Youyou Tu

Tu Youyou
Born	屠呦呦 30 12, 1930
Birthplace	Ningbo, Zhejiang, Republic of China
Nationality	Chinese
Occupation	Pharmaceutical chemist, malariologist
Title	Director, Artemisinin Research Centre
Employer	China Academy of Chinese Medical Sciences
Known for	Discovery of artemisinin
Education	Peking University (B.Pharm.)
Awards	Template:Ubl

Tu Youyou (Template:Lang; born December 30, 1930) is a Chinese pharmaceutical chemist and malariologist whose discovery of artemisinin — a compound derived from the sweet wormwood plant (Artemisia annua, known in Chinese as qinghao) — transformed the global treatment of malaria and has saved millions of lives. Born in Ningbo, a culturally rich city on the eastern coast of China, Tu spent decades working in relative obscurity before her contributions were recognized on the world stage. In 2015, she was awarded one half of the Nobel Prize in Physiology or Medicine for her discovery, sharing the prize with William C. Campbell and Satoshi Ōmura, who were honored for their work on therapies against roundworm parasites. Tu became the first Chinese woman to win a Nobel Prize and, at the time, was the first Chinese citizen to receive a Nobel Prize in a natural science category while working in mainland China. Her work exemplifies a distinctive intersection of traditional Chinese medicine and modern pharmaceutical science, and artemisinin-based combination therapies remain the standard treatment for Plasmodium falciparum malaria recommended by the World Health Organization.

Early Life

Tu Youyou was born on December 30, 1930, in Ningbo, a city on the east coast of China's Zhejiang Province. In her Nobel biographical account, Tu described Ningbo as a place "with a rich culture and over seven thousand years of history." Her given name, Youyou (呦呦), is drawn from the Classic of Poetry (Shijing), one of the oldest collections of Chinese poetry, where the phrase "youyou lu ming" (呦呦鹿鸣) describes the call of deer feeding on Artemisia — a coincidence that would later seem prophetic given her life's work with the Artemisia annua plant.

Tu grew up during a period of considerable upheaval in China, marked by the Second Sino-Japanese War and the Chinese Civil War. Despite these challenges, she pursued her education with determination. As a teenager, Tu's schooling was interrupted when she contracted tuberculosis, requiring her to suspend her studies for two years to recover. This experience with illness was formative; it deepened her interest in medicine and contributed to her resolve to pursue a career in medical research. Tu later reflected that the experience of suffering from a serious disease gave her a personal understanding of the importance of finding effective treatments.

After recovering from tuberculosis, Tu resumed her studies and set her sights on a career in pharmaceutical science. The post-war period in China saw the establishment of the People's Republic in 1949, and Tu came of age during a time when the new government was investing in scientific education and public health infrastructure. Her early years in Ningbo, shaped by traditional Chinese culture and the tumult of mid-twentieth-century China, laid the foundation for a scientific career that would bridge ancient herbal knowledge and modern medicine.

Education

Tu Youyou enrolled at Peking University (then known as Beijing Medical College's Department of Pharmacy) in 1951, where she studied pharmacology. During her studies, Tu received training in both modern Western pharmacology and traditional Chinese medicine, an educational combination that would prove instrumental in her later research. She graduated in 1955 with a degree in pharmacy.

Following her graduation, Tu was assigned to work at the Academy of Traditional Chinese Medicine (now the China Academy of Chinese Medical Sciences) in Beijing. Between 1959 and 1962, she participated in a training program in traditional Chinese medicine designed specifically for professionals with backgrounds in modern Western medicine. This two-and-a-half-year program deepened her understanding of classical Chinese medical texts and herbal remedies, providing her with the scholarly tools to systematically investigate the pharmacological properties of plants described in centuries-old Chinese medical literature. Tu did not hold a doctoral degree, a medical degree, or overseas study experience — distinctions that later made her Nobel Prize all the more remarkable in the context of the international scientific establishment, where such credentials are typically considered essential.

Career

Project 523 and the Search for an Antimalarial

Tu Youyou's career-defining work began in 1969 when she was appointed head of the malaria research group within Project 523, a secret Chinese military research program launched on May 23, 1967, by order of Mao Zedong. The project was initiated in response to a request from North Vietnam's leadership to China for help combating malaria, which was devastating troops during the Vietnam War. The disease was also a significant public health burden in southern China. At the time, the malaria parasite Plasmodium falciparum had developed widespread resistance to chloroquine and other existing antimalarial drugs, making the development of new treatments an urgent priority.

When Tu took charge of the research group at the Institute of Chinese Materia Medica in Beijing, she was 39 years old. The Cultural Revolution was underway, and many senior scientists had been sent to the countryside for "re-education." Tu was one of the few researchers with the appropriate training available to lead such a project. Her husband had been sent to work in the countryside, and Tu placed her young daughters — one an infant and the other a toddler — in the care of relatives so that she could devote herself to the research full-time.

