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Column: Propagating dangerous malaria ‘medicine’ in Africa - by Kate Dieringer

October 31, 2014 - 17:45 -- Ingeborg van Schayk
The column below was contributed by Kate Dieringer
 
A truck rumbles past with ‘Artemisia annua for life’ painted in careful blue letters.
 
In countries across the African continent, outlets for buying, selling and propagating Artemisia for personal use and for profit are infiltrating the market on malaria treatment. Alongside boxes of Coartem and Panadol in rural village tuck shops and urban pharmacy stalls, one can now find small plastic bags of dried Artemisia for sale to the general public. The plant is advertised as beacon of hope in the context of health facilities void of medicines and clinicians. It is said that because this plant is the basis for antimalarial treatment, one can break free from the binds of the global pharmaceutical companies by ingesting powder or tea made from its leaves. Purveyors instruct consumers to simply light a fire, boil water and create tinctures to cure malaria, all outside the purview of the health system. 
 
Non-pharmaceutical use of Artemisia annua
The alarming reality is that this dangerous practice of forgoing medical treatment and opting for ‘natural malaria medicine’ is being introduced to developing countries, from abroad. ANAMED (Action for Natural Medicine) is one such organization that is potentiating non pharmaceutical Artemisia use. [1] The organization is headquartered in Europe and spearheaded by a qualified pharmacist. The mission is centered on providing solutions to death and disease imposed by pharmaceutical companies, corrupt governments and poor infrastructure. This has serious implications for population and individual outcomes, and the World Health Organization has subsequently issued a position statement regarding the non-pharmaceutical use of Artemisia annua for malaria. The statement reinforced the need for extensive research to demonstrate the safety, efficacy and impact on parasite resistance of this method. [2]
 
Collaborating with traditional healers is an important component to bridging the gap between belief systems, modern medicine and indigenous practices. But while working in Malawi on malaria programming, I was angered and alarmed to hear that the organization was discouraging community members from seeking medical care for malaria and teaching the ‘science’ and ‘dosing’ of Artemisia at home. My patients were often discussing concocting Artemisia teas, instead of seeking treatment at medical facilities. Of course plants contain medicinal properties that are the basis for modern pharmaceuticals. But this was something different, something both dangerously commercial and overtly misguided. People were beginning to adopt this method and had access to the plant. I decided to attend a workshop, in order to understand what exactly was being taught in the program.
 
The People’s cure
At the workshop, I was concerned to find local doctors, community health workers, NGO technical staff and religious leaders all in attendance for the week long training. Each focus country has an ANAMED representative that teaches the prescribed curriculum. While nutrition and crop diversification were covered in the course, much of the content was centered on bypassing the challenging health system by creating ‘medicines’ from plants found locally. Honey for burns. Papaya for gastrointestinal worms. Eucalyptus for pneumonia. Then, the testimonials came for Artemisia.
 
Participants attested to personal experiences ‘curing’ malaria in their homes and communities by pounding the leaves into flour to mix with cornmeal and by administering measured ‘doses’ of tea to their children. I asked if the patients who received this treatment were tested and properly diagnosed, trying desperately to steer the conversation towards the scientific method and evidence based medical practice. But the distributed textbooks and unsubstantiated testimonials were referred to as proof that this method worked.  Artemisia annua is touted as an effective way to unbind people from the fetters of the oppressive system.
 
The framework of the training was driven by social ownership and co-operative management of the economy, which I support in many contexts. But I found it most disconcerting to hear leads of child health programs and clinicians reporting that they were interested in growing Artemisia in their homes and treating people with it outside of the hospital setting. ANAMED operates in 15 countries, and every workshop ends with the distribution of an Artemisia annua plant to each attendee. Everyone goes home with a piece of ‘medicine’. 
 
Divergent methods, shared goals
From diet supplements to homeopathic remedies, alternative therapies are generating big business worldwide. But there is no room for using Artemisia in this manner, under the guise of engendering self-reliance. Instead of encouraging people to risk disability and death by not seeking proper treatment, this particular organization could mobilize efforts to work with governments on strengthening supply chain, drug costing and service delivery.
 
