Artemisia annua, Artemisinin, ACTs & Malaria Control in Africa : Tradition, Science and Public Policy
Malaria is thought to be among the oldest of human diseases (Russell, 1955; Bray, 1996; Carter, 2002; Sallares, 2002; Nerlich et al., 2008; Cunha, 2008). It
has long had serious effects on morbidity and mortality, and in turn on the economic and social fabric of nations and society. Various methods have
long been utilized to mitigate its frequency and effects in both temperate and tropical climates. This has proven to be a never-ending battle requiring
constant attention. As stated by Hackett in 1937: “Everything about malaria is so molded by local conditions that it becomes a thousand different
diseases and epidemiological puzzles.” This paper recounts the events relating to the most important chemotherapy (drug) approach to the control
of its most severe form, P. falciparum, which predominates in Sub-Saharan Africa (Guerra, et al., 2008). In the process it provides an introduction to to
the vast array of literature available, much of it now on line.
More:
http://www.mmv.org/sites/default/files/uploads/docs/publications/Malaria_Book.pdf
Synthetic anti-malarial compound is bad news for artemisia farmers
Artemisinin breakthrough by synthetic biologists threatens to open new front in battle between microbes and people
In the constant fight between microbes and people, attempts to rein in the malarial parasite have just taken an interesting turn. On Thursday the founder of Amyris Biotech triumphantly announced production of 70m doses of the anti-malarial compound artemisinin. This sounds like good news for poor people but may be a step backwards – the start of a new hi-tech assault on farmers. There is no doubt that artemisinin is important. Artemisinin combination therapies are the World Health Organisation's drug of choice for battlingmalaria – which caused an estimated 660,000 deaths in 2010 – and other artemisinin-based approaches also exist.
Yet the good news stops there. Until this week, artemisinin for drugs was sourced entirely from the delicate leaves of artemesia annua (sweet wormwood) following sustained efforts to develop artemesia growing as doubly beneficial: a source of livelihood for African and Asian farmers, and a public health good. What makes Amyris's breakthrough significant is that its version has never been near a wormwood shrub. It comes from an industrial vat of bioengineered yeast.
Making this possible is a controversial technology called synthetic biology (synbio). This artificially builds DNA strands in labs, using those strands to re-engineer microbes to behave as tiny factories. Ordinary yeast might ferment sugar into alcohol. Instead, this re-engineered yeast turns sugar into a precursor of artemisinin. This technical breakthrough, nine years in the making, was enabled by $53.3m (£34.6m) from the Gates Foundation. It is held up as the poster child for the brave new world of synbio.
More:
WHO Position Statement (June 2012)
Effectiveness of Non-Pharmaceutical Forms of Artemisia annua L. against malaria
The World Health Organization (WHO) recommends artemisinin-based combination therapy (ACT) for the treatment of uncomplicated malaria due to Plasmodium falciparum (P.
falciparum). ACTs recommended by WHO combine an artemisinin derivative such as artemether, artesunate or dihydroartemisinin with an effective antimalarial medicine. The
five currently recommended ACTs are listed in the WHO guidelines for the treatment of malaria, 2010 (1). A number of herbal remedies made of Artemisia annua L. (A. annua) dry
leaves are suggested for the treatment and prevention of malaria. However, WHO does not recommend the use A. annua plant material ,in any form, including tea, for the treatment or
the prevention of malaria
More:
http://www.who.int/malaria/position_statement_herbal_remedy_artemisia_annua_l.pdf
ARTEMISIA ANNUA L.: THE HOPE AGAINST MALARIA AND CANCER
Malaria is a major scourge of humankind which continues to defy science and technology. Malaria afflicts ca. 500 million people a year worldwide, killing
approximately 2 million of the people who live in endemic regions, which is 41% of the world population (Martens and Hall, 2000). Most victims of malaria are children
from the sub-Saharan Africa, but victims are also counted all over the tropical world. Although malaria has been eradicated from the US and Europe, it still claims
approximately 1,500 cases a year in the US and a few other cases in Europe, mainly around international airports. Malaria is transmitted by Anopheles mosquitoes, and
has the potential to cause outbreaks in the US, where the mosquito vector is found in all 48 continental states. Malaria has been slowly and steadily coming back, and is
developing global resistance against two of the most common antimalarial drugs: chloroquine and the combination sulphadoxine/pyrimethamine (Ridley, 2002).
http://www.ars.usda.gov/SP2UserFiles/person/34667/Ferreira-ArtemisiavsMalariaandCancer.pdf
http://www.hort.purdue.edu/newcrop/cropfactsheets/artemisia.pdf
http://www.youtube.com/watch?v=SE9SVhxBKr4
Artemisia annua - Cultivation methods of a plant with a great future
http://www.youtube.com/watch?v=SE9SVhxBKr4
KENYA: Small farmers cash in on Artemisinin production
NAIROBI, 21 January 2009 (IRIN) - East African farmers are key suppliers of the active ingredient in the most effective malaria drug available.
