Oct
2015

Meditations on Tu Youyou, malaria elimination, and a new generation of advocates

Nobel Prize for Medicine awards global health discoveries

For those in the global health world and beyond, the start of October saw social media and news feeds awash with the announcement of the winners of the Nobel Prize for Physiology or Medicine.

One half of the prize went to William C Campbell and Satoshi Ōmura for their contributions to the development of ivermectin: a treatment for roundworm parasite diseases. The other half was awarded to Chinese phytochemist Tu Youyou for her discovery of artemisinin as a treatment for malaria.¹

The story of Tu Youyou’s breakthrough reads like something out of a spy novel, and as compelling stories do, soon appeared in numerous articles and websites. It goes like this: artemisinin was discovered by Tu and her team under the secret orders of Chairman Mao in response to rocketing malaria deaths among their Northern Vietnamese allies during the Vietnam War and the concurrent realisation that chloroquine - the available malaria treatment at the time - was fast becoming ineffective as malaria parasites developed resistance to the drug.^{2, 3, 4, 5}

Disrupting historical cycles of resistance

Fast forward to today and the context surrounding artemisinin’s discovery strikes a nerve owing to history’s unfortunate habit of repeating itself. While artemisinin-based therapies have saved millions of lives in the intervening period since its discovery, resistance has now emerged in the countries of the Greater Mekong subregion.⁶

Artemisinin resistance poses a direct threat to the large gains made against malaria under the Millennium Development Goals. It has prompted a broad and growing consensus that malaria elimination, and eventual eradication, is the only long term and sustainable strategy for tackling the disease and ending repeated and indefinite cycles of resistance, resurgence and response.

A look at the work of our Partners in the Social Media Awards reveals what is already being done to counter resistance and drive progress for malaria elimination, whether it be ISGlobal’s research into insecticide resistance in southern Mozambique,⁷ the Medicines for Malaria Venture’s mission to accelerate drug discovery and development for malaria,⁸ or the unprecdented regional elimination goal adopted by leaders of the Asia Pacific under APLMA's guidance.⁹

Creating a cadre of Tu Youyous to accelerate progress towards malaria goals

The announcement of Tu Youyou's Prize for artemisinin discovery comes on the heels of several other major milestones for malaria this year, including the endorsement of WHO's Global Technical Strategy 2016 -2030, Roll Back Malaria's accompanying advocacy document 'Action and Investment to Defeat Malaria', the launch of the Sustainable Development Goals, and Gates's 'From Action to Aspiration' campaign for malaria eradication.^{10, 11, 12}

One of the key messages in the latter is that ‘Eradication in the 21st century with differ dramatically from past efforts’, by adopting new strategies, sourcing new financing, and developing and delivering new tools. Innovation at this scale requires individuals and organisations skilled at understanding and collaborating across numerous, and sometimes divergent, sectors. Tu describes her own training along these lines, which equipped her "with a unique, integrated, and philosophic knowledge encapsulating modern pharmaceutical sciences and TCM" and extended to the rest of Project 523’s malaria research group "of historians, chemists, parasite experts and TCM researchers”.³

As the Social Media Awards near their conclusion, we are proud to present our own microcosm of multidisciplinary malaria advocates who share Tu’s passion, perseverance, and persistence to move the malaria elimination agenda forward. Be sure to commend and encourage their efforts in the last few weeks of voting.

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Meditations on Tu Youyou, malaria elimination, and a new generation of advocates

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