On the evening of October 5th, 2015, Tu Youyou, aged 85, received a phone call at her home in Beijing from Adam Smith, congratulating her on sharing half of this year’s Nobel Prize in Physiology or Medicine, for ‘her discoveries concerning a novel therapy against Malaria’. It was four years after Tu received the Lasker Prize the most prestigious in medicine, and about forty years after she and her team discovered the method to isolate Artemisinin from the herb Artemisia annua (qinghao, 青蒿) This herb had been used by Chinese herbalists for thousands of years to treat many illnesses, including Malaria.
When the phone call arrived, Tu was surrounded by her colleagues from the China Academy of Chinese Medical Sciences who came to congratulate her, and she received the praise of the top leaders and broad national media coverage. Amid this overwhelming enthusiasm towards China’s long-awaited Nobel[1], a growing number of observers sharpened their criticisms of China’s science and technology institutions, including the Academician election procedures, and debated on what this award meant for Traditional Chinese Medicine.
Attention has also been directed at how well China moves basic science into practical application. An old news report resurfaced on the struggles the Chinese scientists encountered in developing Artemisinin into an acknowledged drug by the World Health Organisation (WHO) to treat Malaria. It was after Tu won the Lasker Prize that the journalist Liu Wu investigated why such a scientific breakthrough was translated into a WHO’s first-line treatment against Malaria by a foreign pharmaceutical company Novartis, while the domestic companies only hold a share of less than 10% in the international anti-Malaria market[2].
While the Nobel Prize awards the greatest discovers of the day, the motivation of the WHO in the Artemisinin story was to choose reliable manufacturers whose products are proven through multi-centred clinical trials and performed according to internationally acknowledged rules and standards[3]. The Chinese scientist team failed in meeting those standards in the early 1980s, and despite the often-cited occurrence of Chinese intellectual property infringement, they had no idea about protecting their own intellectual property. It is considered a hard lesson learned both by Chinese scientists and the nascent pharmaceutical industry, as Zhang accounts in his detailed book chronicling the work of Project 523. The situation is described by McNeil Jr. for the New York Times:
“Different labs in and outside China were working on derivatives [of Artemisinin]. Patent law had vanished under communism, and China never took out Western patents, so there was no way a major drug company could get a monopoly and make big profits. Malaria was a disease of the poor, and today’s big donor funds did not exist… Aid agencies could not buy drugs that were not W.H.O.-approved”.
It was Novartis who finally bought a Chinese patent and developed the drug for use, later selling it to WHO in 2001. Large international donors – The Global Fund to fight HIV/AIDs, TB and Malaria financed by the Gates Foundation and The President’s Malaria Initiative – have enabled mass distribution.
However, things are somewhat different today.
Not only has the pharmaceutical industry witnessed the rise of China to become the second largest market in the world, with considerable development of its domestic companies, but also China’s growing interest in ‘innovation’ has broadened and integrated into political and economic reforms since the early 2000s. When Tu received the news she referred to the importance of the ‘innovation spirit’: “…we worked very hard to find anti-malaria drug artemisinin and to save millions of lives. It shows that as a scientific worker we need innovation spirit to find new things”. The idea of innovation as a driver of the economy and (to a lesser extent) forbearer of social good has become a persuasive one in China.
This was formally enshrined on January 2005, at the Fourth National Congress on Science and Technology, China’s President at the time Hu Jintao announced China’s new development goal in the 21st century: to become an ‘innovation-oriented’ country. Subsequently, a detailed guideline was published titled ‘National Medium- and Long-term Program for Science and Development (2006-2020)’. The concept of 自主创新 (zizhu chuangxin), often translated as ‘indigenous innovation’, was coined and has since attracted worldwide attention.[4]
International commenters still remain concerned about China’s weak performance in upholding intellectual property rights and doubt that China has real innovation capacities – as shown in this Harvard Business Review article. The situation was quite the opposite if we consider Tu’s discovery and such concerns may soon become outdated. In the recent Global Innovation Index 2015 Report, China was identified to be ‘innovation achiever’ and pitted as an exemplar along countries such as India and Kenya. In addition to increasing expenditures on science and technology, Chen et al. (2015) delineated China’s science and technology policy evolution in the past thirty years, and outlined a new wave of policy change initiated by its current leaders, President Xi Jinping and Premier Li Keqiang.
The areas of policy reforms they highlighted ranged from introducing China’s version of the Bayh-Dole Act[5], issuing the 2014-2020 Action Plan on the Implementation of National Intellectual Property Strategy, to fostering grassroots entrepreneurship. It is clear to the Chinese leaders, scientists, engineers and entrepreneurs that innovation is more than discoveries and breakthroughs. And it seems China has started to address some of the concerns in regard to its innovation policies.
In Alfred Nobel’s will, he wrote that ‘prizes [shall be annually distributed] to those who, during the preceding year, shall have conferred the greatest benefit to mankind’. This year’s Nobel Committee awarded Campbell & Ōmura and Tu because their discoveries helped ‘to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable’. Chinese leaders and innovators should keep this critical fact in mind if they are to integrate social innovation into its overall innovation package. Issues such as social and economic inequality cannot be addressed alone, by science and technology, or by the market. Artemisinin shows all of these components matter.
Notes.
[1] The last was in 2012 in Literature and before that Peace in 2010 and Physics in 1957.
[2] Miller and Su had first brought attention to Tu when they had researched the origins of Artemisinin and were able to identify her as one of the main protagonists, even though isolating the efforts of a large scientific project has proved controversial.
[3] Such as WTO’s TRIPS Agreement and WHO’s Good Manufacture Practice.
[4] See: http://www.nesta.org.uk/publications/chinas-absorptive-state-innovation-and-research-china
[5] Allowing universities and public institutions to issue patents from public funding for R&D.
