The WHO's endorsement of TCM may have helped cause the coronavirus pandemic

About a year and a half ago, I wrote an article titled "WHO endorses Traditional Chinese Medicine. Expect deaths to rise." It went somewhat viral, with over 100,000 views, and then went quiet until last week, when it was revived on Twitter, which has driven thousands of new views to it. Multiple people asked me to re-visit it, in light of the coronavirus and its possible origin in a live animal market in China.

The deaths I was referring to in that title were the deaths of animals (as I'll explain below), not people. What I didn't write about–and what Twitter is buzzing about now–is the possibility that live animal markets in China, such as the one where the Covid-19 virus may have first infected humans, include bats sold for their use in traditional Chinese medicine, or TCM. We now know that the coronavirus almost certainly originated in bats. It's entirely possible–indeed, it seems very likely–that TCM is responsible for the emergence of the Covid-19 coronavirus.

The title of my article might have been more prescient than I guessed at the time.

Indeed, a just-published scientific paper pins the blame for Covid-19 squarely on TCM. The paper argues that

"a live or recently deceased infected bat species was handled by traders because of its value in TCM, and that such an infected individual, or the still infective bat or bat products, may have been the route by which the virus entered the exotic meat market in Wuhan."

Let's back up a bit and review the World Health Organization's involvement in this debacle. Just one year ago, the WHO added a chapter on TCM to its official International Classification of Diseases (ICD-11) for the first time. It apparently took this action after strong lobbying pressure from China: as a 2018 story in Nature pointed out:

"Over the past few years, [China] has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market."

This action by the WHO was the result of a long effort by its previous director (she left in 2017), Margaret Chan, who "worked closely with China" to get the WHO to endorse TCM.

Many scientists decried this action. The editors of Scientific American called it a "bad idea." Nature warned that it could "backfire," writing that it

"risks legitimizing an unfounded underlying philosophy and some unscientific practice.... Whatever its aims, the WHO’s chapter [on TCM] is unlikely to do anything other than fuel the expanding sales of largely unproven treatments."

TCM is not medicine. It's little more than a set of traditional beliefs (or a philosophy, as Nature called it) about various concoctions and their effect on one's health. Most of these beliefs have no evidence whatsoever that they provide any health benefits. Many of them derive from a pre-scientific view (which is not at all unique to China) that eating an animal gives one some of the properties of that animal. This is utter nonsense, of course.

Unfortunately, TCM is far from harmless, as I pointed out in my 2018 article. TCM has led to the horrific slaughter of the last remaining rhinoceroses in Africa in order to hack off their horns, which are sold to become part of elixirs that some people mistakenly think confer strength, virility, or other health benefits. Two years ago, National Geographic ran a heart-wrenching photo essay showing some of the awful results of rhinoceros poaching in Africa; take a look at these photos here (warning: these are very graphic).

TCM is behind the slaughter of the last remaining wild tigers, which are virtually extinct now in Asia, so that men can foolishly eat their bones, claws, and genitals in the mistaken belief that tiger parts will make them virile. Here too, National Geographic has details and photographs of cruel "tiger farms" that are almost too painful to look at.

TCM has also nearly wiped out pangolins, a completely harmless, gentle animal that has been killed in vast numbers because TCM practioners believe, wrongly, that its scale have some medicinal value. (They don't.) For more about this harmful practice, see this article I wrote in 2017.

And donkeys too: the Independent reported last November that "half the global population of donkeys could be wiped out in just five years, due to a surge in demand for their hides, which are used in traditional Chinese medicine." The world's donkey population is now in a state of crisis, according to the article, because of soaring demand in China for donkey hides, which are used to make eijao (donkey hide glue), a popular TCM product with no evidence that it has any medical benefits. Literally millions of donkeys are being slaughtered for nothing.

Before people accuse me of cultural insensitivity, let me add that there's no legitimate reason to use terms such as "Chinese" medicine, or American, Italian, Spanish, Indian, or [insert your favorite nationality] medicine. There's just medicine–if a treatment works, then it's medicine. If something doesn't work, then it's not medicine and we shouldn't sell it to people with false claims.

