As scientists and biotechnology companies around the world are racing to develop therapeutic drugs and a vaccine for COVID-19, China has been busy promoting traditional Chinese medicine (TCM) abroad as an effective treatment for the disease. The Chinese government reported that 87 percent of COVID-19 patients in China received TCM as part of their treatment and that 92 percent of them had shown improvement as a result. This claim hasn’t been independently or scientifically verified. So why is the Chinese Communist Party (CCP) advocating TCM with such vigor? Ultimately, this push is part of a soft-power play.
The American political scientist Joseph Nye believes that, for a nation to be successful on the world stage, it needs both hard power, the ability to coerce others by force, and soft power, the term he coined for the ability to persuade others through charm. The United States is the prime example of a country that excels in both hard and soft power. It has the world’s most powerful military, and at the same time it exerts a great deal of influence through the international appeal of its culture — art, movies, pop music, corporate brands, and political values. China’s dictator for life, Xi Jinping, sees it as China’s destiny to replace the U.S. as the world’s mightiest hegemon. He is keen to establish a new world order centered on China and derived from the CCP’s value system. To achieve what he calls his “China dream,” Xi has sought to enhance his country’s hard and soft power: boosting the People’s Liberation Army (PLA) while enhancing China’s international image and influence by way of CCP-sanctioned Chinese cultural exports, from pandas to Confucius Institutes to TCM.
Although TCM is one of the world’s oldest forms of medical practice, many people outside China are still unfamiliar with it. TCM has always been an integral part of traditional Chinese culture. It is a practice built on the belief that qi, an energy force, infuses the human body as well as the universe, and that there exist two opposite but complementary qi forces, the yin and the yang. When the inner yin and yang energies are in balance, a person is healthy; when they are not, the person is sick. TCM practitioners use acupuncture, herbs, and various animal parts to help cure patients by restoring the balance of qi.
It is estimated that TCM uses about a thousand plants and various parts from 36 species of animals. Visiting a TCM store is like walking into a small natural-history museum: You will likely see drawers of strange-looking herbs and different-sized jars containing animal parts, some dried or ground into powders for ingestion, others immersed in rice wine to make a liquid for drinking. If all of this sounds a bit unscientific to you, you are not alone. Still, many Chinese people put their faith in TCM and claim that taking herbal medicines cured their illnesses. Some research shows that acupuncture may help ease chronic pain in the lower back and elsewhere, and tai chi, a martial art practiced as a form of exercise, may improve balance and stability in older people. Tu Youyou, a Chinese pharmaceutical chemist, said that it was through studying texts of ancient Chinese medicine and screening thousands of TCM herbs that she discovered artemisinin, a plant extract that proved to be effective in treating malaria. For her discovery, she won the 2015 Nobel Prize in Physiology or Medicine. It is fair to say that there is much research to be done before we can truly understand whether TCM has medical value, given that it is a practice that has evolved for several thousand years but has not followed the rigorous scientific standards (such as clinical trials) of modern Western medicine.
Since the late 20th century, TCM has become popular in the West as more people have sought alternative medicine and natural remedies for a variety of ailments. But there is no lack of criticism of TCM, with skeptics pointing to the absence of scientific proof of its effectiveness. Studies of Chinese medicines have had mixed results. One of the most comprehensive reviews of such studies was done in 2009 by researchers at the University of Maryland, who reviewed 70 medical papers evaluating TCM. In most, “there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment.” The researchers pointed to “the poor methodology . . . of the studies reviewed.”
Other studies have found safety issues with TCM. According to the National Center for Complementary and Integrative Health (of the National Institutes of Health), “some Chinese herbal products have been found to be contaminated with undeclared plant or animal material,” or to contain “pesticides or compounds called sulfites, which could cause asthma or severe allergic reactions; or incorrect herbs, some of which have caused organ damage.”
Another question raised about TCM is its impact on animals, including some endangered species. Certain TCM remedies require parts from tigers, rhinoceroses, black bears, and seahorses. The popularity of TCM increases the demand for these animals, which has led to all sorts of problems: illegal hunting and trading, animal cruelty, and unregulated and unsanitary wild-animal markets. One such market in Wuhan is thought to be ground zero of the coronavirus pandemic.
