01 May 2002
The French medical group -- Doctors without Borders -- says newly introduced Chinese drugs come from artemisinin -- which is extracted from a plant known as “artemesia annua,” or wormwood. Scientists say the recipe for the treatment was discovered on a stone tablet in a tomb of an ancient Chinese prince during an archeological dig in China 30 years ago. The potion was used thousands of years ago to fight malaria – and today a purified form is being used to treat malaria in Nigeria and other parts of Africa. The drugs work by attacking high iron concentrations in the cells infected with malaria. The membranes of the cells eventually break apart, killing the parasite – called “plasmodium falciparum."
Some Nigerian doctors are prescribing the Chinese medicine as an alternative to conventional anti-malarial drugs. One of them is Kayode Obembe -- the chairman of the Oyo state chapter of the Nigerian Medical Association, or N-M-A. He also runs a private hospital in Ibadan. He says the artemisinin derivatives are very useful in treating malaria: " [Until now] chloroquine has been the mainstay of treatment of malaria here but you find that in the recent times, there are some strains of the plasmodium falciparum [malaria parasite] which are resistant to chloroquine -- and difficult to treat. It can complicate diseases like typhoid and before you know where you are the patient can even die if you don’t have any substitute. So we have found that as an alternative to chloroquine these Chinese formulations are quite useful."
Doctors Without Borders recommends the artemisinin-derived drugs be combined with other anti-malarials. The group says that's because artemisinin has a very short life that can be prolonged when combined with other drugs.
Artemisinin derivatives are found in many pharmacies in Nigeria. But it's often too expensive for many Nigerians. In fact, it’s reported that in some parts of Nigeria it may cost as much as five dollars to treat one case of malaria with the Chinese drugs compared to less than half that for conventional Western treatments.
Ms. Anja Lund -- the medical coordinator of Doctors Without Borders in Nigeria -- says since many can not afford the drug treatment, the government should focus on preventing the spread of malaria. She says many who have tried to find cheaper versions of the drug have ended up patronizing quacks: " There’s a lot of anti-malarial drugs that are counterfeit, that are not of quality, that should not be used and that are very dangerous. People are buying them from street vendors. You don’t know the effectiveness of these drugs -- they could be effective but [some people] don’t take them according to prescription."
But Kayode Obembe of the Nigerian Medical Association says the Chinese drugs themselves are safe -- and have been approved for use by the Nigerian government: "When a drug has been certified useful by a federal drug agency, it can be used. It’s not actually that you bring the roots and trees from China and start applying it here, no. It has undergone some scientific purification and the combinations are quite specific and the dosages are quite proportional exactly to the body dosage and weight."
Some herbal practitioners in Nigeria are not happy with the growing use of artemisinin. They say the doctors – and the government – are discriminating against homegrown treatments against malaria. But Ibadan-based herbalist Ebenezer Olapade says he’d rather use the Chinese anti-malarials -- which he says have been tested – instead of locally manufactured ones, which have not: "Our problem is that most of the effective drugs herbal practitioners are using are restricted to the practitioners themselves. They’ve not been publicly tested, and there’s no public attestation medically to the potency of these herbal medications. Until we have done adequate research to document the number of cases treated, the efficacy, the safety, the side effects and all these things are well documented, then we can not be talking of our herbal medications."
Treatment for malaria is a pressing issue in Nigeria and other African countries.
In Nigeria, health statistics show that 25 percent of infant deaths and 20 percent of maternal mortality cases in Nigeria are attributed to the disease. About half of all Nigerians are said to suffer at least one attack every year.
A report by American economist Jeffrey Sachs says malaria is one of the reasons for Africa’s underdevelopment. He says the illness can account for up to 20% of a country’s national income over a 15-year period.
Ninety percent of deaths from the disease occur in Africa, with young children most at risk. It is estimated that twenty-five hundred African children under the age of five die from malaria every day.