Marseille 2007
| Abstract #345 - Neo-traditional treatments for AIDS in China: national AIDS treatment policy and local/global use of TCM (Traditional Chinese Medicine) | ||||
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Session: 8.5: Traditional and alternative approaches (Parallel) on Monday @ 11.00-12.30 in 5 Chaired by Jonathan Eflord, Marc Egrot Authors: Presenting Author: Dr Evelyne Micollier - IRD, France |
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| Additional Authors: | ||||
| Aim: The study aims at documenting the role of TCM within the framework of the AIDS treatment scheme in the Chinese context, and at approaching its globalizing use in other contexts. Since the 1950s, China integrates in its state-run health system, a neo-traditional medicine (TCM, zhongyi) deeply rooted in traditional scholarly medicine while including references of modern biology and of standardized biomedicine in its transmission, body of knowledge and practice. Other components and methods of working of TCM may well fit in dynamic models of pluralistic healthcare systems as Chinese medicine is practiced in non-institutional settings as well. | ||||
| Method / Issue: Using tools of social anthropology, the methodology is based on the collection of qualitative data, documentary and archival research, and qualitative research analysis. Ideally, observed facts and discourses will be apprehended in their complexity through in-sites observation and interviews. Still in an exploratory phase, this research is part of a social sciences programme on AIDS jointly run by IRD and CAMS/PUMC. Field research is currently conducted in Beijing. | ||||
| Results / Comments: Drawing on both rationales, scientific and traditional, and on the fact that TCM has become an icon of national identity, its legitimacy tends to be built on evidence-based medicine as far as possible following the on-going trend in biomedical research, and on the valuation of ancient knowledge and Chinese cultural heritage as a whole in line with a current trend for patrimony preservation. According to the results of some clinical trials, TCM herbal preparations may have an immunity protective and/or rebuilding function in patients in the early and middle stage, showing effects in reducing viral load and improving symptoms. The role of TCM can partly be explained by unsolved issues on scaling up treatment and care in China. Within the national scheme, some antiretroviral drugs have been put into production while others are being imported. Simultaneously, the government has scaled up standardization of ART and AIDS research in biomedicine and TCM. Although first-line essential drugs have reached the ART standards recommended by WHO in resource-poor settings, the implementation of combined treatment policy seems to be linked to obstacles in the scaling up of the national programme and shortcomings in its operational phase resulting for instance in lack of adherence and compliance among patients complaining about severe side-effects. | ||||
| Discussion: Since 2004, government-provided ART regimens have become a controversial social issue involving conflicts of interest among a number of national and global actors. Therefore, until now, there is no free access to second-line treatments, and available first-line treatments may be the cheapest but not the best combinations either. In this context, the use of TCM is discussed: is it conceived and implemented as a complementary or an alternative treatment, in the long term or short term? To broaden the scope of the discussion, its globalized use is relevant as well: indeed, a circulation of local/global knowledge and practice may be observed while globalizing TCM gradually becomes a valued CAM (Complementary and Alternative Medicine) in treatment schemes of chronic diseases such as cancer and AIDS out of China. | ||||
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