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Tea against ACT: David against Goliath

February 15, 2014 - 10:38 -- Irene Teis

This PhD thesis of A Sanner, Université de Nancy 1, clearly describes why Artemisia annua tea has no chance against the business of ACT pills and why WHO issued a veto on clinical trials with the herb. Full text on http://docnum.univ-lorraine.fr/public/SCDMED_T_2008_SANNER_ALEXANDRE.pdf

“ Lors de l'importation d'un médicament commercial, le gouvernement bénéficie de deux sources de revenus: la taxe d'importation et la taxe d'enregistrement. Lorsqu'un médicament de Médecine Naturelle est produit à l'échelle locale, le gouvernement bénéficie tout au plus d'une basse taxe d'enregistrement. Des milliers de microprojets de culture d'armoise annuelle répartis sur son territoire le priverait donc de rentrées fiscales conséquentes. L'exemple des droits de douane perçus sur les moustiquaires et les insecticides illustre l'aberration de certaines pratiques étatiques: en 2000, au Swaziland et au Soudan, le prix d'une moustiquaire imprégnée était respectivement de 45 et 30 US dollars du fait de taxes gouvernementales supérieures à 50% du prix d'achat ;

La collusion de l'OMS et de l'industrie pharmaceutique ne permet pas la nécessaire indépendance d'un tel organisme pour évaluer les alternatives médicamenteuses ou médicinales dans la lutte contre la malaria : l'OMS perçoit au titre de frais administratifs 3% du prix de vente de chaque traitement CoartemB et a instauré avec le laboratoire Novartis producteur de cette association une situation de quasi monopole en lui octroyant la seule qualification sur le marché des ACTs à doses fixes, ce jusqu'à très récemment.

Elle a ainsi joué le rôle de promoteur et d'intermédiaire entre la multinationale et les pays en développement, ralenti la recherche de sources génériques d'ACTs, et généré une tendance à la spéculation et à la hausse des prix contraires aux intérêts des malades. Dans ce contexte, comment l'OMS pourrait-elle manifester un quelconque intérêt pour les plantes médicinales ou mener des recherches en ce domaine, alors qu'elle reçoit autant d'argent de l'industrie en introduisant des arguments contraires en sa faveur? En l'absence d'étude clinique rigoureuse à même de valider l'utilisation d'infusions d'Artemisia annua et au regard des risques avancés par ses détracteurs, sommes-nous en droit de faire l'impasse sur cette alternative thérapeutique lorsqu'on mesure les conditions parfois extrêmes d'isolement des victimes du paludisme dans les régions arides d'Afrique et les forêts tropicales d'Amazonie ?

Le paludisme sévit dans les pays les plus pauvres avec une constante : les difficultés d'accès des structures de soins souvent à des dizaines, des centaines de kilomètres des villages et des médicaments trop chers ou falsifiés. Un traitement même partiel dans son efficacité peut permettre à un individu malade de recouvrer ses forces pour accomplir le périple jusqu'à la plus proche clinique, ce qui représente parfois près de 100 kms comme au Congo ou 3 jours de pirogue en Amazonie.

Dans ses textes et ses intentions, l'Occident consacre « le droit des peuples à disposer d'eux-mêmes ». L'hypocrisie consiste ici à les en déposséder par le truchement du système financier mondial et des institutions internationales au sein desquelles ils ne pèsent pas lourd. »

 

Comments

Submitted by Pam Weathers (not verified) on

It is unfortunate that as suggested by this thesis, the use of herbal approaches, be they tea infusion or oral consumption of dried leaves, have not been allowed to be thoroughly tested. There are also entrepreneurial approaches that could significantly lower cost of therapies to treat disease while also stimulating local economies by establishing associated small businesses and creating jobs. Everyone wins then. Fund and conduct the studies.

A growing body of studies thus far have shown that compared to pure artemisinin, delivery of the drug via oral consumption of dried Artemisia annua leaves better fights parasitemia, delivers far more of the drug into the blood, persists longer in the blood of infected animals than healthy ones, requires far less of the drug to get a better therapeutic effect, and is safe and effective in human malaria patients. Furthermore, the dried plant offers a plethora of other endogenous chemicals that could well thwart emergence of drug resistance; many show some anti-plasmodial efficacy. Some work in concert with artemisinin. Likewise, there are simple methods for consistent production of the plant with consistent amounts of both artemisinin and other important chemical constituents. Fund and conduct the studies.

There are claims that use of tea or dried leaves is just monotherapy and will cause artemisinin drug resistance…you do not know. It is wrong to say it cannot work…you do not know. It is crucial that decisions affecting millions of lives be made on solid scientific facts and not just on fearful conjecture. Science should not be obstructed. Fund and conduct the studies.

