International classification of health interventions (ICHI): Establishing the global data architecture for traditional medicine

Health systems cannot be strengthened, financed, or scientifically evaluated without standardized data. While the International Classification of Diseases (ICD) has long provided a global framework for morbidity and mortality, and the International Classification of Functioning, Disability and Health (ICF) captures functional outcomes, global health governance has historically lacked a standardized system for recording what health systems actually do—namely, health interventions. This structural gap led the World Health Organization (WHO) to conceptualize and develop the International Classification of Health Interventions (ICHI) as a core member of the WHO Family of International Classifications (WHO-FIC).[1] The origins of ICHI lie in the recognition that intervention data were fragmented, nationally siloed, and largely incomparable. Earlier efforts, such as the International Classification of Procedures in Medicine (ICPM), failed to achieve sustained global adoption due to limited scope and governance constraints.[2] In response, WHO formally initiated work on ICHI in the mid-2000s with a fundamentally different vision: a comprehensive, interoperable, and discipline-neutral classification capable of describing clinical, preventive, promotive, rehabilitative, and public-health interventions across all health systems.[1,3] ICHI is structured around a three-axis content model—Target, Action, and Means—allowing precise yet flexible representation of health interventions. This design ensures compatibility with diverse service delivery models and enables linkage with ICD and ICF, thereby completing the triad required for integrated health statistics: disease, functioning, and intervention.[3,4] Importantly, ICHI is not limited to hospital-based biomedical procedures; it explicitly accommodates community health actions, public-health measures, and non-pharmacological interventions.[1] From a biomedical perspective, ICHI strengthens health information systems by enabling standardized procedure statistics, improving clinical documentation, supporting quality assessment, and informing health financing and insurance mechanisms.[4] However, WHO’s strategic intent for ICHI extends beyond biomedicine. A critical policy realization underpinning ICHI is that Traditional Medicine (TM) interventions remain largely invisible in global health data, despite being used by a substantial proportion of the world’s population.[5] Historically, TM systems such as Ayurveda, Siddha, Unani, Yoga, Traditional Chinese Medicine, Kampo, and Korean Medicine have been regulated and practiced nationally but excluded from global intervention statistics due to the absence of standardized classification frameworks.[6] As a result, TM has faced persistent challenges in evidence generation, health policy integration, insurance coverage, and international comparability. WHO’s decision to incorporate TM into ICHI represents a structural shift from philosophical recognition to operational codification.[5,7] This shift aligns directly with the WHO Traditional Medicine Strategy 2025–2034, which emphasizes strengthening data systems, improving evidence quality, and integrating TM into national health systems through standardized information architectures.[5] Within this strategy, intervention classification is positioned as a foundational requirement for moving TM from narrative legitimacy to data-driven credibility. A decisive milestone in this trajectory was achieved in 2025, when the Government of India, through the Ministry of Ayush, entered into a formal donor and technical cooperation agreement with WHO to support the development of a Traditional Medicine module within ICHI.[8] This agreement—backed by financial and technical commitments—marked the first large-scale, member-state-driven investment specifically aimed at global TM intervention codification. The initiative is anchored within WHO’s broader classification governance framework and supported by the presence of the WHO Global Centre for Traditional Medicine (GTMC) in India.[9] The first WHO technical meeting dedicated to ICHI for Traditional Medicine for Ayurveda, Siddha, and Unani System of Medicine was convened in December 2025 (in New Delhi immediately after the 2nd Traditional Medicine Global Summit), bringing together experts from multiple WHO regions to initiate structured development of TM intervention codes.[10] This meeting formally launched the technical work required to translate diverse TM practices into standardized intervention descriptors aligned with ICHI principles. Development of the ICHI-TM module follows WHO-FIC norms, ensuring scientific rigor, transparency, and international consensus. The process is structured into sequential phases: an Alpha draft establishing the content model and terminology framework; a Beta draft involving pilot testing, field validation, and multi-country feedback; and a final draft endorsed for global implementation.[1,3] Only recognized and regulated TM systems with defined educational standards, clinical practices, and governance mechanisms are eligible for codification, ensuring quality control and scientific accountability.[5] The TM content model adheres strictly to ICHI design principles, including unique terminology, standardized naming conventions, hierarchical parent–child relationships, exclusion terms, post-coordination options, and linkage to the overarching ICHI intervention structure.[3] Each intervention entry is defined through a standardized schema comprising title, description, classification properties, synonyms, and target–action–means mapping. This approach allows TM interventions—such as Panchakarma procedures, therapeutic Yoga practices, or Unani regimens—to be represented accurately without compromising their theoretical foundations. From a policy and systems perspective, the implications are substantial. Standardized intervention coding enables TM services to be captured within electronic health records, national health accounts, insurance reimbursement frameworks, and research databases.[4,7] This directly addresses the long-standing data deficit that has constrained TM research financing, health technology assessment, and policy decision-making. The ICHI-TM initiative also complements WHO’s GTMC Data Network, transforming fragmented TM datasets into interoperable, analyzable evidence streams.[9] By enabling aggregation and comparison of intervention data across countries, ICHI supports outcome evaluation, cost-effectiveness analysis, and global benchmarking—capabilities that are routine in biomedicine but historically absent for TM. Experiences from countries with long-standing TM integration, such as China, Korea, and Japan, demonstrate that standardized intervention classification facilitates insurance coverage, regulatory oversight, and research translation.[11] ICHI extends these benefits globally, creating a common language through which diverse health systems can evaluate TM interventions on comparable terms. In conclusion, the integration of Traditional Medicine into the International Classification of Health Interventions represents a structural correction in global health information architecture. It does not seek to redefine Traditional Medicine; rather, it ensures that TM interventions are visible, measurable, and governable within modern health systems. With WHO’s stewardship and India’s leadership, ICHI-TM establishes the data foundation required for evidence generation, policy integration, research financing, and global recognition of Traditional Medicine as a legitimate and accountable component of contemporary healthcare. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.