TCM has been a scam for decades: it was revived and heavily promoted in China by former dictator Mao Zedong, who didn't believe in it himself, but pushed it as a cheap alternative to real medicine. I won't go over that again here, but see these stories from Alan Levinovitz in Slate and David Gorski at Science-based Medicine.

The WHO is under new leadership now, but I see no sign that it's revising its endorsement of TCM, which is still lauded on the WHO website. Now we see that, in addition to the pointless slaughter of thousands of animals, some of which are likely to go extinct as a result, TCM might also create conditions that lead to new human pandemic diseases.

The new scientific paper that I mentioned above–the one that explains why trading in bat species for TCM may have caused the current pandemic, concludes that "a change in these practices is highly recommended."

That would be the understatement of the year.

It's sadly ironic that the WHO, which has in many ways been leading the fight against the Covid-19 virus, may have contributed to the conditions (live animal markets trading in wild animals) that allowed the virus to jump into the human population. It's too late to prevent that, but it's not too late for the WHO to take steps to prevent the next pandemic: they can and should remove TCM from their official guidelines.

As for China, they should recognize that the profits they make from the sales of animal parts for TCM are vastly outweighed by the harm these practices cause. China should stop promoting TCM, and it should ban the killing of wild animals for spurious medical reasons.

World Health Organization endorses TCM. Expect deaths to rise.

Mother and young rhinoceros killed for their horns.

Image credit: Wikipedia

A few days ago, a news story in the journal Nature reported that the World Health Organization, which is supposed to be devoted to improving the health and medical care of people around the globe, will for the first time endorse a belief system called "traditional Chinese medicine." I'm labeling TCM a belief system because that's what it is–but the WHO will be endorsing it as a set of medical practices.

The Nature writer, David Cyranoski, presents this news in a classic two-sides-of-the-story format, describing the "endless hours" that TCM proponents spent on such important topics as the "correct location of acupuncture points and less commonly known concepts such as ‘triple energizer meridian’ syndrome." Later in the article (but much later), he points out that scientists have argued that qi and meridians simply don't exist.

Cyranoski also falls into the trap of using the phrase "Western medicine" as if it were just an alternative point of view. An apt response is this comment from a biology Ph.D. student, who goes by @astrelaps on Twitter:

"What a weak, equivocal article from the world's preeminent scientific journal. "For those steeped in Western medicine..." is like writing "For those steeped in climate science" or "For those steeped in evolutionary biology" when reporting on climate change denial or creationism."

Well put. On the other hand, Cyranoski does point out that the major motivation for TCM is money:

"[China] has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market."

Were you thinking this was about health care? Afraid not. Cyranoski goes on to point out some serious problems with TCM, for example:

"Critics view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous: China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year."

Actually, it's much worse than this.  Here's what TCM really looks like: the horrific slaughter of the last remaining rhinoceroses in Africa in order to hack off their horns, which are sold to become part of elixirs that some people mistakenly think confer strength or virility. Last year, National Geographic ran a heart-wrenching photo essay showing some of the awful results of rhinoceros poaching in Africa; take a look at these photos here.

TCM also looks like this: black bears kept in grotesquely cruel "farms" with a permanent tube inserted into their abdomens so that their bile can be harvested. Despite a growing movement to end this inhumane practice (see this NY Times story), it persists today, with thousands of bears kept in cages so small they can barely move. No one can view photos such as these and say that TCM is a good thing.

And TCM is behind the slaughter of the last remaining wild tigers, which are virtually extinct now in Asia, so that men can foolishly eat their bones, claws, and genitals in the mistaken belief that tiger parts will make them virile. Here too, National Geographic has details and photographs that are almost too painful to look at.

And don't get me started on pangolins, the beautiful, peaceful mammal that's now perilously endangered because TCM practitioners think its scales have some sort of medicinal value. (They don't.) For more on these gentle creatures, see the article I wrote last year.

