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On May 29th, the Beijing Municipal Health Commission unveiled a draft of the “Beijing Chinese Medicine Regulations.” Much of the document details the proper administration of traditional Chinese medicine (TCM) and certification of TCM hospitals and practitioners. The draft’s fourth chapter has drawn some online concern, though. Titled, “Protection and Inheritance of Traditional Chinese Medicine,” the chapter calls for the punishment of any who “slander traditional Chinese medicine in any way or in any behavior…” This law would be the first of its kind in China to outlaw the criticism of TCM; however, it is emblematic of a wider effort by Chinese leadership to leverage TCM to strengthen their economy at home while improving their soft power influence abroad.
TCM has been a part of Chinese foreign medical aid since the founding of the People’s Republic of China (PRC). Despite Mao deriding TCM practitioners as nothing more than “snake oil salesmen,” he saw value in the practice’s relatively cheap supplies and procedures. Chinese medical teams sent to Africa during this period often included TCM doctors. To this day, TCM figures prominently in China’s medical aid to Africa with TCM medical centers constructed across the continent. In addition, China sponsors foreign students to study TCM in China at a number of its top TCM colleges.
TCM has also featured prominently in China’s response to COVID-19 since the start of the outbreak. Domestically, China’s National Health Commission regularly promoted the use of TCM in its recommended treatment plan. Early reports of patients recovering from the virus highlighted the use of TCM practices as part of their successful treatment. Chinese news also featured the dispatch of TCM doctors to Wuhan. Turning abroad, China frequently supplied TCM supplies and doctors to countries affected by the disease. In Uzbekistan, local authorities worked through Jiangxi province’s State Administration for Chinese Medicine to coordinate the arrival of a team of TCM doctors and medical supplies. Chinese medical teams arriving in Italy brought TCM pharmaceuticals as well as Western medical supplies. Chinese embassies have also promoted the use of TCM to treat COVID-19 with many of their websites featuring sections titled “Fighting COVID-19 the Chinese Way.”
During the tenure of Chinese President Xi Jinping, TCM has taken on a new level of importance across the Chinese government. Xi often refers to the practice as a “national treasure” and has directed significant resources to research and promotion of TCM. In December 2016, China issued its first white paper on TCM which called for “equal status” between TCM and Western medicine as well as greater investment in TCM research and education. The document also calls for China to “actively introduce TCM to the rest of the world” through its bilateral relations and presence in multilateral organizations.
The world has become well acquainted with TCM since the release of the white paper. In multilateral organizations, China has used its growing influence to lobby for supportive measures. In 2019, China successfully lobbied for the inclusion of TCM in the World Health Organization (WHO)’s influential 11th International Classification of Diseases. The WHO’s decision was criticized as anti-scientific and potentially harmful by many including influential publications such as Scientific American and Nature. More recently, the WHO was criticized for removing a warning on herbal COVID-19 treatments in its Chinese language recommendations while initially omitting that guidance in its English language recommendations.
Why is the Chinese government so keen to promote TCM at home and abroad? For starters, the TCM market is incredibly lucrative. Domestically, the market grew annually by over 10% from $25.8 billion in 2014 to $43.6 billion in 2019. This growth has in part been driven by a 2017 law which requires local governments to expand the provision of TCM and which gives TCM medical institutions equal status to Western medicine under the basic state insurance plan. The ongoing pandemic is likely to drive up domestic sales even further with one TCM remedy selling out on Taobao after Chinese state media supported its potential curative effects.
China is also looking to corner the international TCM market. In March 2019, the Ministry of Commerce and the National Administration of Traditional Chinese Medicine released a plan to construct national TCM export centers. These bases will not only export TCM products and training but will also “enhance the soft power of Chinese culture.” Alongside these domestic projects, China has also actively shaped TCM industrial standards through the Industrial Organization for Standardization (ISO), a members-based NGO with general consultative status with the UN Economic and Social Council. In 2009, China successfully petitioned to create a TCM standardization body. Since then, it has proposed the vast majority of TCM standards, many of which are in line with the Chinese Pharmacopoeia. These standards could position China’s TCM industry as the gold-standard from which other countries should model themselves after.
Economics aside, the Chinese government is also seeking to use TCM as part of its larger effort to increase its “discourse power.” As Nadège Rolland, senior fellow for political security at the National Bureau of Asian Research, points out, President Xi is actively trying to bolster China’s “ability to influence the formulations and ideas that underpin the international order.” Chinese leaders have linked support of TCM to important national doctrines and projects like the Belt and Road Initiative and Xi’s “community with a shared future for mankind.” Chinese authorities have also been quick to punish those who criticize TCM. In April, a month before the TCM Draft Law was released, a well-known Hubei doctor was punished and removed from his leadership position for criticizing TCM.
In the week since the release of the draft TCM regulations, Chinese officials have downplayed online concerns about punishments for TCM critics. One official at the Beijing Municipal Administration of TCM said Chinese netizens were “misreading” the regulations and gave assurances that only select behaviors would be considered criminal. China’s actions will ultimately speak louder than its words, though. With a flagging economy and rising discourse power in mind, Chinese leaders will likely continue to crack down on TCM critics at home while investing in its promotion abroad.