On The Global Situation Concerning Chinese Medicine Legislation, Education and its Clinical and Academic Future

Dear Friends and Colleagues,

The rapidly polarising global situation of East-West encounters is spurred by the
current economic crisis that challenges the relationship between China, U.S.A and
Europe. This process, whether it is of convergence, integration or conflict, will
determine the nature of our future world. Medicine and health are among the most
turbulent areas in which East-West contradictions are socially relevant. Both
intellectually and in practical socio-economics, medicine and health touch all aspects
of our life and society. The challenges from Western medicine towards Chinese
medicine manifest themselves not just in terms of clinical efficacy, pharmaceutical
interests and governmental concern about public health and safety but also in medical
education. These challenges are far-reaching and are subtle in their dynamics and
influence. Such forces can either be progressive for the benefit of humankind, or
regressive forces for serving self-interests.

It has come to my attention that there are global regressive forces who are putting
pressure on the continuous development of Chinese Medicine, Acupuncture and
integrative approaches to medicine. For example, I have recently received a request
from our Australian colleagues to vote for a motion that supports complementary
medicine education, including Chinese Medicine, at the universities. It would seem
there is an internationally concerted action by certain organisations to stop the
teaching of Chinese Medicine and Acupuncture at universities. This campaign was
started in the UK by a group of professors who placed academic pressure on
universities here to close down their Chinese Medicine, Acupuncture and other
complementary medicine degree courses. In fact, I participated in a debate at the
Royal Society of Medicine on 16th April 2010 and won against the motion that ‘Much of
Complementary Medicine is a Con’. We won by 74% of the votes against 26% for the
motion. This illustrates the overwhelming support from the general public and within
certain sections of the medical and health profession.

In the UK, the University of Salford has already closed down its degree course in
Acupuncture and complementary medicine as a result of campaigns. This is of great
concern for all those who are interested in the development of Chinese Medicine and
the integrative future of medicine as a whole.

Furthermore, in a surprising announcement in January 2012, the UK Department of
Health decided to reverse its previous decision, arrived at after much consultation, to
protect the professional title of Chinese Medicine practitioners with Statutory
Regulation, and instead just register herbalists in a new regulative policy called
“functional protectionism”. This would force Chinese Medicine practitioners to register
separately as herbalists and acupuncturists. This decision is about to split a unique
world heritage that is the integral system of Chinese Medicine, with 5,000 years of
clinical history, into separately regulated herbalists and acupuncturists. As a result,
Chinese Medicine will be denied its own identity if the professional title is not protected
by law. The systemic cohesiveness is essential to a Chinese Medical physician for
them to treat their patients effectively. Subsequently, anyone will be able to claim to be a Chinese Medicine Practitioner, and this will inevitably compromise the protection of
the general public that regulation is meant to achieve. If there are no regulating powers
in place to govern good practice, then there will be many misuses of Chinese Medicine
in the hands of the unscrupulous who use endangered species, illegal substances and
perform other besmirching activities and undermining Chinese Medicine’s good name.

My colleagues and I at the Chinese Medical Council UK (CMC UK) have been
campaigning for over 10 years now to legalise Chinese Medicine as a profession in the
UK and preserve all the integral parts of its unique system. Even in the last
announcement from the Secretary of State for Health Andrew Lansley on 16th February
2011, it was promised that the Government’s intention was to create Statutory
Regulation for Chinese Medicine practitioners and herbalists and protect them with
separate professional titles. Now, the surprise change of mind of the UK Government
in its regulation policy is to go down the route of “functional protection” in order to
coordinate with the MHRA (the medicines and healthcare products control agency for
the UK) in its enforcement of the EU Directive 2004/24/EC on unlicensed traditional
herbal medicine and prescription rights in the UK. This means that the current UK
Medicine Act Section 12(1) will have to be amended to meet the current direction in
regulation policy. There will be a public consultation in 2013 after which the Act will
have to go through parliamentary sanction and a transition period of approximately 2-3
years.

The EU Traditional Herbal Medicinal Products Directive 2004/24/EC (EU THMPD) on
the licensing requirements of herbal medicine implemented in the UK and other EU
countries on 30th April 2011 has created dismay in herbal medicine communities as
well as amongst consumers. While the public complain vociferously about the
restrictions that the EU THMPD has placed on their consumer rights, the practitioners
from the non-European traditions are filing complaints of cultural and ethnic
discrimination against the complex nature of Chinese and Ayurvedic herbal traditions.
The Alliance for Natural Health (ANH UK) is taking the case to the European Human
Rights Commission.

