Traditional Chinese Medicine [TCM)
The BRICS of Brazil, Russia, India, China and South Africa is the summit of five emerging countries. BRICS was formed in contradistinction, if not opposition, alternative to the G7 of the seven leading developed countries. What all BRICS countries have in common is that they have a large land area, a large population, and abundant resources. Leaders of at least three of the BRICS - India, China and South Africa - share a commitment to promoting their local traditional medical system as an alternative to the scientific Allopathic mainstream modern medicine of the deeveloped countries.
The origins of traditional Chinese medicine can be traced to Shen Nong Shi, a mythological figure from about 5,000 years ago, who sampled hundreds of herbs for use as medicines. The formal history of TCM starts about 2,500 years ago with the Yellow Emperor's Inner Classic, the first written account of its practice. TCM views a patient's condition as a reflection of the interaction of five elements of nature: wood, fire, earth, metal and water. The goal is to treat each patient holistically, with prescriptions tailored to the individual patient's condition.
The Party treats TCM as a part of China's cultural heritage. "This means that anyone who expresses doubts about it is also expressing doubts about Chinese culture. By June 2020 health authorities in the Chinese capital are considering banning the "slander or defamation" of traditional Chinese medicine (TCM), amid a nationwide campaign by President Xi Jinping to include traditional herbal formulas in the treatment of coronavirus. The Beijing health commission will take comments and opinions until June 28 on the draft rules, which state: "No organization or individual shall make false or exaggerated claims about Chinese medicine ... nor shall they defame or slander traditional Chinese medicine in any way or by any act." Anyone "picking quarrels and stirring up trouble" through the slander of TCM will be dealt with by police, and possibly face criminal charges, the draft rules say.
Chinese consumers generally perceive TCM as more effective for disease and chronic illness prevention, and they view Western medicine as being more effective for acute and serious illnesses. Health experts are already too frightened to criticize TCM openly, given the high level of support in the ruling party.
Another major difference between TCM and Western medicine is that, until recently, TCM has relied on patient experience, not clinical trials, for proof of effectiveness. TCM combines raw materials, principally herbs, to treat disease. Historically, the formulation incorporated as many as 10,000 ingredients, 90 percent extracted from herbs and 10 percent from animal byproducts and minerals.
The basic theory of Chinese medicine attempts to explain the nature of life cycle and disease changes. It includes five theories:Yin and Yang, the five elements, how to direct one's strength, zangfu (internal body organs), and channels. It also researches dialectics, and explains why diseases occur, how to diagnose and prevent diseases, and how to keep the body healthy.
The concept of Yin and Yang comes from an ancient philosophical concept. After observing the phenomenon, ancient people grouped all conflicting ideas into Yin and Yang. They used this concept to explain how things changed. Chinese medicine used Yin and Yang to illustrate the complicated relationship between various things, such as the different parts of the human body and living things versus nature or society. It was believed that the relative balance of Yin and Yang served as the basis to maintain the normal activities of the human body. If such a balance was disturbed, diseases occurred, thus affecting people's health.
The five elements - wood, water, fire, metal, and earth -- emerged from the observation of the various groups of dynamic processes, functions, and characteristics in the natural world. Each of the elements is seen as having a series of correspondences relating both to the natural world and the human body.
TCM uses a system of inter-relationships between the five elements to understand how the various processes of the body support and control each other. Because of these inter-relationships, when one of the organs and its associated element is out of balance, the other elements are also affected. This imbalance will manifest in the individual with many different signs and symptoms. It may show in the facial color, the sound of the voice, or a change in the emotional state as well as disharmony in the functioning of the connected organs.
The theory of directing one's strength focuses on how various components such as astronomy, meteorological phenomena, and climate would affect health. This theory consists of two parts, five strengths, and six climatic factors. The five strengths, namely the strengths of metal, wood, water, fire, and earth, refer to the different seasons of the year such as spring, summer, long summer, autumn, and winter. People regarded wind, coldness, summer, rawness, dryness, and fire as the six elements of the climate. This theory tried to predict climatic change and how disease occurred by parameters in astronomy.
The theory of Zangfu is a collective name for the various Yin and Yang organs identified in TCM. A Yin organ is called a Zang and a Yang organ is called a Fu. Each organ is considered to have its own functions, but these functions have a far wider scope than the purely physiological function described in Western medicine. The Zang consists of the five solid organs -- spleen, heart, lungs, liver, and kidneys. The Fu consists of the six hollow organs -- small intestine, large intestine, gall bladder, bladder, stomach, and san jiao (a three-part invisible metabolizing organ in TCM concept).
