African Traditional Herbal Research Clinic ... - Blackherbals.com

Continued from page 1 – Malaria Rate at 95 Per Cent110,000 people annually, malaria is one of the maincauses of poverty in Uganda. Speaking at a pressConference to launch the malaria week on Tuesday, StateMinister for Health Richard Nduhuura said people shouldview malaria as more vicious than war because it claimsmore life daily than war.Uganda will join the rest of Africa April 25 tocommemorate the African Malaria Day under the theme,Free Africa from Malaria now-Roll back Malaria.The national celebrations are scheduled for Sembabuledistrict. Religious leaders have joined in the malariasensitization campaign.“We are embarking on a combative approach toconstantly remind the public of the danger malariacauses” Dr. Nduhuura said.☻☻☻☻☻☻110,000 Children Die ofMalaria Every YearApril 25, 2007Daily MonitorBy Isaiah Kitimbo, KaliroThe Minister of Health has revealed that between 70,000and 110,000 children under five years in Uganda dieannually due to malaria alone.Dr. Stephen Mallinga said malaria is the number onekiller disease in Uganda and accounts for more than aquarter of all causes of death among children less thanfive years.“In addition, Malaria leads to very poor pregnancyoutcomes like abortion, premature delivery and veryweak babies,” he said. The Minister was on April 23speaking at Kaliro District headquarter where heofficiated at the launch of Malaria No More freemosquito nets distribution campaign.The Ministry of Health is running a campaign todistribute 580,000 long lasting Insecticide treatedmosquito Nets in 26 districts in Uganda plagued bymalaria. The campaign is aim at achieving at least 85%coverage around the country.☻☻☻☻☻☻Uganda Gets 2 MillionDoses of CoartemBy Peter Nyanzi, KampalaMarch 27, 2007Daily MonitorA consignment of at least two million doses of the antimalariadrug Coartem has arrived in the country for feedistribution to health centres countrywide.Top officials of drug manufacturers Novartis, who are inthe country to attend a malaria workshop, yesterday said thedrugs would be officially handed over to the Ministry ofHealth this week.Cost ReductionThe consignment contains 20 million tablets procured at aprice reduction of 36 per cent, which is equivalent to asavings of $9 million (about Shs16.2 billion). The officialssaid other African countries have used funds saved due tothe price reduction to roll out their malaria treatmentprogrammes.Coartem is now the official drug recommended by theWorld Health Organisation (WHO) for the effectivetreatment of malaria in countries like Uganda whereresistance to conventional anti-malaria drugs is high.Over 300 Ugandans, most of them children under fiveyears, die from malaria everyday with annual economicloses estimated at $690 million.Effective DrugNovartis Vice President for Communications said Coartemis currently the only artemisinin-based combination therapypre-qualified by the WHO and procured with grants fromthe Global Fund to fight Aids, Tuberculosis and Malaria.The drug, to be distributed at no cost to patients in publichealth facilities, is a highly effective and well-toleratedanti-malaria that achieves cure rates of up to 95 per cent.Speaking to reporters ahead of the workshop, which willbring together health experts from 14 African countries,and Europe said the US, Prof.Bob Snow, the head of the Malaria Public Health andEpidemiology Group, said “Uganda has been provided withenough funds by the Global Fund to provide Coartem freeof charge in public health facilities country-wide.”Health Minister Stephen Mallinga is expected to open theworkshop, which will among other things address thechallenge of improving accessibility and the administrationContinued on page 5-2-Traditional African Clinic – July/August 2007

AFRIKAN SPIRITUALITYThe Loss of African TraditionalReligion In Contemporary Africaby Rev. Peter E. Adotey AddoThe desecration of Africa in the past by the Western Europeanpowers seriously and adversely affected the traditional cultures ofthe indigenous African people to the extent that many traditionalbeliefs, social values, customs, and rituals were either totallydestroyed or ignored. In most cases they were considered to benothing more than pagan values and superstitions that played nopart in traditional African culture. Culture after all is the way of lifedeveloped by people as they cope with survival. True culture thenmust include the traditional beliefs and spiritualism. Theintroduction of European Christianity and values separated theindigenous Africans from their traditional ancient spiritual roots aswell as their traditional identity as a spiritual people. This shortpaper is to introduce the reader to an introduction to TraditionalAfrican Religion.Traditional African religion is centered on the existence of oneSupreme High God. However, the Europeans who spreadChristianity in Africa never understood or properly appreciated theAfrican's own conception of the Great Creator. They saw nosimilarity between the God they preached and the African's ownbelief in the One Supreme God and creator who was, king,Omnipotent, Omniscient, the Great Judge, Compassionate, Holyand Invisible, Immortal and Transcendent. The traditional Africanbelief is that the Great One brought the divinities into being. Hetherefore is the maker and everything in heaven and on earth owestheir origin to Him alone. He is the Great king above all Kings andcan not be compared in majesty. He is above all majesties anddivinities. He dwells everywhere. Thus He is omnipotent becauseHe is able to do all things and nothing can be done nor created apartfrom Him. He is behind all achievements. He alone can speak andaccomplish his words. Therefore there is no room for failure. He isAbsolute, all wise Omniscient, all seeing, and all Knowing. Heknows all things and so no secrets are hid from Him. If there is rainit is God who wills it and if the fish do not run it is by His will.This Great Creator is the final Judge of all things, but he is able tobe compassionate and merciful. He can look kindly and mostmercifully on the suffering of men and women and is able tosmooth the rough roads through his divine priests and the spirits ofthe ancestors. The God of the African Traditional Religion is also aHoly God both ritually and ethically. He is complete and absolutesince He is never involved in any wrong or immorality.Traditionally Africans believe that since God's holiness blinds Hetherefore can not be approached by mere mortals. He is a spirit andthus must be approached by spirits invisible to mere humans.How is this God to be approached then? He is to be approached________________________Managing Editor: Nakato LewisPUBLISHER: KIWANUKA LEWISPublished monthly and freely by BHSN for the African TraditionalHerbal Research ClinicThe traditional shrine as a symbol of our cultural historydirectly and indirectly only through his chosen priests.Libations or prayers are the only supplications acceptable. Andthey are made by his chosen priests in traditional rituals andceremonies at appropriate times and places. The priest becomesthe keeper of the welfare of the people and subsequently isentrusted with the sacred rituals of worship. The Africantherefore does not need to prove the existence of God toanyone. God is self existing and needs no proof. His existenceis self-evident and even children are taught from birth that theGreat One exists. There is a Ga Language proverb that says,"No one points out the Great One to a child."This God then is given regular and direct worship at regularintervals and the calendar is kept by dedicated priests.However, there is continuous indirect worship on a daily basisthrough the divinities and ancestors at all times during the dayby each family and individual. The ritual altars in the Africanvillages are the indigenous peoples' way of reaching out andpraising the Great Creator. To the Africans they are theboundary between heaven and earth, between life and death,between the ordinary and the world of the spirit. The constantpouring of drink, food and sacrificial animal blood makes themsacred and no one would dare abuse them. Some altars aresimple; especially the ones in homes, but some communitiesand villages have communal altars for the entire village asvehicles for channeling the positive forces from the Great oneand the ancestors to the whole community.Through oral traditions these cultural values are kept andtransmitted from generation to generation. In summary: In theprivate and public life of the African, religious rites, beliefs,and rituals are considered an integral part of life. Life then isnever complete unless it is seen always in its entirety. Religiousbeliefs are found in everyday life and no distinction is madebetween the sacred and the secular. The sacred and the secularare merged in the total persona of the individual African. Life isnot divided into compartments or divisions. Thus there are nospecial times for worship, for everyday and every hour isworship time. There are no creeds written down becausethrough the traditions of the Elders all creeds and functions arecarried in the individual's heart. Each individual by his verynature and life style is a living creed from the time one risesuntil one retires at night. An understanding of the basic natureof the African religious tradition surely illuminates the meaningof spirituality in contemporary Africa.☻☻☻☻☻☻-3-Traditional African Clinic – July/August 2007

