Global health under attack: China has caused huge damage to global health through false information about engineering viruses and epidemics; fake medicines; dangerous food adulterants; defective masks, personal protective equipment (PPE) and diagnostic kits; invalid Vaccines; substandard sanitary equipment; manipulation of WHO, scientific experts and publications; now, ransomware attacks medical institutions. Our health is also affected by pollution and climate change, and China is the biggest contributor. The Chinese vegetable market is the source of zoonotic diseases and the cause of the extinction of endangered species and the destruction of biodiversity. The Chinese medicine currently being promoted by the Chinese government contains part of 36 animal species, including several endangered animals, including tigers, rhinos, black bears, musk deer, and seahorses.

Fake medicines with fake labels: The opening remarks of an article in the Journal of the Canadian Medical Association entitled "The booming trade in counterfeit medicines in China" says it all: "Nigeria has intercepted 600,000 counterfeit antimalarial pills, which is a good thing for China. A daunting moment. The government launched in June 2009. Produced and shipped from China, they carry an unexpected label: "Made in India." Even fakes have been scammed. This is a new low point. "The then head of Nigeria’s National Food and Drug Administration (NAFDAC), Dr. Dora Akunyili said: "Counterfeit drugs are a massacre; this is one of the greatest atrocities of our time. This is a form of terrorism that endangers public health. , Is also an act of economic destruction." A research team from the American Enterprise Institute found that in the 20 countries that collected samples, China was primarily responsible for counterfeit drugs attributed to India. 80% of HIV drugs and nearly half of antimalarials and antibiotics used in developing countries are manufactured in India, while popular brands are forged by Chinese. NAFDAC found that the Chinese criminal counterfeit drug network that employs locals has penetrated the entire supply and distribution chain on all continents. A counterfeit of an Indian antimalarial drug called Lonart DS from the Shenzhen Free Trade Zone in China is just one example. Counterfeit medicines cause death rather than cure.

Adulterated baby milk and baked goods: Echo Huang reported on the 2008 Chinese baby milk tragedy that led to kidney stones. Among them, "a compound called melamine, used in the production of plastics and fertilizers, has entered infant formula milk powder. A total of 22 companies were involved. The tainted milk scandals included Yili, a state-owned dairy company that was a supplier to the Beijing Olympics, and Sanlu, which started as a state-owned enterprise in northern Hebei Province in 1996. In 2005, a joint venture was established with New Zealand dairy company Fonterra." It was found that the melamine content in the powder was as high as 2,560 mg/kg—according to the level set by the U.S. Food and Drug Administration, the daily tolerable intake of this compound was 0.63 mg/kg body weight.” Adulterers “Yes. It goes back to the'protein powder' provided by local farmers, who added melamine to milk to increase protein levels and pass nutrition tests." Cyanuric acid is a structural analogue of melamine, which also increases the apparent protein content in dairy products. And has been used as an adulterant. Many countries have stopped all imports of Chinese dairy products. Later, in Japan and South Korea, melamine was found in Chinese eggs and frozen fried chicken because of its use as animal feed. Malaysia and Taiwan found baked goods contaminated with melamine in baking ammonia (ammonium bicarbonate) imported from China.

Cyberattacks on healthcare: In May of this year, a federal grand jury in San Diego, California returned an indictment accusing four nationals and residents of the People’s Republic of China of “hacking into the computer systems of American companies, universities, and government entities.” . From 2011 to 2018, the United States and abroad focused on information that has significant economic benefits to Chinese companies and the commercial sector, including information on lengthy and resource-intensive research and development processes for infectious diseases, vaccines, and biopharmaceuticals. The defendant and the Hainan National Security Bureau (HSSD) co-conspirators attempted to confuse the Chinese government's role in such theft by setting up a front company, Hainan Xiandun Technology Development Co., Ltd. (since its dissolution) in Haikou City, Hainan Province. "Confidential health data has great commercial and strategic value on the dark web. For example, in 2018, SingHealth targeted a data breach involving 1.5 million patients including Prime Minister Lee Hsien Loong. China was accused of illegally accessing health and genome data in the United States. In order to accurately target important individuals for potential surveillance, manipulation or blackmail. Last weekend, Chinese cybercriminals were accused of attempting to use Deep Blue Magic ransomware to attack 10 Israeli medical facilities.

World pharmacy India has fallen into a Chinese trap: drugs are formulated by mixing medicinal excipients (additives used to improve stability or bioavailability or patient acceptability) and active pharmaceutical ingredients (API). Series of pharmaceutical intermediates. Until the 1990s, World Pharmacy India was able to produce its own APIs and intermediates on its own. In the past two decades, the import of cheap Chinese APIs and intermediates has led to the closure of Indian factories or low capacity utilization (about 30%). According to official estimates, India now imports nearly 68% of APIs and intermediates from China. During the pandemic, there was a sudden supply shortage in China and a sharp increase in prices, leading to a shortage of medicines in India. Any shortage or quality issues will affect India’s health and our reputation abroad. India also imports 80% of medical devices from China, the United States, Germany and other countries. Our huge trade deficit with China is mainly due to imported electrical and electronic products (US$18 billion), machinery (US$12 billion) and organic chemicals (US$8 billion), plastics (US$2 billion), optics and medical equipment (15 One hundred million U.S. dollars). The health sector also needs all these five types of imported products, and the self-reliance or decoupling of these industries will have major benefits for the country’s health. During the pandemic, we realized that our heavy reliance on imports of medical equipment, disposables, medicines and vaccine components had an impact on our health services. The famous proverb "self-help is the best help" is as important as our health and safety, our food security, and our strategic and safety needs.

Dr. PSVenkatesh Rao, MBBS (Vellore), MS (Vellore), DNB, FRCS (Glasg), FACS, FICS, FMAS, FAES are consultants to endocrine, breast and laparoscopic surgeons.

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