Conference on Traditional Chinese Medicine Marks Shift Towards Global Market, Raises Concerns About Social and Ecological Impact

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More than 4,000 doctors, scientists, medical students, lawyers, foreign investors, corporate representatives, and journalists from 43 countries convened in Chengdu, China, in late September to attend the Second International Conference on the Modernization of Chinese Medicine. The three-day event, sponsored by various state offices as well as top research institutes, marked a nationwide effort to shift Traditional Chinese Medicine (TCM) from a localized system that caters largely to Chinese people to one that is widely accepted and valued on the international market. By the conference closing, more than 600 million Yuan (US $76 million) in contracts had been signed between Chinese companies and foreign investors. Largely unheard by conference organizers and reporters, however, were the voices of participants concerned that the internationalization of TCM will mean social and ecological harm.

China’s pharmaceutical sector is the world’s fastest growing, expanding by over 18 percent in value per year and accounting for nearly 96 billion Yuan (US $12 billion) in 2004, said Vice Minister of Science and Technology Liu Yanhua in his opening speech to the conference. Demand for Chinese herbal products is surging not just domestically as consumer power increases, but also overseas as China’s economy is liberalized and TCM is more widely accepted. Despite these trends, Liu voiced the need for further development of this “strategic industry,” calling for the use of “standardized Western pharmaceutical methods to study, extract, and process TCM formulas.”

Overall, the conference held a high sense of optimism for the expanding role of TCM in China’s economic development. “The only difference between this medicine and your American drugs,” proclaimed He Daoshan, Product Marketer for the Shanghai ANPEL Scientific Instrument Company, picking up one of his company products, “is that our medicine is made directly from a plant. Everything else is the same. See this?” he said, pointing at the chemical formula on the box. “It has been tested in the same kind of laboratories, with the same standards as Western pharmaceuticals. Now people can trust it, and it can be sold around the world!”

But not everyone at the conference was equally optimistic. Jin Rongming, a sixth-generation TCM practitioner at the Chengdu City Number 6 People’s Hospital, was quick to point out that the mass production and distribution of TCM had potentially harmful ecological implications. “China’s environment is already severely stressed,” he noted. “Resource shortages and pollution have already compromised the quality and accessibility of many TCM remedies. Adding more stress is just going to make the problem worse.” He added that the process of modernizing TCM too often means “Westernizing” TCM, but that Chinese herbal formulas can’t just be “blindly” plugged into the Western medical system: “Western drugs are synthetic chemicals that can be synthesized in any laboratory. But these new ‘modern’ Chinese pills are still derived from specific plants which, if produced on mass scales, will hurt our natural biodiversity, especially for plants and animal parts that are still wild-crafted.”

China is currently the world’s largest market for medicines derived from endangered species and wildlife parts, including tiger bones, rhino horns, deer antlers, turtle shells, and bear bile. According to the World Wildlife Fund, the increasing popularity of TCM over the past two decades has increased poaching and illegal trade of threatened and endangered wildlife to “crisis levels,” negating progress made to protect these animals through endangered species laws and nature reserves. TCM has been named the top conservation threat, above the loss of habitat, for Asia’s severely depleted bear, tiger, and rhinoceros populations.

The ecological stress resulting from increased harvesting of TCM products is felt far beyond China’s borders. Sixty-seven of 89 species of Asian turtles, used to make a popular “turtle jelly,” are now threatened with extinction. Yet in China, already the world’s largest consumer of freshwater turtles and tortoises, trade in most of these species is legal and demand continues to rise. In 1998, a Sumatran national wildlife park lost 3 of its 37 known tigers to poachers supplying the Chinese medicine market. According to a study by the East-West Center, American ginseng, a popular cure-all that grows wild in much of North America, is now threatened from over-harvesting, in part to meet ever-expanding Chinese demand. Licorice root has also declined by over 60 percent its original growth area in North America due to habitat destruction and over-harvesting for the international market.

To counter the threat of overexploitation, many traditionally wild herbs are now being cultivated domestically. Of the 1,000 registered varieties of TCM herbs, 150 are artificially grown. This is changing the landscape as well as the ways the plants are handled. Sichuan, for example, has long been acclaimed for its high-quality wild herbs, but recent TCM pressures have encouraged the creation of plantation-style medicine farms. There are currently over 30 such large-scale farms covering some 40,000 hectares in this single province alone. While cultivated herbs take the pressure off protected natural ecosystems, they put pressure on already limited cropland, increasing dependency on food imports and threatening political stability in the countryside. In the last five years alone, the amount of land under TCM cultivation in China has nearly doubled, to 1 million hectares nationwide.

Even where trade is legal and TCM ingredients can be sustainably harvested, concerns about breeding and trade remain. Conference participant Zhang Xiuping, Assistant General Manager of the China Bioengineering and Pharmaceutical Industrial Park, suggested that biotechnology and genetic engineering could provide new avenues for obtaining medicinal products. “We will soon be able to replicate turtle shells, tiger bones, and endangered orchids in TCM laboratories for medicine,” he proclaimed. “And there will be no need to go into the forest with spears!” But genetic engineering and cloning carry their own set of social and ecological questions as well as potential biodiversity threats. Furthermore, high tech and expensive cloning of such products would likely encourage the already flourishing black market for the “real thing,” thus spurring continued poaching and wild crafting of endangered species.

On the plus side, more rigorous scientific testing and standards for production hold the potential benefit of proving ineffective some of the TCM formulas that use endangered species. “If a scientific report comes out saying that turtle jelly does not cure cancer or prevent kidney failure,” explained Chen Haiyuan, director of the Chengdu Municipal Science and Technology Bureau, “then doctors will no longer prescribe it for their patients.” And even if these remedies are found to be effective, scientific research can be utilized to find other equally effective remedies that do not use endangered species. Recognizing this, the Chinese government has already issued laws prohibiting the use of endangered species for supplements and has invested over 30 million Yuan (nearly US $4 million) in research on alternatives.

In addition to expressing concerns over biodiversity loss, participants worried about the social implications of the internationalization of TCM. Much of the land used as a source for both wild and cultivated ingredients is home to a vast diversity of ethnic minority groups. The emphasis on advanced Western pharmaceutical processes as the dominant model for TCM will place this 4,000-year-old folk medicine largely in the hands of corporations. One Miao minority woman, dressed in elaborate traditional wedding costume, voiced her concern for the future of her village. “My family has been practicing medicine for more than ten generations. We know all of the plants and animals in our village and how they can help us heal. Sharing this knowledge has helped us participate in the global market. But now I work for Han businessmen. They come and turn our plants into these pills and then they take the money. The government keeps saying that the modernization of TCM is going to bring great wealth, but no one seems to care whether we profit or not.”

Overall, the modernization of Traditional Chinese Medicine promises to provide better quality, more reliable medicines to consumers. Furthermore, its internationalization holds great potential for collaboration with other medical systems to find cures for AIDS, cancers, and many other diseases. But with these promises comes the risks of a watered-down system of Eastern medicine, the potential for unfair exploitation of indigenous peoples, and great threat to already endangered plant and animal products. In addition to the new technology and business investments celebrated at the conference, China urgently needs a system of sustainable harvest and cultivation, as well as strong legal structures to enforce protection of species and their habitats.