African Traditional Herbal Research ClinicVolume 2, Issue 7 NEWSLETTER JulyAugust 2007FEATURED ARTICLESGovernment to reduce all Deaths due to Malaria byHalf by 2010The Malaria Week marks seven days of intensivehighlights of current malaria control activities.During the week, the Public is updated on what ishappening and where we are going as far as the fightagainst malaria is concerned.Today, 25 April, 2007 marks the end of the “MalariaWeek” that was officially started on 17 th April 2007with Media update and Press Briefing at the Ministry ofHealth headquarters.It is therefore our responsibility to build on what hastaken place during the week to achieve the envisagedobjectives for observing Africa Malaria Day 2007.During the malaria week, a Press Briefing was carriedout to inform the country through the media that theGovernment of Uganda is moving in a strategicdirection towards achieving our set objectives ofreducing by a half of all deaths due to malaria by 2010.In line with the Abuja targets, the malaria decade(2001-2010) has seen Uganda strengthen through theMinistry of Health four main strategies to control andprevent malaria.The Home Based Management of Fevers StrategyImplementation of the Home Based Management ofFevers (HBMF) strategy now covers the wholeCountry. Through this approach, medicines have beenavailed to the community to enable children aged lessthan 5 years old access treatment for malaria within 24hours of recognition of symptoms.To-date, at least two Community-based MedicineDistributors (CMDs) have been trained in all Villagesin Uganda. They have been trained to administermalaria treatment using a pre-packaged dose forchildren aged between 4 months – 2 years and 2-5years. This intervention has saved lives of manychildren that in some district reports indicate that over80 per cent of children under five years are able toDr. Nduhura – State Minister for HealthApril 25, 2007Daily Monitoraccess effective treatment for malaria within 24 hours.This strategy has been quite effective for example; inKumi District, reports indicate that the children’s wardis almost closed and the health workers have moretime to attend to other ailments other than malaria.The proportion of children receiving early treatmentfollowing the introduction HBMF increased from abaseline of 54 per cent-62 per cent among children of2-23 months, and from 56 per cent-65 per cent amongchildren aged 24-59 months.There are indications that HBMF helped to reducesevere anemia among children aged 6-12 months by 16percent, 13-18 months by 25 per cent, and 19-24months by 36 per cent.The problem of long distances to the nearest healthfacility is being tackled by bringing services to thepeople. Every Parish is earmarked to have a functionalHealth Centre II (HCII). About 151 Health Centre IV’sat County levels, have been equipped to offset theburden of referral for emergency cases. By end of2003, the number of health facilities had increased to2,930 country-wide hence increasing accessibility tohealth services within a distance of 5 km from 49 percent in 1986 to 72 per cent.There has also been increased Public-PrivatePartnerships in health care delivery. For instance, thenew medicines introduced to treat malaria with acombination of Artemesinin Therapies (ACTs), PublicHealth Facilities and Private not for Profit Clinics havebeen provided with pre-packaged medicines to treatpatients free of charge.Furthermore, the government is supporting bothGovernment and NGO Health Facilities to providemalaria treatment by providing conditional PrimaryHealth Care grants to each health care facility.-4-Traditional African Clinic – July/August 2007Continued on page 5

Continued from page 4 – Government to Reduce AllMalaria Deaths by Half by 2010Prevention of Malaria in Pregnancy (MIP)Intermittent Preventive Treatment of Malaria inPregnancy (IPT) is another strategy to control malaria.Mothers are encouraged to take two doses of SP(Fansidar) during the 4 th and 7 th Month of Pregnancy inAntenatal Clinics. This is meant to reduce frequency ofabortions due to malaria, anaemia and number ofchildren born underweight as a result of malaria. Theproportion of pregnant women receiving IPT with SPincreased from 20 per cent in 2002/03 to 30 per cent in2003/04.Promotion of Insecticide Treated Nets (ITNs)Promotion of Insecticide Treated Nets (ITN’s) is highon government priority list. Through Public-PrivatePartnerships, we have just concluded the distributionof free nets to children below five years and pregnantwomen. There is increased distribution of LongLasting Nets to vulnerable groups country-wide. Oneof the main activities during the Malaria Week was thelaunch of “Malaria No More Nets” that are to bedistributed in 26 Districts. As a starter, Kaliro Districtreceived its share of freely distributed nets on 23 April,2007 to coincide with the Africa Malaria Week.Indoor Residual Spraying (IRS)My Ministry is also putting emphasis on vector controlthrough Indoor Residual Spraying (IRS). We areconsidering the re-introduction and use of DDT forindoor residual spraying for malaria vector control inUganda after being cleared by WHO. As of now tworounds of Indoor Residual Spraying (IRS) using Iconhave been conducted in Kabale District. The analysisof data from health facilities indicates a greatbreakthrough in reducing malaria among the peoplethat would be reporting for treatment.Kanungu District has just concluded the IndoorResidual Spraying (IRS) exercise and in KitgumDistrict, IRS is taking place in IDP Camps right now.In all these Districts, the Leaders together with ourPartners through the Presidential Malaria Initiativehave done a great job. It is this Leadership andPartnership that our theme for this year is emphasizingto Roll Back Malaria for Positive Results.The struggle to Uganda of malaria cannot be overemphasized.Everybody is mandated to contributefrom their point of advantage. As we observe the 7 thAfrica Malaria Day, remember:1. Seek malaria treatment within 24 hours ofsymptoms’ recognition2. Consistently sleep under a treated Mosquitonet3. Clean your environment to avoid and reducebreeding sites for mosquitoes4. Close your windows and doors early to avoidmosquitoes entering your house5. Let your house be sprayed with approvedinsecticidesLET’S FIGHT AND KILL MOSQUITOES NOW.☻☻☻☻☻☻Continued from page 2 – Uganda Gets 2 Million Doses ofCoartemof safe and effective medicines in African countries.The officials said Norvatis has formed a partnership withEast African countries to increase agricultural cultivationof Artemisia, the plant from which Artemisinin, the activeingredient in Coartem is made.☻☻☻☻☻☻New Hope in Malaria WarDr. Salim AbdullaApril 23, 2007Daily MonitorMalaria one of Africa’s oldest and gravest threats, maysoon meet its match: a vaccine. A malaria vaccine has beenconsidered among science’s greatest challenges.But thanks to a remarkable discovery and a novelpartnership, we could have an effective vaccine in just afew year’ time. Let’s make this Africa Malaria Day (April25) by getting ready to adopt the vaccine.The world’s most advanced malaria vaccine, RTS,S madehistory in 2004 when results from a trial of 2,000 youngchildren in Mozambique showed that a vaccine couldreduce severe malaria by 49%.Since severe malaria kills up to a million children a yearand sickens millions more, even partial protection of thiskind could save millions of lives.An unusual partnership – linking a vaccine manufacturer, afoundation and African scientists – is working hard tomake this vaccine available. Right now RTS,s is in latePhase II trials in Gabon, Ghana, Kenya, Mozambique andTanzania.Next year, RTS,s will begin the final stage in the clinicaldevelopment process. If these tests continue to besuccessful the vaccine could be available as soon as 2012.Continued on page 9-5-Traditional African Clinic – July/August 2007

