Advancing inclusive and democratic medical pluralism in Nepal.

Medical pluralism is a global norm rather than an exception. However, the kind of medical pluralism that exists in many settings is exclusionary and undemocratic. In many nations, medical pluralism has official acceptance, allowing both biomedicine and traditional systems of medicine a legitimate space into the formal healthcare system. However, traditional systems of medicine fall far behind biomedicine in terms of structural superiority and institutional strengths. Moreover, various forms of traditional medicine, particularly of popular variants, remain excluded from formal healthcare system, and a variety of traditional healers lack official legitimacy. Though conceptually medical pluralism sounds more or less equal standing of co-existing systems of medicine, the reality is that biomedicine enjoys a dominant status over heterodox medical systems. Upon examining the amount of budgetary allocation, number of health facilities, size of health human resources, educational institutions and research output, this paper reveals an overemphasis on biomedicine, overshadowing both scholarly and popular traditional medicine. This arrangement underscores the undemocratic and exclusionary nature of medical pluralism in the country. In light of the published data sources this paper examines the structure of medical pluralism and proposes measures that can contribute to advancing inclusive and democratic medical pluralism in Nepal.