The text below was written with the hope of being capable to add one or two insights and ideas for the World Health Organization Traditional, Complementary and Integrative Medicine Strategy 2025–2034 Draft that is being collectively built to guide the WHO directives in the next decade, relating to the integration of Traditional, Complementary and Integrative Medicine to the Biomedical or “Conventional” Medicine in the world.

We share a common desire:

“Universal access to safe, effective and people-centered traditional, complementary and integrative medicine for health and well-being“

As per the Draft’s Glossary, we can understand the following important terms by it’s definitions:

Biomedicine – also referred to as “conventional medicine” according to the biomedical model, is a branch of medical science that applies biological and physiological principles to clinical practice. Biomedicine emphasizes standardized, evidence based treatment validated through biological research, with treatment administered via formally trained doctors, nurses, and other licensed practitioners.

Complementary medicine – used interchangeably for “traditional medicine” in some countries, refers to a broad set of health care knowledge, skills and practices that are not typically part of a country’s established traditional or conventional medicine, and may play a supportive role in conjunction with biomedical care.

Digital health – the field of knowledge and practice associated with the development and use of digital technologies to improve health. Digital health expands the concept of eHealth to include digital consumers, with a wider range of smart and connected devices. It also encompasses other uses of digital technologies for health such as the Internet of Things, advanced computing, big data analytics, and artificial intelligence, including machine learning and robotics.

Integrative medicine – is an interdisciplinary and evidence-informed approach aimed at achieving whole-person health and well-being by using a respectful combination or fusion of biomedical and traditional and/or complementary medical knowledge, skills and practices. It provides holistic care spanning the care continuum and may involve various health care providers and institutions.

One Health – is an integrated, unifying approach that aims to sustainably balance and optimize the health of humans, animals, plants and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems) are closely linked and interdependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritional food, taking action on climate change, and contributing to sustainable development.

Traditional knowledge – there is no internationally accepted definition, but it can be considered as knowledge, know-how, skills and practices that are developed, sustained and passed on from generation to generation within a community, often forming part of its cultural or spiritual identity

Traditional medicine – sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, as well as scientific and professional expertise, used for the diagnosis, prevention and treatment of illnesses and to promote health and well-being

Well-being – a positive state experienced by individuals and societies. Similar to health, it is a resource for daily life and is determined by social, economic and environmental conditions. Well-being encompasses quality of life, as well as the ability of people and societies to contribute to the world with a sense of meaning and purpose

Well-being societies – provide the foundations for all members of current and future generations to thrive on a healthy planet, no matter where they live. Such societies apply bold policies and transformative approaches that are underpinned by:
• a positive vision of health that integrates physical, mental, spiritual and social well-being;
• the principles of human rights, social and environmental justice, solidarity, gender and intergenerational equity, and peace;
• a commitment to sustainable low-carbon development grounded in reciprocity and respect among humans and making peace with Nature;
• new indicators of success beyond the gross domestic product that take account of human and planetary well-being and lead to new priorities for public spending;
• the focus of health promotion on empowerment, inclusivity, equity and meaningful participation