While ANAMED argues that its efforts are empowering the powerless, this infusion of misinformation discourages progress. Sovereign nations have not historically benefited from interventions that cause citizens to become further entrenched in positions of vulnerability. Moving forward, it is important to understand and engage on this issue. How should the malaria community intervene and seek to address this concerning practice, as the movement gains more traction in communities desperate for solutions?
 
We all have to go a little rogue in our work. I may even sign up for another workshop, to gain audience and understand the scope of the problem further. But I won’t be advising that those highly prized plants handed out at the trainings be used for anything other than décor or mulch at home, until research suggests otherwise. 
 
Links and reference
[2] World Health Organization Global Malaria Program (2012). Position Statement on Effectiveness of Non-Pharmaceutical Forms of Artemisia annua L. against Malaria. Geneva, WHO. Available online at: http://www.who.int/malaria/position_statement_herbal_remedy_artemisia_annua_l.pdf
 
The opinions expressed in this column are those solely of the author and do not reflect those of the author’s current or previous professional affiliations.
 

Kate Dieringer RN, BSN, MPH worked as a technical advisor for the Malaria Alert Center/Centers for Disease Control and Prevention (College of Medicine, Malawi) providing support for malaria programming and operational research initiatives in Malawi. Her background combines global health and emergency/trauma clinical services. She is invested in malaria prevention and control through community based partnerships, as well as health systems strengthening and investment in human capacity. Kate’s scope has focused on Latin America and the Caribbean and Africa regions involving HIV, malaria and maternal child health programming. Currently, she is working with Partners’ in Health Haiti on capacity building and clinical program implementation.

 

Comments

Submitted by Charles Llewellyn on

It is only a matter of time until malaria parasites develop a resistance to Artemisia in Africa, as is already happening in Asia. It is sad that this organization is hastening that day. Then what will they propose?

Charles Llewellyn

charles.llewellyn@gmail.com

Submitted by Marc Vanacker (not verified) on

« Coartem is not approved for the prevention of malaria », as clearly stated on the homepage of Coartem-Novartis.
Except if you are sponsored by Bill Gates and working for the Peace Corps, young African children and pregnant women may be involved.
At the College of Medicine of the University of Malawi the Malaria Alert Centre (CDC), established by the Gates Malaria Partnership and the Wellcome Trust Laboratories, are situated on the hospital site. The Wellcome Trust laboratories provide laboratory support for malaria research programmes as well as access to field sites where intervention studies can be conducted.
The epidemiological research activities currently being undertaken include:
• Intermittent Preventive Treatment :
This is a randomized placebo-control clinical trial assessing the benefit of intermittent preventive therapy (IPT) using Coartem in children
• Novel strategies in treating and preventing malaria in pregnancy
Investigating the efficacy of various ACT regimes in treating malaria in pregnancy

Dear Malaria Researchers,
Sometimes I wonder what world some people inhabit. Certainly not the world of those who suffer mostly from malaria, it seems!
Here is an email received from Malawi on the same day that the Anamed organisation was slurred:

Dear sir knight,
With my heart down I suncerely come before you for advice.
I am concerned with the youths whose education is hindered by their
parents so called poverty. How do fight this enemy?
Day after day we see wimen climbing and coming down Chongoni mt with
headloads of firewood either for sale or their home use. Looking at
them one could see pregnancies, sicknesses or hunger and lack of
proper dress.
Getting into the villages I see the aged with almost ni bkankets,
food, clothing and at times threatening houses.
Young children with no schools to go to.
We all know there are Ngis and givernment ministries and departments
which are putting more effort on each one of these in some areas even
close to us. I am sure you know Africa better than I di that is why I
decided to write you in your capacity as a development minded guru!
I know that I am writing too much more than one could expect at
times. But I have heard that sharing burdens always gives relief.
May God bless you and your team.
With love from Malawi.
Nelson

Who imagines that such people can buy 'good' drugs?
Anamed is providing Aa plants free to those that really need them?
As for 'resistance' what signs are there that Aa plants have ever given it during 2000+ years of use.
No-one here seems to want to mention the resistance to ACTs now found all over Asia!