Although the Artemisia annua plant (sweet wormwood) is not native to the region, East Africa “is now the third most important growing region in the world”, said Nigel Bremner, commercial manager of Botanical Extracts EPZ Limited (BEEPZ), after China and Vietnam, where it is indigenous.
Speaking to IRIN from his office in Athi River, site of Kenya’s export promotion zone (EPZ), Bremner said cultivation of the herb started more than 12 years ago. Growing in earnest started in 2002 with three to four farmers contracted by BEEPZ to plant about 40ha. Artemisia annua cultivation now supports at least 4,000 smallholder farmers growing more than 4,000ha of the cash crop in 2009, from 2,000-3,000ha last year.
More at:
http://www.irinnews.org/report/82486/kenya-small-farmers-cash-in-on-artemisinin-production
The rise to prominence of Artemisia annua L. – the transformation of a Chinese plant to a global pharmaceutical
This paper focuses on the transformation of a recently promoted medicinal plant named Artemisia annua L. For over 2000 years, the Chinese have used A. annua as a herbal tea
preparation against malaria. Pharmacological studies led to the isolation of artemisinin as the principal anti-malarial compound. Since 2001, the World health Organisation (WhO) has recommended artemisinin-based combined therapies (‘ACTs’) for the treatment of malaria – novartis is the leading actor to extract the compound in tablet form. in the 1990s, A. annua was introduced to Tanzania. Beside the local plant-based promotion of Artemisia-tea as an efficient, inexpensive natural practice to treat malaria, Tanzania hosts influential actors who seek to commercialise the plant. By following the biography of the Chinese medicinal plant, its global transfer, production, marketing, distribution, consumption, and its transformation to a highly demanded commodity, the paper critically reveals the dialectics and reciprocities
between different actors and their relation to existing powerful reference systems (such as WhO, Pharmaceutical industry)
More at:
http://www.ajol.info/index.php/asr/article/viewFile/70234/58423
http://artemisia-for-all.org/wordpress/wp-content/uploads/Silves.pdf
Agriculture, Artemisia annua, Artemisinin, ACTs and Malaria Control in Africa: The Interplay of Tradition, Science and Public Policy The key ingredient in the leading treatment for malaria in Africa - artemisinin - comes not from high-tech research, but is an extract of an ancient medicinal plant, Artemisia annua, commonly known as Artemisia. Quinine and replacement drugs have lost effectiveness with the development of resistance. Derivatives of artemisinin combined with other drugs have
shown good efficacy in resistance. Known as artemisinin–based combination therapies (ACTs), they provide the most effective treatment at present. This has led to efforts to
increase cultivated production of Artemisia in the short run and to develop, through biological and chemical research, synthetic substitutes in the longer run. The resulting juxtaposition of activities and players provides both opportunities and challenges for society. While individual components have been examined, there is little in the way of comprehensive analysis. This paper attempts to weave the many complex and dynamic components - historical, scientific, technical, economic - together in order to aid understanding of the issues and facilitate development of informed public/private policies and actions. Although focused on Africa, the main components and issues are global in nature and resolution and relate to more general issues in infectious disease control and economic development.
http://affordable-antimalarials-for-the-poor.net/resources/Antony_Ellman-Artemisia_Cultivation.pdf
ARTEMISIA ANNUA
A whole against malaria
A program of local production for treatment of malaria in poorest countries Tea preparation from leaves of Artemisia Annua is a hotly debated issue, unleashing
passionate controversies, sometimes not completely objective... Innumerable studies have been dedicated to the subject. It is more and more emerging from the currently published papers that not only artemisinin but the entire plant used as tea preparation or powdered, is effective against malaria. Because of that we intentionally changed the title of this booklet… The aim of this paper is to present this method of treatment of malaria in the more comprehensive way as possible, considering all aspects, from the cultivation of the plant to its effectiveness. Artemisia annua not only provides artemisinin, but also numerous other molecules with synergistic action increasing the artemisinin effectiveness; however we are quite aware of the disadvantages or limitations of the method. As presented, this study probably includes deficiencies or inaccuracies; it will be our pleasure to correct them. We would like this booklet to permit the reader to attempt Artemisia annua cultivation.
http://www.acp-paludisme.org/dl/artemisia-annua-english.pdf
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