Wildlife conservationists are increasingly concerned about Traditional Chinese Medicine (TCM) due to the demands it places on many threatened species. In particular, pangolin populations in both Asia and Africa have experienced drastic declines driven by illegal trade. However, few studies have attempted to determine the level of this demand for traded species. In this study, we use social science approaches to investigate the pangolin scale trade within China, based upon interviews with informants from hospitals and pharmaceutical shops in two Chinese provinces (Henan and Hainan). Doctors from 41 hospitals and shop owners or shop assistants from 134 pharmaceutical shops were interviewed between October 2016 and April 2017. We show that pangolin scales are under heavy demand and products are available in 34% of the shops and 66% of the hospitals included in this study. Sale quantities were found to vary substantially amongst sellers and no significant factors were found to correlate with sale quantity. Moreover, quantities of products traded by permitted legal sellers are estimated to greatly exceed the supply capacity of legal sources. There is an urgent need to reduce demand from TCM on pangolin scales and revise the current legal pangolin scale trade system. We also highlight the importance of incorporating the TCM sector into combating illegal wildlife trade and species conservation beyond pangolins.

animal-based medicine, conservation, demand reduction, market survey, social science, Traditional Chinese Medicine (TCM), wildlife trade

China plays an important role in regulating legal wildlife trade and combating illegal wildlife trade for global biodiversity conservation and further research is required to understand the sustainability of demand and trade in wildlife products within the country (Esmail et al. 2020). In particular, frequent seizures of large quantities of pangolin products have attracted the attention of conservationists worldwide. All eight pangolin species (family Manidae), which occur in Asia and Africa, are threatened with extinction due to illegal trade and threats from trade are not a recent phenomenon. The Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) has listed most pangolin species on its appendices under regulation since 1975, the year the convention came into effect. A stricter zero-trade quota was applied to the four Asian pangolin species in 2000 to further reduce pressures from trade (CITES 2000). In 2016, all eight pangolin species were uplisted to CITES Appendix I, banning all wild-sourced commercial trade (CITES 2016). However, this legislation has not been able to prevent ongoing trafficking in pangolin products (Cheng et al. 2017; Heinrich et al. 2017; Challender et al. 2020).

Pangolin products in trade can be broadly grouped into three types: foods, medicines and ornaments (Challender et al. 2014; Heinrich et al. 2017). Confiscation reports show that each product type is supplied through different trading chains and sold in different end-markets. The current trade of pangolin products is truly international, with over 70 countries across four continents identified as being involved in the trade in various ways (Heinrich et al. 2017). Amongst these countries, China is under the spotlight as one of the main demand markets. All three types of pangolin products are traded in China, with meat and medicinal products reported most frequently (Yang et al. 2007; Xu et al. 2016). Traded medicinal pangolin products are commonly associated with Traditional Chinese Medicine (TCM) (Yin et al. 2015).

TCM has been developed and used in China for many centuries and is still widely practised today (Chow and Liu 2013). In 2016, TCM hospitals and clinics treated 962 million patients, while medical services using TCM treatment accounted for 15.8% of all medical services provided in China (National Health and Family Planning Commission of the PRC 2017). The use of Chinese pangolin (Manis pentadactyla) scales in TCM can be traced back to AD 480 in a medical text entitled “Bencaojing jizhu”, which was later cited in the “Compendium of Materia Medica” (Li 1578). Chinese TCM practitioners generally approve the perceived medicinal value of pangolin scales and use them in prescriptions targeting a wide range of symptoms or illnesses (Wang et al. 2020). Although pangolin scales have recently been removed from the “Pharmacopoeia of the People’s Republic of China”, some patented medicines or ‘zhongchengyao’ in the Pharmacopoeia still contain pangolin scales as an ingredient (National Pharmacopoeia Committee 2020).

