Nobel Prize Based on a Traditional Chinese Medicine Herb & Text: Themes from the Robust Media Coverage

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?

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.

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.

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." 

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

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,

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."

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.