The global reach of traditional Chinese medicine is also likely to continue expanding. Every Chinese hospital has a department devoted to Chinese medicine, with doctors frequently qualified in both Western and Chinese medicine. When Western-style drugs are prescribed they are often combined with traditional Chinese treatments (which was my own experience in a Beijing hospital). [1328] The major constraint on the development of Chinese medicine in the West has been that it is not subject to the same kind of regulation as Western medicine (though clinical trials are quite common in China). [1329] Western drugs have made some headway in China, but traditional Chinese medicines are still favoured by most people, including the affluent middle class and the highly educated, on the grounds that they have thousands of years of experience behind them, are cheaper, and also devoid of toxic side effects. It is accepted that Western drugs are superior for diseases like cancer, but even when these are used, people will generally revert to Chinese medicines subsequently. [1330] The contrast between Chinese and Western medicine eloquently sums up the difference between civilizational wisdom and scientific knowledge. Chinese medicine, rather like the world’s cuisines, is a product of thousands of years of trial and error, of the everyday experience and resourcefulness of hundreds of millions of people and their interaction with their plant environment; Western medicine is a rigorous product of the scientific method and the invention and refining of chemicals. With the exception of those fundamentalists of the scientific method who believe that they enjoy a monopoly of true knowledge, there is a widespread and growing acceptance in the West that medicinal palliatives and cures derived from civilizational experience are a valid and important part of medicine, even if we do not understand, at least as yet, how the great majority of them actually work.

THE DECLINE AND FALL OF THE WEST

The purpose of this chapter has been to explore the ways in which Chinese global hegemony is likely to grow over the next half-century. There is another side to this coin which we should consider before we conclude. The most traumatic consequences of this process will be felt by the West because it is the West that will find its historic position being usurped by China. The change that this will represent can hardly be exaggerated. For well over two centuries, in some respects much longer, the West, first in the form of Europe and later in the shape of the United States, has enjoyed overwhelming global pre-eminence. Since 1945 Europe has been obliged to adjust to the fact that it is no longer the dominant player in world politics. The sense of being less and less central to a world that it had previously dominated has been a traumatic experience for European states, especially Britain and France. One response has been the construction of the European Union as a way of mitigating the decline in the power and status of individual states. The fact that European dominance was replaced by that of the United States, however, has helped to lessen this sense of loss. Driven by the Cold War antagonism towards the Soviet Union, an enhanced and transformed concept of the West was forged which effectively enabled Western Europe, at least until 1989, to remain a major global player alongside the United States, even though it was very much the junior partner. This was no ordinary relationship between nation-states based on specific interests, however. On the contrary, the United States was a product of European migration: it had been built by Europeans (together with African slaves) and saw itself as the New World joined at the hip with the Old World whence it came. In other words, history, civilization, culture, ethnicity and race, as well as the exigencies of geopolitics, served to weld and underpin the Western alliance.

The rise of China will have no such compensations, either for a declining Europe or a dethroned United States. Europe, at least, has had some preparation for this eventuality: it has spent the last half-century adjusting to decline and dethronement. Even now, though, Europe still finds it extremely difficult to understand its increasingly modest place in the world and to adjust its sights accordingly. The case of Britain is most striking in this context. In a desperate attempt to remain a global power with a metaphorical seat at the top table, it has tenaciously hung on to the coat-tails of the United States, constantly walking in its shadow, seemingly always prepared to do its master’s bidding. [1331] Its foreign policy has long been a clone of that of the United States and its defence and intelligence policies are almost entirely dependent on and deeply integrated with those of the US. The UK’s dependence on the US is a measure not simply of its own weakness and of its failure to find an independent place in the world following the collapse of its imperial role, but also of how traumatic it has found the idea of no longer being a great power. The relationship with the United States has been a surrogate for its lost past. Europe’s continuing existential crisis underlines how difficult it is for countries to adjust, not least psychologically, to a world in which their importance is greatly diminished. Europe’s decline, furthermore, will certainly continue into the indefinite future. Its remarkable role over the last four hundred years will never be repeated and will become an historical curiosity in the manner of the Greek and Roman empires, whose present-day incarnations as Greece and Italy reflect the grandeur of their imperial past in little more than the survival of some of their historic buildings.