The Chinese pangolin has been listed as a Second-Class Protected Animal in China and protected under the Law on the Protection of Wildlife since 1989 (SFA of China 1989). It was uplisted to First-Class protection in 2020, with an aim to provide more deterrence and resources for combating illegal trade (SFGA of China 2020). However, the Chinese government still permits a pangolin scale market to operate nationally for medicinal usage, with specific requirements on sources of supply, manufacturers, sellers, annual quotas allowed for sale and a product labelling system (Wang et al. 2022). Market requirements were released by China’s State Forestry Administration (SFA, now State Forestry and Grassland Administration) and came into effect in 2008. These requirements specify 711 hospitals in China that are allowed to sell medicines containing pangolin scales (e.g. patent drugs or ‘zhongchengyao’) and pangolin scale medicines (individual ingredients to be used in prescriptions) (SFA of China 2007, 2008a). All manufacturers and traders are required to hold corresponding permits. There are 209 certified manufacturers in China, which are allowed to produce over 60 types of medicines containing pangolin scales (Xu et al. 2016). All pangolin scale medicines must carry certificates on the smallest packages, to differentiate clearly between legal and illegal products in end-consumer markets. Therefore, illegal trade or illegal products can be identified if: (1) trade participants, such as manufacturers or hospitals, do not hold corresponding permits and/or (2) traded products do not have certificates on the smallest packages.

Trade volume in China is regulated through an annual quota, which has a mean of 26.58 ± 1.58 tonnes, based on released data from 2008 to 2014 (range; 25.09–29.23 tonnes; SFA of China (2008b, 2009, 2010, 2011, 2012, 2013, 2014)). The detailed policy process that determines the annual quota amount is unclear (Wang et al. 2022) and these regulations also do not specify that scales should be from Chinese pangolins. The source of the legal quota is stockpiles held by individuals or companies, which could contain legal imports of pangolin scales from Africa or other parts of Asia when it was allowed. Seized pangolin products may also be auctioned to permitted buyers without species-level identification to supply the legal market. TCM demand for pangolin products within China therefore poses potential impacts on all pangolin species.

As China constitutes one of the largest demand markets for pangolin products, it is essential to understand the nature of TCM-related demand in order to provide information for management options. This approach is also important beyond pangolin conservation, as other threatened species are involved in the TCM trade in other contexts (e.g. saiga horn, bear bile; Doughty et al. (2019), Wang et al. (2022)). Key questions about pangolin trade in China include the trade volume, the level of demand from the legal market and whether the legal supply is the main source for traded products. These questions are difficult to answer, as the geographic scale over which trade takes place is vast and illegal trade is a sensitive topic to investigate. This study aims to provide preliminary answers to these questions using data from two Chinese provinces. Since our data were collected before the COVID-19 outbreak, our study also provides a baseline for understanding the pangolin scale trade from a quantitative perspective prior to the impact of the pandemic on the use of wildlife products in China.

We interviewed doctors or sellers from 41 hospitals and 134 pharmaceutical shops in eight municipalities/counties. Pangolin scale products were sometimes on display and we observed both legal and illegal products being sold (i.e. products with and without trade certificates) by both legal and illegal sellers (i.e. certified hospitals and non-certified hospitals and all pharmaceutical shops). Hospitals with legal trading permits were also found selling products without the legally required certificates, while legal products were also found in uncertified hospitals.

Hospital results

A high proportion of interviewed hospitals sold pangolin products, with sales quantities of considerable size. Of the 41 hospitals, 27 (65.9%) were found to sell pangolin scale products and 20 reported data on sales quantity. In total, these 20 hospitals sold 1905.8 kg roasted scale (2382.3 kg raw scale) in one year, with a mean of 95.3 ± 193.9 kg per hospital per year. Eight of the 27 hospitals that sold pangolin scale products held a legal permit. Seven of these eight permitted hospitals reported sales data; in total, these seven hospitals had sold 423.0 kg of roasted scales during the previous year, equivalent to 528.8 kg of raw scales. In addition, 13 of the 19 unpermitted hospitals that sold pangolin scale products also provided sales quantity data; in total, these 13 hospitals had sold 1482.9 kg of processed scale products during the previous year, with a mean of 114.1 ± 226.5 kg per hospital per year, equivalent to 1853.6 kg of raw scales.

