Sweet Wormwood Heals Malaria
According to an article in The Times, a Chinese herb known as Qing Hao, sweet wormwood or artemisia annua L. is being grown massively to help end the reign of malaria, one of the major killer diseases in Africa, which has become resistant to our standard quinine-based drugs.
The extract made from the herb, artemisinin, has been shown to cut the death rate in those treated with it by 97%. The World Health Organisation says that it is the new gold standard for malaria treatment...
Farmers are converting entire valleys to an ancient crop that could save millions of lives
(original article here)
XU WEIFENG was nearly killed by raging fever when he was six years old. He lay on a cot in the mountain hut of his corn farmer parents, seemingly destined to become one more unknown victim of malaria, the world's second biggest killer after Aids.
"Every day the fevers started around four in the afternoon, and for the next ten hours I would not know if I was dreaming or dying," he recalled this week. Eventually a doctor gave him a concoction of local herbs and Xu quickly recovered. The remedy that cured him is known as artemisinin, and is now being hailed as a life-saver for millions of malaria victims in Africa.
Artemisinin, first mentioned in Han Dynasty medical texts 2000 years ago, looks certain to replace the present remedies whose effectiveness is fast diminishing as malaria develops resistance to quinine. Despite extensive eradication efforts using quinine derivatives over the past 50 years, malaria kills a child every 30 seconds.
The highly effective Chinese herb, known in English as sweet wormwood, is already being grown by the US Army at a secret laboratory in the state of Wisconsin for use by troops in Iraq and Afghanistan.
But the main growing region is a remote mountain range in central China, where farmers are now battling to satisfy the world's sudden demand for the fern-like weed whose medical properties have long been known to local herbalists.
The Beijing Government certified mass cultivation of artemisinin this week and the World Health Organisation (WHO) is planning to buy about 100 million doses of the drug from the Youyang region of Chongqing province by the end of 2005.
Mr Xu, now 26, is one of the local farmers converting entire valleys into shoulder-high artemisinin fields. High above the gorges of the Wu river, for as far as you can see, hillsides are covered in a sea of lush green ferns.
From their scattered huts farmers wearing straw hats follow narrow paths through their shoulder-high crops. They will begin their harvest next week and, since the drug cannot be synthesised, 600 million African malaria sufferers - 10 per cent of the world's population - are dependent on their success.
"In this region at least, there is now no more malaria," Mr Xu said.
To promote the cultivation of artemisinin the Chinese Government this year completed a new road to Youyang, cutting travel time through narrow river gorges to the nearest airport from four days to six hours.
"I guarantee we will provide enough land to grow artemisinin, no matter how great the demand of the international community," said Gong Zemin, Youyang's Communist party secretary. But in reform-minded China, party secretaries no longer have unlimited power over the economy. Local farmers need to agree to plant herbs instead of corn on their land, a switch many are reluctant to make since they do not yet trust official assurance of world demand.
Holley, a Chinese pharmaceutical company that distributes artemisinin extract, is telling them income per hectare will increase by 150 per cent.
"We hope to double the area under cultivation next year, but even that may not be enough to satisfy demand," said Nelson Tan, Holley's medical director.
The sudden switch from quinine to artemisinin started with a Lancet article in January. A group of malaria experts accused leading aid agencies of gross negligence for insisting on using drugs to which infectious agents in large parts of Africa were now resistant.
Britain's Department of International Development had rejected switching to artemisinin saying it was unproven and expensive. Critics countered that at a dollar per saved life it was hardly unaffordable for the international community. The WHO backed them up with test results that showed the drug cut the death rate by 97 per cent. At a conference at New York's Columbia University in April, the embarrassed aid agencies reversed their stance and embraced artemisinin - some at the last minute.
Dr Dennis Carroll, an advisor to the US Agency for International Development, was quoted in the conference pamphlets as critical of artemisinin. By the time the conference started, he was chairing a panel on how to induce farmers to plant more of it.
Luo Rongchang, a Chinese medical researcher, said: "The herb is a powerful de-toxicant and has no side-effects. What a shame that it has taken the international community this long to realise its effectiveness."
The commercial development of artemisinin actually began with the Vietnam War when Ho Chi-Minh asked China for help with the Vietcong's growing malaria problem in 1967. Beijing consulted ancient medical text which included mentions of "qinghao," as artemisinin is known in Chinese. A scholar called Ge Hong (281-340 AD) recommended "a handful of qinghao in two pints of water".
