Yes, it should.
400-level Medicine & Surgery
University of Ibadan
Unconventional or Integrative medicine, an umbrella name for complementary and alternative medicine (CAM), is an aspect of health care known for its lack of conformity to the standard, or conventional, methods of treatments. Traditional medicine, which is very common in Nigeria, is deeply rooted in this domain. Despite the disagreements in the field, there remain fundamentals in medicine. Hence, when certain forms of treatments do not follow these norms, they are often referred to as unconventional.
Unconventional, according to cambridge.org, means being different from what is usual or from the way most people do things. The National Center for Complementary and Alternative Medicine (NCCAM) defines CAM as a group of diverse medical and health care systems, practices, and products that are presently not considered to be part of conventional medicine. Complementary medicine, a component of unconventional medicine, refers to health care practices used together with standard care. Alternative medicine, however, involves forms of medical therapy used in place of conventional medical intervention. Due to a lack of consistency in the definition of CAM, the NCCAM has divided it into five major categories or domains. These include;
• Alternative medical systems: These refer to theories and practices that developed separately from conventional medicine. Some of these practices have been in use earlier than conventional medicine. Common examples include traditional Chinese medicine, Ayurvedic medicine, homoeopathy, and naturopathy.
• Mind-body interventions: These include practices based on the human mind, but also affecting the human body and physical health. Some techniques here, such as patient support groups and cognitive-behavioural therapy that were considered CAM in the past, have become generally accepted (conventional). Other examples include meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.
• Biologically-based treatments: A few of the well-known herbals for which there is evidence of effectiveness include St. John’s Wort for the treatment of mild to moderate depression and Ginkgo biloba for the treatment of mild cognitive impairment.
• Manipulative and body-based methods: These are therapies that involve movement or manipulation of the body. Chiropractic medicine is the best known in this category, and chiropractors are licensed to practice in countries like the United States of America. A defining feature of chiropractic treatment is spinal manipulation—to correct spinal joint abnormalities. Massage therapy is another example.
• Energy therapies: These involve the manipulation and application of energy fields to the body. It includes biofield- and bioelectromagnetic-based therapies.
Over the last few decades, the use of complementary and alternative medicine has been on the rise. According to a government survey, 36% of U.S. adults aged 18 years and older use some form of complementary and alternative medicine (CAM). This only shows that complementary and alternative medicine has come to stay.
In many parts of the world, policy-makers, health professionals, and the public are wrestling with issues regarding the safety, effectiveness, quality, availability, preservation, and regulation of complementary and alternative medicine. It is in light of this fact that the WHO Traditional Medicine Strategy 2014-2023, an update of the WHO Traditional Medicine Strategy 2002–2005, came to be.
At the International Conference on Traditional Medicine for South-East Asian Countries in February 2013, the WHO Director-General at the time, Dr Margaret Chan, stated that traditional medicines, of proven quality, safety, and efficacy, contribute to the goal of ensuring that all people have access to care. For many millions of people, herbal medicines, traditional treatments, and traditional practitioners are the primary and sometimes only source of health care—this is care that is close to home, accessible, and affordable. It is also culturally acceptable and trusted by large numbers of people.
The affordability of most traditional medicines makes them all the more attractive at a time of soaring health care costs and nearly universal austerity. Traditional medicine and other forms of complementary and alternative medicine thus stand out as a way of coping with the relentless rise of chronic non-communicable diseases. Instead of denying the inevitability of CAM, the WHO Traditional Medicine Strategy 2014-2023, seeks to make it safer and more available by encouraging member states to:
- Acknowledge the role and diversity of traditional & complementary medicine (T&CM) within their health care system.
- Define the scope of the sector through the use of data identifying the number of people using specific forms of T&CM, their reasons for using it—whether use follows advice from a health professional, for instance—and whether health care professionals know about patient use of T&CM.
- Implement and integrate T&CM policies and programmes as integral components of their national health system, where appropriate.
- Foster communication and partnership between stakeholders.
- Prioritize and determine actions to be taken in line with national priorities, capabilities, etc.
