a comparative study of traditional chinese medicine - traffic

A Tale ofTwo Cities

A ComparativeStudy of

TraditionalChinese Medicine

Markets in SanFrancisco andNew York City

Leigh Henry

A TALE OF TWO CITIESA Comparative Study of Traditional Chinese

Medicine Markets in San Francisco

and New York City

Leigh A. Henry

May 2004

TRAFFIC North AmericaWorld Wildlife Fund

1250 24th Street NWWashington DC 20037

© 2004 WWF. All rights reserved by World Wildlife Fund, Inc.

All material appearing in this publication is copyrighted and may be reproduced withpermission. Any reproduction, in full or in part, of this publication must credit TRAFFICNorth America.

The views of the authors expressed in this publication do not necessarily reflect those of theTRAFFIC Network, World Wildlife Fund (WWF), or IUCN-The World ConservationUnion.

The designation of geographical entities in this publication and the presentation of thematerial do not imply the expression of any opinion whatsoever on the part of TRAFFIC orits supporting organizations concerning the legal status of any country, territory, or area, orof its authorities, or concerning the delimitation of its frontiers or boundaries.

The TRAFFIC symbol copyright and Registered Trademark ownership are held by WWF.TRAFFIC is a joint program of WWF and IUCN.

Suggested citation: Henry, L. A. 2004. A Tale of Two Cities: A Comparative Study ofTraditional Chinese Medicine Markets in San Francisco and New York City. TRAFFICNorth America. Washington D.C.: World Wildlife Fund.

Front cover photographs of a Siberian tiger by Wolfgang Kaehler; white rhinoceros byHoward Buffett; leopard by Eberhard Brunner; Siberian musk deer © WWF-Canon /Grigori Mazmanyants; brown bear by Steve Morello.

Visit www.traffic.org for an electronic edition of this report, and for more information aboutTRAFFIC North America.

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .III

BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

International and National Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

METHODOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

San Francisco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

New York City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

San Francisco vs. New York City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

RECOMMENDATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

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LIST OF TABLES

1. Uses of Focus Species in Traditional Chinese Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

2. Status of surveyed species under CITES and the U.S. Endangered Species Act . . . . . . . . . . . . . .2

3. Availability of Medicines Claiming to Contain Target Species in 1999 . . . . . . . . . . . . . . . . . . . .3

4. Availability of Medicines Claiming to Contain Target Species in San Francisco Area TCM Shops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

5. Availability of Medicines Claiming to Contain Target Species in San Francisco and Oakland TCM Shops in 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

6. Availability of Medicines Claiming to Contain Target Species in New York City TCM Shops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

7. Availability of Medicines Claiming to Contain Target Species in Manhattan and Flushing TCM Shops in 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

8. Availability of Medicines Claiming to Contain Targeted Species in the San Francisco Area and New York City in 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

LIST OF FIGURES

1. Comparison of Variety of Products Found in New York City and in the San Francisco Area in 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

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TRAFFIC North America wishes toacknowledge the invaluable contribution ofCao Dan to this project. Her friendship,positive energy, and knowledge of traditionalChinese medicines, as well as Chineselanguage and culture, made this work possible.

The author would also like to acknowledge thecontribution of Craig Hoover, Deputy Directorof TRAFFIC North America, for his guidance,support, ever-critical eye, and, most of all, forhis patience throughout the process of

completing this report. The author alsosincerely thanks Steven Broad, TRAFFIC’sExecutive Director; Rob Parry-Jones, ofTRAFFIC Oceania; and Samuel Lee, ofTRAFFIC East Asia, for their careful reviewsand thoughtful comments.

Finally, TRAFFIC wishes to thank theNational Fish and Wildlife Foundation’s Savethe Tiger Fund and the Species Program ofWorld Wildlife Fund-US and for their generoussupport of this project.

ACKNOWLEDGEMENTS

Wild plant and animal species around theglobe are confronted with a variety of threatsto their continued survival, including habitatloss, pollution, and poaching. For thousandsof species, illegal and unsustainable collectionand trade poses a long-standing, consistentthreat that remains inadequately addressed.One of the most deep-rooted and complex ofthese aspects is the international trade incertain species for use in traditional medicines.

Numerous cultures throughout the world havedepended on traditional medicines forthousands of years, and traditional medicine, inturn, depends on tens of thousands of plant andanimal species used as ingredients. Thoughtraditional medicines predominately utilizeplants, the parts of many animal species —such as Tigers Panthera tigris, LeopardsPanthera pardus, rhinos Rhinocerotidae spp.,musk deer Moschus spp. and bears Ursidaespp., also are used as ingredients. Table 1illustrates the use of these species in traditionalChinese medicine (TCM). Some of thesespecies are threatened in large part because oftheir use and trade in a number of traditionalmedicine systems. This report, for reasons ofpracticality, focuses on only one of thosesystems — TCM — examining the availabilityof parts and products derived from rhino,tigers, leopards, musk deer, and bears, withinthe two largest Chinatowns in the USA —those in San Francisco and New York City.

International and National ControlsInternational commercial trade in tigers,leopards, and rhinos, including parts andderivatives, has been strictly regulated since theConvention on International Trade inEndangered Species of Wild Fauna and Flora(CITES) came into force in 1975. However,illegal trade has continued despite extraordinaryefforts by CITES, government agencies, andconservation groups to eradicate it.

