Is there a role for trado-medicine in the Nigerian health sector? (9)

3 January, 2019

Chris: "May I then suggest 1) that the past discussions on the role of TM be summarized"

Yes, I agree it would be useful to summarise the past discussions on this topic. Would anyone like to volunteer to do this - preferably someone whose views on the subject are not partial?

In addition, would anyone be willing to search the literature for systematic reviews of research on the effectiveness of traditional medicine for different clinical conditions?

Chris: "and 2) that Neil and other contributors set forth the alternative view clearly: could you kindly share the evidence that TM doesn't work, that it is worse than the alternatives, etc?"

Traditional medicine clearly *does* work, to the extent that it brings perceived health benefits to many people. The same can be said of placebo. Of course, many herbal medicines also contain pharmacologically active ingredients that may have beneficial and/or harmful effects on the body, and thereby have the potential to be more effective (or more harmful) than placebo. For example, we heard just yesterday on HIFA how, in Zambia, 'herbal concoctions... endangered [women in labour, and their babies] with powerful contractions and precipitous labour'.

Modern medicines are rigorously tested against placebo in randomised controlled trials, and are only made available to the general population when their safety and efficacy has been scientifically proven. As Joseph and others have said, traditional medicine should undergo the same rigorous approach to identify for which clinical cases it is both safe and effective (beyond the placebo effect) and how it works (for example, through pharmacological analysis of plant extracts).

Traditional medicine is not *always* 'worse than the alternatives' (ie it is not always worse than alternatives for every health complaint in every patient). However, if my brother or sister were suffering from a life-threatening illness (or, indeed, most communicable and non-communicable diseases, whether medical or surgical) I would rather they receive treatment from a health professional who practises modern evidence-based medicine than from a traditional healer.

We have heard time and time again on HIFA about the direct and indirect harms of traditional medicine. Our common goal should be to protect people from such harms, while trying to identify and understand any apparent benefits.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG /orcid.org/0000-0001-9557-1487 neil@hifa.org