Climate Change Thread

[Montmorency]

The PRC are notoriously inattentive? They're the torch carriers for science running government, regardless of humanity.

*Chinese laughter*

Demand for traditional Chinese medicine continues to grow in the western world. The lack of evidence-based testing in the sector is a worry, however – as is the political pressure that seems to be driving its aggressive expansion

Selling people on the idea that ancient practices are somehow superior – in the absence of any real evidence – may cause people to suffer unnecessary pain and even permanent disability.” But there are powerful engines in play to make us believe otherwise, for there are billions of dollars to be made from alternative therapies. Accordingly, the market is now expanding at a rapid rate, not just in western countries among educated, high-income individuals, but also in developing nations as a far cheaper option for proper medical care. Aristolochic acid is the embodiment of the dangers that alternative medicines pose. Unfortunately, however, in the battle for global health, the opposing side has a great deal at stake. In addition to the formidable financial incentives for growing the TCM market, there are strong political motivations also. Indeed, it would seem that TCM is currently being used as a political tool – a marker of China’s growing prestige and authority around the globe. The WHO’s worrying actions seem to attest to this.

Spoiler Alert, click show to read: 

Traditional Chinese medicine (TCM) has been expanding at a notable rate as of late: in 2016, the sector grossed CNY 860bn ($130bn), then expanded a further 20 percent throughout 2017, according to China Daily. A similar pattern can be seen overseas, too: according to Nature, a weekly science journal, the selling of TCM and other related products to One Belt One Road countries has surged. Between the years 2016 and 2017, exports experienced a whopping 54 percent growth to $295m. Indeed, according to the National Centre for Biotechnology Information, China exported TCM to 185 countries and regions around the world in 2016, with $526m worth exported the US alone – making up 15 percent of China’s annual TCM exports at the time.
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The Chinese Government – specifically, President Xi Jinping – is consciously driving the expansion of the TCM market at present. This became all too clear in a speech he gave in spring 2018, during which he also outlined plans to stay on as premier indefinitely. According to sources familiar with the matter, he devoted at least half an hour of his speech strictly to TCM, and explained there was no need to test the efficacy and toxicity of such treatments. The president also revealed a key stratagem in the market’s global expansion: the opening of some 300 TCM centres in various countries around the world. Domestic TCM centres, meanwhile, continue to attract more visitors to China, effectively becoming medical tourism hotspots. Since 2002, for example, some 50,000 foreigners (the majority being from Russian-speaking nations) have visited Sanya, a city in China’s Hainan province, for TCM treatments. Clearly, there is a strong financial incentive for promoting TCM around the globe.
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Moreover, Xi’s TCM ambitions have a strong political component. Dr Donald Marcus, Professor of Medicine and Immunology Emeritus at the Baylor College of Medicine, told World Finance: “He’s pushing it very hard for two reasons. One, he’s on a campaign to promote China as a great power and a source of all kinds of wonderful cultural and scientific things. He’s also facing the same problem that Chairman Mao faced, which is that they don’t have enough western-trained doctors to take care of a huge Chinese population, so they’re promoting the idea that TCM is just as good.” He added: “So it’s part of this nationalism push, but also, they’re making a lot of money with it.” Africa, a continent that has a growing dependency on China, is one of the main targets for China’s plans.
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“Insofar as it is being adopted, the impetus to try comes from clever marketing and does not come from any evidence whatsoever that TCM is scientifically sound or medically effective,” said Dr Steven L Salzberg, Professor of Biomedical Engineering, Computer Science and Biostatistics at Johns Hopkins University. Sadly, by using TCM, unknowing patients are less likely to seek proven treatments, which could in turn worsen their respective ailments. But this tragic tale does not end there. Aristolochic acid, which is derived from aristolochia, a large plant genus, is a common ingredient that has been used in Chinese herbal remedies for thousands of years. Following an outbreak in the Balkans in the late 1950s, it was discovered that not only does aristolochic acid trigger nephropathy, or kidney failure – it can also cause cancer. “The International Agency for Research on Cancer has said it’s one of the most potent carcinogens in humans, but what we didn’t know until this century was just how big a problem it is in places like China and Taiwan, where aristolochic acid is used,” Marcus told World Finance. “Several studies that were done in Taiwan and China in this century found that close to 50 percent of kidney tissues from patients with kidney failure or cancer had the molecular signature of aristolochic acid nephropathy,” Marcus explained. “Those data indicate that tens of millions of people in Asia are at risk for aristolochic acid nephropathy.” While many websites in China once brandished warnings about the dangers of aristolochia, it has been noted that within just weeks of Xi’s aforementioned speech, they had all disappeared.
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Last year, the World Health Organisation (WHO) revealed that, by 2022, TCM would be included in its 11th International Statistical Classification of Diseases and Related Health Problems. According to the organisation’s website, the document is “the diagnostic classification standard for all clinical and research purposes”. The work also sets the healthcare agenda for more than 100 nations worldwide. For China’s burgeoning TCM market, this is massive news. It marks the first time that TCM will be recognised by an international body with the prestige of the WHO. It also sets a scene wherein TCM is more commonly used as ‘acceptable’ treatment for various diseases. And yet, there is little to no evidence of the effectiveness, or even simply the safety, of many of the treatments offered by TCM. This is all the more surprising given the high standard of testing that the WHO usually requires. When asked what the WHO could possibly be thinking with such an extraordinary divergence from its standard procedures, Salzberg answered: “The WHO’s endorsement of TCM seems to be the culmination of a campaign by one person – its former director – who mistakenly believes (or seems to believe) that TCM is real medicine.” He is referring to Margaret Chan, who was director of the WHO between 2006 and 2017. “I don’t understand her motives, but scientifically speaking, she’s mistaken.”
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Among the scientific community, it is widely acknowledged that aristolochia is a powerful carcinogen, which can also cause irreversible kidney damage. But despite the fact that around 400 papers attesting this had been published by 2014, there is not a single mention of aristolochia in the WHO’s strategic report from the same year. Aside from Xi’s assertion that TCMs need not be tested, as well as the WHO’s glaring omission, matters are made even worse by the fact that labels on TCM products are often incomplete, failing to list all ingredients included. This is particularly worrying given the ubiquity of aristolochia and its horrendous side effects.

How difficult it should be to think, with all the history behind us, that autocrats are more likely to be steely-eyed scientific rationalists than politically-correct wagermakers.