Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance, Innovation, and Development of Traditional Chinese Medicine

Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance, Innovation, and Development of Traditional Chinese Medicine

(October 20, 2019)

Traditional Chinese Medicine (TCM) is a great creation of the Chinese nation, a gem of ancient Chinese science, and a key to unlocking the treasure house of Chinese civilization. It has made tremendous contributions to the survival and prosperity of the Chinese nation and exerted a positive influence on the progress of world civilization. The Party and the government attach great importance to TCM work. In particular, since the 18th National Congress of the Communist Party of China, the Party Central Committee with Comrade Xi Jinping at its core has placed TCM work in a more prominent position, achieving remarkable results in the reform and development of TCM. At the same time, it must be recognized that the policy of placing equal emphasis on Traditional Chinese Medicine and Western Medicine still needs to be fully implemented; the governance system following the laws of TCM development urgently needs to be improved; the foundation for TCM development and talent cultivation remain relatively weak; the quality of Chinese medicinal materials is uneven; and the inheritance of TCM is insufficient, innovation is inadequate, and its role is not fully leveraged. There is an urgent need to deeply implement the Law on Traditional Chinese Medicine, take effective measures to address the aforementioned issues, and truly inherit, develop, and utilize well this precious legacy left to us by our ancestors.

Inheriting, innovating, and developing traditional Chinese medicine (TCM) is an important component of the cause of socialism with Chinese characteristics in the new era and a major event for the great rejuvenation of the Chinese nation. It is of great significance to adhere to the equal emphasis on traditional Chinese and Western medicine, create a healthcare development model with Chinese characteristics in which TCM and Western medicine complement and coordinate with each other, leverage the original advantages of TCM, promote innovative breakthroughs in life sciences in China, carry forward fine traditional Chinese culture, enhance national and cultural confidence, facilitate mutual learning among civilizations and people-to-people connectivity, and advance the building of a community with a shared future for mankind. To thoroughly implement Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era and the spirit of the 19th National Congress of the Communist Party of China, earnestly implement General Secretary Xi Jinping’s important expositions on work related to traditional Chinese medicine, and promote the inheritance, innovation, and development of traditional Chinese medicine, the following opinions are hereby proposed.

I. Improve the Traditional Chinese Medicine Service System

(1) Strengthen the development of traditional Chinese medicine (TCM) service institutions. Leverage the advantages of TCM as a holistic and health-oriented medical system to establish a TCM service network that integrates preventive healthcare, disease treatment, and rehabilitation. This network should be led by National Centers for Traditional Chinese Medicine and Regional Traditional Chinese Medicine Medical Centers, supported by TCM institutions at all levels and TCM departments in other medical facilities as the backbone, and grounded in primary healthcare institutions, thereby providing TCM services that cover the entire population and the full life cycle. Adhere to the development patterns of TCM, standardize departmental settings in TCM hospitals, revise standards for the establishment and construction of TCM hospitals, improve evaluation and performance assessment systems, reinforce hospital operation models and service functions centered on TCM services, and establish and improve modern hospital management systems that reflect the characteristics of TCM. Vigorously develop TCM clinics, outpatient departments, and specialized hospitals with distinctive features, and encourage chain operations. Enterprises providing TCM wellness and healthcare services shall use the standardized expression “TCM wellness and healthcare services (non-medical)” in their registered business scope. By 2022, achieve comprehensive coverage of county-administered TCM medical institutions, and strive to ensure that all community health service centers and township health centers establish TCM halls and staff TCM physicians.

(2) Strengthen the foundation of traditional Chinese medicine (TCM) services at the primary care level. Expand the scale of tuition-free, targeted enrollment programs for TCM students in rural areas, actively recruit TCM physicians under the special post program for general practitioners, encourage the implementation of the “county-managed, township-utilized” personnel model for TCM staff, incentivize retired TCM physicians to provide services at the primary care level, and relax the criteria for professional title promotion for TCM physicians who serve in primary care settings for extended periods. Improve the training mechanisms for general practitioners and village doctors in TCM knowledge and skills. Support TCM hospitals in taking the lead to establish medical consortia. TCM hospitals at all levels shall strengthen their guidance over primary care TCM services.

