Background :-  Traditional medicine is something that every Indian must have used at some point of their lifetime. Although, in recent years it has been loosing its sheen and gave away to the modern medicinal system, yet its significance still remains. And in the context of spiraling life-style diseases, more and more people are turning towards the ancient system of healthcare. Many are preferring to go through the traditional medicine system to find cure rather than chewing pills every now and then.

Traditional medicine:-

Traditional medicine is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.

Complementary/alternative medicine (CAM)

The terms “complementary medicine” or “alternative medicine” are used inter-changeably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system.

Herbal medicines

Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations.

• Herbs: crude plant material such as leaves, flowers, fruit, seed, stems, wood, bark, roots, rhizomes or other plant parts, which may be entire, fragmented or powdered.
• Herbal materials: in addition to herbs, fresh juices, gums, fixed oils, essential oils, resins and dry powders of herbs. In some countries, these materials may be processed by various local procedures, such as steaming, roasting, or stir-baking with honey, alcoholic beverages or other materials.
• Herbal preparations: the basis for finished herbal products and may include comminuted or powdered herbal materials, or extracts, tinctures and fatty oils of herbal materials. They are produced by extraction, fractionation, purification, concentration, or other physical or biological processes. They also include preparations made by steeping or heating herbal materials in alcoholic beverages and/or honey, or in other materials.
• Finished herbal products: herbal preparations made from one or more herbs. If more than one herb is used, the term mixture herbal product can also be used. Finished herbal products and mixture herbal products may contain excipients in addition to the active ingredients. However, finished products or mixture products to which chemically defined active substances have been added, including synthetic compounds and/or isolated constituents from herbal materials, are not considered to be herbal.

Traditional use of herbal medicines

Traditional use of herbal medicines refers to the long historical use of these medicines. Their use is well established and widely acknowledged to be safe and effective, and may be accepted by national authorities.

Therapeutic activity

Therapeutic activity refers to the successful prevention, diagnosis and treatment of physical and mental illnesses; improvement of symptoms of illnesses; as well as beneficial alteration or regulation of the physical and mental status of the body.

Active ingredient

Active ingredients refer to ingredients of herbal medicines with therapeutic activity. In herbal medicines where the active ingredients have been identified, the preparation of these medicines should be standardized to contain a defined amount of the active ingredients, if adequate analytical methods are available. In cases where it is not possible to identify the active ingredients, the whole herbal medicine may be considered as one active ingredient.

 Education system for TM practitioners in India
In India, all six traditional systems of medicine with official recognition (Ayurveda, Yoga, Naturopathy, Unani Medicine, Siddha and Homeopathy) have institutionalised education systems. India has 508 colleges with an annual admission capacity of 25 586 undergraduate students, 117 of these colleges also admitting 2493 postgraduate students. Colleges can only be established with the permission of central government and the prior approval of their infrastructure, syllabi and course curricula. Annual and surprise inspections ensure that educational and infrastructural standards are met. Central Government has the power to recognize or rescind any qualification and college.

Around the world:-

In 2003, the WHO Regional Committee for South-East Asia developed a regional resolution on traditional systems of medicine  in order to encourage the regional progress of TM. In several countries local T&CM systems have been recognized by the respective governments, such as ayurveda and unani in Bangladesh, India, Nepal and Sri Lanka, sowa rigpa in Bhutan, jamu in Indonesia, koryo medicine in Democratic  People’s Republic of Korea, dhivehibeys in Maldives, Myanmar TM in Myanmar and Thai  TM in Thailand. In Democratic People’s Republic of Korea, koryo medicine is so integrated in the national health system that both TM and conventional health care are available in the same health facilities at all three levels of care. Both health systems are offered in separate facilities at secondary and tertiary levels in nine countries, of which eight have begun to integrate TM and conventional health care at the primary level.

WHO and TM

 Traditional medicine (TM) is an important and often underestimated part of health services. In some countries, traditional medicine or non-conventional medicine may be termed complementary medicine (CM). TM has a long history of use in health maintenance and in disease prevention and treatment, particularly for chronic disease.

The WHO Traditional Medicine (TM) Strategy 2014–2023 was developed in response to the World Health Assembly resolution on traditional medicine (WHA62.13) (1). The  goals of the strategy are to support Member States in:

1)harnessing the potential contribution of TM to health, wellness and peoplecentred health care;

2)promoting the safe and effective use of TM by regulating, researching and integrating TM products, practitioners and practice into health systems, where appropriate.

The strategy aims to support Member States in developing proactive policies and implementing action plans that will strengthen the role TM plays in keeping populations healthy. It seeks to build upon the WHO Traditional Medicine Strategy 2002–2005, which reviewed the status of TM globally and in Member States, and set out four key objectives:

1)policy — integrate TM within national health care systems, where feasible, by developing and implementing national TM policies and programmes
2)safety, efficacy and quality — promote the safety, efficacy and quality of TM by expanding the knowledge base, and providing guidance on regulatory and quality assurance standards.
3)access — increase the availability and affordability of TM, with an emphasis on access for poor populations.
4)rational use — promote therapeutically sound use of appropriate TM by practitioners and consumers.

Despite significant progress made in implementing this strategy around the world, Member States continue to experience challenges related to:

1)development and enforcement of policy and regulations;
2)integration, in particular identifying and evaluating strategies and criteria for integrating TM into national and primary health care (PHC);
3)safety and quality, notably assessment of products and services, qualification of practitioners, methodology and criteria for evaluating efficacy;
4)ability to control and regulate TM and CM (T&CM) advertising and claims;
5)research and development;
6)education and training of T&CM practitioners;
7)information and communication, such as sharing information about policies, regulations, service profiles and research data, or obtaining reliable objective  information resources for consumers.

Way Forward :-

1)build the knowledge base that will allow T&CM to be managed actively through appropriate national policies that understand and recognize the role and potential of &CM.
2)strengthen the quality assurance, safety, proper use and effectiveness of T&CM by regulating products, practices and practitioners through T&CM education and raining, skills development, services and therapies.
3)promote universal health coverage by integrating T&CM services into health service delivery and self-health care by capitalizing on their potential contribution to improve health services and health outcomes, and by ensuring users are able to make informed choices about self-health care