Chinese herb could prevent millions of deaths
By Oliver August
Farmers are converting entire valleys to an ancient crop
that could save millions of lives

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)
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.”

 Source:The Times Newspaper of 17/7/04.







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