TCM Transitioning to Plant-Based Medicines to Safeguard Wildlife

This second of a three-part series, on the availability of pangolin-based traditional Chinese medicines in the market despite the international ban on pangolin trade, takes a look at the shift towards plant-based products to protect wildlife species.  

Traditional Chinese Medicine (TCM) practitioners and shops in Malaysia are transitioning from wildlife-based medicines to plant-based remedies to safeguard biodiversity.

The ingredients commonly used in TCM include animal parts from endangered species such as pangolins, the most trafficked wildlife in the world and popular in TCMs to treat everything from arthritis and swelling to breast milk obstruction.

According to TCM practitioners and industry players, the focus of modern TCM is shifting towards sustainability, ethical sourcing and scientific validation to ensure effective, responsible and cruelty-free treatment options.

This includes actively discouraging the use of endangered wildlife-derived ingredients in TCM and recommending plant-based or lab-synthesised alternatives that offer comparable therapeutic benefits.

Most of the traditional Chinese medicines are plant-based (Source: Freepik)

According to Sunway TCM Centre herbalist Huong Hee, plant-based alternatives are generally more widely accepted due to their sustainability, affordability and ethical advantages.

“While animal-derived ingredients have historically played a role in TCM, there are always effective plant-based or synthetic substitutes that align with both ethical standards and modern scientific research.

“Furthermore, unlike rare and endangered animal-derived ingredients, herbs can be cultivated, making them more accessible and cost-effective,” she told Bernama in an interview recently.

MORE SUSTAINABLE APPROACH 

Huong said identifying effective plant-based or synthetic substitutes is crucial in protecting wildlife from suffering and extinction, while also ensuring that patients receive safe and effective treatments.

“For example, in place of pangolin scales, we now use herbs like Wang Bu Liu Xing (Vaccaria seeds) to promote blood circulation and lactation.

“Similarly, synthetic alternatives such as ursodeoxycholic acid (UDCA) have replaced bear bile for liver-related conditions,” she pointed out.

Pangolin-scales TCM products in a TCM shop in Indonesia, 2019 (Pic credit to WildAid)

The acceptance of these alternatives is growing, particularly as research continues to validate their efficacy and as ethical considerations drive changes in consumer preferences, she added.

She also stressed that not all animal-based medicines or those containing wildlife ingredients, especially pangolin scales, are suitable for all patients.

“Before we formulate a medicine for a patient, we first check their pulse and review their medical history, including any allergies to medication, current use of Western medicine or risks of hypertension.

“It is crucial to ensure there are no medical interventions if we prescribe any medicine containing animal-based ingredients, prioritising the patient’s safety and health,” she said.

Sunway TCM Centre pharmacist and head of operations Chan Si Yan said another part of the success in making the transformation to plant-based medicines is the awareness among TCM practitioners that Malaysia is a multiethnic country and their clientele comes from different racial backgrounds.

“As part of our commitment to inclusivity, we avoid using animal-based medicines and ingredients whenever possible, opting instead for plant-based herbal remedies that offer the same therapeutic effects.

"Plus, most plant-based herbs and TCM products are vegan-friendly, ensuring that they are also halal for Muslim patients. This makes it easier for patients with different dietary preferences, including vegetarians and vegans, to feel comfortable with our treatments," she said, adding if patients are unsure about TCM products they have purchased online, they should consult a certified TCM practitioner or herbalist for verification before consuming.

Chan Si Yan (left) and Huong Hee (right)

HANDBOOK FOR TCM PRACTITIONERS 

In order to increase awareness among TCM industry players and educate the public on the prohibition of endangered wildlife-based TCM products, including those containing pangolin scales, TRAFFIC, in collaboration with the Federation of Chinese Physicians and Medicine Dealers Association of Malaysia (FCPMDAM) has launched the Ren Xin (Kind Heart) initiative to address the use of both locally and internationally protected and threatened species within the industry.

(TRAFFIC is an international NGO working to ensure that trade in wild species is legal and sustainable for the benefit of both the planet and people.)

As part of the 'Ren Xin' initiative, a guidebook titled 'Handbook for TCM Practitioners and Traders in Malaysia' was published in November 2023 to raise awareness about the negative impact of using protected wild species in medicines, as well as the legal risks for those buying and selling products containing such ingredients.

TRAFFIC International Southeast Asia programme officer Serene Chng said this is the first publication of its kind for Malaysia’s TCM industry, compiling clinical trial studies on effective alternative formulations that do not contain protected or threatened species, and clarifying the laws and regulations governing the use of wildlife ingredients in TCM practices.