Tu and her team adopted a systematic approach to the problem, beginning with an extensive review of traditional Chinese medical literature and folk remedies. The team collected and evaluated over 2,000 candidate herbal preparations from traditional Chinese medicine texts, narrowing these to 640 recipes with potential antimalarial activity. They then screened 380 extracts from approximately 200 herbs for activity against the malaria parasite in animal models.

Discovery of Artemisinin

Among the herbs investigated was Artemisia annua L. (sweet wormwood), known in Chinese as qinghao (青蒿). Qinghao had been used in traditional Chinese medicine for over two thousand years, with references to its fever-reducing properties dating back at least to the fourth century CE. However, early extracts of the plant tested by Tu's team showed inconsistent results, sometimes exhibiting antimalarial activity and sometimes not.

The breakthrough came in 1971 when Tu re-examined ancient Chinese medical texts and found a critical clue in a passage from the fourth-century Chinese physician Ge Hong's emergency handbook, Zhou Hou Bei Ji Fang (A Handbook of Prescriptions for Emergencies). The text described a method for treating malaria fevers using qinghao: "A handful of qinghao immersed with two sheng [approximately 400 ml] of water, wring out the juice and drink it all." Tu realized that the traditional preparation method involved cold extraction — soaking the plant in water and wringing out the juice rather than boiling it, as was common in most Chinese herbal preparations. She hypothesized that the high temperatures used in conventional extraction methods were destroying the active compound.

Acting on this insight, Tu redesigned the extraction protocol. She used a low-temperature extraction process with diethyl ether as the solvent, which allowed her to isolate the active fraction of Artemisia annua without degrading it through heat. On October 4, 1971, Tu's team obtained an extract — sample number 191 — that showed 100% inhibition of the malaria parasite in mice and primates infected with Plasmodium berghei. This was a pivotal moment in antimalarial research.

To accelerate the translation of this discovery into a treatment that could be used in the field, Tu volunteered to be among the first human subjects to test the safety of the extract. She and two colleagues from her research group ingested the qinghao extract themselves before it was tested on malaria patients, a decision reflecting the urgency of the wartime research context. Clinical trials in malaria patients followed, and the extract demonstrated clear efficacy against both Plasmodium vivax and Plasmodium falciparum malaria.

In 1972, Tu and her team succeeded in isolating the pure active compound from the extract, which they named qinghaosu (青蒿素), later known internationally as artemisinin. They also determined its chemical structure, identifying it as a sesquiterpene lactone containing an unusual peroxide bridge — a structural feature previously unknown in antimalarial compounds and critical to its mechanism of action against the malaria parasite.

Development and Global Impact

Following the isolation and structural determination of artemisinin, Tu's team and collaborating groups across China worked to develop the compound into a practical drug. They synthesized derivatives of artemisinin, including dihydroartemisinin, which Tu herself developed and which proved to be more effective than the parent compound. Other derivatives, including artesunate and artemether, were developed by other Chinese research teams and became widely used in clinical practice.

The results of the Chinese research on artemisinin were initially published in Chinese-language journals and were slow to reach the international scientific community, in part because of China's relative isolation during and after the Cultural Revolution. It was not until the 1980s that artemisinin-based treatments began to attract global attention. By the 1990s and 2000s, the World Health Organization had recognized artemisinin-based combination therapies (ACTs) as the most effective treatment for uncomplicated P. falciparum malaria, and ACTs became the first-line treatment recommended by the WHO for malaria worldwide.

The impact of artemisinin on global public health has been substantial. Malaria kills hundreds of thousands of people each year, predominantly children in sub-Saharan Africa, and artemisinin-based therapies have been credited with significantly reducing malaria mortality rates. Tu herself described artemisinin as "a gift from traditional Chinese medicine to the world" in her Nobel Lecture.

Throughout her career, Tu held the position of researcher and, later, director of the Artemisinin Research Centre at the China Academy of Chinese Medical Sciences in Beijing. She continued to work on artemisinin and its derivatives well into her later years, investigating potential applications of the compound beyond malaria, including its possible activity against other diseases.

Working Conditions and Challenges

Tu's research was conducted under difficult circumstances. During the Cultural Revolution, academic life in China was severely disrupted, and scientific research was subject to political constraints. The work on Project 523 was classified as a military secret for many years, and individual researchers were not credited for their contributions. Tu and her colleagues worked in laboratories that lacked modern safety equipment; prolonged exposure to organic solvents during the extraction work reportedly affected Tu's health, and she developed toxic hepatitis. Despite these hardships, Tu persisted in her research, driven by the urgent need for an effective antimalarial treatment.

The question of credit for the discovery of artemisinin was a source of controversy for decades. Because Project 523 involved hundreds of researchers across multiple institutions in China, and because the political culture of the era emphasized collective achievement over individual recognition, it was difficult for international observers to determine who deserved primary credit. Tu's role as the leader of the research group that first identified, extracted, and characterized the active compound was eventually established through historical research and the testimony of colleagues.

