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http://www.iht.com/articles/519087.html

 

Switch to herbal malaria drug gains momentum

Donald G. McNeil Jr./NYT

NYT Monday, May 10, 2004

 

After years of hesitation, world health agencies are racing to

acquire 100 million doses of a Chinese herbal drug that has proved

strikingly effective against malaria, one of the leading killers of the

poor.

..

The drug, artemisinin, is a compound based on qinghaosu, or

sweet wormwood. First isolated in 1965 by Chinese military

researchers, it cut the death rate by 97% in a malaria epidemic in

Vietnam in the early 1990s.

..

It is rapidly replacing quinine derivatives and later drugs that the

disease has outwitted by evolving resistant strains. This time, to

prevent artemisinin from suffering the same fate, it will be given as

part of multiple-drug cocktails as AIDS drugs are.

..

Until recently, big donors like the United States and Britain have

opposed its use on a wide scale, saying it is too expensive, has

not been tested enough on children and is not needed in areas

where other malaria drugs still worked. Unicef, the United Nations

Fund for Children, which procures drugs for the world's poorest

countries, opposed its use during an Ethiopian epidemic last year,

saying there was too little supply and switching drugs in mid-

outbreak would cause confusion.

..

Now virtually all donors, Unicef and the World Bank have embraced

it. The new Global Fund for AIDS, Tuberculosis and Malaria has

given 11 countries grants to buy artemisinin and has instructed 34

others to drop requests for two older drugs, chloroquine and

sulfadoxine-pyrimethamine, and switch to the new one.

..

" We want countries to move very rapidly to use it as first-line

treatment, " said Dr. Vinand Nantulya, the fund's malaria adviser.

The fund expects to spend $450 million on the drugs over the next

five years, he said.

..

The World Health Organization, a U.N. agency based in Geneva,

estimates that 100 million doses will be needed by late 2005.

..

Malaria causes about 300 million illnesses a year, and at least 1

million deaths - 90% of them in Africa, and most of them children

under 5. Despite more than a century of eradication efforts, the

disease is endemic from the Mekong Delta in Vietnam to the

Amazon basin in Brazil, and particularly bad across central Africa,

from the cane fields of Mozambique to the oases of Somalia to the

rubber plantations of Liberia.

..

Like many tropical disease drugs, artemisinin is a fruit of military

research. Chinese scientists first isolated it in 1965 while seeking

a new antimalarial for Vietnamese troops fighting U.S. forces, said

Dr. Nelson Tan, medical director of Holley Pharmaceuticals, which

makes it in Chongqing, China. Another antimalarial still in use,

mefloquine, was isolated at the Walter Reed Army Institute of

Research in 1963 for U.S. troops in the same jungles. Under the

name Lariam, it is still issued to troops and sold to travelers.

..

Artemisinin quickly cures fevers and also rapidly lowers blood-

parasite levels, which can keep small outbreaks in heavily

mosquito-infested areas from spreading into epidemics.

..

Two years ago, Dr. Dennis Carroll, a health adviser to the United

States Agency for International Development, said artemisinin was

" not ready for prime time. " On April 30, at a malaria conference in

New York, he led a session on ways to induce farmers to plant

more wormwood.

..

While denying that the U.S. had ever opposed artemisinin in

principle, Carroll said more evidence had emerged that it was safe

and older drugs were not working. Also, the creation of the Global

Fund sped up grants for it. Dr. Stewart Tyson, a health expert in

Britain's foreign aid agency, said his agency's mind was changed

by its experience in Uganda, where resistance to older drugs

climbed from 6% in 2000 to 31% in some areas in 2003.

..

The price of artemisinin cocktails has fallen from $2 per treatment

to 90 cents or less as more companies in China, India and

Vietnam have begun making them. Older drugs cost only 20 cents.

Novartis, the Swiss drug giant, sells its artemisinin-lumefantrine

mix, Co-artem, to poor countries for 10 cents less than it costs to

make, a company official said. The same drug, under the name

Riamet, is sold to European travelers for about $20.

..

As a plant material, artemisinin cannot be patented, said Dr. Allan

Schapira, a policy specialist for the WHO's Roll Back Malaria

campaign.

..

