A couple of days ago a very interesting article was published in the Sydney Morning Herald (SMH) regarding the National Institute of Complementary Medicine (NICM). The article was the result of an in-depth investigation by the award winning science reporter for the SMH and The Age, Liam Mannix. (I also borrowed, with permission, the title of this blog post from one of @liammannix tweets because it perfectly captures the essence of the NICM in one sentence).
The SMH article is in general not very flattering of the NICM’s operations but unfortunately, and maybe I can say as usual, the university hosting the NICM, Western Sydney University, denies any wrongdoing and will in all likelihood continue with ‘business’ as usual. There is however one paragraph in the article that seriously annoys me and it again shows how good these people are at misleading the public. It is the very common example of Artemisinin being used as ‘evidence’ that Traditional Chinese Medicine (TCM) is a real thing as opposed to state sponsored quackery. I’ve copied the article below and will comment on the artemisinin statement afterwards.
Start of article
The National Institute of Complementary Medicine was in trouble. Set up in 2007 with federal government money, its job was to research the scientific validity of complementary medicines such as acupuncture.
But by 2015 it was struggling to bring in research funding.
Confidential board documents, obtained by The Age and The Sydney Morning Herald, show its parent organisation, Western Sydney University, had become “concerned about their relatively high level of financial support for NICM”. At a cost of about $2 million per year, the institute was a drain on the university’s coffers.
So the institute decided to change focus and reach across the seas for funds. Under director Professor Alan Bensoussan, the NICM, and through it the university, began to concentrate on the controversial practices of traditional Chinese medicine.
What happened next shows the extensive, unreported links between an Australian university and the Chinese government – links that had potential to indirectly assist the aims of the Chinese Communist Party.
In response to its funding shortfall, the NICM lined up millions of dollars from a property developer called Yuhu group, chaired by Huang Xiangmo, a man with well-reported connections to organisations associated to the Communist Party. Huang was a big political donor to both sides of politics, a Crown casino high roller and the man whose relationship with Sam Dastyari resulted in the Labor senator quitting politics in disgrace.
Then the NICM secured a pledge of $20 million from the Beijing University of Chinese Medicine. The money was originally lined up for a hospital of Chinese medicine in Westmead, Sydney. Bensoussan prepared to announce the funding as a coup as, according to a 2015 strategic review, “the Chinese government looks for Western validation and greater use/patient benefits from [Chinese medicine]”.
“This is universally regarded as the most critical short term source of additional research funding for NICM,” the review continued, and NICM and Australia were “ideally positioned to leverage its strengths in [Chinese medicine]”.
A separate document, also obtained by The Age and Herald, urged the NICM to “seek endorsement and influence from the Chinese government”, and named Chinese President Xi Jinping as a key person to engage. The strategy was entitled “Building a Bridge Between China and Australia”.
The centre now denies that any of the funding, either from Huang or the Beijing University, actually came through. This year, Western Sydney University cut the ribbon on a new health centre in Westmead, offering services including acupuncture and Chinese herbal medicine. They say it has been fully funded by the university.
What is not questioned is the desire of the Chinese Communist Party leadership to sell the benefits of its medical practices to the West as part of its national propaganda effort.
Recent moves by the federal government to impose greater responsibility on universities to take note of their exposure to foreign influence activities, particularly from China, make the NICM’s overtures to China in retrospect look naive at best. However in the context of the time, it’s unlikely that NICM or Bensoussan recognised that they were at risk of being part of a Chinese influence strategy.
To its supporters, the National Institute is testing traditional medicines with scientific thoroughness to enhance the treatments available for chronic diseases in the West. To its detractors, it’s pushing questionable medical practices with inadequate proof and playing its part in a concerted attempt by the Chinese Communist Party to improve its image in the West.
‘Unethical not to do it’
Traditional Chinese medicine prescribes cocktails of herbs, animal extracts and acupuncture to balance the energy – qi – that runs through invisible channels in the body called meridians.
