Revitalizing Japan through Industrializing Kampo Medicine
September 14, 2016
Dr. Kenji Watanabe
Professor, Keio University Faculty of
Environment and Information Studies,
School of Medicine
An ancient Chinese proverb says “Superior doctors cure the country, mediocre doctors cure patients and inferior doctors cure actual illness.” I recall Genzui Kusaka, a physician who strove to save the country towards the end of Edo Period. Former Prime Minister of Malaysia Dr. Mahathir was also one of the leaders with a medical background. If I may be so bold to say, I wish to cure this country by kampo (traditional herbal medicine). I also encourage my medical students to think hard about the future of our country that struggles with the heavy burden of medical expenses totaling 41.5 trillion yen in FY 2015.
I launched the Kampo Industrialization Consortium in 2013, together with Governors of three prefectures (Kanagawa, Nara and Toyama). It aims to promote kampo both domestically and internationally by reinforcing collaboration among value chain partners towards facilitating its industrialization and extending healthy life-span. Membership currently totals 18 companies and 6 individuals, with cooperative organizations (11 prefectures, 15 municipalities, 7 entities/universities) and 10 advisors.
I want to emphasize that our medical and health care system becomes sustainable only when we diverge from the Western practice, restore the traditional Japanese values and switch back to the Japanese-style treatment including kampo, acupuncture and moxibustion. I also think we can utilize abandoned farmlands and revive the agroforestry industry by cultivating medical herbs.
Japan’s population pyramid will become inverted by 2055. Our public broadcaster NHK produced a special program “2025 Problem” and highlighted our medical expenses estimated to reach 54 trillion yen in 2025 when the postwar baby-boom generation would turn 75 years old.
Kampo can contribute to medical treatment for the elderly as it provides holistic treatment to individual patients, rather than targeting specific illnesses. An increasing number of patients suffer from polypharmacy consequences caused by Western medicine, including increased adverse drug reactions, drug interactions and prescribing cascade. This is because Western drugs focus on a particular part of one’s body and works to eliminate a specific symptom. Kampo, on the other hand, embraces a living body as a dynamic system. It brings positive results for multiple symptoms by a single formulation because kampo medicines are made from a combination of crude drugs which contain multiple active ingredients. For example, a well-known medicine Kakkonto is made of seven crude drugs, including arrowroot and ginger, and contains hundreds of chemical ingredients. Kampo works to activate one’s whole biological system with its complex composition.
Now, can kampo really work to reduce social security expenses? Various estimations prove that kampo is effective for both chronic and acute diseases. If we prescribe Rikkunshito to all gastric cancer patients, we can reduce length of hospital stay, achieve early recovery and cut medical expenses by 10.6 billion yen. Every year, 12 million people suffer from influenza. Another estimation shows that if 3 million flu-stricken patients take Maoto, we can reduce medical cost by 9 billion yen.
I have worked closely with China and South Korea through the World Health Organization initiatives and observed that both countries embark on a global strategy to promote traditional medicine. China has established an organization that links 201 Chinese medical associations spread across 57 countries and regions. 14 ministries and agencies collaborate to internationalize Chinese medical science, based on long-term planning.
In Japan, kampo is used by doctors versed in Western medicine, making this country a unique place where Oriental medicine is merged with Western medicine. For example, kampo is used to alleviate side effects of anticancer drugs. Commercially available Japanese kampo medicines gain high credibility for their quality, making them a big seller among wealthy Chinese people and tourists.
When it comes to self-sufficiency rate, Japan imports over 80% of crude drugs from China and cultivates only 12% of raw materials domestically. However, economic development in China coupled with declining number of farmers has inflated import prices from China. For example, the price of ginseng has quadrupled from 2006 to 2013. I contributed an article to Asahi Newspaper in 2011 and suggested to terminate cultivation of tobacco and switch to produce crude drugs. Many local municipalities supported this suggestion and launched on kampo cultivation, but I must say majority of farmers today suffer from fierce price competition from China.
There is a growing concern, however, over the quality of Chinese products. An international environmental NGO Greenpeace conducted tests on 65 herbal products from China and Hong Kong and detected 26 of them contained 10 kinds of pesticides listed as extremely or highly hazardous. France, the UK and other countries have decided to ban the import of Chinese products. This could open the door for Japanese products to enter the European markets but we still fail to achieve stable access, due to lack of holistic planning to promote industrialization of kampo products overseas with a solid exit strategy.
Before I close my speech, let me highlight the importance of developing a grand design for a strategic planning. I give lectures and conduct research at Keio University Shonan Fujisawa Campus which was designated as the International Strategic Special District in 2013 to promote kampo medicine internationally. I must say much remains to be done to further enhance various initiatives towards industrializing kampo medicine. I am determined to work hard and let me ask for your wise advice and guidance.