Takeaways

1. The World Health Organization (WHO) has drafted a Traditional Medicine Strategy for 2025-2034, which aims to provide universal access to safe, effective, and people-centered traditional, complementary, and integrative medicine for health and well-being.
2. The strategy recognizes the importance of traditional medicine (TM), which is present in both codified and non-codified systems across all six WHO regions, deeply rooted in traditional medical knowledge (TMK), culture, history, and territories.
3. The strategy emphasizes the need to strengthen the role of TM in health systems, improve the quality and safety of TM products, practices, and practitioners, and promote international cooperation and collaboration.
4. The strategy introduces the concept of “traditional, complementary, and integrative medicine” (TCIM), which encompasses TM, traditional and complementary medicine (T&CM), and integrative medicine (IM).
5. The strategy aims to promote the integration of TCIM into national health systems, policies, and programs, and to strengthen the evidence base for TCIM through research and innovation.
6. The strategy calls for the development of TCIM education and training programs for healthcare professionals, students, and community members, and for the promotion of TCIM awareness and public education.
7. The strategy highlights the importance of protecting and promoting the intellectual property rights of TMK holders, and of ensuring equitable access to TCIM for all, particularly for vulnerable and marginalized populations.
8. The strategy recognizes the need to address the challenges and barriers to the implementation of TCIM, such as regulatory frameworks, quality control, and safety standards.
9. The strategy encourages the establishment of TCIM networks and partnerships at the national, regional, and global levels, and the promotion of South-South and North-South cooperation.
10. The strategy emphasizes the need to monitor and evaluate the implementation of TCIM policies and programs, and to ensure accountability and transparency in the use of resources.
11. The strategy calls for the development of TCIM indicators and data collection systems, and for the integration of TCIM into national health information systems.
12. The strategy recognizes the importance of TM in achieving universal health coverage (UHC) and the Sustainable Development Goals (SDGs), and the need to align TCIM policies and programs with UHC and SDGs.
13. The strategy encourages the involvement of all stakeholders, including governments, civil society organizations, academic institutions, private sector, and TM practitioners, in the development, implementation, and monitoring of TCIM policies and programs.
14. The strategy acknowledges the diversity and complexity of TCIM practices and systems, and the need to respect and protect the cultural and ethical values of TMK holders and communities.
15. The strategy emphasizes the need to promote TCIM research and innovation, and to establish TCIM research networks and partnerships.
16. The strategy encourages the development of TCIM policies and programs that are gender-sensitive, age-responsive, and disability-inclusive.
17. The strategy recognizes the need to address the social determinants of health and the broader determinants of TCIM, such as poverty, education, and environment.
18. The strategy calls for the development of TCIM policies and programs that are responsive to the needs and priorities of Member States, and that are adaptable to changing contexts and circumstances.
19. The strategy emphasizes the need to ensure the sustainability of TCIM policies and programs, and to promote TCIM as a means of achieving health and well-being for all.
20. The strategy invites feedback and comments from Member States, stakeholders, and the public during the public consultation period, and commits to incorporating the feedback into the final version of the strategy.

Based on this, i will suggest some points to improve the Traditional Medicine Strategy Document and suggest 12 Efficient and High Impact Strategies that could be implemented in the next decade.

Suggestions to Enhance the Traditional Medicine Strategy Document:

1. Incorporate Stakeholder Feedback: Actively seek input from a diverse range of stakeholders, including traditional medicine practitioners, patients, researchers, and policymakers, to ensure a comprehensive and inclusive strategy.
2. Establish Clear Implementation Plans: Develop detailed action plans with specific timelines, responsibilities, and monitoring mechanisms to facilitate effective implementation of the strategy.
3. Enhance Monitoring and Evaluation: Strengthen monitoring and evaluation frameworks to track progress, measure impact, and identify areas for improvement throughout the implementation of the strategy.
4. Promote Interdisciplinary Collaboration: Encourage collaboration between traditional medicine practitioners, modern healthcare professionals, researchers, and policymakers to foster a more integrated and holistic approach to healthcare.
5. Invest in Research and Development: Allocate resources towards research and development initiatives in traditional medicine to generate evidence, innovate practices, and enhance the credibility of traditional medicine within the broader healthcare landscape.
6. Facilitate Knowledge Exchange: Establish platforms for knowledge exchange and capacity-building initiatives to promote learning, collaboration, and the sharing of best practices within the traditional medicine community.
7. Address Regulatory Challenges: Work towards harmonizing regulatory frameworks for traditional medicine products and practitioners to ensure quality, safety, and efficacy standards are met consistently.
8. Promote Cultural Sensitivity: Emphasize the importance of cultural sensitivity and respect for diverse traditions within traditional medicine practices to preserve heritage and promote inclusivity.
9. Encourage Public Awareness: Develop public awareness campaigns to educate communities about the benefits and risks of traditional medicine, empowering individuals to make informed healthcare choices.
10. Foster International Collaboration: Strengthen international partnerships and collaborations to facilitate the exchange of knowledge, resources, and best practices in traditional medicine on a global scale.

12 Eficcient and High Impact Strategies for the Decade

1. Establish TCIM Research Hubs:

   Create dedicated research centers or hubs that focus on conducting rigorous scientific studies to evaluate the efficacy, safety, and mechanisms of action of various TCIM practices and products. These hubs can collaborate with academic institutions, healthcare providers, and traditional medicine practitioners to generate high-quality evidence.

2. Develop TCIM Education and Training Programs:

   Implement comprehensive education and training programs for healthcare professionals, students, and community members to enhance their knowledge and skills in TCIM. This can include integrating TCIM modules into medical and nursing curricula, as well as offering continuing education opportunities.

