For years, it had almost become a ritual among Chinese media outlets to wonder why the country never had a scientist win a prestigious Nobel Prize. Commentators would express dismay over how poorly China was represented among Nobel winners, and many held it as proof of the country’s inadequate scientific capabilities and of schools’ and research facilities’ failure to cultivate innovation.
Then this year, when the Nobel Committee finally knocked on China’s door, giving an award to medical scientist Tu Youyou for her role in anti-malarial drug research, debate of a different sort erupted. Questions were raised over whether she had played a role big enough to deserve the accolade; if she did, then why had she gotten so little recognition in China? Others wondered what was wrong with the way the country hands out awards, and whether Tu’s honor also belonged to traditional Chinese medicine.
The Nobel Assembly at Karolinska Institutet in Stockholm announced on Oct. 5 that Tu was among three scientists to share this year’s prize in medicine or physiology. The other two are William Campbell of the United States and Japanese Satoshi Omura, for their development of an anti-parasite treatment for river blindness.
Tu, who’s in her 80s, was awarded a Nobel Prize for her contribution to the discovery of “qinghaosu,” or artemisinin, “a drug that has significantly reduced the mortality rates for patients suffering from malaria,” the committee said. When used with other therapies, the drug can reduce mortality from malaria by more than one-fifth. As a result, more than 100,000 lives are saved each year in Africa alone, the body said.
As the first Chinese national to win a Nobel Prize in a scientific field, Tu said she understood the significance of the award. “Chinese people have wished to win Nobel Prize for long time, and this time artemisinin won the prize,” she said in a telephone interview with the Nobel Committee.
The official Xinhua News Agency applauded Tu for her “outstanding contribution to the discovery and research of artemisinin” and said the award is “recognition for China’s contribution to the world.”
The drug was discovered in 1967 as part of a project intended to fight malaria in the former North Vietnam and in southern China. Project 523—named after its starting date of May 23, 1967—involved more than 500 researchers from about 60 institutes around the country, including Tu, who was a research assistant then.
When a final report describing artemisinin’s structure, pharmacology, and efficacy appeared in 1979 under the name “Qinghaosu Anti-Malarial Coordinating Research Group,” it was hard to know who the key figure in the research was. Then, in 2011, two researchers at the U.S. National Institutes of Health, Louis Miller and Su Xinzhuan, looked into the history of artemisinin and named Tu as the drug’s discoverer.
However, in a book published in 2006, the former deputy director of the project, Zhang Jianfang, said the artemisinin success was a “collective honor” for everyone involved, and that limitations on talent, equipment, funding, knowledge, and skills meant no individual could have accomplished such a medical breakthrough on his or her own.
In a society where collectivism trumps individual roles, Xinhua compared the process of discovering artemisinin to a relay completed by many researchers. “Every ‘runner’ is important; no one can accomplish the goal solely,” it said.
However, Tu said in 2011 she played a decisive role in the research by using ether to extract active ingredients from Artemisia annua, or sweet wormwood, a plant native to Asian countries.
“Everyone is entitled to his opinion,” Tu responded to questions about the drug’s discovery in an interview with the New York Times. “We all believed in collectivism. All I wanted was to do good work at my job. Of course, I’d be nothing without my team. Foreign countries like the United States care a lot about which individual should claim credit. Foreigners read the historical records and picked me. Chinese awards are always given to teams, but foreign awards are different. This honor belongs to me, my team and the entire nation.”
After learning that Tu was awarded the Nobel Prize, Lu Bai, a professor at Tsinghua University’s School of Medicine, said Tu played a pivotal role in the research: “Although a lot of people participated in the project, she made the most important decisions and that’s also what the Nobel Committee cared about.”
The Nobel Committee said Tu was the first to show artemisinin was highly effective against the malaria parasite. “After all, discoveries are made by individuals and not by organizations,” Göran Hansson, secretary of the Nobel Committee for Physiology or Medicine, said on the committee’s website, apparently having anticipated questions about an individual’s role in scientific research.
“In a time when organizations and institutions become increasingly important and powerful, it is even more important to identify the creative individuals who change the world,” he said.
In 2011, Tu, a research fellow at the China Academy of Traditional Chinese Medicine in Beijing, won the Lasker Award, one of the biggest prizes in medicine. However, despite international recognition for her work, Tu has received little acclaim for her achievements in her home country.
She does not have a doctoral degree and is not a member of the prestigious Chinese Academy of Sciences, leading some to question the way its members are chosen. “From what Tu has experienced in China, we can see how the selection of academics has been flawed because it is carried away with non-academic issues,” Jin Dongyan, a biology professor at the University of Hong Kong, wrote on a blog.
The Chinese Academy of Sciences and the Chinese Academy of Engineering have been criticized for lacking transparency in how selections are made. Before 2014, intellectuals, military officers, and senior executives at state-owned enterprises could be nominated to a top academy, and the process was sometimes tainted by corruption. Zhang Shuguang, a disgraced former railroad engineer, admitted he once spent more than 20 million yuan ($3.2 million) trying to become a member of Chinese Academy of Sciences.
Tu’s Nobel Prize victory has rekindled the debate over how members of these top bodies are picked. “How to make research achievements the determining factor is the goal for future reform of China’s science and technology system,” Jin wrote.
Some in China have linked Tu’s award to Chinese medicine, even though the Nobel Committee never mentioned it. Her research did involve literature and recipes from traditional Chinese medicine. A large-scale screening of herbal remedies in malaria-infected animals eventually led her to an extract from the artemisia herb. However, the early results were inconsistent. Tu revisited ancient literature, finding clues that guided her to use ether to extract the active component in artemisinin.
None other than the Chinese premier, Li Keqiang, seized upon this as a victory for traditional Chinese medicine. “Tu Youyou’s winning of the Nobel Prize in Physiology or Medicine is an expression of the prosperity and progress of Chinese science, and of the huge contribution that Chinese traditional medicine and pharmacology have made to the health of humankind,” Li said in his message of congratulations.
However, the Nobel Committee emphasized in explaining why Tu won the award that it was not given to traditional Chinese medicine but to a scientist who used sophisticated research methods to find a new therapy for malaria.
The process of turning an active component in plants into a modern drug involves laboratory studies and tests on animals, which is significantly different from how the herb was used in traditional Chinese medicine, Wang Liming, a professor at Zhejiang University’s Life Sciences Institute, wrote in a commentary for Caixin.
But merely calling artemisinin a drug “inspired by traditional Chinese medicine” cannot satisfy the nation and people who have faith in the practice, he said.