The meridian (energy channels) theory is the study of the physiological function and pathological change on the meridians and their related zangfu organs. The essential functions of the meridian system are to "transport qi (energy force) and blood," "to maintain conductivity," and "to resist invasion of exogenous pathogenic factors (such as viruses)."
Today, practitioners of TCM regularly use around 300 ingredients in their widely available formulations. Any given formulation requires four to eight ingredients on average. The principle used for combining ingredients has its origins in the framework of imperial ministerial-assistant-servant, which was documented 5,000 years ago in the Shen Nong Herbal Encyclopedia.
The framework calls for an imperial herb, the chief herb or main ingredient of a formula; the ministerial herb, ancillary to the imperial herb, which augments and promotes the action of the main ingredient; the assistant herb, which reduces side effects of the imperial herb; and the servant herb, which harmonizes or coordinates the actions of the other herbs.
Although only 10 percent of China's 2 million physicians are trained exclusively in TCM, most medical school students receive some training in the discipline. They can prescribe TCM medicines that have earned State Food and Drug Administration approval.
I. Patent protection covers special ingredients, quality standards, processing techniques, dosages, formulations, and design, and is valid for 10 to 20 years. For example, Tasley's Fufang Danshen Diwan, which works to improve circulation and kill pain, has patent protection for its ratio of raw materials and special processing techniques.
II. The innovative-drug protection mechanism covers formulations and dosage forms for two to five years. The protection mechanism applies to TCM and Western medicines.
III. Protected TCM was introduced in 1992 to limit excessive competition. For each protected formulation and form of dosage, there can be no more than 10 manufacturers. Companies typically apply for Protected TCM status when their innovative-drug protection is about to expire. This protection is valid for seven to 30 years.
IV. Heritage secret recipe offers exclusive protection for trade secrets, formulations and processes. This mechanism lasts five to 20 years, but obtaining approval is very difficult. Fewer than 200 traditional drugs are protected under this category, and many of them - for example, Yunnan Baiyao, used to slow internal bleeding, and Pian Zai Huang, used to treat mouth ulcers and bee stings, were first introduced more than 100 years ago.
More than 3 trillion yuan ($434 billion)-that's the estimated annual sales revenue of the traditional Chinese medicine or TCM market by 2020, up more than 71 percent from 1.75 trillion yuan in 2017, a 2019 report said. Released by the State Council Information Office, the report on the TCM industry appears to suggest China's relatively new TCM law, which took effect in July 2017, may be not only regulating the hitherto informal sector better but transforming it into a fast-growing, potentially economy-boosting sector, with an annual compound growth rate of 20 percent.
TCM is going global rapidly, as if to make amends for lost time, and to present a worthy alternative to other medicinal systems that appear to have failed to find lasting cures to the world's most troubling diseases. TCM will also seek to create value through alliances with similar systems in other countries. According to the State Council Information Office report, TCM's global footprint now spans 183 countries and regions. More than 100 member countries of the World Health Organization are now able to use acupuncture, among which 29 have established laws to regulate TCM, and 18 have included acupuncture in their medical insurance system.
Even globally, TCM is gradually entering the international medical system, and is registered in many countries and regions such as Russia, Cuba, Vietnam, Singapore and the United Arab Emirates. Over 30 countries and regions have established hundreds of TCM schools, to cultivate local TCM talent. The World Federation of Acupuncture-Moxibustion Societies, headquartered in China, now boasts 194 members from 53 countries and regions, while the World Federation of Chinese Medicine Societies has 251 members from 67 countries and regions.
The traditional Chinese medicine (TCM) gained greater momentum on going global, boosted by its unprecedented role in the pandemic prevention and control, especially throughout countries along the Belt and Road, becoming containing tool to slow down the spreading of the deadly virus. China's top leadership had all along called for bigger efforts to develop TCM so that more people in the world could benefit from it. The medicine has lately been increasingly embraced by more people from the world, thanks to its effect in combating the COVID-19, SARS and other infectious diseases. The use of TCM has now spread to 183 countries and regions, involving 65 countries and regions along the Belt and Road countries, where people have witnessed the significant cooperation on a shared future even during hard times. Ernst & Young predicted in a July 2021 report that the Belt and Road will become one of the important platforms for the promotion of Chinese medicine.
While TCMs have seen a rising stage for globalization, their effect has not been widely recognized by law in many countries. The decoction of traditional Chinese medicine, for example, cannot be used in hospitals, and the traditional Chinese medicine donated in China is mostly used for preventive medicine. One important remaining challenge is that like many other TCM, it has not been recognized as a drug instead of a food additive. The most important problem of TCM going abroad is the standard, because many western countries do not recognize the clinical standard of TCM, so more exports are used as food additives rather than drugs. At present, the TCM industry is in a weak position in the medical care system since not only the international society lacks confidence in TCM and the modern scientific means and evidence that can prove the efficacy of TCM is not there.
