Traditional Chinese Medicine: Leveraging Unique Strengths and Applications to Benefit People's Health in New Ways

On June 6, 2020, President Xi Jinping delivered a keynote address at a symposium of experts and scholars in which he emphasized that the simultaneous and integrated use of Chinese and Western medicine has been a major highlight of the fight against the Covid-19 epidemic, as well as a vivid representation of how traditional Chinese medicine (TCM) has been carried forward through the preservation of effective practices and the development of new approaches. He gave full affirmation to the contributions that TCM has made in epidemic prevention and control from an overall strategic perspective on the health and safety of the people, and put forward important plans for taking full advantage of the discipline's unique strengths and applications. 

I. Understanding Xi Jinping's statements on TCM-related work to reinforce determination for preserving, innovating, and developing TCM 

Since the 18th CPC National Congress in 2012, Xi Jinping has made a series of statements regarding TCM-related work, focused primarily on the contemporary challenge of preserving, innovating, and developing TCM. In these statements, he has fully affirmed the unique strengths and applications of TCM, and offered thorough answers to fundamental and forward-looking questions such as how TCM should be understood, developed, and shaped in the new era. He has therefore offered a source of fundamental reference and a guide to action for TCM-related work by setting out a clear direction, a blueprint, and a set of tasks for preserving, innovating, and developing TCM in the new era. 

The historical standing and contemporary value of TCM. Xi Jinping has said that the discipline of TCM combines profound philosophical wisdom with thousands of years of the Chinese nation's knowledge and practical experience on health. It is the crown jewel of ancient Chinese science, and the key that unlocks the vast treasure trove of Chinese culture. Traditional medical practices in general are an important vehicle for traditional culture and play an important role in facilitating learning between cultures and keeping people healthy, and TCM is an outstanding example of such cases. These important statements expound upon the historical, cultural, and practical value of TCM and describe how it is a key pillar of confidence in our nation and culture, and have therefore boosted our will and conviction to preserve, innovate, and develop TCM.

A medical worker from the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine leads Covid-19 patients through a qigong exercise routine at Jiangxia temporary hospital in Wuhan, February 25, 2020. The hospital was the first temporary treatment center in Wuhan that followed the treatment and management methodology of traditional Chinese medicine hospitals. PHOTO BY XINHUA REPORTER SHEN BOHAN 

The goals and tasks for preserving, innovating, and developing TCM

Xi Jinping has pointed out that a great opportunity for the vitalization of TCM has arrived due to a confluence of factors conducive to its development. His hope is that workers involved in TCM all over China boost their national pride as they push their discipline toward the heights of medical science. These workers should explore the best of what the treasure trove of TCM has to offer, fully exert its unique strengths, and promote its modernization and popularization around the world, taking solid steps to ensure that this precious tradition handed down to us by our forebears is effectively preserved, developed, and practiced. These statements have made it clear that we must seize important opportunities and focus on key tasks in efforts to preserve, innovate, and develop TCM. They represent a powerful source of momentum for ensuring that TCM-related work is effectively executed in the new era, as well as the focal point and ultimate goal in promoting TCM's development. 

The unique preventative and therapeutic strengths of TCM

Xi Jinping has said that we should continue to lay equal emphasis on Chinese and Western medicine, promoting complementarity and coordinated development between the two disciplines. He has also said that we should exert the important role of TCM in preventative care, the treatment of major illnesses, and the recovery process. 

A member of the fourth-wave national medical team from Shanghai prepares to enter a contaminated area in the isolation wards at Leishenshan Hospital in Wuhan, March 29, 2020. The team finished its last shift at the hospital that same day, and all 122 of its members returned to Shanghai on the 31st. PHOTO BY XINHUA REPORTER CAI YANG 

Furthermore, we should work hard to achieve the development and transformation of TCM's culture of maintaining personal health through creative means, so as to merge this culture with modern perspectives on health and enable it to benefit the people. Finally, Xi Jinping has noted that TCM causes few side effects and produces good results, while the cost of herbal medicines is also relatively low. These statements have fully affirmed the unique strengths of TCM, expounded upon the relationship between Chinese and Western medicine, and demonstrated the important role of TCM in protecting people's health and promoting the development of a uniquely Chinese approach to health. 

