Science of ignoring science: Case study of Chinese traditional medicines

Sergio Restelli

Albert Einstein, with respect to science, proclaimed that “The important thing is to never stop questioning”. Therefore, one has to ask pertinent questions and try to find their answers to follow the scientific way. However, this has been missing in the case of Traditional Chinese Medicines (TCM) and their unregulated penetration in the health systems of the various countries of the world.

The lack of scientific evidence about the efficacy of many TCM formulations, questionable clinical trials, ingredients including heavy metals and toxins are not mentioned on the packaging and numerous cases of adverse drug reactions especially in children have altogether pushed TCM into the bracket of pseudoscience or a science that needs rigorous and unbiased researches and clinical trials before any further use. The World Health Organization (WHO) is a United Nations (UN) agency that supports Universal Health Coverage (UHC). Sadly, ignoring science to achieve UHC is not the right step forward.

The WHO-China Alliance

On January 18, 2022, WHO Director General Tedros Adhanom Ghebreyesus tweeted that he met Huang Luqi, vice-commissioner of the Chinese National Administration of Traditional Chinese Medicine (TCM), to “discuss the role of traditional Chinese medicine in improving people’s health”. This linkage between WHO top officials and TCM proponents is very old and grew particularly strong during the tenure of a Chinese-Canadian physician, Margaret Chan, who served as the DG of the WHO for 2006–2017. Due to Chan’s efforts, China was able to include TCM in the crucial International Classification of Diseases, ICD-11, for the first time. The ICD is a highly influential document that categorises and assigns codes to medical conditions. The inclusion of TCM in the ICD11 has been criticised by the scientific community around the world.

An excerpt from the acknowledgment of “WHO traditional medicine strategy: 2014-2023”2 which talks highly of promoting the TCM reads as: “The government of the People’s Republic of China kindly provided financial support for the development of the document.” On top of it, most of the members of the drafting committee of the WHO strategy were Chinese. The promotion of Traditional Medicines by WHO is appreciable and can be seen as a progressive step to integrate health systems around the globe. However, such a promotion with inaccurate research and without unbiased participants is doing the damage.

Value of evidence based studies

TCM is a popular medicine system in African countries and countries under the Belt and Road Initiative (BRI) due to the rigorous promotion and wolf warrior diplomacy by China. Many people have benefited from these medicines as well, but there are a lot of cases of Adverse Drug Reactions (ADR), which are brushed under the carpet. Moreover, the pieces of evidence and clinical trial results provided for the efficacy of the TCM are paltry. Pakistan, which is battling the 5th wave of COVID-19, recently announced that trials of TCM COVID-19 drugs were successful. They reported that trials were conducted on 300 patients who were treated at home, and the TCM medicine would work on mild to moderate COVID-19 cases. The issue is that the sample size of the people chosen for the trial was too small, their detailed results are not being published on public platforms and the fact that Pakistan is chosen for the trials of Traditional Chinese Medicines raised many eyebrows. Ironically, in late April 2020, a senior doctor at a hospital in Hubei province was reprimanded and even demoted for posting online that TCM remedies for treating COVID-19 were not science-based. The disregard for science does not stop here. The 2nd Gen DNA sequencing studies have detected the presence of heavy metals and plant toxins in various TCM formulations, which have numerous adverse effects on human health. Presence of these toxins and chemicals is not indicated on the packaging of TCM products due to the lack of guidelines and required regulations. Arthur Grollman, a cancer researcher at Stony Brook University in New York, has published work showing how Aristolochic acid, an ingredient in many TCM remedies, can cause kidney failure and cancer.

Children and ADRs

TCM is particularly dangerous for children aged below 16. According to research titled “Safety Concerns of Traditional Chinese Medicine Injections Used in Chinese”, TCM injections pose serious risks to the pediatric population and produce ADRs like anaphylactic shock and fatal anaphylaxis. ADRs in children have been reported in most of the places where TCM is practiced, within China and other countries like Nigeria, Tanzania and South Africa. There are people who have reported being cured by such medicines. However, if ADRs are so severe that they can cause the death of a young person, shouldn’t this science/pseudoscience be researched thoroughly by independent researchers before claiming it as a panacea?

The Way Forward

In 2016, the death of a young Chinese actress Xu Ting, 26, from cancer who was only taking TCM-based treatment sparked a debate on the Chinese social media with the hashtag #XuTing’sDeathAndChineseMedicine trending on Weibo7 . This turned into a massive awareness drive on social media and calls for better clinical trials and research on TCM before any further use. But soon this drive was crushed and forgotten. The way forward is to reinitiate the discussions about the TCM. People-driven awareness campaigns should be initiated for the masses to understand the ADRs TCM is causing. The time is also ripe for the world to tell global bodies like the WHO to stop ignoring science and make way for unbiased and rational decision making while dealing with TCMs.