China’s Nobel Prize win rekindles debate over the role of traditional Chinese medicine
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China's Tu Youyou collects her country's first Nobel Prize for medicine next week for extracting an anti-malarial drug from a herb mentioned in a traditional text.
But her award has also prompted a debate over the relationship between medical science and traditional Chinese medicine.
Tu derived artemisinin from sweet wormwood, which she found cited in a 4th century traditional Chinese medicine document as a treatment for fever.
She thus developed a crucial weapon in the global fight against malaria as resistance to other treatments spread.
READ MORE: Tu Youyou’s Nobel Prize for her anti-malaria drug inspires China’s pharmaceutical firms to innovate and improve
Traditional medicine, or TCM, is a source of cultural pride in some Chinese quarters with Beijing planning to expand its provision.
Premier Li Keqiang also seized on the Nobel award, hailing Tu's discovery as “a great contribution of TCM to the cause of human health”.
But Nobel committee member Hans Forssberg was adamant: “It's very important that we are not giving a prize to the traditional medicine,” he said. He stressed the award was only for the scientific work that had been inspired by it.
Traditional Chinese medicine practitioners say Tu’s award could encourage similar research, but it may ignore the basic principles underpinning their approach.
TCM is based on a set of beliefs about human biology, including the existence of a life force, “qi”, and that illness is the result of “imbalances” between the five elements -- fire, water, earth, metal and wood -- in the system.
Lan Jirui, who has a booming TCM private practice in Beijing, said: “Many fear that the recent Nobel Prize, which celebrates westernised Chinese medicine, will end up doing more harm than good for authentic traditional medical practise.
“The human body is very complicated -- you cannot see it only as a machine,” he added. “The scariest thing is to lack confidence in your own traditions, to allow others to 'update' you, and then destroy what you had.”
Many mainstream medicines were originally derived from plants and some researchers are looking for active ingredients in TCM components, even though Tu failed to find other such drugs despite years of efforts.
“It's good to look into ethno-pharmacology,” said Fan Tai-Ping, head of the Chinese Medicine Laboratory at the University of Cambridge.
“Medicine has evolved since the dawn of humanity, and science,” he said. “We need to have evidence, but there's the possibility now, thanks to science, to begin to discuss this problem, how we can see East and West come together.”
The human body is very complicated. You cannot see it only as a machine
With no standardised guidelines, TCM can offer radically different diagnoses, based on observation and pulse-taking, for the same symptoms.
Similarly, prescriptions are highly variable, made up of multiple herbs, minerals and animal parts -- sometimes from endangered species, now officially banned -- along with massages, acupuncture and other treatments.
TCM is an enormous industry in China, with a total value in excess of US $91 billion in 2013, a third of the total output of the country's medical industry, according to the state-run news agency Xinhua.
READ MORE: Nobel Prize for Tu Youyou gives traditional Chinese medicine a shot in the arm
The government has upped funding and support in recent years, even though most health facilities use orthodox medicine.
National healthcare guidelines released in May said every county and municipality should seek to have a dedicated TCM hospital by 2020.
Pseudoscience, with no rational mechanism of action for most of its therapies
“TCM should be China's solution for improving its medical care”, especially as it was “relatively cheaper than Western medicine”, Wang Guoqiang, director of the State Administration of TCM, told a conference last year.
“TCM is a form of heritage passed down from our ancestors that can offer an instructive approach to modern medical reform,” he added.
But specialists say there is an internal contradiction between the nationalism implicit in such assertions and TCM's claims of universal applicability.
“It is essential to keep the struggle for cultural identity separate from actual medical practice,” said Volker Scheid, an anthropologist at London's University of Westminster who has studied TCM for 30 years.
“I'd say 95 per cent of Chinese would think that I cannot be a very good TCM practitioner because I'm not Chinese, but at the same time, China wants to make Chinese medicine global.
“If you want to make it truly global, you have to take it away from China.”
