Commercialization of Tibetan medicine in China

Below are two brief articles that were published in Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་]. The first article by Tashi Tsering expresses concerns for the social, environmental and the long-term sustainability implications of the Tibetan medical system due to its commercialization. In response, Tsultrim Gyaltsen provides some thoughtful suggestions on dealing with the situation, including payment of royalty fees for using plants from the Tibetan environment and the necessity of regulation being in the hands of people who possess the knowledge system.

Designing Modernization To Promote Traditional Tibetan Medicine
By Tashi Tsering
Source: Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་], Tibet Justice Center, Vol. 2, No. 6, January 2005.

Tibetan medicine has become a lucrative business yielding million-dollar profits to large pharmaceutical companies in China. Various new policies have been instituted to standardize the production and distribution of Tibetan medicinal products, mainly for commercial and bureaucratic reasons. These new policies are proving to be a debilitating legal framework for the persevering practitioners of the unique Buddhist healing tradition.

According to a study, there are 75 pharmaceutical companies dealing with Tibetan medicine in various corners of the Tibetan Plateau, out of which 30 are run by Tibetans. While the spiritual guidelines of making medicine according to the Buddhist medical texts – Gyushi – are increasingly compromised with the onslaught of industrial production of Tibetan medicine, an interesting issue that comes to point is regarding the efficacy of the healing powers of these medicine. “Amchi (Tibetan doctor) makes medicine to heal the patient but the pharmaceutical companies make medicine to reap profits,” explained a concerned Tibetan doctor from Amdo (now incorporated in Qinghai Province).

New government regulations require all Tibetan doctors to go through a cumbersome registration process. When approved, they are allowed to sell medicine, but only to their private patients. Rinchen-Tsotru-Dashel, a pill that normally costs 20 yuan, is now being sold for 50 yuan by pharmaceutical companies.

“Soon, we will be barred from producing these medicines as Chinese companies are gaining patents over different Tibetan medicines,” said the doctor. To the Tibetan people, the long-term issues involve the survival of this centuries-old healing tradition, as well as the access members of the community have to the tradition. Surely the ultimate subversion of the Tibetan medical tradition would be if the Tibetan people themselves were forced to purchase medicine invented by their own culture and made from their own land, at a higher cost, and from a Chinese company because of a contrived patent system set-up to benefit large industries to the exclusion of local practitioners.

Commercialization of Tibetan medicine also has environmental consequences. Most of Tibetan medicine’s plant ingredients are rare herbs that are endemic to Tibet’s high mountains. Currently, there are no mechanisms in place to check indiscriminate harvesting of these species. The commercialization of Tibetan medicine has dramatically increased demands for these ingredients, resulting in the widespread, unsustainable removal of certain plant species. Utpal Ngonpo (Blue poppy, meconopsis sp.), marketed as a cure for Hepatitis B by Chinese companies, is one such rare plant species that the Tibetan doctor fears might not survive if the current rate of harvesting continues.

The challenge for policy makers in China is not just the integration Tibetan medicine into the mainstream economy and modes of production, but also the preservation and promotion of a unique tradition of medical knowledge and expertise. While greater access to, and availability of, Tibetan medicine is a worthwhile goal, it will mean very little if the tradition which produced it is swallowed up and destroyed in the process.
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Response from Tsultrim Tsering Gyaltsen
Source: Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་], Tibet Justice Center, Vol. 3, No. 1, March 2005.

Regarding your last editorial, "Designing Modernization To Promote Traditional Tibetan Medicine," there are some issues that should be given consideration for all parties involved at the practice or production level in "traditional" Tibetan medicine.

The plants and substances used in Tibetan medicine are also part of the fabric of life particular to Tibet and therefore a part of the heritage of the Tibetan people. The fact is that companies selling Tibetan medicines are not only profiting from the knowledge of Tibetan medicine but are also using the actual plants integral to the wholeness of the land. In consequence, I suggest the following two conditions.

