Advancing global herbal medicine: Enhancing herb quality through innovative strategies explored in Hong Kong - An international hub

Abstract Background The Hong Kong Department of Health has been inspecting a number of medicinal herbs circulating in the market every year. Herbs have been recurringly identified to have problems such as over-limit aflatoxins and toxic alkaloids. The distributors had to recall the problematic herbs. Despite the negative business consequences, the problems endured.Purpose This study aimed to find out the contributors of such phenomenon, particularly the reasons of unchanging supply chain practices in Hong Kong.Study Design We interviewed 16 stakeholders from the Chinese herbal medicine industry to investigate the reasons of suboptimal supply chain practices. The interviews were analyzed using a coding framework developed by Pisani and colleagues in 2019 for analyzing national risks for medicines with suboptimal quality. The purpose of our survey was to identify risks in market dynamics and policies associated with substandard and falsified medicinal herbs in Hong Kong.Results Problems of herbs’ quality in Hong Kong attributed to harvesting, collection, processing, packaging and storage errors. Batch-to-batch differences were also the contributors. The results revealed the lack of expertise and motivation in Chinese medicine industry self-surveillance and eradication of such errors. In addition, it was found that chemical inspection tests were generally avoided due to cost and time concerns.Conclusion The current situation is not conductive to consumer right and public health protection, and supply chain practices should be improved for providing good-quality herbs to the community in a consistent manner. We propose establishing a centralized system to purchase herbs. Track-and-trace electronic system can be set up for efficiently tracing the sources and time of transactions such as herb purchase and dispensary. A registration system of Chinese pharmacists is recommended to ensure enough professionalism and regulatory responsibility, guarding the quality of prescription, ensuring safe use of herbs, and protecting public health. These strategies can facilitate the internationalization of Hong Kong herbs by helping achieve high-quality standards. Given that Hong Kong is an international city, the implementation of the proposed strategies in this proposal can serve as a demonstration of ways to improve the quality of herbs on a global scale.