William Jobin's picture
Submitted by William Jobin on

Hi Irene,

Are you satisfied with the accuracy of that statement in the thesis of A.Sanner at Univ. Nancy? If so it is a shocking indictment of both WHO Geneva and Novartis. And I also interpreted the article to say that WHO also favors Novartis in other ways, and in addition they suppress research on cheaper sources of Artemisinin.

French is not my first language, so I would like someone to verify that I am reading this post correctly. I am also puzzled that this thesis of Alexandre Sanner was submitted in 2008. Why have we not heard of it before?

Anyway, if those statements are true, Dr. Chan and WHO have some explaining to do.

Bill, a US taxpayer whose money supports the UN and WHO

William Jobin Director of Blue Nile Associates

Submitted by madou diop (not verified) on

“In 2001, Novartis AG and the World Health Organization (WHO) unveiled a unique 10-year alliance to provide a breakthrough medicine against malaria
Novartis agreed to provide its drug, known as Coartem (artemether-lumefantrine)…The WHO reviewed requests for supplies and distributed Coartem in malaria-endemic countries”
This information is easy to find on the homepages of Novartis and WHO.
For a pharmaceutical company to have a heavy weight distributor of this kind had to be appreciated and “compensated”.
But many African countries viewed this medical colonialism with resentment.
To quote THE EAST AFRICAN of 4 June 2007:
“The first consignement of Coartem worth $8 million, arrives in Kenya in May 2006. Under pressure from the WHO, Kenya adopted the drug…despite opposition by the Pharmaceutical Industry of Kenya, which protested that the drug was too expensive. A full dose of the medicine costs about $8.
Last year alone according to Kenya’s public drugs procurement agency, the Kenyan government and its development partners spent more than $ 58 million on anti-malarial drugs.
For Kenya the irony of the horrendous toll… is that the country has been recognized as the third most important center for malaria research…”
The monopoly of Novartis-WHO ended in 2006 when the Sanofi Coarsucam tablets (artesunate-amodiaquine) entered the market, distributed by DNDi and MSF.

Submitted by Pierre Lutgen on

WHO deserves a fair treatment on this issue. Even if they act as salesmen for Coartem it must be recognized that they take their full responsibility on their home page apps.who.int/prequal/whopar/whoparproducts/Coartem_Disp_BPL.pdf. to alert their customers for all the possible side effects of Coartem (excerpts)
- Coartem is not suitable for treating severe malaria
- Coartem must not be taken with the following medicines: flecainide, metoprolol, imipramine, amitryptiline, clomipramine, macrolides, fluoroquinolones, imidazole, triazole, terfenadine, astemizole, cisapride, anti-retroviral medicines
- The following side-effects are common : headache, dizziness, stomach pain, diarrhoea, rash, aching joints and muscles
As Coartem is freely available in many pharmacies in Africa, how is the mother of a malaria infected child who is able to reach this pharmacy hours or days away from her village, going to apply the self-medication of Coartem without risking severe health problems for her child, or even his life.
Why not recommend and sell the very efficient Artemisia tea which never has shown any side effect, nor any resistance like in the case of ACTs. A medicine which could be planted in every garden in Africa.
Let’s hope that the recent document published by Dr Margaret CHAN apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf is encouraging .

WHO opens the door for herbal medicine!

Submitted by Irene Teis on

For some 10 years the following veto against Artemisia annua tea was posted on the WHO homepage. It had become a dogma for many Health Ministries around the world
Its authenticity however has been questioned, and it is considered as a fake. The scientific document is not dated, it is not signed and has no literature references for its claims. Some of them are wrong like the instability of artemisinin in dry tea leaves or the inefficiency of infusions. The opposite is rather true: artesunate is unstable and leads to widespread resistance in Asia and Africa.

WHO Position Statement on Effectiveness of Non-tablet Forms of Artemisia annua L against Malaria

Since the World Health Organization (WHO) recommended the use of artemisin-based combination therapies for malaria in 2001, a number of other forms of Artemisia annua L for use as anti-malaria "remedies" have appeared, including tea bags made from the plant's leaves. WHO does not recommend the oral use of any form of artemisinin other than capsules and tablets.
The recommended strength of artemisinin is 250mg capsules or tablets according to the International Pharmacopeia, published by WHO. Artemisinin content in raw materials is quite low, approaching 1% even in high-yield raw materials. For this reason it is virtually impossible for a tea bag to contain the amount of substance required to cure malaria.
Due to the instability of artemisinin in raw materials of Artemisia annua L, the leaves need to be stored in cool conditions — preferably below 20°C. Most malaria endemic countries have warm climates and people generally lack access to refrigeration, so it is difficult for patients to keep artemisinin-containing tea bags under 20°C in their homes.

Past history ?

The WHO Traditional Medicine Strategy 2014-2023, quoted in a previous comment on this page, is indeed lifting the ban of the old, obsolete WHO Position Statement.

