Aim and Objectives of the

anamed Malaria Programme

January 2005

anamed is a group of scientists and health workers from many parts of the world who share a commitment to improving the mental, spiritual, physical and economic health of individuals and communities.

Aim

The anamed malaria programme aims to enable communities, hospitals and humanitarian projects in the Tropics to become as self-sufficient as possible in the treatment of malaria.

Objectives

1.     To run seminars in which traditional herbalists and hospital workers learn how to grow anti-malarial plants, how to make medicines and how to treat patients.

2.     To provide seeds of Artemisia annua anamed (A-3), to offer advice and to publish clear, educational materials so that projects, communities and hospitals can develop expertise in the continuous cultivation of A-3.

3.     To undertake or supervise clinical trials in the use of anti-malarial plants in general and A-3 in particular, so that we learn as much as possible about their effectiveness and their side-effects, and so that their use can be defended in the scientific community.

4.     To write pamphlets and to publish books so that this knowledge is widely disseminated.

5.     To ensure that this knowledge is in the public domain, and is not able to be patented for the exclusive use and profit of any (pharmaceutical) company.

6.     To encourage employment opportunities in local communities in tropical countries in growing and harvesting plants, drying the leaves and in their distribution and sale.

7.     To coordinate a network of practitioners who share their knowledge and experience in the cultivation and use of herbal remedies in treating malaria.

To facilitate this exchange on the subject of Artemisia annua anamed, we have put together an artemisia starter kit which contain s all the seeds and materials required to cultivate A-3 and to use the dried leaves for the treatment of malaria and other diseases.

Target Groups

We can supply our starter kit to:

a)     Community groups, NGOs, churches, missionaries and others who wish to grow Artemisia annua in order that the local community can treat malaria with their home grown artemisia tea, and at the same time benefit local small scale farmers.

b)    Self-employed people in the Tropics who wish to grow artemisia  for sale to industry. However, for the reasons explained below, we recommend that such people rather grow Artemisia annua anamed  in order that local people can be treated directly with Artemisia annua tea.

c)    Researchers and research organisations. We hope that such research will contribute to countries developing a “National Self-help Programme” with regard to the treatment of malaria, AIDS and other diseases, by cultivating and using Artemisia annua and other plants.

Comments on the current debate

A. Cultivation

1.      Do not grow Artemisia annua for the purpose of extracting artemisinin, but rather in order to offer Artemisia annua tea to the population in your country.

2.      Do not grow Artemisia annua as a monoculture. Monocultures tend impoverish the ground, and are liable to attack by disease. Mixed cultures however are much more stable. The growing of A-3 should be a benefit to the local ecology and environment, not a detriment.

3.      A story about Cinchona succirubra (the natural source of quinine): Monocultures of several square kilometres were established in Indonesia and D. R. Congo. In the late 70s, a fungus, Phytophthora cinnamomi, which destroyed the water channels of the trees, spread very quickly and, as a result, 80% of the Indonesian and 50% of the Congolese plantations were destroyed. (“Pharmaproduktion im Ostkongo”, Pharmazie, 28/2003) Learn from this mistake when you plant artemisia!

4.      As far as possible do not use chemical pesticides or fungicides (as recommended by many others). anamed partners have planted A-3 in over 60 countries, almost always without suffering any plant disease. Choose an environment in which artemisia grows easily without the need for pesticides. If a plant disease does occur, either follow our recommendations for biological pest control, or plant artemisia in a different place.

5.      Even avoid other agricultural chemicals such as fertilisers. This can be achieved by the appropriate use of leguminous and other soil improving crops, the use of natural manures and compost, and by a mixed culture.

6.     Give local farmers a chance to improve their income by growing artemisia together with their other food and cash crops

B. Use: Rich artemisia instead of poor artemisinin!

1.     Using artemisia tea has the advantage that each country can produce and use its own anti-malarials with Artemisia annua. Scientific results have shown that the artemisinin content in the blood is high enough after drinking artemisia tea. We quote: "...the minimum concentration required for growth inhibition of P. falciparum can clearly be exceeded with the Artemisia preparations" (Mueller, M.S. et al, Randomized controlled trial of a traditional preparation of Artemisia annua L. in the treatment of Malaria, Transactions of the Royal Society of Tropical Medicine and Hygiene (2004) 98, 318-321)

2.     The anti-malarial activity of artemisia tea is much stronger than the same quantity of isolated artemisinin, and this is clearly due to the other anti-malarial components within the tea. When artemisinin is extracted for the production of pharmaceuticals, this is considered to be a process of “purification”. Rather than being purification, it is more like “poorification”! In fact the components that are discarded are not “impurities” but extremely valuable anti-malarial substances. From the same number of Artemisia annua plants, many more people can be treated for malaria with artemisia tea, than if those plants are used for the extraction of artemisinin.

Therefore it makes absolutely no sense for poor countries to throw valuable anti-malarials onto the garbage heap! Because if you remove only artemisinin from your leaves, there is still plenty of anti-malaria activity remaining, that may in fact be even higher than the effect of the isolated artemisinin. We quote: "The ....(other) fractions contained no detectable amounts of artemisinin and/or artemisinin derivates suggesting that their activity was caused by other, so far unknown products" (Francois ,G. et al: Antiplasmodial activities of sesquiterpene lactones and other compounds in organic extracts of Artemisia annua, Planta Medica (1993) vol. 59 (7), pp A677-A678)

3.       Artemisinin is only one of 29 sesquiterpenes .In addition Artemisia annua contains at least 36 flavonoids, many of which have anti-malarial activity. Since 1986 it has been known that the water soluble fraction of Artemisia annua, after removal even of the artemisinin, has the effect of reducing fever. (Merlin Wilcox et. al. 2004 Traditional Medicinal Plants and Malaria, CRC Press, p50.) We quote: "In vitro investigations of the extract of the plant have shown that other constituents, notably flavonoids, enhance the antiplasmodic activity of artemisinin" (Elford, B.C. et al, Potentiation of the antimalarial activity of Qinghaosu by methoxylated flavones, Transactions of the Royal Society of Tropical Medicine and Hygiene, (1987), 81, 434-436.)

4.       There is no doubt that isolated artemisinin, as well as Artemisia annua anamed tea, will not always be sufficient to treat malaria alone. For these cases, we encourage the combination of artemisia tea with either a) a cheap medicines such as Fansidar or Amodiaquine, or b) another herbal tea, as is practised in Kenya, using Euphorbia hirta, or in D. R. Congo, with Cinchona succirubra. According to ourobservations, the A-3CT (Artemisia annua anamed Combination Therapy) is as good as any ACT (Artemisinin Combination Therapy). We warmly invite independent researchers to conduct clinical studies on A-3CT.

5.      Given that Artemisia annua tea has been used in China for 2000 years with the development neither of any resistance nor of any serious side-effects, it is a mystery as to why the WHO does not officially place Artemisia annua tea on the same level as the use of commercially produced artemisinin-derivates.