Traditional Chinese medicine is a defining legacy of Chinese civilization and remains one of the major traditional medical systems still widely practiced in the world today. At a time when global health faces shared challenges such as population aging, the rising prevalence of chronic diseases and escalating health care costs, the holistic worldview, systems thinking and preventive philosophy embedded in TCM have become more relevant across cultures and institutional contexts.

In recent years, TCM has played a prominent role in global health governance and its internationalization has made substantial progress. TCM has spread to about 200 countries and regions and more than 100 member states of the World Health Organization recognize acupuncture therapy. TCM-related content has been incorporated into multiple free trade agreements and regional cooperation mechanisms.

The establishment of overseas TCM centers and the deployment of medical assistance teams have continued to advance. China has supported the high-quality development of around 30 overseas TCM centers and dispatched medical teams to more than 70 countries and regions. TCM consistently serves as an important component of China's foreign medical assistance, laying a solid foundation for its standardized and sustainable development abroad.

In 2019, the WHO approved the inclusion of a separate chapter about TCM in the 11th Revision of the International Classification of Diseases for the first time. TCM has since been officially included in the global medical system. Also, the International Organization for Standardization has issued 119 TCM-related standards, covering terminology, diagnosis and treatment, medical devices and quality control.

The pace of TCM products, technologies and services going global has accelerated markedly in recent years. More than 100 traditional Chinese medicines have been registered and marketed in countries participating in the Belt and Road Initiative, while trade in TCM services and digital applications continues to expand. TCM-related practices and knowledge have also been inscribed on UNESCO's lists of Intangible Cultural Heritage and the Memory of the World, providing important cultural anchors for the international community to better understand TCM systematically.

Despite these achievements, the internationalization of TCM still faces significant challenges. It faces substantial regulatory and market access barriers, as countries differ widely in their requirements for drug registration, approval and supervision. In many jurisdictions, evaluation systems tailored to traditional medicines have yet to be established, and TCM is often categorized as complementary or alternative medicine, resulting in complex procedures and high entry costs. Some countries also impose high tariffs or cumbersome import procedures on Chinese medicinal materials and related products.

TCM is grounded in Eastern philosophy, and due to differing cultural backgrounds, skepticism about its efficacy and safety persists in some Western societies. The theoretical framework and diagnostic approaches of TCM differ from those of modern biomedicine and there is a paucity of high-quality, internationally compliant multi-center clinical studies. As a result, some markets lack a clear understanding of TCM or remain cautious about its use.

There is also a dearth of professionals with expertise in TCM and a solid understanding of international rules, legal systems and cross-cultural communication. Existing training systems have yet to fully meet the needs of cultivating such composite talent. Some TCM practitioners engaged in international cooperation face challenges in accurate terminology translation and effective cross-cultural communication, which affects the quality of international exchanges and limits TCM's development on the global stage.

Some steps can help advance the international influence of TCM. First, TCM services should shift from short-term assistance to long-term capacity building. International education systems for TCM should be strengthened through degree programs, vocational training and continuing education, cultivating local TCM professionals and generating enduring cooperation outcomes.

The key lies in organically integrating medical services, education and institutional development so that TCM can take root locally and overcome common challenges related to sustainability and coordination. For example, the Zhejiang Chinese Medical University and the New Zealand College of Chinese Medicine jointly established a TCM center in New Zealand, which has gradually shifted from project-based exchanges to long-term collaboration through the regular deployment of Chinese faculty and blended online and offline training models. Building on this foundation, coordinated efforts in clinical services and TCM products have enabled standardized application of herbal granules within local diagnostic systems, with expansion underway at the industry level.

Second, scientific research and standards should play a supporting role in enhancing international credibility. Continued efforts are needed to advance the standardization and normalization of TCM and to actively participate in international rulemaking. Clinical studies that meet international ethical and methodological standards, particularly multicenter trials, should be encouraged to strengthen the evidence base for TCM and facilitate its integration into mainstream medical systems.

Third, industry and culture should play a broader role in amplifying the overall impact of TCM. Support should be given to the international registration of TCM products and to the development of service trade and digital health models.

TCM can play a distinctive role in global health governance and contribute Chinese wisdom to the improvement of human health worldwide by upholding the essence of tradition while pursuing innovation, proactively aligning with international rules, strengthening the cultivation of internationally oriented talent and making effective use of modern technologies.

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