China View: Is Beijing’s Backing of Traditional Medicine Good For Public Health?
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The government has historically promoted the use of traditional medicine alongside Western medicine to improve the health and safety of its citizens. Western or modern medicine includes the use of clinically researched drugs, surgery, and scientifically supported medical treatments. Traditional Chinese Medicine (TCM) encompasses a wide range of practices and treatments including the ingestion of herbs, the use of acupuncture, and movement exercises such as Qi Gong and Tai Chi. With the rise of industrialization, lifestyle changes, and an aging population, diseases and illness have continued to evolve. Many have turned to using traditional medicine once again to prevent and cure chronic ailments and afflictions. A group of students have even claimed that they were able to cure a cat of its paralysis through the use of traditional medicine.
Traditional medicine offers assistance to those who have found limited success or relief through Western medicine. While Western medical treatments are supported by clinical trials and extensive research, TCM remedies are often based on thousands of years of historical and cultural practices. The popularity of traditional medicine in China has continued to rise rapidly, largely due to the government’s direct promotion and investment in the industry. However, despite the natural basis of TCM treatments, there are concerns regarding safety and the wider implications that such methods may have on the population and the environment. How will the government respond to these rising concerns?
TCM is based on roughly 5000 years of medical practice and experience that have aided in the development of techniques for preparing and processing materials as well as diagnosing ailments. The basis of TCM is rooted in three core components: energy (qi), blood, and body fluids. Yin and yang are also two of the most fundamental concepts in Chinese medical philosophy. These two concepts represent “opposites in nature, account for changes in the universe, represent hot or cold temperatures, and represent lightness or darkness”. The key to an accurate TCM diagnosis is detecting internal imbalances. During the 1950s, the newly established government began to focus on advancing and modernizing traditional medicine through the construction of TCM universities, hospitals, and research institutes. The country’s ten most distinguished TCM universities were all founded between 1954 and 1960. By the early 1980s, 25 TCM colleges had been established.
The Constitution of the People’s Republic of China (PRC), adopted in 1982, also promoted the use of both modern medicine and traditional medicine. In 1985, the State Administration of Traditional Chinese Medicine (SATCM) was established to regulate TCM treatments and to advance the development of these practices. In 1991, at the 4th Meeting of the 7th National People’s Congress, the government decided to place a greater emphasis on equally developing traditional and Western medicine. In 2003 and 2009, the Regulations of the PRC on TCM and the Opinion on Supporting and Promoting the Development of TCM were also adopted.
Since President Xi Jinping came to power in 2012, the government has issued a stream of plans and policies aimed at increasing the supply and availability of traditional medicine. This included the Plan of Developing Healthcare Service of Traditional Chinese Medicine (2015-2020) which aimed to improve public health through the promotion of TCM methods and techniques. 2016 was a pivotal year for TCM as governance and regulations over the sector expanded substantially.
The government published the Outline of the Strategic Plan on the Development of Traditional Chinese Medicine (2016-2030) and the 13th Five-year Plan for the Development of Traditional Chinese Medicine, which acted as an outline for the development of traditional medicine over the next two decades. In March of 2016, the Guiding Opinions on Promoting the Sound Development of the Medical Industry was established to guide the development of the healthcare industry and to advance the modernization of TCM. In July, the Law of the People's Republic of China on Traditional Chinese Medicine was established to implement safety standards across the industry including regulations on cultivation practices, processing methods, and quality control. This law also loosened requirements to become a TCM practitioner.
Previously, TCM doctors had to qualify as conventional doctors first and then be licensed to practice traditional medicine. The law makes it possible to become a licensed TCM doctor by passing local exams and getting recommendations from other practitioners. Since 2011, the number of licensed practitioners has increased almost 50% to 452,000 in 2017. TCM has also featured prominently in the government’s response to COVID-19. “China’s National Health Commission regularly promoted the use of TCM in its recommended treatment plan”. The government has continued to support traditional medicine partially because of its health benefits, but also because the TCM market is very lucrative. The domestic market grew annually by over 10% from $25.8 billion in 2014 to $43.6 billion in 2019.
Great progress has been made in the past few decades to promote, regulate, and standardize TCM practices. However, several glaring issues continue to undermine its adoption and development. Improving education and standardization of cultivation, storage, and distribution practices are imperative to minimize any adverse effects from the use of traditional medicine. In acupuncture, for example, complications have resulted from the use of non-sterile needles and improper delivery of treatments. When not delivered properly, acupuncture can cause infections and puncture organs. To avoid some of these complications, the government should consider reinstating stricter requirements to become a TCM practitioner. While this would lower the total number of licensed TCM doctors, it can improve the quality of treatments, help improve the standardization of health and safety practices, and minimize the potential for misdiagnosis and adverse effects from treatments.
Some manufacturers of TCM do not comply with safety standards and neglect to report complications and problems with production. In recent years, the drug safety monitoring organizations in the country have made great efforts to improve the monitoring of TCM producers. “The development of the Adverse Drug Reaction (ADR) surveillance system has led to an increase in safety alert reports on Traditional Chinese Medicine preparations”. In addition to stricter safety standards and monitoring protocols, tighter controls on the use of animals and plants are also needed. It is estimated that 22% of the 112 most commonly used ingredients in TCM are on an endangered-species list. While some are from herbs that can be planted and harvested, other ingredients are from animals that are typically captured and smuggled into the country. Despite recent crackdowns against these practices and bans against the sale of pangolin, rhinoceros, tiger appendages, the government is struggling to prevent the illegal trade of these ingredients.
“By keeping the door open for the TCM industry to exploit pangolins, the Chinese Government is undermining international efforts to end the global pangolin trafficking crisis and fuelling transnational organised crime.”
-Chris Hamley, EIA Senior Pangolin Campaigner