Since the Beijing Declaration on traditional medicine was announced by Dr Margaret
Chan, the Director General of WHO, during the Beijing Summit on Traditional Medicine
on 8th November 2008 (in which I participated and reported to the CMIR UK), there has
been negligible progress in the acceptance of Chinese Medicine and other traditional
medicines in the West. Instead, Chinese Medicine has been experiencing intense
pressure from certain academics, clinicians and governmental authorities. Moreover, it
has also become the victim of popular prejudice and stereotyping. For example,
recently the BBC wanted to interview me on the disappearance of rhinoceros horns
from a museum in Britain but I told them that this type of ingredient, along with other
parts of endangered species, is not used in current Chinese Medical practice and
therefore one cannot assume that the stolen horns are associated with Chinese
Medicine. This illustrates the discriminatory attitude against Chinese Medicine that is
widespread across the mass media, conventional medical communities and
governmental authorities.

Many objections have also been raised on the question of the evidence for the efficacy
of Chinese Medicine, based on Randomised Controlled Trials (RCTs). This is a
concerted effort to discredit Chinese Medicine as a valid system of medicine despite its being beneficial and popularly used by the general public. This illustrates the
contradiction between natural systems of medicine, as exemplified by Chinese
Medicine, and Western medical enterprises. Chinese Medicine can only be evaluated
by a new research methodology that is based on a detailed and individualised patient
outcome study rather than with a generalised model based on medical statistics.

I have recently presented a paper in my Guangzhou University of Chinese Medicine
PhD/MSc program on the new integrative approach to medical evaluations which takes
into account the individualistic and complex nature of Chinese medical diagnosis and
treatment. This epistemological reinterpretation involves a re-examination of the logic
that is being used in medical reasoning, as well as the examination of medical
statistics. According to Professor Claus Schnorrenberger in his paper The
Epistemological Evaluation of Chinese Medicine and Acupuncture, Evidence-Based
Medicine is “a fallacy, a logical error” and “the whole individual patient does not exist at
all in the view of EBM”. Both Professor Schnorrenberger and I agree that the scientific
method is one of the ways towards knowledge but not the only way. Therefore,
integrating the wisdom of Chinese Medicine with the empirical methodology of all of
science could be a way forward for the future medicine. Chinese Medicine, with its
holistic individualised approach, promises to be a timely solution to the problems of
generalised scientific medicine. The synthesis of the two could determine the nature of
the new medical paradigm necessary for our progress.

What is the future ahead of us as we try to evolve a medical system that is more
beneficial to humankind? Is this the beginning of a clash of civilisations or, instead, the
hopeful beginning of convergence? As we know, clinically applied Chinese Medicine
represents the intellectual thought of the Chinese civilisation in its most concrete and
practical form. Evidence Based Medicine epitomises the Western scientific ideal and
its fundamental empirical worldview which is increasingly questioned by the theory of
uncertainty and quantum physicists. Medicine, therefore, is on the front-line of such
clashes and convergences of civilisations. The integrative approach to medicine is an
attempt to harmonise the two different systems of generalised medicine and
individualised medicine. What is being described above are indeed the manifestations
of a yin and yang process of mutual opposites and mutual transformations.

I am writing the above in order to raise issues for discussion among all those who are
concerned with the future of our world. We need to promote convergence to attain
harmony instead of conflicts that lead to wars. As I am expressing to you my
sentiments of concern for the important questions that have been raised, I solicit
support from all those who are passionate about saving the human civilisation and our
Earth from the rapidly deteriorating situations on the international scene, as reflected in
the financial crises and the confrontations between the East and the West.

There should be no national boundaries in our pursuit of healing. When there are good
intentions there is hope. When there is falsification there is injustice. The future of our
world depends on how we gather harmony instead of spreading conflicts. Greater
interests of the human civilisation should be above the national and regional interests.
Our knowledge and wisdom must be shared among nations to serve the interests of us
all. Whether in economics or medicine, we can only be secure and prosperous
together. The intellect of the East should be integrated with the intellect of the West to enable a new harmonious world to emerge. If we do not respect each other at this time
of crisis, we are dishonouring our ancestors and harming the future of our children.

Wishing you health and inspiration for a new world.

Sincerely yours,

Professor Man Fong Mei

Chairman, Chinese Medical Council UK (CMC UK) www.cmc-uk.org
Chairman, Chinese Medical Institute and Register UK (CMIR UK) www.cmir.org.uk
February 2012, London

The Chinese Medical Council UK is conducting a survey on your views
regarding the Chinese Medicine and Acupuncture regulation. Please express
yourself by visiting the Chinese Medical Council UK website www.cmc-uk.org and particiating in the survey: the http://survey.cmc-uk.org/index.php?sid=81623&lang=en

You are also invited to join the CMIR discussion forum on Chinese Medicine and
Acupuncture regulation, integrative medicine issues as well as a discussion on
East-West integration. Please visit: http://forum.cmir.org.uk/viewforum.php?f=2.

Thank you.