As TCMs receive wider recognition during the pandemic, the integration of Chinese medicine into the world's virus prevention and control will become an important pillar in building the Health Silk Road. To promote the construction of a healthy Belt and Road, the National Development and Reform Commission of China said that it will formulate the 14th Five-Year Plan (2020-2025) for the development of TCM, which includes encouraging and supporting private sectors to adopt the market-oriented approach and jointly building a group of TCM hospitals with countries that have the potential and willingness to cooperate.
After the WHO added a section on traditional medicine to its reference document on medicine in 2019, two groups of European experts from the Federation of European Academies of Medicine and the European Academies Science Advisory Council published a joint statement urging the WHO to reconsider. "Although there has been some convergence there is no agreed international standard to allow collection of comparable data between countries and no common starting point for testing efficacy of interventions or monitoring safety," the statement said.
Trendy health products with no medical value made from endangered animals are only a status symbol for the wealthy. Trade in animal parts for traditional Chinese medicine is a leading cause of species endangerment in Asia, and poaching is increasing at an alarming rate. Most of traditional Chinese medicine relies on herbs and other plants, and is not a cause for concern. But rhinos are being illegally poached for their horns, as are tigers for their bones, thought to improve virility. Booming economies and growing wealth in parts of Asia are increasing demand for these precious medicinals. Already endangered species are being sacrificed for temporary treatments for nausea and erectile dysfunction. These “traditional” cures are throwbacks to a superstitious view of the world that would have people believe that by consuming parts of an animal they can imbibe its natural properties from longevity to vigor.
One hundred years ago, there were probably 100,000 tigers in India, South China, Sumatra, Bali, Java, and the Russian Far East. The South Chinese, Caspian, Balinese, and Javan species are extinct. There are now fewer than 5,000 tigers in all of India, and the numbers are dropping fast. By contrast, captive tigers now outnumber the wild population, with more than 7,000 tigers being kept in captivity in facilities in China, Lao PDR, Myanmar, Thailand, and Viet Nam as well as in tiger farms in South Africa. A large number of these facilities have been implicated in the illegal trade in captive-bred tigers and their parts and derivatives. Tiger organs are used for traditional medicines. Bones are used to make traditional medicines as well as wine, which is marketed as both a tonic and as a virility product, depending on location of consumption. Almost every part of a tiger has a market.
There are five species of rhinoceros -- three in Asia and two in Africa -- and all have been hunted to near extinction so their horns can be ground into powder, not for aphrodisiacs, as commonly thought, but for ailments ranging from arthritis to depression. In 1930, there were 80,000 black rhinos in Africa. Now there are fewer than 2,500. Ancient traditional medicinal beliefs that rhino horn consumption cures illnesses, such as cerebrovascular disease, treats fever, and improves health encourages the illicit trade. More recently, belief in its efficacy for treating other ailments, from hangovers to cancer, appear to have increased demand. There is no legal international market for rhino horns as zero trade is permitted for commercial purposes under the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).
The prices that rhino horn currently commands – usually cited in the tens of thousands of dollars per kilogram – are disproportionate to any medical utility it might have and may be more tied to its cultural significance. Rhino horn appears to be conspicuously consumed as a status symbol, particularly in Viet Nam and China, the two largest markets for illicit rhino products. Chinese nationals have been arrested in possession of illicitly obtained rhino horn throughout Africa and Europe, with several cases recorded in Namibia in recent years. Criminal networks of Chinese origin operating in South Africa may no longer be illegally exporting whole rhino horns, but are increasingly processing and working the horns into smaller pieces locally to better evade detection en route to consumers in Asia.
While ivory and rhino horn are two of the biggest components of illicit market value and receive the most public attention, pangolin has become the most illegally trafficked animal in the world in just a few years. The pangolin is a nocturnal mammal with scales that eats ants and insects. The eight species native to Asia and Africa are in serious decline. Over the past decade, more than one million individual pangolins are estimated to have been killed. The international trade is driven by the demand for their scales for use in traditional medicines and for the luxury consumption of their meat, primarily in China.
Profits generated by organized crime groups focusing on wildlife crime can be significant, yet the legal penalties remain considerably more lenient than for other types of crime such as drug trafficking. Attracted by the high-profit, low-risk opportunities of the trade, organized crime actors have gotten more involved in the trafficking chain.
Many in the TCM community tried to dissuade the uses of animal-based remedies. In 1993 rhino horn and tiger bone were removed from the traditional Chinese pharmacopoeia, and in 2010 the World Federation of Chinese Medical Societies released a statement urging members not to use tiger bone or any other parts from endangered species.
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