SciDev.Net article - 21-09-2016
In a recent article about the spread of resistance to ACT in SE Asia, the authors recommend new drugs and better drug strategies:
'FEMS Microbiol Rev. 2016 Sep 8. pii: fuw037. [Epub ahead of print]
The clinical impact of artemisinin resistance in Southeast Asia and the potential for future spread.
Woodrow CJ1, White NJ2'.
Similarly, multiple resistance of Anopheline vectors is supposedly to be met with more careful selection of insecticides!
Allelopathy related to Artemisia plants has already been described 100 years ago (Bode, H. R. 1939. Über die Blattausscheidungen des Wermuts und ihre Wirkung auf andere Pflanzen. Planta 30:567-589). The work of H Bode was completed a few years later (GL Funke. Blumea - Biodiversity, Evolution and Biogeography of Plants, 1943 5, 281-293). Eighteen species of plants, most of which were chosen at random, were sown beside a hedge of Artemisia absinthium; they were severely injured and in one case even killed by the chemical excretions of the latter within a distance of ± 100 cm.
illumigene® Malaria, a novel, highly accurate test developed by Meridian Bioscience, has been awarded the coveted Journées Internationales de Biologie prize for Innovation in emergency treatment and point of care testing.
I am delighted to welcome Dr Fred Binka as Coordinator of WHO’s Emergency Response to Artemisinin Resistance (ERAR) hub in Phnom Penh, Cambodia.
Most of us ignore that on Nov 3, 2015 a Convention was signed in Bali declaring the fight against the looming TB-Diabetes co-epidemic, one of the greatest global health challenges.
An estimated two billion people, or one third of all people worldwide, live with a tuberculosis (TB) infection, of whom 9.6 million people develop active TB disease annually. TB is the leading cause of death worldwide due to a single infectious pathogen, responsible for 1.5 million human deaths in 2014, and 95 percent of human TB deaths occur in low- and middle-income countries.
It has traditionnally been accepted that drying of Artemisia annua should take place in the shade because drying in the sun would destroy many useful molecules. But recent papers have questionned this belief and have studied the effect of ultraviolet radiation on the accumulation or decrease of medicinal compounds in plants (WJ Zhang et al., Fitoterapia, 2009, 80, 207-18). A study in Turkey showed that UV-C radiation had remarkable promoting effects on the accumulation of secondary metabolites in the calli of a grape cultivar (E Cetin, Biological Research, 2014, 47 :37).
Plasmodium is thriving on iron. One of the first mistakes of Western medicine in Africa was the iron supplementation to the Somali nomads in 1968. Blood analysis of these nomads had shown that according to European standards they were suffering from anemia (MJ Murray et al., Brit Med J. Oct 1978, 1113-1116). But iron administration was associated with a significant increase of the disease it was supposed to suppress and even to reactivation of pre-existing diseases. The conclusion of the authors was that iron deficiency eventually plays a part in suppressing certain infections
There is dangerous obstacle - we call it the Immunity Trap - in malaria prevention strategies which is most dangerous for countries which have relied on the ephemeral methods recommended by WHO and used by PMI, but which have not included permanent methods. In the 19 African countries in the US Presidential Malaria Initiative administered by the PMI for the last decade, of the 30 million who have lost their immunity, about half are also no longer protected by house spraying because of the high cost of new biocides.
In a pionneering study in 2010, the University of Louvain had studied the anti-inflammatory effect and modulation of cytochrome P450 activities by Artemisia annua tea infusions in human intestinal Caco-2 cells (Melillo de Magalhães P1, et al.,. Food Chem. 2012 Sep 15;134.:864-71). These assays were done on aqueous infusions (3.3/L) of Artemisia annua samples from 7 different origins.