In 1994, the CITES member nations (hereafterParties) agreed that additional measures focusedon the protection of tigers needed to be taken,including specific acknowledgment of the threatposed to unsustainable trade in tiger parts foruse in traditional medicine. Similarly, in 1997,the Parties saw the need to increase efforts inbear conservation and to stem illegal bear trade,as well as to increase public awareness efforts inthe traditional medicine industry (Gaski, 1998).The Parties found these efforts necessary tofocus attention on the conservation ofoverexploited wild species used in traditionalmedicines. The Parties recommended that lawenforcement be increased, forensic analyses bedeveloped or improved, substitutes oralternatives be sought, and captive-bred orartificially propagated sources of specimens bedeveloped. In response to theserecommendations, the TRAFFIC network, alongwith other nongovernmental organizations,provided governments with information on

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BACKGROUND

Table 1. Uses of Focus Species in Traditional Chinese Medicine

Part Used Symptom Treated

Rhino horn Extreme heat or heat signs; high fever; erythema; purpura;nosebleed; vomiting of blood; convulsions; delirium; manic behavior

Tiger bone, leopard bone Migratory joint pain and stiffness; paralysis; weak knees and legs;spasms; stiffness and pain in the lower back; pain in bones

Bear gall High fever and convulsions; spasms; hot skin lesions; red, painful,swollen eyes; trauma; sprains; swelling and pain; hemorrhoids

Musk grains Convulsions; delirium; stupor and fainting; closed disorders; titaniccollapse; seizures; swelling and pain; toxic sores; carbuncles;coronary artery disease

Source: Bensky and Gamble, 1993

threatened species involved in traditionalmedicines so that a profile of the trade could bedeveloped in order to form a conservationstrategy, both for the species and traditionsinvolved (Gaski, 1998).

As part of these efforts, TRAFFIC NorthAmerica (hereafter “TRAFFIC”) conductedmarket surveys in TCM shops in seven NorthAmerican cities with large, well-establishedChinese-American communities — Atlanta,Los Angeles, New York City (Manhattan), SanFrancisco, Seattle, Toronto, and Vancouver —in 1996-97 (Gaski, 1998). At that time, theillegal trade in raw products of endangeredspecies for use in TCM was an undisputedproblem, but there was debate over, and a lackof information on, whether or notmanufactured medicines posed a similar threatto these species as well. TRAFFIC’s marketsurveys, which investigated the availability ofthese manufactured medicines, showed that

50% (55 shops) of the TCM stores surveyedoffered for sale one or more medicines orproducts labeled as containing derivatives oftiger, leopard, or rhino. The surveys alsoassessed the availability of products labeled ascontaining musk deer and bear. Productslabeled as containing musk were verycommon, while bear products were the leastcommon (Gaski, 1998).

The species included in the surveys, or certainof their populations and/or subspecies, arelisted as “endangered” under the U.S.Endangered Species Act (ESA). Table 2 showsthe status, and the meaning of that status, ofthese species under the ESA as well as CITES.Under the ESA, the law through which theUSA implements CITES, the U.S. governmentbears the burden of proof to show that productsclaiming to contain protected species actuallycontain those species. However, forensictechniques are often unable to confirm the

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Table 2. Status of surveyed species under CITES and the U.S.Endangered Species Act

CITES* U.S. Endangered Species Act**

Tiger Appendix I Endangered

Rhino Appendix I (except the South African Endangered (except for Ceratotheriumpopulation of Ceratotherium simum simum, simum simum)which is App. II)

Leopard Appendix I Endangered (Panthera pardus is listed asendangered except in Africa, in the wild,south of, and including, the followingcountries: Gabon, Congo, The DemocraticRepublic of the Congo, Uganda, Kenya —where it is listed as threatened.)

Musk deer Appendix I (Only the populations of Endangered (populations in Afghanistan, Afghanistan, Bhutan, India, Myanmar, Bhutan, Burma/Myanmar, China (Tibet, Nepal and Pakistan; all other populations Yunnan), India, Nepal, Pakistan)are included in App. II)

Appendix II (Except the populations of Afghanistan, Bhutan, India, Myanmar, Nepal and Pakistan, which are included in App. I)

Bear Appendix II (except for species listed on Endangered (Ailuropoda melanoleuca and App. I: Ailuropoda melanoleuca, Ailurus these subspecies/populations only: Ursusfulgens, Ailuropoda melanoleuca, Helarctos thibetanus gedrosianus, Ursus arctos malayanus, Melursus ursinus, Tremarctos pruinosus, Ursus arctos arctos in Italy, ornatus, Ursus arctos (only the populations Ursus arctos nelsoni in Mexico)of Bhutan, China, Mexico, Mongolia — all others on App. II), Ursus arctos isabellinus, Ursus thibetanus)

*CITES: Appendix I – prohibits all international commercial trade; Appendix II – strictly regulates commercial trade through a permit system.**U.S. Endangered Species Act: 50 CFR 17.11 and 17.12, December 1999. “Endangered” means any species that is in danger ofextinction throughout all or a significant portion of its range. Endangered species cannot be traded commercially.

presence of prohibited species ingredients suchas tiger bone or rhino horn in manufacturedmedicinal products labeled as containing thoseingredients. In addition, the ESA onlyprohibits the import and export of, andinterstate commerce in, listed species and doesnot specifically prohibit intrastate sale.

As a result of our 1996-97 survey findings, andin recognition of these existing loopholes,TRAFFIC worked with the U.S. Congress topass the Rhino and Tiger Product Labeling Act(RTPLA) in October 1998. The RTPLA, anamendment to the Rhino and TigerConservation Act, prohibits the import, exportand sale of any product for human consumptionor application containing, or labeled oradvertised to contain, any substance derivedfrom any species of rhinoceros or tiger; carries apenalty of up to six months in prison, and finesof up to USD12 000 per violation; and providesfor the development and implementation of aneducation outreach program in the USA for theconservation of rhinos and tigers. With thepassage of the RTPLA, significant progress wasmade in closing existing loopholes – but onlyfor rhinos and tigers.