1) There should be strict limits established regarding the sustainable harvest of these plants and that all companies, in some fair way, should share in that supply and those restrictions.
2) Non-Tibetan owned companies should pay a royalty fee for using plants from the Tibetan environment. When companies substitute foreign plants for native Tibetan plants then the resultant production should not be called Tibetan medicine.

Such measures could insure benefit for future generations in three ways.

1) The integrity of the environment would be assured by mitigating potential environmental damage from overuse.
2) They would create an economic basis for the enforcement of those regulations.
3) There would be an ongoing source of funds to support further research and training in all aspects of the tradition of Tibetan medicine.

Furthermore regarding the production of medicines the traditional texts often specify many conditions under which the ingredients for the medicines were to be collected, handled, and prepared. The texts may state, for example, that certain plants are to be collected only in certain months because their medicinal properties are then active, or that some medicines were only collected from north facing slopes, or in a certain season, or at night, or during a certain phase of the moon. These are some of the many subtleties that, in combination, make Tibetan medicine effective. It does not suffice for a manufacturer to have a list of ingredients that can be haphazardly combined to hopefully produce a positive result.

If what is called a "Tibetan medicine" is in the sole judgment of physicians, fully qualified in the Tibetan medical tradition, to be found to be of diminished quality, efficacy, or that it has a negative consequence for the environment as a result of its production, that product and its producer should be made to conform to traditional practice or the production should be discontinued.

Furthermore if the Tibetan medical system is to be regulated it should be done from the bottom up, not the top down. It must be put under the supervision of those who are intimately familiar with the traditional training and all of the prerequisites for the qualification of doctors and the production of the medicines. In such case, there should be assembled a congress of knowledgeable and qualified Tibetan doctors to establish the requirements for the formulation of the compounds used and the practice of the traditional medicine.

Regulation should come only from within the ranks of those who have an intimate understanding of the tradition and not by governmental officials or profit driven companies who know little or nothing of its nuances. The members of that congress should provide certification for a qualifying product that the product has been produced in accord with tradition and is an "authentic Tibetan medicine." This is the only way to insure the continued efficacy of the medicines and to prevent the bastardization of the Tibetan medical tradition for profit.

With this approach the twin goals of establishing standards of practice and production would be accomplished along with the guarantee of the preservation of all of the many nuances of understanding that are critical to the authentic continuation of the tradition.

A final point is that all names traditionally used for medicines should be part of the public domain. They should be available for use to anyone who produces medicines in accord with the above standards. They must not belong to any single company who could disenfranchise other legitimate producers of traditional medicines simply by controlling the rights to the names.
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"Climate Change as a Human Rights Issue for Subsistence-Based Societies"

Is it fair if the climate costs of development of industrialized economies such as US and China are borne by subsistence-based societies like those of Tibetans and the Inuits? Should the victims of climate change be compensated by its perpetrators? What if Tibetan nomads and pastoralists are being blamed and forcefully relocated for grassland degradation that is caused by global warming? Read an article by Professor Julia Klein of Colorado State University addressing some of these issues.




Climate Change as a Human Rights Issue for Subsistence-Based Societies
By Julia Klein
Source: ource: Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་], Tibet Justice Center, Vol. 2, No. 6, January 2005.

In December 2004, a meeting of the United Nations Framework Convention on Climate Change took place in Buenos Aires, Argentina, in anticipation of the upcoming entry into force of the Kyoto Protocol. At the same time, the Inuit -- 155,000 seal-hunting peoples scattered around the Arctic -- announced they were preparing a petition to the Inter-American Commission on Human Rights stating that the United States, by contributing substantially to global warming, is threatening their existence. The Inuit people's lives and culture depend upon the Arctic ice. Scientists have concluded that climate change caused predominantly by human influences is causing that ice to melt and causing other impacts to the Inuit way of life. In their petition, the Inuit assert that because the United States is responsible for 25% or more of the greenhouse gas emissions that are contributing to climate change, the United States has an international obligation to prevent these human rights violations. The Inter-American Commission will forward the petition to the United States, which is the respondent, hold a series of hearings on the matter and determine whether this constitutes a violation of human rights.


