Small-scale Farmers Can Fight Malaria Battle

Malaria is one of Africa’s biggest killers. Each year globally 300 to 500 million people are infected, and around 1 million die from the disease (theglobalfund). Ninety percent of malaria deaths occur in sub-Saharan Africa – mostly to children under the age of five. The disease costs African countries US$12 billion a year in lost gross domestic product.

Malaria is a parasitic disease – the parasite plasmodium – transmitted by mosquito bites. Symptoms include fever, headache and vomiting. Internal bleeding, kidney and liver failure may follow and can result in coma and death.

The most common and effective treatment, recommended by the World Health Organization, is artemisinin-based combination therapies, known as ACTs. ACTs have low toxicity, few side effects and act rapidly against the parasite. Research shows that artemisinin remedies cure 90 percent of patients within three days.

But there are far fewer doses available than people who need them. WHO has claimed the quantity made available by pharmaceutical companies falls far short of the more than 130 million doses required to combat malaria throughout the world.

And ACTs are very expensive to deliver: in just one country, Tanzania, providing such therapy for three years would cost US $48.3 million. Every year, this would account for 9.5 percent of Tanzania’s health budget, and 28.7 percent of yearly spending on medical supplies: a six-fold increase in budget for malaria treatment (Malaria Journal 2008, 7:4).

But a cheap alternative to the expensive pill form of the treatment is being piloted across Africa. It involves the drinking of a tea made from the bushes of the artemisia plant. Artemisia annua is an annual shrub and the active ingredient in the pills (artemisinin). It is native to China and Vietnam and has been used for 2,000 years to treat fevers.

Bushes cultivated by farmers in Kenya, Malawi, Tanzania, Zambia, Zimbabwe and Mozambique under the supervision of the World Agroforestry Centre in Nairobi, Kenya, are helping to bring down malaria rates without the long wait for the pills to arrive.

The leaves are boiled and made into a tea. Drinking the tea gives a high enough dose of artemisinin in the blood to cure malaria. Helen Meyer, a nurse operating nine mobile health clinics in rural Mozambique, is using the bitter tea made from the dried leaves. Even in treating drug resistant malaria, she has found the artemisia tea effective: “If you drink the tea, you feel better after the first day. Other medicines take a few days.”

A special hybrid of artemisia, A-3, is used because it is adapted for warmer climates. The wild variety grows to only five centimetres in the tropics, but A-3 grows to three metres and packs 20 times more artemisinin. It is also highly economical: thousands of plants can come from a single stem.

The daily adult dose of anti-malaria tea just needs five grams of dried A-3 leaves in one litre of water. The tea is drunk every six hours for seven days. Each plant produces 200 grams of dried leaves, and a thousand shrubs can cure 5,700 people. Since it is a cheap cure, money can be spent instead on other things. Farmers are also able to supplement their income by growing the bushes. And the dried leaves have long-lasting power: even after three years the leaves retain close to a 100 percent of their artemisinin.

Access to authentic artemisinin is critical: it is estimated 16 percent of malaria medicines in Kenya are counterfeit. Elsewhere, the proliferation of counterfeit anti-malarials substantially raises the risk of the emergence of resistance to artemesinin combination therapy, the last truly effective treatment against malaria. Past misuse of other malaria drugs, such as chloroquine in the 1980s and sulphadoxine/pyrimethamine in the 1990s, resulted in the malaria parasite becoming resistant. Hundreds of thousands of people in malaria-prone areas may have died as a result.

The World Agroforestry Centre, recognizing potential problems with artemesinin monotherapies, is working to combine it with indigenous herbal remedies made from other anti-malarial trees, producing a herbal combination therapy (HCT).

“I used to grow fruits and beans here,” said Charles Kiruthi, a Kenyan farmer, to the IRIN news service. “but I will get a better return from this plant. No pests attack it, and until harvesting time it requires very little labour.”

“I expect to get a good return, and I am also very happy to be helping fight malaria,” continued Kiruthi. “I recently lost two friends to the disease, and my child gets sick with malaria sometimes.”

By David South, Development Challenges, South-South Solutions

Published: July 2008

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Safe Healthcare is Good Business and Good Health

 

Many people have been shocked by recent stories about the proliferation of counterfeit drugs and the rate at which they are killing and harming people in Nigeria. The International Narcotics Control Board found that up to 50 percent of medicines in developing countries are counterfeit. This has driven home the point that without the presence of legitimate players in the African drug market, the illegal sharks will step in to make large profits – and a literal killing.

To counter this negative trend, what is most needed is support for reliable Africa-based companies: businesses that are long-term, sustainable and not living from one grant to the next. But as experience has shown around the world, nurturing businesses requires certain fundamentals: they must work to be profitable, they must find a market and exploit it, and they need cash infusions that are timed to the company’s growth, not to the cycle of international donors. This role, often served in developed countries by venture capitalists, who want a fast return of 35 percent – is too onerous a burden for most African businesses. What African companies need is a more conservative, long-term approach; one that expects returns of between five and 10 percent.

Kenyan company Advanced Bio-Extracts (ABE) is one good example. Only 18 months old and based in Nairobi, the company produces one of a new generation of low-cost anti-malarials known as artemisinin-based combination therapies (ACTs). The drug is produced from the green leafy plant Artemisia, or sweet wormwood. The company is the first in Africa to make this drug, and employs 7,000 local farmers in Kenya, Tanzania and Uganda, as well as scientists.

ABE has received two infusions of cash from non-profit social venture capitalists Acumen, as well as investment from Swiss drug giant Novartis. Acumen has so far invested US $9.6 million in 11 active investments focused on a diverse set of health challenges, including basic healthcare access in rural areas and treatment for malaria and HIV/AIDS.

“We are commercializing a product that had never been commercialized,” said ABE’s owner, Doug Henfrey, to the New York Times. “Those little windows of support make these things happen. We could not have done it otherwise.”

Acumen’s Kenya country director, Nthenya Mule, said “there are positive things happening in Africa, but they are not happening overnight, and some are happening quietly. ABE is exemplary. You will not see it as front-page news, but in 18 months they set up a factory with 160 people interfacing with 7,000 farmers and supplying one of the major pharma companies in the world.”

Stimulating private sector solutions to African healthcare problems is receiving an additional boost from a new fund established by the World Bank’s private sector arm, the International Finance Corporation. To be launched later in 2007, it will offer cash and loans totaling US $500 million to commercial healthcare projects in Africa. According to its own statistics, 60 percent of health expenditure in sub-Saharan Africa is privately funded, and the market, excluding South Africa, is worth US $19 billion.

By David South, Development Challenges, South-South Solutions

Published: May 2007

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

Follow @SouthSouth1

Like this story? Here is a dirty secret: this website is packed with stories about global South innovators. We spent 7 years researching and documenting these stories around the world. We interviewed the innovators to learn from them and we visited them to see how they did it. Why not use the Search bar at the top and tap in a topic and see what stories come up? As for my work, I have been involved with start-ups and media ventures since the early 1990s. While most tech entrepreneurs were either still in their nappies in the 1990s (or just a drunken night away from being conceived in the 2000s), I was developing content for this new thing they called the "Internet". In the years since I have learned a great deal about innovation and digital and have shared these insights in the stories on this website as well as in the 5 issues of Southern Innovator magazine. So, stick around and read some more!    

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