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The Top Secret Chinese Military Project That Led To a Nobel Prize

HughPickens.com writes: Jeff Guo reports at the Washington Post that development of qinghaosu — or artemisinin — is one of modern China's proudest accomplishments winning a Noble Prize in Medicine this year for Tu Youyou, but it's also a story about Communism, Chairman Mao, and China's return to the world economy. On May 23, 1967, Chinese scientists commenced Project 523, a secret effort that enlisted hundreds of researchers to discover a new malaria drug during the Vietnam War. Although in a better warfare position, the People's Army of Vietnam (North Vietnamese Army) and its allies in the South, Viet Cong, suffered increasing mortality because of malaria epidemics. The project began at the height of Mao Zedong's Cultural Revolution, a brutal time during which academics and intellectuals were murdered, imprisoned, or sent to "reeducation camps" in mass purges.

For doctors and chemists. Project 523 was a lifeline, according to Professor Zhou Yiqing. "By the time Project 523 had got under way, the Cultural Revolution had started and the research provided shelter for scientists facing political persecution." Tu's husband had been banished to the countryside when she was asked to get involved in Project 523. Tu's research project sought to find modern logic in ancient ways, much as the French researchers identified quinine from the bark of the cinchona tree. According to Tu, she and her team screened over 2,000 different Chinese herbs described in old texts, of which about 200 were good enough to test in mice. That's when they hit upon a plant called Artemisia annua: annual wormwood, or qinghao in Chinese. At the time, all of this work remained a Chinese military secret; some of the results were published in Chinese-language journals, but it would be well after the death of Mao Zedong until China would reveal that it had discovered a surprisingly potent new weapon against malaria.

According to Guo the lion's share of the credit rightly goes to Tu and the countless other Chinese scientists who worked on Project 523. But Oxford anthropologist Elisabeth Hsu suggests that the political climate at the time also deserves recognition. Qinghaosu might never have been discovered had it not been for Maoist China's nationalist infatuation with Chinese folk medicine. "It was thus a feature specific to institutions of the People's Republic of China that scientists, who themselves had learnt ways of appreciating traditional knowledge, worked side by side with historians of traditional medicine, who had textual learning," Hsu argues. "This was crucial for the 'discovery' of qinghao."

15 of 73 comments (clear)

  1. Yes, but ... by Kiaser+Zohsay · · Score: 2

    Experiment 626 is what we are really anxious to hear about.

    --
    I am not your blowing wind, I am the lightning.
  2. "feature specific to institutions of .. China" by Anonymous Coward · · Score: 2

    Seriously? In the same summary that describes how the French found quinine from cinchona? In a world where scientists developed aspirin because of people's use of plants for thousands of years? This is hardly unique to China.

  3. Spoils of War by rmdingler · · Score: 3, Interesting
    From the far reaches of Mao's introverted China to the warring nations of the West, and yonder into the African continent, the propensity towards a warring culture is synonymous with humankind.

    It seems like we are at our industrious best when working in concert during a time of great conflict.

    Sadly, times of contentment and peace are seemingly less productive. Do we require strife to excel?

    --
    Happiness in intelligent people is the rarest thing I know.

    Ernest Hemingway

    1. Re:Spoils of War by Nutria · · Score: 2

      War is not required (e.g. the Apollo program)

      Cold War.

      --
      "I don't know, therefore Aliens" Wafflebox1
  4. When's her birthday? by alvinrod · · Score: 3, Funny

    When's her birthday, because being able to sing "Happy birthday to Tu Youyou" is way to awesome to miss.

  5. Deserved! by virve · · Score: 2

    I was truly happy when I heard that the Nobel prize had been awarded for the discovery and development of artemisinin. This drug has saved the lives of many.

    Sad that substandard preparations of artemisinin has led to spread of resistance in Indochina.

    --
    virve

  6. Burden of proof. by DerekLyons · · Score: 3, Insightful

    From TFS: "According to Tu, she and her team screened over 2,000 different Chinese herbs described in old texts, of which about 200 were good enough to test in mice. That's when they hit upon a plant called Artemisia annua: annual wormwood, or qinghao in Chinese."

    Yeah, I've already heard from from my crunchy greenie friends about how this "proves" the value of traditional medicine. That one text mentions on herb that worked, and 1,999 texts listed herbs that didn't shows the exact opposite... completely escapes them.