I can almost hear the counter argument: but what about artemisinin? That's a plant extract derived from Artimisia annua, an herb that was traditionally used in China to treat malaria. Turns out that it really works, and artemisinin is now the basis of a number of modern malaria treatments.

Well, great. If an herb has the potential to treat disease, we should (and can, and do) study it, figure out what the active ingredient is, develop a controlled process for delivering effective doses, and use it. That's what happened with artemisia, and it also happened with taxol, an effective cancer chemotherapy derived from the Pacific yew tree, and common aspirin, derived from the willow tree.

But one success doesn't excuse hundreds of bogus claims that are based on little more than magical thinking.

There's no legitimate reason to use terms such as "Chinese" medicine, or American, Italian, Spanish, Indian, or [insert your favorite nationality] medicine. There's just medicine–if a treatment works, then it's medicine. If something doesn't work, then it's not medicine and we shouldn't sell it to people with false claims. The same is true for alternative, holistic, integrative, and functional medicine: these are all just marketing terms, with no scientific meaning. They merely serve to disguise sloppy, unscientific thinking at best, and in a less charitable interpretation, outright fraud.

As the Nature article points out, TCM has been a scam for decades: it was revived and heavily promoted in China by former dictator Mao Zedong, who didn't believe in it himself, but pushed it as a cheap alternative to real medicine. I won't go over that again here, but see these stories from Alan Levinovitz in Slate and David Gorski at Science-based Medicine.

Finally, why would the World Health Organization start pushing a set of unscientific practices that are likely to harm people's health? Support for TCM grew during the tenure of former WHO director Margaret Chan, who ran the WHO until 2017 and who had close ties to China. When Nature tried to contact Dr. Chan, the WHO responded that Chan "is not answering questions on matters related to the WHO."

By endorsing TCM, the WHO is taking a big step backwards. Let's hope that the current leaders of the WHO will realize that this step undermines their core mission. The WHO should not advocate treatments that not only have no evidence to support them and that can cause real harm to patients, but also are the primary reason that humans are hunting rhinoceroses, tigers, pangolins, and other animals to extinction.

It's time to destroy our smallpox

The eradication of smallpox was possibly the greatest victory of science over disease in the history of mankind. Thanks to a determined, worldwide vaccination effort, led by the World Health Organization, the last known human smallpox case occurred over 30 years ago, in Somalia in 1977. The WHO declared smallpox eradicated in 1980.

But smallpox isn't completely gone. That's because two large government laboratories, one in the U.S. and one in Russia, insist on maintaining stocks of the smallpox virus (called variola). In the U.S., the smallpox virus is kept at the Centers for Disease Control in Atlanta. In Russia, it's at the Vector lab in Siberia.

Why keep this incredibly deadly virus around? The scientists at the CDC and in Russia give the same answer: more research is needed to develop better vaccines, to protect us from a bioterrorism attack. "We still have work to do to protect the public," said Ali Khan, a smallpox researcher at the CDC, quoted just last week in the Washington Post.

They've been making this argument for 30 years now, but they are wrong. The only thing they need to do is to destroy their stocks of smallpox, and wipe out this virus once and for all. This seems like an obvious thing to do, but it's obvious now that the scientists whose jobs depend on keeping the smallpox around will never agree to destroy it. Nor will their bosses at the CDC. Yet keeping the smallpox around dramatically increases the risk that a deranged person will get his hands on it and release it in the population.

A smallpox outbreak would indeed be a frightening scenario: smallpox has a mortality rate of 30-35%, and it has been called one of the most devastating diseases in the history of mankind. In the 18th century, it killed 400,000 Europeans each year, and in the 1950s it was still infecting 50 million people a year worldwide. Routine vaccination ended about 35 years ago, which would make an outbreak today truly devastating. But an outbreak cannot happen if we destroy the smallpox that the U.S. and Russia are still holding.

Back in 1999, the WHO set a deadline to destroy the remaining smallpox samples, but the U.S. and Russia have repeatedly delayed action. At the 2006 meeting of the World Health Assembly (WHA), virtually every country agreed, again, that the smallpox should be destroyed, but the U.S. and Russia objected, and no date was set to destroy the remaining stocks. The WHA will meet again this coming May, and smallpox will be on the agenda. Unless President Obama takes a firm stand, I expect that the U.S. will once again insist on keeping its smallpox stores.