Graham K

Submitted by Kate Dieringer (not verified) on

Dear Graham,

To quote Duncan Green,

"To imply it is not worth trying to provide the best and most rigorous evidence to those who need to make difficult decisions because they will have other influences as well is like saying to someone going for a walk in dangerous mountains that they do not need a map because there will be many other factors that will determine where they go"..

Because people are entrenched in poverty does not mean that they as humans deserve access to second tier, unsubstantiated health services and commodities. It is the XX large T shirt conundrum but on a more dire scale. People deserve evidenced base medical services, end point.

With respect and solidarity,
Kate

Submitted by Pamela Weathers (not verified) on

I draw your attention to the developing series of reports and reviews showing that oral consumption of the dried leaves of Artemisia annua is safe and effective against malaria. Google Weathers, Elfawal, Rich, etc. More documentation is forthcoming. Three points: 1. Resistance readily evolves against single drugs. The plant contains many antimalarial compounds of varying degrees and thus highly unlikely to evoke resistance. 2. Random distribution of the plant for consumption as a tea may prove useful as a prophylactic, but unlike dried leaf consumption, the dose for therapy cannot be controlled and should be discouraged. 3. Unless the Anamed plants are clonally propagated, the subsequent generations of A. annua may not yield the high level of artemisinin found in the parent plants being so distributed.

Submitted by Roger Samson (not verified) on

As I mention in another reply Dr Weathers, my Gambian wife was fully ACT resistant after numerous attempts to use various versions. She thought she was going to die when the successful back up therapy of quinine and clindamycin failed. I gave her 9 mg Whole plant artemesia daily (3 grams every 8 hours in cold water) and 4.5 mg Curcurmin (3 x 1.5 grams every 8 hours) along with the WHO quinine/clindamycin treatment and she recovered. She would be dead today if she were kept on ACT therapy. I am very greatful for your efforts on developing more holistic strategies to malaria control. There is nothing more distressing than speaking with your life partner who fears she is going to die from drug resistance malaria medicines. I am an agricultural research scientist and did the science readings for alternative therapies and came across your work on whole plant artemesia and other scientists work on curcurmin. The ACT resistance reminds me very much of herbicide resistance in field crops that I experienced early in my agronomic career.

Artemisia annua Tea
- a revolution in the history of
tropical medicine

The golden opportunity that, because of economic and bureaucratic
interests, the world is likely to miss

Updated: 15th August 2014

Each year 300 million people suffer from malaria, and between 1 and 3 million people die of malaria. The rediscovery of the plant Artemisia annua is therefore a matter of joy in the world of tropical medicine. Artemisinin, extracted from the plant, acts 10 to 100 times more quickly than all other known malaria medicines (1).

The key question is, is it necessary to first extract the artemisinin from the dried leaves with an organic solvent, and then to manufacture tablets, or is it possible more simply to grow artemisia and to make tea from the dried leaves?

Let’s think: A reduction in the death-rate due to malaria in Africa of only 20% would result in an economic benefit equal to the entire development aid Africa receives (20 billion USD per year) (2). Or, if we could show that artemisia could heal 80% of malaria cases, then this Natural Medicine, that costs almost nothing to produce, could bring a financial benefit equal to 4 times the entire development aid budget for Africa!

In reviewing artemisia, the German television channel RTZ announced „Malaria: Victory in sight!“ and the „Sueddeutsche Zeitung“ (a newspaper for southern Germany) described it as “The plant that could save Africa” (3). We say, quite simply, yes, victory is in sight, not in the sense of the destruction of the enemy, but in the sense of co-existence. Humanity will never eradicate malaria, and malaria need no longer threaten to eradicate mankind! Our vision is that malaria can be treated, that it can be treated for the next thousands of years, and that also the poorest people may have malaria treatment for thousands of years. That is the golden opportunity.