“ Much has changed since the previous global strategy was published in 2002.
The WHO Traditional Medicine Strategy 2014-2023 will require Member States to determine their own national situations in relation to T&CM, and then to develop and enforce policies, regulations and guidelines that reflect these realities. For many millions of people, herbal medicines, traditional treatments, and traditional practitioners are the main source of health care, and sometimes the only source of care, close to their homes, accessible and affordable”.

This would thus lift the ban on clinical trials with Artemisia and other medicinal herbs, give the freedom and responsibility to Member States to implement their own herbal medicine strategy: it acknowledges an existing situation: Artemisia annua is part of the official Pharmacopeia in China and Artemisia afra in several African countries.

Enfin les pays africains peuvent se rendre indépendants de la médecine occidentale et de ses pilules!

Submitted by madou diop (not verified) on

Coartem: 3% for WHO, or 6%?

In the document below it appears that two parties have to contribute 3% to WHO for the supply of Coartem

archives.who.int/tbs/access/CoA_website5.pdf

THE WHO-NOVARTIS AGREEMENT

Q: Why does WHO add a fee of 3% to the price of the drug?
A: The 3% fee, which is assessed on the cost price of the drug, covers procurement
and administrative costs.

HOW TO PLACE AN ORDER FOR COARTEM THROUGH WHO
The country must first fill in the submission form.
Before WHO makes commitment on behalf of a requesting authority or organization, funds equal
to the total cost as estimated by WHO shall be deposited in US dollars or Swiss francs or other
freely convertible currencies, to the credit of WHO either by cheque or bank transfer payable
unconditionally to WHO at sight.

A charge of 3% shall be levied by WHO from the public sector agency involved
and shall be applied on the net cost of items of purchase.

Submitted by marc vanacker (not verified) on

Recent WHO annual reports quote a yearly death toll of 655 000 for malaria, a sharp decline from the 1 200 000 quoted five years ago. The Institute for Health Metrics (IHME) however reports 1 238 000 deaths (The Lancet, 4 Feb 2012). The Malaria Action Programme for States (MAPS) reports 300 000 death children for Nigeria alone. The Center for Global Health Reseach (CGHR) in Toronto revealed that more than 200 000 deaths are caused by malaria each year in India, far more than the 15 000 estimated by WHO.

Does WHO try to convince the media that the fairly drastic increase in funding has been effective in controlling malaria?

The annual budget of the Global Fund and WHO-RBM exceeds 20 billion US$.
Without counting the dark number of financial contributions of African countries who have to buy, under the umbrella of philanthropy, the ACTs or ITNs approved by WHO.

Andrew Lover's picture
Submitted by Andrew Lover on

Marc,

The underlying issue here is data at all reporting levels are poor. The IHME estimates used quite different methods from the WHO, and included 'verbal autopsy' estimates with country-specific correction factors. The countries with the highest burdens (Nigeria, DRC, etc) have the most limited data, so the global tally is really just a poorly-informed estimate. I don't think there's really any agenda behind the differences in numbers, just differing methods to extract measures of progress from very scarce data.

William Jobin's picture
Submitted by William Jobin on

For years we have been spending millions of dollars to suppress malaria in Africa, and have had the embarrassing realization that nobody knows how much malaria there is. WHO has had egg on its face ever since they first announced their goal to cut malaria in half, without knowing how much there was to start with, and without having a way of measuring the latest amount.

What is worse, there is a simple way to measure prevalence, well within the capabilities of African MOH labs. If WHO would simply organize annual sampling of parasite prevalence in sentinel populations such as students, we could have the data every year. Or to save money, if that is the problem, it could be measured every 5 years.

Instead we are reduced to the indignity of depending on computer contortions performed with useless data which generate beautifully colored maps with no value.

What is wrong with the malaria folks in Geneva? Are you there?

Bill

William Jobin Director of Blue Nile Associates

Submitted by marc vanacker (not verified) on

Why?

1. The objective for Novartis is to sell to tourists an antimalarial pill which cures the infected person without recurrence. It would be a disaster for Bigpharma if after the cure recrudescence was frequent. The pill must thus eliminate 100% of the parasites from the blood, not only on day 3 but also on day 14 and 28, when the traveller is back home.

2. The objective for an African is to overcome the infection without running into severe or cerebral malaria which may be fatal. The risk is particularly high for a child, but with age, after several infections the person develops immunity and often is an asymptomatic carrier of Plasmodium falciparum parasites. For millenaries people have been able to reduce fever and parasite load with herbal medicine and survived. To check for the presence or absence of parasites on day 14 and 28 as recommended by WHO is futile for an African. Meanwhile he has been re-infected by numerous new mosquito bites but its immunity will often be strong enough to protect him.

Bigpharma needs an incremental market for ACT pills. Even sold at 49.50 euro in Europe the market for Riamet is too small to have a nice ROI. An incremental market is needed to cover production costs and this huge market exists in Africa. The pretention to be a humanitarian outfit which offers low price Coartem pills at 6 euro in Africa without making money is insulting. With a stale smell of medical colonialism.
Out of Africa! They are able to solve their problems by themselves.

