8-4 Study of Traditional Chinese Medicions for Preventing and Treatment of Acquired Immunodeficiency Syndrome (AIDS) and Malignant Cancer Project Scope and Relationship to China's Agenda 21 This project studies and evaluates traditional Chinese medicines, particularly with respect to their use in treating AIDS and cancer. The project will also help modernize the manufacture of TCM and the procedures associated with its clinical testing. This project is based on chapter 9 of China's agenda 21 and related to 9A, 9C 1. Background Human health is essential for the successful implementation of environmentally sustainable social and economic development. Traditional methods of healing offer a cost effective and efficient way of dealing with many of the major diseases that affect humanity. In recent years, the advantage of using traditional Cbinese medicine( TCM) has been demonstrated in preliminary studies on the treatment of AIDS and malignant cancer. Malignant cancer is a major cause of death for rural and urban inhabitants in China. Most patients are not diagnosed until the disease has reached a late stage and the disease does not respond to rediotherapy or chemotherapy. Preliminary studies with TCM showed that the treatment helped increase the average survival time from 7.5 months for patients undergoing chemotherapy to 12.5 months for those on TCM. AIDS is a disease that is threatening a global pandemic. Although the disease is still relatively rare in China ( about 2000 cases had been reported by 1993), China needs to pay attention to the prevention and treatment of this disease.Preliminary trials with 158 AIDS patients in Tanzania showed about 25% of patients showed some improvement in symptoms. Seven cases also showed a change in HIV antibodies from positive to negative. The encouraging results with both diseases shows that TCM offers some promise as a treatment for these ailments. Studies from 1965 to 1985 on the use of TCM to treat severe diseases have been supported by the Scientific Committee of China. Results have been published and the level of academic research and scientific study has been improved. A number of personnel have been trained and have become leaders in this field. This has laid a from foundation for further work in this area. In order to realize the full potential of TCM, it is necessary to build on these foundations and modernise the TCM manufacturing facilities as well as to improve the scientific and clinical basis of the experiments and trials for these medicines. Although some facilities exist for making TCM, these are inadequate for any large scale and scientifically sound testing. Also,there is a lack of trained personnel both to manufacture the TCM and to carry out and analyze the clinical trials. This will require improved technical facilities and training for scientific and clinical personnel. This project offers an unique opportunity to evaluate and apply traditional knowledge about herbal medicine in scientifically conducted trials and experiments on diseases that have a profound impact on humam health in China and world wide. 2. Objectives Long-term Objectives Investigate and develop the usefulness of TCM for treating major illness such as AIDS and malignangt cancer and to improve the facilities for manufacturing and testihg TCM. Immediate Objective Investigate the efficacy and mechanisms of TCM for treatment of AIDS and cancer. ldentify possible medicines that could be against these diseases and to produce these on a commercial scale. To improve the manufacturing and testing procedures for TCM to assist with their commercial production. 3. Activities 3.1 Scientific Research to investigate and evaluate the potential of TCM to help prevent and treat diseases such as AIDS and malignant tumour by: A survey of the epidemiology of AIDS and the impact of TCM on the disease. This will include clinical research on the effects of TCM on disease development and prevention and the identification of any possible impacts through scientific research. The mechanisms of how TCM acts on the disease will also be investigated with a view to identifying and isolating the active ingredients . Study the effects of TCM on malignant cancers through scientific research and clinical trials. Identify the mechanism by which TCM works to evaluate the potential of TCM as a possible treatment for cancer. This activity will be carried out by the Scientific Committee of China, the Administration Office of TCM, and the Academy of TCM of China. 3.2 Modernization of Herb Medicine Factory To modernize and establish TCM factories that comply with international standards and to ensure that the production of herb medicines is safe and effective. Modernize the trial factory of Academy of TCM of China and ensure that its workshop complies with international standards. Introduce the requisite equipment and instruments for testing medicines. Introduce possible commercialization of any TCM identified to have a beneficial effect and to patent these wherever feasible. This activity will be carried out by the Ministry of Health, Administration Office of TCM and Medicine Administration Office of China. 3.3 Capacity Building The scientific and clinical institutions carrying out the research will be modernized with the introduction of new and better equipment and improvements in training of scientific, technical and clinical staff in research and clinical trials. Introduce scientifically based procedures for testing TCM that are ethically sound. This activity will be carried out under the supervision of the Administration Office of TCM. The duration of this project will be 5 years. 4. Inputs 4.1 Chinese Inputs Administration. Scientific expertise and traditional knowledge. Equipment and materials for scientific research. Data about scientific techniques, traditional knowledge, and patents. Training of technical personnel. 4.2 International cooperation Equipment, instruments and chemicals. Modernization and standards for herb medical factory. Training of technical personnel. Experts in drug testing and clinical research. Scientific and clinical techniques. 4.3 Budget A total of US $ 6 million is needed to carry out this project. The Chinese contribution will be US$ 3 million and the rest will be sought from international grants and soft loans which will be used to buy the necessary equipment. Budget ( in million US dollars ) Items Chinese Inputs External Inputs Grant Soft-loan Total Equipment 0.50 1.00 1.50 Experts 0.20 0.30 0.50 Training 0.20 0.20 0.40 Technical transfer 1.00 1.00 2.00 Research 1.00 0.50 1.50 Others 0.10 0.10 Total 3.00 2.00 1.00 6.00 5. Benefit The benefits of implementation of this project include the modernization of the manufacturing facilities for TCM and the training of scientific and clinical personnel. The application of scientific procedures to the use of TCM will help to gain acceptance amongst the medical community of the valuable traditional knowledge embodied in the practice of TCM and allow the benefits to be used more widely.Any successes with remission of symptoms of AIDS or cancer arising from the TCM trials will have obvious social and economic benefits. Moreover,identification of the active ingredients of TCM which are effective against these diseases will open the way for commercialization and possible joint ventures for manufacturing and marketing. 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