For this purpose we have proposed detailed treatment guidelines (4). We recommend using dried and powdered artemisia leaves as a tea for internal use, and in the form of an aqueous extract as an enema for unconscious patients. For those cases in which artemisia alone is not enough, we describe how artemisia may be combined with old, patent-free and therefore cheap, synthetic anti-malarials, particularly for example with AIDS patients or children under 5 years old. Using these malaria treatments, based on artemisia tea, an African country can build an effective front against the threatening advance of malaria, without either suffering ever increasing drug prices or holding out the begging cap to Bill Gates.

There are many who disagree with our recommendations. We take their comments seriously. We answer our critics as follows:

1. “You have not examined sufficient numbers of malaria patients to claim that artemisia tea is effective”. During recent years, anamed partners have collected a wealth of experience. For example, Ralph Wiegand in Arba Minch, Ethiopia, Maike Ettling in Musoma, Tanzania. Both have treated over 1000 malaria patients with a success rate of between 80 and 100% (5).

2. “The healing rate with the whole plant extract is too low”. In the scientific literature, three Chinese studies showed up to 100% effectiveness when powdered artemisia leaves were administered directly as powder, or mixed with oil, or extracted with alcohol (1). These are all procedures that even the most basic and most remote African clinic could follow.

3. “The tea does not kill every last plasmodium”. The most important thing for the African is not that every last plasmodium is destroyed, but the freedom from symptoms. Many Africans always have plasmodia in their blood, which provide a protection against new infections. The study of Dr Mueller (6) in the University of Tübingen showed that 7 days after the start of treatment with artemisia tea, 77% of the patients no longer had an elevated temperature, in 88% the tiredness disappeared, and in 92% muscle pain and nausea disappeared. In fact, the experience of anamed groups in many African countries is that the cure rate, and the rate of loss of symptoms, is much higher than this. If at this stage the patient has not recovered, at least he should now have enough strength to walk to the nearest clinic for a full medical examination to determine what his disease really is. (In the Congo that could easily be 100 km (7), or in Amazonia a 3 day journey by boat (8)).

4. “The artemisinin level in the blood is too low. To treat malaria properly, patients would have to drink 20 litres of tea every day”. The University of Tübingen (6) has shown that after drinking 1 litre of artemisia tea each day for 7 days, antimalarial effective blood levels were reached. Volunteers that drank tea made from 9 grams of dried artemisia leaves had a peak plasma level of 240 nanograms of artemisinin per ml. This is 26 times higher than the minimum artemisinin concentration required for growth inhibition of Plasmodium falciparumin vitro (14). This university, however, does not recommend artemisia tea for the treatment of malaria because, within four weeks of being treated many patients in the clinical study suffered a new malaria attack. This may, however, be due to new infections. We would like to point out that artemisinin has a very short half-life, only 1½ hours, in comparison with, for example, Fansidar, which has a half-life of up to 3 weeks! For this reason we insist that the tea is drunk for 7 days, even sometimes 12 days, and that everything possible be done to prevent a new infection.

It is also important to remember that the artemisinin in artemisia tea has the additional effect of strengthening the immune system (1). Many patients, including those who suffer from quite different diseases such as typhoid fever, AIDS, rheumatism or bronchitis, tell us that, after drinking the tea, they feel new strength.

5. “Worldwide the greatest fear is that the malaria parasite might develop resistance to artemisinin, and this danger will increase through the use of artemisia tea. That would render the last weapon in the fight against malaria useless”. We also share this concern, but we have absolutely no fear that by using artemisia tea we are increasing this risk. The tea has been used in China for 2000 years, without resistance developing. Now the pharma industry has become involved. Drug companies have isolated artemisinin and produced tablets of this single antimalarial component, and in less than 20 years the first signs of resistance have been observed (9). If artemisinin were to become ineffective, then, sorry, it is industry and not natural herbal therapy that would be to blame.

Throughout history there is in fact no record of any parasite becoming resistant to a whole plant extract. For example, there is resistance to synthetically made chloroquine, but tea made from the bark of the cinchona tree is just as effective today as it has been for hundreds of years.

