Australasian Science: Australia's authority on science since 1938

Follow the Money

By Loretta Marron

The Chinese government is behind efforts to promote Traditional Chinese Medicine despite its lack of evidence.

Federal Health Minister Greg Hunt’s recent announcement that a host of complementary and alternative medicine (CAM) practices, lacking any evidence base for their effectiveness, will no longer receive taxpayer-funded rebates for treatment. That is good news, but at the same time Traditional Chinese Medicine (TCM), similarly lacking an evidence base, is being promoted and adopted widely with strong government support. You have to ask why.

In 2014, the Australian government signed an $18 billion Free Trade Agreement with China, with TCM singled out for special attention. With no definitive evidence to support claims that TCM can cure any disease or disorder, you have to ask why Australia is embracing TCM.

TCMs are among the fastest growing “health” products in Australia, where the growth of TCM has been influenced by the Chinese and Australian governments, and international agencies including the World Health Organisation (WHO), our regulators and our universities.

China is pushing TCM. It is a $40 billion industry in China, and TCM products are among the most profitable of all Chinese exports even though it has been in decline in China in recent decades, with 80% of people now relying on western medical treatment. To boost TCM a new Chinese law, promising equal status for TCM and western medicine, came into effect this year. Provisions include encouraging hospitals to set up TCM centres.

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 appetite suppressants, stimulants and anti-inflammatories.

In 2014, 230,000 reports of adverse reactions to TCM products were received by China’s “National Adverse Drug Reaction Monitoring”. You might expect China to be at the forefront of researching TCM’s effectiveness, but while the majority of studies from China report that it’s effective, this is unreliable as negative results aren’t published,

Acupuncture is included within TCM, but it doesn’t work. Cochrane reviews are the “gold standard” for evidence-based medicine, and nearly 50 reviews have failed to find robust evidence for acupuncture. A rigorously scientific review of the evidence for acupuncture by non-acupuncturists concluded that it was a theatrical placebo. Despite many Chinese parents considering it useless, and regarding the teaching of it as a waste of precious school time, 12-year-olds are being taught about TCM and how to administer acupuncture; government sees it as a way to boost confidence and pride in China. More than 700,000 TCM textbooks are being distributed to schools.

The WHO is also involved. Quoted worldwide as “evidence”, a 2002 WHO publication on acupuncture claimed that it is “clinically proven to be effective” or “effective” for more than 90 disease and disorders, including depression, dysentery, induction of labour, rotating breech-position babies, rheumatoid arthritis, stroke and whooping cough.

For the past decade, Margaret Chan was the Director-General of the WHO. A Chinese-Canadian physician, she uses TCM, and urged the Chinese government to promote TCM worldwide, claiming it could “reduce the burden on health services”.

Australian regulators are also to blame. As part of the Department of Health, the Australian Therapeutic Goods Administration’s role is to safeguard the health of Australians “through effective and timely regulation of therapeutic goods”. However, the latest proposed changes to their advertising code include more than 1000 TCM and traditional indications, such as “harmonise middle burner (spleen and stomach)”, “unblock/open/relax meridians”, “balance yin and yang”, “renal tonic” and “helps healthy liver regeneration”.

Collaboration with Chinese institutions is bringing millions of dollars into our universities. These collaborations aim to integrate TCM “research into a clinical setting,” supposedly to “accelerate the development of more effective treatments for the most pressing and costly chronic health problems facing the world”. China wants to grow its exports of TCM by influencing governments, universities and regulators. Australian business wants to tap into the $170 billion global TCM market.

This is not about improving our health and well-being, but about growing Chinese business influence internationally and boosting the Chinese economy. The chronically ill and other vulnerable patients pay the price.

Here in Australia, Friends of Science in Medicine has made some progress. The links to the acupuncture report have been removed from the WHO website. The Chinese Medicine Board of Australia has published a statement that “acceptable evidence to support advertising claims needs to be based on findings obtained from quantitative methodology such as systematic reviews of randomised and high quality controlled trials”.

However, with no way to modify TCM practitioners’ scope of practice, for those who venture into their local TCM clinic it will remain “business as usual”.

Loretta Marron is the Chief Executive Officer of Friends of Science in Medicine.