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From A to QI: The Global Rise of Traditional Chinese Medicine


From A to QI: The Global Rise of Traditional Chinese Medicine

Find Your Qi

Maintaining balanced Qi (many of us know it as “chi”) – the body’s vital energy level — is a bedrock of Traditional Chinese Medicine (TCM). To help your Qi flow, TCM offers herbal supplements and treatments like acupuncture and cupping.

Strongly promoted by the Chinese government, TCM has become a global industry and an economic driver for China. The sector grossed $130 billion in 2016. According to World Finance, China exported $526 million worth of TCM to the United States alone, making up 15 percent of China’s TCM exports in 2016, while China’s overall TCM exports grew 54 percent between 2016 and 2017.

Recalling the ancient spice routes, TCM is sprouting up as a traded item all along China’s modern Belt and Road routes. The Belt and Road initiative set a goal to register 100 TCM products and establish 30 TCM centers in Belt and Road countries by 2020.

Taking Root but Germinating Concerns

Meeting a goal of Chinese President Xi, TCM got a big boost in legitimacy in 2019 when the World Health Organization (WHO) included TCM for the first time in its global compendium of health conditions and treatments.

But many in the medical field have expressed concern over the move. TCM treatments may lack rigorous scientific study. Testing has revealed the presence of heavy metals, pesticides and toxins in plants grown and harvested in China, and standardization of natural ingredients is not well regulated.

Stats on Traditional Chinese Medicine

Chinese Ginseng in Wisconsin?

In part to remedy quality concerns, China’s TCM producers are partnering to establishing growing sites overseas. They include operations in Wisconsin, which produces over 90 percent of total U.S. cultivated ginseng. Global ginseng production is between 4.5 million and 5.9 million kilos per year. The United States produces roughly half a million kilos. Last year, U.S. ginseng exports were valued at about $30 million, with China the biggest buyer, though ginseng shipments were significantly dampened by 25 percent tariffs applied by China as part of the ongoing trade war.

As ginseng’s health benefits have become popularized in the United States, import demand for Asian ginseng has increased in recent years. The Asian variety is considered “hot,” versus American ginseng which has a “cooling” effect on the body, so trade may flow in accordance with the flow of consumers’ Qi.

Beyond ginseng, more small farms around the United States are producing a variety of Chinese herbs both for export and domestic use in response to concerns with the age and potency of imports, possible contamination, and over-harvesting of wild herbs in China.

The Side Effects of TCM

Africa has become the largest regional TCM export market for China. In 2015, Chinese researcher Tu Youyou won the Nobel Prize for Medicine for discovering the antimalarial properties of the Asian plant Artemisia annua. That validation increased confidence in the use of TCM, particularly in countries that suffer shortages of biomedical healthcare practitioners and in remote, rural areas that lack access to healthcare facilities. But many in the healthcare sector worry that the limitations or risks of TCM are not well understood and that patients turning to TCM may be less likely to seek proven treatments, causing a worsening of their conditions. Quality control and counterfeit medicines prevalent in Africa are also serious concerns.

WHO listing of TCM text

Another side effect is increased demand for African wildlife, already a serious problem. The plight of endangered species such as pangolins are well known, but common farm animals such as donkeys are now in high demand as well. Sought after for gelatin, TCM has driven demand to over four million donkeys per year and growing. Donkeys are being poached from small farmers and landowners and smuggled to such an extent that illegal donkey trade is being compared in severity to rhino poaching.

TCM is also spawning an increase in crocodile farming in Kenya, Zambia, Zimbabwe and South Africa. Eighty-five percent of African crocodile exports go to China, Hong Kong and Taiwan, which gives rise to yet another major concern. TCM can include the practice of eating of exotic wild animals. Wild animals can carry diseases transmitted to humans, as was the case with the SARS outbreak in 2002, traced to consumption of wild civet cat. Exotic species available in a wet market in China may also be the origin of the current strain of Coronavirus affecting thousands. Out of caution, China recently announced a temporary ban on wild animal trade.

Deep Trade Roots

It could be that the U.S.-China trade relationship is founded on traditional Chinese medicine. In February 1784, a cargo ship named Empress of China set sail for China loaded with nearly 30 tons of American ginseng. The profits from that trade prompted a congressional resolution encouraging further trade with China. President George Washington is said to have had Daniel Boone search forests for ginseng in an effort to help fund the fledgling U.S. government through trade with China.

Such is the storied history of TCM. But as TCM is traded globally in the modern age, the industry will need to find its own Qi for a balanced approach to quality, safety, and the sustainability of precious resources.


Sarah Smiley

Sarah Smiley is a strategic communications and policy expert with over 20 years in international trade and government affairs, working in the U.S. Government, private sector and international organizations.

This article originally appeared on Republished with permission.