If Europe will suffer, that is nothing to the material and existential crisis that will be faced by the United States. It is almost completely unprepared for a life where it is not globally dominant. Under the Bush administration it sought to redefine itself as the world’s sole superpower, able to further its interests through unilateralism and shun the need for alliances: in other words, far from recognizing its relative decline and the prospect of a diminution in its power, it drew precisely the opposite conclusion and became intoxicated with the idea that US power could be further expanded, that America was in the ascendancy, that the world in the twenty-first century could be remade in the country’s image. The dominant ideological force during the Bush era was neo-conservatism, which was predicated on the belief that the United States could and should assert itself in a new way. In the wake of 9/11 Washington was in thrall to a debate about empires and whether the United States was now an imperial power and what that might mean. The Bush administration represented the most extreme expression so far of an aggressive, assertive and expansionist America, but even after it was widely seen to have failed as a result of the Iraq debacle, there were not many in the United States who drew the conclusion that the country was in longer-term decline, that far from it being on the eve of a new global dominance, its power had, in fact, already peaked; on the contrary, there was a widespread perception that the United States simply needed to find a less confrontational and more consensual way of exercising its global leadership. Not even the advances made by China in East Asia were interpreted as the harbinger of a major shift in global power.

The heart-searching that accompanied the 2007- 8 primary and presidential campaign around Barack Obama’s candidature did not, at least until the financial meltdown just before the election, reach the conclusion that the United States would have to learn to live with decline. Even the precipitous decline in the value of the dollar in 2006-7 did not provoke fear of American decline, though a small minority of observers recognized that in the longer term the position of the dollar might come under threat. The United States thus remained largely blind to what the future might hold, still basking in the glory of its past and its present, and preferring to believe that it would continue in the future. Britain displayed a similar ignorance — and denial — about its own decline after 1918, constantly seeking to hold on to what it had gained, and only letting go when it could see no alternative. Indeed it only began to show an underlying recognition of its own decline in the 1950s, when it became obvious it would lose its colonies. The turning point in the United States may well prove to have been the financial meltdown in September 2008, with the near collapse of the financial system and the demise of neo-liberalism. The US National Intelligence Council report in November 2008 represented a 180-degree shift compared with its previous report just four years earlier in 2004. While the latter predicted continuing American global dominance, ‘positing that most major powers have forsaken the idea of balancing the US’, the new one anticipated American decline, the emergence of multipolarity, and a world in which the US would increasingly be obliged to share power with China and India. It declared: ‘By 2025, the US will find itself as one of a number of important actors on the world stage, albeit still the most powerful one.’ [1332] The task facing Barack Obama’s presidency is far from enviable. The worldwide euphoria that greeted his election sits uneasily with what appears to be the most difficult task that has confronted any US president over the last century: managing long-term decline in an immediate context of the worst recession since 1945 and a commitment to fighting two wars. Encouragingly, Obama’s election indicates that the US is capable of opting for an imaginative and benign response to its travails. But these are very early days yet: we are only at the beginning of a protracted process with many acts to follow over several decades, if not more. The American Right is powerful and entrenched, with deep well-springs of support. The biggest danger facing the world is that the United States will at some point adopt an aggressive stance that treats China as the enemy and seeks to isolate it. A relatively benign example of this was the proposal of the Republican presidential candidate Senator John McCain for a ‘league of democracies’, designed to exclude China and Russia (which he also wanted to expel from the G8) and thereby create a new global division. [1333] The longer-term fear must be that the US engages China in military competition and an arms race in something akin to a rerun of the Cold War.