3. Implement TCIM Regulatory Frameworks:

   Develop robust regulatory frameworks to ensure the quality, safety, and efficacy of TCIM products, practices, and practitioners. This can involve establishing guidelines, standards, and certification processes to protect consumers and facilitate the integration of TCIM into mainstream healthcare.

4. Promote TCIM-Inclusive Health Insurance:

   Advocate for the inclusion of TCIM services and products in health insurance coverage, making them more accessible and affordable for patients. This can help to increase the utilization of TCIM and promote its integration into the broader healthcare system.

5. Establish TCIM Demonstration Projects:

   Initiate pilot projects or demonstration sites that showcase the successful integration of TCIM into primary healthcare settings, hospitals, and community-based programs. These projects can serve as models for replication and scale-up in other regions.

6. Facilitate TCIM Knowledge Exchange:

   Create platforms and networks for the exchange of TCIM knowledge, best practices, and experiences among practitioners, researchers, and policymakers, both within and across countries. This can foster collaboration, mutual learning, and the dissemination of innovative TCIM approaches. This can be accomplished by the creation of Health Education Centers (HEC) connected or articulated with the Research Hubs and building a suprastructure called Integrated Health Education Network (IHEN), that will aggregate all knowledge build and distribute and spread the knowledge to where it is more needed.

7. Promote TCIM-Inclusive Public Health Campaigns:

   Develop public health campaigns that raise awareness about the benefits and appropriate use of TCIM, empowering individuals to make informed healthcare choices. These campaigns can also address misconceptions and promote the integration of TCIM into self-care and preventive health strategies.

8. Strengthen TCIM Supply Chain and Sustainability:

   Implement measures to ensure the sustainable supply and availability of TCIM resources, such as medicinal plants, by supporting local cultivation, sustainable harvesting practices, and equitable distribution mechanisms. This can help to safeguard the long-term viability of TCIM.

9. Protect Traditional Medical Knowledge:

   Establish mechanisms to protect the intellectual property rights and traditional medical knowledge of indigenous and local communities, ensuring that they are recognized, respected, and equitably shared in the development and use of TCIM.

10. Integrate TCIM into Disaster Response and Pandemic Preparedness:

    Explore the potential role of TCIM in enhancing resilience and providing complementary care during public health emergencies, such as natural disasters and disease outbreaks. Incorporate TCIM strategies into disaster response and pandemic preparedness plans.

11. Establish TCIM Monitoring and Evaluation Systems:

    Develop comprehensive monitoring and evaluation frameworks to track the implementation, utilization, and impact of TCIM policies and programs. This can inform decision-making, facilitate continuous improvement, and demonstrate the value of TCIM within the broader healthcare landscape.

12. Create a Fitopaedia:

    Create a digital encyclopedia of all herbal and natural medicines available in the world, documenting all science based and tradicional based evidence there is, and making its database public and acessible to health practicioners

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These strategies can help to leverage the availability and potential of TCIM in a comprehensive and impactful manner, ultimately contributing to the goal of universal access to safe, effective, and people-centered traditional, complementary, and integrative medicine.

The integration of traditional, complementary, and integrative medicine (TCIM) into modern healthcare systems is a critical step towards achieving universal health coverage and promoting holistic well-being for all. The strategies and examples outlined in this document demonstrate the immense potential of TCIM to enhance the accessibility, affordability, and effectiveness of healthcare services globally.

By establishing comprehensive regulatory frameworks, investing in research and education, fostering collaborative partnerships, and protecting traditional medical knowledge, we can unlock the transformative power of TCIM. These efforts will not only bridge the gap between traditional and modern practices but also empower individuals and communities to make informed choices about their healthcare. Moreover, the strategic incorporation of TCIM into disaster response, pandemic preparedness, and public health initiatives can bolster the resilience of healthcare systems, particularly in underserved and marginalized regions.

As we look towards the future, we urge the World Health Organization and its member states to embrace these innovative strategies and work together to integrate TCIM into the fabric of global healthcare. By doing so, we can unlock a new era of integrated, people-centered care that celebrates the diversity of healing traditions and empowers individuals to take an active role in their own health and well-being.

Rafael Reinehr
Alchemist of Possibilities
Santa Maria, April 25th, 2024.