Beyond regulatory recognition: Capacity building outcomes in traditional medicine South-South cooperation

Capacity building dimensions of Traditional Chinese Medicine (TCM) internationalization remain theoretically underdeveloped. This conceptual analysis introduces capacity building theory from development studies into TCM cooperation research, comparing the United Arab Emirates (UAE) and Saudi Arabia under a most-similar-systems design across five capacity dimensions: institutional, talent, technological, industrial, and discourse. Both countries regulate traditional medicine, but their frameworks differ in kind rather than in scale. UAE licensing is administered at emirate level and accords TCM integrated-whole status alongside two other codified ethnomedical systems federally and in Dubai, and four others in Abu Dhabi, whereas Saudi Arabia licenses acupuncture as a discrete practice and accords that status to no codified system. Abu Dhabi licenses acupuncture separately as well, so whole-system recognition and practice-level licensing are not alternatives; the two countries differ in the presence of the former. Neither has developed commensurate capacity in local education, research infrastructure, or comparative scholarship. The broader recognition accorded in the UAE has not produced proportionately greater capacity elsewhere, which indicates that statutory recognition of traditional medicine practice is a necessary but insufficient condition for comprehensive capacity building. The analysis contributes to South-South cooperation literature by showing what capacity building theory brings into view that output-oriented assessment obscures, and identifies the structural dominance of biomedicine as a constraint across all five dimensions. Sustainable capacity outcomes require cooperation frameworks prioritising education system development and knowledge transfer, an emphasis consistent with the WHO Global Traditional Medicine Strategy 2025-2034.