    1. Re:Burden of proof. by ChrisMaple · · Score: 2

      Of the advances in drug testing in recent years, one is a technique to test a hundred or so substances at once. Until computational methods allow prediction of what chemicals will cure what disease, scattershot procedures are necessary. Considering that hundreds of Chinese researchers took many years to screen only 2000 things, that's not a very efficient record.

      Of course, it's valid to ask if this drug's 1 in 2000 discovery is better than what would have resulted in testing thousands of plants completely at random.

      Note that they "screened over 2,000 different Chinese herbs described in old texts", not that they "screened over 2,000 different Chinese herbs described in old texts as being effective for malaria." We're given no clue as to whether the old texts claimed that all the herbs were useful for malaria, it seems unlikely. For that matter, we don't know if the old texts claimed qinghaosu cured malaria. Not enough information.

      Sure, there's a lot of nonsense in "traditional medicine". Researchers have to start somewhere, and assuming that everything old was written by fools or charlatans seems like an error.

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    2. Re:Burden of proof. by Gadget_Guy · · Score: 2

      Yeah, I've already heard from from my crunchy greenie friends about how this "proves" the value of traditional medicine. That one text mentions on herb that worked, and 1,999 texts listed herbs that didn't shows the exact opposite... completely escapes them.

      To be fair, those traditional herbal medicines were not all supposed to be malaria cures specifically. In fact this particular herb was a general cure for fever.

      From Artemisinin: Discovery from the Chinese Herbal Garden:
      During their search, Youyou Tu and colleagues investigated more than 2,000 recipes of Chinese traditional herbs, compiling 640 recipes that might have some antimalarial activity.

      Of course, traditional techniques for extracting the compound to make the medicine were still wrong though, so your friends who you are denigrating still don't have cause to celebrate. But traditional medicine is just an early version of modern medicine with just as sloppy scientific rigor as the doctors in the 60s who used to prescribe smoking to their patients. So there is no point feeling all high and mighty as our modern medicine can trace its roots back to a lot of leach-loving doctors.

    3. Re:Burden of proof. by Anonymous Coward · · Score: 2, Interesting

      I'm an acupuncturist and herbalist in the U.S. All chinese herbalists are trained with knowledge of qing hao, which has been known for a couple thousand years as an herb that can be used in the treatment of many tropical diseases, including malaria. I have treated several people with sequelae of several tropical diseases contracted during scientific expeditions overseas, and have seen the effectiveness of herbs in treatment.

      I believe that the scientists involved must not have consulted any actual chinese doctors in their research, because they could have given them immediate answers as to what herbs to use in the treatment of malaria. If they went through all those herbs in a search, they wasted a heck of a lot of time.

      Western scientists should seriously consider consulting the real experts when investigating things they know nothing about. Every major pharmaceutical company is in China now, investigating Chinese herbs for possible treatment options for many diseases. Tamiflu is a drug that has come out of that research. Open minds are needed in searching for new treatments.

    4. Re:Burden of proof. by ShakaUVM · · Score: 2

      >(I'm betting that it's Very Few, since "alt med" that is proven successful isn't "alt med" anymore.)

      While I acknowledge the meme, alt med is actually defined by every major medical organization in the world as something that is not used as part of mainstream medicine. It's not an assessment of effectiveness.

      Quite a bit of the drugs in the alt med bible were wholly ineffective, and quite a few more had weak or modest medicinal purposes (tea alone had hundreds of studies showing its mild effectiveness in many different areas), and a fair number had significant medical effects.

      Alt med is (or was, I haven't checked recently) a mandatory class at UCSF Pharmacy School, since even if the future pharmacists aren't going to be doing traditional medicine, there are a number of significant drug/drug interactions with alt meds.

  7. Re:Best weapon against malaria: DDT by hey! · · Score: 5, Interesting

    I have some actual knowledge about this issue from projects I've worked on.

    DDT is excellent in domestic applications (i.e., to house interiors) because it leaves a long-lasting toxic surface when sprayed on walls. Other pesticides such as permethrin are more expensive to use because you have to go back and spray the surfaces of the house several times a year, whereas a DDT application is good for a year or more. This kind of domestic application is especially effective at stopping malaria transmission because the infectious agent (Plasmodium) has no natural focus other than humans.

