Pizzas galore!

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)
• Two patients contracted malaria while being treated at a hospital in Nottingham in 1999
• 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.”

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