Despite all these criticisms, Beijing sees TCM as a useful tool in enhancing China’s soft power. In 2019, Xi gave TCM his personal endorsement, calling it “a treasure of Chinese civilization embodying the wisdom of the nation and its people.” China lobbied the World Health Organization (WHO) to endorse TCM for years, not only to lend TCM credibility but to boost China’s cultural self-confidence and open potential new markets for TCM, all with the larger goal of the “rejuvenation of the great Chinese nation.” Xi believes that in order to establish China as the center of a new world order, China must show its superiority by providing the rest of the world with “made in China” solutions in every area, including medicine. Therefore, he has devoted national resources to promoting TCM globally as a viable alternative to Western medicine. In his nationalist mindset, worldwide acceptance of TCM would be an endorsement of the superiority of Chinese culture, and any endorsement of Chinese culture is an endorsement of the CCP’s leadership.
In 2019 the WHO, in a highly controversial move, complied with Xi’s wishes and endorsed TCM for the first time by including it in its International Statistical Classification of Diseases and Related Health Problems (ICD-11), a compendium of world health trends. The WHO explained this change by stating that “traditional medicine . . . is used by hundreds of thousands of people worldwide.” Scientific American called the endorsement an “egregious lapse in evidence-based thinking and practice.” Conservationists and animal-rights activists are concerned that the WHO’s endorsement and Beijing’s politically driven promotion of TCM could finally drive some already endangered animals to extinction because of increased demand. When Xi ordered Chinese health officials to use “integrated Chinese traditional herbal medicine and Western medicine” to treat and cure COVID-19, the WHO instantaneously removed herbal medicine from a list of measures it deems ineffective against the disease in its website’s “Q&A on coronavirus (COVID-19).”
Although China’s contribution to the WHO’s annual budget is less than one-tenth of the U.S. contribution, Beijing exerts disproportionate influence on the body by cultivating personal relationships with WHO officials, showering them with lavish trips and praise, while continually promoting its preferred candidates for leadership positions within the organization. The WHO’s current director general, Tedros Adhanom Ghebreyesus, a microbiologist and malaria researcher, was elected in 2017 with strong backing from Beijing, despite the fact that he was not a trained medical professional and had no prior experience in managing global-health organizations. His home country, Ethiopia, has been deeply involved with the Belt and Road Initiative, a major soft-power project to help China expand its geopolitical influence and secure access to strategic locations and resources worldwide. Acquiescing to Beijing’s wishes, the WHO has barred Taiwan from membership, a decision that proved to have fateful consequences in dealing with the coronavirus outbreak.
As the coronavirus began to spread around the globe, the WHO ignored Taiwan’s warnings about human-to-human transmission as well as about its successful methods of containing the epidemic. Tedros hasn’t publicly commented on Taiwan’s success. Instead, he has gone out of his way to praise Beijing, helping the CCP deflect blame, and to repeat Beijing’s talking points, including its dismissal of the early reports of human-to-human transmission. He has said nothing about Beijing’s cover-ups. According to German intelligence, Tedros delayed the declaration of the coronavirus pandemic for two weeks after Xi personally asked him to do so in a January 21 phone call (though the WHO denies the call took place). This delay not only caused great suffering within China but also contributed to a worldwide health crisis as the numbers of confirmed cases and deaths outside China kept rising. The WHO’s shameful kowtowing to Beijing led the Trump administration to announce a temporary suspension in funding to the organization, which, for its most recent two-year budget cycle, received more than $800 million from the U.S., by far its largest contributor.
By promoting TCM, Xi, not wanting to let a crisis go to waste, hopes to recast China’s image as a villain for having mishandled the outbreak into that of the world’s leader, expanding China’s influence and the market share of TCM at the same time. Following Xi’s directive, China’s National Health Commission instructed medical professionals and institutions to “actively promote the role of traditional Chinese medicine (TCM) during treatment” of the coronavirus domestically and internationally. Chinese health officials announced the donation of TCM and acupuncture equipment to a number of countries, including France and Italy, saying they are “willing to share the ‘Chinese experience’ and ‘Chinese solution’ of treating COVID-19, and let more countries get to know Chinese medicine, understand Chinese medicine, and use Chinese medicine.” Chinese doctors who are doubtful of TCM’s effectiveness in treating COVID-19 — for which the regime has provided no scientific evidence — have been silenced.
For Beijing to treat this global health crisis, which originated in China, as a public-relations opportunity to strengthen the CCP domestically and expand its influence abroad is a disgrace. Its infamous “mask diplomacy,” the gesture of sending medical-grade masks and coronavirus test kits to hard-hit countries, failed miserably: One after another, those countries — including Spain, with one of the highest COVID-19 death rates — reported that most of the masks were unusable because of design malfunctions and that the much-needed test kits had an accuracy rate of less than 30 percent. Now we have TCM diplomacy, which defies science to audaciously claim to promote health while serving Beijing’s political motives. This, too, is likely to backfire.