In 1999, the same investigator who conductedthe 1996-97 survey returned to San Franciscoand New York City (Manhattan) to againsurvey the TCM markets. The goal of thisunpublished survey was to gauge the progressof the RTPLA in stemming the availability ofmedicines labeled as containing rhinos andtigers, and of a new World Wildlife Fund(WWF) cooperative conservation outreachprogram with the American College ofTraditional Chinese Medicine (ACTCM) inSan Francisco. The outreach program,which included materials targeted at educating

both the business community and theconsuming public, was launched in 1998 and continues today.

Of the 44 shops visited in the two cities in1999, 71% (31 shops) offered medicineslabeled as containing the target species. Table3 shows the percentage and number ofinspected shops in each city that offered eachtarget species.

Medicines labeled as containing tiger bonewere found in 64% of New York City shopsand 32% of San Francisco shops in the 1999survey, while leopard bone medicines werefound in only 45% and 9% of these shops.Twenty-three percent of New York City shopsoffered medicines labeled as containing rhinohorn, compared to only 14% of San Franciscoshops. Musk and bear bile medicines werefound in 64% and 27% of New York Cityshops, and in 23% and 5% of San Franciscoshops, respectively.

As they had done for tigers and bears, CITESParties agreed in 2000 to undertake measuresto heighten awareness and conservationefforts targeting another species used formedicinal purposes - musk deer – whose rawmusk is heavily utilized in traditionalmedicine and is subject to substantial illegaland unsustainable trade.

In 2002, the Parties expanded the tigerconservation measures they had first agreed toin 1994 to include all Asian big cats, includingleopards, as it became clear that many big catspecies face many of the same threats as tigers,including use in traditional medicines. Further,it was recognized that, as tigers receivedgreater protection and attention, the demandfor tiger parts used in traditional medicines

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Table 3. Availability of Medicines Claiming to Contain Target Species in 1999

New York City San FranciscoStores Selling: 22 stores surveyed 22 stores surveyed

Tiger bone 64% (14) 32% (7)Leopard bone 45% (10) 9% (2)Rhino horn 23% (5) 14% (3)Musk 64% (14) 23% (5)Bear bile 27% (6) 5% (1)

shifted to other Asian big cats and furtherthreatened their continued survival. Inrecognition of these increasing threats, theParties agreed to expand tiger conservationmeasures to include tigers and other AppendixI Asian big cat species.

In the spring of 2003, researchers returned tothe Chinatowns of New York City and SanFrancisco to again measure the efficacy of theRPTLA, CITES, and five years ofcollaborative outreach work by WWF andACTCM within San Francisco’s Chinese-American communities.

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In 2003, TRAFFIC assessed traditionalmarkets and pharmacies in the Chinatowns ofSan Francisco and New York City. Twoinvestigators conducted an initial walk-throughof each Chinatown to identify as many TCMshops as possible and to set a plan to surveythem. Each survey was then conducted over aperiod of roughly three days.

The investigators mirrored as closely aspossible the methodology and shops visited inthe 1996-97 and 1999 surveys. Wherepossible, the same shops were visited. Someof these shops, however, were no longer inbusiness, and new shops were surveyed in theirplace; therefore, a different number of shopsare included in each of the three surveys. In1996-97, 1999, and 2003, most TCM shops inboth cities were surveyed. Additionally, the2003 survey included shops in Oakland,California, in the San Francisco metropolitanarea, and in Flushing, another part of NewYork City, each of which have large Chinese-American communities. The 1999 survey alsoincluded shops in Oakland. Only shops withsignificant selections of traditional medicineswere chosen. If a shop, for example a grocerystore, carried only a few shelves of medicines,it was not included in the survey.

The two investigators — both female, oneChinese and one American – posed as

customers at each shop, scanning the shelves,reviewing ingredients, and talking withshopkeepers. As in previous surveys, noattempt was made to persuade any shopkeeperinto selling a product that was not normallyavailable; the survey was aimed at findingwhat items would be readily available to theaverage consumer on any given day. Uponleaving the shop, notes were made about whatwas found. Never, in either city, did theinvestigators feel that the shopkeepers were atall suspicious of their intent, which is mostlikely due to the presence of the Chineseinvestigator, as well as the rapidly increasingpopularity of TCM in Western society.

The survey documented the availability of bothraw parts and manufactured medicines labeledas containing tiger, rhino, leopard, musk deer,and bear. Where possible, investigatorsrecorded the name and address of the shop,raw products of protected species, the name ofany manufactured medicine labeled ascontaining protected species, the species themedicine was labeled as containing, themanufacturer, the date of manufacture, and theprice. Where applicable, investigators alsonoted any differences in the ingredients listedin Chinese versus English on any product. Noattempt was made to verify the actualingredients of any of the products reviewed.

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METHODOLOGY

San Francisco

ResultsThe two investigators visited the Chinatowns ofSan Francisco and Oakland, California, duringthe week of 3 March 2003, to assess theavailability of products containing threatened orendangered species in TCM shops. While everyattempt was made to follow previous surveys, 5of the shops surveyed in 1999 had since closedand 12 not previously surveyed were added. Theshops were surveyed for raw and manufacturedmedicines made from or labeled as containingtiger bone, leopard bone, rhino horn, musk, orbear bile. Assessments were made by browsingthe shelves, as well as by requesting particularproducts from shopkeepers. The percentage andnumber of the 33 stores (29 in San Francisco, 4in Oakland) found to be carrying these productsis outlined in Table 4, compared with theprevious surveys.

Between 1996-97 and 2003, the number of SanFrancisco shops readily offering medicineslabeled as containing tiger dropped from 42%to 3%, making these products virtuallyunattainable in the city. Rhino horn medicines

could not be found in any shop. However,there was in increase in the availability ofmedicines labeled as containing leopard bone,musk, and bear bile over this seven year period,from 5% to 27%, 32% to 58%, and from 0% to24%, respectively. No raw products of any ofthe target species were found.