Though it grows wild even in the United States, artemesia is

cultivated only in China, Vietnam and at pilot projects in Tanzania

and India. It is planted in December and needs eight months to

mature, and drug companies want firm orders from donors before

they try to triple production.

..

Even if enough artemisinin can be made, obstacles will arise,

experts warned. For example, said Dr. Kopano Mukelabai, a Unicef

malaria specialist, shopkeepers will have to be trained not to sell

patients one or two pills if they lack the money for a full course of

12.

..

And what Richard Allan, director of the Mentor Initiative, a public

health group that fights malaria epidemics, called " the love of

chloroquine " will have to be broken. That quinine derivative, in use

since the 1950s, is now virtually useless against parasites, but

poor people still buy it because it's cheap and lowers fever as

aspirin does.

..

The New York Times

After years of hesitation, world health agencies are racing to

acquire 100 million doses of a Chinese herbal drug that has proved

strikingly effective against malaria, one of the leading killers of the

poor.

..

The drug, artemisinin, is a compound based on qinghaosu, or

sweet wormwood. First isolated in 1965 by Chinese military

researchers, it cut the death rate by 97% in a malaria epidemic in

Vietnam in the early 1990s.

..

It is rapidly replacing quinine derivatives and later drugs that the

disease has outwitted by evolving resistant strains. This time, to

prevent artemisinin from suffering the same fate, it will be given as

part of multiple-drug cocktails as AIDS drugs are.

..

Until recently, big donors like the United States and Britain have

opposed its use on a wide scale, saying it is too expensive, has

not been tested enough on children and is not needed in areas

where other malaria drugs still worked. Unicef, the United Nations

Fund for Children, which procures drugs for the world's poorest

countries, opposed its use during an Ethiopian epidemic last year,

saying there was too little supply and switching drugs in mid-

outbreak would cause confusion.

..

Now virtually all donors, Unicef and the World Bank have embraced

it. The new Global Fund for AIDS, Tuberculosis and Malaria has

given 11 countries grants to buy artemisinin and has instructed 34

others to drop requests for two older drugs, chloroquine and

sulfadoxine-pyrimethamine, and switch to the new one.

..

" We want countries to move very rapidly to use it as first-line

treatment, " said Dr. Vinand Nantulya, the fund's malaria adviser.

The fund expects to spend $450 million on the drugs over the next

five years, he said.

..

The World Health Organization, a U.N. agency based in Geneva,

estimates that 100 million doses will be needed by late 2005.

..

Malaria causes about 300 million illnesses a year, and at least 1

million deaths - 90% of them in Africa, and most of them children

under 5. Despite more than a century of eradication efforts, the

disease is endemic from the Mekong Delta in Vietnam to the

Amazon basin in Brazil, and particularly bad across central Africa,

from the cane fields of Mozambique to the oases of Somalia to the

rubber plantations of Liberia.

..

Like many tropical disease drugs, artemisinin is a fruit of military

research. Chinese scientists first isolated it in 1965 while seeking

a new antimalarial for Vietnamese troops fighting U.S. forces, said

Dr. Nelson Tan, medical director of Holley Pharmaceuticals, which

makes it in Chongqing, China. Another antimalarial still in use,

mefloquine, was isolated at the Walter Reed Army Institute of

Research in 1963 for U.S. troops in the same jungles. Under the

name Lariam, it is still issued to troops and sold to travelers.

..

Artemisinin quickly cures fevers and also rapidly lowers blood-

parasite levels, which can keep small outbreaks in heavily

mosquito-infested areas from spreading into epidemics.

..

Two years ago, Dr. Dennis Carroll, a health adviser to the United

States Agency for International Development, said artemisinin was

" not ready for prime time. " On April 30, at a malaria conference in

New York, he led a session on ways to induce farmers to plant

more wormwood.

..

While denying that the U.S. had ever opposed artemisinin in

principle, Carroll said more evidence had emerged that it was safe

and older drugs were not working. Also, the creation of the Global

Fund sped up grants for it. Dr. Stewart Tyson, a health expert in

Britain's foreign aid agency, said his agency's mind was changed

by its experience in Uganda, where resistance to older drugs

climbed from 6% in 2000 to 31% in some areas in 2003.