(3) Strengthening the service system with information technology support. Implement the “Internet + Traditional Chinese Medicine (TCM) Health Services” initiative, establish foundational databases focusing on electronic TCM medical records and electronic prescriptions, encourage medical institutions to develop internet-based TCM hospitals, develop intelligent TCM-assisted diagnosis and treatment systems, and promote integrated online-offline services and telemedicine. Leverage existing resources to build national and provincial TCM data centers. Accelerate the establishment of a national comprehensive statistical system for TCM. Improve the comprehensive regulatory information system for TCM, employing methods such as random inspections, targeted monitoring, and penalties for violations and dishonesty to achieve precise and efficient regulation.

II. Leveraging the Unique Role of Traditional Chinese Medicine in Safeguarding and Promoting Public Health

(4) Highlight the advantages of Traditional Chinese Medicine (TCM) in disease treatment. Strengthen the development of TCM specialty disciplines with competitive advantages, and enhance the quality and capacity of specialties such as orthopedics and traumatology, proctology, pediatrics, dermatology, gynecology, acupuncture, and tuina massage, as well as specialized diseases including cardiovascular and cerebrovascular diseases, nephropathy, and peripheral vascular diseases. Timely summarize and formulate diagnosis and treatment protocols to consolidate and expand these advantages, thereby driving distinctive development. Accelerate the establishment of evidence-based medicine centers for TCM. Within approximately three years, screen and identify 50 disease types where TCM demonstrates therapeutic advantages, 100 appropriate TCM techniques, and 100 traditional Chinese medicinal products with unique efficacy, and release this information to the public in a timely manner. Focus on cancer, cardiovascular and cerebrovascular diseases, diabetes, infectious diseases, Alzheimer’s disease, and antibiotic resistance, among others, to carry out collaborative research and breakthroughs integrating TCM and Western medicine. By 2022, develop and promote approximately 50 integrated TCM-Western medicine diagnosis and treatment protocols. Establish a consultation system involving both TCM and Western medicine in general hospitals and specialized hospitals, incorporating TCM into multidisciplinary consultation frameworks. Establish effective mechanisms to better leverage the role of TCM in the prevention and control of emerging and sudden infectious diseases such as influenza, as well as in emergency responses to public health incidents.

(5) Strengthen the role of Traditional Chinese Medicine (TCM) in disease prevention. In conjunction with the implementation of the Healthy China Initiative, promote the upgrading of the TCM “preventive treatment of disease” health project. Enrich the content of preventive TCM care within the National Basic Public Health Services Program, encourage family doctors to provide contracted services for preventive TCM care, and promote 20 TCM preventive intervention protocols among key populations and patients with chronic diseases by 2022. Vigorously disseminate knowledge of TCM health preservation and popularize wellness practices such as Tai Chi and health Qigong (e.g., Baduanjin), while promoting healthy work and lifestyle habits that embody the TCM concept of preventive treatment of disease.

(6) Enhance the capacity for rehabilitation with distinctive Traditional Chinese Medicine (TCM) characteristics. Promote the integration of TCM, traditional Chinese sports, and modern rehabilitation technologies to develop rehabilitation medicine with Chinese characteristics. Implement a project to enhance TCM rehabilitation service capabilities. Leverage existing resources to establish a network of TCM rehabilitation centers, strengthen the construction of rehabilitation departments in TCM hospitals, and promote TCM rehabilitation techniques in other hospitals. Develop and promote a set of TCM rehabilitation protocols for chronic diseases such as cardiovascular and cerebrovascular disorders and diabetes, as well as for disabilities, and drive the research and development of a range of TCM rehabilitation devices. Vigorously conduct training programs to facilitate the adoption of TCM rehabilitation techniques in communities, households, and institutions.