While the sample of stores surveyed inOakland was small – only 4 compared with the29 surveyed in San Francisco – a comparisonof the different results is informativenonetheless (Table 5).

Roughly the same percentage of stores in SanFrancisco and Oakland offered items for salelabeled as containing tiger bone (3% vs. 0%) andleopard bone (28% vs. 25%), with none offeringrhino horn. However, there was a significantdifference in musk and bear bile products: allstores surveyed in Oakland offered musk andbear bile products, while only 52% and 14% soldthem, respectively, in San Francisco.

The interactions between the investigators andshopkeepers in San Francisco were extremelypositive. The majority of these shopkeeperswere aware that rhino and tiger products werenow illegal and that the species were

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RESULTS

1996-97 1999 2003Stores Selling: 19 stores surveyed 22 stores surveyed 33 stores surveyed

Tiger bone 42% (8) 32% (7) 3% (1)Leopard bone 5% (1) 9% (2) 27% (9)Rhino horn 5% (1) 14% (3) 0% (0)Musk 32% (6) 23% (5) 58% (19)Bear bile 0% (0) 5% (1) 24% (8)

Table 4. Availability of Medicines Claiming to Contain Target Species inSan Francisco Area TCM Shops

Table 5. Availability of Medicines Claiming to Contain Target Species inSan Francisco and Oakland TCM Shops in 2003

2003 San Francisco OaklandPercentage of stores selling: 29 stores surveyed 4 stores surveyed

Tiger bone 3% (1) 0% (0)Leopard bone 28% (8) 25% (1)Rhino horn 0% (0) 0% (0)Musk 52% (15) 100% (4)Bear Bile 14% (4) 100% (4)

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endangered, and many told the investigatorsnot to waste time looking for these products, asthey could no longer be found. In fact, oneshopkeeper lectured the investigators about theneed to preserve species such as tigers andrhinos for future generations, so that ourchildren and grandchildren can enjoy them.San Francisco shopkeepers also readilysuggested alternative therapies.

DiscussionWe believe that three key factors have led tothe declining availability of rhino and tigermedicinals in San Francisco.

➤ Outreach: WWF and ACTCM, as well asTRAFFIC, have conducted significantoutreach work in the San Francisco areafocusing on tiger and rhino conservationand on the laws prohibiting the sale of tigerand rhino medicinal products. This includesmeetings and collaborations with TCMpractitioners, retailers and manufacturers,and participation in Chinese communityevents, such as Chinese New Year andMother’s Day celebrations, to educate usersof TCM on some of the conservation issuesinvolved in its practice. This education andawareness effort, coupled with the passageof the RTPLA, seems to have produced apositive change in the market for andavailability of tiger and rhino products inSan Francisco.

➤ Improved Legislation: The passage of theRTPLA in 1998 closed a large enforcementloophole by making the sale of any productlabeled as containing rhino or tiger illegal.In this way, enforcement officials no longerbear the burden of proof to show that aproduct actually did contain either of thesespecies, making their job much morestraightforward.

➤ Enforcement Action: In addition, inFebruary 2003, immediately prior to oursurvey, an Oakland, California, TCM shopowner was sentenced to four months inprison and a USD10 000 fine for conspiracyto violate the RTPLA and the ESA byoffering medicines containing protectedspecies (U.S. Fish and Wildlife Service inlitt. to TRAFFIC North America, 18December 2003). Though convictionsunder the RTPLA had been virtuallynonexistent until this time, this conviction

may have helped to dissuade other shopowners in the area from also attempting tosell similar illegal products.

However, it is possible that the increase in theavailability of leopard products, from 5% to27% of stores, is also a result of these threefactors, and that leopards are now beingutilized as a tiger substitute. Indeed, most ofthe products found labeled as containingleopard bone, such as medicinal plasters usedto alleviate joint pain, are those that previouslyutilized tiger bone. Tiger bone and leopardbone are used to treat the same symptoms andit appears that, as awareness of the illegality ofthe sale of products labeled as containing tigerhas grown amongst TCM practitioners andconsumers, they have made a shift in use tomedicines labeled as containing leopard bone.As with tigers, commercial import of leopardparts and products is also prohibited into theUSA under CITES, but unlike tiger products,leopard products are not covered by RTPLA oran equivalent labeling law. Therefore, it ismuch more difficult to enforce the importrestriction as it would be necessary to provethat items labeled as containing leopard boneactually contain leopard bone, and enforcementis therefore also extremely difficult. Inaddition, no outreach work has been conductedin the area on the conservation issuessurrounding the use of leopard bone intraditional medicinals.

A significant increase was also found in theavailability of musk and bear bile TCMproducts. As with leopard products, this isprobably due in part to the fact that thesespecies are not covered by a labeling law and,therefore, enforcement efforts have beendifficult. Again, the community outreach inSan Francisco has focused solely on rhinos andtigers to date, and musk deer and bear specieshave yet to receive the same attention.

The reason for the discrepancy between thetargeted TCM products available in SanFrancisco versus Oakland is also unclear, butone explanation may be that the conservationoutreach conducted in San Francisco simplydid not filter out to the surrounding areas. Thishypothesis is supported by the fact that noshopkeepers in Oakland informed theinvestigators of the laws governing the sale ofproducts containing the target species as theyhad so readily in San Francisco.