..

The price of artemisinin cocktails has fallen from $2 per treatment

to 90 cents or less as more companies in China, India and

Vietnam have begun making them. Older drugs cost only 20 cents.

Novartis, the Swiss drug giant, sells its artemisinin-lumefantrine

mix, Co-artem, to poor countries for 10 cents less than it costs to

make, a company official said. The same drug, under the name

Riamet, is sold to European travelers for about $20.

..

As a plant material, artemisinin cannot be patented, said Dr. Allan

Schapira, a policy specialist for the WHO's Roll Back Malaria

campaign.

..

Though it grows wild even in the United States, artemesia is

cultivated only in China, Vietnam and at pilot projects in Tanzania

and India. It is planted in December and needs eight months to

mature, and drug companies want firm orders from donors before

they try to triple production.

..

Even if enough artemisinin can be made, obstacles will arise,

experts warned. For example, said Dr. Kopano Mukelabai, a Unicef

malaria specialist, shopkeepers will have to be trained not to sell

patients one or two pills if they lack the money for a full course of

12.

..

And what Richard Allan, director of the Mentor Initiative, a public

health group that fights malaria epidemics, called " the love of

chloroquine " will have to be broken. That quinine derivative, in use

since the 1950s, is now virtually useless against parasites, but

poor people still buy it because it's cheap and lowers fever as

aspirin does.

..

The New York Times

After years of hesitation, world health agencies are racing to

acquire 100 million doses of a Chinese herbal drug that has proved

strikingly effective against malaria, one of the leading killers of the

poor.

..

The drug, artemisinin, is a compound based on qinghaosu, or

sweet wormwood. First isolated in 1965 by Chinese military

researchers, it cut the death rate by 97% in a malaria epidemic in

Vietnam in the early 1990s.

..

It is rapidly replacing quinine derivatives and later drugs that the

disease has outwitted by evolving resistant strains. This time, to

prevent artemisinin from suffering the same fate, it will be given as

part of multiple-drug cocktails as AIDS drugs are.

..

Until recently, big donors like the United States and Britain have

opposed its use on a wide scale, saying it is too expensive, has

not been tested enough on children and is not needed in areas

where other malaria drugs still worked. Unicef, the United Nations

Fund for Children, which procures drugs for the world's poorest

countries, opposed its use during an Ethiopian epidemic last year,

saying there was too little supply and switching drugs in mid-

outbreak would cause confusion.

..

Now virtually all donors, Unicef and the World Bank have embraced

it. The new Global Fund for AIDS, Tuberculosis and Malaria has

given 11 countries grants to buy artemisinin and has instructed 34

others to drop requests for two older drugs, chloroquine and

sulfadoxine-pyrimethamine, and switch to the new one.

..

" We want countries to move very rapidly to use it as first-line

treatment, " said Dr. Vinand Nantulya, the fund's malaria adviser.

The fund expects to spend $450 million on the drugs over the next

five years, he said.

..

The World Health Organization, a U.N. agency based in Geneva,

estimates that 100 million doses will be needed by late 2005.

..

Malaria causes about 300 million illnesses a year, and at least 1

million deaths - 90% of them in Africa, and most of them children

under 5. Despite more than a century of eradication efforts, the

disease is endemic from the Mekong Delta in Vietnam to the

Amazon basin in Brazil, and particularly bad across central Africa,

from the cane fields of Mozambique to the oases of Somalia to the

rubber plantations of Liberia.

..

Like many tropical disease drugs, artemisinin is a fruit of military

research. Chinese scientists first isolated it in 1965 while seeking

a new antimalarial for Vietnamese troops fighting U.S. forces, said

Dr. Nelson Tan, medical director of Holley Pharmaceuticals, which

makes it in Chongqing, China. Another antimalarial still in use,

mefloquine, was isolated at the Walter Reed Army Institute of

Research in 1963 for U.S. troops in the same jungles. Under the

name Lariam, it is still issued to troops and sold to travelers.

..

Artemisinin quickly cures fevers and also rapidly lowers blood-

parasite levels, which can keep small outbreaks in heavily

mosquito-infested areas from spreading into epidemics.

..

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

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