III. Vigorously Promote the Improvement of Traditional Chinese Medicine Quality and High-Quality Industrial Development

(7) Strengthen quality control of Chinese medicinal materials. Enhance environmental protection in the authentic producing regions of Chinese medicinal materials, revise the Good Agricultural Practice (GAP) for Chinese Medicinal Materials, and promote ecological planting, wild tending, and bionic cultivation of Chinese medicinal materials. Strengthen the conservation of rare and endangered wild medicinal animals and plants, and support the research, development, and utilization of substitutes for rare and endangered Chinese medicinal materials. Strictly manage the use of pesticides, chemical fertilizers, plant growth regulators, and other agrochemicals, and improve the standards for pesticide residues and heavy metal limits in Chinese medicinal materials by region and by variety. Formulate administrative measures for the seeds and seedlings of Chinese medicinal materials. Plan the construction of bases for authentic Chinese medicinal materials, guide resource factors to converge in authentic producing regions, and promote large-scale and standardized cultivation. Explore and formulate incentive policies for the implementation of the Good Agricultural Practice (GAP) for Chinese Medicinal Materials. Encourage traditional Chinese medicine (TCM) enterprises to independently establish or jointly build stable production bases for Chinese medicinal materials through order-based cooperation, and evaluate and designate a batch of national and provincial-level bases for the breeding of improved varieties and ecological cultivation of authentic Chinese medicinal materials. Improve the third-party quality testing system for Chinese medicinal materials. Strengthen market supervision of the trading of Chinese medicinal materials. Deeply implement poverty alleviation initiatives through the Chinese medicinal materials industry. By 2022, basically establish a technical standard system for the production of authentic Chinese medicinal materials and a grade evaluation system.

(8) Promote the improvement of the quality of traditional Chinese medicine (TCM) decoction pieces and proprietary Chinese medicines. Accelerate the revision of TCM standards (Part I) in the Pharmacopoeia of the People’s Republic of China, with experts organized by the drug regulatory department under the State Council in conjunction with the TCM administrative department to undertake relevant work and establish the most rigorous standards. Improve the standard system for TCM decoction pieces, and formulate and implement national processing specifications for TCM decoction pieces. Improve the market competition environment to promote high quality and competitive pricing for TCM decoction pieces. Strengthen quality control of proprietary Chinese medicines, promote the application of modern information technology in TCM production, and enhance the level of intelligent manufacturing. Explore the establishment of a clinical value-oriented evaluation pathway, comprehensively utilize methods such as evidence-based medicine, intensify post-marketing evaluation of proprietary Chinese medicines, and establish linkage mechanisms with public hospital drug procurement, essential medicine selection, and adjustments to the medical insurance catalog, so as to promote industrial upgrading and structural adjustment.

(9) Reform and improve the registration management of traditional Chinese medicine (TCM). Establish and improve safety and efficacy evaluation methods and technical standards for TCM that align with the characteristics of TCM theory and practice. Timely refine the classification system for TCM registration, formulate regulations for the review and approval of TCM products, and implement a priority review and approval system based on clinical value. Accelerate the development of an evidence system for TCM registration review that integrates TCM theory, human use experience, and clinical trials. Optimize technical requirements for the review of new TCM drugs with human use experience, such as those derived from ancient classic prescriptions, formulas from renowned and experienced TCM practitioners, and medical institution preparations, so as to expedite the approval of new TCM drugs. Encourage the improvement of marketed TCM products through the application of new technologies, new processes, and new dosage forms that demonstrate advantages in clinical application, and optimize technical requirements for changes to marketed TCM products. Improve and standardize the filing management of TCM preparations produced by medical institutions. The State Council’s department in charge of TCM and the drug regulatory department shall take the lead in organizing the formulation of guidelines for verifying key information on the prescriptions included in the catalog of ancient classic prescriptions.