6. With modern artemisinin based drugs we have an absolutely reliable therapy for malaria – why use a primitive tea? In our opinion, the opposite is true! Firstly, a tea made of home-grown artemisia can be trusted much more than tablets bought in a pharmacy in a tropical country. Artemisinin or its derivates (e.g. artesunate, dihydro-artemisinin) worldwide are expensive and not available in sufficient quantities. This has proved to be the ideal situation for the illegal production of counterfeit medicines. (See “Manslaughter by Fake Artesunate”, 15). That means that these firms add just enough of the declared ingredients, maybe as low as 1%, so that the tablets pass the quality checks. This is tantamount to murder. It also gives the malaria plasmodia every opportunity to develop resistance. In contrast, the characteristic taste of artemisia tea is such that no fakes have ever yet been reported.

Secondly, today, even the majority of Artemisinin Combination Therapy (ACT) drugs (i.e. isolated artemisinin combined with another antimalarial drug) sold in Vietnam and Cambodia are fakes (12)!

Thirdly, in ACT preparations, we have two different antimalarial drugs that have different half-lifetimes in the blood. The ACT drug is usually taken during 3 days. The first component is a artemisinin derivate that always has a half-life of one to two hours. This means, on the evening of the third day, there is no more artemisinin in the blood of the patient. The second drug however is lumefantrine with a half-life of 5 days, or even mefloquin with a half-life of 3 weeks! This means, if a patient takes the artemisinin derivate + lumefantrine, on day 4 to day 9 he has only lumefantrine in his blood. If he takes the combination artemisinin derivate plus mefloquin, on day 4 to day 25 he has only mefloquin in his blood, and sub-therapeutic doses of it many weeks more. This means that if a person is bitten by a mosquito during this later "window" period, (and many patients are bitten by mosquitoes every day) the plasmodium encounters only a monotherapy. The plasmodium has, therefore, enough time to develop resistance to this second product. We quote, “reports of treatment failure emerged soon after artemether – lumefantrine was introduced in Zanzibar, with genetic evidence for selection of lumefantrine resistant parasites” (16).

It is, therefore, absurd to demand that we do not use artemisia tea to treat malaria so as not to endanger the effectiveness of the tablets: the artemisia tea is a far more sustainable solution!

7. “Compared with the use of a single isolated substance, the effect of a whole extract cannot be accurately quantified and therefore gives too many uncertainties”. We should learn from history. For decades scientists have condemned valerian tincture because no single, effective substance could be isolated. The conflict was resolved by the acknowledgement that valerian tincture is only effective because of the synergy of all the various constituents, and to isolate one ingredient makes no sense. Many independent scientists confirm that this is also true for artemisia tea (13).

8. “Artemisia tea is a monotherapy and should therefore not be used.” Artemisia tea is certainly no monotherapy. Antimalarial substances in the plant include artemetin, casticin, chrysoplenetin, chrysosplenol-D and cirsilineol (1). The effectiveness of the tea depends upon the synergistic effect of 29 sesquiterpenes, 36 flavonoids und a variety of essential oils (1). The effect of artemisia tea depends only to a low extent on the artemisinin content. It has even been demonstrated several times that extracts from the tea containing no artemisinin at all are still effective against malaria. There are in fact varieties of artemisia that contain no artemisinin at all, and are still effective in treating malaria, e.g. A. absinthium, abrotanum and afra.

9. “After 6 months the dried leaves have lost most of their artemisinin content and are then useless. We have shown that the artemisinin content of a properly dried sample of artemisia tea remains stable for three years. The research scientist Dr. Pedro Mellilo of the University of Campinas in Brazil has even shown that, in a properly stored sample the artemisinin content actually increases with time, as a result of the conversion of the precursors (8). We in anamed take care to ensure that our African partners dry and store their artemisia tea properly.

10. “anamed should recommend that people in Africa grow artemisia only for sale to industry.” There is today a worldwide shortage of artemisinin. The price of isolated artemisinin has exploded, because farms cannot produce enough artemisia leaves. It is in our view irresponsible, out of the available harvest, only to extract the artemisinin and to throw the rest of the plant away. The precursor of artemisinin, artemisinin acid, can be present in the plant in a concentration eight times higher than artemisinin itself (1), but in extracting artemisinin alone this is all thrown away. Many more people could be treated if these same plants were used for artemisia tea. African farmers can sell their dried tea as a medicine for around 20 Euro per kilo to hospitals but for less than half a Euro to the pharmaceutical industry (our experience in Tanzania).

