China’s use of bear bile to treat critical Covid-19 patients another potential PR nightmare

China’s ban on the trade and consumption of wild animals in February, right in the middle of the novel coronavirus pandemic, was widely welcomed in light of the fact that the zoonotic virus was as a result of natural processes.

Zoonotic infections are infectious diseases caused by pathogens that have jumped from non-human animals to humans.

And, seeing as China’s 2003 Severe Acute Respiratory Syndrome (SARS) epidemic, and the 2012 outbreak of Middle East Respiratory Syndrome (MERS), from Saudi Arabia, were both also zoonotic coronaviruses, banning China’s thriving wildlife trade was the best way to quickly curb the consumption of wild animals, as well as to prevent a future outbreak.

But conservationists now fear that another potential problem is brewing on the horizon for the region: bear bile farming in China to treat critically ill Covid-19 patients.

What is bear bile farming?

Bear bile farming, which started in China in the 1980s, involves the extraction of bile from gallbladders of Asiatic black bears and Sun bears.

It is also practised in South Korea and Vietnam.

Bear bile has been a traditional Chinese medicinal property for over 3,000 years. However, because bears are protected by China’s Wildlife Protection Law and are not allowed to be killed, they are instead confined to small cages and subjected to regular surgical procedures to extract bile.

As Asiatic black bears are listed as Class II under the law, they may be used for commercial use.

And these procedures are cruel. The most ‘humane’ procedure, according to the Animals Asia organisation, involves creating a permanent open wound from a sedated bear’s gallbladder through their abdomen.

The wound stays open as tubes are continuously forced through them.

What is bear bile used for?

Bear bile has been used for thousands of years to cure fever, gallstones, liver disease and eye irritations, thanks to its active ingredient, ursodeoxycholic acid (UDCA).

In terms of Covid-19, China’s medical fraternity will be using bear bile to alleviate acute bronchitis and pneumonia.

But bear bile farming, often associated with sub-standard hygiene conditions, means the risk of extracted bear bile containing pus, blood and bacteria is high. Because of this, China has involved large pharmaceutical companies, to put consumers’ worries at ease.

On 3 March, China’s National Health Commission and the National Administration of Traditional Chinese Medicine released a document titled “Covid-19 Diagnosis and Treatment Plan (7th Trial Version)”.

In the document, the government laid out a patent medicine known as Tan Re Qing Injection Liquid. One of the ingredients in Tan Re Qing is bear bile powder, referred to as Fel ursi, as was discovered by the Environmental Investigation Agency (EIA).

The EIA found that Tan Re Qing is intended for critical Covid-19 cases, said to alleviate respiratory complications.

International Fund for Animal Welfare (IFAW) Asia Director Grace Ge Gabriel said bear bile as an ingredient was replaceable, and that traditional Chinese medicinal practitioners tended to prefer plant-based ingredients to bear bile.

“In the late 1990s, TCM [traditional Chinese medicine] doctors in Chinese hospitals told us that they have been using herbal alternatives because bear gallbladders are too expensive and hard to obtain. Bile from farms are too unsanitary and unsafe,” Ge Gabriel told The Citizen.

Despite many coming out in stark opposition of China’s decision, the general office of the National Health Commission and the general office of the State Administration of Traditional Chinese Medicine have published their recommendations on treating critical Covid-19 patients.

But China’s alleged treatment of critical patients comes with a host of potential complications, both moral and physical.

What is in Tan Re Qing?

According to Capital Animal Welfare Association (CAWA), the injection is being produced by Shanghai Kaibao Pharmaceutical Co., Ltd.

The injection has reportedly been in production since 2003, but adverse reactions earned it a spot in the State Food and Drug Administration’s list of medications with serious side effects in 2007.

This was confirmed to CAWA by Professor Zhou Chaofan, Chinese Pharmacopoeia editorial board executive member and member of the State Academy of Traditional Chinese Medicine, and Professor Sun Zhongshi, a senior expert from the region’s former Food Evaluation Center of the State Food and Drug Administration.

Both concurred that Tan Re Qing lacked reliable quality control methods, and that one injection contains hundreds of ingredients, which when mixed together can cause serious complications.

This was reiterated just last year, after data from 1,577 patients injected with Tan Re Qing led to the conclusion that serious clinical attention should be paid to the side effects of the injection.

Some ingredients include Scutellaria baicalensis, bear bile powder, goat horn, honeysuckle, forsythia, earthworm, deer, bear, water buffalo and sheep.

As pointed out by Ge Gabriel, 97% of Ten Re Qing’s ingredients are derived from plants and minerals, and that only 3% comes from domestic and wild animals.

This begs the question of why China is going to all this trouble by continuing to use an ingredient that could potentially be replaced by a plant-based, potentially safer product.

It also points to pharmaceutical companies potentially taking advantage of the current pandemic to push their own profit-orientated suggestions.

Another potential wildlife PR disaster for China?

Ge Gabriel concurred that China is conveying mixed messages regarding their stance on conservation and their willingness to ban wildlife trade, just to use bear bile as medicine.

“Just as China is coming out as a country that seems to have won the victory fighting Covid-19, now it has another PR disaster in its hands.

“Like all countries, China is not a monolithic whole. China’s Health Commission which recommends the injection probably has no idea the Asiatic bear is an endangered species, it is on CITES Appendix I. Even if China wants to send traditional Chinese medicine to help other countries fight the pandemic, the inclusion of Tan Re Qing would be violating the international law,” she explained.

This lack of communication among Chinese authorities, compounded with a controversial reintroduction of a notably problematic treatment method riddled with ethical conundrums, could dampen all positivity associated with the region’s ability to combat Covid-19.

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