@Kunal_Chonkar
Taipei’s meticulous working across various dimensions under its slogan “Taiwan Can Help” to reach out to the world with support on COVID-19 continues to win hearts, while also giving the much-needed impetus to President Tsai Ing-wen’s New Southbound Policy (NSP). Taiwan’s strong response to COVID-19 and its assistance abroad has not only helped Taipei raise its global profile but also affirm its apodictic visibility as a nation in the Indo-Pacific. Continuing in its strides to actively support nations against COVID-19, Taiwan now aims to help India with a path-breaking medicine formula, which is already been sold as a dietary supplement in Europe and the United States. In his exclusive conversation with Kunal Chonkar, the Director of the National Research Institute of Chinese Medicine (Taipei) Dr Yi-Chang Su talks about the development of this medicine formula, its anti-COVID-19 potency, and plans to introduce it in India.
Excerpts of the interview:
Question: What is the NRICM 101? When was it discovered and what lead to its discovery?
Dr Yi-Chang: The NRICM101 is a botanical preparation developed by Taiwan’s National Research Institute of Chinese Medicine in February 2020 to combat the coronavirus. It treats COVID-19 in the early stage. The research team predicted a global pandemic even when the caseload in Taiwan remained low. The highly infectious disease reminded us of SARS which took 73 lives in 2003. We learned our lessons from that disaster. Ancient wisdom also played a key role in the development of the so-called new drug. A classic of TCM literature written more than 600 years ago documented therapy for treating the epidemic. Our team modified the ancient therapy while taking into account our SARS experience, as well as limited reports of COVID-19 pathogenesis and the NRICM101, was born.
Question: The NRICM 101 is a mixture of 10 traditional Chinese ingredients – what are these ingredients, how do they assist in countering the COVID-19 effects in a human body, and in what regards are the medicine different from other COVID-19 medicines or drugs?
Dr Yi-Chang: The medicine formula is composed of 10 herbs, which are – Scutellaria root, heartleaf Houttuynia, Mongolian Snakegourd fruit, indigo woad root, Magnolia bark, peppermint herb, fine leaf Nepeta, mulberry leaf, Saposhnikovia root, and baked Liquorice root. They are very common herbs. Taiwanese people have used them for thousands of years as medicine and as food. The TCM theory sees the symptoms caused by coronavirus as heat in the lungs. So, we use fine-leaf Nepeta, Saposhnikovia root, peppermint, and mulberry leaf work as diaphoretic to induce sweat. We use Scutellaria root, indigo woad root, and heartleaf Houttuynia for clearing heat, ventilating lung qi, and detoxification. Mongolian Snakegourd fruit is for relieving discomfort in the lungs and resolving phlegm. Magnolia bark is good for treating cough, and finally, liquorice plays the role to harmonize all the above ingredients. In modern biomedical labs, the NRICM101 is found to block the entry of SARS-CoV-2 infection, inhibit viral replication, reduce virus growth and neutralize virus infectivity in P3 laboratory analysis. In addition, it can also regulate alveolar macrophages and reduce the occurrence of cytokine storms. In other countries, herb-based treatment for COVID-19 is used, however, they either contain too many ingredients, which makes it difficult for quality control, or they contain materials like ephedra or mineral gypsum that are unsafe for human bodies. The NRICM101 has kept the number of ingredients below 10 and uses safe-to-use materials to facilitate scaling up for wider access.
Question: Taiwanese hospitals and several other medical institutions have used NRICM 101 as part of combined therapy for some COVID-19 patients and there have been reported positive results. Could you talk about the aspects of – using the NRICM 101 as part of combined therapy and the results?
Dr Yi-Chang: Taiwan did not have many patients throughout 2020 thanks to the effective public health measures or so-called non-pharmaceutical interventions. Between January and April 2020, a total of 35 COVID-19 patients were admitted to the Tri-Service General Hospital and Taichung Veterans General Hospital. A total of 13 patients were administered the NRICM101. Among the 13 patients were nine mild cases, three severe cases, and one critical case, with the age range between 22 years and 80 years. Before the intervention of the NRICM101, the patients were hospitalized for about 19 days without seeing improvement. We observed that nine days (median) after using the NRICM101, all of them reached the discharge criteria, which is testing negative for three times in a row. In summary, the NRICM101 demonstrated the following effects according to our clinical observation: It relieved fever, stabilized cardiopulmonary function, and reduced the days from hospitalization; Shortened the days before obtaining three consecutive negative results (median is nine days), shortened the duration of hospitalization; and there were no observed adverse events or drug interactions.
