Resilience and Sustainability in Traditional Chinese Medicine: Environmental Challenges for Medicinal Plant Sourcing under Climate Change—A Taiwan Perspective

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Climate change is increasingly affecting the ecological stability, cultivation conditions, and bioactive compounds of medicinal plants used in Traditional Chinese Medicine (TCM), raising concerns about resource sustainability and therapeutic reliability. This scoping review aims to map current evidence on climate-related impacts on TCM medicinal plants and to examine how such evidence may inform future sustainability-oriented regulatory approaches. Following framework developed by Arksey & O’Malley, major databases were searched from inception to December 2025 for studies examining environmental or climatic influences on TCM medicinal plant distribution, growth, yield, or phytochemical characteristics. Reported outcomes were synthesised into three fields consisting of herb availability, herb quality, and adaptation strategies. To support consistent botanical identification and explore regulatory implications, identified species were subsequently mapped to the Taiwan Herbal Pharmacopoeia (THP) as analytical framework. From 2457 screened studies, 74 met inclusion criteria. Global warming was shown to impact availability of botanical drugs with predictive models, with species like Gentiana manshurica projected to lose highly suitable habitats, while some (e.g., Leonurus japonicus ) have expanded into new regions. Moderate drought stress was found to improve active compound synthesis, but prolonged stress decreased yield and quality in plants such as Panax notoginseng and Glycyrrhiza uralensis . However, existing studies that systematically address adaptation policies and protocols remain limited. Climate change poses a substantial challenge to the resilience and sustainability of TCM plants. Integrating climate vulnerability into pharmacopoeia standards and prioritizing interdisciplinary adaptation strategies are essential to safeguard the global supply and clinical efficacy of TCM botanical resources.