The future of traditional Unani medicine education in Pakistan has come under a cloud as proposed legislative changes raise fears about the survival of tibb colleges and the legal status of thousands of practising hakeems.
For students like Arsalan Ali, the uncertainty is deeply personal. A pharmaceutical chemist with an MPhil degree, Ali left the allopathic drug business after becoming disillusioned with what he describes as the side effects of modern medicines. He enrolled in the government-recognised Fazil-i-Tibb-wal-Jarahat programme to practise Unani medicine — a centuries-old healing system rooted in Greek, Persian and Arabic traditions and based on balancing bodily temperaments through herbal remedies.
Now studying at a tibb college in Lahore, he fears his qualification may lose its legal standing. The government has reportedly directed colleges not to admit new students from the next academic session, sparking concerns that a proposed merger of the National Council for Tibb and the National Council for Homoeopathy could eventually shut down institutions that have trained traditional practitioners for decades.
The move is part of a broader effort by the health ministry to “right-size” regulatory bodies through new legislation titled the National Traditional and Complementary Medicine (NTCAM) Act, 2025. Practitioners argue that the changes could jeopardise the livelihoods of more than 70,000 hakeems holding the Fazil-i-Tibb-wal-Jarahat qualification and threaten the existence of around 40 tibb colleges nationwide.
Professor Imran Lodhi, principal of Ajmal Tibbia College in Rawalpindi, says traditional medicine operates under a distinct legal framework. While allopathic medicine is regulated under the Drug Act 1976, hikmat falls under the Unani, Ayurvedic and Homoeopathic Practitioners Act, 1965, which established separate councils for oversight.
He noted that there are currently 40 hikmat colleges and 140 homoeopathic institutions across the country. According to practitioners, hakeems often serve remote and underserved areas where MBBS doctors are reluctant to practise.
Pakistan Tibbi Alliance General Secretary Hakeem Muhammad Sajjad has urged the government to reconsider the draft law, warning that it contains serious gaps that could dismantle the traditional medicine sector. Critics argue that the councils place minimal financial burden on the state and question the rationale for merging them.
Some officials privately acknowledge the administrative challenges the merger could create, noting that Unani and homoeopathic systems differ significantly in philosophy and practice. However, the health ministry maintains that consultations are ongoing and says the objective is to improve standards.
Students, meanwhile, worry about affordability and access. Annual fees at tibb colleges range between Rs35,000 and Rs40,000 — far lower than medical university fees, which can be several times higher. Many students from lower-middle-income backgrounds see hikmat as their only realistic path into healthcare. They also warn that rural communities, already facing shortages at basic health units, may suffer if tibb colleges close.
Supporters of traditional medicine argue that neighbouring countries such as India and China actively promote their indigenous systems and generate significant revenue from them. They believe Pakistan risks sidelining a long-standing medical tradition.
Patients, too, share accounts of relying on hakeems after exhausting conventional treatment options, although medical experts caution that there is no scientific evidence that traditional or homoeopathic remedies can cure diseases such as cancer.
Amid mounting concern, representatives of tibb institutions have met state health officials, including Minister of State for Health Malik Mukhtar Ahmed Bharat, to advocate for the protection of the existing legal framework.
Until a clear policy direction is announced, thousands of students and practitioners remain uncertain about whether the system sustaining their education and livelihoods will continue to exist.