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Legal, clinical and regulatory obstacles to establish TCM as an integral part of the official European NHS (and how to solve them)

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Speaker: Jan Ruzicka, Senior Advisor to the Minister, Ministry of Health of the Czech Republic (and proud member of Downing College)

Synopsis: Traditional Chinese Medicine (TCM) is already well-received therapeutic system by many European patients. Many public and non-governmental organizations have long been involved in this field. However most of the TCM clinics and ambulances are privately owned and operate partly or completely outside the official health systems of European countries.

Unfortunately, there is more than one obstacle to solve before our NHSs will be able to embrace TCM as integral part of healthcare service.

First obstacle are different philosophical approaches between evidence-based “western medicine” with its problem solving strategy and holistic, long-term and preventive ideas incorporated in the very heart of TCM . Lot of European doctors, scholars and health leaders think that getting involved with TCM and its different approach would be violation of Hippocratic oath.

Second obstacle is the legal one. Most of the European countries don’t recognize TCM Chinese medical degrees or don’t recognize TCM curricula at all. Which creates not only legal vacuum but it gives to TCM “forbidden” and “dangerous” labels in cases of possible malpractice.

Third obstacle is derived from the second. If you are not recognized, you cannot be reimbursed. So it is very complicated to get insurance coverage for TCM . Fourth and final obstacle is the regulatory one. European “drug” agency (EMEA) banned most of the TCM drugs from the continent. Legally (i.e. within health systems) you can get only those herbal active pharma ingredients that are on the EU market for more than 15 years.

However, situation is not hopeless and five or six things have already created momentum for TCM in Europe. 1) European health systems need cheap, long term solutions for civilization diseases and ageing society. TCM might be that solution in many cases. 2) Situation of European insurance systems is not stable and TCM can be solution for some DRG groups, because it can be easily sold to patients as “out-of-pocket payments” 3) Don’t forget the “power of customers!” – European patients want their TCM , Ayurveda and homeopathy and they get it within health systems or outside of them. And it would be smarter for health leaders to open the doors to regulated “alternative” medicine than to have unregulated “on every corner.” 4) Chinese producers are changing: lot of them already have GMP and EDQM certificates and lot of them are able to deliver quality APIs and final products for very competitive prices. And with growing commercial interdependence between China and European countries more and more of these players will come to our common market directly (and not as suppliers of western companies). 5) Chinese governmental agencies, especially SATCM , understand that it is important to create more evidence based version of TCM and they are actively working to use the momentum create by the Nobel prize winner Prof. Tu Youyou. 6) WHO is actively supporting TCM (and other alternative methods) as possible substitute for more expensive health solutions.

In the Czech Republic we are actively working to be leader of the change descripted above in the region of CEE . Our government, our Ministry of Health and our leading university hospital are collaborating with WHO in Genève, with Chinese government (NHFPC, SATCM ) and especially with Shanghai TCM University to establish first teaching clinic within the boundaries of the “western” university hospital. Furthermore, we are already changing our legislation to open the doors for regulated, more evidence based version TCM that will be able to cohabit with our own healthcare tradition. Furthermore, we have an ambition to serve as sort of role model “how to do it” for other CEE countries as well.

This talk is part of the Talks from the CU Society of Traditional Chinese Medicine series.

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