Bensoussan, the NICM’s director, is a longtime practitioner. He says Chinese medicine’s herbs might hold secrets to treating the West’s chronic disease problems. “We would be unethical to not do this research, to turn our backs on it,” he said.
This is not a wild claim. The anti-malarial herbal extract artemisinin emerged from a broad survey of traditional Chinese medicine and has saved millions of lives. In Australia, Chinese medicine practitioners are registered with the Australian Health Practitioner Regulation Agency, and Bensoussan is on the Natural Therapies Review Team at the National Health and Medical Research Council, Australia’s peak funding body for medical research. In May this year, the World Health Organisation agreed to include traditional remedies in its foundational document – a strong endorsement.
But it also has its detractors.
Venerable academic journal Nature responded to the WHO’s decision with an unusually stinging editorial: “[Traditional Chinese medicine] is based on unsubstantiated theories about meridians and Qi. Most Western-trained doctors and medical researchers regard TCM practices with scepticism: there is no substantial evidence that most of them work, and some signs that a few do harm.”
The NICM’s reason for being is to test the science behind complementary medicine.
But questions have been raised about industry funding of its research, and what that might mean for its rigour. In 2015 NICM launched a clinical trial of Sailuotong, a herbal mixture for vascular dementia, funded by a Chinese-linked pharmaceutical company called Australia Shineway Technology Pty Ltd. And The Beijing Tong Ren Tang Chinese Medicine Corporation is funding NICM research into the health benefits of cow gallstones. Both companies already sell the medicines under study.
This sort of research – where a private company pays a university to confirm that a substance it is already selling actually works as medicine – has the potential to create “a very significant conflict of interest that is usually intolerable in science”, says John Dwyer, a professor emeritus of medicine at the University of NSW.
NICM responded that the institute “conducts itself with the highest degree of integrity, ethics, scientific enquiry and social responsibility. The University has strict protocols in place to ensure the independence of its research.”
‘An unprecedented opportunity’
In 2014, Western Sydney University signed a Memorandum of Understanding with the Beijing University of Chinese Medicine to work together on a jointly-run Chinese medicine clinic in the heart of Sydney, to be known as the Australia China Academy for Integrative Healthcare. At the signing were then prime minister Tony Abbott and Chinese President Xi Jinping.
Background briefing notes from NICM’s top leadership called the centre “an unprecedented opportunity for the advancement of Chinese medicine in Australia, including the development of the Chinese medicine market in the West; promoting Chinese heritage and culture; and integrating Chinese medicine with the Australian healthcare system.”
Leaked emails show NICM’s leadership ensured that, as a potential donor to the institute, Huang Xiangmo was sent a copy of the MOU briefing notes before the signing. The Beijing University proposed spending more than $20 million on the collaboration. The clinic was to “introduce Chinese medicine to Australian clinicians and the community”, according to a leaked staff briefing. It would have included a museum of Chinese medicine.
Western Sydney University now says that the funding never arrived, and insists it has received no money from the Beijing University of Chinese Medicine. The new Chinese medicine centre in Westmead is “wholly operated and financed by Western Sydney University”, a spokeswoman said.
The University has denied that NICM had funding issues in 2015, and Bensoussan also denied that NICM’s embrace of Chinese medicine had anything to do with money: “That is completely wrong. It is really hard to get money out of China. China has very strict rules around these sorts of things.”
But the documents suggest it was not for want of trying.
In 2012, NICM signed a cooperation agreement on Traditional Chinese medicine with the China Academy of Chinese Medical Sciences, China’s top traditional medicine organisation – which is run by the Chinese government.
The following year, Bensoussan found himself at the Great Hall of the People, on the edge of Tiananmen Square in Beijing, receiving the International Award for Contribution to Chinese Medicine. According to a leaked draft of his speech notes, Bensoussan planned to say Chinese medicine was “exceptional” because of the “conscientious, vigorous support of the Chinese government”. NICM would not confirm if Bensoussan made the speech.
