Traditional Chinese medicine (TCM) is expected to play an important role in meeting the healthcare challenges of Singapore's ageing society, said Health Minister Gan Kim Yong. As such, the Ministry of Health (MOH) has dedicated a S$3 million fund to encourage collaborative clinical research in TCM. 

In an international conference on the modernisation of Chinese medicine on 24 October, he said that acupuncture for specialised areas such as pain management and stroke rehabilitation is an important step to a more holistic approach to patient care.

Treating pain through acupuncture is a common practice in both Chinese clinics and hospitals where Western medicine is practiced, but a major hindrance faced by practitioners is the lack of knowledge mainstream doctors have in Chinese medicine.

"They tend to regard it with a great deal of suspicion," said Professor Hong Hai, chairman of the organising committee, International Conference on the Modernisation of Chinese Medicine.

"If Western doctors were to have a better understanding of Chinese medicine, they could ask their patients if they are taking Chinese medicine, and what they are taking. If they had basic knowledge, they would be able to say: "That's fine, it's just a tonic. It's not going to interfere with what I do."

Merging Western and Chinese disciplines together

Therefore, Gan has pointed out that the integration of three important aspects - education, clinical practice and research - is essential in the modernisation of TCM, due to the increasing demand for TCM treatment in Singapore and the rising number of patients.

He urged the TCM community to continuously improve on professional standards, strengthen academic research and enhance academic exchange and research cooperation.

The World Health Organisation Director-General Margaret Chan also attended the conference and lauded Singapore's progress in TCM, saying that the country has pioneered good policies that shield against the profession's perceived dangers. She also said that Singapore's regulatory control of TCM has contributed to the modernisation of the profession.

"The Government has a legal framework to regulate TCM because it is used in a much bigger proportion," she said, adding that, “Whether the practitioners are properly trained as well as registered and the medical products, particularly the ready-to-use forms, they also look at in terms of safety before they are licensed to be sold on the market."

S$3 million is not enough, says ACMS

"The focus of such research initiatives should be on conditions which are prevalent in Singapore, such as chronic diseases. TCM professionals can work alongside medical colleagues to improve patient outcomes. I encourage the healthcare community to form effective partnerships to conduct such research," Gan said.

But the Academy of Chinese Medicine Singapore (ACMS) executive council member Hong Hai said, "We need more funding and a bigger population sample. The S$3 million is actually 'peanuts'."

TCM physician Karen Wee concurs and explains that in pharmaceutical research, one drug can take up to S$500 million to $S1 billion to study. However she stresses that they are not trying to produce drugs but instead carry out clinical trials to provide substantial evidence.

"If TCM has an advantage in controlling or treating certain diseases, clinical trials can be held to see if using a mix of Western medicine and TCM, or TCM alone is more effective," she added.

Wee also says that research capabilities of doctors trained in western medicine can contribute to the research on TCM. But Professor Hong said that because many traditional remedies cannot be patented and sold as a brand, the lack of incentive might dissuade companies to do trials.

Looking into the future, there is a need to formulate policies as well and associate professor Joanne Yoong, director of the National University of Singapore's centre for Health Services and Policy Research said that there is a need for a more systemic, outcome-based framework beyond clinical research.

"We need a framework... How is it paid for? How is safety assured? How is quality assured?" she asked. She also said that health expenditures coupled with rising life expectancies make this task more urgent.

For now, there is minimal but sure progress as MOH has granted six projects with the S$3 million fund - four of them related to acupuncture treatment. MIMS

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