Traditional Medicine at the World Health Organization: A Critical Analysis of Changing Political Discourses, 2008 - 2023


Nadine Ijaz, Carleton University

Traditional medicine (TM) refers to the wide range of Indigenous, ethnomedical and otherwise non-biomedical therapeutic systems and practices in use worldwide. In 1976, the World Health Organization (WHO) established the first working group to advance TM’s inclusion within national health systems. By 1978, the WHO’s Alma Ata Declaration on primary health care called for inclusion of TM practitioners in health systems, a call renewed and extended thirty years later, in the WHO’s 2018 Declaration of Astana, which further emphasized the value of TM knowledges. Other key TM-related WHO documents include two TM Strategies (2002-2005, and 2014-2023), the Beijing Declaration (2008), and the Gujarat Declaration (2023). These documents address a range of complex TM-related issues, including the integration of safe, effective TM into national health systems, scientific evidence pertaining to safety and effectiveness, governance of TM practitioners, practices and products, traditional/Indigenous knowledge protection, and the logistics of ‘integrating’ TM into national health systems. Despite its ongoing expressed interest in advancing TM’s inclusion within health systems over almost five decades, the WHO’s investment in the field has been relatively minor, compared to other areas of political commitment. In 2022, however, the WHO announced it would establish a major Global TM Centre in India, and in 2023, held its first Global Summit on TM. Taken together, these material investments appear to signal an increased political investment in TM on the WHO’s part. In light of the WHO’s recently-increased material investment in the TM field, this study aims to evaluate possible shifts in the ways in which the WHO’s political narratives surrounding the TM field may be concurrently shifting. Using an intertextual, critical discourse analysis approach, the authors analyze key narratives evident across an exhaustive compilation of TM-related public statements delivered by the WHO’s Directors-General (DG) Margaret Chan and Tedros Adhanom Ghebreyesus, over the last fifteen years. Notably, whereas just two public TM-related statements were made by DG Chan over the period 2008 – 2015, DG Ghebreyesus made four such statements in 2022 and 2023 alone, signaling a sudden, recent and notably-increased degree of attention to the TM field by the WHO highest political actors. The TM-related discourses evident within Chan’s two speeches are substantially consistent over time, as are Ghebreyesus’s four statements. However, key similarities as well as important differences exist between the two DGs’ public statements. Aligned with discourses expressed within the two WHO’s TM Strategies, both DGs’ statements recognize the long histories of many TM systems and practices, their cultural importance, and their major role in community-based primary health care, especially in global South settings. Both DGs furthermore affirm the potential advantages of TM’s increased inclusion within national health systems, the unique contributions of both biomedicine and TM to quality, equitable and people-centred health care, and recognize the strong demand for non-biomedical therapeutics worldwide. Chan’s statements uniquely point to possible reasons for such demand, including the lack of available biomedical care in some settings, and peoples’ pursuit of alternatives to biomedicine’s reductive, depersonalized therapeutics. Chan’s speeches, at odds with Gebreyesus’s, strongly emphasize the limits and possible dangers of TM in some contexts, as well as the inadequacy of the related scientific evidence base and quality assurance mechanisms. Gebreyesus’s remarks take a less cautionary tone, strongly emphasizing in positive historical terms TM’s ‘enormous contributions’ to the development of key biomedical therapeutics, and pointing to TM’s ‘enormous potential’ for advancing human health. Echoing the 2018 Declaration of Astana’s calls for the inclusion of traditional as well as biomedical knowledges in primary health care, his remarks decry the widespread stigmatization and dismissal of TM as ‘unscientific,’ calling for health systems to ‘bring together ancient wisdom and modern science in the pursuit of health for all’. Echoing the Gujarat Declaration, these narratives emphasize TM’s potential role in advancing planetary health and the importance of benefit-sharing with knowledge holders. Gebreyesus’s comments foreground the WHO’s active commitment to advancing the scientific evidence base to inform the governance and health systems integration of ‘safe, cost-effective and equitable’ TM therapeutics. Overall, important shifts are evident between the two WHO DGs’ public narratives regarding TM, affirming an increased political commitment at WHO to actively invest in advancing TM’s inclusion within health systems worldwide.

Non-presenting author: Daniel Gallego-Perez, University of North Carolina

This paper will be presented at the following session: