturing practice; this system should also generate and support a comprehensive programme of research

    When conventional medicine dominates complementary medicine, loss of essential features of complementary medicine can occur, and professional conflicts can arise

    Policy should aim to keep fees for complementary medicine affordable and within reach of all levels of society

    Major sectoral investment is a prerequisite for the development of effective services for complementary medicine; underinvestment risks perpetuating poor standards of practice, services, and products

    Traditional medicine

    Almost 20 years ago the World Health Organization estimated that “In many countries, 80% or more of the population living in rural areas are cared for by traditional practitioners and birth attendants.”2

    The WHO has since backed away from the 80% estimate, settling for the safer position that most of the population of most developing countries regularly use traditional medicine. Whereas most people use traditional medicine in developing countries, only a minority have regular access to reliable modern medical services. Hence the formalisation of the traditional sector has implications for equity, coverage of primary health care, and …

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