The origins, the species and the global political power of Chinese traditional medicine

The jury is still out on the origins of COVID-19, also known as SARS-CoV-2 virus. 

What is known is that a new form of corona virus crossed over from animal to human hosts in Wuhan over the final weeks or months of 2019, before galloping across the province of Hubei in December to reach epidemic proportions in China later in January and then spreading internationally at remarkable speed.

By the time the World Health Organisation (WHO) confirmed a global pandemic on March 11 2020, the thing had bolted.

Identifying the source of the novel coronavirus is another matter. There are many competing explanations some of which can probably be dismissed out of hand. The latter include theories advanced by nationalists in China and the US about the deliberate release of new biological weapons by US military personnel or Chinese security agencies respectively.

In the cluster of more-feasible scenarios, two stand out from the crowd. 

One involves the accidental release of a viral sample from the Wuhan branch of the Chinese Centre for Disease Control and Prevention, or from the nearby Wuhan Institute of Virology. Or possibly a contraction of the virus by a staff member at one of these institutes who went on to infect others, unnoticed and unreported.

Researchers at these facilities have been collecting and experimenting with bat coronaviruses for some years and reporting their findings in international scientific journals, some as early as 2015. Writing in The Washington Post, David Ignatius offers a reliable account of this version of events. 

A second plausible explanation involves the sale and consumption of bats, pangolins or other exotic wildlife at the Huanan Seafood Wholesale Market in Wuhan. Bats are known to carry a similar strain of coronavirus to SARS-CoV-2.

Microbiologists tell us that the viral strain found in bats would need to mutate through an intermediary animal host before it could infect human cells, and the most likely intermediate host appears to be the pangolin, a scaly ant-eater said to have been available for sale and consumption in the Huanan market. 

The initial pattern of infections supports both explanations while favouring neither. The first reported cluster and fatality emerged among people who worked or shopped at the Huanan market, which was closed early in the outbreak on 1 January. The Centre for Disease Control and Prevention is located just a few hundred metres from the market, and the Wuhan Institute of Virology is situated nearby.

As far as we know neither institution was closed in consequence of the outbreak.  Nevertheless tracing an initial cluster to the vicinity of the market and the institutes could support either scenario. 

From censored news reporting it is quite clear which of the two more plausible explanations is preferred by China’s party leadership. Few official sources have taken the laboratory version seriously and yet none to my knowledge has rejected accounts tracing the outbreak to the trade in wild game at the Huanan market.

The official Xinhua newsagency reported research suggesting that genome sequences in samples taken from pangolins were a 99% match with those found among COVID-19 patients. This later turned out to be incorrect.

Still, the outpouring of official statements denying evidence of human-to-human transmission that flowed over a period of six weeks, from December 1 through January 14 (when WHO publicly echoed Beijing’s claims) together implied that all who contracted the disease did so through non-human vectors, presumably animals traded at the Huanan market before it was closed on January 1. 

Authorities in China finally acknowledged community transmission on January 20 when the epidemic was well underway. By then, they had also framed a consistent media position maintaining that tracing the source of the virus was secondary to managing the epidemic and could await an independent scientific inquiry.

Early in April, 100 Chinese scholars — almost none of them scientists — published an open letter along these lines concluding “in the end we will all respect the final determination of scientists”. 

While it strikes the right tone, this judgement is hardly reassuring to anyone familiar with the state of scientific inquiry in contemporary China.

Earlier in his term, Party General Secretary Xi Jinping undermined the country’s capacity for independent, evidence-based inquiry of any kind by declaring that all science was based on Marxism-Leninism-Maoism and, true to Mao, insisting that scientific inquiry must serve the party leadership. 

Traditional Chinese medicine and the Chinese Communist Party

It is not difficult to see why the Communist Party would want to suppress speculation linking the outbreak to viral research establishments in Wuhan.

These institutes work to party directives under Beijing’s ten-year national science and technology plans, which are closely aligned in turn with national defence and security strategies. The national science and technology planning system leads ultimately to Xi as head of the military and party apparatus and is off limits to public inquiry.

If we concede that the culprit is a pangolin in the pantry rather than a bat in the laboratory, any link between pangolins and the party would seem at first glance to be tenuous. 

An ungainly-looking creature with a long snout, and around 38 centimetres long in its Chinese iteration, the pangolin is covered with tough scales that are valued for their medicinal qualities. In traditional Chinese medicine (TCM) the dried scales are used to treat a variety of nervous conditions in women and children, along with malarial fever and deafness.

