Traditional medicine faces a test of trust

When Prime Minister Narendra Modi told the World Health Organisation Global Summit on Traditional Medicine in New Delhi that traditional medicine must win trust through science to expand its reach, he articulated a challenge that has long defined this sector. Traditional systems command deep cultural legitimacy and wide public use across continents, yet continue to struggle for full acceptance within modern health systems that are grounded in evidence, regulation and accountability. Their future depends not on nostalgia or assertion, but on whether they can meet the same standards of proof, safety and transparency expected of any public health intervention.

Traditional medicine today is neither marginal nor obscure. According to the World Health Organisation, traditional, complementary and integrative medicine is used in 170 of its 194 Member States. In India alone, systems such as Ayurveda, Siddha, Unani, Sowa Rigpa, Yoga and Homoeopathy are embedded in everyday life and institutional practice, supported by thousands of hospitals and dispensaries and more than seven and a half lakh registered practitioners. Similar patterns exist in China, Japan, Africa and Latin America, where traditional healing often forms the first point of care, particularly in rural and low-income settings.

One of the enduring strengths of traditional medicine lies in its holistic orientation. Most traditional systems approach health as a state of balance between body, mind, diet, behaviour and environment. They prioritise prevention, lifestyle regulation and long-term resilience over episodic treatment alone. In an era marked by a rising burden of chronic disease, mental health stress and lifestyle related disorders, this preventive and person-centred philosophy has renewed relevance.

Accessibility is another significant advantage. Traditional medicine is often affordable, locally available and culturally familiar. For large populations with limited access to specialist or tertiary care, it can offer continuity, early intervention and community trust. It is this combination of cultural legitimacy and reach that has led the World Health Organisation to increasingly view traditional medicine as a potential contributor to health equity and universal health coverage, provided it is safe, regulated and evidence informed.

Scientific interest in specific traditional interventions has also grown. The example cited by the prime minister, Ashwagandha, illustrates both promise and complexity. Used for centuries in Indian medical traditions, the herb attracted heightened global attention during the Covid pandemic. India’s attempt to advance it through structured research on safety, quality and usage reflects a broader effort to translate traditional knowledge into forms legible to modern regulatory and scientific frameworks. Similar work is under way in areas such as herbal pharmacology, yoga research, mental well-being interventions and integrative care models.

Yet it is precisely here that traditional medicine faces its most serious test. Its drawbacks are real and cannot be wished away. The most persistent criticism is uneven evidence. While some practices and formulations are supported by clinical trials, observational studies and biological plausibility, others rely largely on classical texts, lineage-based transmission or anecdotal experience. The methodological challenge is genuine. Traditional systems are complex, individualised and context specific, which makes them difficult to evaluate using standard randomised trial designs. But difficulty cannot become an alibi for the absence of proof.

Quality and safety concerns represent another major obstacle to wider acceptance. Variability in raw materials, processing techniques and practitioner training has resulted in inconsistent outcomes and, in some cases, adverse effects. Without robust pharmacovigilance, standardisation of formulations and transparent labelling, public trust is easily eroded. The global herbal products market has also been marred by exaggerated claims and commercial opportunism, reinforcing scepticism among regulators and clinicians.

There is also a deeper philosophical tension that continues to cloud the debate. Traditional medicine is sometimes framed, by its most vocal proponents and critics alike, as an alternative to modern medicine. This false binary weakens both systems. It risks patients delaying or abandoning proven treatments for serious conditions, while also depriving modern healthcare of potentially valuable complementary approaches. As World Health Organisation Director General Tedros Adhanom Ghebreyesus stressed at the summit, the goal is not substitution but integration, with science and tradition treated as complementary rather than competing.

India’s policy response over the past decade reflects an awareness of these challenges. The creation of a dedicated Ministry of AYUSH was not merely an act of cultural recognition but an attempt to bring regulation, research and accountability to a fragmented sector. The co-location of AYUSH services within public hospitals, investment in research councils, drug testing laboratories and continuing medical education, and the introduction of initiatives such as the Ayush Mark all signal a shift away from informal practice towards institutional credibility.

Digitisation has been another important pillar. Platforms such as the Traditional Knowledge Digital Library aim to preserve classical knowledge while protecting it from misappropriation. The broader Ayush Grid seeks to create interoperable data systems for education, research and service delivery. These efforts matter because the future acceptance of traditional medicine will depend as much on data and documentation as on philosophy.

At the global level, the World Health Organisation Traditional Medicine Strategy 2025 to 2034 marks a decisive move from passive acknowledgement to active governance. Its focus on strengthening the evidence base, establishing risk based regulatory frameworks, integrating traditional medicine into primary healthcare and safeguarding biodiversity reflects lessons learnt from decades of uneven growth. The launch of the Traditional Medicine Global Library, with over one and a half million records, is particularly significant. By mapping evidence, policies and research gaps, it provides a shared foundation for future collaboration rather than parallel national efforts.

Despite these advances, acceptance will not come automatically. Scepticism within sections of the scientific and medical community remains strong, shaped by past overreach, poor quality studies and inflated claims. Conversely, parts of the traditional medicine ecosystem remain wary of scrutiny, fearing loss of autonomy or dilution of identity. Bridging this divide will require sustained investment in interdisciplinary research, openness to negative findings and a willingness to abandon practices that do not withstand evaluation.

There are also ethical and environmental dimensions that cannot be ignored. Many traditional medicines depend on biodiversity and indigenous knowledge systems. Scaling up without safeguards risks over exploitation of medicinal plants and inequitable benefit sharing. The emphasis placed at the summit on conservation, intellectual property protection and respect for cultural heritage is therefore central to long term sustainability, not an optional add on.

The author is a yoga practitioner who writes on public health, traditional medicine and policy.