Submitted by marc vanacker (not verified) on

There are reports and scientific papers describing resistance to ACTs in the following countries:
Sudan, Uganda, Kenya, The Gambia, Senegal, Gabon, Tanzania, Cameroon, Ghana, Burkina Faso, Madagascar, Nigeria.

Cronica de una muerte anunciada, as Gabriel Garcia Marques would say.

Submitted by Pierre Lutgen on

In light of all the previous comments on this weblog I recommend reading the in-depth report

'The clinical trials industry in Kenya: Realities, Risks and Challenges'
published 13.02.2014 on www.wemos.nl.

For centuries Africans were our slaves, now they are our guinea pigs.

As European, I feel ashamed.

Submitted by Emile Schmitz (not verified) on

I was flabbergasted to find on the generally sound www.malariaworld.org a flurry of press releases relating malaria to climate change.

This is nonsense. Malaria is not a tropical disease. It was common throughout Europe, not only in Spain, Sardinia, Greece but as far North as the Baltic and northern Russia. Siberia registered 600 000 deaths due to Plasmodium falciparum in 1920. Falciparum malaria was common in Europe during the Little Ice Age 5 centuries ago. Activist organizations, such as the World Wildlife Fund and Greenpeace, continue to quote the IPCC statement that malaria can only be transmitted in regions where winter temperatures are above 16ºC. Al Gore’s absurdities.

Malaria has been wiped out in the US and in Europe mostly by DDT.
The WHO declared Holland malaria-free in 1970. But then the battle ended and Africa was left alone. A genocide resulted !

Prof P. Reiter, Institut Pasteur, Paris, in a paper published in Malaria Journal 7 (2008) “Global warming and malaria: Knowing the horse before hitching the cart” criticizes very well the nonsense generated by computer modelling. Fast food for the popular press!
P. Reiter has been a member of the WHO Expert Advisory Committee on Vector Biology and Control since 1998.

In a Memorandum which can be found on internet he explains his disappointment with the operating practices of IPCC. The third assessment report in its health chapter cites more than 65 lead authors. Only 3 were an established authority on vector-borne disease.
“After much effort and many fruitless discussions, I decided to resign from the IPCC project. My resignation was accepted, but in a first draft I found that my name was still listed. I requested its removal, but was told it would remain because "I had contributed". It was only after strong insistence that I succeeded in having it removed…

In my opinion the IPCC has done a disservice to society by relying on “experts” who have little or no knowledge of the subject…
Alarmist activists operating in well-funded advocacy groups have a lead role in creating this misinformation.

We would be better off redirecting the millions spent on climate change research to preventing diseases such as malaria. “

Submitted by Irene Teis on

 Surprised and delighted by the numerous comments my weblog generated.

 

It appears thus that artemisinin monotherapy was leading to resistance already 30 years ago, even at high doses. Derivatives like artesunate were invented to allow higher bioavailabilty. But the same resistance became evident very soon. Bigpharma was desperate. Somebody had the brilliant idea to combine artemisinin with molecules like mefloquine or amodiaquine, despite the fact that their resistance was well known. ACT’s are thus two leaking buckets placed one inside of the other. The clever parasites which pass through this filter will develop generations of superresistant Plasmodium.

A programmed genocide.

 

Will WHO recognize someday that Artemisia annua tea, a true polytherapy, has never generated any resistance ?

Submitted by Emile Schmitz (not verified) on

Is it moral or amoral for a company to openly call for donations to support its business and products, whatever the claimed benefits are for mankind?

Be it pesticides against mosquitoes, pills against headache or chlorine for water disinfection.

Including a contribution from the government of the country at the receiving end.

http://www.csrwire.com/press_releases/36897-Novartis-and-Malaria-No-More...

Submitted by Emile Schmitz (not verified) on

Received from a partner additional pieces of information 1.and 2.

Accordingly Zambia paid $2 400 000 for Coartem tablets in 2013 and received 200 000. The Conference of Cali quotes a price of $300/kg artemisinin.

References
1. malaria.novartis.com/newsroom/feature-stories/zambia.shtml
September 2013. Delivered in July, the first 200,000 Novartis pediatric treatments are starting to fill Zambia’s treatment gap. Over the years, Novartis has had a longstanding relationship with the Zambian government, supporting its efforts to meet immediate and anticipated malaria needs. Zambia was the first African country to make the bold switch in treatment guidelines from chloroquine to Artemisinin-based Combination Therapies (ACTs) and contributed USD 24 million toward malaria control in 2013.

