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We will see future disease outbreaks if we don’t speak out on the dangers of TCMs
  1. Ben Sturgeon

Abstract

Ben Sturgeon argues that the rise in unregulated wet markets and traditional Chinese medicine production will potentially lead to further disease outbreaks and loss of important animal populations.

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Veterinary director at the Society for the Protection of Animals Abroad, London

The current coronavirus pandemic has not only provided us with an opportunity to discuss issues surrounding the proposed source of the viral outbreak, but also to highlight the profession’s role in advocating for animal welfare, supporting evidence-based medicines and supporting global human health and sustainability.

The Covid-19 outbreak originated from the Chinese city of Wuhan, in a proposed ‘wet market’ selling live animal species, many of which are potentially endangered. There are currently no animal welfare laws in China – a draft of a 2009 Protection of Cruelty to Animals Act has yet to be accepted – and so it is perhaps unsurprising that traceability, biosecurity and animal welfare are absent from such markets.

The scenario of mixing multiple species from unknown sources in close proximity is a hot bed for disease transfer and pathogen mutation; we saw this with the generation of influenza strains via fowl and pigs.

But the existence of such markets isn’t the only problem. I would like to draw your attention to two recent events. First, in June 2018 the World Health Organization (WHO) published the 11th edition of its International Classification of Diseases,1 which for the first time included a chapter on traditional Chinese medicine (TCM). The publication lists globally available treatments for medical conditions, and is considered influential with governments – they look at its recommendations when deciding how to spend their health budgets. Following its publication, with the new addition of a chapter on TCMs, the Federation of European Academies of Medicine and the European Academies’ Science Advisory Council issued a joint statement urging the WHO to clarify how TCM and other complementary therapies should be used. They also warned that this inclusion effectively supports and may result in the promotion of TCMs.

Secondly, legislation has recently been drafted in Beijing that outlaws criticism of TCMs, which bring a significant financial benefit to the Chinese economy. The Chinese State Council Information Service states that by 2020 every Chinese citizen will have access to a basic TCM service, and by 2030 TCMs will be available in all areas of medical care. This is expected to drive the TCM market (domestic and international) to US$737.9 billion by 2030.2 This draft legislation has been backed by the Chinese president, a supporter of TCM use. Furthermore, TCMs, many of which have attracted attention due to potential harmful effects to human health caused by some of the ingredients, have been reclassified as ‘healthcare’ products in the legislation; this removes any need for TCMs to fulfil safety requirements.

The use of endangered species, such as tigers, rhinos and pangolins (the scales of which are often found in wet markets), to produce TCMs has been recorded in multiple investigations. But it’s not just endangered species that the production of this medicine affects. Donkeys are now killed in their millions to supply the Chinese market with ejiao – the gelatin obtained from soaking or stewing their skins – with current slaughter rates, again without legislation or control, predicted to lead to the near extinction of donkeys within 10 years. The popularity of ejiao has put the lives of many millions of people in developing countries, who rely upon donkeys for income and livelihoods, at risk. In fact, British- and UN-endorsed plans for 2030 have highlighted 17 sustainable development goals, of which the donkey directly supports 10 – their loss would be catastrophic.

The slow and perhaps subversive move of TCMs into mainstream medicine, without legislative control of ingredient source or rigorous and reliable testing to prove efficacy and safety, will give rise not only to further potential disease outbreaks similar to Covid-19, but also to further loss of important animal populations, compromise of their welfare and potential ‘iatrogenic’ harm from the products.

As veterinary surgeons, advocates for animal health and welfare, scientists who base medical treatments on evidenced-based research, colleagues who swore to do no harm, and as a voice advocating against activities which can negatively impact individual and global human health, our collective concerns should be raised. We need to start by supporting campaigns such as End the Trade,3 the International Union for Conservation of Nature,4 and UK-based International Coalition for Working Equids,5 and we should provide our expert opinion at G20 meetings to this end.

To place the current pandemic at the fault of animal and/or pathogen evolution is abhorrently incorrect

To place the current pandemic at the fault of animal and/or pathogen evolution is abhorrently incorrect. We need to be implicitly aware of our roles in preventing future outbreaks while protecting animals and people alike. ●

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