Sri Lanka joins many developing countries in efforts to preserve its systems of Traditional Medicine (TM). In fact, in the early 20th century, many Sri Lankans, with the intention of preserving and promoting TM, had prevailed on the British colonial government to set up a board of indigenous medicine to train doctors, treat patients, manufacture and distribute medicines, and to promote research. Although the beginning was humble, considering that it commenced under a reluctant colonial regime, there was an expectation that subsequent independent Sri Lankan governments would make greater strides in providing institutional support for TM. Independent Sri Lankan governments did, in fact, aid in the development of TM institutions. Yet, my conversations with parampara(lineage) TM practitioners reveal that there is a chasm between the government’s measures and the needs on the ground in terms of ensuring preservation and continuation of traditional knowledge. Taking this phenomenon into consideration, my paper interrogates the trajectory of progress using a critical lens to problematize the flow of communication or lack thereof between the government and the paramparaTM practitioners. The central argument is that there is an inherent conflict between commercial forces insisting on the commodification of Traditional Medicine as the way forward and those TM practitioners desperately trying to maintain ecological sustainability for their work, which they see the only way of ensuring the continuation of their profession.