The article (‘A potential treasure trove’: World Health Organization to explore benefits of traditional medicines, 20 December) is of great interest. However, it is regrettable that an organisation such as the World Health Organization appears willing to promote the incorporation of traditional and other medicines into mainstream practice by leaning heavily on emotive language – “heritage”, “tradition”, and the sharing of local resources – rather than on clinical evidence. Then it appears to contradict itself by saying that it doesn’t support it if there isn’t robust and reliable evidence.
The difficulty seems to lie in a misunderstanding of what medicine is. Medicine should be understood as a single enterprise: evidence-based medical practice, with patient safety and effectiveness at its core. It should not be fragmented into categories such as “biologic”, “traditional” or “complementary” medicine.
Mainstream medicine does not, as implied, dismiss treatments simply because they originated in traditional practice. On the contrary, interventions such as tai chi, yoga and many plant-derived drugs have been readily adopted once rigorous clinical trials demonstrated their safety and effectiveness. Much of modern pharmacology has its roots in traditional herbalism, refined and validated over time. The medicinal gardens at the Royal College of Physicians in London stand as a reminder of how clearly this is acknowledged.
What mainstream medicine rejects is unproven claims and practices that pose a risk of harm. Attempting to legitimise such practices under the banner of “traditional” or “complementary” medicine amounts to a back-door entry into clinical care. To suggest otherwise is misleading at best – and, at worst, dangerous.
Dr Radhamanohar Macherla
Retired consultant physician, Barts NHS trust; junior epidemiologist, global smallpox eradication programme, World Health Organization, 1974