Reported annual sales also varied considerably across hospitals (Fig. 2). Ten hospitals reported selling less than 20 kg per year, while four hospitals reported annual sales quantities of over 200 kg of roasted scales; three of these four hospitals did not hold trade permits. The four hospitals with the highest annual sales quantities were all located in Henan. Sales quantity was not explained by any predictor variables included in GLMs (P > 0.1 or NA, N _hospital = 19), including price (Fig. 2). Hospitals in cities with larger populations were more likely to report selling scale products (P = 0.03, N _hospital = 41).

Figure 2.

a Box plot showing reported sales quantities in hospitals and shops (N _hospital = 20, N _shop = 25) b scatter plot showing sale quantities and corresponding prices reported by hospitals (circles) and shops (triangles) (N _hospital = 19, N _shop = 25).

Two hospitals in Zhengzhou also provided longer-term sales data on the total amounts of roasted scales purchased each year from 2012 to 2016, in addition to sales data for 2017 (Fig. 3). Both hospitals purchased pangolin scale medicines multiple times per year depending on demand, so that purchase quantities indicate annual sale quantities. For both hospitals, the mean of sales across the previous five-year period did not differ statistically from sales data estimated for 2017, based on sales during the first four months of 2017 (one-sample t-test, P _{hospital 1} = 0.208; P _{hospital 2} = 0.998), indicating that sales data for 2017 are representative of the general market situation.

Figure 3.

Reported volumes of roasted pangolin scales purchased by two hospitals in Zhengzhou, Henan Province, from 2012 to 2016.

Our study reveals that pangolin scale products were widely available in hospitals and pharmaceutical shops across Henan and Hainan Provinces during the time of our survey. At a policy level, government regulations specify that only 711 listed hospitals in China are legally allowed to sell pangolin scale products directly to consumers (SFA of China 2007, 2008a). However, we found that 46% of surveyed hospitals and 34% of surveyed pharmaceutical shops were selling pangolin scale products illegally. Some legal sellers (i.e. permitted hospitals) were also observed selling illegal pangolin scale products, as evidenced by the absence of trade certificates on product packages. Our study, therefore, highlights the urgent need for managing legal and illegal pangolin product trade across China.

The presence of illegal pangolin scale products in pharmaceutical shops has been previously reported (Yin et al. 2015; Xu et al. 2016). However, little research has previously been conducted on trade in pangolin products in Chinese hospitals. The co-occurrence of legal and illegal trade makes the trade in hospitals more complex than for other types of sellers. Our results show that many hospitals sell pangolin scale products illegally and annual sales quantities reported by these hospitals are also high and of significant conservation concern. These findings together suggest that illegal products have penetrated the legal pangolin product sale system.

The quantity of pangolin scale products involved in the three types of sales channels varies substantially, both between different groups of sellers and within the same seller group. None of the variables investigated in this study was found to explain the observed variation. Qualitative observations during interviews suggest that this variation might instead be more related to individual doctors’ preferences and specialities rather than wider external factors, posing difficulties in estimating accurate provincial-level or national-level trade volumes across China using regional data.

However, it is still meaningful to estimate market size on a larger geographic scale, to provide some understanding of the possible level of medicinal trade in pangolin products across China. Extrapolating from the sales data that we obtained from permitted hospitals included within our study, we provisionally estimate that annual sales across the 711 permitted hospitals in China could be 53.7 tonnes, twice the mean legal quota of 26.58 tonnes per year. Although we recognise that this extrapolation is only approximate, it suggests that the demand on medicinal pangolin products in China is likely to be high and above legally permitted levels. We also note that our survey did not collect data on sales levels for patent drugs, another group of medicines that can legally contain pangolin scale products and share the annual national quota with prescription medicines. As our estimates are based only on data for prescription medicines, actual trade volumes of medicinal pangolin products could, therefore, be even higher, further widening the gap between legal supply capacity and market demand.

Our results show that sale of medicinal pangolin products is more likely to be reported by hospitals in cities with higher populations, suggesting a potential greater demand for pangolin products across more heavily urbanised areas of China and, thus, raising further potential concerns about sustainability of levels of demand. Our shop survey results also demonstrated that sale of pangolin products was more likely to be reported by chain shops rather than by private non-chain shops. This finding might indicate either genuine variation in sales between different types of shops or that owners of private non-chain shops know more about the illegal nature of pangolin scale trade and are, thus, less likely to report sales (Wang et al. 2020).

