Traditional Chinese medicine — grown in a petri dish?

Each month, Hong Kong school teacher Kala Wan simmers a bundle of herbs, donkey-hide gelatin and velvet deer antler for 75 minutes, until she has a dark murky soup. Pinching her nose, she quickly gulps it down.

"Donkey-hide gelatin and velvet antler can nourish blood and boost my health," the 27-year old said, adding that she tends to dose up during her period.

Wan's doctor, who provides the ingredients for her monthly brew, is one of the Traditional Chinese Medicine (TCM) practitioners who prescribe treatments — for everything from common colds to cancer — to many in Hong Kong.

TCM includes a wide array of practices, such as acupuncture, diet and physical exercise. These treatments are aimed at rebalancing energy flows, known as "Qi," in the human body. The principles are not recognized by conventional Western science, and there is little evidence-based research into the effectiveness of TCM. Yet global the TCM market was worth $434 billion (€374 billion) in 2020, according to China's state-run newspaper China Daily.

TCM remedies like acupuncture are popular in many parts of the world. And while most skeptics of pressure points and needles would at least agree treatments such treatments are fairly harmless, other aspects of TCM are far more controversial.

Around 12% of medicines prescribed by traditional Chinese practitioners are derived from animals. Those that are, often include the body parts of endangered species — such as pangolin scales, rhino horn, tiger bone and bear bile.

The Chinese and US governments have banned the use of most of these products and their international trade is outlawed by the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Still demand remains high. The annual trade in rhino horn is worth some $230 million, according to the UN. 

So, what if there was a way to supply the market without touching these endangered species? 

As lab-grown meat promises to keep the carnivores among us satiated without the cruelty and environmental fallout of the meat industry, so scientists are exploring whether the emerging industry could do the same for TCM.

The first step is to extract tiny samples of tissue from live animals which are used to generate "induced pluripotent stem cells" (iPSC). These in turn are grown in the lab to create synthetic animal tissue. Biomedical scientist Kenneth Lee says it is now possible to generate iPSC which can "be induced to differentiate into muscle cells, bone, cartilage, fat and so on."

Lee is a professor at the Chinese University of Hong Kong. But he is about to retire and move to Scotland to set up his own cultured-meat company. He says it should be possible to use stem cells to produce slaughter-free rhino horn and tiger claw, as well as shark's fin for soup, and dog meat to supply the Chinese dog meat festival. "I think this is a legitimate process that can counteract illegal animal trafficking," Lee said.

The entrepreneur admitted it will be several years before these products might be on the market. But he's not the only one working toward that goal. Hong Kong lab-grown meat start-up Avant Meats is developing cultured swim bladders, known as fish maws, as part of the range of lab-grown fish it hopes to launch by 2025.

Could lab-grown TCM be a boon for smugglers?

"We want to address the environmental impact of the consumption of fish maws in the ecosystem that has led to the [near] extinction of several species, including bahaba, totoaba and vaquita," said Avant Meats' CEO Carrie Chan.

Many Chinese believe that fish maws have medicinal value, for example in treating arthritis. Swim bladders from totoaba, which is caught illegally off the coast of Mexico, are worth some $46,000 per kilo ($22,500 per pound) on the Chinese black market, according to the Porpoise Conservation Society. 

Not only is the totoaba listed as critically endangered, the nets designed to catch it are also a threat to the vaquita, a small porpoise that is the world's most endangered cetacean.

But not everyone believes that TCM using products grown in a lab will do much to protect these rare species.

 "There is a high possibility that lab-grown meat imitating exotic and endangered animals would instead stimulate the demand for raw meat and pose a challenge to enforcement," said Zhaomin Zhou, a researcher at the Southwest China Wildlife Resources Conservation lab at China West Normal University.

Zhou points to the case of synthetic ivory, which was supposed to replace genuine tusks. Her research has shown unscrupulous traders were able to pass off real ivory as its synthetic counterpart to avoid law enforcement.

Asked whether cultured fish maws might drive up demand for the real thing, Chan of Avant Meats said, "with or without this invention, these fish species are endangered."

"I don't think the demand for that is driven by a sole factor, and cultured products exist because we want people to switch from conventional meat to a more sustainable version," she added.

Just like the real thing?

Others argue that if lab-grown alternatives could be produced cheaply and plentifully enough, they would drive down the cost of animal-based TCM, taking away the economic incentive for poaching and smuggling.

A survey last year indicated that 70% of Chinese consumers were willing to try lab-grown meat, and nearly 60% were willing to buy it. But will consumers of TCM be equally ready to accept something grown in a petri dish as interchangeable with something caught in the wild?

TCM doctor Cristine Li says her Hong Kong clinic would consider using products from lab-grown animal tissue if they were available. "If artificial products can reach half of its real counterpart's effectiveness it's good news," she said.

Given the scant scientific evidence of the effectiveness of these treatments, this raises the question of how to compare the two. But Wan, with her deer-antler brew, says she would be happy to rely on her doctor's judgement. "If my TCM practitioner believes its effectiveness, I'll use it," Wan said. "I am against animal killing, so I am willing to try it."

Still, she doubts the older generation would take to cultured TCM so easily: "My mother, for example, doesn't trust such artificial animal drugs. To her, it would be very difficult for them to imitate the function of real animal parts. Her generation will probably stick to real animal drugs."