And yet TCM is not quite the grass-roots cultural practice that it might appear to outsiders. It is deeply embedded in the party’s management of daily physical health in China, where it is allocated a respected place alongside evidence-based medical practice, or “Western medicine” as it’s known in China.

“Chinese medicine treats the basics, Western medicine treats symptoms” goes the saying. What’s more, TCM has the backing of Xi.  

In China, it could be said, all roads lead to Beijing. On the home front Xi has silenced critics of TCM. Internationally, he has been its champion. 

TCM and Chinese values

To the extent that pangolins and other exotic animals sold in China’s wet markets provide ingredients for TCM, it is hard to see Xi escaping a degree of responsibility for the sale of wildlife that could well have started a global pandemic.

A thriving and growing international consumer market for pangolin meat and scales, rhinoceros horns, leopard bones, tiger plasters, black bear bile, donkey hide, and kangaroo penises is a predictable outcome of the grandiose repackaging and political marketing of TCM as a global equivalent to evidence-based medicine in Xi New Era of global leadership. 

TCM is a significant and growing source of revenue for China. According to CNN, China’s State Council has estimated the value of trade in TCM could well exceed ¥3 trillion (US$430 billion) this year, a whopping 71% increase over 2017. 

Internationally, Beijing has been actively promoting TCM along the route of its Belt and Road infrastructure initiative where sales of TCM remedies are reported to have surged more than half between 2016 and 2017.

TCM is also a potent weapon in the party’s ongoing struggle with universal values and human rights. Beijing tends to view and portray human rights and values as a nasty concoction of false hopes and evil intentions brewed up by US institutions and liberal media to promote the global hegemony of the West.  

In place of universal values, Xi champions his own brew of national values blended with national folk science and culture. He is also building the propaganda platforms and communications infrastructure needed to deliver his concoction to homes throughout the world.

At the moment the corona virus was leaping from animal to human hosts under the Huanan market scenario, Xi attended a meeting to endorse TCM. On October 25 2019 he told a national TCM conference in Beijing that traditional medicine “is a treasure of Chinese civilisation embodying the wisdom of the nation and its people”.

According to Xinhua reports, he also endorsed “efforts to promote TCM internationally and fully develop its unique strength in preventing and treating diseases”.

TCM and world health

At the time he was speaking, Xi had already succeeded in persuading foreign countries and international agencies to concede that the treasures of Chinese folk wisdom offered cures for many of the ills ailing the world. 

In 2016 he met with WHO director general Dr Margaret Chan in Beijing. Chan was reported in Nature magazine at the time as showing considerable sympathy for official recognition of TCM during her tenure as WHO director from 2006 to 2017.

In 2017 Xi Jinping visited Geneva where he met with WHO officials and promoted TCM medicinal practice. According to WHO’s report of the meeting:

President Xi presented as a gift to WHO a statue highlighting acupuncture, a widely used form of traditional Chinese medicine. As he unveiled the bronze statue, President Xi described it as a replica of the first teaching model for medicinal practice.

In September 2018, not long after Xi had paid his visit and Chan had stepped down from her leadership role, the organisation signalled it would grant TCM recognition.

In May 2019 the organisation’s governing body, the World Health Assembly, duly agreed to include a chapter on traditional medicines in its guide to acceptable global health practice, the International Classification of Diseases — an authoritative document that assists doctors around the world in diagnosing medical conditions.

Traditional medical practitioners around the world applauded the decision. There are of course many varieties of alternative medicine across the world, with hundreds of millions of adherents who attest to their various effects. People in Germany swear by homeopathic remedies. Britons once professed the health benefits of herbal teas and tinctures of laudanum. 

Whatever their alleged benefits, inclusion of traditional folklore diagnostic tools in the authoritative WHO compendia of medical practice was without precedent.

Practitioners employ these diagnostic tools to prescribe specific folk remedies. Much of the credit goes to Xi.

Gobal backfire, China pushback

The world scientific community was appalled. The editors of Scientific American branded the decision “an egregious lapse” in evidence-based scientific practice. 

Nature warned in an editorial that the decision could backfire on WHO in years to come. The organisation’s endorsement of practices that were untested and potentially harmful was “unacceptable for the body that has the greatest responsibility and power to protect human health”.

When it came to endangered wildlife, such as panthers and pangolins, it did not take long to backfire. 

Wildlife conservationists feared the worst following WHO’s decision. CNN reported some of their concerns, noting that although a range of TCM practitioners do act responsibly, WHO’s stamp of approval lent UN endorsement to practices involving wild game in unregulated markets where anything goes.