2. Development of Industrial Scale Production of ss-artemisinin. InternationalSymposium. Colombia, Cali. February 27- 28, 2012

Submitted by modou diop (not verified) on

Bujumbura: pharmaceutical colonialism

A conference which had been organized by local associations for the International Malaria Day on April 25 2014 was cancelled on April 24 by the Ministry of Health in Burundi, obviously under the pressure of outsiders. The obvious reason was that some of the local and invited speakers were advocating the use of Artemisia annua: a real interference in the monopoly held in Burundi by ACT pills imported from the North. The surprise and disappointment was enormous, the more as WHO has published recently a Traditional Medicine Strategy 2014-2025, which encourages African countries in developing their independant herbal medicine approach, in disregard of all external pressures.
The media were full of outrage
http://www.youtube.com/watch?v=g_cWkWQHOL4
http://www.iwacu-burundi.org/artemisia-un-espoir-pour-vaincre-le-paludisme/

Submitted by modou diop (not verified) on

A thesis from J Squires (Virginia Polytechnic Institute, 2009) studying the effects of plant products on Haemonchos conturtus in gerbils finds that artemisinin treated groups exhibited higher main parasite burden than control groups. Artemisia annua extracts however produce a noticeable reduction in parasite load. The authors conclude that other substances present in Artemisia might cause this beneficial effect, and they demonstrate that limonene has an extraordinary efficacy.

Patent WO2006120568 when comparing the antimalarial of artesunate and carvacrol in vivo on Plasmodium berghei infected mice find that artesunate does not protect the animals, that carvacrol alone has a remarkable antimalarial activity, but that the two are synergistic.
A more recent work (T d’Addabbo et al., Eur J Plant Pathol, 2013, 137, 295-304) finds that the nematocidal efficiency of Artemisia aqueous extracts was high, but that the efficacy of artesunate was zero and that of artemisinin low.
The same applies for cancer therapy. During many years artemisinine and its derivatives artesunate and artemether were proclaimed as new wonder cure against cancer. But the cytotoxity of artemisinin against a series of cancer cells is in no way stronger than that of other molecules present in Artemisia annua, like scopoletin, arteannuin-B, artemisitene, 1.8-cineole (T Efferth et al., Phytomedicine, 20111, 18, 959-969) and artesunate has led to severe resistance of some cancer cells. A death sentence!

When comparing the in vitro effects of aqueous extract of Artemisia sieberi and artemisinin on Leishmania major It was found ( FE Haydari et al., Jundishapur J Nat Pharm Prod 2013, 8, 70-75) that the aqueous extract was stronger than pure artemisinin and completely eliminated the promastigotes.

A more extensive study by the Swiss Tropical Institute (M Kaiser et al., Antimicrob Ag Chemother 2007, 51, 2991-3) shows that artemisin is active against Plasmodium falciparum in the ng/ml range but against Trypanosoma brucei, Trypanosomi cruzi, Leishmania donovani, Giardia duodenalis, Babesia divergens the activity is 3 orders of magnitude lower.

And we should not forget that based on the position of WHO/MAL/98.1086 for in vivo treatment of malaria doses are prescribed which are at least 4 orders of magnitude higher than the 1-2 ng/ml values found in in vitro. Nevertheless the problems of failure and resistance become overwhelming in Asia, Africa and South America. ACTs are the combination of two failing monotherapies, Artemisia annuais a true polytherapy.

Artemisia annua tea or powder, even when low in artemisinin, gives a cure rate >95% and never has shown any sign of resistance.

Submitted by irene teis (not verified) on

I liked very much the recent paper by Richard Horton in The Lancet May 17, claiming that the global health investments benefit the countries of the North more than those of the South.

“Given that the US is the biggest contributor to WHO why are you surprised that WHO dances to the song of the biggest income source”
And others too!
“Go to the website of Global Fund and look up its partners: Chevron, Coca-Cola and the mining company Vale”.
“Over 80% of the Bill & Melinda Gates Foundation went to recipients in the US”
They are all “part of an apparatus of power, self-interest and control that denies justice and dignity to billions of people worldwide”

Son tecnicas luteranas de comerciantes inclementes (Alvaro Mutiz)

Submitted by Pierre Lutgen on

The interference of analgesics with ACTs (Coartem, Corsucam…) has barely been studied in clinical trials.

Aspirin (acetylsalicylic acid) is sold over the counter in Africa and appears to be the first line treatment when children or adults have fever. Chronic salicylate poisoning by overdosis is common. Many children brought to a hospital in Africa have a high load of salicylic acid in their blood. Paracetamol is also of common use.

In all children admitted to Kilifi District Hospital between July and September, 1994, who had a positive blood film for Plasmodium falciparum, and one or more of coma, prostration, or respiratory distress  salicylate concentrations were measured. (English M1, et al., Lancet. 1996 347(9017):1736-7). Data were available for 143 children with initial primary diagnoses of severe malaria. 129 had detectable (>l mg/dL) salicylate. Six of these had salicylate concentrations of 20 mg/dL or higher. All six had neurological impairment and metabolic acidosis and four were, or became, hypoglycaemic. OTC drugs were the first-line treatment in 74 percent of the patients. 21 percent of the mothers gave a dose higher than the manufacturer's recommended maximum. These cases suggest that in some children salicylate poisoning may cause or contribute to the development of metabolic acidosis and hypoglycaemia, complications of severe malaria associated with high mortality.