Reducing illegal pangolin trade within China is recognised as a global conservation concern (Wang et al. 2022). Our results thus demonstrate that illegal trade in pharmaceutical shops and uncertified hospitals within China represents a management priority for pangolin conservation. Understanding and reducing consumer demand for pangolin products and collaborating with the TCM sector to encourage the use of substitutes and raise awareness about legislation, are identified as potential mitigation strategies (Luo et al. 2011; Wang et al. 2020). Another proposed option is to increase the supply of medicinal pangolin products through farming. However, although conservation breeding has been carried out for some pangolin species (Parker and Luz 2020; Yan et al. 2021), establishing pangolin farming at a commercial scale is still a long way off, due to numerous well-recognised technical difficulties, such as designing suitable feed (Wicker et al. 2020). The two current problems facing pangolin conservation that we highlight in China, widespread illegal trade and very limited legal supply capacity compared to market demand, instead both need urgent mitigation rather than relying on solutions that are not feasible in the near future. More generally, the effectiveness of farming wildlife to relieve pressure on wild populations requires comprehensive and critical evaluation to ensure that it does not have unforeseen negative consequences, such as increasing demand or providing a cover for laundering of illegal products (e.g. Kirkpatrick and Emerton (2010); Lyons and Natusch (2011); Turvey et al. (2021)). More research is, therefore, needed to understand the complex dynamics of pangolin trade, to ensure that commercial farming would not pose additional threats to wild pangolin populations (Challender et al. 2019; Chen and ’t Sas-Rolfes 2021).

Collecting accurate data using social science research methods can be challenging for sensitive topics such as illegal activities. However, illegality of pangolin product trade was not well recognised by most respondents during interviews (Wang et al. 2020), which led to greater willingness to discuss the trade openly. Moreover, we aimed to build trust with respondents by providing maximum anonymity and maintaining a neutral position during interviews (Cunliffe and Alcadipani 2016). All hospital respondents were approached through social network connections, which further helped to establish trust (van Uhm 2016). Respondents were not pushed to answer questions and were free to withdraw at any point during the interview. However, despite these protocols, we consider it more likely that respondents will have under-reported rather than over-reported sales behaviour due to the sensitive nature of the subject and our direct questioning technique (Olmedo et al. 2021). This consideration thus suggests that actual sales levels of medicinal pangolin products might be greater than indicated in our study, raising even further concerns about the sustainability of this trade and its wider impact on wild pangolin populations.

Our study shows that the illegal pangolin scale trade is widespread in China and that pharmaceutical shops and hospitals are both contributors. Legal products were observed in illegal sale channels and hospitals holding legal permits also sold illegal products. The amount of scale products sold by certified hospitals might greatly exceed the legal supply capacity. Our findings, thus, highlight the need to better regulate and re-think the current legal market. More detailed regulations might be needed to ensure a close legal trade framework that will prevent legal products leaking out of allowed trade routes, while preventing the sale of illegal products. Redesign of existing legal market management strategies, combined with large-scale demand-reduction interventions and stronger enforcement of existing regulations, is, therefore, an urgent policy priority in China for both global pangolin conservation and public health concerns.

Although this study only focused on pangolins, our methods and insights are also useful for studying and conserving other threatened species involved in the TCM trade. For example, the saiga horn trade is regulated within a similar legal framework in China, with only certified hospitals allowed to sell products to patients (SFA of China 2007). Conservation issues identified in pangolin trade might, therefore, also be concerns in saiga horn trade and other animal-product trades. This highlights the need for more research on the dynamics and sustainability of TCM trade across different species, with a focus on understanding markets and assessing enforcement effectiveness. We also recognise that this study was conducted before the COVID-19 pandemic, which has had a major impact on wildlife trade management and markets within China. We, therefore, provide a baseline for future studies to investigate markets and trade dynamics before and after COVID-19.

We give special thanks to all the anonymous respondents who participated in our surveys and everyone who helped with social network access to respondents. Thanks to Cambridge University Library Central Open Access Funding for supporting the publication of this article. We also thank Dr Dan Challender for helping with the development of this project.