    In fogging applications the impact of the DDT ban is nil; in fact using DDT this way is arguably counter-productive, not even counting downstream ecological effects. The reason DDT is bad for outside applications is the very same reason it's good for interior applications: the durability of the molecule -- or more precisely its breakdown products. DDT is not much more long-lived than malathion or permethrin, it's half-life is about 50 days; but it breaks down through loss of HCl into Dichlorodiphenyldichloroethylene (DDE) which has a half-life of almost six years and does a lot of DDT's residual killing.

    Why is long lasting toxicity good for inside pesticide applications and bad for outside applications? Because outside the pesticide doesn't stay put. It washes away into soil and pools of water -- where mosquitoes lay their eggs. Bathing the larvae in sub-lethal concentrations of DDE puts evolutionary pressure on the mosquito population, producing adult mosquitoes who are resistant to DDT. You never want to expose mosquito larvae to pesticides which are used against adults. So for outside fogging applications you want something that'll kill mosquitoes the fog contacts, then breaks down as quickly as possible into something that's non-toxic.

    Before you advocate something like the widespread reintroduction of DDT, it would be best if you educated yourself on its effects, methods of application, and side effects. There's a lot of misinformation out there to the effect that DDT is a panacea; it's not. For example I've seen one old toxicology study that is frequently cited by anti-environmentalists as proof DDT doesn't have toxic effects on birds. The flaw with that study, and the reason that they don't have more recent studies to cite, is that question of DDT per se in the environment is moot; it doesn't last long enough to bioaccumulate. It's actually the very long-lasting DDD and DDE breakdown products that are the culprits.

    It would be reasonable to reintroduce DDT for domestic applications, provided that we can structure its use so that the effectiveness of the program isn't undermined by DDT that has been stolen and diverted to agricultural use. I can tell you from experience that theft is an enormous problem for teams operating in places that have serious endemic malaria problems.

    So it really comes down to this: is the lower cost of DDT offset by the security and audit trail you need to ensure the program's long viability? Either way there's no reason to not eradicate malaria, and we don't need DDT to do it. The cost of eradication is tiny compared to the cost malaria has in economic output, lives shortened, and political destabilization.

    --
    Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
  8. Re:What a BS Nobel by Gadget_Guy · · Score: 2

    So she "discovers" something that was widely known for, what, 500 years? and she gets a nobel? WTF is this about?

    It's about eliminating the other 1,999 herbs that were also "known" about. It's about applying the herb that had been traditionally used to treat generic fevers to now fight malaria. It's about isolating the compound in the herb (Artemisinin) and figuring the best way to extract it (which wasn't the method traditionally used).

  9. Re:Best weapon against malaria: DDT by hey! · · Score: 5, Interesting

    I should also point out the problem with your graph, which shows an increase in malaria deaths starting around 1972, when the US banned DDT. The problem is that DDT was not banned in the rest of the world in 1972. In fact it has continued to be used in the rest of the world, often with funding from USAID. About five million kilograms of DDT are still used every year worldwide, the bulk of it in India.

    The current international status of DDT is that it is banned in signatory countries to the Stockholm convention for all purposes except mosquito borne disease control. This ban is actually beneficial for DDT in malaria eradication, because it reduces the populations of mosquitoes that have become resistant due to agricultural applications. DDT is fully banned in most first-world countries, but they don't need it. They have the resources and sophistication to control malaria vectors with IPM.

    So if DDT is legal to use in places that have endemic malaria, why haven't we used DDT to eradicate malaria worldwide? There are several reasons, but the big one is that we haven't made any serious attempt yet to eradicate malaria worldwide with DDT or any other pesticide. People have talked about it, people have advocated for it, but nobody's ponied up the billions of dollars it would take to actually put a program together that could do it.

    Funding clearly is the limiting factor in DDT use; most of the countries using DDT today are in subsaharan Africa, but the quantities involved are tiny, sporadic, or both; often amounting to a thousand kilos every couple of years.

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    Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
  10. Let's get this straight: there's NO global ban. by hey! · · Score: 3, Informative

    See my other post on this; under the Stockholm convention DDT is allowed in the control of vector borne diseases and in fact the world uses some five million kilos of the stuff annually on mosquitoes. The reason more isn't used is the places where it would be most useful don't have the money to buy the stuff, cheap as it is. That's what you should be getting in a huff over, not some non-existent ban.

    The places that do have bans (like the US and the EU) can afford better solutions.

    --
    Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.