“China remains on a strong trajectory to develop [traditional Chinese medicine] internationally … It is now up to China to help us with this task … We look forward to ongoing collaboration with our Chinese partners [and] the continued support of the Chinese government,” the draft speech continued.
‘Promoting the Communist Party’
Leaked documents reveal that the same year, Western Sydney University was in talks about a major new project with Huang’s Yuhu Group, researching Chinese herbs for cancer medicine. Yuhu indicated it would be willing to invest up to $12 million – a huge sum for an institute that was earning a little over a million dollars in annual revenue. But Yuhu did not have any experience or other interests in medical research – it was a property development company.
Confidential strategy documents show NICM targeted Huang as a potential donor to be “cultivated”. He was later to become leader of the Council for the Peaceful Promotion of the Reunification of China, the peak Chinese Communist Party lobbying and influence organisation in Australia – another organisation identified by NICM to target for influence and funding.
Earlier this year, Huang was banned from Australia over ASIO’s fears he was peddling influence for Beijing – a claim he denies.
A spokeswoman for the university said NICM never received any funding from the Yuhu group. “The draft proposal was never advanced,” she said.
However, that was not the end of the university’s dalliance with Huang. In 2015 he donated $3.5 million to establish a new Australia-China Institute for Arts and Culture. At the time, the gift was the single-largest donation ever received by the university. NICM director Bensoussan is listed as one of the Australia-China Institute’s key researchers.
The promotion of traditional Chinese medicine fits with Beijing’s broader use of “soft power” to build its influence in the West, says Alex Joske, a Beijing-watcher based at the Australian Strategic Policy Institute. In 2016, Beijing released a white paper saying “the Chinese government is dedicated to promoting the development of traditional medicine throughout the world”.
The country has been rolling back medical safeguards for the herbs; Chinese doctors who question the science face arrest. And new laws in China require hospitals to open TCM departments.
“One of the important things to understand is for Beijing there is no real clear line between politics, culture, education and propaganda,” Joske says. “For Beijing, promoting traditional medicine isn’t just about pushing alternative scientific approaches and medical techniques. It’s also about promoting the Chinese Communist Party.”
In 2013 Western Sydney University signed a non-disclosure agreement that mentioned sharing herbal recipes with a man named Yu Long Yu.
The Age and the Herald twice asked NICM if this was the same Chinese medicine practitioner called Yu Long Yu who faced court in 2006 for importing material from endangered species in Australia – including tiger, rhinoceros and musk deer material, and more than 200 kilograms of pangolin (anteater) scales.
The Institute refused to answer the question.
Critics contend poaching of endangered animals is often fuelled by demands for the ingredients for use in certain Chinese medicines. Pangolins, for example, are being pushed into extinction.
Bensoussan has long history with Yu. In 2006, when he was director of the Centre for Complementary Medicine Research, NICM’s predecessor, Bensoussan appeared at Yu’s trial as a character witness. Bensoussan was described at the time as Yu’s friend and sometime business associate, and described his friend as “absolutely exceptional”, saying “there are very few clinicians of his ilk in Australia”.
The judge disagreed. Yu “was propagating the decimation of protected species”, he said.
It was Bensoussan who would sign NICM’s 2013 agreement with Yu.
Another apparent money-making effort was named Project Rozella. The plan, conceived of around 2014, was for NICM to develop a label – much like the Heart Foundation Tick – that companies could place on herbal medicines that would mean the NICM had endorsed their safety and effectiveness.
“This could be a significant source of revenue for NICM,” internal documents say. “Risks could be minimised by a simple evaluation of the data held, rather than a detailed qualitative assessment of the trial itself.”
A NICM spokeswoman said Project Rozella was a “defunct proposal for a point-of-sale health-labelling system”. She denied any suggestion that it was designed to gloss over the existing lack of proven medical evidence that the NICM was set up to test.