The path of high-quality development for TCM in the new era

Xi Jinping has stated that we must follow the patterns underlying the development of TCM, and carry on its essence by preserving effective practices while creating new ones. He has also said that we should take steps to establish and improve laws and regulations on TCM, policies and measures for promoting the growth of TCM, mechanisms for managing TCM, and systems of standards and evaluations that accord with the development of TCM. Lastly, he said that we should better integrate traditional and modern medical science through an open and inclusive attitude, and make greater contributions in pursuing health for all humanity and improving global health governance. These comments demonstrate a broad vision for human health featuring clear goals and a distinct problem-oriented approach, offering an effective prescription for preserving, innovating, and developing TCM in the new era through a full spectrum of measures. 

II. Reviewing the use of TCM in the fight against Covid-19 in order to leverage its unique strengths and applications in combatting epidemics and preventing and treating disease 

Looking back on history, though the Chinese nation has suffered the devastation of natural disasters, wars, and epidemics countless times, it has always pulled through, with its population continuing to grow and its civilization continuing to progress. TCM has played a significant hand in this success. The discipline is a medical science that has gradually taken shape and constantly grown through the long experience of Chinese people of all ethnic groups as well as their struggle with disease. Classic works that were produced in times of struggle against epidemics such as the Treatise on Cold Damage Disorders, Differentiation of Epidemic Febrile Diseases, and the Treatise on Epidemic Febrile Diseases in particular form a unique and systematic framework of theories, methods, prescriptions, and medicines for the prevention and treatment of disease that remains invaluable today. For example, the famous researcher Tu Youyou discovered the compound artemisinin thanks to the inspiration of the Handbook of Prescriptions for Emergencies written by Ge Hong many centuries ago. For this discovery, which has saved millions of lives around the world, she was awarded the Nobel Prize in Physiology or Medicine in 2015. Meanwhile, with the frequent spread of viral respiratory diseases in recent years, TCM has shown clear positive effects in the treatment of diseases such as SARS and H1N1, and has accumulated a wealth of experience, unique theories, a system of techniques, and typical prescriptions for responding to novel infectious disease outbreaks. 

Leveraging the organizational strengths of our national system to mobilize TCM resources across the country in providing aid to Hubei and its capital city Wuhan

Since the beginning of the Covid-19 epidemic, the National Health Commission has facilitated the full engagement of the nationwide TCM system in prevention and treatment efforts in accordance with the instructions and plans of the central authorities as well as the overall requirements to maintain unity and confidence and to put up a targeted and science-based response. Through coordination with government bodies and relevant departments in Hubei Province and the city of Wuhan, the whole discipline became deeply involved in the fight against the epidemic from the outset. National TCM experts were immediately dispatched to Wuhan to observe the situation and treat patients. These experts developed an understanding of the disease through the unique diagnostic approaches of TCM. From there, they were able to study its pathogenesis, and define the principles for treating it. Versions 3 to 7 of the national diagnosis and treatment protocols released by the National Health Commission featured the combination of Chinese and Western medical techniques, and directed the targeted application of TCM in the frontline clinical setting. Immediately after the outbreak began, a national team of TCM doctors was established to take over management of hospital wards, provide treatment, conduct clinical research, and investigate hybrid diagnosis and treatment models incorporating TCM. Five such teams were eventually established with a total of 773 members, and these took charge of medical facilities in Wuhan including the temporary Jiangxia Hospital as well as eight wards at Jinyintan Hospital, Leishenshan Hospital, and Hubei Provincial Hospital of Integrated Chinese and Western Medicine. 

Leveraging the support of clinical research on TCM to consistently produce better diagnostic and treatment protocols and more effective prescriptions

Under the planning of the scientific research group of the Joint Prevention and Control Mechanism of the State Council, major studies have been conducted including one on TCM and the treatment of Covid-19 patients and another on the combination of Chinese and Western approaches in the clinical setting. These studies focused on clinical treatment using TCM, screening useful drugs and assessing their effects, and advancing scientific research in the domain of TCM, and they have provided strong support for clinical treatment. Meanwhile, special emergency response research has been launched in line with the objective of rapidly providing practical and effective solutions for the clinical setting and the principle of observing and making improvements while conducting treatment. This research has delved into China's vast historical experience in the prevention and control of epidemic diseases, and filtered through existing classic Chinese medicinal preparations used for treating such diseases, with promising candidates incorporated into national diagnosis and treatment protocols. At the same time, clinical observations and scientific research on the effectiveness of medicinal preparations being used in treatment were conducted, and a list of three medicines and three preparations that were proven effective was released in a timely manner. 