African Traditional Herbal Research ClinicVolume 2, Issue 7 NEWSLETTER July/August 2007FEATURED ARTICLESSeeking to Reduce the Malaria BurdenPatience AtuhaireDaily MonitorJanuary 31, 2007Malaria is widely spread throughout the country with90% of the total population in highly endemic,primarily rural areas. It accounts for 25% of alloutpatient attendances in Uganda and 15.4% discountedlife years lost due to death from malaria as well as 12.9workdays lost due to absenteeism. The overall cost ofmalaria in Uganda is estimated at nearly 1% of theGross National Product. The National Malaria ControlProgramme outlines insecticide treated nets (ITNs) as akey strategy for malaria control but their access andavailability to the population is still limited.NetMark, therefore, is an organization with a timelimitedinvestment by USAID whose goal is to reducethe burden of malaria in sub-Saharan Africa byincreasing the commercial supply of an public demandfor Insecticide Treated Nets (ITNs).This is done through partnerships with commercialcompanies and national malaria control programs, andnational scale public education and promotional efforts.The organization launched in Uganda in 2003 and hascontributed to several successes in the fight againstmalaria in the following ways:• The number of nets distributed in Ugandajumped from 280,295 to about 2.5 million in2004.• Ninety-three percent of net distribution inUganda in 2005 came from the private sector.• There are now eight ITN distributors in Ugandacompared to only one in 2002.• The number of outlets selling nets increasedfrom only five in Kampala to 1,164 throughoutthe country.• The average ITN price dropped to $5.50 from$8.00 in 2002.• The commercial sector’s investment in the ITNbusiness more than quadrupled from $445,694in 2003 to nearly $1.9 million by the end of2005, with businesses investing $2.55 or everydollar USAID spent in fiscal year 2005.Through Netmarks’ work, commercial sales of ITNs anduntreated nets topped 2.2 million and 2.5 million,respectively, for a total of nearly 5 million nets between2003 and March 2006. Netmark’s goal in Uganda is tobattle malaria by creating a sustainable, national marketfor ITNs that makes them accessible and affordable forall.To do this, NetMark developed the Full Market Impact(FMI) approach to establish a sustainable commercialmarket that complements donor-led ITN efforts byreaching people who can buy ITNs. This frees upresources that can be used to reach more people whocannot pay for nets by:-6-Traditional African Clinic – July/August 2007• Expanding public knowledge and use of ITNs(particularly long lasting ITNs) through amultimedia campaign to create demand.• Providing support to manufacturers anddistributors to ensure consistent supply of stock.• Providing support to distributors to make theirproducts more widely available through retailoutlets throughout the country, in both urbanand rural areas.• Encouraging participation of more internationalmanufacturers and local distributors for greatcompetition among brands. This has ultimatelylowered prices and made the products availableto all socio-demographic groups, especiallythose more vulnerable to malaria.• Evaluating progress and measuring impactthrough ongoing retail audits and periodichousehold surveys.Continued on page 7

African Traditional Herbal Research ClinicVolume 2, Issue 7 NEWSLETTER July/August 2007FEATURED ARTICLESHow Malaria Impoverishes UgandaUntil recently malaria was only known as the leadingkiller disease in Uganda and sub-Saharan Africa. Butstudies from the Ministry of Health indicate thedisease is also the leading cause of poverty.This is because it has serious impact on theeconomic, social and cultural aspects of society.A study carried out in 2002 in Uganda identified illhealth as the most frequent cause of poverty. Thestudy showed that a poor malaria-stricken familymight spend up to 25% of its income on malariatreatment and prevention. There are also direct costsin form of treatment, treatment seeking and funeralexpenses.IndustryMalaria leads to loss of household incomes throughabsenteeism from work. It is estimated that workerssuffering from a malaria bout can be incapacitated forfive to 20 days. A study showed that a highpercentage of employees were absent from work dueto malaria.In Apac district 54 per cent of workers cited malariaas the reason for absenteeism, in Kampala 33 per centand 50 per cent in Rukungiri. On the average out ofseven working days, between four to nine days werelost per malaria episode. This means that recoverywould take longer than a week in some workers.During such a period some companies pay forworkers’ treatment while the employees are notproductive at the moment. Company production isaffected leading to lower profit levels and highercosts of production. And this occurs several times ayear in many families. This affects the nationalbudgets because the lower the output, the lower thetaxes paid to the government. As such, thegovernment cannot meet the obligation of providingservices such as in health, thus creating a viciouscycle of poverty.Apart from direct effects of malaria to industries isJane NafulaDaily MonitorMay 9, 2007the additional low demand level. A sick and perenniallypoor population has low consumption levels. Because oflow household incomes, such a population can hardlyafford basic necessities in life. This makes it difficult forsuch a country to attract investment because of the smallmarket available. The opportunities that go withinvestment (jobs, taxes, social infrastructure and a higherstandard of living) are lost.In industry and agricultural enterprises like tea,sugarcane, coffee, rice, tobacco estates, malaria accountsfor the greatest number of man-hours lost, which maybeup to or more than 50% of all the man-hours lost. Thisaffects production and revenue for the industry, familiesand the nation as well.Malaria also leads to loss of investment funds thusaffecting the economy. It is known that investors are notmuch interested in investing in countries where most oftheir profits will be eroded through absenteeism fromwork due to malaria an on treatment of malaria infectedworkforce.Agriculture, EducationThis means there are high chances that children in suchfamilies will not be able to attend school. This affectsperformance. It is estimated that in endemic areas likeUganda, malaria may impair as much as 60% of theschoolchildren’s learning ability.Children from such families will perform poorly, go topoor schools and have fewer or no opportunities to highereducation. This makes them miss out on goodemployment opportunities and they end up doing lowskilled labour intensive jobs.In case the dead person is the breadwinner for the family,children will automatically drop out of school and arecondemned to living a wretched life.In agriculture, the period parents (mostly mothers) spendnursing sick children is lost whereas it could be used togrow crops for food and income.Continued on page 9-8- Traditional African Clinic July/August 2007

