Doctors call for stricter regulation of traditional Chinese medicine | Medicine

Leading European doctors are calling for stricter regulation of traditional Chinese medicine, fearing that recent recognition by the World Health Organization could encourage the use of unproven therapies that can sometimes be harmful.

The Federation of European Academies of Medicine (FEAM) and the European Academies Scientific Advisory Board will issue a joint statement on Thursday urging the WHO to clarify how traditional Chinese medicine and other complementary therapies should be used.

Earlier this year, the WHO decided to add a chapter on traditional Chinese medicine to the International Classification of Diseases, which lists treatments available worldwide for medical conditions. The ICD exerts influence on governments, which consider its recommendations when deciding how to spend health budgets.

The WHO says it’s not an endorsement, but European scientists fear it could be used by manufacturers to promote their herbal and other remedies – and the public be misled thinking there is good evidence that they work and are safe. There is a risk, they say, that some people with serious illness will avoid or even delay seeing a conventional doctor.

Doctors stress the importance of evidence-based medicine, said Professor George Griffin, president of FEAM. “We don’t give drugs and surgical treatments unless there’s real evidence that they work and don’t cause any harm and basically the feeling is that most traditional Chinese medicine drugs don’t are unregulated,” he said. “They are not tested properly for toxicity. They probably vary a lot between batches produced, for example algae, which is newer, and they can be harmful.

“The other side of the equation is that they can trick patients into thinking they’re taking appropriate therapies for a serious illness.”

Traditional Chinese medicine includes herbal remedies, tai chi, cupping, and acupuncture. Its practitioners focus on the whole mind and body and do not diagnose on the basis of isolated symptoms. They believe that vital energy, called qi, flows through the body’s channels, connected to organs and functions. Although many therapies have been used for hundreds of years, there is little evidence of benefit from scientific trials and some evidence of harm.

The doctors behind this statement recognize that traditional Chinese medicine has sometimes produced treatments of real value to the world. Most notable recently is artemisinin therapy, which is the mainstay of malaria treatment in Africa. But, they point out, the original artemisia preparations were chemically modified and rigorously tested to produce the drugs used in combination today.

They say they agree with the good intention of the WHO to encourage rigorous testing of the remedies used by so many people. But they believe that the list of traditional Chinese medicine will be misinterpreted.

“Multiple risks of harm from herbal ingredients have been documented,” they will warn. Sometimes herbal remedies have been adulterated with chemicals. Interaction with conventional drugs can be a serious threat. And acupuncture, they will say, “is not necessarily trivial”. A review in 2017 revealed numerous injuries, infections and adverse effects.

Although those who use complementary medicines consider them to be from small businesses, overall they are big business. “The production and delivery of traditional Chinese medicine has grown into a large industry with estimates of $60 billion [£46.5bn] per year and an annual growth rate of more than 10%,” the statement said.

Doctors “urge the European Commission and Member States to do more to ensure that all medical products and procedures undergo an appropriate level of quality, safety and efficacy assessment, in accordance with testing procedures standardized”.