A decade ago, I helped the US Presidential Malaria Initiative get its start in Angola. Since then the Malaria Initiative (the US PMI) has expanded under Tim Ziemer to 19 African countries, protecting 30 million people. Consequently, over the last decade these 30 million people have lost their immunity to malaria. Now that might seem obvious and maybe a good thing. But since they live in regions where malaria is endemic, it raises a serious issue about durability of the PMI strategy.
The Resistance Treadmill
WHO recently released a report on the fight against malaria, by Cibulskis et al *. It seems very positive, in fact they claim that the progress is "remarkable". but I find two ironic aspects which are troubling.
Dear Partners and Friends,
After a period of extensive consultation, the RBM Board agreed at its 29th Meeting in December 2015 on a new governance architecture. This included the establishment of a reconstituted Partnership Board, which could take advantage of the tremendous skill, energy and effectiveness of its partners and lead the organization into a new era.
Would you like to hear some Good News? Here are some nuggets, stimulated partly by recent comments from my colleagues Robert Bos, Tony Kiszewski and Pierre Bush.
Classic Problems we used to face
ARTEMISIA PLANTS INCREASE THE CD4 AND CD8 CELL COUNT
The great benefit in saving so many children by suppressing malaria, might have a negative consequence - malnutrition. As more and more children survive, who will feed them? This reflects the classic dilemna enunciated by the Rev. Malthus some centuries ago. He saw it as a race between population growth and growth in food supply - with the food supply losing. Do we face that same dilemma when we suppress malaria? Let us look at some recent data from Africa.
In a recent Comment - Does malaria cause poverty or vice-versa? Patrick Sampao explored the relation between malaria and poverty. In accord with his opinions, and in agreement with our dear friend Anton Alexander, I posted three comments, based on statistical analyses of the impact of the US Presidential Malaria Initiative. The comments show us some really Good News about suppressing malaria, especially in Africa where the data is robust. Please take a look at the comments. It is kind of heavy reading but I assure you, it is worthwhile.
Ἓν οἶδα ὅτι οὐδὲν οἶδα
Our association IFBV-BELHERB has received numerous anecdotic reports on the prophylactic effects of Artemisia plants. This effect has been documented in scientific papers. Patrick Ogwang from Uganda (Ogwang PE, et al. Trop J Pharm Res. 2012;11:445–53) showed that an infusion of Artemisia annua consumed once weekly reduced the risk of Plasmodium falciparum episodes due to a yet unidentified constituent.
Reported by Dr Patrice Bouygues, Paris.
A young French traveller was infected by Plasmodium falciparum during a two week stay in Tchad in 2013. He had been treated prophylactilly and therapeutically with Malarone. After his return home he continued suffering from headaches, high fever surges, rachialgies, cardiac troubles... Several medical services were consulted. Despite the absence of noticeable parasites in blood smears, doctors prescribed a more or less continuous malarone and tardyferon treatment.
Dr Sylvia Meek meets with community drug distributors supported by our integrated community case management and nutrition project
Many plants have antiplasmodial properties but nobody really knows why some do and others do not. We have paid most of our attention to artemisinin and derivatives, to flavonoids and antioxidants, swamped and blinded by thousands of papers on these molecules, billions invested and earned in ACTs, the prohibition of clinical trials with Artemisia annua by WHO-Geneva, the Vatican of malaria, and the colonial ITG-Antwerp. And we have forgotten that there are other molecules in Artemisia which may play an equivalent or stronger role.
THE BREAKING NEWS PAPER OF MAVONDO
“As a scientific worker we need innovation spirit to find new things” commented Tu Youyou in a telephone interview following the announcement of the 2015 Nobel Prize in Physiology or Medicine. The Chinese scientist was awarded the Prize for her discovery of artemisinin in the 1970s, now a life-saving antimalarial drug. Leading a small team of researchers, she was the first to isolate the active ingredient from the Artemisia plant, using ether to extract it.
ACT Consortium launches free resources for malaria community
On World Malaria Day, ACT Consortium researchers launched five resources to help guide those working in malaria endemic countries.