Continued from page 8 – How Malaria ImproverishesUgandaHence, an episode of malaria affects health, education,agricultural activity and food security. All these buildup to increasing poverty in homes.Statistics from the Ministry indicate that malariaafflicted families on the average can harvest only 40%of the crops.It must be remembered that Uganda is basically anagricultural-dependent country. About 90 per cent ofthe population is engaged in agriculture. The countryearns more from agriculture than from any sector.When this mainstay of the economy suffers, the veryfabric of the country is threatened.Malaria is transmitted by the anopheles mosquito andit spreads faster during the rainy season. Unfortunatelythis is the main farming season, when families canleast afford to be sick. Hence malaria interferes withfarm activities increasing poverty in homes.Social-cultural ImpactMalaria has also caused serious socio-culturalconsequences in families.Frequent illness or deaths of children due to malariacan lead to misunderstandings within families(especially polygamous families) and betweenfamilies.Those with sickly children or children dying often arelikely to accuse others whose children do not fall sickor die often of bewitching their children, which mayresult into a fight or hatred.Families with a lot of problems (frequent illnesses,poverty, low education levels and inability to fend forchildren) are usually unstable.In most parts of rural Uganda (if not all) it is conceivedinsensitive if a person continues with farm work likedigging. Until a person is buried no digging ispermitted. Yet during this period the bereaved familiesprovide food for mourners although some neighboursassist. This increases poverty and food insecurity asPresident Yoweri Museveni noted. Whereas food isbeing consumed, no production is taking place thuscreating not only food deficit but increasing povertysince agriculture is the income earner in rural Uganda.Cost of TreatmentDr. John Bosco Rwakimri, the National MalariaControl Programme manager in the Ministry of Healthsays Uganda loses at least $690 million to malariaevery year. This is in terms of treatment, prevention,time lost due to sickness not counting burial expenses.According to the Ministry of Health direct cost oftreatment for an episode of malaria is estimated atShs8,000 ($4.10) in urban settings and Shs3,300 ($1.80)in rural populations.Assuming that 50% of the 5,200,000 children under fiveyears old currently in Uganda suffer an average of sixepisodes annually and are treated in health facilities at2,000/= per episode, then Ugandans are spending (50/100x 5,200,000 x 6 x 2,000) = 31,200,000,000/= annually formalaria treatment of the under fives only! (US$20million, ed. note)This does not include other expenses incurred, such astransport while seeking treatment, treatment for adults,and children over five years old, treatment of adults andchildren admitted in health facilities, the higher costs oftreating the under 5s and other family members in privateclinics and urban areas, chloroquine failures whichrequire more expensive drugs, funeral expenses forchildren and adults who die, aerosol sprays, mosquitocoils, mosquito nets and other mosquito control expenses.It therefore follows that controlling malaria is not only ahealth concern but a socio-economic and culturalobligation for all sectors. It is one way of improvinghuman development and fighting poverty in Uganda.Statistics used are from the Ministry of Health obtainedfrom www.health.go.ug. However, some adjustmentshave been made to reflect the growth in population andthe currency exchange rate, although the figure fortreatment of malaria has remained at Shs 2,000 as perstudy.☻☻☻☻☻☻Continued from page 5 – New Hope in Malaria WarAfricans are at the forefront of testing this vaccine. Asone of the principal investigators of one of the clinicaltrial sites, I have witnessed the positive impact of the trialon African scientists and communities.African scientists, working closely with the otherpartners, participate in the design of the clinical trialprotocols, implement the protocols, and manage the dayto-daywork of the trial. The investigators build strongworking relationships with local communities enrolled inthe trials. We liaise with the Ministries of Health andlocal institution to update them. The trials have alsoimproved medical care provided.The writer is the principal investigator of one of theRTS,s trial sites, and the chairman of the group thatcoordinates all the clinical trials.☻☻☻☻☻☻-9- Traditional African Clinic July/August 2007

Four New Malaria DrugsInventedDaily MonitorMay 7, 2007Jane NafulaAfter a seven-year search for the best drug that can curemalaria, the Medicines for Malaria Venture, (MMV), anon-profit making organisation has finally developed fournew highly effective anti-malarial drugs.The NGO with headquarters in Geneva, Switzerland isdedicated to reducing the burden of malaria in diseaseendemiccountries by discovering, developing anddelivering new affordable anti-malarials through effectivepublic-private partnerships.MMV’s Vice President Public Affairs Anna Wang toldjournalists in Kampala on Saturday that the four drugs arein the pipeline and would be ready within the next twoyears.“Clinical trials started three years ago and we are now inthe last stage of developing the new and affordable drugsto ensure universal access. Almost half of people whosuffer from malaria don’t have access to drugs becausethey are expensive,” Ms Wang said.She said by mid next year, one of the drugs, pediatriccoartem, a formulation for children would be ready.Children under five years and women are vulnerable tomalaria because of their low immunity levels.Ms. Wang said the other three drugs are ArteminisinbasedCombination Therapy with different formulationswhich include, Pyramax, DHA-PIQ (Dihydroartemisinin/Piper-aquine), and LapDap combined with artesunate(CDA).The NGO will today hold a stakeholders’ meeting atSpeke Resort Munyonyo. President Yoweri Museveni isexpected to officiate at the opening of the meeting.According to Ms Wang, a patient is supposed to swallowone table for three days and afterwards he or she will berelieved of the disease.The drugs will be supplied in endemic countriesincluding Uganda. This will be done in collaboration withthe Ministries of Health, researchers and otherstakeholders both in private and public sectors.MMV’s goal will register at least four new anti-malarialsbefore 2010 and maintain a sustainable pipeline of antimalarialsto meet the needs of over 3.2 billion people atrisk from this deadly disease.-10- Traditional African Clinic July/August 2007Last year alone, the organization injected about $50 millionin the development of the drugs. Donors mainly fund itsactivities. The new treatment could be an importantdevelopment in the fight against malaria, which isescalating mainly due to multi-drug resistance including themost frequently use and affordable treatments for malaria,such chloroquine.The available Artemisinin-based Combination Therapy(ACTs) are relatively expensive, currently costingapproximately US$1.20-3.50 (SHS 8,000) per adult dose.Globally, malaria kills between one and two million peopleannually.According to Unicef, malaria infects 350 to 500 millionpeople each year, kills a child somewhere in the worldevery 30 seconds, accounts for about one in five of allchildhood deaths, and is most prevalent in Africa.☻☻☻☻☻☻Study Suggests New MalariaDrugDaily MonitorMay 28, 2007Kakaire A. KirundaA new study suggests there is a better alternative to thecurrent first-line drugs for the treatment of uncomplicatedmalaria in the country.The study suggests the DP (dihydroartemisinin-piperaquinedrug combination appears to be a good alternative to AL(artemether-lumefantrine) as first-line treatment ofuncomplicated malaria. DP is popularly known by thebrand name Duo Cotecxin while AL is what is branded asCoartem.The study was carried out in Apac, a district with highmalaria transmission intensity. Its findings were publishedin the PLoS Clinical Trials Journal of May 18. Researchersfrom Makerere University Medical School and the Instituteof Public Health as well as their counterparts from the UK,USA and Thailand carried out the study.“Patients treated with DP had a lower risk of recurrentparasitemia due to non-falciparum species, development ofgametocytemia, and higher mean increase in haemoglobincompared to patients treated with AL,” says the study.“Both drugs were well tolerated; serious adverse eventswere uncommon and unrelated to study drugs.”Continued on age 11

