Pearls and Irritations

Remarkably and unfortunately politics, not clinical effectiveness, is powering the global penetration of Traditional Chinese Medicine into health care systems. The term “Traditional Chinese Medicine” (TCM) was dreamt up by Chairman Mao Zedong in a cynical response to the Communist Party’s inability to provide evidence-based health care for the then 500 million Chinese. Mao knew that TCM was largely useless and was derogatory about TCM practitioners but he none-the-less set about its expansion. This saw a reversal of a progressive acceptance of scientific medicine in China which started in the 19th century. 

In 1822, Emperor Dao Guang issued an imperial edict stating that acupuncture and moxibustion should be banned forever from the Imperial Medical Academy. Indeed, the teaching of acupuncture was banned by the Imperial Medical Academy in 1882 and its use banned in 1929. The “four humours theory” had long been discredited by evidence-based developments and TCM was being superseded. Not surprisingly, the Chinese Communist Party, embracing the materialist philosophy of Marxism, rejected TCM, including acupuncture, labelling it as superstitious.

Despite this however, Chairman Mao Zedong championed the expansion of the availability of TCM as part of his Great Proletarian Cultural Revolution of 1966. The emergence of China as a political and economic giant is associated with a marked increase in the nation’s pride in its cultural heritage and, as part of this, it sees TCM as a way of expanding its influence in the world. In 2011, China signed 91 TCM partnership agreements with more than 70 countries with the aim of promoting greater recognition of TCM around the world. This is really big business. The world wide sale of TCM products is worth almost 180 billion dollars with sales in China exceeding 40 billion dollars.

In 2016, the Chinese government published its first “white paper” on TCM detailing policies and measures on TCM development and highlighting its unique value in the new era. “TCM has created unique views on life, on fitness, on diseases and on the prevention and treatment of diseases during its long history of absorption and innovation”, said the white paper. As ideas on fitness and medical models change and evolve, traditional Chinese medicine has come to underline a more and more profound value, according to the document. Boasting the establishment of a TCM medical care system covering both urban and rural areas in China, the white paper said there were “3,966 TCM hospitals, 42,528 TCM clinics and 452,000 practitioners and assistant practitioners of TCM across the country by 2015 making contributions to the prevention and treatment of common, endemic and difficult diseases”. For every hospital practicing Western medicine, another must be built to provide TCM. Also stated inaccurately is the suggestion that “TCM has played an important role in the prevention and treatment of major epidemics, such as HIV/AIDS”.  A number of laws and regulations have been enacted and implemented to strengthen the protection of TCM’s wild medicinal resources; and artificial production or wild tending has been carried out for certain scarce and endangered resources, according to the document. This is  not good news for a number of animals e.g. TCM still uses bile extracted from the gall bladders of live bears!

Stressing the innovative development of TCM for health preservation, the white paper said: “China aspires to enable every Chinese citizen to have access to basic TCM services by 2020, and make TCM services to cover all areas of medical care by 2030”.  Chinese educators have decided that children in the final year of primary school will have a weekly Chinese medicine class taught by their schools’ science teachers, ”not just for the medical knowledge, but the culture and philosophy behind it and as a way to boost young people’s confidence and pride in their country” commented the president of Zhejiang University of Chinese Medicine.

Meanwhile, the TCM is going global, the white paper noted, saying TCM has been spread to 183 countries and regions around the world. According to the World Health Organisation, 103 member states have given approval to the practice of acupuncture and moxibustion, 29 have enacted special statutes on traditional medicine and 18 have included acupuncture and moxibustion treatment in their medical insurance provisions.

Mr Abbott appointed Mr Andrew Robb as Minister for Trade in 2013 and tasked him with finalising the Free Trade Agreement (FTA)  with China. With a PM who was clearly in favour of ineffective complementary medicines and much lobbying from the National Institute for Complementary Medicines ( NICM) based at Western Sydney University and much endowed with Chinese money, it came as no surprise that Mr Robb included TCM in the FTA. At the time this was called a tragedy by an eminent Australian scientist, professor of neurophysiology and co-founder of the group “Friends of Science in Medicine”, Professor Marcello Costa, who said the agreement would give unwarranted legitimacy to Chinese medicine.

The trade agreement with China and Australia (2015) included a special arrangement to enable TCM professionals to practice, and TCM methods to be fostered, in Australia. Abbott strongly supported increasing the availability of TCM to Australians.  Mr Abbott publicly defended this part of the deal, which states that: “Up to 1800 visas for Chinese service suppliers to enter Australia for up to 4 years, the visas will be for Traditional Chinese medicine practitioners, Chinese chefs and Chinese Language coaches”.  After signing the FTA, Mr Abbott also sent a congratulatory note to WSU when the NICM opened a Chinese Medicine Centre in 2016, with their objective being “…. the spreading of Chinese medicine further to the world”.

This inclusion will allow WSU and the Chinese government managed ‘Beijing University of Chinese Medicine’ (BUCM) to be used as vehicles for the Communist Party’s agenda to exert its influence via TCM on the Australian healthcare system. The inclusion of TCM in the FTA has paid off and has resulted in a TCM hospital being established in Westmead, Sydney set to  open this year. The BUCM will operate this ‘integrative’ TCM facility and it will be based on a similar 80-bed hospital which the BUCM is already operating in Germany. According to associated documents, this facility will be commercial (run by the BUCM) and the NICM will co-occupy  this space to further their (and the Chinese Communists Party’s) agenda regarding the continued legitimisation and internationalisation of TCM. Many have described these Chinese initiatives as an example of their constant striving for “soft power” in the world.

A Chinese company has purchased Australia’s Suisse Wellness company and there are signs China wants to buy Blackmores. Both are hugely successful companies making huge profits by selling a myriad of products to Australians (and the Chinese) that they don’t need and do not provide claimed benefits.

Medical-tourism hotspots in China are drawing tens of thousands of foreigners for TCM. Overseas, China has opened TCM centres in more than two dozen cities, including Barcelona, Budapest and Dubai in the past three years, and pumped up sales of traditional remedies. And the WHO has been avidly supporting traditional medicines, above all TCM, as a step towards its long-term goal of universal health care. According to the agency, traditional treatments are less costly and more accessible than Western medicine in some countries. Pity the goal is not universal health care that works!

Many adherents argue that TCM appeals because it is “natural”, but in 2015 DNA analysis of imported TCM-products found that nearly nine in ten contained some form of undeclared substance including strychnine, arsenic, snow leopard, pit viper, warfarin and Viagra.  A 2017 review of nearly 500 TCM-products by Hong Kong hospital toxicologists found that most contained modern, pharmaceutical-grade anorectics, stimulants and anti-inflammatories; they were not in reality TCM products. In 2014, 230,000 reports of adverse reactions to TCM products were received by China’s ‘National Adverse Drug Reaction Monitoring’. In part three of this series I’ll examine the realities of TCM practice in modern day Australia.

John Dwyer, Emeritus Professor of Medicine at UNSW, is the President of “Friends of Science in Medicine”, an organisation championing the need for credible scientific evidence of effectiveness to underpin health care in Australia.

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