One of the co-recipients of the 2015 Nobel Prize in Physiology or Medicine is Youyou Tu, Chief Professor at the China Academy of Traditional Chinese Medicine, for her discoveries leading to a new therapy for malaria. Malaria, a mosquito-borne disease caused by single-cell parasites, has been plaguing humankind throughout history. The parasites invade red blood cells, causing fever and, in severe cases, brain damage and death. Malaria infects close to 200 million individuals yearly, primarily in the poorest areas of the world and claims the lives of more than 450,000; the majority of whom are children.
Tu’s discovery of the drug Artemisinin, which has significantly reduced the mortality rates for patients suffering from Malaria, is, in and of itself, a remarkable accomplishment. But what has captured the attention of many is the way in which her research, which led to the discovery, was rooted in her expertise in traditional Chinese medicine (TCM). For some, the fact that the Nobel Assembly recognizes and acknowledges the importance of TCM in Tu’s work points to a paradigm shift in modern medicine, which has generally dismissed or largely ignored any scientific basis for TCM. Many are proclaiming Tu’s story and recent recognition a major win for the field of traditional Chinese medicine.
In the 1960’s, as the efficacy of traditional Malaria treatments, namely chloroquine or quinine, was sharply declining, the number of those infected began to rise. It was around this time that Tu conducted a large-scale review of herbal remedies in Malaria-infected animals and an extract from the plant Artemisia annua caught her attention as a potentially viable treatment, albeit with inconsistent results.
Turning to traditional Chinese medical texts dating back to the fourth century, Tu uncovered important clues that helped her successfully extract the active component from Artemisia annua so that she could conduct comprehensive testing, which found this component, later called Artemisinin, to be highly effective against the Malaria parasite both in infected animals and in humans.
As the Nobel Prize press release explains, “Artemisinin represents a new class of antimalarial agents that rapidly kill the Malaria parasites at an early stage of their development, which explains its unprecedented potency in the treatment of severe Malaria.” When used in combination therapy, Artemisinin is estimated to reduce mortality from Malaria by more than 20% overall and by more than 30% in children. Based on these efficacy rates, more than 100,000 lives are saved each year in Africa alone.
Several experts who are weighing in on the debate that Tu’s win indicates a victory for TCM are quick to point out that the significance of Tu’s work is not a showdown between traditional Chinese medicine and modern medicine. As Guan Weidong, senior TCM specialist at Puhua International Clinic in Beijing explains, “The significance of this award lies in recognizing an accomplishment and the benefit to humanity this accomplishment had, not a certain research method.” He goes on to point out that, while the Nobel Prize recognizes her success in “the development and application of clinical medicine,” Tu drew her inspiration from and “was very much informed by TCM’s customs on preparing and applying that medicine.”
Marta Hanson, associate professor of the history of Chinese medicine at John Hopkins University suggests that the focus of the debate shouldn’t be about eastern versus western medicine at all; rather, the Nobel Prize committee is indirectly recognizing a movement or concept she refers to as “medical bilingualism.” It’s a concept she develops in the book Health and Hygiene in Chinese East Asia: Policies and Publics in the Long Twentieth Century. According to Hanson: “[Medical bilingualism] is the ability of people to not just read in two medical languages but to understand two different medical systems. In light of this, it is too simplistic to reduce what Youyou Tu did. She was able to systematically work through the 1,700-year-old classical texts not only because she was native Chinese, but more importantly, she understood Chinese medical history, concepts and doctrines to access the complex historical archive of TCM.”
Regardless of your position on the role of traditional Chinese medicine in modern biomedicine, there is no disputing Tu’s work is significant and deserving of the recognition it has received. Millions of lives will be spared because her revolutionary work in the treatment of Malaria. In addition, the subsequent dialogue about TCM reminds us that ultimately the goal of medicine is to serve humanity, regardless of the system or ‘language’ used to achieve that very goal. The realm of biomedicine is complex and evolving, with the threat of new diseases, mutations, or drug tolerance always looming. It makes sense then that the most effective, ‘modern’ medicine should evolve similarly with a comprehensive, holistic approach to all medical knowledge, traditional or otherwise. We may not all speak the same language, but we share a commitment to using what we can to make the world a better, healthier place.
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