# International collaborative research and development (R&D) on traditional medicine and its contextual factors: a cross-sectional analysis from 1996 to 2022

## TL;DR

This study examines global R&D collaborations on traditional medicine from 1996 to 2022, showing most efforts involve high-income countries and non-communicable diseases.

## Contribution

The study provides new insights into global R&D collaboration trends in traditional medicine, emphasizing the need for increased LMIC participation.

## Key findings

- Most collaborative outputs (92.4%) came from high-income countries.
- Collaborations with LMICs increased from 0% in 1996 to 11.7% in 2022.
- Low-income countries contributed more to communicable disease research compared to high-income countries.

## Abstract

Traditional medicines can contribute to achieving universal health coverage, particularly in low- and middle-income countries where access to conventional treatments is limited. International collaboration is crucial to bridge the lag in modernised research and promote access to traditional medicines. This study focused on China’s global collaborative research and development (R&D) efforts on traditional medicine, in the hope of improving global recognition for traditional medicine.

We conducted a cross-sectional study to analyse collaborative R&D outputs on Chinese patent medicines from 1996 to 2022. The study cohort included the collaborative outputs of scientific research, patent applications, and clinical trials between China and other countries. We analysed the outputs using data from the Web of Science, Worldwide Patent Statistical Database, and the International Clinical Trials Registry Platform. The Zero Inflated Negative Binomial regression model was employed to investigate the association between outputs and the characteristics of participating countries.

The majority of collaborative outputs (n = 964, 92.4%) originated from collaborations with high-income countries, with only 7.6% involving low- and middle- income countries (LMICs). The percentage of R&D collaborations with LMICs showed an increasing trend from 0% in 1996 to 11.7% in 2022. Most collaborations focused on non-communicable diseases (n = 912, 87.4%). Low-income countries accounted for a larger share of collaborative R&D on communicable diseases (14.3%) compared with high-income countries (1.4%). The total number of outputs was positively associated with the degree of cooperative institutionalisation and the collaborator’s traditional medicine development score.

Gaps still remain in the involvement of low- and middle-income members compared with high income countries. Findings highlight the importance of encouraging greater engagement of low- and middle- income countries in global R & D collaboration on traditional medicine, particularly through South-South partnerships. Such collaborations should prioritise research agendas that address local health priorities, especially those related to communicable diseases.