Platelets kill intraerytrocytic malarial parasites and mediate survival to infection (B J Mc Morran et al Science, 2009, 323:797). Experiments in mice showed that animals genetically deficient in platelets were significantly more susceptible to death from Plasmodium chabaudi infection than were isogenic non–platelet-deficient mice. Similarly, aspirin-treated mice were more susceptible to death from P. chabaudi infection than were placebo-treated animals. This effect has been confirmed by a very recent paper (CN Morrell et al., Blood, 2014, Feb28).

Thrombocytopenia, low platelet count, is common in malaria. (Shuaib Ansari et al.,J Ayub Med Coll Abootabad 2009;21-2). The same author refers to 5 other studies describing the same effect. It is more frequent than anaemia and can be used as a predictor of severity of malaria. This is an important finding, because blood platelets are parasitocidal (McMorran BJ et al., Science, 22012 338, 1348-51). They bind to parasitized cells and kill the Plasmodium falciparum parasite within.

An extensive study was undertaken in India (P Sentikumaar et al., Europ J Exp Biology, 2013, 3, 199-195) to compare certain serological parameters. Hb content, total blood cell count, WBC differential count, platelet count etc between normal persons and malaria affected patients. Mainly the platelets count and serum potassium levels in malaria infected blood were significantly different. A very recent paper from Thailand (M Kotepui et al., Malaria Journal 2014, 13:218) studied the effect of malaria on haematological parameters for a large sample size. The most common complication is thrombocytopenia (platelet counts <150 000/microliter).

Aspirin, like other platelet antagonists abrogate the antiparasitic activity of human platelets. Salicylic acid decreases the size of platelets (LF Fajardo Am J Clin Path 1975, 63-4, 554-8). The Finnish Medical Society guideline on thrombocytopenia states: “Many drugs cause thrombocytopenia relatively frequently… Non-steroidal anti-inflammatory drugs, especially acetylsalicylic acid frequently impair platelet function and bring about a bleeding tendency. This tendency is disproportionately strong among thrombocytopenic patients. 

Paracetamol vs placebo in treatment of non-severe malaria was studied in Guinea Bissau. It showed that time to parasite clearance is significantly longer in children treated with paracetamol and recrudescence was higher ( P E Kofoed et al, Malaria Journal, 2011, 10:148).

This confirms a previous study from Gabon. TNF which has an important antiparasitic role in malaria was reduced in the paracetamol group (CH Brandts et al., Lancet 1997, 350, 704-9). Paracetamol by itself may lead to thrombocytopenia (JR Thornton et al., British Medical Association 1990, ISSN 0017-5749). The cost of paracetamol for poor families is substantial. No evidence shows that it is beneficial in malaria.

No papers could be found studying the effect of artemisinin or derivatives on platelet count or inflammation. Platelets control many inflammatory processes. Only the study made at the University of Louvain (P de Magalhaes et al., Food Chemistry, 2012) has shown that the Artemisia annua from Luxembourg, poor in artemisinin, reduces IL-6 and IL-8). A thesis from the Western Cape University (Y Kriel) on Artemisia afra confirms these anti-inflammatory findings and shows that sesquiterpene lactones inhibit platelet aggregation. This effect of Artemisia decoctions could also be related to the presence of scopoletin which is known to inhibit platelet aggregation in the use of the Noni fruit.

The hematological effects of a few other herbs have been studied. The methanolic extract of Anthacleista grandiflora (Odeghe Othuke B et al., Internet J of Applied Science and Technology 2:5,2012, 58-65) significantly increased the number of platelets and white blood cells in malaria infected mice. The aqueous extract of Euphorbia hirta also has a platelet increasing effect in thrombocytopenic rats ( JC Apostolet al., IJPFR 2012 2, 1-11). And reduces clotting time and mean bleeding time. Aqueous extracts of Carica Papaya ( Swati Patil et al., J Pharmacognosy and Phytochem, 1, 5, 2013, 57-60) and Ocimum gratissimum (OE Ofem et al., 2,-1, 2012, 38-42) also increase the platelet count.

All these studies are fairly recent and open a new research field in the fight against malaria.

Submitted by Irene Teis on

If you want a disease to be worried about, forget Ebola. Try malaria instead. In 2013, malaria killed more than 1 200,000 people in Africa, which is about 1 000 times as many people as Ebola has killed so far, as claimed by WHO. Seriously: you might catch malaria and die.

But Ebola is more lucrative for Bigpharma and their salesmen in Geneva.

1. GOLD COAST 'Ebola' case just as likely to be malaria, says disease expert A 25-year-old man, just back from the Democratic Republic of Congo, is placed in isolation in Queensland.