Continued from page 7 – President Bush donates 500,000Mosquito Nets“We are committed to helping our African partners buildon these efforts, and so I want to share with you two newendeavours: First, America will expand our cooperationwith the government of Uganda, and the non-profitgroup, Malaria No More, to distribute more than a half-amillionbed nets in Uganda,” President Bush said.Malaria is one of the most deadly and prevalent diseasesin Sub-Saharan Africa and also the most preventable andtreatable. More than 1 million people die of malaria eachyear, 75 percent of them African children, and more than300 million people worldwide fall ill from malariaannually.According to the 2006 Malaria Country Action Plan forUganda, household ownership of bed nets is only 25%and that only 15% of children under five are sleepingunder a treated bed net. The President’s Malaria Initiativeestablished a goal that 85% of children under five and85% of all pregnant women will have slept under a bednet by 2010.“Working in partnership with the President’s MalariaInitiative and Malaria No More will produce a total of530,000 bed nets for Uganda together,” according to theorganisation’s website.☻☻☻☻☻☻Ministry, PMI in JointCampaign against MalariaIsaiah Kitimbo, KaliroDaily MonitorApril 30, 2007The President’s Malaria Initiative, Malaria No More, andthe Ministry of Health have started a joint campaign todistribute 580,000 insecticide-treated mosquito nets.The nets are to be distributed to pregnant women,children under five and other vulnerable people in 26districts.The group last week launched the free mosquito netdistribution campaign at Kaliro district headquarters.The ceremony was officiated by the Health MinisterStephen Mallinga.Malaria is the leading cause of death in Uganda.Paid for by PMI and Malaria No More, the nets will bedistributed alongside 1.8 million others from the GlobalFund.“This is an example of how collaboration can help us withour mission: saving lives together and working togethertowards our common goal of stopping malaria” PMICoordinator Tim Ziemer said in a press release.“It will only be through working hand in hand with otherorganizations that we achieve our goal given to us byPresident Bush of stopping malaria and protecting thosewho are most susceptible and in most need.”President Bush launched the PMI in 2005 and challenge therest of the world to match the $1.2 billion pledge, to reducemalaria deaths by 50 per cent in 15 African countries.Mr. Bush urged that the PMI be a collaborative USgovernment effort led by the US Agency for InternationalDevelopment (USAID).☻☻☻☻☻☻Continued from page 10 – Study Suggests New Malaria DrugAccording to the researchers, Duo Cotecxin was superior toCoartem for reducing the risk of recurrent parasitemia andgametocytemia, and provided improved hemoglobinrecovery.Parasitemia is the quantitative content of parasites in theblood while gametocytes refer to one of the stages in thelife cycle of the malaria parasite. Gametocytemia thereforemeans the parasites presence in the blood.The study findings show that patients treated with DuoCotecxin had a significantly lower risk of recurrentparasitemia in both falciparum and non-falciparuminfections.Both Duo Cotecxin and Coartem are fixed dose coformulatedArtemisinin-based combination therapies(ACTs). ACTs are a newer group of anti-malarials thatproduce fast response in patients, are active against multidrug-resistantP. falciparum malaria, are well tolerated bypatients and have the potential to reduce malariatransmission by decreasing gametocyte carriage.However, researchers contend that Duo Cotecxin has asimpler, once daily dosing schedule compared to Coartem,which is provided twice daily, ideally with a fatty meal.Despite the excellent initial parasite clearance by thetwo drugs as indicated in the study and the provision ofinsecticide treated nets at enrollment, the researchersobserved that approximately half of all participantsexperienced recurrent malaria within 42 days.The researchers said the finding emphasizes the need formore aggressive approaches to malaria control in areas withvery high malaria transmission.-11- Traditional African Clinic July/August 2007To reduce new malaria infections, they called a sustainedContinued on page 12

