China

The FDA tackles tainted drugs from China

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(This story was #3 in Discover Magazine’s top 100 stories of 2008.)

Following a series of high-profile scandals concerning tainted food and drugs imported from China, the U.S. Food and Drug Administration (FDA) announced in March that it would establish a drug-monitoring office in that country.

The most alarming report involved contaminated batches of the blood thinner heparin, which caused at least three deaths and is under suspicion in dozens of others. In February FDA officials admitted that they had never inspected Changzhou SPL, the manufacturing plant in Changzhou, China, to which they traced the contaminated heparin. When the FDA eventually inspected the Changzhou SPL plant (in February), it found a host of quality-control and hygiene problems.

Many drugs sold in the American marketplace are now imported, transforming what was once largely a domestic agency to one that must police products from more than 200 countries, notes Murray M. Lumpkin, FDA deputy commissioner for international and special programs. “The reality of globalization has hit the products for which we’re responsible very, very significantly,” he says. The pharmaceutical production process is also vastly more complex than it used to be. Individual ingredients are made in one place, put together in another, and bottled and labeled in still other sites.

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SARS: Open season

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(I stumbled across this story when I was in Beijing in October 2005, interviewing scientists for a special package on Chinese research. I had lunch with Hongkui Deng, a rising star, who took me completely by surprise when he told me his lab had shifted focus from stem cells to SARS. When I looked into it and discovered he wasn’t alone, I knew I was on to a nice story about Chinese science, a rarity in those days. You can download a pdf of the article.)

SARS caught China unawares. But the ensuing struggle to characterize and contain the virus has put the country’s work on infectious diseases back on target.

Like anyone who was in Beijing in the spring of 2003, Hongkui Deng remembers it vividly. The Chinese government could no longer deny that the country was in the grip of a new and potentially fatal disease: severe acute respiratory syndrome (SARS). By July, the epidemic would have spread, affecting more than 8,000 people worldwide and claiming 813 lives; but in April, the panic was already palpable.

Normally bustling, the streets of Beijing were virtually deserted. The few people who ventured out wore masks and gloves, and avoided even eye contact with others. Cinemas, schools and shops were closed. It was, as many describe it, frightening and eerie — even apocalyptic. “Everyone was scared,” Deng recalls.

Deng, a cell biologist, had returned home in 2001 after more than a decade in the United States. Now based at Peking University, he was pursuing his research on embryonic stem cells. Returning from a conference in April 2003, he learnt that the mother of one of his students had SARS. Once officials had sprayed the lab, Deng’s students began asking if they could work on the disease that was paralysing the nation.

“Everybody wanted to do something,” he says. Deng had limited experience in virology, apart from a short stint working on HIV, and his students had even less. But like many other scientists in China, the team saw research on SARS as both an opportunity and a duty, and set about mastering the basics — fast.

Feverish activity

For at least six months, Deng’s lab stopped working on stem cells and focused entirely on SARS. It wasn’t alone. Across the country, scientists trained in protein science, anatomy, immunology and biochemistry — almost anybody who could contribute in any way — were shelving their normal projects. “Everyone was working on SARS,” says Deng. “You just had to.”

That commitment has paid off. Although China still faces a great many hurdles, its government and scientific community are becoming better prepared to combat epidemics, say some US scientists. Long after global interest in SARS has waned, Chinese scientists are still publishing important work on the disease.

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Bird flu: the ongoing story

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(I wrote this blog post for Nature’s bird flu coverage from Shanghai, China, after a sobering trip to a local market. Thanks to my guide, stem cell researcher Hui Zhen Sheng, I was able to see things tourists are not normally privy to. You can read the post in its context here.)

To test whether a chicken is healthy, the vendors hold it upside down and check its rear for pinkness. Credit: Marc Lipsitch

It all begins in Asia. That’s the recurring theme in the countless stories that, probably like you, I’ve been reading the past few months. But none of it really hit home till last week when I was in China, where I got to see people and poultry mingling uncomfortably close.

At one street market in Shanghai, a few blocks west of the city’s famed Yuyuan Gardens, vendors piled plucked chickens next to stalls of vegetables, fruit and fried insects. The sheer volume of unidentifiable creatures and creature-parts was bizarre enough. But truly frightening was how the vendors handled the birds.

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AIDS epidemic set to escalate in Asia

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(I reported this article for Nature from the XV International AIDS Conference in Bangkok. It appeared on Nature’s news site on July 12, 2004.)

Leaders urged to take immediate action.

Around 7.4 million people in Asia are already living with HIV.

Bangkok – A massive AIDS epidemic is spreading rapidly in Asia, and is sneaking below the radar of governments in the region, experts warned on 11 July.

Speaking at the XV International AIDS Conference in Bangkok, scientists urged Asian governments to scale up prevention and treatment efforts by providing sterile needles, condoms and antiretroviral drugs.

“This conference must be a wake-up call to Asian leaders,” says Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS. “They’re starting to respond, but sometimes too timidly.”

An estimated 7.4 million people in Asia are already living with HIV. Unlike in Africa, where the disease has spread into the general population, the Asian epidemic is driven largely by intravenous drug users, sex workers and men who have sex with men, according to a
new report released by the network known as Monitoring the AIDS Pandemic (MAP).

“That pattern has held in virtually every country in Asia,” says Tim Brown, an epidemiologist at the East-West Center research organization in Bangkok, and a member of the MAP network.

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