Will TCM move centre stage in global health tourism?

At the end of 2018 the World Federation of Chinese Medicine Societies agreed a global set of principles and practices for Chinese medicine practitioners. It also established a special committee to promote TCM health tourism worldwide. Ian Youngman looks at the growing potential of Traditional Chinese Medicine.

Traditional Chinese Medicine (TCM) originated in ancient China. Using techniques evolved over thousands of years, it applies herbal medicines and various mind and body practices such as acupuncture, cupping therapy, massage, dietary therapy and tai chi, to treat or prevent health problems.

China has been heavily promoting TCM on the international stage, for a share of the estimated US$50 billion global market. Beijing and Hainan have pioneered TCM tourism and are actively targeting domestic and international health travellers, particularly form Hong Kong, Macao and Taiwan. There are plans to build 15 TCM ‘model zones’ similar to the one in Hainan by 2020.

According to a report in 2018 by the China Tourism Academy, about 2% of visitors from Hong Kong and Macao sought traditional Chinese therapies in 2017, while 0.9% of foreign travellers to the Chinese mainland that year bought tourism products focusing on TCM. With inbound Chinese tourism at 140 million in 2018, a small increase in the percent of travellers taking part in TCM could produce large numbers.

Overseas, China’s Belt & Road trade initiative calls for creating 30 centres by 2020 to provide TCM medical services and education, and to spread its influence. Centres have already opened in more than two dozen cities, including Barcelona, Budapest and Dubai in the past three years.

Global set of TCM principles and practices

In December 2018, the World Federation of Chinese Medicine Societies (WFCMS), a Beijing-based community of 258 member societies in 67 countries and regions, passed a formal declaration on Chinese medicine. A global first, this ‘Declaration of Rome’ calls upon all Chinese Medicine practitioners and professional bodies to adopt the following principles and practices:

  • Respond to the goal of universal health cover and support the traditional medicine strategies by the World Health Organization, making full use of Chinese Medicine, so contributing to the promotion of human health and the realisation of a better vision of health for all
  • Pursue legislation in all countries to ensure the legal status of Chinese Medicine and Chinese Medicine practitioners, to protect Chinese Medicine professional intellectual property, and to instate Chinese Medicine into medical service and insurance systems
  • Promote the standardisation of Chinese Medicine and the establishment of an international Chinese Medicine standard, including diagnosis and treatment, while constantly improving the level of Chinese Medicine
  • Elevate the academic and applied studies of Chinese Medicine, respecting traditional knowledge and encouraging innovation and the application of new knowledge to bring the full use of Chinese Medicine’s unique advantages in the prevention, treatment and rehabilitation of common and complex diseases
  • Strengthen Chinese Medicine education and training at higher education institutions, emphasising the evaluation of Chinese Medicine practitioners and optimising the practice to meet the needs of global health service
  • Engage in the dissemination of Chinese Medicine knowledge and cultural value in the development of the social environment to integrate Chinese Medicine with the local culture in different countries
  • Boost international Chinese Medicine communication to promote the academic strength of Chinese Medicine, to advocate for inter-professional practice and better integration of Chinese Medicine and modern medicine, to endorse multi-disciplinary research, and to actively participate in the improvement of global health governance
  • Support the Belt & Road initiative by the Chinese government to maximise the role of Chinese Medicine in improving people´s well-being and promoting international communication, to contribute to the creation of a global human health community.
  • Fortify the international solidarity of Chinese Medicine practitioners and professional bodies to build consensus, cohesion, inclusivity, and unity around common goals
  • Formalise the international recognition of Chinese Medicine by celebrating the October 11th each year as World Chinese Medicine Day

Evolution of a holistic health treatment

TCM dates back to the third century B.C. and for more than 2,200 years, generations of scholars have added to and refined the knowledge. The ancient beliefs on which it is based include:

  • The human body is a miniature version of the larger, surrounding universe
  • Harmony between two opposing yet complementary forces, called yin and yang, supports health, and disease results from an imbalance between these forces
  • Five elements (fire, earth, wood, metal, and water) symbolically represent all phenomena, including the stages of human life, and explain the functioning of the body and how it changes during disease
  • Qi, a vital energy that flows through the body, performs multiple functions in maintaining health

Traditional systems of medicine also exist in other East and South Asian countries, including Japan (where the traditional herbal medicine is called Kampo) and Korea. Some of these systems have been influenced by TCM and are similar to it in some ways, but each has developed distinctive features of its own.

TCM is a medical system, with comprehensive theory and technology, that grasps the connection between the principles of a healthy life and the evolution of disease. It embodies individualised differentiation of syndrome and symptoms, balanced prevention and treatment principles, personalised treatment methods with diversified interventions, and an orientation to natural medication. It is characterised by clinical efficacy, medication with few side effects, flexible service modes, affordable cost, huge innovation potential and room for development.

In China, traditional medicine remained the primary form of health care until the early 20th century and it remains a vibrant part of the state health care system. Most Chinese hospitals still have a ward devoted to ancient cures.

Citing traditional medicine’s potential to lower costs and yield innovative treatments, not to mention raise China’s prestige, President Xi Jinping has made it a key part of the country’s health policy. He has called the 21st century ‘a new golden age for traditional medicine’.

Global growth of TCM

Concerns remain about the scientific underpinning and clinic efficacy of TCM. Many (mostly Western-trained) physicians and biomedical scientists view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous.

However, scientists from leading universities in the US and Europe, including UCLA, Duke, and Oxford, as well as many in Asia, are looking at the scientific underpinnings of some traditional treatments for diseases such as cancer, diabetes, and Parkinson’s.

These concerns have also not stopped the World Health Organization supporting traditional medicines, above all TCM, as a step towards its long-term goal of universal health care. In addition, in its Exploring Health Tourism report published the end of 2018, the World Tourism Organization recognised Chinese medicine as part of a holistic approach to health that attracts health travellers. This holism definition, they suggest, is a very broad phenomenon and incorporates aspects of both medical and wellness tourism. Korea already includes traditional medicine in its medical tourism data and if TCM is included within the definition of medical travel for numbers worldwide, then within a few years China could come top.

The international development of Chinese Medicine continues to open up new health travel opportunities. TCM practices can now be seen in 183 countries. As the spectrum of known human diseases expands, medical models and health concepts change, and medically caused epidemics become more common, TCM could offer both invaluable thinking and established methodology to address health problems and diseases.

In conclusion, the potential for TCM looks significant, but it still needs serious promotion, with scientific backing, on the international stage. With their new declaration, the WFCMS is now pushing hard for this recognition and adoption within the medical and health systems across the globe.