But according to Ken Harvey, president of Friends of Science in Medicine, NICM appeared to be trying to find a way to give a tick of approval to herbs without thoroughly checking the evidence.
“The problem with looking at these trials is they generally don’t stand up. You’re better off bullshitting and hoping that no one is going to pull you up,” he said.
End of article
The below statement is one that I come across quite regularly when people such as Alan Bensoussan tries to vindicate their promotion of TCM. Unfortunately it seems that this statement is quite convincing but in reality it is actually a very irresponsible statement to make.
“The anti-malarial herbal extract artemisinin emerged from a broad survey of traditional Chinese medicine and has saved millions of lives.”
So why is this statement so wrong? There is a number of issues, some of which I will list below:
- Artemisinin is not an herb or an herbal extract, it is a compound (a sesquiterpene lactone endoperoxide to be more exact).
- Why would the Chinese government embark on a large scale project to find effective antimalarials if they have this wonderful and highly effective TCM? Why bother? Because they know TCM is BS, but they also know that modern science can indeed yield valuable compounds for the treatment of disease.
- TCM is however a massive market (people are quite gullible), and hence the Chinese government decided to promote all of TCM internationally – nothing to do with healthcare, everything to do with business. Alan Bensoussan and the NICM are just too happy to be the conduit for the CCP’s plans regarding TCM in Australia.
- Chinese scientists isolated artemisinin in the 1960/70’s, derivatised it into artemether and artesunate and it is currently being used as a first-line treatment against malaria in combination with other antimalarial compounds. It is called ‘artemisinin combination therapies’.
- It is not TCM that saved millions of lives, modern science did. The Chinese scientists involved in this research was rightfully awarded the Nobel prize for their efforts.
- It is very rare to find compounds such as artemisinin – I would say the chances are 1 in a 100 herbs tested, but in reality it is much closer to 1 in a 1000 herbs tested. The Chinese scientists had to test many many hundreds of herbs to find this one compound. (I’ve been trying for 20 years to find compounds such as artemisinin – I haven’t yet found anything remotely as good as artemisinin).
- Alan Bensoussan and the like abuse science by making use of A. annua (herb) and artemisinin (compound) as evidence that TCM is effective. He has done so before. The Australian Skeptics published an article in 2017 rebuking Alan Bensoussan’s use of this example to promote TCM.
- The WHO explicitly warns against the use of A. annua or artemisinin mainly because resistance against these compounds can and probably will eventually occur. Therefore the irresponsible promotion and use of the herb, A. annua can in effect lead to millions of people dying. (The WHO advocate the use of combination therapies to slow the development of resistance). Unfortunately there are already signs that resistance has developed against this class of compounds in Asia.
- The WHO quite recently again published a position statement and explicitly warned against the use of ‘non-pharmaceutical forms of Artemisia’ (the herb) and yet Alan Bensoussan will dig in his heals and continue to insinuate that TCM is effective using the example of A. annua.
- Is A. annua really the only example that they have? Anything else? ‘rhino horn’ maybe?
There is a lot more that can be said but I’ll leave it at that – they will continue to use the A. annua/artemisinin example to mislead the public into thinking that TCM herbs are effective, ignoring the explicit warning of the WHO not to do so. Where is the ethics in that? But now back to the question; is this article in the SMH the beginning of the end of the NICM? Short answer is, no. The reason for this is that Universities are mainly self regulating, which implies that one person makes the decisions about what science is and what it is not (a decision that seems to be mainly driven by money). In this case it is the vice-chancellor Barney Glover. Now if this man cannot be moved even when members of the public gets hurt (and unfortunately die) because of the promotion of ineffective remedies peddled by the NICM, then this article in the SMH will not really have much of an impact. If anything this is free marketing for the NICM and this is just the sad, unfortunate reality.