New York City

ResultsThe two investigators visited two Chinatownsin New York City: Manhattan and Flushing,during mid-April 2003, to assess theavailability of products containing threatened orendangered species in TCM shops. Whileevery attempt was made to follow previoussurveys, 7 of the shops surveyed in 1999 hadsince closed and 14 not previously surveyedwere added. The shops were surveyed for rawand manufactured medicines made from orlabeled as containing tiger bone, leopard bone,rhino horn, musk, or bear bile. Assessmentswere made by browsing the shelves, as well asby requesting particular products fromshopkeepers. The percentage and number ofthe 27 stores (21 in Manhattan, 6 in Flushing)found to be carrying these products is outlinedin Table 6, compared with the previous surveys:

In New York City, the percentage of storesreadily offering medicines labeled ascontaining tiger dropped from 83% to 41%,and those offering to sell medicines labeled ascontaining rhino were essentially unchangedbetween 1996-97 and 2003. As in SanFrancisco, medicines labeled as containingleopard were more abundant, with 63% of

stores selling these products, compared to only17% in 1996-97. Medicines labeled ascontaining musk increased from beingavailable in half of New York City’s TCMshops to all of them, and bear bile medicinesincreased from being available in 17% ofstores to 70%. No raw products of any of thetarget species were found.

While many of the New York City shopkeepersinformed the investigators that they did not sellcertain products, none ever mentioned that theywere illegal or offered any alternativeremedies, nor did they mention theconservation concerns regarding the use of thespecies in TCM. A TCM practitioner in oneshop even recommended a prescriptioncontaining tiger bone to both investigators.

As with San Francisco and Oakland, there weresome noteworthy differences in the productsavailable in Manhattan versus Flushing shops.Flushing had significantly fewer shops offeringtiger bone products at 17% compared toManhattan’s 48%, and no stores selling rhinohorn products, while 10% of Manhattan shopsstill offered these for sale. Sixty-two percent ofManhattan shops offered bear bile products,while 100% of the Flushing shops did, but therewas virtually no difference in the availability ofleopard bone and musk products (see Table 7).

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1996-97 1999 2003Stores Selling: 12 stores surveyed 22 stores surveyed 27 stores surveyed

Tiger bone 83% (10) 64% (14) 41% (11)Leopard bone 17% (2) 45% (10) 63% (17)Rhino horn 8% (1) 23% (5) 7% (2)Musk 50% (6) 64% (14) 100% (27)Bear bile 17% (2) 27% (6) 70% (19)

Table 6. Availability of Medicines Claiming to Contain Target Species inNew York City TCM Shops

Table 7. Availability of Medicines Claiming to Contain Target Species inManhattan and Flushing TCM Shops in 2003

2003 Manhattan FlushingPercentage of stores selling: 21 stores surveyed 6 stores surveyed


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DiscussionThe survey results for New York City indicatethat the RTPLA and other related laws havehad a nominal effect on the market for tigersand rhinos. Outreach efforts have been far lessextensive in New York City than in SanFrancisco, and the survey results suggest thatoutreach similar to that conducted in SanFrancisco may be necessary to underscorethese laws by educating consumers as well asretailers. Tiger bone and rhino horn productswere still available in 41% and 7% of thestores surveyed, respectively. Since the sale ofthese products is now completely illegal, thesenumbers are of concern, and indicate that lawenforcement and outreach efforts have beenineffective to date.

Despite the fact that tiger bone products arestill available in New York City, a dramaticincrease in the availability of leopard boneproducts is still apparent. However, similar towhat was found in San Francisco, the leopardbone products found in New York City,namely plasters, were those that were formerly

labeled as containing tiger bone. So again, itappears that leopard bone is being substitutedfor tiger bone as an ingredient in certainproducts. Additionally, the products foundclaiming to contain tiger bone appeared to bevery old and may have been imported into theUSA prior to enactment of the RPTLA in1998, and may not be indicative of currenttrends in the industry.

As in San Francisco and Oakland, theexplanation for the differences betweenManhattan and Flushing remains unclear. It ispossible, however, that the difference lies inthe fact that the newer shops sprouting up inthe suburb of Flushing have newer stock, andtherefore offer fewer tiger bone or rhino hornproducts because they are no longer readilyavailable. The older stores in Manhattan,where these products are still available, arepossibly just carrying over old stock that stillhas not sold. Investigators attempted toidentify the date of manufacture on all of theproducts surveyed, but, for most, the date wasnot visible or easily identifiable on theexternal packaging.

San Francisco vs. New York City

DiscussionThe differences in availability of medicineslabeled as containing protected or regulatedspecies in the San Francisco and New York Cityareas are alarming (Table 8). Only 3% of SanFrancisco stores offered any medicines labeledas containing tiger, while 41% of New YorkCity shops did. Only 27% of San Franciscoshops offered leopard bone products, comparedto New York City’s 63%. Rhino hornmedicines were not found for sale in SanFrancisco, while they were still available in 7%

of New York City shops. Musk medicines wereoffered for sale in 58% of San Francisco storesand in all New York City stores; and bear bilemedicines were found in 24% of San Franciscoshops and 70% of New York City shops.

New York City stores offered a greater varietyof tiger, rhino and musk products for sale thanSan Francisco shops. Both cities offered thesame two leopard bone products — bothplasters — and San Francisco offered a greatervariety of bear products. (See Appendices IIand III for a list of products.)

Additionally, San Francisco shopkeepers wereacutely aware of the laws regulating the use ofthese species, and many also demonstrated that

10

Table 8. Availability of Medicines Claiming to Contain Targeted Speciesin the San Francisco and New York City in 2003

San Francisco New York City(including Oakland) (Manhattan and Flushing)

Percentage of stores selling: 33 stores surveyed 27 stores surveyed


Figure 1. Comparison of Variety of Products Found in New York Cityand in the San Francisco Area in 2003

0

2

4

6

8

10

12

14

16

Tiger Rhino Leopard Musk Bear

San Fancisco

New York City

Nu

mb

er o

f D

iffe

ren

t P

rod

uct

s

they were aware of the reasons behind theseregulations – that these species are endangered,due in part to unsustainable use of their partsin traditional medicines. In New York City,however, no shopkeepers mentioned theillegality of these products, much less theconservation status of the species used in theirmanufacture.

