Standardizing TCM will help it go global

During these extraordinary days, it seems like the news everywhere is completely dominated by the latest developments concerning the novel coronavirus. But believe it or not, there are other medical stories that merit our attention. One of them is the great leap forward about to be made on the world stage by traditional Chinese medicine. That's important because long after the coronavirus is a distant memory, greater global adoption of TCM will boost the Chinese economy, contribute to global health and prove to be a shot in the arm for China's soft power.

TCM has many proponents in China and abroad and it is practiced, especially acupuncture, massage and cupping, in over 180 countries. However, TCM does have many skeptics, especially in the foreign medical and pharmaceutical communities. Some of their negativity is obviously from self-interest in avoiding competition, but many are also well-motivated by wanting to see rigorous scientific evidence that TCM is both effective and safe. When the skeptics are satisfied, TCM will likely grow exponentially.

One of the first giant steps toward this was the official establishment a year ago of the world's first evidence-based TCM Medical Center in the Chinese Academy of Chinese Medical Sciences. Proof of efficacy requires having statistically significant double-blind clinical trials in which a large number of patients get either a placebo or the medical treatment or medicine with the doctors not knowing which one any given patient gets, so as to not bias the results.

The second step is being taken now but knowledge of it has been eclipsed by the necessary laser-like focus on containing and defeating the novel coronavirus. This involves setting government-sanctioned industry standards for TCM ingredients.

Experts have criticized some TCM ingredients, of which there are thousands, for consistency, purity and for sometimes containing poisons, heavy metals and other toxins. Part of the reason was that a traditional TCM pharmacy was, well, traditional, certainly a sight to behold—full of dried seahorses, bird feathers and other exotic ingredients hand measured by the pharmacist and taken away to be prepared as a (usually foul tasting) soup or decoction — with no consistency from one batch to the next. So now the government is requiring the manufacturers to meet minimum standards , starting with the first 160 most commonly used ingredients, largely abandoning the soup and requiring that each ingredient be made into what's called concentrated TCM granules. This will not only ensure a healthy level of safety but help avoid problems for TCM neophytes like me. When I first tried TCM in New York decades ago, I wasn't told to make a soup and instead ate the ingredients, amazingly I survived none the worse for wear.

In addition, in 2022 the World Health Organization will include TCM in its compendium International Classification of Diseases. While this doesn't imply an official endorsement of efficacy it certainly will put TCM on the map in a number of ways. According to WHO spokesperson Tarik Jasarevic, its inclusion will promote TCM internationally by improving international comparability of practices, diagnoses and outcomes, and even enable TCM's integration into insurance coverage. One additional major advantage will be to save lives by for the first time globally tracking data on TCM-western medicine drug interactions which have sometimes caused unforeseen severe problems for some patients when used in combination.

These three steps will inevitably be the catalyst for TCM to go global in a massive way. It's already a big business domestically, as well as in countries with substantially Chinese populations. For example, according to a Chinese government white paper published in December 2016, the TCM pharmaceutical industry's output value increased by 20 percent year-on-year from 2010 to 2015, reaching 786.6 billion yuan ($113.3 billion) in 2015.

But it's not merely about growing the Chinese economy. It's also about improving people's health around the world with treatments that have not merely stood the test of time but that have also been subjected to the most rigorous scientific efficacy and safety testing. It also will improve China's image and soft power as Dr. TuYouyou, China's first Nobel Prize winner, did when she created the antimalarial drug Artemisinin based on a TCM herb described in a 1,600 year old Chinese medical text, saving countless lives globally.

And coming full circle back to the latest novel coronavirus outbreak, with these enhancements perhaps next time there is a public health emergency here or elsewhere, traditional Chinese medicines and their ever growing number of practitioners at home and abroad will be able to make critical contributions to averting a catastrophe. Keep in mind that two millennia before the West did, China developed an inoculation against smallpox and has never stopped innovating.

The author is a senior fellow at the Beijing-based think tank Center for China and Globalization.