Continued from page 11 – Study Suggests New MalariaDrugcombination of several malaria control measures,including treatment with ACTs, provision of ITNs(with education about their use), and potential use ofindoor residual spraying as has been the case in SouthAfrica.This, they argued, will likely decrease the malariaburden and reduce drug pressure due to repeated use ofACTs.Monitoring of the impact of these combined controlmeasures will be critical to assess success in malariacontrol in Uganda, they further observed.The study results could have important policyimplications, according to the researchers, whoobserved children aged 6 months to 10 years withuncomplicated falciparum malaria in the study,‘Artemether-Lumefantrine versus Dihydroartemisinin-Piperaquine for Treatment of Malaria: A RandomizedTrial.’☻☻☻☻☻☻Shs3.7b Malaria, ARV DrugsRot in NMSAgness NandutuJuly 12, 2007Daily MonitorAs thousands of Ugandans die everyday of HIV/AIDSand malaria, drugs worth about Shs4 billion are rottingin the National Medical Stores Entebbe.While on their fact finding tour of NMS in Entebbeyesterday, MPs on the Social Services Committee ledby James Kubeketerya (Bunya East) were shocked tofind eight containers of 2-feet, full of expired drugs yetUgandans are perishing in hospitals with treatment.The NMS General Manager Apollo Newton Mwesigyetold MPs that due to over stocking of drugs by thirdparty programmes at NMS, ARV drugs valued atShs900 million and other drugs work Shs1.2 billionhave already expired. Those that are bout to expire arevalued at Shs1.65 billion.Third parties are programmes like Global Funds thatstore drugs at NMS.Mr Mwesigye said, “Due to unique nature of NMSoperations, expiry of drugs has remained a bigchallenge. We can only minimize these losses if NMSis given power to perform its statutory mandate ofprocurement, storage and distribution of drugs. We can-not do away with the expire drugs but if procurement isharmonized, we can reduce,” he told MPs.Former NMS General Manager Robert Rutagi was last yearsuspended for the mismanagement that led to the expiry ofARV packs worth Shs936 million.Thousands of Ugandans die of malaria and HIV/AIDSannually due to inadequate drugs in hospitals countrywide.He told MPs that big volumes of expire drugs and thosethat are about to expire belong to third party programmesbut few of the drugs belong to NMS.Out of the 13,000 square metre-storage space, only 2000store NMS drugs.Mr. Mwesigye told MPs that third party programmesprocure big volumes of drugs, which are sometimes alreadyprocured by NMS.“NMS is not involved in the planning or procurement of theitems and we are expected to accept all consignments atvery short notice. This has led to a distortion in NMS henceexpiry,” he said.He said many of the programmes procure short-lived drugsand leave them for a long time at NMS, which in manycases expire. Mr. Kubeketerya demanded for the list ofprogrammes that bring in the drugs that expire at NMS.“If you don’t expose them, it’s your name that gets spoiled.It’s proper to avail to us the names of these programmes sothat people get to know their negligence,” he said.Some of the programmes that were named to have leftdrugs for a long time at NMS to expire are Global Fund,Aids Control Programme, Clinton Foundation, MalariaControl Programme among others.Mr. Mwesigye told MPs that there is an increased numberand volume of redundant stock at NMS.He said high on the redundant stock list are condoms,homapaks for malaria, ARV oral dosage forms and syrups,Uganda Aids Commission lab supplies and other Globalfund stock among others.“This translates into high inventory holding costs and theexpiry risk that in turn leads to financial loss. This isbecause NMS is not involved in the planning andprocurement of the items,” he said.He said big volumes of the drugs that expire have a shortlife span and are brought in without proper planning.-12 - Traditional African Clinic July/August 2007He said some of the drugs are procured in preparation foroutbreaks like bad flu but expire if the outbreaks don’toccur. Said Mr Mwesigye “If there is harmonizing ofprocurement with third party programmes, we can doproper planning and schedule the distribution in a wellContinued on page 13

Continued from page 12 –Shs3.7b Malaria, ARV Drugs Rotin NMScoordinated manner to reduce expired drugs,” he said.Rukiga MP Samuel Byanangwa said, “These donorsshould be told how it works. How can they bring in drugsand them fail to distribute them? Uganda is not adumping ground.”☻☻☻☻☻☻Quinine Crippling ChildrenRichard Otim, KumiMay 7, 2007Daily MonitorKumi Hospital Medical Superintendent John Opolot hasasked the government to prohibit the use of quinineinjections as malaria treatment, saying the drug iscrippling children.He said whereas no case of polio related disabilities hadbeen reported in Kumi district for the past five years,quinine has been the cause of the increasing cases ofdisability among infants.He was speaking to Daily Monitor last week in KumiDistrict.“Quinine is very toxic and most cases of disability wereported are due to post injection paralysis.” Dr. Opolotsaid.He said some infants develop “glutial fibrosis”, orhardening of the child buttocks, after administering thedrug.“Parents should insist on oral or intravenousadministration of the drug and by qualified healthpersonnel,” Dr Opolot said. He said the cases, whichrange from physical to mental disabilities, have beeninflicted on children by mal-administration of quinineinjection conducted especially by quack health assistants.He said this result into post injection paralysis.Quinine may also cause paralysis, hearing problems, andblindness in adults. Medical personnel advise that one onquinine treatment should take a lot of fluids to avoid suchcomplications.☻☻☻☻☻☻Fake Quinine on MarketHussein Bogere & Jane NafulaMay 10, 2007Daily MonitorThe public has been warned against using counterfeit Quinetablets in the treatment of Malaria. The warning came fromthe National Drug Authority, which together with theMinistry of Health have launched an investigation into thesource of the counterfeit Malaria tablets.NDA lifted the lid on the counterfeits yesterday in a publicstatement.“It has come to our attention that counterfeit Quine®(Quine Sulphate) BP 300mg tablets have found their wayinto the Ugandan market,” the statement reads in part.NDA however, warns that any one found selling the tabletswill be prosecuted.“We are investigating, if there is anything wrong, the lawwill take its course,” Sam Okware, the Commissioner forCommunity Health (in the Ministry of Health) told DailyMonitor yesterday.NDA says the particulars appearing on the tin of thecounterfeit Quine tablets are Batch No. 0908 with amanufacturing date of 05/2005 and expiry 04/2009.“Contrary to what is purported on the label, the productwith the above particulars has not been manufactured in thefacilities of Kampala Pharmaceutical Industries (1996) Ltdin Uganda. They are the sole license holders andmanufacturers of Quine® tablets which are registered inUganda Reg. No 0780/06/97,” NDA warns.NDA further warns that anybody found selling thecounterfeit tablets will be prosecuted because their sale,purchase and use has been prohibited immediately.The available stock must be quarantined as well, NDA said.DangerousDr. Okware said the sale of counterfeit drugs is a verydangerous practice. “Those drugs have adverse effects onthe users because they give a false sense of security, theydon’t cure and they easily cause side effects.” He saidnormal drugs must not have side effects.Lately, there have been reports of patients experiencingside effects as a result of using Quinine. On Monday, KumiHospital Medical Superintendent John Opolot asked thegovernment to prohibit the use of Quinine injectionsbecause they were crippling children. He said maladministrationof Quinine injections has inflicted a rangeContinued on page 14-13 - Traditional African Clinic July/August 2007

