From Patrick Davey
Martin de Smet reports that malaria in Cambodia is developing resistance to artemisinins (20 June, p 22).
I lived in Uganda for four years, and saw the impact of malaria there. It is clear that if resistance becomes widespread it will be a death sentence for many people.
In Uganda we grew artemesia and made a tea from it that is a valuable prophylactic and treatment for malaria. I understand that there are about 20 compounds in artemesia that have anti-malarial properties, and some strains of the plant are effective against malaria although they contain no artemisinin. The chance of resistance developing to a composite of so many compounds is negligible. So rather than purifying one active compound from artemesia, we might do better to make a plant extract.
Unfortunately, this does not fit with international standards for the preparation of pharmaceuticals, which require exact quantities of active components to be specified. It ought nevertheless to be possible to market such preparations under regulations relating to herbal remedies, which only require quantities of the major components to be included on the product label.
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Some effort may be needed to achieve the necessary international agreement, but it will be well worthwhile.
We cannot allow the fight to prevent malaria becoming resistant to treatment to be tied up in red tape.
Shankill, Dublin, Ireland