11. “In comparison to tablets, it is too difficult to measure the correct dosage of tea.” In our anamed publications we have clearly defined the minimum quality of “Artemisia annua anamed” tea. Artemisia tea can be given in dosages that are just as precise as those for tablets. Anamed Tanzania fills artemisia tea manually into tea-bags. Anamed South Africa uses a machine to fill tea bags or capsules, and now produces 3 tonnes a year (10).

Our work would be made very much easier, if:

1. African governments were more interested in the health of their people and the economic development of the country, rather than government income. When a commercial drug is imported, the government receives income from two sources; the import tax and the registration fee. When a Natural Medicine is produced locally, the government can only benefit, at most, from a low registration fee. For example, governments have much more income from imported Voltaren for rheumatism treatment, than from locally produced chilli ointment. This is equally true for the import of Coartem to treat malaria, as compared with if local clinics grow and use artemisia tea.

2. The WHO were to free itself from the tentacles of industry, by having its administration costs paid out of public funds and not by courtesy of the pharmaceutical industry. The world urgently needs an independent WHO, not a WIO (World Industry organization)! The WHO would appear to be so poor that it receives a fee of one million USD, just for acting as an intermediary for the supply of Coartem to Kenya, according to the Kenyan newspaper Daily Nation (11). How could the WHO possibly have any interest in healing plants or conduct any research in this area, when for putting counter-arguments in their favour they receive so much money from industry? And, worldwide, how can doctors remain neutral and advise their patients with a clear conscience, when they are legally obliged to give recommendations that arise out of such vested interests?

3. University research worldwide were to be paid out of public funds, so that it became more problem orientated than product orientated in the interests of the pharma industry.

In summary, artemisia tea is ready for the market, not from big industry but in a way that thousands of small projects can take on. Anamed does not patent anything. Only this way can tropical countries develop their own production capability. A European military organisation offered to finance our research, on condition that we did not publish the results. We declined this generous offer!

Anamed offers humanitarian organisations worldwide: 1) freedom to grow appropriate varieties of artemisia without the payment of any royalties, 2) freedom to use artemisia tea without the payment of royalties and 3) access, completely free of charge, to the instructions for its use for the treatment of malaria and other diseases (available on the internet www.anamed.net).

On the other hand, as is clear from our series of books “Natural Medicine in the Tropics”, anamed is not fixed on one single plant. We encourage all countries to examine further locally available antimalarial plants, for use alone or in combination with Artemisia annua. RITAM has recorded over 1000 medicinal plants that are used for malaria. We look forward to the results of research that is being conducted in many tropical countries into their locally available medicinal plants. Some of these may in the future be used in a combination with Artemisia annua, which would be an example of “herbal combination therapy” (HCT). For the few cases in which artemisia tea alone is not effective, such an HCT could be the answer.

Acknowledgement: We thank all those who have contributed to us being able to reach this position, particularly scientists, doctors and thousands of patients.

Anamed partners look after 650 artemisia fields in 75 countries.

Dr Hans-Martin Hirt, anamed (Action for Natural Medicine), Schafweide 77, 71364 Winnenden, Germany Web: www.anamed.net

Copyright: anamed. This means that humanitarian organisations are free to photocopy this text and to use it for educational purposes. The text may not be used to support any claims of industry.

