China promotes bear bile as coronavirus treatment, alarming wildlife advocates

Less than a month after taking steps to permanently ban the trade and consumption of live wild animals for food, the Chinese government has recommended using Tan Re Qing, an injection containing bear bile, to treat severe and critical COVID-19 cases. It is one of a number of recommended coronavirus treatments—both traditional and Western—on a list published March 4 by China’s National Health Commission, the government body responsible for national health policy. This recommendation highlights what wildlife advocates say is a contradictory approach to wildlife: shutting down the live trade in animals for food on the one hand and promoting the trade in animal parts on the other.

Secreted by the liver and stored in the gallbladder, bile from various species of bears, including Asiatic black bears and brown bears, has been used in traditional Chinese medicine since at least the eighth century. It contains high levels of ursodeoxycholic acid, also known as ursodiol, which is clinically proven to help dissolve gallstones and treat liver disease. Ursodeoxycholic acid has been available as a synthetic drug worldwide for decades.

The World Health Organization says no cure exists for COVID-19, though some medicines, such as pain relievers and cough syrup, can treat symptoms associated with the disease. (Read about what scientists know and don’t know about treating coronavirus.)

Traditional Chinese medicine practitioners typically use Tan Re Qing to treat bronchitis and upper respiratory infections. Clifford Steer, a professor at the University of Minnesota in Minneapolis, has studied the medical benefits of ursodeoxycholic acid. He knows of no evidence that bear bile is an effective treatment for the novel coronavirus. But, he says, ursodeoxycholic acid is distinct from other bile acids in its ability to keep cells alive and may alleviate symptoms of COVID-19 because of its anti-inflammatory properties and ability to calm the immune response.

Enacted in 1989, China’s wildlife protection law sees wild animals as a resource to be used for the benefit of humans. In 2016, it was amended to further legitimize the commercial use of wildlife, asserting explicitly that animals can be used for traditional Chinese medicine, Humane Society International’s China policy specialist Peter Li wrote at the time.

Although use of bear bile from captive animals is legal in China, bile from wild bears is banned, as is the import of bear bile from other countries. According to Aron White, wildlife campaigner for the Environmental Investigation Agency (EIA)—a nonprofit based in London, England, that exposes wildlife crimes—his organization learned first about the Chinese government’s recommendations to treat COVID-19 via social media posts from illegal traders.

“We were witnessing how this government recommendation was being coopted by the traffickers to advertise their illegal products as a treatment,” White says. Illegal bile from wild bears is produced in China, he says, and is also imported from wild and captive bears in Laos, Vietnam, and North Korea. The illegal trade persists even though Asiatic black bears, one of the species most commonly farmed for their bile, are protected from international commercial trade under the Convention on International Trade in Endangered Species of Wild Fauna and Flora, which regulates cross-border trade of wildlife and wildlife products.

Wildlife advocates worry that China’s recommended use of Tan Re Qing injections, which contain goat horn powder and extracts from several plants in addition to bear bile powder, will increase the trade in illegal wildlife products and justify animal abuse. “There’s a consistent preference among consumers for the wild product, which is often regarded as more powerful or ‘the real deal,’” White says. “So, having this legal market from captivity doesn’t reduce pressure on the wild populations—it actually just maintains demand that drives poaching.”

At bear bile farms in China and across Southeast Asia, the animals may be kept for decades in small cages. Bile is routinely extracted by inserting a catheter, syringe, or pipe into the gallbladder. All methods for extracting bile are invasive and “cause severe suffering, pain, and infection,” according to Animals Asia, a nonprofit dedicated to ending bear bile farming. Neglect and disease are common on these farms, and consumers risk ingesting bile from sick bears, which may be contaminated with blood, feces, pus, urine, and bacteria, according to Animals Asia.

Another traditional medicine on the National Health Commission’s approved list that could be in demand for use against COVID-19 is a pill called Angong Niuhuang Wan. The remedy, used to treat fever and various diseases, traditionally contains rhino horn, which is strictly banned from global trade. Under Chinese law, the pills must contain buffalo horn, White says, but some traders continue to tout pills containing rhino horn.

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Promotion of Tan Re Qing injections and other wildlife-based treatments at a time when Beijing seems intent on shutting down the country’s trade in live wild animals “really speaks to the mixed messages coming out of China at the moment,” White says.

But in China, use of traditional medicine, most of which is plant-based, spans thousands of years and was the primary form of health care until the early 1900s, when the last emperor of the Qing dynasty was overthrown by a Western-trained doctor. Traditional cures are often endorsed by the government as a pillar of Chinese culture, and in 2018, the World Health Organization included traditional medicine diagnoses in its medical compendium. During the coronavirus pandemic, officials have emphasized their use, and 85 percent of COVID-19 patients receive some form of herbal treatment, according to the Ministry of Science and Technology.

China’s National Health Commission did not respond to requests for comment.

Risks to human health

All wildlife farms pose health risks, regardless of whether the animals are being bred for meat or traditional medicine, White says. For example, in both cases, hundreds of wild animals often live crammed together, and people often interact with carcasses.

“Whether [wildlife is] being consumed as meat or as medicine, the risks are still there in how the animals are being slaughtered, gathered and stored, processed, consumed,” White says. If China is closing farms that produce meat from wild animals such as peacocks, porcupines, and boar because they pose a disease risk, White says, “why are they also not looking at farms—you know, bear farms, tiger farms? You have many of the same issues.” Besides, he adds, “the vast majority of traditional Chinese medicine doesn’t contain any wildlife parts. This doesn’t need to be a threat to wildlife.”

When it comes to COVID-19, what we need is clear, says the University of Minnesota’s Clifford Steer. “At the end of the day,” he says, “the world just has to develop a vaccine against this to protect people.”