[Photo by Raul Gutierrez]

Just as the Inuit rely on the arctic ice for their subsistence, Tibetan pastoralists depend on the alpine rangelands of the Tibetan Plateau for their survival. The pastoralists rely on the rangeland vegetation to convert the sun's energy into products - via domestic herbivores - that form the basis of their culture and subsistence. These products include food, clothing, housing, fuel, stored wealth, and transportation. The Tibetans also directly rely on vegetation for goods such as medicinal plants and other products.

Scientists, range managers and development personnell working on the Tibetan Plateau have primarily ignored issues of climate warming effects on the Tibetan rangelands. Rather, they have focused on the Tibetan rangelands with respect to grazing issues. The Tibetan rangeland debate is often couched in terms of whether the Tibetans are "rational" or "irrational" land managers, whether animal densities are increasing or decreasing on the Tibetan Plateau, the merits and drawbacks of fencing and sedentarization, and the effects of small mammal grazing on the rangelands. While most of these issues are very important, they should be studied in the context of a changing underlying climatic condition. These topics also highlight the propensity for scientists, range managers and development personnell working on the Tibetan Plateau to observe rangeland degradation, observe grazing animals (or fences or small mammals), and make a causal connection between the two based on observation rather than a valid scientific analysis of cause and effect.

While very little research has been conducted on how climate warming may affect ecosystem goods and services on the Tibetan Plateau, work has recently been published in the scientific literature (Klein et al. 2004) that shows climate warming could cause as much as a 36% decline in plant species diversity on the northeastern region of the Tibetan Plateau. This includes declines in medicinal plant species and palatable forage species richness. This work also indicates warming could reduce overall vegetative productivity and increase shrub encroachment in this region of the Tibetan Plateau (Klein 2003).

There is a consensus among the scientific community that much of the present climate warming on Earth is due to human activities (IPCC 2001). According to the New York Times, the United States was the only country at the climate meetings in Buenos Aires which continues to question the climate change science. There is also evidence that climate warming is occurring on the Tibetan Plateau (Thompson et al. 2000). China, which ratified the Kyoto Protocol in 1992, is the second largest emitter of greenhouse gases, but per capita emissions of global warming pollutants in China are just 15 percent of U.S. levels. China accepted no mandatory greenhouse gas emissions target under the Protocol -- only developed countries are subject to binding emission targets in the Kyoto Protocol's first emission control period, 2008 to 2012.

Climate warming is an unusual environmental problem because the primary actors driving the changes can be far removed from the most vulnerable recipients of the climate change effects. This large spatial disconnect between drivers and recipients is due to the nature of greenhouse gases, which mix relatively rapidly in the atmosphere across the globe. The Inuit people can assert their rights in the international arena because there has been careful documentation of climate change in the arctic, because the ecological and social impacts of climate change on the Inuit people have been rigorously studied for over a decade, and because supporters of the Inuit people recognize the links between politics, human rights and climate change. The Tibetan pastoralists, who are potentially highly vulnerable to climate change impacts, will also need to rely on rigorous science and an interested community to assert their rights to a resource base that is being affected by anthropogenic climate changes and to bring this issue to the attention of the international community.

References cited:
1. Intergovernmental Panel on Climate Change (IPCC) 2001. Climate change 2001: Summary for Policymakers. In: Climate Change 2001: The Scientific Basis. Contribution of Working Group I to the Third Assessment Report of the Intergovernmental Panel on Climate Change (ed. Houghton, J.T., Griggs, D.J., Noguer, M., van der Linden, P.J., Dai, X., Maskell, K., & Johnson, C.A.). Cambridge University Press, Cambridge.
2. Klein, J.A., J. Harte & X.Q. Zhao. 2004. Experimental warming causes large and rapid species loss, dampened by simulated grazing, on the Tibetan Plateau. Ecology Letters 7(12) 1170-1179.
3. Klein, Julia A. 2003. Climate warming and pastoral land use change: implications for carbon cycling, biodiversity and rangeland quality on the Northeastern Tibetan Plateau, PhD Thesis, University of California, Berkeley.
4. Thompson L.G., Yao T., Mosley-Thompson E., Davis M.E., Henderson K.A. & Lin P.-N. (2000) A high-resolution millennial record of the South Asian monsoon from Himalayan ice cores. Science, 289, 1916-1919.