(10) Strengthen supervision of the quality and safety of traditional Chinese medicine (TCM). Focusing on the regulation of TCM decoction pieces, extend oversight to both upstream and downstream sectors, enforce the primary responsibility of TCM manufacturers, establish a multi-departmental collaborative regulatory mechanism, and explore the establishment of a full-process traceability system covering the production, distribution, and use of TCM materials, decoction pieces, and proprietary Chinese medicines. Within approximately five years, gradually achieve traceable sources, trackable destinations, and accountable responsibilities for key TCM varieties. Strengthen quality supervision and rational use of proprietary Chinese medicines, enhance market sampling inspections of marketed products, and severely crack down on illegal addition of chemical substances to proprietary Chinese medicines. Enhance adverse reaction monitoring for TCM injections. Promote the construction of integrity systems for TCM enterprises by integrating them into the National Credit Information Sharing Platform and the National Enterprise Credit Information Publicity System, and intensify joint disciplinary actions against dishonest practices. Improve the legal framework for TCM quality and safety supervision, and increase accountability for the manufacture and sale of counterfeit and substandard products.

IV. Strengthening the Development of Talent in Traditional Chinese Medicine

(11) Reform the talent cultivation model. Strengthen the cultivation of Traditional Chinese Medicine (TCM) thinking, reform education in TCM colleges and universities, adjust and optimize the structure of disciplines and majors, reinforce the principal status of TCM majors, increase the proportion of classic courses in TCM-related majors, implement graded examinations on proficiency in TCM classics, and establish a system for early apprenticeship and early clinical learning. Increase investment in TCM colleges and universities jointly established by provincial governments, ministries, and national administrations. Include TCM courses as compulsory subjects in clinical medicine majors to improve the knowledge and skills of clinically licensed physicians in TCM. Improve the standardized training model for TCM physicians. Reform and improve integrated TCM-Western medicine education to cultivate high-level talents in integrated TCM-Western medicine. Encourage Western medicine practitioners to learn TCM; allow clinically licensed physicians to provide TCM services and participate in professional title evaluation and appointment for integrated TCM-Western medicine positions after passing assessments. Allow professionals specializing in integrated TCM-Western medicine to participate in standardized training for general practitioners in the clinical category.

(12) Optimize pathways for talent development. Through the development of disciplines and specialties, the construction of major scientific research platforms, and the implementation of major projects, cultivate a cohort of high-level TCM clinical professionals and interdisciplinary innovative leaders in traditional Chinese medicine (TCM), and support the formation of high-level innovation teams. Support TCM universities in collaborating with other higher education institutions to jointly cultivate high-level, composite TCM talents. Establish a mentorship system for senior TCM physicians, linking it to professional title evaluations and awards for excellence. Formulate administrative measures for TCM apprenticeship education. Apprentices recognized by the national TCM administrative department under the State Council may apply for professional degrees in TCM based on equivalent academic qualifications, provided they meet the necessary conditions. Vigorously cultivate technical and skilled personnel in areas such as medicinal herb cultivation, processing of Chinese herbal medicines, and TCM health services. Improve assessment methods for individuals with proven expertise, intensify training for TCM (specialty) physicians, support the establishment of positions for TCM (specialty) physicians in TCM hospitals, and promote the inheritance and development of folk characteristic therapeutic techniques.

(13) Improve the talent evaluation and incentive mechanism. Implement the requirements that allow medical and health institutions to exceed the current wage control levels for public institutions, and that income from medical services, after deducting costs and setting aside various funds in accordance with regulations, shall be primarily used for personnel rewards; improve the compensation system for public TCM medical institutions. Reform and improve the professional title evaluation and appointment system for traditional Chinese medicine (TCM), emphasizing professional competence and work performance, while overcoming tendencies to overemphasize academic qualifications, seniority, and publications. Major national talent programs and academician selections shall increase support for TCM talent, and the establishment of a dedicated TCM group within the Health and Medicine Division of the Chinese Academy of Engineering shall be studied. Research and establish a system for commending and rewarding TCM talent, strengthen national recognition for TCM inheritance and innovation, establish a long-term mechanism for industry-wide commendations, and focus on identifying and promoting young and middle-aged key professionals and inheritors. Various commendations and awards shall be tilted towards grassroots frontline workers and those in hardship areas.