Continued from page 13 –Fake Quinine on Marketof physical and mental disabilities on children.It is not clear whether these side effects are a result ofthe use of the counterfeit drugs. Dr. Okware said this isan issue worth investigating.FearsThe Minister of State for Health (Primary Health Care),Emmanuel Otaala said the use of counterfeits mayworsen the impact of malaria in Uganda.Studies show that malaria is not only the leading causeof death in Africa, but also the leading cause ofpoverty. About 20-23% of deaths in Uganda areattributed to malaria.On the issue of quinine injections crippling children,Dr. Otaala admitted the problem is rampant. He saidquinine injections kill muscles, that’s why the ministryis recommending that it is administered through drips.☻☻☻☻☻☻Chloroquine to be PhasedOutEphraim KasoziJuly 26, 2007Daily MonitorIn an effort to strengthen the fight against malaria in thecountry, the National Drug Authority has resolved tophase out anti-malarial drugs that have high resistanceagainst the disease.According to Deus K. Mubangizi, the chief Inspector ofdrugs, the drug regulatory body would phase outchloroquine and Homapak.“We have launched a countrywide survey to assess theamount of mono-therapies in stock and sub optimal toresolve. We intend to phase out the previous antimalarialdrugs that have higher resistance againstmalaria,” he said.Mr Mubangizi made the remarks yesterday at thestakeholders meeting held in Kampala. TheStakeholders’ meeting was organized by Afford todiscuss the role of local pharmaceutical sector inpromoting access to Artemisinin-based CombinationTherapies (ACTs) in Uganda.Mr Mubangizi said the move is aimed at advocating forincreased availability of ACT drugs that includeCoartem, a drug that the government monopolized todistribute in its health centres.☻☻☻☻☻☻Does it Matter: WhetherUganda refuses to take $28mfor Malaria Drugs?with Joachim BuwemboAugust 26, 2005Daily MonitorWho told those fellows sitting in Geneva or whatevertown it is called that Uganda is so poor it needs someoneto treat mosquito bites for it? Reports published earlierthis week indicate that they tried to give us $28m worthof Coartem medicine to treat malaria victims in thiscountry. Between the Global fund chaps and those otherones in World Health Organisation, they even took itupon themselves to negotiate for us with themanufacturers so that they can sell the medicine to uscheaply, at only $2 a dose instead of $40, which a dosecosts on the open market. Were they insinuating that ourrich government cannot afford the “right” price so theygo head and treat us like broke chaps?But our proud officials have showed them a move, as theteenagers would say. In the spirit of national pride, ourofficials have ignored the offer for over a year, leavingthose patronizing Global Fund fellows no choice but tocancel it. That is the way to go. Who told them that weare such weaklings we need those mzungu medicines forour very strong children? Don’t they know we have ourherbs to mix and drink when we fall sick? Do theyimagine Ugandans are tourists who need to be pamperedwith sophisticated medicines in order to fight malaria?Today, malaria only kills a few hundred children a week.If it was killing a million, there would be cause foralarm. But it cannot even kill ten thousand a day, andsome fellow wants to give us mzungu medicine! Theproblem with some of these donors is that they imagethat our rich forests do not have enough plants to treatour diseases. They forget that we have a very richheritage of flora in our forests to deal with simplematters like mosquito bites. Have they ever seen amonkey dying of malaria for example?Why do we have the only colony of mountain gorillas inthe world? Isn’t that proof that our forests are veryhealthy? If they continue dangling their money in frontof us, trying to rush us into making transactions inGeneva, we can all walk to the forest in protest and livethere for a year. This will show them that we can dowithout their Coartem. Or do those Global Fund busybodies forget that our present leaders lived for five yearsin the bush without dying of malaria?”Continue on page 15-14- Traditional African Clinic July/August 2007

Continued from page 14 – Does it Matter:We can live without it. And if a few hundred kids die aweek, well, that creates more room in our crowdedclassrooms, doesn’t it?☻☻☻☻☻☻☻☻☻☻☻☻GM Mosquito Could FightMalaria - StudyDaily MonitorMarch 21, 2007AgenciesA genetically modified (GM) strain of malaria resistantmosquito has been created that is better able to survivethan disease-carrying insects.It gives new impetus to one strategy for controlling thedisease: introduce the GM insects into wild populationsin the hope that they will take over.The insect carries a gene that prevents infection by themalaria parasite.Details of the work by a US team appear inProceedings of the National Academy of Sciencesjournal.In the laboratory, equal numbers of geneticallymodified and ordinary “wild-type” mosquitoes wereallowed to feed on malaria-infected mice.As they reproduced, more of the GM or transgenic,mosquitoes survived. After nine generations, 70% ofthe insects belonged to the malaria-resistant strain.The scientists also inserted the gene for greenfluorescent protein (GFP) into the transgenicmosquitoes, which made their eyes glow green.This helped the researchers to easily count thetransgenic and non-transgenic insects.Dr Mauro Marrelli and his colleague from JohnHopkins University in Baltimore, Maryland, wrote inPNAS: “To our knowledge, no-one has previouslyreported a demonstration that transgenic mosquitoescan exhibit a fitness advantage over non-transgenic.”The modified mosquitoes had a higher survival rate andlaid more eggs.☻☻☻☻☻☻Mosquito Bacteria Identified inMalaria BattleMay 16, 2007Daily MonitorReuters, RomeScientists in Italy say they have identified a potentialweapon against malaria living inside the blood-suckingmosquitoes that spread the disease – their internal bacteria.Malaria, a mosquito-borne disease used by a parasite, killsat least a million people annually. Most of the victims areyoung children in sub-Saharan Africa.With attempts to completely eradicate mosquitoes or createa vaccine so far unsuccessful, the Italian scientists set out tofind any bacteria that lived symbiotically inside the pests.Such bacterial could potentially be genetically altered laterto attack the malaria parasite when it reaches the mosquito,said Daniele Daffonchio at the Universita degli Studi diMilano, one of the five Italian universities behind theresearch.In the study, published in the Proceedings of the NationalAcademy of science on Monday, the team said it identifiedone candidate – a bacteria called Asaia, which is foundthroughout the mosquito’s body.That includes the mosquito’s gut and saliva gland as well asits reproductive organs, meaning that the altered bacteriacould spread to mosquito offspring.“Instead of spraying chemical or biological pesticides, youcould use this symbiotic bacteria that is passed on,”Daffonchio said. “You don’t have to spray every year.”Daffoncio said research into modifying bacteria like Asaiawas being conducted to battle the deadly Chagas disease.Malaria has become resistant to some drugs, and work on avaccine has been slow.☻☻☻☻☻☻-15- Traditional African Clinic July/August 2007

