Last year I wrote an article describing what we called “The Dark Side” of medical tourism abroad, unproven stem cell therapy. I was prompted to write the article after coming across a job add for a “World Class” stem cell clinic in Beijing. The issue is that the add was posted on an expatriate forum that can, at best, be described as rowdy. After looking at the website of the stem cell clinic placing the add I decided that the clinic was a sham, and a state sponsored one at that. I referred to current stem cell ‘treatments’ as nothing more than shaman cures;

“Stem cells, like witch doctors, are a last breath destination for patients and families of patients desperate to ‘cure’ diseases for which no current cure exists. (For example, if you look at the website of the above described stem-cell center, you will see a large number of patients who came to be ‘cured’ of Alzheimer’s.) And stem cell witch doctors readily peddle stem cells as the “cure”. (For example, look at the case of this woman and decide for yourself if she was “cured” or if she and her husband were manipulated into feeling the short term healing placebo affect of hope’s wings). But, for now, whether they are casting old dog bones, or injecting people with stem cells, witch doctors are only 100% successful at two things – stealing money from those who deserve it the least, and providing care that works 0% of the time.”

I further cautioned that when stem cell therapy made real breakthroughs in curing so far incurable conditions, the news would quickly disseminate throughout the world.

“My advice then, is to stay away from anyone advertising their stem cell services. When real breakthroughs for diseases like Alzheimer’s and conditions like full body paralysis happen, it is inevitable that the whole world will hear about it. And, the company that makes this kind of breakthrough, won’t be looking to a local employment website to hire its Director of Marketing because they’ll be more than a few Fortune 100 companies ready to pay for the rights to that job.”

So, this week when I opened The Economist (you should absolutely get a hard copy of this magazine because there’s just something about it that can only be savored away from the computer screen) I was delighted to see my thoughts echoed in an article, Stem Cells in China: Wild East or Scientific Feast?

The article is excellent because it points out the current dangers of China’s unregulated, shaman stem cell therapy market, and the potential of an academic environment in which stem cells therapies can be openly researched.

The heart of the article is a study recently published in the Journal of Regenerative Medicine, by Halla Thorsteinsdottir of the McLaughlin Rotman Centre for Global Health in Toronto and her colleagues. In effect the study finds that of the hundreds of vendors offering stem cell therapies, all are overstating the effectiveness of their treatments, and that these activities seem to have the tacit approval of the government despite regulations issued last May which were designed to curb stem cell offerings at hospitals.

China’s health ministry has, however, turned a blind eye to the unauthorised stem-cell therapies offered by hundreds of hospitals under its jurisdiction. One company in particular, Beike Biotechnology in Shenzhen, Guangdong province, is notorious for its internet claims and marketing efforts in countries around the world. It claims to supply stem cells to a network of more than two dozen hospitals in China and one in Thailand for treating myriad conditions at a cost of about $20,000 a pop.

Beike says it has treated over 6,000 patients, but it has yet to publish any papers in internationally recognised, peer-reviewed journals. Yet it seems to have powerful friends. It claims to have received funding from the China State National Fund and Shenzhen municipality. It also claims to have members of the Chinese Academy of Sciences and Chinese Academy of Engineering on its scientific advisory board.

On the other hand, and perhaps more importantly, Thorsteinsdottir finds that Chinese clinical trials into stem cell application are flourishing.

“Dr Thorsteinsdottir found that though many hospitals are making a profit from offering unproven therapies, a number of proper clinical trials are also being conducted using stem cells, for conditions such as heart-muscle damage, ischemia (restricted blood supply) of the limbs, liver disease and neurological disorders. These include a multi-centre trial organised by the China Spinal Cord Injury Network, a consortium of over two dozen centres in mainland China, Hong Kong and Taiwan, to test whether a combination of lithium and transplants of stem cells from umbilical-cord blood could lead to improvements in patients with spinal-cord injury.”

Where these two trends come together, according to Thorsteinsdottir, is that the allure of fast money and prestige that would come from successful clinical application of stem cell therapy could end up taking funds away from the so far more fruitful enterprise of basic clinical research. The tentative conclusion is that this trend could mean less than optimal progress for stem cell research, in China, when the potential seems to exist for China to become a world leader in this field. The Economist, however, makes this point in much starker terms.

Dr Thorsteinsdottir also noted that regenerative medicine in China is a matter of national prestige. Some researchers in China believe that this is an area in which their country is likely to produce a Nobel-prize laureate. They should, perhaps, be reminded that nationalism was the force that propelled Dr Hwang to stardom before reality destroyed him. For nature, unlike people, cannot in the end be cheated.

In my opinion, the proliferation of productive, and legitimate stem cell research, like so many other things in China, will come down to a basic need of health reform, better doctor compensation. Simply put, when doctors get paid more, and consequently, doctors’ prestige is no longer tied down to institutions and titles but is, instead reflected in fairer compensation, the instances of stem cell shams will decrease to less troubling levels. A part of this causal chain has to do with the fact that the government is keenly aware of how dire the financial statements of its state run hospitals are. To preserve order, red envelope payments (i.e. under the table payments above the listed cost of treatment) are tolerated. Allowing hospitals to offer bogus stem cell therapy is just another, unofficial way that doctors can compensate their salaries. Once the government feels that doctor’s are getting a fairer deal, that the doctors themselves are okay with, they will crack down on, as of now, unofficially tolerated corruption.