V. Promoting the Inheritance, Openness, and Innovative Development of Traditional Chinese Medicine

(14) Excavate and inherit the essence and core of the treasure house of traditional Chinese medicine (TCM). Strengthen the research and utilization of classic texts, compile the Chinese Medical Canon, formulate catalogs of TCM classics, techniques, and prescriptions, establish a national digital library for TCM ancient books and traditional knowledge, and study and formulate regulations for the protection of TCM traditional knowledge. Accelerate the promotion of living inheritance, improve the academic inheritance system, strengthen the inheritance of academic experience from renowned senior TCM practitioners and traditional skills from veteran herbalists, and achieve digital and video recording. Collect and screen folk TCM empirical formulas, secret recipes, and techniques, and establish mechanisms for cooperative development and benefit sharing. Promote the development of TCM museums, implement TCM culture dissemination actions, integrate TCM culture into national education throughout, further enrich TCM cultural education in primary and secondary schools, and make TCM a cultural consciousness among the public for promoting health.

(15) Accelerate scientific research and innovation in traditional Chinese medicine (TCM). In response to national strategic needs and major scientific questions in TCM, establish multidisciplinary integrated research platforms. Build national key laboratories in priority areas of TCM, and establish a cohort of national clinical medical research centers, national engineering research centers, and technological innovation centers. Within the framework of central fiscal science and technology programs (including special projects and funds), explore the establishment of special national S&T R&D programs for TCM, major special projects on key technologies and equipment, and international mega-science initiatives. Deepen research into and interpretation of fundamental theories, diagnosis and treatment patterns, and mechanisms of action; conduct clinical studies on the prevention and treatment of major, refractory, and rare diseases as well as emerging and sudden infectious diseases; accelerate the development of new TCM drugs; and develop advanced TCM instruments and pharmaceutical manufacturing equipment. Support and encourage innovative R&D of proprietary Chinese medicines for pediatric use. Study and implement science and technology innovation projects. Foster collaborative innovation among enterprises, medical institutions, higher education institutions, and research organizations, aligning innovation chains with industrial and service chains to improve the integrated industry–academia–research innovation model for TCM. Strengthen intellectual property protection and utilization in the TCM industry. Improve management systems that grant greater autonomy to TCM research institutions and personnel, and establish mechanisms to safeguard rights and interests in intellectual property and the conversion of scientific and technological achievements. Reform and improve the organization, acceptance, and evaluation systems for TCM scientific research, avoiding the simplistic application of generic research evaluation methods. Highlight the distinctive characteristics and development needs of TCM, and establish a coordinated planning and management mechanism for TCM scientific research involving both science and technology authorities and TCM administrative authorities.

(16) Promote the opening-up and development of Traditional Chinese Medicine (TCM). Incorporate TCM as a key component in building a community with a shared future for mankind and in international cooperation under the Belt and Road Initiative, and implement special projects for international TCM cooperation. Advance the formulation of international standards for TCM and actively participate in the development of international rules related to traditional medicine. Promote the overseas dissemination of TCM culture. Vigorously develop trade in TCM services. Encourage non-governmental entities to establish high-quality overseas TCM centers, international cooperation bases, and service export bases. Study and promote the steady conduct of international transactions on existing TCM trading platforms. Build the Guangdong-Hong Kong-Macao Greater Bay Area into a TCM hub. Strengthen exchanges and cooperation in TCM with the Taiwan region, and promote the integrated development of TCM across the Strait.

