A crowd gathered at a Shanghai hospital, lining for remedies made with plant mixtures and animal parts including scorpions and freeze-dried millipedes — medicines that China hopes will find an audience overseas.
With a history going back 2,400 years, traditional Chinese medicine (TCM) is deeply rooted in the country and remains popular, despite access to Western pharmaceuticals.
The authorities are hoping to modernize and export the remedies, but they face major obstacles.
A veritable forest of medicinal plants surrounded patients waiting at Yueyang Hospital’s pharmacy. Some left with boxes of pills, others took away plastic sachets filled with herbal extracts.
Lin Hongguo, a 76-year-old pensioner, has bought herbal remedies that he would boil to make a tea to treat his “slow-beating heart.”
“I prefer it to Western medicines. It’s not about the cost, it’s because it works well,” he told reporters.
Another patient, pet fish seller Wang Deyun, 51, is also a believer.
“Two months ago my skin had an allergic reaction to a modern medicine for high blood pressure,” she said from her hospital bed.
However, after a treatment of facial masks and plant infusions, she said she is almost fully healed.
Traditional medicine is subsidized in China and is cheaper than Western medicine. It consistently makes up one quarter of the country’s pharmaceuticals market — even as China increasingly opens up to modern medicine.
The WHO is next year to include a chapter on traditional medicine in its “International Classification of Diseases” — a tome of reference for medical trends and global health statistics.
China hopes the WHO inclusion will spur global recognition of its traditional remedies as it seeks to export them.
However, Beijing still faces significant hurdles, not least the fact that TCM focuses on tailoring treatment to each individual, which means different people with the same condition can be prescribed different medicines and dosages.
“It’s like a painting — it’s composed differently each time, while Western medicine is more similar to photography” with its standardized products, said Wang Zhenyi, a proctologist at Yueyang Hospital.
That is the crux of China’s challenge in gaining overseas acceptance: Its traditional medicine is largely incompatible with modern clinical trials, which require an identical product to be tested on a large number of patients.
As these medicines typically contain dozens of ingredients, understanding how they work together and proving their effectiveness is a complex task.
Even within China there have been public skirmishes over the efficacy of TCM, pitting its proponents against doctors who advocate evidence-based, peer-reviewed medicine.
Conservationists have said that growing demand for products like rhino horn and pangolin scales — which are used by some practitioners even though they have no proven medical properties — have decimated vulnerable species.
China last month partially lifted a ban on trading tiger bones and rhino horns, despite warnings from conservationists, although state media later quoted an official as saying the change had been “postponed.”
Chinese experts have said endangered animal parts are increasingly being replaced by synthetic versions, but TCM might still prove a tough sell abroad.
“I think the best potential is in the consumer market, such as nutritional supplements,” said Tony Ren, a pharma analyst with Kim Eng Securities in Hong Kong.
Few Western pharmaceutical companies are keen to try to untangle these difficulties.
However, French biotech company Pharnext has taken on the challenge, partnering last year with Tasly, one of China’s biggest producers of traditional medicines.
Together, they are looking to transform the industry by streamlining “the procedures to have a more stable production of plants, which have identical properties, and understand why the mixture works,” Pharnext founder and chief executive officer Daniel Cohen said.
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