She noted that previous engagement with the TCM sector revealed confusion within the industry regarding laws and regulations on the use of protected wildlife in TCM.

“We aim to provide clarity and increase awareness about the negative consequences and legal implications of prescribing or selling protected wildlife ingredients,” she told Bernama, adding they conducted a legislative review and consulted government authorities to map out the relevant laws and procedures before publishing the handbook.

“It (handbook) also includes a list of legally protected wild animals and plants commonly used in Malaysia’s TCM industry, helping practitioners identify which ingredients require permits or should be completely avoided. These sections are presented in English and Mandarin”.

TRAFFIC has also carried out extensive research, including surveys of TCM shops across Peninsular Malaysia and Sabah and Sarawak, over the past 10 years.

TRAFFIC has done surveys of TCM shops across Peninsular Malaysia and Sabah and Sarawak, over the past 10 years.

TRAFFIC programme officer Leslie Tsen said they have been engaging with Malaysia’s TCM industry for some time to develop practical guidelines to help businesses adopt more sustainable practices, rather than simply impose restrictions on them.

On May 7, 2024, TRAFFIC organised a conference attended by over 100 individuals from Malaysia’s TCM industry, including practitioners, traders, manufacturers, academics and students, along with representatives from 15 government agencies such as the Peninsular Malaysia Department of Wildlife and National Parks, National Pharmaceutical Regulatory Agency, Traditional and Complementary Medicine Division and Pharmacy Enforcement Division.

“Most of them welcomed our initiative to stop trading and using illegal wildlife for TCM purposes, and found our handbook useful. In fact, all 500 printed copies of the handbook were distributed throughout the initiative.

“TCM practitioners from outside the Klang Valley requested copies of the handbook as an essential reference for identifying endangered wildlife species by conservation status. Pangolins, for example, are listed under Appendix I of the Convention on International Trade in Endangered Species of Wild Fauna and Flora, which means they are prohibited from international commercial trade,” he said. 

He added the soft copy of the 40-page handbook and other resources are available online at www.healersforthewild.com.

“We also raise public awareness through social media and multilingual videos in various Chinese dialects, featuring influencers, to ensure the message about stopping illegal wildlife poaching for TCM is delivered in an accessible way.

“By partnering with TCM industry experts like FCPMDAM, our campaign becomes more effective, as the industry is more receptive and patients are more likely to trust advice from professionals in the field due to their expertise and credibility,” he added.

TRAFFIC International Southeast Asia programme officer Serene Chng (left) and programme officer Leslie Tsen (right)

COUNTERFEIT PRODUCTS 

Meanwhile, as far as pangolin scales are concerned, China – the largest consumer of pangolin scales ­– has already reduced the annual quota on the use of pangolin scales for traditional medicines from 25,000 kilogrammes to just 1,000 kg, alongside intensified conservation measures and stricter regulations on the purchase of such products.

However, this has raised another concern – the rise in sales of traditional medicines made from fake animal parts.

According to Kuala Lumpur and Selangor Chinese Drug Dealers Association president Ma Kum Keong, the local TCM industry has largely moved away from the use and sale of animal-based products, particularly those involving endangered species, over the past decade.

He said there has been a reduction in the availability of pangolin-scale products in the market following their removal from China’s Pharmacopoeia during the COVID-19 pandemic. (The Pharmacopoeia is a legally binding collection of standards and quality specifications for medicines used in a country or region.)

"TCM products made from pangolin scales that are sold online mostly lack serial numbers and are highly likely to be counterfeit," he said

“This is because to legally purchase pangolin scale products from China, one must provide identification documents and a prescription from a licensed practitioner. These transactions must also be reported to the Chinese government for record-keeping.” 

Kuala Lumpur and Selangor Chinese Drug Dealers Association president, Ma Kum Keong

Conservationists are also concerned about the artificial breeding of pangolins as well as other endangered species in China, which is allowed under amendments to its Wildlife Protection Law that came into effect in 2023. 

Erin Chong, a Malaysian pangolin campaigner from the United Kingdom-based Environmental Investigation Agency (EIA), said in the case of pangolins, artificial breeding, if done for commercial purposes, could be considered a “legal” source of pangolin scales.

“The language in (China’s) Wildlife Protection Law, as amended in 2023, allows for pangolins (and other endangered species) to be artificially bred for the protection of cultural relics and other (undefined) special circumstances. This could potentially result in a continued and sustained demand for pangolin products,” she said.

(Note: This story is part of the Macaranga Mentorship on Covering Wildlife Crime in Malaysia 2024, and is supported by Internews Earth Journalism Network.)