Summary of the Core Content
This article discusses how complementary and alternative medicine (such as traditional Chinese medicine, acupuncture, and herbal remedies) should be regulated. The main argument is that these practices should not be completely unregulated (as this could create a haven for fraud), nor should they be subjected to the same strict standards as modern drugs (which could stifle a heritage of thousands of years of experience). Instead, a “regulatory sandbox” approach is needed—a framework that allows these practices to develop within a bounded and supervised environment, where the good methods are retained while the ineffective ones are eliminated, thus protecting both tradition and mitigating risks.
1. Complementary and Alternative Medicine Is Not a Niche: It’s a Part of Everyday Life for Many People Worldwide
You might think that traditional Chinese medicine and acupuncture are just used by a minority, but data shows otherwise. Approximately 80% of the world’s population has used some form of complementary and alternative medicine (according to the World Health Organization, which surveyed 170 countries and found that 40%-90% of the population uses such practices). Even in developed countries like Canada and the United States, 70% and 40% of adults have used these therapies, respectively. Americans spend over $30 billion each year on these treatments out of their own pockets (most of which are not covered by health insurance).
These therapies are not just based on superstition; many modern drugs have their origins in traditional medicine. For example, artemisinin comes from an ancient formula by Ge Hong during the Eastern Jin dynasty, aspirin is derived from the traditional use of willow bark, and the ingredients for birth control pills come from wild yams. Even the U.S. health insurance system includes acupuncture as a treatment for chronic lower back pain (with conditions such as requiring certified practitioners and limiting the number of treatments)—indicating that there is indeed a real demand and value in these practices.
2. Both Extremes Are Unworkable: Either Frauds Will Flourish or Tradition Will Be Lost
- Complete Unregulation = A Haven for Frauds: The U.S. management of dietary supplements, for example, does not require proof of safety and effectiveness before they are marketed; responsibility is only pursued after problems arise. As a result, the market is flooded with false claims about miracle cures, and herbal remedies can interact dangerously with Western drugs (such as the anticoagulant warfarin), delaying or even causing fatal outcomes.
- Overly Strict Regulation = A Loss of Heritage: If all traditional therapies had to undergo the same rigorous “double-blind trials” as new drugs (where neither doctors nor patients know which treatment is real or a placebo), practices like acupuncture and qigong would be eliminated. Thousands of years of cultural and medical knowledge would be lost.
China’s Traditional Chinese Medicine Law has struck a balance: it requires registration for TCM clinics, separate assessments for practitioners, and regulation of classic formulas, although there are still gaps in coverage (such as in areas related to health maintenance and cross-border supplements).
3. The Regulatory Sandbox: A “Middle Ground” Inspired by Finance
The term “sandbox” originates from the financial sector. In 2015, the UK created a testing ground for fintech companies, allowing them to test new products in a supervised environment with temporary exemptions from certain rules, while continuously refining the regulations. The medical field has also adopted this approach. In 2024, the UK launched the “AI Airlock,” the world’s first regulatory sandbox for AI in healthcare, where 11 AI-based medical companies are testing technologies (such as cancer diagnosis and eye disease detection). Regulators and companies work together to develop better regulations based on these trials.
Complementary and alternative medicine also needs such a sandbox: it’s not about lowering safety standards but about allowing effective therapies to be tested within a controlled framework.
4. Four Practical Approaches to Establishing a Regulatory Sandbox
The article proposes four practical steps:
1. Set Clear Boundaries: Start with small-scale trials in designated areas (such as free trade zones or pilot hospitals for integrated TCM and Western medicine) and only allow therapies that are low-risk, highly demanded, and lack sufficient evidence to be tested comprehensively.
2. Closed-Loop Verification: Establish rules for the inclusion of these therapies in regular medical practice; if they prove effective, they can be incorporated; if not, they should be removed.
3. Risk Classification: Use a tiered regulatory system like Australia’s, where low-risk products (such as long-used herbal remedies) can rely on traditional usage evidence rather than undergoing new drug trials, while high-risk therapies require more stringent evaluation.
4. Mandatory Transparency: Products within the sandbox must clearly list their ingredients and provide a rationale for their use. Exaggerated claims should be prohibited, and adverse events must be reported immediately; problematic products should be removed from the market.
Conclusion: A Balanced Approach Is Needed
Ordinary patients do not want an unregulated or overly restrictive environment. What they need is a regulated framework that ensures accountability, evidence-based practices, and the option to exit if necessary. Complementary and alternative medicine should not grow unchecked in the shadows, nor should they be completely banned. Instead, a balanced approach that allows these therapies to develop while protecting patients’ safety is essential. After all, many medical breakthroughs have originated from practices that were once unproven but proven effective. By maintaining an open-minded attitude, we can avoid missing the next artemisinin discovery.