Artemisinin is currently the most effective drug we have against malaria, a disease which kills a child every 30 secs, and which we in Europe need to remember was only finally eliminated from Europe in the 1950’s….. and with climate change may well be back, and not just in travellers.
Artemisinin works on the parasite and its only current source is the plant Artemisia annua (annual wormwood). Its origins lie in Chinese traditional medicine, and it was first developed as an effective anti-malarial drug by Chinese scientists but this was not widely known until the 1970s.
It has poor bioavailability so is chemically altered to make it more effective; artesunate and artemether being the best known derivatives. These derivatives are then used in combination with other drugs (the combinations are known as ACTs) in order to reduce the chances of the parasite building up resistance.
With the increased demand for artemisinin, obtaining this drug from the plant leaves was becoming a problem.
It led to an illegal trade in fake artesunate in SE Asia (1)
In response, the Artemisinin Enterprise was set up comprising the Centre for Novel Agricultural Products at the University of York, UK (CNAP): the Institute for OneWorld Health, USA; and the Medicines for Malaria Venture, Switzerland (MMV).
CNAP were to fast-breed high-yielding plants, Oneworld were to derive artemisinin by microbial fermentation in yeast and MMV were to develop a novel class of compounds (peroxides) to incorporate into antimalarial drug combinations. The 3rd Artemisinin Enterprise conference was held in 2008 at York to update partners and the malaria community.
This week, CNAP have announced (2) that, following an intensive year-long breeding program with the speed made possible by using (non-GM) molecular biology techniques, they now have plants with double the original yield. A herculean effort in which they screened 23,000 plants!
The super-plants are now being sent out to field testing in Africa, India and China. Obviously plants which have done well in the greenhouse may not do so well in the fields, subject to weather and pests, so they need to do further selection and breed from those.
This is excellent news, but already there are reports of artemisinin resistance occurring in Cambodia (Noedl et al, 2008 (3))… time is of the essence.
Global Health subscribers can read the Report of the 2008 Artemisinin Enterprise Conference October 8-10 York UK in our fulltext repository. They can also access an abstract which we created for the Noedl et al. report which appeared only as correspondence in the New England Journal of Medicine. Global Health and its sister database CAB abstracts are the only abstract databases which include correspondence & will create an abstract for it.
- Evidence of artemisinin-resistant malaria in Western Cambodia.
Noedl H. et al., New England Journal of Medicine, 2008, 359, 24, 2619-2620. (Correspondence)
- BBC news: Plant boost to malaria fight
- A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.Newton, P. N. et al., PLoS Medicine 2008, 5, 2 e32 . doi: 10.1371/journal.pmed.0050032