Returning to tradition

Chinese medicine regaining traction in domestic healthcare market

Tu Youyou

Tu: the 84 year-old is one of the Nobel prize winners for medicine this year

In 1969, the Vietnam War was raging. In the dense jungles, where the Communist North Vietnamese troops waged a guerrilla war, malaria was a greater threat than any other enemy. To help alleviate this pestilence for his Vietnamese comrades, Mao Zedong established a research project codenamed “523” (the date it was established), to find a cure for the disease.

Earlier this week, the scientist who headed the project – and made a breakthrough discovery – was belatedly awarded the Nobel Prize for her work. Project 523 discovered the effective application of artemisinin, a chemical derived from sweet wormwood, which has since become the mainstay of anti-malarial drugs, saving millions of lives. This insight – i.e. to use sweet wormwood to fight the disease – was sourced from a fourth-century book of traditional Chinese medicine.

The timing of Tu Youyou’s award once again turns international attention to traditional Chinese medicine (TCM). Meanwhile in China itself TCM may be about to impact the market for Western vitamin and dietary supplements, which have been enjoying a recent boom.

Sales of vitamins and supplements have experienced tremendous growth in the country over the last six years. In May, Euromonitor predicted that the market for the products would grow to Rmb101.7 billion ($16 billion) by the end of this year – almost twice its size in 2008.

The market will further grow to $20 billion by 2019, a recent report by Reuters suggests, although the growth rate will slow down to 5%, or half what it has enjoyed since 2009. But in the same period, the TCM market will reach $40 billion, doubling its growth rate to 10%.

Blackmores is one of the foreign suppliers of supplements that has enjoyed the recent boom. According to Reuters, the Australian firm’s shares have nearly quadrupled this year, boosted by surging Chinese demand. Reports in The Australian place the trade value of Australia’s exports of vitamin supplements to China at A$230 million ($165 million). This is anticipated to grow when the China Australia Free Trade Agreement is fully ratified.

Christine Holgate, CEO of Blackmores, believes “Chinese consumers are willing to pay a premium for our products because they know that those products are quality-checked before they’re sent out to China”.

But these quality-control issues may be being increasingly trumped in China by a reviving confidence in the ancient origins of TCM. This faith puts Western supplements at a disadvantage, in part because Western medicines are obliged to detail their ingredients and possible side effects, which can generate concern amongst the average consumer. According to Southern Weekend, TCM producers have always resisted listing side effects, in case it unnerves their customers.

An average TCM treatment is a boiled concoction of multiple ingredients, Southern Weekend notes, the final product of which has an indeterminable composition. Due to this, the potential side effects are difficult to determine. Moreover, the ambiguity of a batch’s composition means it can be offered to treat an array of maladies, whilst Western counterparts are restricted to their specified usage.

This means that sales of TCM and vitamin supplements are not strictly comparable, because the TCM market encompasses a much wider area – including other holistic practices, such as acupuncture.

Nor is the use of TCM and Western supplements mutually exclusive. In 2011 the Chinese University of Hong Kong noted that it was common for Chinese people to use Western and traditional medicines together, despite some dangers of overdosing.

Some Western companies are trying to take a hybrid approach to increase their share of the Chinese market. In 2013, Amway invested $13 million in a TCM research laboratory based in Jiangsu province. Jia Chen, vice president of the firm’s China research and development division, told Reuters it was hoping to “learn the heritage and marry it with modern life sciences”.

However, Amway’s leading share in the Chinese vitamin market fell from 14% to 11% in 2014.

In a bid to reverse this decline, Amway China has come up with products to improve memory, incorporating TCM ingredients such as ginseng and liquorice. Pfizer – which produces the fourth most popular supplement brand in China – has started to offer “gift boxes” of vitamins, in line with the Chinese custom of making gifts of medicine.

As these Western companies attempt to play on Chinese traditions, Tu Youyou’s Nobel victory has prompted the Chinese to reassess their own TCM industry. Premier Li Keqiang wrote in a letter of congratulation to Tu that he felt her honour demonstrated the “great contribution of traditional Chinese medicine to the cause of human health”.

In Europe – where Tu’s prize was awarded – TCM’s contribution to health has struggled for medical credibility. In 2004, the EU passed a regulation which required TCM manufacturers to register their specific medicinal use by April 2011 in order to continue being sold in the EU.

However, the procedures involved prevented many TCMs from registering. According to the Royal Society of Chemistry, in order to register, each TCM product had to have a proven history of 15 years safe use as a medicine in the European market. Liu Zhanglin, former vice-president of the China Chamber of Commerce for Import and Export of Medicine and Health Products explained that “most TCMs are sold as food supplements in the EU market, and it is very difficult to prove their safety history in medical use”.

As a result, by the 2011 deadline, “none of the major TCM makers in China” had carried out the registration procedures.

But the story of China’s latest Nobel winner has stirred notions that TCM might now gain greater recognition in the West. The People’s Daily suggests that achievements by Chinese scientists have thus far been overlooked. “Evidently, Chinese scientific research has been playing a leading role in the world. And one can be sure that there is going to be a second or third ‘Tu’ coming soon.”

However, as Quartz notes, Tu’s story is one in which her team “managed to marry the knowledge of Chinese traditional medicine with the rigours of modern medicine”. Others may struggle to merge these two disciplines with the same skill… n

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