Discourses on the future of traditional medicine in Africa and other indigenous societies often assume government recognition and integration into the formal health care systems. There is very little attempt, however, to understand the contexts in which the knowledge and practice of traditional medicine are currently reproduced, let alone the social, economic and cultural factors that determine consumer choices. Based on the participant observation combined with in-depth interview method, a longitudinal study was designed to determine the longer term trends in the reproduction of the knowledge and practice of traditional medicine in contemporary Ghana. This preliminary report covers: socio-economic conditions of the typical village practitioner; their belief systems and how that affects practise orientation; and perceptions as to whether traditional medicine could be taught and practised as part of the formal health care sector. This paper highlights some of the key issues which policy-makers may wish to explore with regard to the future of traditional medicine in Ghana and other African countries. These include: the role of "spiritually based" traditional practitioners in the provision of care, especially for people with mental health and other psychosocial problems; professional relationships between the biomedically trained and the traditional practitioner, particularly with regards to policies aimed at integrating traditional medicine into the formal health sector; equity of access, given that efforts to "control" the quality of herbal preparations through biomedical research can dramatically alter costs, thereby undermining ease of access normally associated with traditional medicine; a need to re-examine underlining reasons for the current popularity of traditional medicine in Ghana and other African countries, given the fact that the introduction of user pay services may be forcing the poor to sometimes turn to obsolete therapeutic practices in the name of "traditional medicine"; and potential public health benefits accruing from better understanding of traditional African notions of illness causation and preventative health.