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Development and investment in politically volatile regions

There are no stringent international laws to regulate foreign investment in politically volatile regions like Tibet. Canada, for example, is a world leader in the mining industry and is actively seeking to profit from Tibet's gold and copper even though the ownership of Tibet's resources is a disputed issue. Tibet could benefit from foreign investment but it is difficult to ensure a fair and sustainable development under current political conditions. The Central Tibetan Administration of the Dalai Lama has laid out a guideline for foreign investment. In the following article, Carole Samdup of Montreal based Rights and Democracy opines that the Tibetan guidelines would have been more appropriate with a human rights based approach for development.

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A Human Rights Framework for Development in Tibet
By Carole Samdup
Source: Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་], Tibet Justice Center, Vol. 2, Issue 3, May 2004.

When the Tibetan government-in-exile (TGIE) released its new Guidelines for International Development Projects and Sustainable Development in Tibet last month, it emphasized a "needs-based approach" for planning and implementation of development initiatives on the high plateau. In adopting this needs approach, the TGIE has failed to take into account the current momentum within development circles for a rights-based framework for development planning, implementation and evaluation strategies.

In describing its rationale for a needs-approach, the TGIE said:

"It is time for a new approach based directly on human needs because the human needs approach is direct, observable, locally-based and not reliant on mammoth investment, grandiose visions or ideological convictions."

A needs-based approach to development in Tibet abandons the Tibetan people to the whims and discretionary policies of politicians within the various levels of government in China as well as those of Western bureaucrats and the aid agencies they control. Moreover, a needs approach does nothing to address the negative impact that sometimes results from the activities of international agencies or transnational corporations. The Tibetan people are provided neither dignity nor legal recourse should their human rights be violated as a result of inappropriate or harmful “development” practices of any type.

A rights framework for development is holistic in nature and promotes the realization of all human rights – civil, political, economic, social and cultural rights. It emphasizes the interdependence between democratic governance and social progress. Far from focusing on "grandiose visions" or "ideological convictions," a rights framework places the human person at the centre of the development process and provides an internationally-recognized legal framework for meaningful individual and collective participation. This quality is particularly relevant for the Tibetan people living under Chinese rule.

The trend towards rights-based frameworks for development stems primarily from concerns about the erosion of national autonomy in the face of globalisation and, in particular, of economic liberalization and integration. It is related to the inability of national governments to create or protect national legislation designed to ensure equitable distribution of wealth and non-discriminatory provision of services within their borders. A rights-based framework also responds to the particular problems faced by a people living under the political control of another group with conflicting interests or priorities for development programming.

In the case of Tibet a rights-approach would, theoretically at least, empower the Tibetan people to claim such things as the continuous improvement of living standards, non-discrimination in the provision of healthcare or education, and active participation in decision-making with regards to the use of natural resources. It would influence programming by Western agencies to prioritize activities that serve those objectives.

A rights framework for development provides a number of other distinct advantages. Primarily, it uplifts the human person to a position of dignity in that he/she claims specific inalienable rights or entitlements from government rather than accepting random benefits provided on a discretionary basis for undetermined lengths of time and under variable conditions. Moreover, the non-discrimination requirement that governs all human rights mitigates social exclusion by requiring that special emphasis is placed on the delivery of development benefits to vulnerable sectors of society, such as rural people.

Oxfam International has articulated the value-added of a rights framework for development in a recent paper entitled, International Frameworks, Policies Priorities and Implications: A Guide for NGOs:

"A rights approach assumes that there is an acknowledged duty-bearer with a responsibility to respect, protect and fulfil the rights of a legitimate claimant or rights holder. The welfare concept of beneficiary is incompatible with a rights-based approach. Further, the language of unfulfilled or denied rights, must replace the language of needs, an idea of entreaty or charity that is also incompatible with a rights-based approach".