Clinical forms of artemisinin were introduced in the 1980s but since China has relatively few cases of malaria it attracted little international attention until the growing resistance to quinine-based drugs.
"Artemisinin will be the first Chinese herbal cure that not only complements Western medicine but actually replaces it," Mr Tan said. A cowherd leads his animal through a field of sweet wormwood or artemisinin in a valley near Chongqing in Sichuan province. Artemisinin has become a lucrative crop for Chinese farmers in the region as they rush to grow enough of the plants for use in the fight against malaria. The fern-like weed, known as a medical remedy to the Chinese for at least 2,000 years, seems set to replace other drugs whose effectiveness against malaria is diminishing. The World Health Organisation says that it is the new gold standard for malaria treatment and a spokesman for the Department for International Development said: "It‚s . . . the future of first-line treatment."
SILENT KILLER OF THE TROPICAL WORLD
About 40 per cent of the world's people - mostly in the poorest countries - are at risk of malaria
The World Health Organisation estimates that malaria causes more than 300 million acute illnesses and at least one million deaths a year
The combined death toll of the Commonwealth Forces - from all causes - in the two world wars was 1.7 million
75 per cent of deaths are African children, and malaria accounts for one in five of all childhood deaths in Africa
The disease causes anaemia, low birth weight, epilepsy, and neurological problems, which compromise the health and development of millions of children throughout the tropical world
The malaria parasite is transmitted through the bite of the female Anopheles mosquito. Inside the human host, the parasite invades red blood cells, where it multiplies and develops, finally bursting out of the cells ready to continue its life cycle in the gut of the next feeding mosquito
Most deaths due to malaria are caused by the Plasmodium falciparum type of parasite
Burst red blood cells block blood vessels supplying the brain (cerebral malaria), or damage other vital organs
The traditional antimalarial drug in the West, quinine, is derived from the South American cinchona tree
Four Nobel prizes have been awarded for work associated with malaria, to: Sir Ronald Ross (1902), Charles Louis Alphonse Laveran (1907), Julius Wagner-Jauregg (1927) and Paul Hermann Muller (1948)
Update December 2004:
Sweet wormwood extract containing artemisinin, found extremely effective for treating malaria, should not be the only source for the life saving drug, according to UC Berkeley scientist Jay Keasling, who was given a $43 million dollars grant by the Gates Foundation to aid in the development of a genetically engineered version.
Not content with having to cultivate and harvest the plant to obtain artemisinin, Berkeley scientists have taken a different tack - they are genetically engineering E. coli bacteria to produce the malaria fighting compound found in wormwood. The scientists, led by Jay Keasling spliced chemical-producing genes from the wormwood plant and yeast genes into E. coli to produce a chemical precursor to atemesinin. They are now looking for the additional wormwood genes needed to produce artemesinin itself.
Here are two articles about this development:
California scientists are combining Eastern and Western technologies to battle malaria. University California, Berkeley scientists are engineering E. coli bacteria to produce a malaria fighting compound found in wormwood.
For more than 2,000 years, Chinese herbalists have ground wormwood to release the malaria fighting component artemisinin. When combined with other therapies, artemisinin ó a chemical known as an isoprenoid ó is an effective malaria treatment.
The Berkeley scientists, led by Jay Keasling spliced chemical-producing genes from the wormwood plant and yeast genes into E. coli to produce a chemical precursor to atemesinin. The scientists are looking for the additional wormwood genes needed to produce artemesinin itself.
By producing the artemesinin in bacteria, the researchers hope to develop a method to preserve plants like wormwood now destroyed for their chemical benefits. For example, the popular cancer-fighting drug Taxol is extracted from the Pacific yew tree. Only about four million Pacific yews grow in the Northwest.
"This process could be of interest to everybody ó drug companies making cancer agents, the government producing antibiotics against bioterror agents or industries making flavors or fragrances," Keasling said. "A company could tweak the bacteria a bit, adding any number of plant genes involved in making the chemical of interest, to get pretty much any isoprenoid."
"It's potentially important," said Dyann Wirth, a microbiologist who directs the Harvard Malaria Initiative. "In the long term, it will probably be best to find a more efficient way to do this than with plants."
