Can the East meet the West in medicine? Onboarding is a slow process

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Liberian Joelle Karnwhine came to China two years ago to study Western medicine, but has now expanded her discipline to include traditional Chinese medicine.

Now a postgraduate student at the University of Traditional Chinese Medicine in Shanghai, Karnwhine takes courses that integrate Chinese and Western medicine.

“My clinical practice shows me that traditional Chinese medicine improves blood flow to the eyes by treating conditions such as dry eyes, optic nerve atrophy and diabetic macular edema,” she said. “Furthermore, I have found that it can help with insomnia, lower back pain, constipation, facial paralysis, and even promote beauty.”

Ti Gong

Liberian Joelle Karnwhine, who holds a doctorate from Shanghai, sees great opportunities for traditional Chinese medicine in Africa.

She also found the traditional treatment beneficial for herself.

Karnwhine said massaging several acupuncture points on her head helped relieve her long-term migraines.

“Now whenever I feel the onset of a migraine, I start massaging those acupuncture points and the headache goes away instantly,” she said. “For about eight months now, I haven’t taken migraine pills.”

In recent years, traditional Chinese medicine has become more internationally recognized. Schools for its study have opened in the West. In the United States alone, about 50 programs are accredited by the American College of Acupuncture and Oriental Medicine.

Lawrence Tien, a doctor of acupuncture and Oriental medicine for 17 years in California, said there are more than 12,000 acupuncturists operating businesses in the United States, where more than 10 million acupuncture treatments are performed each year.

Can the East meet the West in medicine?  Onboarding is a slow process

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Acupuncture has become popular in the United States with office workers looking to relieve muscle pain and lose weight.

“Because acupuncture is considered an ‘invasive treatment’ in California, it requires a license to practice, issued by the California Acupuncture Board,” Tien said.

Most of Tien’s customers are office workers looking to relieve muscle pain, lose weight, or promote general physical and emotional well-being.

“Although many people in the United States believe that the theories and practices behind traditional Chinese medicine are not based on scientific knowledge, I am still fascinated by the rich culture behind it,” said said Tien. “It has a tradition of ‘preventive’ treatment. So for Chinese medicine, maintaining health is the goal, and treating disease is only a means.”

An American patient who identified herself only as Lisa M. said acupuncture cured her long-term TMJ disorder related to a sore, chattering jaw.

“All a dentist or doctor said to me was, ‘Yeah, there’s something wrong with your jaw. Try not to open your mouth too much or eat hard things,’” she said.

But after a session of massage and acupuncture, the symptom disappeared for the first time in 10 years.

While acupuncture and massage are becoming more common in the United States, herbal medicine is having a harder time penetrating the mainstream market.

Tien said traditional Chinese medicines are still classified as “dietary supplements” and are not as tightly regulated as prescription or over-the-counter drugs. No license is required to sell them.

The road for these “supplements” to be classified as prescription or over-the-counter drugs is long and winding, especially for compound preparations. The requirement for three phases of clinical trials deters most Chinese manufacturers of traditional medicine from seeking to enter the US market.

“It’s a huge investment, which could reach billions of dollars – well beyond the interests of most Chinese companies,” said Dr. Zhan Changsen, vice president of Shanghai Hutchison Pharmaceuticals.

An example is a type of “dripping compound” pill widely used in China to treat angina. Clinical experiments in the United States have been conducted intermittently for almost two decades, but the treatment has not yet been approved by the United States Food and Drug Administration.

“We need to find other ways to introduce our drugs to the overseas market, but it depends on which market it is,” Zhan said.

Can the East meet the West in medicine?  Onboarding is a slow process
Can the East meet the West in medicine?  Onboarding is a slow process

Ti Gong

Shanghai Hutchison Pharmaceuticals Danning brand herbal tablets are now sold in the Canadian market.

Hutchison manufactures a traditional medicine called “Danning’s Tablets (胆宁片)” which has acquired a “Natural Product Number” issued by Health Canada and is now available in Canadian pharmacies as an over-the-counter medicine under the trade name Biliflow . The drug is used to treat chronic gallbladder inflammation and constipation.

“Different countries have different requirements for herbal medicines,” Zhan said. “Canada does not require three phases of clinical trials for registration of compound traditional medicine preparations and acknowledges data collected in China.”

Before entering the Canadian market, Hutchison spent years “standardizing” Biliflow. It has established criteria for the entire production process to ensure that each batch of Biliflow contains the same amount of active ingredients and has the same efficacy.

“It was a big challenge to measure how active ingredients are metabolized in the body because the content is usually quite low,” Zhan said.

Can the East meet the West in medicine?  Onboarding is a slow process

Zhan explained that the effectiveness of traditional Chinese medicine is mainly questioned overseas due to the different theoretical systems underlying Western and Chinese medicine.

In the Chinese system, prepared herbs are classified according to “taste and character (性味)” and “canal tropism (归经)”. The latter is a key feature of herbal properties theory, which classifies drugs acting in the “viscera and meridians of the body” to illustrate the effects of a drug on a certain part of the body.

In the Western system, a drug is defined by its content, character, identification, composition, and contaminants, in addition to other criteria.

Currently, 15 types of herbs, such as panax notoginseng (三七) and red sage (丹参), have been included in the US Pharmacopoeia and 14 in the EU system.

“But there is still a long way to go, especially for compound traditional medicine preparations to be globally recognized,” Zhan said. “But the success of Biliflow has broadened our horizons, and we believe more herbal remedies will come to overseas markets.”

Karnwhine is also confident about her future career in traditional medicine.

“I think it has so much potential that most parts of the world have yet to experience,” she said. “I plan to one day open a traditional Chinese medicine hospital in my country and perhaps expand further into other African countries to give people access to effective and affordable treatment without high costs.”

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