The disparities between the two cities existedin 1996-97 (compare Tables 4 and 6), but havecontinued to increase over the past seven years.Both cities have shown improvement wheremedicines claiming to contain tiger and rhinoproducts are concerned, though medicineslabeled as containing these species arevirtually unattainable in San Francisco, whilestill available in 41% and 7% of New YorkCity’s TCM shops, respectively (see Table 8).These disparities are probably a result of theextensive outreach work conducted in SanFrancisco to raise awareness about the RTPLAand the conservation status of tigers andrhinos, and possibly of the February 2003conviction of the Oakland TCM shop owner aswell (see page 7).

While awareness of the RTPLA may haveacted as a deterrent, it is unlikely thatenforcement of this law has had much impactin the five years that it has been in place. TheU.S. Fish and Wildlife Service reports a total

of 29 convictions under the RTPLA, but 26 ofthese have been civil violations, mostly ofindividual international travelers bringingpersonal supplies of tiger or rhino medicinesinto the USA. Of the three criminal cases,only one resulted in a four-month prisonsentence and USD10 000 fine, while the twoothers resulted in only USD250 and USD500fines via a Notice of Violation (U.S. Fish andWildlife Service in litt. to TRAFFIC NorthAmerica, 26 February 2004).

However, a more significant impact may havebeen made in February 2004 when the U.S.Fish and Wildlife Service served searchwarrants on 16 retail TCM shops and oneTCM wholesaler/distributor in New York City.The warrants focused on rhino and tigerproducts, with the vast majority of productsseized being those that were labeled ascontaining tiger. All of the products seizedwere manufactured medicines, with theexception of one raw bone that is in theprocess of being identified. The U.S. Fish andWildlife Service believes that this case has senta strong message and that it will probably havea significant impact on the availability of rhinoand tiger products in TCM shops, particularlyin the New York City area (U.S. Fish andWildlife Service, pers. comm. to Craig Hoover,16 March 2004).

11

Three key conclusions can be extrapolatedfrom the San Francisco and New York Citymarket surveys, though the margin of errorinherent in surveys conducted in differentstores of varying numbers over a seven yearperiod should, of course, be kept in mind.

Laws are a deterrent but appear to be muchmore effective when coupled with outreachwork and active enforcement

Comparisons of surveys conducted in 1996-97with the more recent survey conducted in 2003strongly indicate that enactment of theRPTLA, together with educational outreachwork, has had a positive effect on theavailability of rhino and tiger medicines in SanFrancisco and New York City. In New YorkCity, the percentage of stores selling medicineslabeled as containing tiger dropped from 83%to 41%, while the percentage of stores sellingmedicines labeled as containing rhinoremained low. In San Francisco, thepercentage of stores selling medicines labeledas containing tiger dropped from 42% to 3%,and those selling medicines labeled ascontaining rhino dropped from 5% to none.

Though both cities had a drop in theavailability of both tiger and rhino medicines,the result in San Francisco is much morepositive, with the elimination of the availabilityof medicines labeled as containing rhino, andwith only 3% of shops still selling medicineslabeled as containing tiger. This differencedemonstrates that the concentrated outreachefforts of WWF and ACTCM regarding theRTPLA and endangered species conservationin this area, as well as the U.S. Fish andWildlife Service’s enforcement effort inOakland, have been highly effective, all butwiping out these illegal sales. The ChineseAmerican community in San Francisco was notonly more aware of the law at the time of thesurvey, but was also aware of the impacts theiractions have on the continued survival ofspecies in the wild.

Eliminating one problem may lead to another

As people have become aware that tigers areendangered and that medicines containingthem are illegal, demand for productscontaining substitute species grows. Theavailability of medicines labeled as containingleopard bone has increased dramaticallybetween the 1996-97 and 2003 TCM marketsurveys, undermining the otherwise positivetrend of reduced availability of tiger medicines.In New York City, the percentage of storesselling medicines labeled as containing leopardincreased from 17% to 63%, and in SanFrancisco, the percentage increased from 5%to 27% (See App. I, Fig. 2).

As the percentage of stores in both SanFrancisco and New York City selling tigerbone products decreased from just under 60%in 1996-97 to 20% in 2003, the percentage ofstores selling leopard bone products increasedfrom 10% to over 40% (See Fig. 2). Leopardand tiger bone are used interchangeably totreat the same ailments (Bensky and Gamble,1993) and leopard bone is, in fact, listed as aningredient in some of the very same productsthat were once labeled as containing tiger, suchas a specific brand of plaster. The trend is astrong indication that leopard bone is beingused as a replacement for tiger bone.

Leopards are banned in internationalcommercial trade, as they are listed in CITESAppendix I. Thus, it is likely that all leopardmedicines found in the survey were illegallyimported into the USA. However, leopards arenot covered under the RTPLA as are tigers andrhinos, making the government’s task ofidentifying and prosecuting illegal sales farmore difficult.

Enforcement Challenges for Other SpeciesRemain

In addition to the increase in leopard products,an increase in the availability of musk and bearproducts was also found in TCM shops in bothcities. Some populations of musk deer are

12

CONCLUSIONS

listed in CITES Appendix II, while others arelisted in Appendix I. Musk, therefore, may belegally traded on the international market withthe appropriate permits. Similarly, bears arelisted in CITES Appendices I and II,depending on the species or population, andproducts labeled as containing bear bile may ormay not have been legally imported, or may ormay not have come from legal domesticsources. TRAFFIC’s review of legal importsinto the USA from 1999 to 2001 shows nolegal imports of bear and musk products,however, which would seem to indicate thatthe majority of bear and musk medicines foundin recent market surveys were, in fact, illegallyimported. (TRAFFIC analysis of USFWSLEMIS data, 2003.)

