Artemisia annua, Artemisinin, ACTs and Malaria Control in Africa: The Interplay of Tradition, Science and Public Policy
The key ingredient in the leading treatment for malaria in Africa - artemisinin - does not come from high-tech research, but is an extract of an ancient medicinal plant, Artemisia annua, commonly known as Artemisia. Chloroquine and replacement drugs have lost effectiveness with the development of resistance and have increasingly been replaced by derivatives of artemisinin combined with other drugs. Known as artemisinin–based combination therapies (ACTs), they provide the most effective treatment at present. This has led to efforts to increase cultivated production of Artemisia in the short run and to develop, through biological and chemical research, synthetic substitutes in the longer run. The resulting juxtaposition of activities and players provides both opportunities and challenges for society. While individual components have been examined, there is little in the way of comprehensive analysis. This paper attempts to weave the many complex and dynamic components - historical, scientific, technical, economic - together in order to aid understanding of the issues and facilitate development of informed public/private policies and actions. Although focused on Africa, the main components and issues are global in nature and resolution and relate to more general issues in infectious disease control and economic development.