References:

1. Willcox, Merlin et al (2004) "Artemisia annua as a Traditional Herbal Antimalarial" in "Traditional Medicinal Plants and Malaria", CRC Press Washington, pp43-59.
2. WHO, (2000) "Economic costs of Malaria....", Press Release WHO /28, 25 April 2000.
3. Süddeutsche Zeitung, 21.12.2004, "Ein Kraut gegen den Killer" page 3.
4. see www.anamed.net.
5. Wiegand, Ralph, Arba Minch, Ethiopia, and Ettling, Maike, Musoma, Tanzania, personal communications, April 2006.
6. Mueller, Markus et al, Transactions of the Royal of Tropical Medicine and Hygiene (2004), 98, pp318-321.
7. Hirt, Hans-Martin: Report of the visit to Bokungu-Ikela, D. R. Congo, 12/2003.
8. Melillo, Pedro, University of Campinas, Letter to RITAM , 11.03.2006.
9. Afonso, A et al, (2006). “Malaria parasites can develop stable resistance to Artemisinin...” Antimicrobial Agents and Chemotherapy 50: pp480-489 cited in "The world of Artemisia", Royal Tropical Institute, Netherlands, 2006.
10. Example: Mirmed tea 35 g in 14 tea bags, Emseni Farming, (mail@ksb.org.za) and Malarlife capsules (www.malarlife.dfl.org.za).
11. Daily Nation, Newspaper in Kenya, April 14, 2005:"Factions differ over drug tender" "But pharmaceutical sources accuse WHO of pushing Coartem because as a procurement agency for the country it will be paid a three per cent agent fee by the buying country. Kenya will use a total of $ 34 million a year for purchasing the drug and therefore WHO will get approximately $1 million."
12. Gathura, Gatonye, (2005), "Counterfeits hit new malaria drugs", The Daily Nation newspaper, Kenya, 17 Nov. 2005.
13. Duke, James R, (2005), Chemical and Engineering News, May 2, Vol. 83, No 18, pp4-5. (James Duke is the author of the famous Duke Phytochemical and Ethnobotanical Database.)
14. Heide, Lutz, (2006), “Artemisinin in traditional tea preparations of Artemisia annua”, Trans. Of the Royal Society of Tropical Medicine and Hygiene, Vol. 100. Issue 8, p 802.
15. Newton, Paul et. al., (2006), « Manslaughter by Fake artesunate in Asia – Will Africa Be Next ?”, Plos Medicine, Vol.3, Issue 6, p e197 www.plosmedicine.org.
16. Duffy, Patrick E and Mutabingwa Theonest K, (2006), Artemisinin Combination Therapies, The Lancet, 367, pp 2037-2039
APPENDIX:
1.The mueller study shows that 9 g of artemisia tea per day is not better than 5 g. So we can abandon the idea that Artemisia tea is only an empty plant with not enough Artemisinin in it...otherwise, if there would not be enough antimalarial efficacy in it,9 g per day would show a far better result than 5 g.
You all agree?
2. Kooy has shown that even a 9 year old sample of artemisia tea is still in the range of even freshly harvested Artemisia tea. We dry allover our artemisia tea in 3 days!!! so the leaves remain dark green. If this tea is not stored in dry conditions, you see it directly because the tea becomes yellowish...so evern without analysis we see directly that the tea has to be thrown away.
But if you dry the tea in a way like we see in commercialised teabags during 10 days or so, the tea is brown and remains brown even if it becomes wet. There are many packages in Africa containing Artemisia annua tea bags as HERBA, not FOLIA as grey-brown powder....there you do not see the change from green to yellow. So these firms make money with a very low quality and by this the reputation for Artemisia suffers!
3. All the samples from us that Dr. Kooy has examined had a hygrometer in it showing 40-50% air humidity in the package, otherwise said the water content of the leaves was 7-8g per 100 g of dried tea. So I insist:We dry Artemisia tea leaves until an exact (!!) hygrometer shows max . 40 % relative humidity of the surrounding air in the barrel. Afterwarrds we pack the tea in sachets (polyethylen 50 or 60 micrometers thick) and these sachets again we keep in plastic barrels or metal barrels or glass containers together with a hygrometer controlling that the hygrometer does not exceed 50 %.

Submitted by Roger Samson (not verified) on

My wife in Gambia has a weak immune system and has developed 8 malarias in the past 3 years. She rapidly developed resistance to ACT therapies and more recently quinine-clindimycin. The only thing that saved her was whole plant artemesia and curcurmin added to the quinine treatment. We need more complex chemistry working to stop resistance and that will only come through more whole plant medicines to complement conventional chemotherapy treatments.