An underlying issue for all of these concerns iswhether or not medicinals labeled as

containing rhino, tiger, leopard, musk or bearactually do, and therefore, how much of aconservation threat the use of these productsactually poses to these species. Furtherinvestigation is warranted into whether or notmedicinals labeled to contain leopard, forinstance, actually contain leopard. If thesemedicines do not contain leopard, perhaps theyare fraudulently labeled as containing it tomake the product more appealing, or perhapsthey are labeled as containing it as a knowncover for an illegal ingredient, such as tiger.These are all questions that remainunanswered, as tests to determine theseingredients are expensive and, sometimes,inconclusive.

13

Figure 2. Percentage of Stores Offering Tiger and Leopard Products(NYC and SF areas combined)

0%

10%

20%

30%

40%

50%

60%

1996/97 1999 2004

Tiger bone

Leopard bone

1. The U.S. government should enactregulations that incorporate the definitionof "readily recognizable part or derivative"under CITES Resolution Conf. 9.6 (Rev.)and prohibit the import, export, andinterstate commerce of species andproducts containing, or claiming tocontain, all protected species (i.e., thoselisted in CITES Appendix I or asEndangered under the ESA).

2. State and local governments should enact laws that prohibit the sale ofproducts containing, or claiming tocontain, all species listed as Endangeredunder the ESA.

3. Appropriate federal agencies should makeenforcement of the RTPLA, as well as ofthe ESA and CITES, a priority and insurethat blatant offenses, such as those seen inSan Francisco and New York City, areaddressed. To this end, TRAFFIC hasprovided the appropriate authorities withthe information gathered in this survey,including names and addresses of shops inviolation of U.S. law, and will continue toprovide such information as appropriate.

4. As provided for under the RTPLA,appropriate government agencies, such asthe U.S. Fish and Wildlife Service, as wellas conservation groups, should conducteducation outreach programs with TCMstakeholders (i.e., manufacturers, retailers,practitioners, consumers) throughout theUSA, and particularly in the greater NewYork City area. Similar to the successfuloutreach work in San Francisco, the NewYork outreach should focus on these

stakeholders as well as the broadercommunity, through schools, specialevents, and other venues, and — wherepossible — should be expanded beyondtigers and rhinos to include other regulatedspecies being illegally or unsustainablyutilized in traditional medicines.

5. Appropriate federal agencies, as well asU.S. conservation groups, should workwith their partners in China to determinewhere the enforcement gaps lie that allowillegal medicinals manufactured in Chinato be offered for sale in U.S. shops, andshould work to quickly close those gapsonce identified.

6. The increasing availability of medicineslabeled as containing leopard, bear andmusk should be investigated to determinewhether or not these products actuallycontain these species and how theincreased production of these medicinesmay be affecting leopard, bear and muskdeer populations in the wild.

7. Trends in various traditional medicinesystems should be monitored in an effortto understand the constantly changing useof wildlife species for medicinal purposes.Such monitoring allows for more targetedand effective law enforcement andoutreach efforts. These trends, as well asthe conservation status of species used formedicinal purposes such as bears andmusk deer utilized in TCM, will need to becarefully monitored in the future so thatappropriate outreach efforts and legislativeand enforcement actions can beundertaken.

14

RECOMMENDATIONS

Anon., CITES Res. Conf. 9.13, Conservation of and Trade in Tigers.

Anon., CITES Res. Conf. 10.8, Conservation of and Trade in Bears.

Anon., CITES Res. Conf. 10.19, Traditional Medicines.

Anon., CITES Res. Conf. 12.5, Conservation of and Trade in Tigers and other Appendix I Asian Big Cat Species.

Anon., Convention on International Trade in Endangered Species of Wild Fauna and Flora. Foundon Internet at: http://www.cites.org. Viewed January/February 2004.

Anon., U.S. Fish and Wildlife Service. 1999-2001. Law Enforcement Management InformationSystem (LEMIS).

Bensky, D. and A. Gamble, 1993. Chinese Herbal Medicine Materia Medica. Eastland Press,Seattle, Washington, USA.

Gaski, A., 1998. While Supplies Last: The Sale of Tiger and Other Endangered Species Medicinesin North America 1996-97. TRAFFIC North America, Washington, DC, USA.

15

REFERENCES

APPENDIX I

Percentage of All Stores Surveyed Offering Medicines Claiming to Contain each of the Target Species

Figure 1.Percentage of Stores Where Tiger Products Were Offered for Sale

16

APPENDICES

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

San Francisco

New York City

1996/1997 1999 2003

100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

San Francisco

New York City

1996/1997 1999 2003

100%

Figure 2.Percentage of Stores Where Leopard Products Were Offered for Sale

17

Figure 3.Percentage of Stores Where Rhino Products Were Offered for Sale

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

San Francisco

New York City

1996/1997 1999 2003

100%

Figure 4.Percentage of Stores Where Musk Products Were Offered for Sale

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

San Francisco

New York City

1996/1997 1999 2003

100%

18

Figure 5.Percentage of Stores Where Bear Products Were Offered for Sale

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

San Francisco

New York City

1996/1997 1999 2003

100%

APPENDIX IIProducts Found in San Francisco and Oakland

KEY

TB tiger bone

LB leopard bone

RH rhino horn

BB bear bile

MK musk

Tiger

TB — pills, Du Zhong Hu Gu Wan, Guang Chang Hang distributor

TB, MK — pills, She Xiang Du Zhong Hu Gu Wan, Sichuan Yi Yao Bao Jian Gong Si

TB, MK, BB — pills, She Xiang Xiong Dan Zhui Fong Tou Gu Wan, Supervised by Tongrentang

Rhino

None

Leopard

LB, MK — plaster, She Xiang Zhuang Gu Gao, Sichuan Chong Qing Pharmaceutical factory