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Question: One of the most common concerns and questions with any medicine is the side effects. Have there been any cases of side-effects of any kind?
Dr Yi-Chang: The NRICM101 has been used clinically in Taiwan. We also work with pharmaceuticals that market the NRICM101 overseas to collect feedback from users. So far there is no report of adverse effects. The question as to why there are no side effects is because these 10 herbs have been used for more than 2,000 years and no observation of adverse effects has been documented. It means these herbs are very safe. Our lab tests also confirmed it. Some of them are even used in food preparation or herbal tea. The NRICM101 has been used in Taiwan and abroad and received no complaints. Based on these we do not think there are undesirable side effects. However, according to TCM theory, the NRICM101 might cause mild diarrhoea for people with weak or sensitive digestive systems.
Question: The NRICM 101 continues to be sold as a dietary supplement in Europe and the United States, though it has not been approved for medicinal use in either jurisdiction. How does the formula work as a dietary supplement and could you comment on it not receiving a ‘medicinal use’ permit in the two continents?
Dr Yi-Chang: The 10 herbs in the NRICM101 have been used in Europe and the US as safe-to-use botanical materials for a long time, which is why the two jurisdictions allow them in as dietary supplements. The option to treat it as a botanical drug is there, but from application to marketing the process will be extremely lengthy. Given the urgency to contain the pandemic and the issue of accessibility, we decided to treat it as a dietary supplement in the US and EU.
Question: There are reports of the NRICM 101 set to be introduced in India as well. Could you talk to us more about that plan?
Dr Yi-Chang: As soon as the application for a new drug or dietary supplement is approved by the Indian authorities, we will encourage GMP certified pharmaceutical companies to supply NRICM101 to help combat the pandemic in India.
Question: How do you see the NRICM 101 working in India, which is seeing a significant rise in COVID-19 cases caused by multiple variants of the COVID-19 strain?
Dr Yi-Chang: The NRICM101 has multiple targets, meaning it works on 3 fronts. First, it blocks the entry of the virus by inhibiting the binding of the spike protein to the human ACE2 receptor. Second, it interrupts virus replication by inhibiting 3CL protease. Third, it prevents fatal inflammatory responses by modulating cytokine. Taken together, the effectiveness of NRICM101 is not as easily compromised as other single-target therapeutic when the virus mutates. In India where the infection is surging, NRICM101 can help mild cases from turning severe as it is designed for the majority of COVID patients suffering from mild symptoms. With this, the number of people transmitting the virus to healthy people will be reduced and therefore mass transmission may be halted.
Question: Could we tag the NRICM 101 as part of Taiwan’s COVID-19 diplomacy efforts in extending to new countries as well as enhancing ties with old partners?
Dr Yi-Chang: The drive for the institute to develop NRICM101 was to join hands with scientists and governments around the world to combat the global pandemic. We will make every effort in our capacity to introduce a safe and effective solution to mitigate the suffering in every society that needs it. Even during the current crisis, Taiwan is facing, we do not hesitate to say that Taiwan can help.
Question: Lastly, could you share the work done by MOHW in efforts to battle the new mutant strains of COVID-19 and the surge in cases across Taiwan?
Dr Yi-Chang: The UK mutant rampant in Taiwan at this moment is indeed much more powerful and deadly than the original virus. MOHW in Taiwan has taken all-out measures to contain the spread of the virus, including enhancing the production of NRICM101. The government has increased the number of rapid-screening stations, hospital beds, manpower as well as quarantine centres, schools are closed, identified hot zones, enforced comprehensive outdoor mask policy, and under level 3 alert the nation has entered a “soft” lockdown. We are hoping that the use of NRICM101, a vigorous vaccination rollout along with public health measures will bring COVID-19 under control soon.