VI. Reform and Improve the Management Systems and Mechanisms for Traditional Chinese Medicine

(17) Improve pricing and medical insurance policies for Traditional Chinese Medicine (TCM). Guided by clinical value and focusing on TCM’s advantageous and distinctive services, strengthen policy support and refine the mechanism for forming medical service prices. When adjusting medical service prices, give priority to those reflecting the technical and labor value of medical personnel, such as TCM services. Establish a medical insurance payment system suited to the characteristics of TCM. Improve coding systems, including TCM disease and syndrome classification, to align with the International Classification of Diseases. Select diseases with clear TCM advantages, well-defined treatment pathways, and transparent costs in batches for implementation of diagnosis-related group (DRG) or disease-based payment, and reasonably determine payment standards. Encourage and guide primary healthcare institutions to provide appropriate TCM services by implementing capitation payments for certain chronic diseases and improving relevant technical specifications. Timely include eligible TCM medical institutions in the network of designated medical insurance providers. Actively incorporate appropriate TCM medical services and traditional Chinese herbal medicines into medical insurance coverage in accordance with regulations. Encourage commercial insurance institutions to develop insurance products covering TCM preventive care (“treating potential diseases”). Conduct research on eliminating markups on TCM herbal decoction pieces.

(18) Improve the investment guarantee mechanism. Establish a sustainable and stable diversified investment mechanism for the development of traditional Chinese medicine (TCM), make overall arrangements for TCM development funds within health expenditures, and increase support. Strengthen investment in the development of TCM, improve the operational conditions of TCM hospitals, and expand the supply of high-quality services. Effectively ensure the implementation of government investment responsibilities for public TCM hospitals. Encourage local governments to establish TCM development funds guided by the government, participated in by social capital, and operated through market-oriented mechanisms. Guide commercial insurance institutions to invest in the TCM service industry.

(19) Improve the management system for traditional Chinese medicine (TCM). Enhance the cross-departmental coordination mechanism for TCM work, strengthen the coordinating role of the Office of the Inter-Ministerial Joint Conference on TCM Work under the State Council, and coordinate efforts in formulating development plans and standards for Chinese herbal medicines.

formulation, quality management, and other tasks to promote the coordinated development of Traditional Chinese Medicine (TCM) and Chinese herbal medicine. Health commissions, drug regulatory authorities, and other relevant departments at all levels must adhere to the principle of placing equal emphasis on Traditional Chinese and Western medicine. In formulating and implementing policies and measures related to TCM, full consideration shall be given to, and opinions from, the competent administrative departments for TCM shall be incorporated. The regulatory mechanism for TCM services shall be improved. In accordance with the relevant provisions of the Law on Traditional Chinese Medicine, a sound TCM administration system shall be established and perfected. Institutions responsible for TCM administrative functions shall be clearly designated at the provincial, municipal, and county levels, with staffing resources allocated reasonably.

(XX) Strengthening Organizational Implementation. Local Party committees and governments at all levels shall formulate implementation measures tailored to local conditions, and incorporate the implementation of these Opinions into their performance evaluations. Centered on the goal of achieving substantial health benefits at lower costs, a number of National Comprehensive Reform Demonstration Zones for Traditional Chinese Medicine (TCM) shall be planned and established, encouraging pilot initiatives in service models, industrial development, and quality supervision. Major central news outlets, key news websites, and other media platforms shall intensify publicity efforts for TCM culture, strengthen and standardize the dissemination and popularization of knowledge on TCM-based disease prevention and treatment, and foster a social atmosphere that cherishes, embraces, and promotes the development of TCM.

Further strengthen the work of traditional Chinese medicine (TCM) in the military, vigorously carry out research and development of new TCM diagnostic and treatment equipment for modern military medical support, and promote the exploration and innovation of new drugs and therapies. Continuously deepen the project to enhance TCM service capabilities at the grassroots level of the armed forces, thereby improving the overall level of TCM support within the military.

Ethnic minority medicine is an important component of Traditional Chinese Medicine (TCM). Relevant local authorities may, in accordance with these Guidelines, formulate and improve relevant policies and measures to promote the development of ethnic minority medicine in their respective regions.