Putting traditional Chinese medicine to the test

Putting traditional Chinese medicine to the test

A saleswoman weighs some herbal ingredients for a customer in a traditional Chinese medicine pharmacy. (File photo)
A saleswoman weighs some herbal ingredients for a customer in a traditional Chinese medicine pharmacy. (File photo)

Toad skins and turtle shells aren't the cures most westerners turn to when they learn they've developed cancer. But in China, the market for traditional remedies like these grew 35% last year, twice as fast as the overall anti-cancer market. Though the effectiveness of these treatments is unproven, Western doctors, elite medical institutions and pharmaceutical companies are starting to put them to the scientific test.

At first glance, the gap between dried centipede (a traditional Chinese anti-cancer drug) and conventional medicine seems a wide one. But westerners have adopted Chinese medical practice before. In 1971, The New York Times editor and columnist James Reston wrote about his experience with acupuncture after an emergency appendectomy at Beijing's Anti-Imperialist Hospital. It was the first time that many Americans had ever heard of the procedure, and is widely acknowledged to have done much to legitimise it in the eyes of patients, medical professionals and even insurance companies.

But acupuncture, even if badly administered, is unlikely to pinprick a patient to injury or death. The same cannot be said for some of the drugs associated with traditional Chinese medicine, widely known as TCM. TCM remains very much a craft, largely unregulated and barely vetted by science. Tragic consequences are well documented. A 2013 study of acute liver failure in China found that 17% of reported cases were caused by herbal remedies, while a 2014 study found that 42.5% of all drug-induced liver failure in China was caused by TCM. Many of the most popular medicines are known to contain lead, arsenic, and other dangerous substances. The use of endangered species is widespread. So is cruelty in harvesting compounds like bear bile from living animals.

China's TCM industry has resisted disclosing or acknowledging the side effects of their treatments. These problems are well-known to the Chinese public, which remains emotionally split over TCM and its effectiveness despite government efforts to promote it. So far, such concerns don't appear to have crossed over to western patients. But their governments are not so tolerant. The UK, for example, has largely banned their import while Hong Kong -- a thriving market for TCM -- strictly regulates them.

None of these prohibitions are unreasonable (conventional medicine is also highly regulated), but for the Chinese government, which has long supported TCM as a key cultural export, this is a public policy problem that needs addressing. Export revenue reached US$3.13 billion (113 billion baht) in 2013 and the government has bigger plans. TCM growth was even included in China's last five-year plan, the national blueprint for economic development.

Achieving those goals, and putting overseas patients at ease, won't be easy. The most important step is for China's government-subsidised TCM establishment to put traditional medicine to the same scientific test as any other kind of medicine. It's been done before. During the Cultural Revolution, for example, a group of Chinese researchers tasked with finding new anti-malarial drugs isolated and extracted artemisinin from qinghao, an herb used for centuries. Today, artemisinin is a leading anti-malarial drug worldwide, and researchers are now investigating its anti-cancer properties.

For TCM to gain international legitimisation, its practitioners will have to isolate compounds and subject them academic studies and regulatory approvals in countries where research and approval standards are high. China, with its corrupt FDA and culture of academic misconduct, doesn't qualify. That's not cheap, and it's not quick, but it's more or less the route that US hospitals and researchers are taking today as they seek to integrate the benefits of TCM into established therapies. The end result may not look like a Chinese medicine cabinet, but the benefits will be far more palatable to scientists, doctors and patients. ©2015 Bloomberg View

Adam Minter is an American writer based in Asia, where he covers politics, culture, business and junk.

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