2. MYANMAR : a man who is being tested for the Ebola virus has been diagnosed with two types of Malaria, the Ministry of Health has confirmed.

3. ITALY.'Ebola' patient has malaria Doctors have said that the Nigerian resident in Italy who was hospitalized on Tuesday with suspected Ebola is suffering from malaria

4. THAILAND : Ebola suspect contracted malaria The Guinean woman earlier suspected of having Ebola virus disease, in fact, contracted malaria and is free entirely of EVD, a second blood test confirmed. Dr Opas Karnkavinpong, deputy director-general of the Department of Disease Control, told a press conference Friday.

5. NEW YORK man quarantined after he was suspected of having Ebola 'probably' just has malaria

Submitted by Marc Vanacker (not verified) on

China Is Testing An Unproven Malaria Drug On An Entire African Nation ?!

By George Dvorsky
…….excerpts

Malaria is a serious problem for Comoros, where in some districts upwards of 90% of people carry the parasite. But as CBS News reports, a team of Chinese scientists, in partnership with the Comoran government, have apparently wiped the disease off the islands with a new, Chinese-made drug called Artequick. The unproven drug was given to everyone on the island across three waves of treatments — all 700,000 inhabitants — despite it not being approved for use in humans by any international health body.
And they're not making any apologies for their approach, saying that the ultimate plan is to "contribute to the elimination of malaria in the world."
The Comoran government says the massive drug experiment is bringing free medicine to its people, saving it $11 million each year in health care costs.
Artequick is a new medicine that has not been studied a lot and it is not widely available. For example, Artemisinin — an active ingredient in the drug — has been shown to be toxic to early stage embryos in animal studies, but there is no data available on use in pregnant women during the first trimester.
The World Health Organization is not disputing the claim from the Chinese scientists and the Comoran government that malaria has all but vanished on the islands since the Artequick "mass drug administration." But the howls of outrage have begun. As CBS reports:
[Andrea] Bosman, of the WHO's Global Malaria Program, is critical of how the Chinese experiment's managers are handling reported side effects from Artequick.
In Bosman's view, it is also a missed opportunity to learn lessons from the project that might have helped other countries in the fight against malaria…

My comments
- It is not true that Artequick has not been tested previously. Many clinical trials have been run in many countries and can easily be found on internet
- It is in use in China since 10 years and in on the way of eradicating malaria in this country (Quian Zhang et al, Malaria Journal 2014, 13:419)
- The clinical trials have shown that Artequick is more effective and better tolerated than Coarsucam
- Artequick (via piperaquine) has a preventive, prophylactic effect and a prolonged therapeutic effect, decreasing the rate of recurrence and reinfection . Coartem and Coarsucam have no prophylactic effect (AR Hasugian, RN Price et al., Clin Infect Dis 2007, 44, 1067-1074)
- The reaction of WHO is understandable: they receive a royalty for every pill of Coartem sold in Africa. Shameless.

Submitted by Marc Vanacker (not verified) on

WHO in several documents states that ACTs are not recommended as a first-line treatment due to concerns about drug resistance, that they should only be administered to patients with evident malaria infection and they should not be used by pregnant women.
The press release hereafter however declares that 2.4 million people will indiscrimently receive antimalaria drugs.from UNICEF
- Who trained these 9.300 health workers?
- Who guarantees that people will take the full prescribed dose to avoid recrudescence?
- Who will make the medical test confirming that people really have a Plasmodium infection?
- Who guarantees that the drug will not be delivered to pregnant women ?
- Who will guarantee that it will not be administered to children below six years of age?
- Who will check renal, hepatic, cardiac fitness of patients before treatment?
- Will it be administered compulsively to Africans only or to Caucasians too? (see Book : Le scandale de la Lomidine, quand la médecine coloniale est criminelle)

FREETOWN/GENEVA, 5 December 2014 - Around 2.4 million people will receive anti-malarial drugs during a UNICEF-supported campaign that begins today. As the malaria transmission season peaks in Sierra Leone, the move aims to reduce cases of malaria, ease the strain on the health system and allow true cases of Ebola to be found and treated.

“Malaria is the number one killer in Sierra Leone, but patients who may be infected do not seek care for fear of being shunned from health centres as suspected Ebola cases,” said Roeland Monasch, UNICEF Representative in the country. “People are dying in their communities for lack of diagnosis and treatment. This campaign will benefit the fight against both malaria and Ebola.”

The symptoms of malaria – fever, headache, aching joints – are so similar to Ebola in its early stages that it can easily be misdiagnosed, causing confusion among patients and health care workers and unnecessary referrals to Ebola Treatment Units.

Reducing the number of people exhibiting a high fever will result in less patients requiring screening and isolation care to eliminate Ebola as the cause of illness. It will also reduce the risk of malaria patients contracting Ebola.

