This is part of FJN’s Topic Briefs for Journalists series.
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The parallel health sector
“Natural health”, “alternative treatments”, “holistic health” or “whole person” approach in the medical field are descriptors for what is now being grouped collectively as Traditional, Complementary & Integrative Medicine (TCIM), and they cover a range of practices that are mostly provided outside public healthcare systems.
Among scientists and health professionals, these treatments have been given various labels over time, due to scientific, political or other considerations.
You will find the terms “Complementary and Alternative Medicine” (CAM), “Complementary Medicine” (CM), “Traditional Medicine” (TM), “Integrative Medicine” (IM) and “Traditional and Complementary Medicine” (T&CM). In everyday speech you will still hear “alternative medicine” or similar expressions in different languages.
The changes in the designations are to a lesser extent due to scientific or health-related factors. But the choice of words matters when medical and health professionals aim to be taken seriously by authorities or funding institutions.
“Alternative Medicine”, for example, can be perceived as an opposition to the public health system, and therefore in the 2000s, among researchers this term was replaced by “Complementary Medicine”, i.e. something that supplements conventional treatment.
In the 2010s, the health care industry adopted “Integrative Medicine”.
Today, the most widely accepted naming convention seems to be “Traditional, Complementary and Integrative Medicine” (TCIM). “Integrative Medicine” is preferred by researchers and those working with the public health service.
Indigenous cultures
Traditional Medicine (TM) has been part of indigenous cultures, usually as an integrated part of belief systems. The gods or spirits were in charge of health and illness, and thus the healing was in the hands of priests and shamans. The rituals, herbs and other remedies used in this process were considered sacred, and this mindset is continues in some of today’s existing indigenous cultures.
In some cases, this evolved into health systems, including theories, treatment procedures and techniques. The most well-known ancient health systems are Traditional Chinese Medicine and Ayurveda, still being used by millions of people all over the world.
Today, it’s widely held that most third-world countries are influenced by natural science and the pharmaceutical industry, but in some of them TM still plays a dominant role in healthcare – partly because they cannot afford modern Western medicine, and partly because they recognise the value of their own systems.
Industry
TCIM is provided in different settings depending on traditions and legislation. In some countries it is provided only by medical doctors, and in others it is provided only by practitioners trained in the specific treatments; yet in some countries, it is practiced by both.
TCIM is provided mainly outside conventional health care, but in some countries certain practices are used in conventional medical settings. The most prominent TCIM modalities in Europe are acupuncture and homeopathy, followed by herbal medicine (phytotherapy) and reflexology.
Most used TCIM modalities 2012 (WHO):
- Acupuncture
- Herbal Medicine
- Traditional Medicine (TM) by indigenous cultures
- Homeopathy
- Traditional Chinese Medicine (TCM)
- Naturopathy
- Chiropractic
- Osteopathy
- Ayurvedic Medicine
- Unani Medicine
It’s difficult to ascertain the TCIM market for two reasons: Figures on the whole TCIM industry are not published, and there is no economic footprint — most TCIM provision is “hands-on” and/or consultative, without substantial turnover in medicinal products or equipment (mostly herbs or homeopathic products), according to CAMbrella.
Still, there are indications of growth.
TCIM treatments such as acupuncture, homeopathy, and chiropractic, have become increasingly popular in western societies. For example, in the U.S., the use of TCIM increased rapidly during the 1990s, reports the National Institutes of Health. The estimated number of visits to TCIM practitioners in 1997 exceeded the projected number of visits to all primary care physicians in the U.S. by an estimated 243 million.
In Europe, the herbal remedies and nutritional supplements industry is small: It comprises about 0.7 % of the European pharmaceutical market and about 7% of the non-prescription market, generating about €1 billion in 2010. It employs about 8,200 people, according to ECHAMP. The NIH reports that France and Germany have the highest prevalence of TCIM use among eight European countries in 1992, with 49% and 46% respectively of the populations having used some form of TCIM.
Of the WHO’s 194 member states, 170 acknowledge the use of TCIM. However, TCIM is not mentioned specifically in WHO “Health system summaries”.
Compiled by Jesper Madsen for FJN
