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Chinese shrub gives best cure for deadly malaria
2007-01-25
If it wasn't for the fresh, sharp scent, you could easily mistake Sweet Wormwood for any other kind of shrub. But this shrub, also called the Artemisia annua, is widely regarded by medical experts as the best cure for malaria, one of the world's leading killer diseases. It was here in Luofushan in China's southern Guangdong province that the shrub with fern-like leaves first found its way into Chinese medical annals more than 1,600 years ago. No one knows how the Chinese discovered the shrub's life-saving properties, but it was doctor Ge Hong (283-363 AD) who first wrote about it in his Book of Emergency Medicine when he served as a Taoist priest in this mountainous region. "Taoist priests were obsessed with the idea of elixirs. Ge Hong never found any elixir, but he discovered many herbal drugs, and he was the first to record the properties of artemisinin," said Zhang Shaoping of Guangdong New South Group Co. Ltd., which produces artemisinin-based combination therapies (ACTs). Artemisinin is the malaria-fighting compound extracted from the shrub and is used to treat the disease, which causes fever, vomiting, body aches, diarrhea, anemia, loss of concentration, delirium, convulsions, coma and eventually, death. Children and pregnant women deteriorate especially rapidly because of their weak immune systems, and the very young can die within 24 hours of the onset of symptoms if they are not treated. The World Health Organization recommends that artemisinin be used in combination with other drugs, or artemisinin-based combination therapies (ACTs), to slow the development of any resistance. TOP LIFESAVER There has been no let-up in the search for an efficacious anti-malaria drug with minimal side effects. The disease kills more than 1 million people each year, or one person every 30 seconds, and makes 300-500 million ill. Ninety percent of the deaths occur in sub-Saharan Africa. The WHO describes malaria and HIV/AIDS as two of the most devastating health problems of our time, accounting for 4 million deaths a year. Africa, many parts of Asia and South America have long been hotbeds for the malaria parasite, but it's not just a problem for poorer nations. Even the most developed nations, which deploy troops in far-flung, often mosquito-infested territories, have also been searching for the best cure. Compounding the urgency is the lack of a vaccine against the malaria parasite, which has grown resistant to well-known anti-malarials, such as chloroquine and pyrimethamine. Quinine, extracted from the bark of the South American cinchona tree and in use for more than 160 years, was regarded as the drug of choice up to the early 2000s, until it was displaced by artemisinin in the controversial SEAQUAMAT (Southeast Asia Quinine Artesunate Malarial Trial) of June 2003-May 2005. In this largest ever real-life trial for severe malaria, doctors in India, Bangladesh, Indonesia and Myanmar split 2,000 patients suffering from severe malaria into two groups, giving half of them artemisinin and the other half quinine. Speaking about the trial at an anti-malaria conference in China's southern Guangzhou city recently (week beginning Jan 15), Arjen Dondorp, of the Mahidol University in Thailand, said: "We had to stop the trial because of the huge difference in mortality in the two groups." Twenty-two percent of patients in the group given quinine died, while 15 percent in the arteminisin group died. "Artemisinin is better than quinine in all sub-groups of patients with severe malaria. Artemisinin is the treatment of choice for severe malaria," he said. REDISCOVERED It wasn't until the late 1960s, when the Chinese army launched a massive search for a good malaria cure that scientists in the country managed to identify the anti-malarial ingredient in the plant -- or the compound, artemisinin. China, home to the Artemisia annua, is now an exporter of ACTs to many malaria-afflicted countries in the world. Plans are afoot to export its technology and expertise to African nations, where malaria is a leading killer and which need the drug to survive. In Luofushan, visitors can see a tiny pond, where Ge Hong used to wash herbs and lay them out to dry. Next to it stands a furnace, which he used to brew his elixirs. Close by is a plaque, detailing what Ge Hong wrote about the magic shrub, which modern clinicians say is able to control raging malaria-fevers in less than two hours in some cases. "One bundle of Artemisia annua, soak in two liters of water, wring out for juice extract, then take it all for treatment of malaria," wrote the Taoist priest and doctor. Legend has it that Ge Hong died, aged 80, after consuming an elixir he created. But a shopkeeper near a shrine that was erected in Ge's honor in 1985 insists that's not true. "He went into a cave in the mountain and turned into a butterfly," the woman said, glancing at a mountain in the distance.
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