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Nobel Prize Based on a Traditional Chinese Medicine Text: Themes from the Robust Media Coverage |
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Written by John Weeks
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Nobel Prize Based
on a Traditional Chinese Medicine Herb & Text: Themes
from the Robust Media Coverage
.jpg) Tu: Nobel laureate makes a point
Global traditional medicine news is over-flowing
with multiple reflections on the meaning of the award of the Nobel Prize in
Medicine to Chinese scientist Tu Youyou. The award followed the
discovery by Tu and her team of the usefulness of a drub based on sweet wormwood (Artemesia annua) to combat malaria. The discovery
has saved tens of millions of lives. Artemisinin-based drugs are still "routinely
used by pharmaceuticals giants like Sanofi and Novartis in the fight
against malaria." All the Nobel awards, as reported here
at Nature, stimulated dialogue in
the twitter sphere, yet it was Tu "who inspired much of the online discussion." Here
are some of the intriguing themes in these media accounts, with some commentary
built in. The announcement
of the award is here.
A Turning Point
for Traditional Medicines?
.jpg) Behind the Nobel: sweet wormwood
One of the themes is whether this acknowledgement of the
power of an herb will be part of a turning
point for traditional medicines, from China and elsewhere. In Fortune, a writer speaks to the surprise with which the award was greeted: "Traditional medical knowledge anywhere in the world has not even been
on the radar for Nobel Prize prospects. Until now, that is." Then the question: "So how should we
interpret this arguably seismic shift in international attention on traditional
Chinese medicine?" At another piece
the writer asks: "Traditional Chinese Medicine Wins Nobel Prize 2015; Western
Science Ready to Embrace Alternative Medicine?"
.jpg) The Nobel award
Most people raised in a medical culture dominated by big pharma and surgery are disconnected from awareness that a significant percentage of drugs are based on, or synthesized
from, natural agents. The Nobel to Tu is a blunt lesson on the life-saving power of one
herb, processed correctly. Members of the Nobel committee shared views - see video
here - that it is the potential power of traditional medicines as paths to new drugs that was their interest, rather than as herbal medicines themselves. A writer at The Conversation is cautious: "So can we hope to find
new remedies by studying ancient medical texts, as Tu did so successfully? The
answer to that question is complex and unfortunately cannot be an unmitigated,
resounding ‘yes'." Time will tell whether this highlighting of a traditional medicine might, for instance, boost
interest in the four African herbs that former US Ambassador to the United
Nations Andrew Young was urging exploration at this
recent press conference.
Victory for China
in its Global, Cultural Exportation of TCM
.jpg) Great news for a global push on TCM
Readers of the Global Integrator Blog will know that medial evidence of the Chinese government's commitment to exporting their traditional medicine
appears routinely. In recent weeks, for instance, stories emerged of Chinese government-backed initiatives in Australia, Malta, Central
Europe, multiple nations in Africa, and elsewhere, of this medico-cultural-industrial campaign. The
award of the Nobel well certainly be a door-opener for the Chinese where parties are wary, and a
likely booster for initiatives already underway. The South
China Morning Post characterized the award as "giving
traditional Chinese medicine a shot in the arm."
While lobbying is well known to happen for
the Nobel Peace Prize, I have not seen any report that explores the extent to
which China may have actively lobbied for Tu's award. Give the importance of their global TCM campaign, that would not be surprising. The Telegraph of London quotes one Li
Chenjian, a vice provost at Peking University: "'This is indeed a glorious moment. This also is an acknowledgement
to the traditional Chinese medicine, for the work began with herbal medicine.'"
An Indian science
writer notes: "Chinese premier Li Keqiang has quickly positioned the Nobel
prize as reflecting China's ‘comprehensive national power and the uninterrupted
rise of China's global influence'."
The Multiple
Firsts in this Nobel Award: What, No PhD?
Much has been made of the award being the
first Nobel to a Chinese woman, and the first award of a Nobel in Medicine to
a Chinese national. The award was also remarkable for its elevation for a
lowly-herb amidst the rarified ‘omics" in the modern era of genetic exploration. It is
also likely the first award for a contribution to scientific
advancement from Mao's China.
Yet perhaps even more remarkably, the award went to a person who
does not have a doctoral degree. A Japanese
account notes that Tu Youyou "is a ‘scientist with none of three key
factors,' namely the title of ‘master scholar' presented to a scientist of
highest caliber in China, doctoral degree and experience in overseas study." There
has been reportedly
feverish interest in Tu in China. Her given name
"Youyou" reportedly "derives from ‘phrases' in the Classic of Poetry,
which means ‘dear feeds on grass in the field, shedding tears.'"
Tu, however, as one
writer asserts, "embodies, in both her history and her
research, what I call medical bilingualism - the ability not only to read in two different medical languages but
to understand their different histories, conceptual differences, and, most
importantly for this unexpected news, potential value for therapeutic
interventions in the present." Remarkable, at every level. A two-minute
video of Tu is here. A look at her past is
in this article entitled: "The home, the
herbalist and the high school: Feverish interest in Nobel Prize-winner Tu
Youyou's background."