John Goodrich, a senior director for an organisation that protects wild cats, Panthera, was quoted as saying that WHO’s “failure to specifically condemn the use of Traditional Chinese Medicine utilising wild animal parts is egregiously negligent and irresponsible”.

Criticism of this kind may be warranted but it is not welcome in Xi’s China. Indeed, criticism of TCM is silenced to any extent possible, because the thread of responsibility leads to party leaders who actively promote the “treasures of Chinese civilisation” at home and abroad through international agencies.

Where they can, Chinese authorities pressure international agencies into silence. Early in the COVID-19 epidemic, according to reports, the WHO website advised against using “traditional herbal remedies” such as TCM in treating COVID-19. On March 4, WHO retracted this statement on its official Chinese WeChat on the ground that it was “too broad”.  

While effectively silencing domestic sceptics and international agencies, China’s authorities have turned to promoting TCM globally as a remedy for COVID-19. 

Early in March the State Council Information Office hosted a press conference at which a leading official was reported as saying the government was “willing to share the ‘Chinese experience’ and ‘Chinese solution’ of treating COVID-19, and let more countries get to know Chinese medicine, understand Chinese medicine and use Chinese medicine,” in wake of the pandemic. 

On March 4, the State Council’s National Health Commission published a list of recommended treatments for COVID-19, including injections that contain bear bile powder.

Chinese solutions

State Council promotion of TCM as a Chinese solution for COVID 19 is not just about TCM or even the about the pandemic. Beijing is in damage control over its long-touted “Chinese Solutions” for everything. 

The party uses this term for the “solutions” it wants to share with the world.

These go beyond TCM to include the country’s policy processes, development model, financial management, foreign aid, and its industry, climate, infrastructure, energy and social policy agendas, along with its no-holds barred authoritarian style of government.  

Fu Ying, at one time China’s Ambassador to Australia, explained in a recent issue of People’s Daily that the challenges for the government of China arising from the pandemic go well beyond the illness itself.

The big challenge is how China is to be heard above the din of global anti-China “prejudice” resisting Xi’s solutions for the world. 

“There are always some people in the world,” she wrote, “who set out to distort and discredit China.” Some, she claimed, were driven by ideological prejudice, others by arrogance, others again by unstated “ulterior motives”. 

None of the international questioning about the viral outbreak came, presumably, from people wanting to know what happened exactly, and how and why.

Any questioning of China’s conduct during the pandemic, Fu Ying suggests, is symptomatic of the arrogance and prejudice of the hegemonic powers. It is bigger than SARS-CoV-2 and COVID-19. Beijing needs to seize the opportunity presented by the pandemic to push its voice even more firmly and advance its global position.

Cynics might respond that Xi has done a fairly impressive job advancing the country’s voice internationally, to the point where China has cajoled sovereign nations to do its bidding and undermined the ethics and white-anted the institutions of the post-war liberal international order. He has certainly helped to shatter the credibility of WHO.  

But that could be a prejudiced cynic speaking.  

Best to listen to what the pandemic itself is telling us. The pandemic is unfolding as a story impervious to silencing and beyond parody. No cynic could improve on it. It is not a good China story but it is one the whole world needs to heed, at its peril.

Lessons

While no good can come out of this pandemic there are lessons that can be drawn. 

For Xi and China’s communist leadership, the lessons of the COVID-19 pandemic reach well beyond managing the pandemic to combatting prejudice everywhere and promoting Chinese solutions for everything. 

The liberal West is likely to draw different lessons. I’d like to highlight three of them.

First, TCM could turn out to be the major political and cultural vector for this devastating global pandemic. If wild game is involved then TCM has a lot to answer for. 

Although many TCM practitioners act responsibly, the continuing provision of wildlife remedies in TCM cornucopia, and the promotion of TCM by national chauvinists in China and its endorsement by international health agencies abroad, together place wildlife and human lives at risk.

These practices must end and those responsible for its global promotion should be held to account.

Second, a divided world is ill-prepared to deal with strategic efforts by Xi and the Communist Party of China to promote national values and folk cultures in place of good science. 

Countries need to act separately and together to ensure there are fewer Chinese solutions and more universal ones — more human rights, universal values, freedom of speech and assembly, and scientifically sound solutions wherever they happen to come from. 

Third, China would be a welcome and indispensable partner in such a world. 

A few things would have to change and if China’s people have any say in the matter they may well do.