China bids for scientific supremacy

At the Euroscience Forum meeting in Munich this week two scientists who have returned to China from research posts abroad described what it is like to be part of this extraordinary movement, and the roles they are playing in the modernisation – for which read the westernisation – of Chinese science.

“You might find it unusual in a conference about European science to be talking about science in China,” said Rainer Holl of the Robert Bosch Foundation in Stuttgart, Germany, introducing the session. “But China has seen a massive growth in the past few years and there is a lot more to come.” Rather than picking particular fields, the Chinese will be investing across all disciplines from agriculture and transport to the country’s ambitious space programme.

With the money attached to the latest blueprint China has signalled its intent to be a world super power in science and technology by the middle of the twenty-first century. But there is excellent science in China already and Europe is just waking up to this fact said Holl.

Support for developing high-tech products

The new national policy will build China’s strengths in basic research. But crucially it stated that in life sciences government funding for technical and product development would provide more support to biotechnology companies, in preference to channelling the funds through research institutes.

Unlike the funding model in US and European biotechnology, investors are looking for companies that can make short-term profits, rather than going through several funding rounds and then (maybe) exiting through an IPO or a trade sale. Chinese biotechs know there is no such thing as a second round funding, so they need to construct a business plan around raising enough when they are founded to support development all the way through to market.

This has given the Chinese biotech industry unique features, but also causes some unique problems. One major strategy has been to draw on the resources of Chinese traditional medicine to develop products to western standards of drug development. Based on this strategy Wolwo Biotech Company has successfully developed vaccines against allergies and put them through the western-style approval process overseen by SFDA, China’s equivalent of the US Food and Drug Administration.

The country has also made huge progress in genomic technologies, leading to the formation of a number of biochip companies, including HealthDigit Biotech Company, which has developed diagnostics for detecting cancer in people who are known to be at high risk, but are as yet asymptomatic.

Introducing western-style clinical research

Substantial government investment is going into the transformation of clinical research, moving it from approaches used in Chinese traditional medicine to implement objective, randomised and placebo-controlled approach used in western clinical trials.

Spearheading this movement is Ming Lui, who in 1997 persuaded the Chinese Ministry of Health to set up a Chinese Cochrane Centre for the promotion of evidence-based medicine. This has resulted in hundreds of Chinese doctors and clinical investigators receiving training in the methods used to conduct clinical trials in the west. The project has involved introducing novel concepts such as placebo controls, investigator blinding, and randomised trials.

The philosophy behind evidence-based medicine – that patients should be treated on the basis of the best available evidence, doctors’ clinical expertise and experience, and patients’ preferences – originated in Canada in 1992. The Cochrane Centre was established subsequently in Oxford, UK, to provide the databases that would enable this approach to be applied systematically.

Lui, who is professor of neurology and director of the Stroke Clinical Research Unit at West China Hospital, Chengdu, studied evidence-based medicine at the Cochrane Centre in Oxford after working on stroke in the Department of Clinical Neuroscience at Edinburgh University, Scotland.

Evidence-based medicine enters China

After the official opening of the Chinese Cochrane Centre in March 1999, Lui went on to be involved in the launch of the Chinese Journal of Evidence-Based Medicine. In September 2002 the first course on evidence-based medicine for Chinese medical students was approved by the Ministry of Education.

Lui is most famous for setting up systematised trials in China to assess the value of using acupuncture to treat stroke. This is a standard treatment for stroke patients, and a number of trials had been conducted in both traditional and western-style hospitals. Ming started by reviewing 14 of these trials involving 1,208 patients.

“Most trials were of poor quality, and the meta analysis showed borderline significance,” she told delegates. “The conclusion was that acupuncture is promising, but there is no randomised clinical trial evidence to back up the current routine use.”

This led her to set up an 800 patient-study, which received funding from the National Bureau of Traditional Chinese Medicine, a government body.

“Randomisation of trials is very difficult in China: we had to use computers to ensure randomisation. We had to train researchers on how to randomise and how to standardise because there is currently no accepted standard of care.” It was also necessary to introduce internationally accepted standards for assessing outcomes, and to ensure clinicians making the assessments were blinded to the treatment each patient had received.

The trial showed a trend to positive but this was not statistically significant. “So acupuncture is safe, it is well-tolerated and it is a relatively cheap treatment. But the study did not support its routine use,” said Lui.

The importance of Lui’s work in stroke to date may be more that she has persuaded the government and doctors of the value of conducting clinical trials in Chinese traditional medicine. “This reflects the fundamental transition that is taking place in Chinese medicine,” she said.

As a result said Lui, western pharmaceutical companies are beginning to conduct trials in the country. She herself is currently running a trial with the German pharma company Boehringer Ingelheim.

The great advantage of conducting clinical trials in China is the huge number of patients. A second strength is that patients usually stay in hospital longer so it is easier to ensure they receive standard treatment and to assess the effects, said Lui.

While ten years ago drugs were approved in China on the basis of preclinical toxicology, evidence-based medicine is now a hot topic. “The growth in clinical research has been like the growth of the economy,” concluded Lui

Basic science still needs to be built up

But while clinical research forges ahead, basic science still needs to be built up, and it remains easier to do good work abroad. One scientist who is trying to change this is Zhan Mingheng, who is at the heart of China’s move to become a world force in quantum computing.

“The combination of potential industrial application and the big challenges in fundamental physics and technologies makes quantum computing a very bright spot, not only for scientists but also for funding agencies and policy makers,” said Zhan.

Quantum computing has received strong support over the past two years and was highlighted in the national science and technology blueprint.

Zhan, who is professor of physics and director of the Institute of Physics and Mathematics of the Chinese Academy of Sciences in Wuhan, described how the academy has pulled together the disciplines of mathematics, computer sciences, materials sciences and others to focus on quantum computing as a “key state project”.

From 2006 to 2020 the research will concentrate on quantum manipulation and the physics of future information technologies. In the short term the aim is to establish basic research facilities; longer term the aim is to realise the industrial application of quantum computing.

Zhan’s group began work on the quantum manipulation of single particles (atoms, ions or spins) with the aim of controlling their state and suppressing harmful interactions. The group has the ability to make and control cold atoms and is credited with proposing some new ideas in cold atom theory. It has also developed the ability to capture single ions, and has worked with the National Physical Laboratory in Teddington, near London, UK, to show that they have trapped single ions

The latest big investment at the institute in Wuhan is in a scanning tunnelling microscopy system to try to detect single spins.

“Quantum computing is still in its infancy, still basic research, but milestones have been passed and it has wide potential future applications,” said Zhan. “Stable support is crucial, as is international collaboration.”

Zhan highlighted the progress made in Wuhan by showing how the institute is catching up in the publication stakes with one of the US’s foremost centres for quantum physics, the Joint Institute of Laboratory Astrophysics at the University of Colorado. “While JILA is steady at around 150 papers per year in the leading journals we are experiencing a linear increase.”

Wuhan is still behind, but if it maintains the same rate of growth that will not be the case for long – an achievement that is likely to be duplicated in numerous other fields as China continues to beef up its science and technology.