A Product of Maoist
Science Stimulated by a War in Vietnam; Global Education Later
.jpg) An initiative of the Maoist era
Multiple accounts place this increase of
knowledge squarely in the zone of war-time
discoveries with peace-time applications. Mao had a war in Indochina on his
hands and "malaria became the number one affliction compromising Vietnamese
soldiers' health." In this
article, the writer describes how Mao initiated a covert operation entitled
Project 52 that was "headed by a young Chinese medical researcher by the name
of Tu Youyou."
Interestingly, "the Chinese
conditions prevented these discoveries from being reported beyond the
Chinese language journals" because of the wartime environment. The breakthrough for the world came in 1979
when the China National Committee of Science and Technology, in Tu's
recollection, "granted us a National Invention Certificate in recognition of
the discovery of artemisinin and its antimalarial efficacy." Two years later,
at the fourth meeting of the Scientific Working Group on the Chemotherapy of
Malaria, in Beijing, sponsored by WHO and World Bank among others, the discovery reached the outside world.
The Remarkable
Path of Discovery in a 1700 Year of Text
Tu's Chinese team reviewed "systematically
screened the well-documented texts and sifted through more than 2,000 herb
preparations of traditional Chinese herbs and from these identified 380 herb
extracts and tested them on mice being infected by malaria parasites." Sweet wormwood was a common denominator in
many.
The breakthrough for the researchers came when Tu encountered the medical text
of a fourth-century Chinese physician and alchemist named Ge Hong (circa
283-343). Ge Hong briefly described his primitive means of processing
the herb: "A handful of qinghao
immersed with 2 liters of water, wring out the juice and drink it all." Tu
Youyou comments: "This sentence gave me the idea that the heating involved in
the conventional extraction step we had used might have destroyed the active
components, and that extraction at a lower temperature might be necessary to
preserve antimalarial activity. Indeed, we obtained much better activity after
switching to a lower-temperature procedure." Tu has reportedly "always maintained that she drew her inspiration" from Ge Hong.
Wake Up, India (and
Japan)
 India: reflection, and a little envy
A short article
in The Hindu begins: "The success
story of Tu Youyou, whose work was based on herbal pharmacology of ancient
China, should serve as a spur to researchers in Indian traditional medicine." Another
Indian writer
complains that "each time India takes forward her traditional knowledge
into the realm of science, there has been a concerted effort from the Indian
media to ridicule and negatively portray it." An Indian writer suggests that the message
for India is to link its traditional practices with modern sciences.
Another Indian writer uses the prize to make a "call
for unification" of India's distinct traditional system. He is prompted to
an unfavorable comparison of India to what he found in visits to China: "In
China, one can see two hospitals standing side by side. One would be practicing
traditional medicine while the other would provide modern treatments. After the
disease is diagnosed, traditional treatments get more preference. Allopathy is
tried as a last resort. Patients are given the option to select his or her
treatment mode and most would opt for traditional treatments." He adds: "Let the achievement of YouYou
invigorate the traditional system of medicine in India."
.jpg) Japan: a different approach to the West
The
Japanese account, noted above, looks at Mao's plan with TCM as compared to the
way Japan responded to the West's medicines: "At, the first national health and hygiene
meeting in 1950, late Chinese supreme leader Mao Zedong established the
principle that ‘Chinese medicine must combine with Western medicine' as one of
the four principles in health. The measure is contrasted with Japan's decision
to discard traditional medicine when it introduced Western medicine through the
Meiji Restoration." Notably, the Indian writer above similarly opines that the "Indo-phobe"
perspective from India's Nehru era was at least partly responsible for retarding the advance of traditional medicine in
his country.
Meantime, in Jamaica, this
article characterizes the Nobel as "encouragement for local scientists."
For instance: "We see similar research being done by the likes of Dr. Henry
Lowe, who, along with his team over the past 10 years, has made significant
headway in the battle against cancer and other chronic diseases through the
development of therapies from Jamaican plants such as ball moss."
Conclusion: A
Collision in Time, Space, Politics and Culture
The elements of this story are outrageous: a war in Vietnam, Maoist
medicine, a well-known herb, a 1700 year old "recipe" and a researcher with
relatively little formal education, but with a curiosity toward and grasp of two medical cultures. One writer at ExtremeTech characterized the breakthrough of Tu and her team this
way: "An ancient version of science managed to find the general
location of this drug, but the modern version of science is what nailed it
down." Notably, it was also an ancient means of extraction that allowed the
modern scientists to release the potency of anti-malarial properties.
Ray Yip, the former China director for the USA Center for
Disease Control and the Gates Foundation quipped
as follows in this account: "The impact on traditional Chinese medicine
could also be mixed, My. Yip said. While most advocates would welcome the
exposure, it would irritate the purists, he said: ‘A lot of Chinese traditional
medical practitioners actually hate this approach of extracting chemical
compounds from a plant. They believe you need to take the herbs all together.'"
The discovery may never have been made were the research direction left to such
purists. Yu's award honored scientific integration.
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