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The Power of Integration
Nobel Prize winner provides new context for traditional Chinese medicine research
By Yin Pumin | NO. 43 OCTOBER 22, 2015


Tu Youyou talks with Chen Keji, one of her former colleagues at the China Academy of Chinese Medical Sciences, in Beijing on October 8 (XINHUA)

For those who had placed bets on who would be the first winner of a Nobel Prize in science from the Chinese mainland, October 5 was likely a big upset. Tu Youyou, a name unfamiliar to most Chinese mainlanders outside of the scientific community, emerged as the relatively unheard-of victor.

The 85-year-old pharmacologist shared this year's Nobel Prize in Physiology or Medicine with Irish-born William C. Campbell and Japan's Satoshi Ōmura, announced the Nobel Assembly at the Karolinska Institute in Sweden's Stockholm.

The Nobel Assembly honored Tu for discovering artemisinin, a drug that "has significantly reduced the mortality rates among patients suffering from malaria," while Campbell and Ōmura were recognized for their novel therapy against infections caused by roundworm parasites.

According to Xinhua News Agency, Tu termed artemisinin a gift bequeathed by traditional Chinese medicine (TCM) to humanity after the announcement.

"The discovery of artemisinin is a successful example of collective research on TCM. Winning the prize is an honor for the Chinese scientific cause and TCM in their course of reaching out to the world," she added.

At present, artemisinin-based combination therapies (ACTs) are recommended by the World Health Organization (WHO) as the first-line treatment for uncomplicated P. falciparum malaria. The WHO estimated that approximately 240 million people in Sub-Saharan Africa have benefited from ACT treatment since 2000.

In a congratulatory letter extended to Tu, Chinese Premier Li Keqiang said that her accolade marks a great contribution by TCM to promoting human health.


Fang Shan, a registered TCM practitioner, herbal pharmacist and acupuncturist, treats a patient in Sydney, Australia (XINHUA)

A hard-won success 

Tu's study on artemisinin started in the 1960s when China launched an initiative to find an herbal cure for malaria in response to the global dilemma of the disease's resistance to drug treatment.

In 1969, Tu, then a researcher with the Beijing-based China Academy of Chinese Medical Sciences, was appointed head of the government project. Prior to the appointment, she had dedicated herself to researching Chinese and Western medicines for a number of years, having graduated from Beijing Medical College, now Peking University Health Science Center, in 1955.

Tu took inspiration from a large number of ancient medical books and folk remedies in the course of her research. She also visited and interviewed many experienced doctors.

On the basis of records sourced from an ancient medical tome, Tu noticed the extract from the plant Artemisia annua, also known as sweet wormwood or qinghao in Mandarin, showed promising results when used in tests to treat malaria in mice.

According to Tu, using the plant to cure malaria was first recorded in the Manual of Clinical Practice and Emergency Remedies  penned by TCM master Ge Hong of the Eastern Jin Dynasty (317-340).

She then reconfigured the process to extract active, potent ingredients from qinghao, using ether as a solvent. After 190 failures, Tu had a dramatic breakthrough in 1971, in the process of which she volunteered herself as the first human subject to test the drug.

In 1972, a pure anti-malarial ingredient called qinghaosu was derived and became known as artemisinin.

In an interview with Xinhua, Juleen R. Zierath, Chairwoman of the Nobel Committee for Physiology or Medicine, said that Tu's "inspiration from traditional Chinese medicine" was important.

"But what was really critical was that Tu identified the active agent in that plant extract," said Zierath, adding that "there was a lot of modern chemistry, bio-chemistry attached to this to bring forward this new drug."

In 2011, Tu was awarded the Lasker Debakey Clinical Medical Research Award, commonly referred to as "America's Nobel Prize," for the anti-malaria treatment.

While receiving the award, Tu said that "the continuous exploration and development of traditional medicine will, without doubt, bring more medicines to the world."

Rising confidence 

In an address to a forum sponsored by the State Administration of Traditional Chinese Medicine in Beijing on October 8, Tu said that her discovery of artemisinin represents a combination of TCM knowledge and standard Western medicine procedures.

She referred to TCM as "a great treasury" that needs further in-depth scientific research so more benefits can be discovered in the future.

At the same event, Chen Zhu, Vice Chairman of the Standing Committee of the National People's Congress and former Minister of Health, also spoke highly of the multidisciplinary approach to medical research and drug development. Chen noted that great findings have been inspired by cornerstone TCM works and brought to fruition via the methods of modern Western medicine.

Chen also revealed that the method developed by him and fellow scientist Wang Zhenyi to integrate the use of arsenic trioxide with Western approaches in treating acute promyelocytic leukemia was also inspired by some of the ancient classics of TCM.

"Tradition is our source of inspiration, and modern technology takes it further. They don't go against each other. They go hand in hand with each other," said Zhao Haiyu, an associate professor with the Chinese Academy of Chinese Medical Sciences, in an interview with national broadcaster CCTV.

Overseas promotion 

At present, TCM is winning an increasing amount of recognition throughout the world. According to Zhang Honglei, a researcher with the Nanjing University of Chinese Medicine in east China's Jiangsu Province, about 500,000 registered TCM practitioners has set up shop in more than 160 countries and regions by 2010.

In Australia, Chinese medicine was brought under the National Registration and Accreditation Scheme and became a nationally regulated profession on July 1, 2012.

China Daily  recently quoted Lu Chuanjian, Vice President of the Guangdong Provincial Hospital of Chinese Medicine in Guangzhou, south China's Guangdong Province, as saying that many Western pharmaceutical companies have looked for a formula for natural products when they develop new drugs.

Since 2008, Lu's hospital and Australia's Royal Melbourne Institute of Technology has launched a TCM research project based on modern interpretations of ancient documents in conjunction with high-level clinical research.

In April, the State Council, China's cabinet, released a national program for developing TCM and pledged greater efforts toward promoting TCM abroad over the next five years.

According to the document, prestigious TCM enterprises and medical institutions will be encouraged to set up hospitals or clinics abroad. It also states that the government will nurture large TCM service providers that will operate internationally and support cooperation programs on TCM education between Chinese and foreign higher-learning institutions.

In addition to more funding, TCM researchers and experts suggest that the Chinese Government still has much to do to help TCM become mainstream in the international market by taking measures to promote the legalization of TCM practitioners in foreign countries and cooperating with foreign governments on unifying standards for the development and registration of patented TCM drugs.

In an article published in the science journal Nature  in 2011, Tu wrote, "It is my dream that Chinese medicine will help us conquer life-threatening diseases worldwide, and that people across the globe will enjoy its benefits for health promotion."

Copyedited by Eric Daly

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