One Young Scientist. One Breakthrough Discovery. One Long Delay for Recognition.

19 October 2015

Malaria is a preventable and treatable disease. Artemisinin-based combination therapies – also called ACTs – are currently the most effective drugs to treat malaria once it is diagnosed.

The introduction of ACTs, along with widespread use of mosquito nets and other interventions, have led to a 60 percent drop in malaria deaths globally between 2000 and 2015.

Unlike many transformative drugs, the discovery of artemisinin was not immediately known or used worldwide, when the breakthrough was achieved more than 40 years ago. If it weren’t for this year’s Nobel Prize in Medicine, awarded to Youyou Tu, a scientist from China, many people still wouldn’t know the story behind it.

In 1967, Dr. Tu was a young scientist in China, where a radical political movement was underway at the same time that China was supporting Vietnam in its war against the United States. Universities and research centers were shut down or upended by political extremists. But Mao Zedong, China’s leader, took a selective approach to politics and academia, and protected some scientific projects from the upheaval. He authorized a special project called 523, so named because it started on 23 May, to find effective treatment for malaria, because with the disease killing soldiers at a high rate, North Vietnam asked China for help.

Dr. Tu was a specialist in traditional Chinese medicine when she was assigned to the project. She went through ancient Chinese medical texts and conducted experiments using the leaves of Artemisia annua. She discovered that a low-temperature extraction process could be used to isolate an effective antimalarial substance from the plant. Artemisinin was found to clear malaria parasites from patients’ bodies faster than other drugs. While she worked with others, and there has been some dispute about the precise role played by various team members, the Nobel Committee awarded her alone for her role in what was a momentous discovery.

Dr. Tu, who is now 84, is the first scientist from China to win a Nobel Prize. She shared this year’s prize for medicine with two other scientists: Irish-born William Campbell and Satoshi Omura of Japan for their discoveries on other drugs against parasitic diseases.

The Nobel Prize committee said that the discoveries of these scientists have helped combat diseases “that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable." A member of the Nobel Prize committee also said that the work of the 2015 medicine laureates could help eliminate diseases affecting 3.4 billion people.

With China so cut off from the rest of the world, and with political restrictions on sharing science, not to mention excessive suspicion, the discovery and full application of artemisinin was not embraced by the global community for more than 30 years. It was only approved by WHO in 2000, and only became widely available in 2006. In recent years, the Global Fund and partners in global health have vastly expanded the use of ACTs, distributing more than 515 million doses worldwide, and increasing the number of lives saved each year. Reducing the impact of malaria requires a multipronged plan that includes education, prevention, diagnosis, treatment and monitoring. Artemisinin, thanks to Dr. Tu, is a very large prong in that plan.

Photo: Mawa Simon, a community-based distributor, received training to diagnose and provide treatment for malaria patient in his community in South Sudan. A mother brings her child with fever symptoms, has just been diagnosed with malaria, and will receive free treatment.