In fact, a needs-approach may be effective in democratic states with active civil societies and freedom of expression, association and opinion. In that situation, government is generally responsive to community participation and accountable to public scrutiny of the implementation process. In Tibet, this is not the case. Development priorities are determined in Beijing, often with political objectives, and foreign development assistance is required to adopt the overarching design of that development strategy. Even if some needs are met along the way at the project level, there is no over-arching framework that addresses the structural causes of under-development.

While the substantive content of the TGIE guidelines is comprehensive and relevant, it is the framework in which it is written that fails to empower the Tibetan people to adequately lead their own development process. What is required is a fresh look at the meaning and goal of development in its broadest sense. A rights framework for the TGIE's development recommendations would build Tibetan autonomy by providing the Tibetan people with a measure of ownership over their development process.

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Letter to the Editor
From the Environment and Development Desk of the Tibetan Government-in-Exile
Trin-Gyi-Pho-Nya, Vol. 2, No. 4, July 2004

This is in response to Carole Samdup's comments (Op-ed: A Human Rights Framework for Development in Tibet) on the Guidelines for Development in Tibet in the last issue of TRIN-GYI-PHO-NYA, May 06, 2004, Vol. 2, No. 3. Her comments are highly appreciated. However we feel that our stress on needs-based development as an alternative to China's present development strategy in Tibet under the Rationale section of the Guidelines has been misunderstood.

A careful study of the Guidelines in its entirety would show that we are deeply concerned about the rights of the Tibetan people to participate in the development process right from the planning stage. When we say "a new approach based directly on human needs....", we are not necessarily advocating the conventional needs-based strategy. We are talking about a strategy that addresses the basic needs of the Tibetan people through their own active participation.

In the Guidelines, the last of four underlying principles, Participatory and Needs-based Development, should make our stand clear:

"Usurpation and co-option of public powers by groups or individuals becomes self-development of vested interests rather than addressing the interests of the people. To ensure that development projects are sensitive and accountable to the needs of the people, empowerment of the grassroots level populace through genuine participation is essential. Participatory development would naturally safeguard the needs of local people...

So, when designing projects, it is crucial that the development agencies find skillful and innovative ways to assess the needs and involve the local populace, and at the same time avoid the clear danger of putting them at risk due to the ire of local authorities. Institutionalisation of procedures and democratic governance at the grassroots level are essential steps toward self-governance..."

The Guidelines have advocated neither a needs-based nor a rights-based approach per se. Instead, we have taken a pragmatic and flexible approach to development based primarily on the needs of Tibetans. To be precise, under the section Crosscutting Guidelines, it says:

"...The Tibetan worldview and modern synthesis of appropriate development practices encourages a respectful, thoughtful approach to development that embraces many factors rather than a narrow, technical compliance with shallow and literal considerations..."

The Guidelines are an attempt to facilitate and promote better development practices under the present, complicated situation. They emphasize that the needs of the Tibetan people should be articulated by the Tibetans themselves and not by the State or other outside actors.
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Tibetan perspectives on the significance of mountains and lakes

[Photo: Tashi Tsering]

By Tenzin Choezin, Tibetan Buddhist Resource Center, New York
Translated by Tenzin Bhuchung, UC Berkeley Rotary Peace Scholar
Original source: Trin-Gyi-Pho-Nya [སྤྲིན་གྱི་ཕོ་ཉ་], Tibet Justice Center, Vol. 1, Issue 3, January 2004.

Tibetans’ traditions and their way of life are intimately linked to the landscape: its spectacular high mountains and pristine lakes. The significance of landscape finds meaning and expression both in pre-Buddhist Bon tradition as well as in Tibetan Buddhist culture.

