Mao Zedong himself ordered the creation of a secret research program called Project 523 with the goal of drawing from traditional Chinese medicine to develop a drug that could be immediately used to combat malariaIn the mid-twentieth century, at the height of the Vietnam war, an enemy common to both sides was killing more civilians and soldiers than the bullets and bombs. The enemy was malaria, a lethal infectious disease for which there was no cure. Overwhelmed by the losses among their troops, the government of Vietnam (through Ho Chi Minh) requested the assistance of China that was in the middle of its Cultural Revolution. In 1967, Mao Zedong himself ordered the creation of a secret research program called Project 523. They recruited around 500 scientists from more than 60 laboratories and institutions, with the goal of drawing from traditional Chinese medicine to develop a drug that could be immediately used in the battle field to combat malaria.

In parallel, the American scientists in the Walter Reed Research Institute had stepped up their efforts and found a malarial drug with partial efficiency: mefloquine.

In 1972 they managed to crystalize the active compound of Artemisia and they called it artemisininOutside China, nobody was aware of the Chinese project since it was considered a military secret and the Cultural Revolution had forbidden the publication of scientific reports.  In Beijing, the scientists led by Youyou Tu, a pharmacologist at the Chinese Academy of Traditional Medicine, analysed more than 2,000 samples of Chinese medicinal herbs and found 640 with a certain degree of activity against the malaria parasite. They then tested 380 extracts in experimental models of malaria in mice, without encouraging results until they came upon the Artemisia annua plant. After a thorough review of existing literature   on Chinese herbal medicine, Youyou Tu found a one thousand year-old recipe to treat periodic fevers using “quighaosu” and that explained how to prepare the medicine. By using lower temperatures to extract the active compound, Youyou Tu’s team managed to obtain extracts with higher anti-parasite activity. The scientists then tested its toxicity in humans- the guinea pigs were themselves! 

In 1972 they managed to crystalize the active compound of Artemisia and they called it artemisinin. Meanwhile, the American scientists, that had heard rumors of the new antimalaria drug, were eagerly searching for the plant, which they finally found on the banks of the Potomac River, right in the middle of Washington D.C.!

In 1981, the WHO and the World Bank reunited the Chinese experts with European and American colleagues in Beijing.  Soon after, artemisinin was successfully used in campaigns to control malaria in Asia and Africa. Artemisinin, in combination with other malaria drugs, has proved to be the most efficient treatment against malaria, allowing a 50% reduction in deaths during the last decade.   

Artemisinin, in combination with other malaria drugs, has proved to be the most efficient treatment against malariaHowever, due to the challenges of treating all infected persons and the lack of an effective vaccine, malaria remains a major public health problem and is responsible for 200 million infections and half a million deaths per year, most of them in Africa and particularly among children under the age of five.  

In addition to its antimalarial activity, artemisinin and its derivatives are being investigated for their potential use in some types of cancer, as anti-inflammatory drugs, and their effect on virus and other parasites. 

Thus, despite provoking the death of millions of people, the Vietnam War also led to the discovery of artemisinine, that has saved the lives of millions of people infected with malaria.  

Despite provoking the death of millions of people, the Vietnam War also led to the discovery of artemisinin, that has saved the lives of millions of people infected with malariaThis marvelous story that illustrates the value of scientific research has concluded with the reception of the 2015 Nobel Prize in Medicine by Professor Youyou Tu, 85 years-old, together with two scientists that discovered ivermectin, a drug that has contributed to the elimination of another poverty-associated parasitic disease: onchocerciasis. 

Professor Youyou Tu is known in her country as the “three-times no” scientist: no PhD, no postgraduate studies abroad and not a member of the Chinese Academy of Sciences – as they say, no-one is a prophet in their own land!. I would add another “no”: she has no scientific publications in english.  

Artemisinin, in combination with other malaria drugs, has proved to be the most efficient treatment against malariaThe Nobel Committee stated: “The discoveries made by the Awardees have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable».