Professor Karl Wah-Keung Tsim, a neurobiologist who heads a research team in the Life Science Division of the Hong Kong Special Administrative Region University of Science and Technology, believes that, for all the challenges it may face, traditional Chinese medicine is potentially a pharmacological gold mine. "There are around 100 000 formulas going back 2000 years, drugs that can be used to treat a range of illnesses from depression and insomnia, to osteoporosis," he says, pointing out that researchers have already found at least one gem in the form of artemisinin, which is known as qinghaosu in Mandarin.
The therapeutic value of artemisinin m the treatment of Plasmodium falciparum malaria was discovered in 1972 by Professor Tu Youyou, a member of the China Academy of Chinese Medical Sciences in Beijing, who researched traditional medicine texts as well as folk remedies. But artemisinin is one of only a few derivatives of traditional drugs to make the jump from ancient texts to contemporary science-based medicine, and it is certainly the only example so far of a drug that could be described as a gem. Traditional Chinese medicine, in this context, is distinct from other forms of traditional medicine, such as Ayurvedic medicine, or other forms of traditional medicine.
Traditional medicine, primarily the use of a combination of herbs prescribed in compounds, is hugely important in China, where it represents around 40% of the Chinese pharmaceutical market, with annual sales of US$ 21 billion. A popular choice among patients in China, it is also a choice that the government increasingly supports. According to Vice Health Minister, Wang Guoqiang, in 2011 the Chinese government invested roughly US$1 billion (RMB 6 billion) in traditional medicine research and projects, nearly tripling the amount invested in 2010.
More than RMB 4 billion of that was used to support services in Chinas 1814 traditional medicine hospitals while another 1 billion went into building 70 county-level traditional medicine hospitals. "Traditional hospitals constitute around 15% of the total hospital system," explains Dr Zhang Qi, coordinator of the traditional medicine team at the World Health Organization (WHO), who notes that traditional Chinese medicine is also offered in the country's so-called 'western medical hospital'.
Traditional Chinese medicine is big in China and other Asian countries, where, according to WHO, up to 80% of some populations use it for health care. However, it is less accepted elsewhere, partly because of the lack of an evidence base as well as concerns about quality. Such doubts are typified by the reports produced on a regular basis by the Medicines Healthcare Products Regulatory Agency in the United Kingdom of Great Britain and Northern Ireland, which recently said that there is a substantial global trade in Chinese remedies of questionable quality. In an attempt to prevent the sale of poor-quality products, in May 2011 the European Union made it illegal to sell any traditional Chinese herbal treatments not registered under the European Union Traditional Herbal Medicines Registration Scheme.
Improving drug quality standards is at the top of Chinas agenda and is the focus of the work being done by Professor Liu Liang, director of the State Key Laboratory for Quality Research in Chinese Medicines, in Macau, China, where he and his team of researchers are working on quality control of traditional Chinese medicines, using contemporary technology. "Our main focus is how to arrive at some standards in order to achieve consistency in production, including in the manufacturing process," Liang says.
Convincing the global research and development community of the evidence basis for traditional Chinese medicine is proving even more challenging than establishing quality standards. However, here too Chinese researchers in state and academic institutions are pushing forward. …