LB, MK — plaster, She Xiang Zhuang Gu Gao, Hu Bei Huang Shi Pharmaceutical factory

Musk

MK — powder, Yun Nan Bai Yao

MK — skin cream, Bing She Xiao, Hong Kong

MK — plaster, She Xiang Zhui Fong Gao, Guang Xi Pharmaceutical factory

MK — cream, Ma Ying Long She Xian Zhi Chuang Gao, Wu Han Pharmaceutical factory


LB, MK — plaster, She Xiang Zhuang Gu Gao, Sichuan Chong Qing Pharmaceutical factory

BB, MK — hemorrhoid cream, Xiong Dan Zhi Cuang Gao, Wu Han Tian Yi Pharmaceutical factory

BB, MK — hemorrhoid cream, Zhong Huan Pharmaceutical factory, 1981

TB, MK — pills, She Xiang Du Zhong Hu Gu Wan, Sichuan Yi Yao Bao Jian Gong Si


Bear

BB — turtle and bear bile detoxic pill (Gui Xiong Dan Jie Du Wan), Guang Dong Pharmaceuticalfactory

BB, MK — hemorrhoid cream, Xiong Dan Zhi Cuang Gao, Wu Han Tian Yi Pharmaceutical factory

BB, MK — hemorrhoid cream, Zhong Huan Pharmaceutical factory, 1981


19

20

APPENDIX IIIProducts found in New York City: Manhattan and Flushing

KEY

TB tiger bone

LB leopard bone

RH rhino horn

BB bear bile

MK musk

Tiger

TB — pill, Du Zhong Hu Gu Wan, Guang Chang Hang

TB — pill, Du Zhong Hu Gu Wan, Hua Bei Pharm. factory

TB — pill, Du Zhong Hu Gu Wan, Gui Yang TCM factory

TB — pill, Tian Ma Hu Gu Wan, Sichuan Dong Feng Pharmaceutical factory

TB — pill, Tian Ma Hu Gu Wan – Chengdu 7th Pharm. factory

TB — pill, Tian Qi Hu Gu Wan, Sichuan Pharm. factory

TB — pill, Hu Gu She Xiang Tou Gu Wan – Guang Zhou Pharm. Ind. Factory

TB — pill, She Xiang Hu Gu Wan – Chong Qing Chinese Medicine factory

TB — pill, Tsei Hung Chui Fung Tou Ku Wan, Supervise manufacture – Tongrentang

TB — pill, Yuan Tian brand Zhui Feng Hu Gu Wan, Guang Dong Pharm. Factory.

TB — pill, Qiang Li Zui Feng Hu Gu Wan, Guang Zhou Pharm. Factory

TB — pill, Yen Shen Zai Zao Wan, Fo Shan Lianhe Pharm. Co.

TB, MK — pill, She Xiang Hu Gu Zhuang Gu Wan – Sichuan Yi Yao Bao Jian Co.

TB, BB, MK — pill, She Xiang Xiong Dan Zhui Fong Tou Gu Wan, supervised by BeijingTongrentang

Rhino

RH — Golden Shield Brand Rhino horn detoxifying pill, Xi Jiao Jie Du Pian, Guang DongPharmaceutical factory

Leopard


LB, MK — plaster, She Xiang Zhuang Gu Gao, He Nan Ling Lui Pharmaceutical factory

Musk

MK — hemorrhoid cream, Ma Ying Long She Xiao Zhi Cuang Gao, Wu Han Ma Ying LongPharmaceutical factory

MK — Tiger brand musk deer plaster, Guang Dong Yue Wei Pharmaceutical factory

MK — plaster, She Xiang Feng Shi Gao, Zhe Jiang pharm. Co.

MK —plaster, She Xiang Gou Pi Gao, Tian Jing TCM Pharm. Co.

MK — plaster, She Xiang Zhuang Gu Gao

MK — plaster, She Xiang Zhui Fong Gao

MK — plaster, Yong Fong Ya Zhou pharmaceutical

MK — pill, She Xiang Hua Shi Wan

MK — pill, Qiang Li She Xiang Hua Shi Ling

MK — pill, Qiang Li She Xiang Hua Shi Wan

BB, MK — pill, Xiong Dan She Xiang Dian Qi Du Zhong Wan

BB, MK — hemorrhoid cream, Xiong Dan She Xiang Zhi Cuang Gao, Wu Han Tian YiPharmaceuticals


TB, MK — pill, She Xiang Hu Gu Zhuang Gu Wan, Sichuan Yi Yao Bao Jian Co.

TB, BB, MK — She Xiang Xiong Dan Zhui Fong Tou Gu Wan – Tiger bone, bear bile, musk pill,Supervised by Beijing Tongrentang

Bear

BB, MK — hemorrhoid cream, Xiong Dan She Xiang Zhi Cuang Gao – Wu Han Tian YiPharmaceutical factory

BB, MK — pill, Xiong Dan She Xiang Dian Qi Du Zhong Wan

TB, BB, MK — pill, She Xiang Xiong Dan Zhui Fong Tou Gu Wan, supervised by BeijingTongrentang

21

The TRAFFIC Network is the world’slargest wildlife trade monitoringprogram with offices covering mostparts of the world. TRAFFIC is aprogram of WWF-World Wildlife Fundand IUCN-The World ConservationUnion, established to monitor trade inwild plants and animals. It works inclose cooperation with the Secretariatof the Convention on InternationalTrade in Endangered Species of WildFauna and Flora (CITES).

For further information contact:

The Director

TRAFFIC North America

c/o World Wildlife Fund-US

1250 24th Street, N.W.

Washington, D.C. 20037

Telephone: 202-293-4800

Fax: 202-775-8287

Email: [email protected]

Web Site: www.traffic.org

a comparative study of traditional chinese medicine - traffic

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