Leveraging the unique strengths and applications of TCM to enhance prevention, control, and treatment. Following the model used in Wuhan's Wuchang District, Chinese medicine was given to people to take during medical observation in order to boost their immunity. In addition, with temporary hospitals as the main points of distribution, efforts were made to distribute Chinese medicine to as many patients with mild symptoms and as early as possible, which effectively reduced the number of cases that progressed from mild to severe. A system was also set up for doctors of Chinese and Western medicine to conduct joint visits and consultations with severely and critically ill patients. This system integrated Chinese and Western techniques and utilized medicines from both disciplines, which slowed the progression of cases from severe to critical and raised the effectiveness of treatment as much as possible. Furthermore, a package of Chinese medicines was put together for convalescent patients that had been released from hospital in order to speed up their recovery. CPC and government authorities across the country persisted in laying equal emphasis on Chinese and Western medicine, and boosted coordination while managing the resources of both disciplines. This allowed working mechanisms employing hybrid approaches to play an effective role, and opened up new frontiers for the integrated application of Chinese and Western medicine in preventing and controlling contagious diseases. Chinese medicine was involved in the treatment of 92% of confirmed cases across China, and in Hubei Province its rate of use and rate of effectiveness both topped 90%. TCM has thus contributed greatly to the success that has been achieved nationwide in controlling the epidemic. 

Leveraging the qualities of China's response to launch international exchange and cooperation on TCM. Through press conferences and central mainstream media outlets, more than 30 broadcasts featuring anti-epidemic experts have been held in which the experts have discussed the TCM preparations and solutions that have been employed in fighting Covid-19 and the lessons that have been learned therein. These broadcasts have shown how TCM has remained deeply involved as the fight against the epidemic has evolved, displayed the success that has been achieved in using TCM to treat Covid-19 patients, and conveyed moving stories about TCM practitioners who have fought to counter the epidemic. In addition, Chinese medicine was donated to countries in need, and expertise on using TCM for treatment was provided to Italy, Germany, Japan, South Korea, and Pakistan. These actions have boosted approval of TCM and recognition of Chinese culture among the international community. 

The fight against this epidemic has been a vivid exercise in implementing the Guidelines on Preserving, Innovating, and Developing Traditional Chinese Medicine released by the CPC Central Committee and the State Council and the spirit of the National Conference of Traditional Chinese Medicine. It has illustrated how TCM is being carried forward through the preservation of effective practices and the development of new approaches, and demonstrated the admirable sense of mission and duty among TCM practitioners. The extent to which TCM has been involved in the response to Covid-19 and the level of attention it has received are both unprecedented. The discipline played an important role not only in alleviating pressure from concentrated outbreaks and strained medical resources in the early stages of the epidemic, but also in raising the recovery rate and lowering the mortality rate. As a result, TCM became a major highlight and defining strength of China's approach. It has been proven through practice that China's health development model that places equal emphasis on Chinese and Western medicine possesses marked advantages, and that the coordinated and complementary application of both disciplines is an important reason why China's efforts to curb the epidemic have been so successful. Furthermore, this experience has also shown that the precious traditions passed down by our forebears have not become faded despite going through countless trials, but remained useful, practical, and reliable. The strengths and applications of TCM as a simple and economical medical option are worthy of further development. 

III. Promoting complementarity and coordinated development between Chinese and Western medicine in order to benefit the health and wellbeing of the people 

At the National Health Conference in 2016, Xi Jinping stressed that China's approach of laying equal emphasis on Chinese and Western medicine and promoting complementarity and coordinated development between the two is one of the marked strengths of its endeavors in the field of health. This approach is outlined in the Guidelines on Preserving, Innovating, and Developing Traditional Chinese Medicine. 

We must maintain commitment to carrying on the essence of TCM by preserving effective practices and developing new approaches while highlighting the discipline's unique strengths and applications.

The development of TCM is based on the passing on of tradition and fueled by innovation; without the former, it would be deprived of its roots and soul, and without the latter, it would lack contemporary relevance and practical value. The fundamental objective of innovation in TCM is to spur the development of the discipline, raise its therapeutic effectiveness, and boost the capacity and proficiency in clinical practice. Facing varying demands regarding the prevention and control of common ailments, frequently occurring illnesses, serious and medically challenging diseases, and novel contagious diseases, it is imperative that TCM abides by underlying laws, neither getting mired down in tradition nor getting carried away with innovation. The discipline should develop itself by passing on essential traditions and highlighting its unique strengths, while also bringing about theoretical and practical innovations by drawing upon modern science, technology, and cultural achievements. Doing so will help address current needs in disease prevention and treatment, and allow the unique strengths and applications of TCM to shine. 

We must promote integrated, high-quality development of TCM as both a discipline and an industry while adhering to basic requirements on safety and effectiveness. 