Update June 2005:
African Experts Eye Malaria Drug Supply
By Sukhdev Chhatbar
The Associated Press
Monday 06 June 2005
Arusha, Tanzania - Medical experts, farmers and manufacturers began discussing efforts on Monday to ensure a reliable supply of a critical drug that could prevent hundreds of thousands of deaths from malaria, one of the world's leading killer diseases.
The meeting is seeking to encourage wider cultivation of the sweet wormwood plant from which manufacturers extract artemisinin, used in the manufacture of the more-effective malaria combination therapy.
Increased supply of the plant, Artemisia annua, could help drive down costs of the therapy to at least $1 a course, from the current $2 a course, said Dr. Andrew Kitua, head of the Tanzania Medical Research Institute.
Malaria causes an estimated 400 million infections and as many as one million deaths a year, mainly in poor countries. The malaria parasite is increasingly becoming resistant to long-used drugs and experts recommend artemisinin-based combination drug treatment.
Demand for the new treatment rose to 30 million courses in 2004, from just 2 million courses in 2003, the World Health Organization said in a statement Monday. The increase can be traced to more countries switching from the older drugs to the newer combinations over the last few years.
Growers of Artemisia annua, representatives of international and non-governmental organizations, government agencies and companies distributing the medicines to patients have gathered in Tanzania to discuss plans to ensure a dependable supply of the malaria drug.
Others attending the three-day meeting include officials from the ministries of health and agriculture of Tanzania, Kenya and Uganda.
Until last year, China and Vietnam were the main sources of Artemisia annua. The two countries, however, were unable to meet the steep increase in demand because they can only grow one crop a year, said Dr. Allan Schapira of the World Health Organization.
It was then found that the plant can grow well in the East African countries of Kenya and Tanzania.
"Now since this year, here in East Africa, there has been a great increase in the cultivation of Artemisia annua and this is going to be part of the solution to the problem of supply shortage," Schapira said.
"In all likelihood, the supply shortages will be resolved from 2006," Schapira said. "What is exciting is we are seeing a problem which has had its effect on health in Africa and very quickly it has been possible to involve Africans in solving that problem. I think that is very unusual."
See also related:
Britain backs anti-malaria fight
24 November 2004 - Britain joined with other countries in buying up doses of a new anti-malaria vaccine developed by GlaxoSmithKline, to ensure supply. This seems like governments are getting together to help western pharma industry overcome competition from a natural remedy, even to the tune of paying for the vaccine...
Traditional herbal medicines for malaria - British Medical Journal
Improved Nutrition Could Lessen Malaria Burden Worldwide - A large percentage of child deaths related to malaria are attributable to undernutrition and deficiencies of vitamin A, zinc, iron and folate, according to a new report by researchers with the Johns Hopkins Bloomberg School of Public Health. Their review of recent data from malaria endemic regions showed that improving child nutrition could prevent more malaria-related illnesses and deaths than previously thought.
Drug 'could boost malaria fight' - Scientists have developed a new drug which they say could transform the fight against malaria. The drug is a synthetic version of Artemisinin - a herb extract that has been used for centuries in China.
Sepp's comment: Let's see if the synthetic version works as well as the natural one, and whether the pharmaceutical companies that developed it will ramp up the price to meet or exceed that of the actual herb extract.
Chinese Herbs: a Natural Solution
With a history of over 5,000 years, Chinese Medicine is a highly organized system to health and prevention. Recently, there has been a growing interest and acceptance of Chinese Medicine...
Chemical and Engineering News: An herbal solution?
Philanthropists should seek the best and most affordable medicine for the patient. In "Bootstrapping via Philanthropy," C&EN cites One World Health figures when it says that "the current three-day malaria treatment containing artemisinin, a terpenoid compound laboriously extracted from Artemisia annua, is nearly 100% effective.
New England Journal of Medicine: Making Antimalarial Agents Available in Africa
September 2005: Malaria drug gets recommendation
Malaria experts are changing their advice after a study showed a drug can save more lives than current therapy. The World Health Organization said it will recommend artesunate, a drug derived from traditional Chinese medicine, for severe malaria.