In conclusion, on the inclusion of unconventional forms of medicine in national health care, it is important and very crucial that policy-makers and public health personnel gain an understanding of the extent to which complementary and alternative health care forms an integral, albeit often marginal or marginalized, part of the public health apparatus of any society. Unconventional medicine should be allowed to evolve, like all aspects of human existence tend to, and made safer for people who practice it. This way, it will be possible to eliminate the harm unconventional medicine tends to pose, perhaps not entirely but majorly.
No, it should not.
400-level Medicine & Surgery
University of Ibadan
Unconventional medicine, also known as alternative, integrative, or complementary medicine, refers to medical treatments that are used instead of traditional (mainstream) therapies. These include energy therapies, herbal medicine, Ayurvedic medicine, acupuncture, chiropractic medicine, et cetera. The point debated now is whether or not these should form part of our national health care in Nigeria.
According to the Merriam Webster dictionary, medicine is the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of diseases. So, medicine is an art on the one hand and a science on the other. Science, on the other hand, is a body of knowledge based on tested facts. Conversely, anything not based on tested fact cannot be considered science, and hence, cannot be termed medicine. Interestingly, according to medicinenet.com, any practice that aims to achieve the healing effects of medicine but lacks biological plausibility, and is untested, untestable, or proven ineffective is alternative medicine. We can then see that, whether we brand this phenomenon complementary medicine, complementary and alternative medicine, integrated medicine, holistic medicine, or any other tag, the fact remains that it is not a science.
All forms of alternative therapy share one common factor: they reside outside medical science and rely on pseudoscience—statements, beliefs, or practices that are purported to be both scientific and factual but are, in fact, incompatible with the scientific method. Pseudoscience, characterized by contradictory, exaggerated, or unfalsifiable claims, relies on confirmation bias rather than rigorous attempts at refutation. It lacks openness to evaluation by other experts and the presence of systematic practices when developing hypotheses, while continuing adherence to pseudoscientific hypotheses, long after they have been experimentally disproven. It is clear then that alternative therapy is many things; medicine, however, is not one of them.
Unconventional forms of medicine also have many dangerous and fatal side effects. Researchers have found toxic minerals, like lead, in some Ayurveda products. There also has not been enough research or clinical trials to support that Ayurveda works. So, while we are sure it is quite dangerous, we are not even sure it has any benefits; this makes it even more menacing than cocaine. Including un-orthodox forms of medicine in the national healthcare plan of Nigeria would be as ridiculous as the president asking citizens to drink bleach to treat COVID-19.
Much of the perceived effect of alternative practices arise from the mere belief that it will be effective (the placebo effect), or from the treated condition resolving on its own (the natural course of the disease). Added to that is the tendency to turn to alternative therapies upon the failure of medicine; at which point the condition will be at its worst and most likely will spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies.
First, do no harm. The alternative sector is a highly profitable industry with powerful lobbying and faces far less regulation over the use and marketing of unproven treatments. However, medicine is not like any form of commerce, and human lives cannot be placed at the mercy of the highest bidder.
It is worth adding that unconventional forms of medicine have also proven to be a great way to waste a nation’s wealth. Billions of dollars have been spent studying it, with little to no positive results.
Also, alternative therapies do not “complement” functional medical treatment, as many people claim. On the contrary, significant drug interactions caused by alternative therapies may negatively impact functional treatment by making prescription drugs less effective, as seen in interference by herbal preparations with warfarin action.
Biologically-active forms of alternative medicine can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bio-resonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anaesthetics during surgery, among other problems.
And lastly, there’s the cynicism, disappointment, and depression that some patients get from going from one alternative medicine to the next. They find that after three months, the placebo effect wears off; they’re disappointed and move on to the next one. Such constant disappointment can cause disillusionment and depression, making the eventual and proper treatment of the patient difficult due to a lack of compliance from having seen failure so often in the past.
In conclusion, Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative; and in 2011 published his estimate that over 95% of the alternative therapies he and his team studied, including acupuncture, herbal medicine, homoeopathy, and reflexology, are statistically indistinguishable from placebo treatments. Alternative medicine is basically glorified ignorance and would be an added scam to all the scams that already plague us in Nigeria.