Low-tech medicine: Enhanced definition and scope. A narrative review

Industrial societies have experienced exponential growth in both technological innovation and life expectancy. "High-tech medicine" - the dominant paradigm - assumes that technological innovation is the primary pathway to improving health. However, trade-offs among patient care, environmental impacts, public health, costs, and accessibility are rarely made explicit. In the context of multiple global crises, including climate change, biodiversity loss, rising inequalities, and geopolitical instability, we argue that perpetual and unrestricted technological development in healthcare is unsustainable. As an alternative framework, we explore the concept of "low-tech medicine" and seek to clarify its definition and scope. A standard scoping review methodology proved unsuitable: a literature search using MEDLINE and Web of Science restricted to "low-tech medicine" and related terms yielded very few relevant references, whereas broadening the search retrieved thousands of heterogeneous results across diverse fields. We therefore adopted a hybrid approach combining selected peer-reviewed literature with additional sources (grey literature, web-based resources, and textbooks), structured through an analytical framework derived from the multidisciplinary reflections of the LowTechMed group. Rather than a strict definition, "low-tech medicine" should be understood as a guiding mindset for medical research and practice, based on 3 core criteria: 1) relevance, referring to usefulness within a given context; 2) sustainability, encompassing financial and environmental considerations; and 3) accessibility, including local resilience and the reduction of health inequalities. "High-tech medicine" presents an increasingly unsustainable benefit-harm trade-off. A "low-tech medicine" mindset may offer a pathway toward more effective, equitable, and resilient healthcare systems.