Role of traditional and complementary medicine in universal health coverage
Key arguments
Traditional and complementary medicine (T&CM) plays a significant but underrecognised role in healthcare delivery worldwide, particularly in developing nations where it may serve as the primary form of healthcare for large populations.
The WHO has advocated for the integration of T&CM into national health systems as a pathway toward achieving universal health coverage, recognising that conventional medicine alone cannot meet the needs of all populations.
Malaysia’s physicians have expressed support for making traditional medicine a complement to the conventional medical system, with some supporting T&CM as part of basic medical training.
The cheaper cost of traditional treatments — with Ayurvedic treatment costing up to 50% less than conventional alternatives — makes T&CM a practical component of affordable universal health coverage.
Overview
This guest editorial examines the case for integrating traditional and complementary medicine into national healthcare systems as a strategy for achieving universal health coverage. Written by researchers from the United Nations University International Institute for Global Health and Universiti Kebangsaan Malaysia, the editorial draws on global evidence to argue that T&CM deserves a structured role alongside conventional medicine — particularly in countries across Asia where traditional healing practices remain deeply embedded in the culture and healthcare-seeking behaviour of populations.
Defining traditional and complementary medicine
One of the challenges in discussing traditional medicine at the global level is the inconsistency in terminology. The editorial notes that what is broadly called “traditional and complementary medicine” goes by many different names depending on the region and cultural context. Terms in use include traditional medicine, complementary and alternative medicine (CAM), complementary medicine, alternative medicine, and unconventional medicine.
In some countries, the practice is known by its specific cultural name. India recognises Ayurveda, Unani, and Siddha as distinct traditional medical systems. China encompasses Chinese medicine, Uyghur medicine, Tibetan medicine, and Mongolian medicine under its traditional medicine framework. In Malaysia, traditional Malay medicine (perubatan tradisional Melayu), traditional Chinese medicine, and traditional Indian medicine all coexist within the broader T&CM landscape.
The World Health Organization defines traditional medicine as “the sum total of the knowledge, skill, 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.”
Global variations in practice
The practice and modalities of traditional and complementary medicine vary widely from one country to another, shaped by culture, historical understanding, and accessibility. In many developing nations, T&CM serves as the primary — and sometimes only — form of healthcare available to rural and underserved populations. The WHO has estimated that in some African and Asian countries, up to 80% of the population relies on traditional medicine for primary healthcare.
Even in developed nations where conventional medicine dominates, the use of complementary therapies has grown significantly. Patients increasingly seek out traditional treatments either as alternatives to or supplements for conventional care, particularly for chronic conditions, pain management, and mental health.
| Region / Country | Traditional medicine systems |
|---|---|
| India | Ayurveda, Unani, Siddha, Yoga |
| China | Chinese medicine, Uyghur medicine, Tibetan medicine, Mongolian medicine |
| Malaysia | Traditional Malay medicine, Traditional Chinese medicine, Traditional Indian medicine |
| Japan | Kampo medicine |
| Korea | Korean traditional medicine (Hanbang) |
| Africa | Various indigenous healing systems (region-specific) |
The case for integration into universal health coverage
The editorial argues that achieving universal health coverage — the goal of ensuring that all people have access to the health services they need without financial hardship — requires countries to look beyond conventional medicine alone. In many parts of the world, the infrastructure, workforce, and financing for conventional healthcare are insufficient to meet population needs. Traditional medicine practitioners, who are already embedded in communities and trusted by local populations, represent an underutilised resource.
Cost is a significant factor. The editorial cites evidence that traditional treatments such as Ayurveda can cost 50% less than equivalent conventional medical treatments, making T&CM an economically practical component of healthcare coverage in resource-limited settings.
The Malaysian context
Malaysia presents a particularly instructive case study in T&CM integration. According to a 2004 survey cited in the editorial, approximately 69.4% of the Malaysian population had used T&CM at some point in their lives, with 55.6% using it annually. A separate survey conducted in primary care clinics in Kuching, Sarawak found that 51.4% of patients had used complementary and alternative medicine, with nearly half of those using more than one type.
The economic scale of T&CM in Malaysia is substantial. Annual sales of traditional medicines grew from approximately RM 1 billion in 2000 to RM 4.5 billion in 2005 — a 3.4-fold increase within five years. Out-of-pocket expenditure on T&CM was estimated at RM 500 million in 2007 alone.
The government established the Traditional and Complementary Medicine Division under the Ministry of Health in 2004, which led to the establishment of integrated hospitals in 2006. At the time of publication, nine public hospitals were practising T&CM services — including traditional Malay massage for chronic pain and stroke, acupuncture, herbal oncology as a complement to conventional chemotherapy, and postnatal massage. Six universities and colleges offered T&CM programmes, and 11,691 practitioners were registered, representing a practitioner-to-population ratio of 1:2,421.
The editorial notes that physicians in Malaysia expressed support for making traditional medicine a complement to the conventional medical system, with some agreeing that T&CM should be incorporated into basic medical training. Malaysia’s two-tiered healthcare system — a government-led public sector and a private sector — does not yet provide universal T&CM coverage, but limited T&CM practices are covered in the pilot integrated hospitals with positive health outcomes reported.
Evidence of effectiveness
The editorial presents evidence from several studies demonstrating the therapeutic applications of T&CM across a range of conditions. In Africa, HIV patients receiving herbal therapy for four to eight months showed significant health improvement with a 226% increase in CD4+ T cell counts. In Taiwan, traditional Chinese medicine preparations improved liver function among cancer patients undergoing chemotherapy by reducing liver damage and activating antioxidant pathways.
In Ghana, Mali, Nigeria, and Zambia, herbal medicines were used as first-line home treatment for 60% of children with high fever caused by malaria. In China, traditional herbal medicine played a prominent role in the strategy to contain and treat severe acute respiratory syndrome (SARS). Research cited in the editorial also found that herbs such as valerian root and kava-kava showed benefits for insomnia and anxiety, while St. John’s wort was reported effective in treating mild to moderate depression.
However, the authors acknowledge that while usage is high, many people remain unaware of potential side effects. A US nationwide survey found that 72% of respondents who used unconventional therapy did not inform their medical doctor, resulting in unintended interactions between traditional and conventional treatments. The editorial emphasises the need for more clinical research into T&CM safety and efficacy.
Implications for health policy
The editorial concludes that for countries striving toward universal health coverage, traditional and complementary medicine should not be viewed as an obstacle to modernisation but rather as a resource that can expand access, reduce costs, and meet the cultural expectations of diverse populations. However, the authors emphasise that integration must be accompanied by evidence-based evaluation, quality standards, practitioner regulation, and robust research into the safety and efficacy of traditional treatments.
The piece has since been widely cited in subsequent research on healthcare integration, traditional medicine policy, and universal health coverage frameworks across Southeast Asia, making it a foundational reference in the field.