Innovation on ancient Chinese medicine: China’s Tu Youyou 'not very' surprised at Nobel Prize win

China’s joint Nobel Prize winner for medicine Tu Youyou, who has been recognised for her work on a drug used to treat malaria, said she was “surprised, but not very surprised” by her award and claimed it was an honour for all scientists in China.

The scientist earned half of the award for her work on artemisinin, a drug based on ancient Chinese herbal medicine, which had significantly reduced the mortality rates of malaria patients, the Nobel Assembly at Sweden’s Karolinska Institute said on Monday.

READ MORE: Chinese Nobel Prize winner Tu Youyou’s drug has saved lives of millions of malaria sufferers

“I don’t have special feelings [about winning the award],” said Tu, 84, who is the first Chinese national to win a Nobel Prize in science.

“I was a little bit surprised, but not very surprised,” she was quoted as saying by Zhejiang Evening News.

“Because this is an honour not only for myself, but also for all Chinese scientists. We all did decades of research together."

Tu has been a controversial figure in mainland science and was criticised by some Chinese scientists for not crediting her team.

However, she put great emphasis on teamwork when she was interviewed by state broadcaster CCTV on Tuesday morning – attributing the discovery of artemisinin to the whole research team.

“It shows that Chinese medicine’s scientific research has gained great attention from international science, which makes me very glad,” Tu said.

She also recalled that the research had been a difficult process.

“I carried out research on more than 200 traditional herbal medicines, and there were more than 380 different ways of extraction, but none of them worked,” she said, adding that the effective component for treating malaria had been discovered after completing 191 experiments.

Premier Li Keqiang was just one of the many mainland people to congratulate Tu after news of her success was announced.

READ MORE: How the West waited 20 years to use Tu Youyuo's Nobel prize-winning malaria discovery

He said her win showed the prosperity and progress of China’s science and technology, the huge contributions that Chinese medicine had made to human health, and the continuing increase of the Chinese nation’s power and international influence.

Tu told Adam Smith, chief scientific officer of the Nobel organisation’s media arm, through an interpreter on Monday: “I am very glad that the new anti-malaria drug, artemisinin, has earned international recognition from the Nobel Prize committee. Chinese people have wished to win the Nobel Prize for a long time.”

She said when her team of scientists first started their research into a drug to treat malaria the effectiveness of the original medicine had become reduced and they had needed to work hard to find a new substitute.

“This shows that as a scientist we need an innovative spirit to discover new things,” she said.

Her success has sparked huge interest in China, with other senior officials, relatives and even former school classmates joining Li in congratulating her.

Officials in her hometown, Ningbo city, in eastern Zhejiang province, said Tu’s former home would be preserved, while the People’s Daily newspaper, the ruling Communist Party’s flagship mouthpiece, published the story of her award and her photograph on the front page.

Tu’s relatives and former schoolmates in Ningbo also praised her achievement.

“The whole family feels happy for her!” one of Tu’s relatives in Ningbo wrote on WeChat. “But she told us to keep things low profile and not to tell everyone about it.

“She is the pride of our family, the pride of the Ningbo people, and the pride of the Chinese people!”

Weng Maokang, Tu’s former classmate at Ningbo Secondary School, said: “She was a very ordinary person, always wearing plain clothes and seldom caught anyone’s attention. She was the type of person that always kept a low profile.”

Tu’s husband, Li Tingzhao, said Tu now suffered from poor health, including diabetes, and was feeling “very tired” because of all the attention she had received following the announcement.

“She doesn’t go out often,” Li was quoted as saying, adding that Tu was not planning to hold any press conference.

A modern use for an ancient drug

What is artemisinin?

Artemisinin kills plasmodium parasites that cause malaria.

The drug is derived from a plant called sweet wormwood - Artemisia annua in Latin, or "qinghao" in Chinese.

It is in use today because of work in 1970s by Tu and her team, who spotted references to a fever-easing plant in ancient Chinese medical texts and sought to extract the active ingredient to combat malaria.

From the 1990s, artemisinin gradually took on a frontline role, replacing previous generations of medicines that had lost their effectiveness as malaria parasites became resistant to them.

How did the drug change malaria treatment?

Artemisinin has greatly increased the odds of survival for people hit with the most stubborn strains of the disease.

The chances of dying from malaria have been halved from one in five a decade ago to nearly one in 10 today in severe cases where people are hospitalised.

It is an element in a broader strategy to fight malaria, which includes simple, low-cost measures such as distributing insecticide-treated bednets.

The coordinated effort had reduced the number of deaths by nearly three-quarters over the past decade, said parasitology expert Colin Sutherland at the London School of Hygiene and Tropical Medicine.

World Health Organisation statistics show malaria deaths have fallen from about two million per year in the early 2000s to an estimated 584,000 in 2013.

What does the future hold for it?

The malaria parasite has a tremendous ability to mutate, causing it to build resistance to treatments when used incorrectly.

From the 1950s to 1970s, chloroquine-resistant parasites spread from Asia to Africa. Chloroquine was then replaced by sulphadoxine-pyrimethamine, which itself lost its parasite-killing powers and was followed by artemisinin.

In February this year, researchers said they had observed malaria strains showing resistance to artemisinin in Myanmar, and raised fears that this could spread.

In Africa, where malaria claims most of its victims, some artemisinin-based therapies were also no longer working as well as they used to, doctors reported.

At a WHO meeting later this year, experts will consider recommendations to beef up the combination therapy, perhaps by increasing doses of the drug or the duration of treatment on malaria patients.