When Tu Youyou (Ningbo, 1930) received the Nobel Prize in Medicine in 2015, some glass ceilings were broken. Not only was she the first Chinese to win a Nobel Prize (in any category) and the twelfth woman to receive the Nobel Prize in Medicine, but her research has represented a shock to the Western foundations of science and medicine.
Furthermore, her life and professional career, outside academic centers of international prestige, stands out from the majority of winners. Despite these conditions, her scientific production, unknown to the general public, has had an enormous global impact.
Environment of anti-scientific violence
Daughter of a wealthy family in the coastal city of Ningbo, Tu Youyou was able to pursue a modern education, despite growing up in the poor, chaotic and violent environment of China’s war against Japan (1937-45) and the Chinese civil war (1946). -49). In this context and after contracting tuberculosis, she decided to study Pharmacy and Chinese Medicine at the Beijing Medical College of Peking University and, later, at the Institute of Chinese Materia Medica of the Chinese Academy of Medical Sciences.
In 1949, with the arrival of Mao Zedong to power and the proclamation of the People’s Republic of China, the new regime encouraged the fusion between Chinese and Western medical traditions. Thus, they sought to attract Chinese doctors trained abroad to solve the serious deficit of health personnel, a product of ten years of wars and the paralysis of university activity.
However, this scientific impulse was soon limited by the radical mass campaigns promoted by Mao in the 1950s. These culminated, in the following decade, with the Cultural Revolution, which produced devastating effects on academic activity.
While the anti-scientific violence of the Red Guards harshly attacked Chinese universities, some research projects considered strategic were able to continue with their tasks, but in spaces isolated from the rest of the world. In this exceptional and unfavorable context, Tu Youyou developed revolutionary research on the treatment of malaria.
Project 523 is born
The Vietnam War (1955-1975) highlighted in the West the importance of this mosquito-borne disease in Third World countries. While the United States was testing various remedies with its troops, in China, with the utmost secrecy and led by the army, Project 523 was launched to search for effective treatments.
After a few unsuccessful first years, in 1969, in the midst of the chaos of the Cultural Revolution, those responsible for the program recruited Tu Youyou to be in charge of pharmacological research.
Instead of conventionally reviewing the international academic literature, which was partly beyond his reach, Tu Youyou abstracted himself from the difficult political and personal situation by reading the Chinese classics of philosophy, alchemy and medicine. Thus he was able to recover more than 2,000 treatments for various diseases (he published a compilation of 650) and tested them with the limited means he had at his disposal.
First trials with wormwood
Alexander Mahmoud/NobelPrize.org
In a 4th century book by Ge Hong, Taoist doctor, alchemist, traveler and heterodox writer, Tu Youyou found a recipe for malaria based on wormwood (the plant of the genus Artemisia). Between 1969 and 1971, with practically no resources, Tu Youyou experimented with various extracts of the plant. After many attempts, solution number 191 achieved a very significant recovery rate in infected animals.
The results of this experiment and the relative pacification of Chinese society, with the gradual return of scientific activity, allowed Tu Yuoyou to collaborate with other medical centers, which had more resources and technology. In this way, in 1972, the extract could be tested on a real population on the island of Hainan.
Finally, in 1977, the chemical formula of the extract discovered by the scientist was published in a Chinese magazine, which was named artemisinin. In 1981, at the beginning of China’s reform and opening-up period, the World Health Organization (WHO) met in Beijing and confirmed the effectiveness of the new medicine. In a short time, it was distributed throughout the world.
The success of artemisinin
Since then, 200 million malaria patients have been treated with artemisinin, especially in poor countries, where 90% of the incidence is concentrated. Mortality remains heartbreaking, with 619,000 deaths in 2021, especially African children under five years of age, but has decreased by more than 40% in recent decades thanks in large part to artemisinin-derived treatments.
As a result of this achievement, some articles appeared in prestigious scientific journals, such as cell either Naturebegan to show a less negative image of Chinese medicine, highlighting the corpus of accumulated historical knowledge waiting to be exploited and validated by science.
However, since its implementation in the 1980s until today, Tu Youyou’s discovery has lost effectiveness, due to the growing resistance to artemisinin of malaria-causing parasites, such as Plasmodium falciparum. This fact emphasizes the need to continue research in all areas, including traditional non-Western recipe books, which have traditionally been excluded or marginalized from scientific debate.
Thus, Tu Youyou not only transcended the borders of Chinese medicine, testing and modernizing a recipe from the 4th century, but also the Western medical canon.
In his speech at the Swedish academy, Tu Youyou highlighted his persevering character, despite material obstacles, teamwork and the need to approach any research with an open mind and desire for interdisciplinarity.
