How it began
Project 523 was launched on May 23, 1967 to find a cure for chloroquine-resistant malaria. Tu Youyou, a pharmacologist at the Academy of Traditional Chinese Medicine, joined the effort in 1969 and first traveled to Hainan Island to study the disease. Back in Beijing her team reviewed ancient medical texts and found a reference to sweet wormwood, used in China around 400 CE to treat intermittent fevers. In 1971 the team obtained an active extract, and the following year it isolated the active ingredient, artemisinin, known in Chinese as qinghaosu.
Before it existed
The single-celled parasite that causes malaria had become resistant to chloroquine, the standard treatment. North Vietnam had asked China for help because malaria was causing heavy casualties among its soldiers during the Vietnam War. By the time Tu's team turned to the old texts, more than 240,000 compounds had already been tested as potential antimalarial drugs, and none had worked.
How it works
The first extracts of wormwood did not work. Tu returned to the ancient text and wondered whether the active ingredient was being damaged when the plant was boiled. She tried a preparation with an ether-based solvent, which boils at a lower temperature. Tested on mice and monkeys, the new extract had a 100 percent success rate. Tu and two colleagues took the substance themselves before it was given to 21 patients in Hainan Province, all of whom recovered.
How it spread
The work was not published in English until 1979. In 1981 the World Health Organization, the World Bank and the United Nations Development Programme held a meeting on qinghaosu in Beijing at which Tu presented the findings. It took about two decades, but the WHO eventually recommended artemisinin combination therapy as the first line of defense against malaria.
What lasted
The Lasker Foundation, which gave Tu its Clinical Medical Research Award in 2011, called the discovery arguably the most important pharmaceutical intervention in the last half-century. In 2015 Tu received the Nobel Prize in Physiology or Medicine for her discoveries concerning a novel therapy against malaria. She was the first mainland Chinese scientist to receive a Nobel Prize in a scientific category. The Nobel organization credits the compound with saving millions of lives.
