HerbalEGram: Volume 8, Number 1, January 2011

WHO Developing New Traditional Medicine Classification

The World Health Organization (WHO) recently announced a new project that could bring greater respect and more widespread recognition to traditional medicine* systems across the world. With the goal of easing and encouraging the use of traditional medicine in clinical, epidemiological, and statistical settings, WHO’s International Classification of Traditional Medicine (ICTM) will provide a harmonized traditional medicine evidence base with stated terminologies and classifications for diagnoses and interventions.¹

In a recent press release, WHO said the ICTM is in part a response to the increasing worldwide usage of traditional medicine while classification and terminology tools remain sparse. The classification will initially include information on practices and customs in China, Japan, and the Republic of Korea, and will use an interactive, online platform that traditional medicine users can use to document terms and concepts with which they are familiar. Joining other significant activities like the 1978 Alma Alta Declaration and the recent 2008 Beijing Declaration,² the ICTM further illustrates WHO’s dedication to aiding traditional medicine’s globalization and integration into worldwide healthcare.

A few of the expected outcomes that WHO has for the ICTM include the production of data that can be used to objectively evaluate traditional medicine’s benefits, safety, use, spending, and trends; as well as the ability to study traditional medicine’s role in disease prevention and treatment. Additionally, one accepted classification system will allow all countries throughout the world to base their monitoring of traditional medicine on the same set of data.

“The ICTM may have wide impact on both traditional and allopathic practitioners, as well as hospital administrators, insurance companies, and policy makers,” said Ryan Abbott, director of research and project management for Nova Worldwide Consulting and a former member of WHO’s traditional medicine team (e-mail, January 8, 2011). Abbott noted that this impact will likely be greater in countries such as the United States where no comparable domestic classifications exist, as opposed to some Asian countries that already have standardized, domestic versions of traditional medicine disease classifications. “International standards should improve communication between [sic] providers in different nations, and endorsement by WHO still carries significant weight,” he continued.

“The ICTM may have a legitimizing effect for traditional healthcare practitioners and practices that are still looked down upon by allopathic providers,” said Abbott. “The use of traditional medicine in developed countries such as the United States is significant, both in the number of people using traditional medicine and in the out-of-pocket costs they are willing to pay for traditional products and services. This initiative potentially represents an important step toward greater integration of traditional and allopathic medicine.”   

ICTM will join similar WHO classifications, such as the International Classification of Diseases (ICD),³ which are meant to provide a consensual, meaningful, and useful classification framework and language for governments, healthcare providers, and consumers.⁴ ICD, for example, is used to “classify diseases and other health problems recorded on many types of health and vital records, including death certificates and health records.”⁵ These informational records are stored and retrieved for clinical, epidemiological, and quality purposes, and are also used by countries around the world to form their mortality and morbidity statistics.

“Inclusion in the WHO Family of International Classifications, a very conventional tool of mainstream medical care, would be a powerful endorsement of traditional medicine,” said Abbott.

Additional impacts of the ICTM, according to Abbott, might include greater insurance reimbursement for traditional providers and services and creating a more scientific approach to traditional medicine by having answers to such questions as how many patients have particular traditional diseases, which receive a certain therapy, what are their outcomes, etc. “It may also help generate data on drug-herb interactions, which is an area where data is sorely lacking,” he continued. “Better data in this area may help patients avoid adverse effects, and may also improve conventional reluctance on the part of physicians to combine [conventional pharmaceutical] drugs and herbs.”

While the positive effects of the ICTM are broad and significant, the potential for challenges and negative effects exists as well. “Traditional medical practices tend to be characterized by a highly individualized approach to treatment, which may be difficult to reduce into simple or standardized terms,” said Abbott. “Also, it will be challenging to translate traditional medical concepts into terminology the mainstream medical community can understand and work with.” Additional integration disadvantages include the possibility of traditional medicine’s facing some of the same problems as mainstream medicine, such as the modern role of billing and insurance that some consider to be a constraint on clinical practice and physician autonomy.

Though just announced by WHO in December  2010, the first meeting discussing the project took place in May of 2010.⁶ The ICTM is currently being drafted and WHO hopes for it to be completed in time for approval voting at the May 2014 World Health General Assembly.

*Traditional medicine refers the practice of historical and indigenous systems of medicine and is distinguished from modern conventional, mainstream, orthodox, standard-practice, or sometimes, “allopathic” medicine, which is sometimes referred to erroneously within the conventional medical profession as “traditional medicine.”

—Lindsay Stafford

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