In the spring of 1963, a rubella epidemic began in Europe and quickly swept around the globe. In the US alone, around 11,000 newborns died and 20,000 suffered birth defects, including deafness, heart disease, and cataracts. Hilleman was already testing a vaccine he had developed, but agreed to work with a vaccine from federal regulators, which he later described as “toxic, toxic, toxic.” By 1969, he had cleaned it up enough to obtain FDA approval and prevent another rubella epidemic. In 1971, he combines the measles, mumps, and rubella vaccines to make the MMR vaccine, replacing a series of six shots with two.
In 1978, having found a better rubella vaccine than his own, Hilleman asked its developer if he could use it in the MMR. The developer, Dr. Stanley Plotkin of the Wistar Institute in Philadelphia, was speechless. It was an expensive choice for Hilleman’s employer and might have been a painful one for anyone other than Dr. Hilleman. According to Plotkin, “It’s not that he didn’t have an ego. He certainly did, but he valued excellence above that. Once he decided that this strain was better, he did what he had to do,” even if it meant sacrificing his work.
It’s impossible to know how many lives Maurice Hilleman’s work has saved. By one estimate, it is eight million per year. Though he was forced to retire at age sixty-five, he continued to work for the greater good, serving as an adviser to the World Health Organization. He never won a Nobel Prize, but Hilleman did receive the National Medal of Science from President Ronald Reagan in 1988.
Youyou Tu
When it comes to deadly animals, sharks, cobras, and anything native to Australia, all pale in comparison to the mosquito, courtesy of its tiny passenger, malaria. For example, in 2008, plasmodia, the parasite that causes malaria, infected 247 million people and caused almost one million deaths. Symptoms include fever, headache, and vomiting. Malaria can quickly become life-threatening by disrupting the blood supply to vital organs. The disease strikes children hard, especially in sub-Saharan Africa. Thanks in part to traveling humans, malaria affects more than a hundred countries, from Asia, Latin America, the Middle East, to parts of Europe.
The single greatest arrow in our quiver in the fight against malaria was discovered by a doctor looking not only to the future, but also to the wisdom of the past. The drug, called artemisinin, was found in the 1970s by Chinese scientist Youyou Tu and her team, who discovered ancient references to a fever-easing plant in traditional Chinese medical texts. Because of their work, malaria death rates have decreased 47 percent worldwide; the rate of infection in children has dropped 46 percent.
Tu was born in Zhejiang, China in 1930. A tuberculosis infection interrupted her high school education but inspired her to go into medical research. Tu graduated from Beijing Medical University School of Pharmacy in 1955 and attended the China Academy of Chinese Medical Sciences to continue her research on Chinese herbal medicine.
While teaching and researching in 1969, Tu was suddenly appointed head of a group of chemists and pharmacologists for a top-secret military program. Project 523 was established by Chairman Mao with the goal of finding ways to prevent and cure malaria. For two years, the project had focused on developing Western-style antimalarial drugs, but synthetic compounds bore no fruit, so Project 523 turned to traditional herbal medicine for answers. This was a surprising turn of events, considering one of Mao’s objectives with the Cultural Revolution was to promote communist ideology by purging China of traditional literature and art. Because of this, scholars were considered the lowest caste of society, and scientific research was only sanctioned if the Communist Party decided the purpose was sufficiently practical. Tu was told she had been chosen because of her unique combination of skills—she had a degree in Western pharmacology, yet she could differentiate thousands of traditional herbs. Tu felt deeply honored to be appointed to the post, especially as a woman and relatively young, but she knew the task before her was a difficult one. Malaria can develop resistance to drugs faster than new ones can be created, and nearly a quarter-million compounds had already been tested by scientists around the world. Not making things any easier for Tu was the fact that her husband had been “sent down to the countryside” on a mandatory exchange program for “reeducation,” leaving her a single parent; she would often be separated from her daughter for long periods of time.
Tu and her team traveled from village to village to talk to traditional medicine practitioners and scoured libraries for every medical text they could find. In the end, they collected over 2,000 recipes for herbal, animal, and mineral-based compounds, choosing from these 640 with the most potential. Back in Beijing, her team began distilling those best bets into 380 herbal extracts they could test on mice. One challenge was overcoming the primitive conditions of their own lab, which was poorly ventilated against the harsh solvents the team used and had only household pots and pans as equipment.
By 1971, the researched began to zero in on the herb quinghao, or sweet wormwood. It first appeared in a silk scroll from the Han Dynasty two thousand years ago entitled Prescriptions for 52 Kinds of Diseases and was mentioned frequently in texts throughout the centuries as a remedy for intermittent fevers, a symptom of malaria. That still left the team with many questions: Which species of quinghao did the texts refer to? Where did it grow? Which part of the plant do you use and how should it be prepared? Other research groups joined the quest and after an exacting process of elimination, Artemisia annua L. was found to be the only variety of quinghao containing antimalarial properties. Despite this, disappointingly, no extract of it had produced a consistent effect on the lab mice.
The miraculous sweet wormwood.
Frustrated, Tu began rereading the ancient texts, searching for clues. A medical manuscript from the East Jin Dynasty, written in 340 CE, advise, “A handful of quinghao immersed in two liters of water, wring out the juice, and drink it all.” It was so simple! The team had been boiling samples and the heat had damaged the active ingredients. Tu immediately modified their methods and on October 4, 1971, they found a formulation that proved 100 percent effective in curing malaria-infected mice, though it would take an additional six years to isolate the drug’s molecular structure. Tests in infected monkeys were also successful. The next step was testing humans. To move the process along as quickly as possible, Tu and her team volunteered themselves as test cases. By August of 1972, Tu was able to perform clinical trials of artemisinin on thirty malaria patients. Tu presented the drug at a World Health Organization meeting on malaria in 1981 and the Chinese Ministry of Health finally officially approved artemisinin in 1986, fifteen years after Project 523 began.
In the 1990s, artemisinin gradually began replacing previous generations of medicines that had lost their effectiveness. Artemisinin was effective against even the most stubborn strains of malaria. In severe cases where patients were hospitalized, artemisinin cut the mortality rate in half. World Health Organization statistics for 2013 showed that malaria deaths had fallen from about two million per year a decade earlier to an estimated 584,000.
There was some controversy attached to Tu’s 2015 Nobel Prize in Physiology or Medicine, as hundreds of scientists had been involved. However, it was Tu herself who brought in the sweet wormwood plant and created a method for extracting the active ingredient, as well as leading the first human trials.
Frances Oldham Kelsey
A medical crisis need not be germ-based to spread dangerously. Beginning in 1960, tens of thousands of babies were born with improperly developed limbs, and, in some cases, malfunctioning eyes, ears, or other organs. It was a tragedy as had never been seen before, catastrophically striking families