According to the indigenous Bon tradition, Tibetans believe that mountains, lakes, ponds, springs and river sources are dwelling places of the protector gods of Tibet and most of these sites are named, often in a modified version, after the name of a particular deity believed to be dwelling there. Furthermore, all mountains and lakes have at least one amazing legend surrounding them. The sky-touching mountains are believed to be stairways to heaven (ལྷ་ཡུལ་/Lha-yul) and the crystal clear lakes as gateways to the underworld realm of the Nagas (ཀླུ་ཡུལ་/Lu-yul).

From a Tibetan Buddhist interpretation, mountains like the Jomolangma (ཇོ་མོ་གླང་མ་/Everest), Ghung-gyal, Amnye Machen and many other high mountains of Tibet are regarded as abodes of the gods and the twelve female guardian deities that were believed to be present at the formation of the Tibetan landscape and civilization. Mountains such as Ghang Rinpoche (གངས་རིན་པོ་ཆེ་/Mount Kailash), Mount Tsari Tsagong (ཙ་རི་) and Mount Khawa Karpo (ཁ་བ་དཀར་པོ་) are regarded as heavenly dwelling places of various trans-worldly deities.

Even lakes such as Mapham Yutso (མ་ཕམ་གཡུ་མཚོ་/Lake Manasarovar), Namtso Chukmo (གནམ་མཚོ་ཕྱུག་མོ་), Yamdrok Yutso (ཡར་འབྲོག་གཡུ་མཚོ་/Turquoise Lake), Trishor Gyalmo (མཚོ་སྔོན་ཁྲི་ཤོར་རྒྱལ་མོ་/Kokonor Lake) and others are widely revered as abodes various female deities such as Dorji Phagmo (རྡོ་རྗེ་ཕག་མོ་/Vajra Yogini). There are also lakes that Tibetans believe reveal prophetic visions in them such as Lhamo Lhatso (ལྷ་མོ་བླ་མཚོ་), Thod-lung Tsehu (སྟོད་ལུང་མཚོའུ་), O’lkha Tsehu (འོལ་ཀ་མཚོའུ་), and Tsari Yutso (ཙ་རི་གཡུ་མཚོ་). These lakes are revered as miraculous sources of protection and are believed to have helped in identifying the next incarnation of Lamas (བླ་མ་/spiritual teachers) including the current Dalai Lama.



Three lakes in eastern Tibet—Kyaring (སྐྱ་རིང་), Ngoring (སྔོ་རིང་) and Doring (དོ་རིང་) —are surrounded by high mountain ranges with one mountain rising distinctively higher. Tibetans regard this area as the dwelling place (བླ་གནས་) of King Ling Gesar (གླིང་གེ་སར་རྒྱལ་པོ་), and have named the highest mountain after the legendary King. It is a common practice for local Tibetans to offer prayers in these sacred sites. There are also numerous natural fountains and hot springs that Tibetans believe are blessed by the Medicine. Tibetans believe that when they drink or bathe in them, many chronic diseases can be cured. Then there are lakes such as Nagphak Tso and O’tso that serve as winter migration places for rare and endangered species of birds like the black-necked crane (ཁྲུང་ཁྲུང་སྐེ་ནག་).

In particular, Ghang Rinpoche (གངས་རིན་པོ་ཆེ་/Mount Kailash) and the River Ganga (ཆུ་མོ་གངྒ་) are sacred places of worship not only for Tibetans but also for many in India and Nepal. Many of Tibet’s high Lamas (Dharma teachers) have built monasteries and meditation houses near these sacred sites, while others have spent their lives there in solitary contemplation. Thus these places are considered doubly blessed. Animals dwelling in these sacred places are regarded as divine manifestations. Respect for the lives of these animals is such that not even a small plant is cut, let alone the animals killed. Instead, Tibetans customarily pile white pebbles into a heap in such places to symbolize the enhancement of their pure motivations. Instead of fishing, Tibetans throw precious objects into the lakes as offerings to the deities believed to be residing in them.

Even today, the Tibetan people deeply believe in the world of gods (ལྷ་)and demons (འདྲེ་). In all their worldly activities, they evoke gods and spirits for their accomplishment. Such traditional practices and belief systems associated with local ecosystems are an inseparable part of Tibetan culture and way of life.
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