Fungi 'new tool' against malaria
Fungi native to East Africa could be used as a new tool in the fight against malaria, recent studies suggest. An international team of scientists from the Netherlands, Tanzania and the UK say their technique could significantly reduce malaria cases. Mosquitoes are unlikely to develop resistance to the fungi, say scientists
Ancient Chinese remedy shows "potential" in preventing breast cancer
An extract of the sweet wormwood plant used for centuries to fight malaria, and shown to target and kill cancer cells, may help prevent breast cancer, researchers have found. The two bioengineers with the University of Washington in Seattle, Wash., found that the substance, artemisinin, seemed to prevent breast cancer in rats that had swallowed a cancer-causing chemical. The study appears in the latest issue of the research journal Cancer Letters.
Malaria drug gets recommendation
Malaria drug gets recommendation
BBC 30 August 2005
Malaria experts are changing their advice after a study showed a drug can save more lives than current therapy. The World Health Organization said it will recommend artesunate, a drug derived from traditional Chinese medicine, for severe malaria. The move follows a Lancet study that showed using this drug in adults living in areas of low malaria transmission cut deaths by over a third.
World Bank accused over malaria
BBC - 24 April 2006
The World Bank has been accused of publishing false accounts and wasting money on ineffective medicines in its malaria treatment programme. A Lancet paper claims the bank faked figures, boosting the success of its malaria projects, and reneged on a pledge to invest $300-500m in Africa. It also claims the bank funded obsolete treatments - against expert advice.
Herbal Treatment That Really Works For Malaria
Hard to believe, it took so long for conventional medicine to accept the herbal drug artemisia was such an effective treatment for malaria. Chinese herbalists have used leaves from the sweet wormwood shrub for more than 1,500 years to treat malaria, but it wasn't until the late 1960s that scientists finally accepted artemisia as a bona fide treatment.
Rectal artemisinins rapidly eliminate malarial parasites
Derived from sweet wormwood, artemisinin has been used in traditional Chinese medicine for thousands of years. In the 1990s, researchers recognised its antimalarial activity and since then a number of safe and effective artemisinin derivatives have been developed. These drugs, given by mouth, as a rectal suppository or injected into a vein or muscle have been shown to rapidly reduce heavy parasite infection. Oral artemisinin-based combination treatments now form the basis of antimalarial treatment policies in most malaria endemic countries.
Suppositories are easy to administer and the World Health Organization Malaria Treatment Guidelines currently recommends rectal artemisinins as a pre-referral treatment for severe malaria.
December 2008: Pfizer and Sigma-Tau Announce an Agreement to Market a Potential New Treatment for Malaria in Africa
Eurartesimģ (dihydroartemisinin + piperaquine), a Phase III product candidate, aims to treat uncomplicated Plasmodium falciparum malaria in adults and children, while reducing the potential for re-infection. The product candidate, developed jointly by Medicines for Malaria Venture (MMV) and Sigma-Tau, is expected to be filed for registration with the European Medicines Agency and the U.S. Food and Drug Administration in 2009. Eurartesimģ has already been granted orphan drug status by both the European and U.S. regulatory authorities.
The World Health Organization (WHO) recommends that all uncomplicated malaria be treated with ACTs. This policy is designed to reduce drug resistance which has rendered the most widely used monotherapies, such as chloroquine, useless in many parts of the world.
posted by Sepp Hasslberger on Saturday July 17 2004
updated on Friday December 10 2010
URL of this article:
Blood Electrification Effectiveness On Malaria
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July 23, 2004 - Chris Gupta
Legal Action Over Mefloquine (Malaria Drug)
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November 08, 2004 - Chris Gupta
European Directive on Medicinal Herbs Discriminates Against China, India, Other Cultures
On 31 March 2004, the European Union put the finishing touches on its directive for herbal medicinal products, which was published in the official journal and can be downloaded as a pdf here. The directive will have to be transformed into national law by the 25 EU member countries. It introduces a simplified registration for herbal medicinal products that have been on the market in Europe for at least 30... [read more]
July 19, 2004 - Sepp Hasslberger
WHO Issues Guidelines for Herbal Medicine: Press Exaggerates Warnings
The World Health Organization is engaged in a strategy of helping traditional medicine (TM) and complementary and alternative medicine (CAM) to emerge and gain recognition as a valid alternative to our pharmaceutically controlled western-style medical system. One of the steps in this WHO program is to develop a consumer information strategy. A report released by WHO in January 2004 - "Guidelines on Developing Consumer Information on Proper Use of Traditional,... [read more]
June 30, 2004 - Sepp Hasslberger