Personal insights into the frontier of Chinese biomedicine

“I foresee that within the next few years, patients from the West will actually start coming to China to receive treatments.”

That prediction drew my eye. It’s from an interview with Michael Donovan, who has a master’s degree in biomedical engineering from Hunan University, and founded a biotech company in Changsha. The interview is on the website Tomorrow Edition, written by Benjamin Stecher, who himself has a fascinating story that is connected to his interest in biotech. I asked Ben questions about his experience in China and his current pursuits.

Jeremy: Where are you from and how did you end up working in China?

Ben: I was born in Nairobi, Kenya, but grew up just outside of Toronto, Canada. Made my way to China at 26 following an interest in the Chinese language, history, and culture, as well as an understanding that it was going to be an important part of the future. Picked up a teaching gig and rose quickly to become a managing partner in a Shanghai-based education company called San Li 三立, very soon found myself traveling frequently between various cities in China helping them grow their brand.

Jeremy: How did you discover you had Parkinson’s?

Ben: My first symptoms appeared as a very mild tremor that I didn’t think much of. Over time, it got worse. It took three years before I saw a movement disorder specialist during a trip back home and was quickly diagnosed with Parkinson’s disease. Carried on living and working in China for a couple of years, but the disease slowly progressed and eventually I made the decision to leave to try to tackle my illness head on. I left China in May 2016 to do so and have been traveling the world meeting Parkinson’s experts ever since in an attempt to figure out what is going on in my head and what I might be able to do about it.

Jeremy: Reading your work, you seem to have taken on the challenge of this disease with courage and good humor. Although obviously you would rather not have contracted the disease, your writing does not elicit pity, but rather wonder at the possibilities of science. Was this attitude easy for you to adopt, or did it take you some time to adjust the way you look at the world?

Ben: There was definitely some despair earlier on, and I still at times seesaw between hope and futility, but one thing this disease has made me keenly aware of is just how much progress we have made in the biomedical sciences in recent years. This first dawned on me during my first trip on this world tour to a stem cell lab at Scripps Research Institute in San Diego. They are working on a novel stem cell therapy using what are called iPS cells (induced pluripotent stem cells). Essentially, they are able to scrape off some of your skin cells, reprogram them back into their embryonic form, and then convert them into the exact dopamine-producing cells that are dying in my brain. It really instilled a sense of awe in me and gave me hope that soon we will have more effective therapies for this and other diseases.

Since then, I have toured dozens of labs around the world and spoken with hundreds of experts pushing forward the boundaries of human biology. I have come to believe that many of these therapies being tested on people with Parkinson’s, particularly stem cells, gene therapy, and some brain machine interface technologies, will have profound impacts on the species as a whole and the future of human health and longevity. I didn’t really know any of this before the diagnosis, so in an odd way, I am grateful to this disease for opening my eyes to this ongoing revolution in the biomedical sciences.

But, the brain is still proving to be a particularly tough nut to crack. So whether all of that progress will result in substantially improved therapies for people with Parkinson’s in time to help me is difficult for anybody to say.

Jeremy: What led you back to China? Tell us about your research into biotech and medical sciences in China?

Ben: I never really came back to China. I do try to stay in touch with what is going on there (SupChina and Sinica definitely help in that regard). I have recently started to follow the biotech and medical science field in China more closely, though I still have a lot to learn about it.

My time spent in China trying to figure out all that is China was in some way a good preparation for the study of the brain and neurodegeneration, as with both, the deeper you go, the less you realize you understand.

In China, what is the state of Parkinson’s disease — incidence, treatment, and social stigmas if any?

There are more people with Parkinson’s in China than anywhere else in the world. This is due to the large rapidly aging population as well as environmental factors known to play a significant role in the incidence of Parkinson’s. Best estimates say that there are 1.5 million people in China with Parkinson’s.

Like all things medical in China, there are two worlds of care. When I lived there, I had top-flight medical insurance, so I went to an exclusive medical facility (WA Optimum Health Care) that I could visit whenever I wanted and where I was under the care of teams of doctors and nurses. But I also visited a public hospital to see one of the few world-renowned experts China has in the field. He had a lineup of 50 people outside of his door and had roughly a minute to diagnose and treat each before sending them on their way.

However, in both worlds, there is a certain level of expertise that is missing, which is a part of the reason why I left China because I knew that I wouldn’t get the proper care I needed living there.

I wouldn’t say the social stigmas are that much different from what they are in the West. If anything, I would say that Chinese culture has instilled in individuals a better sense of acceptance and coming to terms with growing old and the diseases that come with that. Though I would say there is more stigma in China around young people like myself with chronic diseases (I’m 33). Young people are, I think, seen as being more resilient to such diseases, and that if you get one, it is indicative of some kind of character flaw (or that your qi is out of whack, as Chinese medicine posits that the two — character and qi — often go hand in hand).

Might China one day lead in the treatment of Parkinson’s?

A lot of the people I talk to say the same thing — because China doesn’t really invest as much in the basic sciences, it’s hard to see it making the fundamental breakthroughs needed to become a leader in the field.

That said, because China is more willing to try riskier therapies and because it can push them forward faster than the West can, it is possible that it will stumble across something that changes the way we treat Parkinson’s or other diseases. Breakthroughs frequently happen by accident in the biomedical sciences, so the simple fact that they have so many people trying things could lead to them finding unexpected solutions to these problems. Though that will come at the expense of the health of a lot of people who get recruited for some of these riskier clinical trials. One in particular is underway in Zhengzhou and has drawn the scorn of stem cell researchers in the West who believe the procedure to be too risky to try on people.

But it’s important to remember that just a few decades ago, China had no biomedical industry. Given all the progress made so quickly, I wouldn’t be completely shocked if it happened. The country has also recently done a pretty good job of attracting Chinese graduates from the West back to China. Plus the amount of money it is pouring into the biomedical field is really unprecedented. I’ve spoken with several people who say they’ve never seen the kind of investment that China is making anywhere before and they rave about the facilities available.

The biotech startup field is also now really taking off. As I write this, I actually just got off the phone with an executive at one of the big pharma companies in China (who asked to remain nameless), who told me that they are moving one of their biggest neurodegenerative R&D facilities out of China because they have difficulty keeping up with the pace of change and the overturn in their staff from people constantly leaving to work for biotech startups.

In addition to all of that, there is the enormous push from Beijing to be a leader in some of the new computational technologies that are about to emerge, which will significantly impact the biomedical sciences. Most people now are pretty aware of the burgeoning field of AI, which by itself will have some profound impacts on medicine. But the real advantage of that in China is the access that companies have to enormous medical datasets. It is a big part of the reason why the biggest genomics company in the world is BGI (Beijing Genomics Institute), which is collecting unprecedented amounts of data that could lead to novel insights. But this is only the beginning of what’s to come. Within the decade, quantum computers (which Beijing is also investing heavily in) will be good enough to allow us to study the 3D structure of proteins like never before. This will blow open the doors to the era of precision medicine, which will one day allow us to tailor drugs to an individual’s unique biological makeup.