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Vila Ulongue (Mozambique)— Slightly bowed with age, Brother Elias Pereira de Macedo, leads the way to the nursery behind his Catholic Church. A friendly man with a strong gaze he points proudly to the tall, fluffy rows of Artemisia.
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Dr Hans-Martin Hirt of Anamed with Brother Macedo and his Artemisia
Photo: Walter van Opzeeland | Brother Macedo is proud because his Artemisia plants are hailed as the best—the tallest and bushiest—by most members of the local community. Brother Macedo began producing Artemisia with seed provided by the Pressure Group on Action for Natural Medicines (Anamed), who first brought the annual shrub to Mozambique two short years ago.
Artemisia is a highly coveted plant. In the temperate regions of China, where Artemisia annua originated, the leaves have been used to treat fevers for more than 2000 years. The treatment was so effective that the Chinese (who continue to be the largest producers of Artemisia in the world) patented the use of the plant for treating malaria, a deadly parasitic infection.
Everyone who comes up with a new twist on this old remedy has continued to jealously guard their intellectual property, including giant pharmaceutical corporations who have invested millions of Euros in Artemisia R&D, identifying an active ingredient in the shrubs, artemisinin, that is now used in the anti-malarial drug Coartem.
Dr Hans-Martin Hirt of Anamed explains how this activity boosts the legitimacy natural medicine, without the financial burden. “The big advantage is that the pharmaceutical industry does all the research. To scientifically prove the effectiveness of a medicinal plant in treating a particular ailment costs 5 million Euros.”
And the word is in on Artemisia.The World Health Organization (WHO) has approved the use of artemisinin-based drugs as the first-line defense for treating malaria. But like many tropical areas where malaria is endemic, the local people cannot afford expensive drugs like Coartem.
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A healthy hybrid
Photo: Walter van Opzeeland | A Natural Advantage
For those unable to purchase conventional drugs, there is still hope—the leaves from the plant are effective in treating malaria.Published scientific studies show that the artemisinin content in the blood is high enough after drinking Artemisia tea to cure malaria.
The tea may even have a few advantages over artemisinin-based drugs like Coartem. Laboratory experiments demonstrate that there are other anti-malarial components in Artemisia, namely the 36 flavonoids contained in the leaves, many of which enhance the effectiveness of artemisinin.
This potent, natural drug cocktail is especially coveted for its ability to cure drug resistant malaria. Helen Meyer, a nurse using Artemisia from Brother Macedo’s garden to treat malaria at her nine mobile health clinics in rural Angonia, says, “The hospital has started using Coartem, because the malaria is becoming resistant to chloroquinine.”
According to Ms Meyer, the tea is can be even more effective in treating these difficult cases. “If you take the tea, you feel better after the first day.Other medicines take a few days.” For this reason, the few locals who can afford conventional drugs actually prefer taking the bitter Artemisia tea sweetened with honey or sugar.
Spilling the cure
For both the practitioners of traditional medicine and the pharmaceutical companies, access to the plants is the biggest barrier to using Artemisia to cure malaria.
Through a secretive agreement struck in 1997 between Anamed and an undisclosed pharmaceutical player, they were granted access to a special hybrid of Artemisia annua, known as Artemisia annua anamed (A-3).
A-3 is especially important for the natural treatment of malaria, because it is adapted for the warmer climes where the disease is endemic. Where as wild varieties of Artemisia grow to only 5 cm in the tropics, A-3 can reach heights of 3m and contains 20 times more artemisinin.
Last year, the World Agroforestry Centre (ICRAF), attracted by the usefulness of Artemisia as a medicinal species and its potential to manage pests in agroforests, began growing A-3 from seed provided by Anamed.
ICRAF has facilitated the broad propagation of Artemisia by teaching thousands of farmers in its extensive network how to cultivate Artemisia from stem cuttings. The programme has extended to four districts in Tete Province—Angonia, Moatise, Tsangano and Makanga—located in North Western Mozambique.
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Artemisia seedlings at ICRAF Mozambique
Photo: Rachel Rumley |
Dubbed vegetative propagation, this technique is favoured because of the difficulty in growing from the tiny seeds. Dr Patrick Matakala, Director of the ICRAF Southern Africa Regional Programme, explains, “Artemisia seeds are so minute. They are very difficult to propagate from seed.” Just one gram of seed contains an estimated 12 000 seeds, each seed weighing a scant 0.07 mg.
Luckily, multiplying the plant from cuttings is easy, takes less time and maintains the genetic qualities of the plant. Mr Richard Chintu, Technical Agroforestry Researcher with ICRAF Mozambique, demonstrates by snapping off a few centimeters of a thin, green Artemisia stem. Planted first for 2-3 weeks in polythene pots, the seedlings can then be safely transferred into the ground. He is teaching farmers how to use sand in the planting media to improve drainage and looking into intercropping Artemisia with fertilizer trees to increase nutrient availability during the critical early stages of growth.
Thousands of Artemisia plants can be propagated from a single stem cutting. This makes for a lot of cheap, easy and effective medicine. The daily adult dose of anti-malaria tea requires mixing just 5g of dried A-3 leaves in 1L of water. This tincture is split into four parts and taken once every six hours. This is repeated for seven days. Given that each plant yields 200g dry weight, 1000 shrubs can cure malaria in 5700 adults.
Saved Income and Fresh Funds
Artemisia treatments for malaria create big savings at the pharmacy for cash-strapped farmers. Money spent on malaria medication can be spent elsewhere. There is also an untapped potential for getting much-needed income from selling Artemisia medicines.
In Vila Ulongue, theft of the plants is turning into quite a headache for farmers. Ms Meyer laments, “When people want Artemisia, they just come and fetch it.But they need to learn to pay for it because if farmers can’t make money, they’re not going to produce it.”
Anamed- Angonia in cooperation with ICRAF, Medicins sans Frontiers (MSF) and the Mozambique Ministry of Agriculture and Rural Development (MADER) are training farmers how to process and manufacture Artemisia medicines.
Harvesting and air drying the leaves, as well as the production of medicines is a straight forward, non-labour intensive project. Even after three-years, dried leaves retain practically 100 percent of their artemisinin content, suggesting that under proper conditions Artemisia medicines can be stored for a long time.
When asked about the scale of Artemisia farming in Mozambique, Dr Matakala replies, “I wouldn’t call it large scale production for profit yet.” But for the ambitious farmer, there is a definite possibility of scaling up Artemisia production for sale to pharmaceutical companies in the future.
There will certainly be a market. WHO estimates that of the 40 countries—20 in Africa—using Artemisinin-based drugs, five are expected to have shortages due to lack of raw plant extracts, including Mozambique. However, scaling up for pharmaceuticals will require resolving the proprietary issues surrounding A-3.
In the meantime, this remarkable shrub is saving the lives of those most vulnerable to malaria and promises to provide income through the sale of medicines in local communities.
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Artemisia drying
Photo: Dr Patrick Matakala |
Richard Chintu demonstrates how to use a simple apparatus to dry and separate leaves
Photo: Rachel Rumley |
Dried Artemisia ready to make tea
Photo: Anamed |
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