Medicine is an essential tool; without it, there would be no such thing as medical science. We must therefore uphold basic requirements on the quality, safety, and effectiveness of Chinese medicine, and make quality the priority in order to make consistent improvements in this regard. The use of high-quality materials is the key to ensuring that ready-to-use preparations of Chinese medicine are of good quality, that TCM is effective at preventing and treating illness in the clinical setting, and that the Chinese medicine industry and the discipline of TCM achieve high-quality development. With this in mind, we should focus on the goal of using relatively low-cost investments to capture major health benefits. To be more specific, we should make plans to establish a number of national-level demonstration zones for comprehensive reform of TCM, and push forward high-quality development of the Chinese medicine industry and its products by encouraging experimentation in areas such as service delivery, business development, and quality control. We must advance TCM-related work in medical reform, enhance TCM's effectiveness and its capacity to prevent and treat illness, and spur integrated, high-quality development of TCM as both a discipline and an industry, exploring policies, measures, and approaches that can be used to boost the Healthy China initiative and socioeconomic development. 

We must sharpen China's strengths in the health domain by upholding complementarity and coordinated development between Chinese and Western medicine. 

Pharmacists prepare Chinese medicine pellets at the Gansu Hospital of Traditional Chinese Medicine, February 20, 2020. After the Covid-19 epidemic began, the Health Commission of Gansu Province brought together experts and established working mechanisms combining Chinese and Western medical approaches in treating the disease, achieving notable results. PHOTO BY XINHUA REPORTER FAN PEISHEN 

In the 2020 government report, developing traditional Chinese medicine and applying it alongside Western medicine was identified as a key task. This represents an essential component of China's approach to development in the field of health. At present, TCM lags behind Western medicine in terms of the services it offers, and needs improvement in many areas such as the training of skilled practitioners, the use of scientific and technological resources to support preservation and innovation of the discipline, and the enhancement of capacity and proficiency in the pursuit of integrated, high-quality development of TCM as a discipline and as an industry. More efforts need to be made in this regard to address inadequacies, shore up weaknesses, and generate momentum. First, we should augment efforts to review and draw insights from ancient medical works, and establish a set of platforms to support scientific research. We should step up the systematic examination, compilation, and utilization of ancient Chinese medical texts, pay attention to preserving TCM's vitality in the process of carrying it forward, and set up systems for protecting its traditional knowledge that are interlinked and mutually complementary with intellectual property systems. We should establish multidisciplinary platforms for scientific research, and strive toward major breakthroughs on the prevention and control of disease, the formulation of important new medicines, and the development of key technological equipment. Second, we should improve TCM's system of services, and raise the emergency response and treatment capacity of TCM hospitals. We should establish a number of national Chinese medical science centers, regional Chinese medical treatment centers, and national bases for providing emergency assistance and preventing and controlling epidemic diseases with TCM. We should strengthen the development of TCM hospitals across the board, and raise the capacity of TCM to provide specialty services and emergency treatment. Third, we should advance reform of evaluation and approval mechanisms for Chinese medicine, and spur the development of new medicines and the growth of the Chinese medicine industry. Adhering to basic requirements on safety and effectiveness, we should make Chinese medicine safer and higher in quality by improving standards, strengthening oversight, implementing full traceability, and building systems of credibility. We should set up standards and methods of appraisal suited to TCM, and streamline procedures for the registration and review of Chinese medicines that are compounds of well-known classical prescriptions. Fourth, we should step up the training of unique TCM professionals, and create a national team of TCM experts for the prevention and control of epidemic diseases. We should bolster reform of TCM instruction at educational institutions, training students to apply the concepts and skills of the discipline. We should make greater efforts to ensure that the knowledge and experience of famous TCM experts is carried on. We should build and refine evaluation and incentive mechanisms for promoting the emergence of talent in the field of TCM. Fifth, we should establish mechanisms for highly efficient coordination between Chinese and Western medicine in responding to major epidemics, and build a distinctly Chinese system for managing national public health emergencies that places equal emphasis on Chinese and Western medicine. We should encourage disease prevention and control organizations at all levels to establish platforms and positions for TCM-related work, and see that TCM hospitals are incorporated in the development of bases for the treatment of major epidemics. 

Yu Yanhong is Member of the CPC Leadership Group of the National Health Commission, and Secretary of the CPC Leadership Group of the National Administration of Traditional Chinese Medicine; Yu Wenming is Administrator of the National Administration of Traditional Chinese Medicine. 

(Originally appeared in Qiushi Journal, Chinese edition, No. 16, 2020)