Under the campaign, which has been supported by the German Government, more than 9,300 trained community health workers will go door-to-door in districts where the risk of Ebola is highest to help administer the anti-malarial tablets to everyone ages 6 months and above. Families will also be educated on the similarities of the symptoms of Ebola and malaria and the importance of taking this life-saving medicine.

A second round of this multi-partner anti-malaria drug distribution will take place in January 2015.

Cui bono ?

Submitted by Marc Vanacker (not verified) on

Je me suis lancé dans la recherche d'alternatives aux insecticides pour la lutte contre les vecteurs du palu il y a 7 ans... J'ai fait beaucoup de sacrifices avec mes étudiants pour développer les produits dont je vous ai parlés. Mes compatriotes sont fiers de nous, mais pour les gens du ministère de la santé y compris le ministre, nous sommes indésirables. Un cadre de ce ministère me demandait de quoi eux ils vont vivre si je détruisais les anophèles. J'avais tellement du mal a comprendre le comportement de ces gens, mais a la conférence du palu en Afrique du Sud, j'ai tout compris: Les compagnies pharmaceutiques ont entièrement pris en charge la participation des coordonnateurs des programmes nationaux de lutte contre le palu (billets d'avion, hôtel de luxe, dîner de gala, per diem). Allez y comprendre le reste! Je suis triste pour les pauvres Africains qui souffrent, mais je reste très motivé pour continuer mes travaux de recherche & développement.
Bien à vous
Thiery

Merci Thierry de ce partage. Ne soyons pas tristes pour les Africains. Les choses avancent. Ma consolation est l'espoir que les générations futures - nos enfants, grandiront forcément dans la lumière sur les jeux d'intérêts du business international. Continuons la recherche et mettons à jour les évidences aussi irréfutables que scientifiques et éthiques.
Personnellement, sans me faire d'illusion sur les véritables visages du combat, je demeure enthousiaste de l'avancement des choses!
Bon courage à tous!
Ginette

Ci joint le rapport de notre travail sur les Artemisia annua et afra qui ouvre de toutes nouvelles pistes dans la lutte contre les maladies tropicales
Je suis sincèrement désolé pour le retard du indépendamment de ma bonne volonté, J'ai subi, je subis des pressions sur ces résultats. Artemisia fait trembler les institutions.
Cordialement
Jérôme

Bonsoir Pr ,
L'Afrique doit avoir sa propre médecine a un coût adapte au niveau de vie des Africains.
Nous devons créer une rupture du cycle de dépendance en faisant la promotion des oeuvres d'Afrique!
Plusieurs maladies menacent l'Afrique en particulier le paludisme et les Bigpharma trouvent un espace idéal pour se faire de l'argent!
Certes le chemin est encore long et plusieurs paramètres influencent l'autonomisation.
Le coût du traitement de ses maladies appauvrit les populations .
Constant

Concerning new vaccine discovered in the US
I agree they may be trying to account for the Bill Gates funding and lure governments in Africa not to put efforts in research thinking that solution is already at hand.
Patrick

Merci Pr Lutgen pour cette information. Aujourd'hui l'Africain doit comprendre que son devenir et son sort dépend de lui. nous avons des ressources pour intervenir en
première ligne en attendant les technologies les plus sophistiquées. A nous de choisir, ou A. annua ou la mort programmée de l'Afrique, encore que cette plante a d'autres vertus
A bientôt

Lysette

Submitted by Marc Vanacker (not verified) on

The Roll Back Malaria (RBM) partnership, established in 1998 as part of a global drive to galvanize stronger action to curb malaria, is to restructure. In light of this restructuring and continued financial difficulties, the governing board has recommended disbanding the current RBM secretariat hosted by WHO in Geneva. The Board’s decision was prompted by a financial shortfall in the 2015 budget. RBM partners include WHO and other UN entities, notably UNDP, UNICEF and the World Bank, as well as foundations, private sector entities, non-governmental organizations, research and academic institutions, and development partners.

This info was posted on the WHO site on August 25 and on other webpages. But for many of us the information went unnoticed. A funeral without much mourning !

Whatever the reason, the disbanding probably was not because of a lack of funding. The following companies are members of the RBM Council (www.gbchealth.org) : BASF, Bayer, ExxonMomil, Giulin Pharmaceuticals, GSK, Kuehne&Nagel, Novartis, Sanofi, Sigma-Tau, Sumitomo, Syngenta, Tana Netting, Vestergard.

Maybe there was too much fiddling of data and the worldwide claim this summer that malaria incidence had been halved was too optimistic. In 2010 RBM had forecasted near-zero deaths by end of 2015 (www.reuters.com/article/2011/09/12). The same year RBM had claimed international funding had significantly increased since 2003.

But already in 2006 Roger Bates from AFM had stated that the joint venture of the World Bank and the World Heath Organization in Roll Back Malaria was a bad combination. International funders have probably started to demand how their money is spent and what good it really does.