TRADITIONAL MEDICINE INTEGRATION INTO NATIONAL HEALTH SYSTEMS: A COMPARATIVE STUDY OF CHINA AND SOUTH AFRICA
Résumé (anglais)
Achieving SDG 3 (Good Health and Well-Being) requires ensuring healthy lives and promoting well-being for all at all ages, including access to safe, effective, quality, and affordable essential medicines and health services (Target 3.8). Traditional medicine, including herbal medicine, acupuncture, traditional birth attendance, bone-setting, and spiritual healing, is widely used globally, particularly in low- and middle-income countries, serving 60 to 80 percent of the population in some regions. However, traditional medicine integration into national health systems varies dramatically across countries, shaped by historical recognition, regulatory frameworks, research investment, medical education, and political will. This study conducts a comparative analysis of traditional medicine integration into national health systems in China and South Africa, two countries with rich indigenous medical traditions, contrasting colonial histories, and divergent policy trajectories. China has achieved the most comprehensive integration of traditional medicine into a national health system globally, with constitutional recognition, legal protection, health insurance coverage, and widespread integration into public hospitals and primary care. South Africa, despite having a diverse indigenous medical heritage and enabling legislation, faces significant implementation gaps, including slow registration of traditional healers, lack of integration into health insurance and medical education, and limited research funding. Using a qualitative comparative case study methodology, the study analyzes secondary data from government reports, WHO documents, peer-reviewed literature, and program evaluations over the period 2000 to 2025. The study finds that China's successful integration is attributable to strong political commitment, investment in research, education, quality control, and health insurance coverage. South Africa's integration lags due to colonial and apartheid legacy, weak political will, lack of funding, professional resistance, and a fragmented regulatory framework. The study concludes that traditional medicine integration requires legal recognition, regulation, education, research, health insurance coverage, and collaboration between biomedical and traditional practitioners. Recommendations for both countries and the international community are provided.
Mots-clés: Traditional medicine; integration; China; South Africa; SDG 3; Traditional Chinese Medicine; sangoma; inyanga; national health system
Résumé (français)
Atteindre l'ODD 3 nécessite l'accès à des services de santé essentiels. La médecine traditionnelle est largement utilisée. Cette étude analyse l'intégration de la médecine traditionnelle dans les systèmes nationaux de santé en Chine et en Afrique du Sud. La Chine a intégré la médecine traditionnelle chinoise (MTC) dans son système national de santé : reconnaissance constitutionnelle (1982), loi sur la MTC (2017), prise en charge par l'assurance maladie (80 à 90 pour cent), universités (plus de 50), hôpitaux (90 pour cent des hôpitaux de comté). L'Afrique du Sud a adopté la loi sur les praticiens de santé traditionnelle (2007), mais la mise en œuvre est faible : seulement 5 000 des 200 000 à 300 000 guérisseurs traditionnels (sangomas, inyangas) sont enregistrés, pas d'intégration dans l'assurance maladie, pas d'enseignement universitaire. L'étude conclut que l'intégration nécessite une reconnaissance juridique, une réglementation, une éducation, une recherche et une couverture par l'assurance maladie. Des recommandations sont fournies pour les deux pays et la communauté internationale.
Mots-clés: médecine traditionnelle, intégration, Chine, Afrique du Sud, ODD 3, médecine traditionnelle chinoise, sangoma, inyanga, système national de santé