For tropical medicine researcher Nick White, victory has been a long time coming. Since the early 1980s, the Thai-based medical doctor, who is recognized as one of the world's top authorities on malaria, worked to get international relief agencies to acknowledge that established treatments for the disease were no longer effective. Instead, he argued, medical workers should be given the green light to use artemisinin, an herbal drug from the wormwood plant that has been a staple of traditional Chinese medicine for thousands of years.
This past spring, White's arguments finally hit home. The World Health Organization (WHO) and other multinational agencies changed their policy and admitted what White had known for years: The unconventional Chinese drug could bring desperately needed relief in the war against malaria, a disease that kills 3,000 people a day, mostly in Asia, Africa, and Latin America.
White, director of the Wellcome Trust's Southeast Asia unit, cautions against declaring the artemisinin treatments a medical breakthrough. Still, he does believe that the new policy opens up a major bureaucratic logjam. "The breakthrough is the realization by international agencies that we have here a very effective antimalarial drug," says White, who in addition to his work in Thailand has opened a clinic in Ho Chi Minh City, Vietnam.
White first read about artemisinin in 1981 when a friend in Hong Kong forwarded an obscure journal article about the herb's use in China to him and his colleagues. White was impressed with the amount of research that had already been done in China, which showed that artemisinin acts faster than commercial drugs and that no malaria strains are resistant to it yet. Yet the international health-care bureaucracy doesn't move quickly, and White became frustrated with the lack of progress in making artemisinin available to people at risk of contracting the deadly parasite that causes malaria. So he helped organize trials instead. "Gradually we began to build up experience," he says. In those tests, "the number of cases fell dramatically."
In 1998, White was named chairman of a WHO task force focusing on drug-resistant diseases. That gave him the chance to coordinate trials not only in Asia but also in sub-Saharan Africa. As doctors saw that artemisinin was working, the pressure for change mounted.
White, a 53-year-old Englishman, has been fighting tropical diseases his entire career, starting with a program in Nepal shortly after he finished medical school. He says that now that artemisinin is an approved treatment, the urgent need is to find the funds to make it available. "We need to get our act together to get the money to do this job," he says. While White emphasizes that he is not a lobbyist, he passes up no opportunity to sing the praises of the drug that he thinks can finally diminish the toll of one of the world's biggest killers.