Singapore Charts Evidence-Based Path to Integrate Traditional Chinese Medicine into Mainstream Healthcare
核心洞察
Singapore is advancing an evidence-based strategy to integrate Traditional Chinese Medicine (搜索) (TCM) into its mainstream healthcare system, anchored by the Healthier SG national prevention strategy.
One in five adult Singaporeans use TCM annually, and nearly 40% of these individuals combine TCM with Western medicine for the same condition, according to MOH's 2022 National Population Health Survey.
The TCM Integrative Sandbox (TCMIS) initiative, launched in January last year, is testing evidence-based, cost-effective TCM treatments in public hospitals to generate real-world evidence.
Singapore is moving to formally integrate Traditional Chinese Medicine (搜索) (TCM) into its mainstream healthcare system through an evidence-based, collaborative approach, Professor Kenneth Mak, Director-General of Health at the Ministry of Health (MOH), told the inaugural Singapore-Australia Integrative Medicine Symposium on 5 September 2026.
The symposium, organised by Tan Tock Seng Hospital (搜索) (TTSH), Nanyang Technological University (NTU), and the Prevention and Recovery through Integrative Medicine (PRIME) team—a collaboration between TTSH and NTU—brought together experts from Singapore and Australia, as well as practitioners from both Western medicine and Chinese Medicine.
Professor Mak framed the initiative within Singapore's rapidly ageing population, noting that more people are living longer while also living with multiple chronic conditions, including diabetes (搜索), hypertension (搜索), cardiovascular disease (搜索), cancer (搜索) and neurological disorders (搜索). "As these needs grow more and more complex, what patients require is not just clinical excellence, but care that is coordinated, preventive and holistic," he said.
Alignment with Healthier SG
The integration effort sits at the heart of Healthier SG, Singapore's national strategy that shifts healthcare focus from treating illness to proactive prevention. Professor Mak described Healthier SG as "a fundamental shift in how we think about healthcare," moving away from systems-level approaches focused primarily on treating illness toward investment in prevention, wellness and long-term health outcomes.
TCM's philosophy, he argued, aligns closely with this concept. "TCM's philosophy and strengths lie in holistic wellness, emphasising the balance not only between bodily systems but also across mental health and the wider socio-environmental factors that affect and influence our well-being," he said. In practice, TCM practitioners guide patients on diet, exercise and lifestyle modifications that complement Western doctors' health plans.
Patient-Driven Demand
Data from MOH's 2022 National Population Health Survey underscore the demand for integrated care. One in five adult Singaporeans use TCM every year on a regular basis, and nearly 40% of these individuals combine TCM and Western medicine for the same condition. Their reasons commonly centre on the holistic and complementary value they perceive in TCM, particularly in chronic disease management, symptom relief, or supporting recovery and rehabilitation.
"Patients are not waiting for the healthcare system to catch up," Professor Mak observed. "They are already integrating TCM and Western medicine on their own, navigating between providers and making decisions largely without any formal guidance or coordination." The central question, he said, is how the healthcare system can ensure such integrated care is safe, well-coordinated, evidence-based and accessible.
Regulatory Foundations
Singapore was among the first in the region to establish statutory regulation of TCM practitioners, doing so in 2001 through the formation of the TCM Practitioners Board (TCMPB). Today, over 3,500 registered practitioners meet the TCMPB's professional standards. Beyond statutory regulation, MOH made a strategic decision to place TCM services under a system of self-regulation rather than imposing the full clinical governance framework of Western medicine on TCM clinics.
Building an Evidence Base
Since 2014, the MOH TCM Research Grant has supported more than 20 research projects, bringing together public healthcare institutions, academic institutions and TCM practitioners. These projects have helped build the evidence base, strengthen professional relationships across disciplines and develop a shared language for integrative care.
In January last year, MOH advanced this further with the launch of the TCM Integrative Sandbox (TCMIS) initiative. The sandbox aims to test and evaluate evidence-based, cost-effective TCM treatments for specific conditions in public hospitals within a controlled environment. "Through carefully selected evidence-based treatments that complement existing practices, we are exploring how TCM and Western medicine can work hand in hand, leveraging the strengths of both systems to achieve synergistic outcomes that ensure optimal care and yet not compromise patient safety," Professor Mak said.
The TCMIS creates a space to gather real-world evidence needed for informed decisions without prematurely committing to system-wide changes. In the longer term, MOH intends to draw on local data generated through the sandbox to guide decisions on mainstreaming selected TCM treatments for specific conditions into the broader healthcare system.
Three Enablers for Integration
Professor Mak identified three areas that must advance together for integration to succeed. First, research: rigorous, high-quality clinical studies, implementation research and health services research are needed to understand where integrative approaches work best, for whom, and for which conditions, alongside systematic tracking of clinical and cost-effectiveness.
Second, education and capability building: Western medicine-trained doctors need a deeper understanding of TCM principles, while TCM practitioners need to understand how modern healthcare systems operate. He highlighted the PRIME initiative's efforts to strengthen collaboration through integrated educational programmes as "an important step in this direction."
Third, governance: robust governance must underpin clinical practice through clear standards and quality assurance processes for credentialing, supervision, incident reporting and professional accountability. This includes establishing referral pathways, developing collaborative care protocols, clarifying scopes of practice, and systematising drug-herb guidance within pharmacy and clinical workflows, as well as ensuring interoperability of TCM electronic records with well-defined clinical diagnosis codes and appropriate data privacy.
"Research, education and capability building, and robust governance in clinical practice must all advance together," Professor Mak said. "It is only when they progress in step that integrative medicine can mature into something that healthcare system and patients can truly rely on."