Tu Youyou


Tu Youyou is a Nobel Prize-winning malariologist and pharmaceutical chemist and member of the China Academy of Chinese Medical Sciences. She received the Nobel Prize for Physiology or Medicine in 2015 for her discovery and development of artemisinin and related compounds. Tu pursued her education in pharmaceutical sciences at the Peking University School of Medicine and later focused on traditional Chinese medicine at the Institute of Materia Medica. Her achievements and experience have inspired other researchers and emphasized the development of traditional Chinese medicine.
Malaria is caused by a single-cell parasite that causes severe fever. During the Vietnam War in 1967, China and Vietnam were significantly affected by malaria, with approximately 30 million cases and 300,000 deaths just from China. Scientists worldwide had screened over 240,000 compounds without success for finding a cure. She then investigated the history of Chinese medical classics, visiting practitioners of traditional Chinese medicine across the country on her own. She gathered her findings in a notebook titled "A Collection of Single Practical Prescriptions for Anti-Malaria." By 1971, her team had screened over 2,000 traditional Chinese recipes and made 380 herbal extracts, from some 200 herbs, which were tested on mice. Finally, she discovered breakthrough medicines, artemisinin and dihydroartemisinin, used to treat malaria. In the 1970s, after studies of traditional herbal medicines, Tu Youyou focused on sweet wormwood and extracted a substance, artemisinin, that inhibits the malaria parasite. Artesunate is special among artemisinin-based drugs because it dissolves in water, allowing rapid absorption into the body. The fast absorption enables the doctor to inject the medicine into a vein, muscle, or rectum; moreover, severe malaria can cause symptoms that deteriorate quickly, and patients cannot take medicine orally. Artemisinin-based medication has led to the survival and improved health of millions of people. This treatment saved millions of lives in South China, Southeast Asia, Africa, and South America.
Currently, artemisinin and its derivatives remain the most important and widely used drugs for the treatment of malaria. However, artemisinin requires ongoing research into new therapies because parasites are showing resistance. Medicines for Malaria Venture further discovers and develops the project from the discovery of Tu Youyou. MMV's strategy to 2030 aims to cure, prevent, and eliminate malaria by developing a strong pipeline of future medicines.

Early life

Tu was born in Ningbo, Zhejiang, China, on 30 December 1930.
She attended Xiaoshi Middle School for junior high school and the first year of high school, before transferring to Ningbo Middle School in 1948. A tuberculosis infection interrupted her high-school education, but inspired her to go into medical research. From 1951 to 1955, she attended Peking University Medical School / Beijing Medical College. In 1955, Youyou Tu graduated from Beijing Medical University School of Pharmacy and continued her research on Chinese herbal medicine in the China Academy of Chinese Medical Sciences. Tu studied at the Department of Pharmaceutical Sciences, and graduated in 1955. Later Tu was trained for two and a half years in traditional Chinese medicine.
After graduation, Tu worked at the Academy of Traditional Chinese Medicine in Beijing.

Research career

Tu carried on her work in the 1960s and 70s, including during China's Cultural Revolution.

Schistosomiasis

During her early years in research, Tu studied Lobelia chinensis, a traditional Chinese medicine believed to be useful for treating schistosomiasis, caused by trematodes which infect the urinary tract or the intestines, which was widespread in the first half of the 20th century in South China.

Malaria

In 1967, during the Vietnam War, President Ho Chi Minh of North Vietnam asked Chinese Premier Zhou Enlai for help in developing a malaria treatment for his soldiers trooping down the Ho Chi Minh trail, where a majority came down with a form of malaria which is resistant to chloroquine. Because malaria was also a major cause of death in China's southern provinces, especially Guangdong and Guangxi, Zhou Enlai convinced Mao Zedong to set up a secret drug discovery project named Project 523 after its starting date, 23May 1967.
In early 1969, Tu was appointed head of the Project 523 research group at her institute. Tu was initially sent to Hainan, where she studied patients who had been infected with the disease.
Scientists worldwide had screened over 240,000 compounds without success. In 1969, Tu, then 39 years old, had an idea of screening Chinese herbs. She first investigated the Chinese medical classics in history, visiting practitioners of traditional Chinese medicine all over the country on her own. She gathered her findings in a notebook called A Collection of Single Practical Prescriptions for Anti-Malaria. Her notebook summarized 640 prescriptions. By 1971, her team had screened over 2,000 traditional Chinese recipes and made 380 herbal extracts, from some 200 herbs, which were tested on mice.
One compound was particularly effective, sweet wormwood, which was used for "intermittent fevers," a hallmark of malaria. As Tu also presented at the project seminar, its preparation was described in a recipe from a 1,600-year-old traditional Chinese herbal medicine text titled Emergency Prescriptions Kept Up One's Sleeve. At first, it was ineffective because they extracted it with the traditional technique using hot water. Tu discovered that a low-temperature extraction process could be used to isolate an effective antimalarial substance from the plant; Tu says she was influenced by the source, written in 340 by Ge Hong, which states that this herb should be steeped in cold water. This book instructed the reader to immerse a handful of qinghao in water, wring out the juice, and drink it all. Since hot water damages the active ingredient in the plant, she proposed a method using low temperature ether to extract the effective compound instead. Animal tests showed it was effective in mice and monkeys.
In 1972, she and her colleagues obtained the pure substance and named it qinghaosu, or artemisinin in English. This substance has now saved millions of lives, especially in the developing world. Tu also studied the chemical structure and pharmacology of artemisinin. Tu's group first determined the chemical structure of artemisinin. In 1973, Tu was attempting to confirm the carbonyl group in the artemisinin molecule when she accidentally synthesized dihydroartemisinin.
Tu volunteered to be the first human test subject. "As head of this research group, I had the responsibility," she said. She had no bad reactions, so she conducted successful clinical trials with human patients. Her work was published anonymously in 1977. In 1981, she presented the findings related to artemisinin at a meeting with the World Health Organization.
For her work on malaria, she was awarded the Nobel Prize in Medicine on 5 October 2015.

Later career

Tu Youyou was promoted to Researcher in 1980, shortly after the beginning of the reform and opening up in 1978. In 2001, she was promoted to academic advisor for doctoral candidates. As of 2023, she is the chief scientist of the China Academy of Chinese Medical Sciences.
As of 2007, her office is in an old apartment building in Dongcheng District, Beijing.
Tu is regarded as the "Three-Without Scientist" – no postgraduate degree, no study or research experience abroad, and not a member of either of the Chinese national academies, the Chinese Academy of Sciences and Chinese Academy of Engineering. Tu is now regarded as a representative figure of the first generation of Chinese medical workers since the establishment of the People's Republic of China in 1949.

Awards