Experts such as D.A. Henderson, who led the effort to eradicate smallpox, have pointed out that we can develop new vaccines without the virus. The genome has been sequenced several times over, and we have the technology to synthesize parts of the virus if we really need it for vaccine design. Despite these facts, the old guard at the CDC will never agree to destroy their smallpox willingly.

President Obama: here is an opportunity to do the right thing. You can order the CDC to destroy their stocks of smallpox, and eliminate this unnecessary risk from the planet. The United States can and should take the moral lead on this public health threat, rather than stonewalling once again at the next World Health Assembly. Destroy the smallpox, and wipe out this scourge once and for all.

Non-GMO foods: nonsense

I was at a local organic food market recently buying lunch, and I noticed that my avocado-and-hummus sandwich proclaimed that it contained "non-GMO" ingredients (GMO = "genetically modified organism).

Now, I happen to like organic groceries. The ones near me tend to have better produce and fish, two of the main ingredients in my diet. But organic markets are a hotbed of bogus, even laughable health claims, and I often have to suppress my urge to complain to the store's management. (I once wrote to Whole Foods, but they never responded.)

Here in the U.S., most of our food supply is filled with so-called GMO foods, but in Europe the situation is dramatically different. For some reasons, our otherwise well-educated European friends are terrified of GMO foods. They don't seem to realize that we've been modifying the genes in our foods for centuries, and it's generally been a good thing. The latest biotechnology merely allows us to modify plants (and animals too, though none are yet on the market) much more quickly, and more intelligently. Today we can alter just a few genes to produce a more-desirable plant, rather than doing it by trial-and-error over many generations.

In fact, the "GMO" foods of the past likely had hundreds of unknown gene modifications.Farmers selected plants for seed because they looked and tasted good, without having any idea of what was really different about them.

Let's take a look at corn. The corn we eat today, organic or not, looks nothing like the "real" corn (or maize) from centuries ago. The earliest corn cobs discovered by archaeologists were tiny, with only a few kernels. This picture shows a primitive form of corn, called teosinte, compared to modern corn:

The history of corn is a history of genetic modifications made by earlier humans who didn't even know what a gene was. Today's GMO food is simply a continuation of that history.

That hasn't stopped opponents of GMO foods from sounding the alarm. Even the World Health Organization makes some errors on its website, where it discusses three main "issues of concern for human health":

1. Allergenicity. Not a problem. The WHO says "No allergic effects have been found relative to GM foods currently on the market."
2. Gene transfer. The WHO gets this one wrong. They write that "gene transfer from GM foods to cells of the body or to bacteria in the gastrointestinal tract would cause concern if the transferred genetic material adversely affects human health." Gene transfer is a topic that I've studied in some detail, and published papers on. The WHO says that the likelihood of a gene transfer event is "low," but in fact it is vanishingly small - so small, in fact, that not a single gene transfer event has ever happened. In the history of our species, and of all mammals, going back tens of millions of years, not a single gene from something we've eaten has been transferred into the human genome or, as far as we can tell, into bacteria within our guts.
3. Outcrossing. This is "the movement of genes from GM plants into conventional crops," and this really can happen - they're the same species, so they can interbreed. But it's only a concern if GM plants are harmful, which they're not.

The bottom line is, you're far more likely to be harmed by being hit on the head by a corn cob than by some kind of deviant GMO corn gene.

The WHO concludes that GM foods "are not likely to present risks for human health." Of course, not all GMO foods are good. I'm not a fan of engineering crops to be more tolerant of pesticides, for example: this type of GMO food benefits big agricultural firms rather than the consumer. And it is theoretically possible to insert harmful genes into plants, but agricultural firms wouldn't have any reason to do that.

So the next time you see the non-GMO claim in your grocery, ask yourself whether the ingredients could really be completely unmodified from their "natural" state. I doubt it.

My sandwich was really good, by the way.