Chinese traditional healers had been using the leaves of the sweet wormwood plant, orqinghao, for two centuries to treat malaria and fevers when
Project 523 began. Though villagers in Southern China knew of the plant's curative properties, it took the better part of a decade for government and
military researchers to isolate one particular chemical and the correct dosing that would cure malaria, not kill the patient.
As Yi describes it, Project 523 was a massive undertaking, especially in a China convulsed by the destructive decade of the Cultural Revolution, a movement
that ruined many other academic institutions and set back scientific research for years. Yi says the project itself withstood turmoil by pulling in
hundreds of scientists and researchers, many of whom didn't last long and were replaced as others were purged. Often, scientists would work for a year only
to be replaced as they were consumed by political vendettas. "Participating institutions were spread across China, involving hundreds of individuals from
Beijing, Shanghai, Yunnan, Shandong, Guangdong, and Guanxi, which borders Vietnam," Yi wrote. "It was undoubtedly a large collaborative project with
contributions from administrators, scientists, and soldiers who volunteered for tests of the early treatments."
Chemist Tu Youyou joined the project in 1969, a time when "most senior scientists could barely survive the 'struggles' against them."
Tu got most credit for the discovery, despite its having been the result of the work of 50 institutions and more than 500 scientists. In 2011, she
became the first Chinese scientist working in China to receive the $250,000 Lasker-DeBakey Clinical Medical Research Award, a
prestigious U.S. foundation prize given for medical advances.
Malaria-focused aid groups say artemisinin and resulting ACTs are revolutionary tools for Africa, yet the intriguing tale of the drug's invention in China
and its eventual emergence as a first-line treatment is getting lost in the deadly battle against fakes and counterfeits.
Festus Ilako, Tanzania Country Director for the African Medical and Research Foundation, is confident ACTs have dramatically reduced malaria deaths and
that the disease can be defeated with the drugs. Unfortunately, the prevalence of fake medicines in Tanzania, Uganda, and elsewhere across East Africa is
worsening, according to medical professionals and academics.
"There's actually quite a lot of success against malaria in recent years, mainly because there are very effective medications that are available," Ilako
said in an interview in Dar Es Salaam. "Artemisinin, when it's used, kills 90-95 percent of the parasites."
But when it's fake, it cures nothing.
The reporting in Africa for this story was funded by the Pulitzer Center on Crisis Reporting. To see more stories in this series, click here.This post also appears at ChinaFile, an Atlantic partner site.