The Bite In The Anti-Malarial Drug
The Nobel for China’s Tu Youyou for discovering artemisinin has upset Indian scientists
|The Charges||The counter|
The old Indo-Chinese rivalry is coursing through the Indian scientific establishment ever since China’s Tu Youyou bagged the Nobel for medicine earlier this month. After her recognition for discovering the anti-malarial artemisinin, there’s a growing sense that the Nobel committee may have overlooked the work of Indian scientists in the same field. Letters are flying thick and fast, as China’s first Nobel for science has become an occasion for Indian scientists to draw attention to their own work on the anti-malarial drug and draw credit they rarely get.
Some scientists even argue that malarial research in India rivals Chinese achievements on “scientific principles”—in the sense that it was done according to globally accepted scientific practice in methodology and publication. Others say Tu’s work was based on traditional knowledge so no single person can be credited for it. Implicit in this is the charge that China has been making a stronger case for its researchers in world fora, pushing in the right places to win them awards, while Indian efforts remain unknown.
R.S. Thakur, 84, a scientist who worked on artemisinin in the government’s labs in the 1980s, believes this work deserves at least as much acknowledgement from the Nobel committee as Tu’s. He says Tu’s discovery was during the ‘Cultural Revolution’, and true to that period, the work was published only in China and remained isolated from international peer review and criticism. “China’s isolation at that time raises questions on the research’s scientific merit. One wonders if certain practices of Tu—such as testing the initial compound on herself—pass the Nobel standards for ethics,” says Dr Thakur, who retired as a director of the Central Institute for Medicinal and Aromatic Plants (CIMAP), Lucknow.
The plant source of artemisinin, a wormwood shrub of the scientific name Artemisia annua, grows wild in China and has been used as traditional medicine to treat fever since the 4th century. Chinese doctors would have therefore known of its specifically anti-malarial potential. When Chinese scientists like Tu conducted studies to discover the active ingredients, the results were inaccessible to scientists elsewhere. “There was no report on scientific findings from Tu Youyou,” says Thakur. “CIMAP’s work, on the other hand, followed standard international protocols, including tests for efficacy, toxicity and so on. We did not use short-cuts such as testing on humans.”
Much of the work of converting the active ingredients into an anti-malarial drug was done in India, according to Prof Anil Kumar Tripathi, the present director of CIMAP. “I would not like to make as strong a statement as ‘We should have got the Nobel’, but we would like to emphasise that while the Chinese discovered artemisinin, it was not concretised into a medical discovery (or application) there—it’s we who did that,” he says.
Using seeds imported from London, CIMAP grew the shrub and started extracting artemisinin in 1981. But the yield was of “low quality” and “unstable”. So the Central Drug Research Institute was called in as collaborator and a high-yielding variety of A. annua was developed in India, bringing down production costs from Rs 45,000 to Rs 10,000 per kilo. Thousands of farmers, and the pharma industry, were brought in to eventually develop an affordable drug. “Millions of lives were saved,” says Tripathi.
These stages were recorded in a scientific paper co-authored by Thakur, then a CIMAP scientist, in 1986. Then, the extraction process and related developments were patented. “I think the Chinese research was taken over by Americans—they highlighted it. Our original paper of 1986 didn’t come into the limelight,” says Tripathi, who has now written about this work to the Indian National Science Academy, the National Academy of Sciences and the Indian Academy of Sciences. His letter says: “It may be relevant to underline that ‘proof’ is more important than the ‘concept/principle’.” Clearly, the reference is to China getting a Nobel for something Indians had rigorously worked out.
At a time when the Indian government is pushing research institutions to raise half their funding on their own, Tripathi’s letter takes pains to highlight how Indian scientists have taken their work beyond the lab, to practical use. It says: “Indian scientists have amply proven their ability to translate basic research on artemisinin to artemisinin-based therapies to shoulder the national responsibility of affordable healthcare for millions.... I hope... (this) should convince and satisfy our policy planners that scientists of our country have the desired level of concern, commitment and grit to solve the problems of our country.”
Chinese Nobel winner Tu Youyou tested the anti-malarial drug on herself—sounds dramatic, but not exactly the model of scientific practice.
It remains, however, that Tu’s work dates to the 1970s, a decade before the Indian labs, prompted by international reports on artemisinin, began their work on the plant. “A discovery is a discovery, no matter the language it was in,” says Prof R.C. Dhiman, a scientist with the National Institute of Malaria Research. “Once the Nobel has been awarded, it is awkward to bring up claims.” But there are those who aren’t averse to raising questions. Dr Sunil Kumar Verma, a senior molecular biologist from Hyderabad, raises a question as a practitioner of science. Was Tu really the first to discover artemisinin as a malaria cure? His view is that artemisinin is a variety of artemisin, and while the former is extracted from A. annua, native to China, the latter is obtained from A. maritima, which is found to grow in India. But both traditional fever-curing plants have been named in old Indian treatises on medicine. “A 500-year-old Indian book mentions these plants. And in 1918, B.D. Basu’s Medicinal Plants of India described the plant as curing ‘remittent and intermittent’ fever—what we now call malaria,” says Verma. “Something more should have been achieved by Tu Youyou so that her discovery didn’t fall within the domain of previous knowledge. Right now, the award going to China seems like a political rather than a scientific move.”
It was only in the 1880s that the term malaria specifically came to be applied to a certain specific type of fever caused by a protozoan and spread by mosquitoes. Therefore, scientists perusing older texts infer the illness meant to be treated by reading descriptions of symptoms. The ancient Chinese text Tu relied on for a recipe to extract artemisinin is 1,700 years old. Her award, the Nobel committee has said, is for elucidating what part of that herb—the bioactive constituent of it—treats malaria. This, they said, paved the way for large-scale artemisinin production. Says Verma, “If a minor variant of a well-known compound extracted from a plant found around the world can be given the Nobel, poorer countries will be the losers, as scientists from technologically advanced societies can always find plants with similar chemical compounds elsewhere and extract the ingredient from them. Communities with traditional cures will lose out,” he says.
Whatever be the case, Tu’s award is being hotly debated in China as well. In a recent interview with the New York Times, she said that the Chinese government had once assigned “acupuncture specialists” to cure malaria patients—unsuccessfully. She admits self-injecting the drug to allay safety concerns: “Two colleagues and I took it to show that it wasn’t lethal. I thought it was my responsibility as a medical chemist and all part of the job.” Obviously, some Indian scientists disagree with that last point!
After the article was printed, the Secretary-General of the Nobel Assembly for Physiology or Medicine, Professor Urban Lendahl respond?ed to Outlook's questions. Edited excerpts?
Since the award went to China's Tu Youyou this year for medicine, there are claims by Indian scientists who believe that similar scientific works were underway in India. So?? me also believe the award for China's work relates to Chinese traditional medicine.
The discovery the award was made [for was] in the early 1970s and there are of course works that have followed since the original discovery; but the Nobel Prize is always awarded for the original discovery that changes the direction of a research field. The discovery by Tu Youyou was inspired ?b?y Traditional Chinese Medicine, but to bring the discovery all the way to a functional therapy, modern experimental technologies were also required.
Have the scientists (as they claim) approached the Nobel Foundation with their counterclaim following the announcement of the award this year?
We, by principle, do not discuss other scientists work, only what we award in the Prize.
Also, are such counterclaims unusual? Is there any precedent for review or change in the decision of the Committee?
There have been no formal claims this year, and to my knowledge not in previous years. A decision is never altered.
By Pragya Singh in Delhi
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