There is a great need for education at the grass-roots so that communities and health centres can grow and use their own antimalarial herbal plants.

The arguments for such a programme could not be made stronger than in the following articles, published in November 2008.

New malaria drugs need subsidy, study finds

Published in the British Medical Journal (BMJ)12 November 2008
see http://www.bmj.com/cgi/content/extract/337/nov12_1/a2495

Peter Moszynski

An entire new class of effective antimalarial drugs will have little effect on the prevalence of the disease unless they are made more affordable. Research by the government of Uganda and the non-governmental organisation Medicines for Malaria Venture shows that such drugs are "too expensive and not widely available for millions in Africa."

 In its first report on the antimalarial drugs market in Uganda, the venture says, "Replacing older classes of drugs with ACTs [artemisinin based combination therapies] is critical to ensure appropriate treatment of malaria, a disease that has grown resistant to a number of drugs, such as chloroquine (CQ) and sulphadoxine-pyrimethamine(SP)."

Yet the study found that effective treatments are "not widely available in the rural areas of Uganda, particularly outside of government health facilities." Artemisinin combination therapies can cost as much as 60 times the price of ineffective drugs, such as chloroquine. Although artemisinin combination therapies are ......(full article is not available without subscription to the BMJ). .

The article was based on the very readable MMV report “Understanding the Antimalarials Market: An overview of the supply side”. See: http://www.mmv.org/IMG/pdf/Uganda_Antimalarials_Market_report_MMV_2007_FINAL_.pdf

A “rapid response” with the title “Affordable Antimalarials” was made by Simon Challand and Merlin Willcox - see http://www.bmj.com/cgi/eletters/337/nov12_1/a2495#205024. They write:

 “Affordable” is the key word in the news item by Moszynski [1]. Having worked in rural primary health care in Uganda I have encountered firsthand the problems people have in paying for any health care. As the MMV report shows, 50% of people do not buy a full course of antimalarial medication, even of the older and lower priced drugs [2]. 

A complementary approach is to develop the rational use of medicinal plants which have been used in almost all cultures and communities for thousands of years. Up to 75% of patients in malaria endemic countries use medicinal plants not only because of issues of accessibility, affordability and availability of western drugs, but also because of perceived efficacy [3]

Artemisinin is the active compound in Artemisia annua, a plant originally used by the Chinese to treat malaria. Several randomised controlled trials using the plant to treat malaria have shown promising results [4]. Anamed (Action for Natural Medicine) has promoted the cultivation and use of an Artemisia hybrid in over 70 countries so that rural people affected by malaria have an affordable antimalarial option [5]. 

More research is needed to develop an evidence base for the use of Artemisia annua and other traditional antimalarial plants to support the work of Anamed and similar grassroots organisations. A network which seeks to do this is the Research Initiative on Traditional Antimalarial Methods (RITAM) comprising of over 200 researchers from at least 30 countries working together to validate the use of medicinal plants for malaria [6].

These are small initiatives with tiny budgets but they provide a glimmer of hope in the desperate struggle against malaria. Perhaps Mr Yamada [7] would be interested in developing this pipeline?

For a more detailed justification of anamed’s work in general and with Artemisia annua in particular, click here