Personal Life

Tu Youyou married Li Tingzhao, a metallurgical engineer. The couple had two daughters. During the early years of Project 523 research, Tu's commitment to the classified military project required her to be away from her family for extended periods. She entrusted the care of her young daughters to relatives, including placing her younger daughter in a nursery, in order to focus on the malaria research. When she finally reunited with her older daughter after an extended absence, the child reportedly did not recognize her.

Tu has been described as modest and reserved. She lived and worked in Beijing for most of her professional life, remaining at the China Academy of Chinese Medical Sciences. Despite her Nobel Prize and international fame, Tu has maintained a relatively low public profile. She did not attend the Nobel Prize ceremony in Stockholm in person in December 2015 due to health reasons, though she delivered her Nobel Lecture there.

Tu has been characterized as someone who lacked the conventional markers of elite status in the Chinese scientific establishment — she did not hold a doctorate, had no overseas research experience, and was not a member of any Chinese national academy, earning her the informal designation of the "three nos" (三无) scientist. This background made her international recognition all the more notable and prompted discussion within China about the criteria used for recognizing scientific achievement.

Recognition

Tu Youyou's work went largely unrecognized by the international scientific community for decades after the initial discovery of artemisinin in the early 1970s. The secrecy surrounding Project 523, the collective attribution practices of the Cultural Revolution era, and the limited exchange between Chinese and Western scientific communities all contributed to this delay.

The first major international recognition came in 2011, when Tu was awarded the Lasker–DeBakey Clinical Medical Research Award, one of the most prestigious honors in American medicine, for "discovering artemisinin as a treatment for malaria." The Lasker Foundation described her work as having led to "the most powerful antimalarial drug" and noted that it had "saved millions of lives." Tu was the first Chinese scientist to receive a Lasker Award.

In 2015, Tu was awarded one half of the Nobel Prize in Physiology or Medicine. The Nobel Assembly at the Karolinska Institute cited her for "her discoveries concerning a novel therapy against Malaria." She shared the 2015 prize with William C. Campbell and Satoshi Ōmura, who received the other half for their work on avermectin, a treatment for infections caused by roundworm parasites. Tu was the first Chinese woman to receive a Nobel Prize and the first citizen of the People's Republic of China to win a Nobel Prize in a natural science while based in mainland China.

In her Nobel telephone interview, Tu expressed her hope that the recognition would inspire young Chinese scientists and encourage further integration of traditional Chinese medicine with modern scientific methods.

In 2019, Tu was among the recipients of China's Medal of the Republic, the country's highest state honor, awarded in recognition of her contributions to the nation's development. A special issue of Medicinal Research Reviews was published in 2021 in honor of Tu's 90th birthday, dedicated to her as "the director of Artemisinin Research Centre, China Academy of Chinese Medical Sciences."

Legacy

Tu Youyou's discovery of artemisinin is considered one of the most significant contributions to tropical medicine in the twentieth century. Artemisinin-based combination therapies remain the cornerstone of global malaria treatment, and the World Health Organization estimates that these therapies have contributed to substantial declines in malaria morbidity and mortality, particularly in sub-Saharan Africa and Southeast Asia.

Tu's work demonstrated the potential of systematic, evidence-based investigation of traditional medicine as a source of new drugs. Her approach — mining ancient texts for therapeutic leads, then applying modern scientific methods of extraction, purification, structural analysis, and clinical testing — has been cited as a model for drug discovery that integrates ethnopharmacological knowledge with contemporary pharmaceutical science. In her Nobel Lecture, Tu emphasized that "artemisinin is a gift from traditional Chinese medicine to the world," underscoring her view that traditional medical knowledge, when subjected to rigorous scientific investigation, can yield treatments of global significance.

Her recognition also had a broader cultural and political impact within China. Tu's Nobel Prize stimulated renewed interest in traditional Chinese medicine as a resource for modern drug development, and the Chinese government increased funding for research in this area. At the same time, Tu's status as a "three nos" scientist — lacking a doctorate, foreign training, or membership in a national academy — prompted reflection on the criteria used to evaluate and promote scientific talent in China.

The story of artemisinin's discovery also raised important questions about scientific credit and the recognition of contributions made within collective research programs. The decades-long debate over who deserved credit for the discovery highlighted the challenges of attributing individual achievement within large, state-directed scientific projects, particularly those conducted under conditions of political secrecy.

Tu Youyou's career and achievements have been the subject of numerous books, documentaries, and academic studies. She has been held up as an example of perseverance in the face of adversity, having conducted her most important work during one of the most turbulent periods in modern Chinese history. Her legacy endures not only through the continued use of artemisinin-based therapies worldwide but also through the ongoing scientific investigation of traditional medicinal plants inspired by her pioneering approach.