1

• 9/11
• The Malaria epidemic is like loading up seven
  Boeing 747 airplanes each day then deliberately
  crashing them
• into Mt Kilamanjaro
• Chairman
• Malaria Foundation International

2
Please dont forget

• An African dies every 30 seconds from malaria.
• That means that by the end of this conference
  about 9000 people will have died from this
  disease.
• By the end of the year just under 1 million will
  have died.

3
of deaths under 5 caused by malaria

• Zambia
• Malawi
• Senegal
• Mozambique
• Uganda
• Kenya
• Ghana

• 50
• 48
• 42
• 37
• 34
• 27
• 22

4
Counting the cost

• Poor families spend 25 of their annual income on
  malaria prevention and treatment
• In Malawi Malaria accounts for 40 of the total
  public health spending
• Malaria costs Africa 12 billion per year
• Roll Back Malaria Program report

5
Where are the products?

• We have a ridiculous situation in that
  governments together with individuals like Bill
  Gates and George Soros are providing funds to
  treat malaria and people are still dying every
  day from malaria when a treatment approved by WHO
  exists but is not available to them
• CEO
• Essential Nutrition
• August 2005

6
Access

• the weapons to fight malaria exist medications,
  insecticide treatments, spray equipment, tests to
  diagnose the disease. But these weapons are
  useless if they do not reach those who need
  them.
• RBM report 2004

7
Fond hopes

• The Roll Back Malaria (RBM) programme launched in
  1998 by WHO, UNICEF , UNDP and World Bank has as
  its stated goal to halve Malaria by 2010
• By the end of 2005 in Africa at least 60 of
  those suffering malaria should be able to access
  and use correct,affordable and appropriate
  Treatment within 24 hours of the onset of
  treatment
• Abuja Declaration 2003

8
Malaria and Malnutrition

• The major cause of malnutition in Africa is not
  lack of food but malaria and war
• CILSS-IAI report 1982

9
Cost

• Of the currently available antimalarials only
  three cost lt 1 per treatment which is the
  threshold set by WHO for affordable treatment.
  These include chloroquine, sulfadoxine-pyrimethami
  ne and amodiaqunene all of which are fast
  becoming useless. ACTs are expected to cost circa
  3 per treatment.
• White 2003

10
Some Key Issues 1

• Elite planting material, does it exist?
• Is growing artemisia profitable?
• High tech cultivation or smallholder crop?
• Artemisinin yields per hectare?
• Shortage or surplus who knows?
• Where should we grow? Asia, Africa, both?

11
Some Key Issues 2

• Why focus just on Artemisia?
• What alternative herbal antimalarials exist?
• Is sufficient funds going into this?
• What about their safety and efficacy?
• Can they be sustainably sourced?
• Can they be used in combination?
• If so with what else?

12
Some Key Issues 3

• Combination therapy dogma or must?
• What combinations are possible?
• Who makes the rules?
• When is monotherapy appropriate?
• What is the risk reward ratio?

13
Some Key Issues 4

• Finding cost effective products?
• ACTs are too expensive for Africa?
• Village Artemisia teas are dangerous?
• Novel extraction methods Co2, CFT
• Suppositories, sub lingual sprays

14
Some Key Issues 5

• Drug approvals why so few?
• Who gets fast tracked and why?
• Detailed international national registration
  guidelines dont exist
• Is safety testing used as a barrier to entry?

15
Some Key Issues 6

• MARKETING
• Antimalarials are not a profitable business in
  the first place compare anticancer drugs
• The suffers cannot afford to pay
• It is the travellers market that makes the money
  for malaria drug producers
• But artemisia is NOT recommended for prophylaxis
• So who will buy the ACTs, Bill Gates?

16
Objectives

• Sharing information between research,
  development, healer, policy and regulatory
  organizations involved in malaria treatment and
  control,

17
Objectives

• Identifying issues affecting the conservation,
  cultivation and production of potent medicinal
  plant species relevant to malaria treatment,

18
Objectives

• Encouraging new products and novel delivery
  systems that offer cost effective and safe
  remedies for malaria sufferers, and identifying
  investors and entrepreneurs will to develop such
  products,

19
Objectives

• Encouraging appropriate investment in the
  growing, processing and distribution of herbal
  antimalarials,

20
Objectives

• Forwarding to government and international
  agencies clear recommendations concerning
  rationalization and streamlining of safe
  manufacturing practices and marketing regulations
  for antimalarials,

21
Objectives

• Developing appropriate Africa-wide quality
  control and quality assurance standards for
  cultivation, production and distribution of
  herbal antimalarials and methods to implement and
  police such standards.