Traditional medicine is receiving global attention. Centuries-old treatment and healing practices will now be studied systematically to validate and pave the way for greater acceptance.

In a first of sorts, the World Health Organisation (WHO) Global Centre for Traditional Medicines (GCTM), coming up at Jamnagar (Gujarat), has been tasked with this mammoth effort. It will drive innovation for sustainable traditional medicines (TMs), even as it supports existing ones using modern scientific tools to document and underpin the traditional knowledge with evidence.

Podcast | Unlocking the secrets of traditional medicine  Podcast | Unlocking the secrets of traditional medicine  

About 80 per cent of the world's population uses traditional and complementary medicines (T&CM), says the WHO. Naturally, the fraternity, including practitioners and consumers around the globe, are ecstatic. The WHO Centre, they say, will bring much-needed recognition to these time-tested therapies discounted by critics as “a science of fraud".

Validation is important

Traditional medicines have followed a practice-based evidence approach. Modern medicine, on the other hand, follows the evidence-based approach. And therein lay the mistrust.

But Dr K Jagannathan, President, Board of Unani, Siddha and Sowa Rigpa, under the National Commission for Indian System of Medicine (NCISM), is optimistic. An evidence-based approach will strengthen the understanding of traditional medicines, he says.

"The Indian system of medicine is time-tested and practised from time immemorial. But scientific validation is also important, to ensure the quality, efficacy and safety of these medicines. Moreover, every country has its own traditional medical science, drugs and regulatory bodies. If these are scientifically validated, and expressed in terms of scientific data, we can easily convince the global community for adoption," he says.

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At the launch of the centre a fortnight ago, WHO Director General Dr Tedros Adhanom Ghebreyesus called for more study to help “bring the benefits of traditional and complementary medicine into wider use”.

WHO is also planning to use artificial intelligence (AI) to document the impact of traditional medicine practices, where standard randomised trials are not possible or are difficult to undertake.

Efficacy demonstration

The Ayush systems of ayurveda, yoga and naturopathy, unani, siddha and homeopathy often face financial constraints when it comes to clinical trials for medicines. Local clinical trials cost upto ₹3.5 crore and global trials cost ₹20 crore, making them unviable, industry sources say.

Traditional medicines in WHO regions
Africa: African traditional medicines
America: Osteopathy, chiropractic
Eastern Mediterranean: Traditional Arab and Islamic medicine
Europe: Naturopathy, homeopathy
South-East Asia: Ayurveda, yoga, unani, nuad Thai
Western Pacific region: Traditional Chinese medicine, acupuncture, tuina

Ashish Kumar, Chief Executive Officer, Dr Willmar Schwabe India (a leading firm in homoeopathy medicines), said, “We can't compare with the chemical industry or allopathy industry, because there the trials for a product run for years. Homoeopathy has about 20,000 products including mother tinctures and so on. For each product if you ask for trials, neither the Ayush industry nor the government will be able to do it. So, there is a need for certain efficacy-demonstration studies, which will be a combination of qualitative and clinical aspects."

The world of traditional and complementary medicine 
WHO's 170 members use traditional and complementary medicine (T&CM) and have formally developed policies, laws, regulations. WHO has identified ten T&CM practices:
 1. Acupuncture (113 members use it)
2. Herbal medicines (110 members)
3. Indigenous TM  (109 members)
4. Homoeopathy (100)
 5. Traditional Chinese medicines (100)
6. Naturopathy (90-plus)
7. Ayurvedic medicine
8. Chiropractic
9. Osteopathy
10. Unani (82)
WHO looks to include traditional medicine in the 11th revision of the International Classification of Diseases to establish reliable data on their use.
WHO to use artificial intelligence to document the impact of traditional medicine practices wherever standard randomised trials are not possible or are difficult to undertake.
WHO's Covid-19 research database has over 2,500 citations of traditional medicine.
Traditional medicine publications are among the top five downloaded on the WHO website.

Also, countries look for different specifications of the same herbal product. Take ashwagandha — some seek root specifications, others ask for leaf specifications. "There is no parity in specifications and applications. We see the government pushing for equity in specifications. It is a challenging task, but with WHO doing it, it will get global acceptance," says Kumar.

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Anup Thakar, Director of Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar, which will be GCTM's interim office, says, "WHO is already on the task to develop a suitable methodology to validate claims of traditional medicines and compile the data. A suitable scientific method will be developed. It is a dynamic process. "

"The basic principle-based parameters of different systems such as the five-elemental theories, 96 tatva theories, vaata-pitta-kafam, seven body constituents, body temperament, and so on need to be integrated. That will be beneficial for the wholesome understanding of our traditional medical systems, drug activities and outcome of treatment methods," said Dr Jagannathan.

Much hope is pinned on the upcoming centre and its tools to help unravel the secrets locked in traditional therapies, for a wider benefit.

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