Tcam: A Missing Piece Of Phc Structure, By Oladoja M.o

TCAM: A Missing Piece of PHC Structure

By Oladoja M.O

Recently, I had the privilege of attending the Africa Primary Healthcare Forum Conference 2025, a prestigious gathering of minds, stakeholders, policymakers, technocrats, and visionaries all convened to dissect and diagnose the many ailments plaguing primary healthcare PHC across Africa, and especially in Nigeria, and from the panels to breakout sessions, the discussions were fiery, engaging, and thoroughly necessary. Topics ranged from the tired over-reliance on curative health systems to a renewed focus on prevention. People talked big on digital health innovation, sustainable financing, away from donor-reliance health financing, better public-private partnership frameworks, and the urgent need for government prioritization. It was a medley of necessary ideas floating in urgency, as it should be.

But to me, something was off. Something critical was missing from the table, from the speeches, from the slides. I waited. And waited. But no one mentioned it. Not even once.

Where, in all these conversations about saving PHC, was traditional and complementary medicine?

Silence. Complete erasure.

And that silence is dangerous.

Because, whether policymakers like to admit it or not, traditional medicine is not just a sidebar in African healthcare, it is, for many, the first and only form of healthcare they know. For decades, and still to this day, traditional and complementary medicine TCM has been the anchor often the only accessible, trusted, and affordable system of care for millions, especially at the grassroots. In fact, WHO data boldly states that nearly 80 of people in Africa rely on traditional medicine in one form or another. That's not a statistic. That's a screaming reality.

And yet, at a high-level summit on PHC in Africa, it was treated as invisible.

Why?

Is it shame? Is it ignorance? Is it the elite delusion that healthcare must be boxed strictly within biomedical confines to be legitimate?

Whatever the reason, that silence reveals something tragic: we are trying to fix the house by ignoring the foundation.

Let me be blunt: any attempt to "fix" PHC in Africa without giving a front-row seat to traditional medicine is a performance. It is incomplete. It is misaligned with reality. It is tone-deaf to culture.

Primary healthcare is not a hospital-centric concept. It is not a digital app. It is not a modern building with drugs and machines. It is first and foremost a philosophy, healthcare that begins with the people. It is decentralised, embedded in the community, rooted in culture, and closer to the home than to the clinic. And there is nothing closer to the home physically, socially, and culturally than traditional medicine.

So why are we treating it like it's a relic?

What we need is not another dusty "Traditional Medicine Department" sitting idle in the ministry office. Not another limp paragraph in a policy document no one reads. What we need is real, strategic integration, bold, systemic inclusion of traditional and complementary medicine into the national PHC framework.

This is not sentiment. It is common sense.

Traditional healers are already doing the work without the recognition, without the training, without the regulatory framework. They are already where formal systems cannot reach. In remote villages, urban slums, even suburban corners. They are treating, advising, consoling, and sometimes even preventing illnesses all with cultural fluency and deep trust.

Imagine if they were trained. Imagine if there was a framework to equip them, link them with formal PHC centres, include them in health education initiatives, and embed them in the referral ecosystem. Imagine if our systems stopped seeing them as a threat and started seeing them as the assets they already are.

Because heres the truth: You can't reach the people without going through the gatekeepers they already trust. And trust is not something digital tools or biomedical superiority can automatically buy. Trust is cultural. It is emotional. It is generational. Traditional medicine carries that trust. And no matter how sophisticated our health architecture is, if people don't trust it, they will not use it.

We can digitise all we want. We can build more PHC centres, fund PPPs, and launch one policy after another. But if we don't build a bridge between formal healthcare and the informal systems people already use, we are widening the gap we claim to want to close.

Let me be clear, this is not to downplay the importance of infrastructure, digitalisation, or global best practices. We need all of that. Desperately. But in a sector choked by multifactorial issues, poor funding, misinformation, health worker shortage, lack of political will, no solution should be left on the table, especially one that's been working quietly for centuries.

We must stop treating traditiona