African Traditional Herbal Research ClinicVolume 2, Issue 7 NEWSLETTER July/August 2007FEATURED ARTICLESNo Money for DDT SprayingSteven Kibuuka, KampalaDaily Monitor, April 24, 2007Deaths from malaria are likely to continue after thegovernment yesterday expressed doubt that the plannedwidescale spraying of DDT to fight the disease willstart in July.Speaking in an interview with Daily Monitor,Emmanuel Otaala, the minister of State for PrimaryHealthcare said the government has failed to raise closeto $400 million (Shs750b) needed to kick-start thespraying.“We don’t have money to buy DDT right now,” Dr.Otaala said.“We did not budget for it this financial year so wecannot use it this year.”The Ministry of Heath had announced plans to beginusing DDT to combat malaria in June 2007, in thepioneer districts of Apac in northern Uganda, Kanunguin the southwestern and all IDP camps.An estimated 320 people die of malaria in Ugandadaily. According to the World Health Organization,there are between 1.5 million and 2.5 million deathsdue to malaria in the world with 90 per cent of cases insub-Saharan Africa.Added to the deaths are the social-cultural costs whichcannot be easily monetized. But such costs indicate thatthe disease is also the leading cost of poverty inUganda.Dr. Otaala, however, said the government has startedrequesting Development partners to help out. “AlreadyUSAID has agreed to help us,” he said. “USAID haspromised to give us US$50 million but this can coveronly 7-8 districts,” Dr. Otaala said.However, the minister said the American agency wouldonly release the funds after carrying out its ownassessment of the effects of the chemical.“The USAID promise is not yet guaranteed becausethey are right now carrying out an impact assessmentwhich involves finding the impact of DDT on theenvironment and that takes long,” Dr. Otaala said.“The earliest they can finish this is June and then makea report which may also take a lot of time. Developmentpartners, who are willing to help us out, shouldnot put difficult conditions as usual because people’slives are at stake here,” he said.The National Environment Management Authorityapproved the use of the chemical last year as a meansof controlling Malaria in the country.Nema said that DDT would have no harm as feared byenvironmental activists.The World Health Organization also approved its use inUganda as long as it’s sprayed indoors.Dr. Otaala says that DDT would be use as a malariaprevention programmed by the government, malariahas caused many deaths among Ugandans.DDT will be sprayed in the inside walls of homes andbuildings. The crystalline solid residue left behindserves to repeal and kill mosquitoes, the vectorresponsible for the spread of malaria.“DDT is one of the cheapest, most effective tools in thefight against malaria in many developing countries andwe also want to use it here,” Dr. Otaala said.There has been considerable controversy surroundingthe harmful effects of DDT since 1962, when RachelCarson, an American environmentalist, published SilentSpring, a comprehensive study detailing the damagethat wide-scale DDT use had inflected on theenvironment and wildlife in the United States.Concerns regarding the impact of DDT are notunfounded. There is little doubt within the scientificcommunity that the chemical can cause seriousenvironmental harm; however, its precise impact onhumans is a subject of debate.Anarfi Asamoa-Baah, the Director General for Malariaat WHO said in a statement on September 15, 2006 thatContinued on page 17-16- Traditional African Clinic July/August 2007

Continued from page 16 – No Money for DDT Spraying“DDT presents no health risks when used properly.”However Jay Feldman, the executive director of BeyondPesticides, an American company specializing in DDTissues, says this view is “short-sighted and doesn’trecognize the long-term problems and hazards.”There was concern, that if Uganda began using DDT, itsagricultural products could be banned in Europe. DDTuse has been prohibited in Europe for over 20 years.Dr. Otaala believes that by weighing in favour of DDTuse, WHO has completely laid these concerns to rest.Currently the government is spraying lambdathylothrin(ICON) in malaria-infected regions.The National Coordinator of Roll Back Malaria ControlProgramme, John Bosco Rwakimari, said last week theyare spraying Icon after all traditional ways they have beenusing failed.The ministry has been using case management, mosquitonetting, and clearing bushes as methods of fightingmalaria.☻☻☻☻☻☻DDT Agenda is SuspiciousMay 10, 2007Daily MonitorEllady MuyambiI have heard Ministry of Health officials agitating for there-introduction of DDT in Uganda in order to fightmalaria. DDT cannot be a solution to this problem.We submitted our petition to the National EnvironmentManagement Authority (Nema) for failing to observe therequired standards. Government must employ DDTalternatives. For example, using pyrethrins. Some peoplehave argued that these are expensive, but in reality theyare cheaper than DDT. All you need to do is to computethe cost of implementing the WHO recommendation forapplying DDT for IRS. Secondly, there has been massproductions of these products basically because there areno legal provisions for biocides.Johnson and Johnson of USA signed a contract with theWHO board to deliver 60,000 tons every year. Thecompany, however, is not obliged to buy the stocks butthe stocks have to be there – a silly contract? No it is not,it was meant to stifle the development of pyrethrin-basedproducts for malaria control especially at the height of thenegotiations for the Stockholm Convention. This wasmeant to create the impression that there was no productwhich could replace DDT.I was appalled at the level of ignorance of some Ministryof Heath officials. They are convincing people that DDTwiped out mosquitoes in the US. Have they visited theUS in summer? Secondly, in early 2000, there was anoutbreak of encephalitis transmitting mosquitoes in NewYork and Mayor Rudi Guilliani contemplated using DDTbut never due to public pressure.Any entomologist will tell you that IRS can only work inepisodic malarial regions and in these places mosquitodensity peaks at certain (levels) as is the case in SouthAfrica, where contrary to popular opinion they have notwiped out malaria with DDT spraying.The writer is General Secretary, Uganda Networkon Toxic Free Malaria Control.☻☻☻☻☻☻Chinese Malaria DrugsRecalled in KenyaAugust 17, 2007BBC NewsA Chinese pharmaceutical firm plans to recall thousandsof anti-malarial drugs supplied to Kenya after discoveringa counterfeit syndicate.The vice-president of Holley-Cotec Pharmaceuticals said20,000 doses of Duo-cotecxin will be removed fromsale. He told the BBC an analysis of the counterfeitproduct showed it had very low active ingredients andpatients taking it would not be cured. An estimated35,000 people die of malaria in Kenya each year.Duo-cotecxin is one of the artemisinin-based combinationtherapy drugs highly recommended by World HealthOrganization to treat malaria and is widely supplied ingovernment and private hospitals in Kenya. A full doseof Duo-cotecxin costs about $5 in Kenya, thecounterfeited drug is being sold for less than $1.New technologyThe Ministry of Health has been spearheading acampaign to crack down on counterfeit drugs that arereadily available in the Kenyan market.Dr Willy Akwale, who heads the government antimalariacontrol unit, said this is the first case of acounterfeit supply of artemisinin combination therapydrugs. "There have been many counterfeits on thesulphur-based anti-malaria drugs before, forcing us tohave difficulties in countering the disease," Dr Akwaletold the BBC's Focus on Africa programme.Eric Law, Holley-Cotec Pharmaceuticals' vice-president,Continued on page 18-17- Traditional African Clinic July/August 2007

Continued from page 17 – Chinese Malaria Drugs Recalledin Kenyasaid they are yet to locate the source of the counterfeits,but there is strong evidence linking the supplies toAsia. "We are now going to introduce a new technologyto tamper-proof the doses that will be supplied to replacethe withdrawn drugs," Mr Law told the BBC NewsWebsite.Health officials warn of a global health catastrophe if agrowing trade in fake anti-malarial drugs leads towidespread resistance. Sophisticated trans-national gangsare thought to be behind the counterfeit drugs, a fastgrowingmultibillion dollar business.Meanwhile, the Kenyan government said on Thursdaythat there has been a dramatic rise in the number ofchildren sleeping under insecticide treated mosquitonets. It said that a two-year campaign to provide nets atsubsidised prices has resulted in more than two-thirds ofunder five-year-olds sleeping under them.http://news.bbc.co.uk/2/hi/africa/6951586.stm☻☻☻☻☻☻Govt Studies Biological Drugfor MalariaSolomon Muyita & Grace NatabaaloFebruary 11, 2007Daily MonitorAs the debate, on whether or not to spray DDT rages on,the government is negotiating with an internationalbiological research group on the possibility of using anorganic larvaecide to fight malaria.BTI (Bacillus Thuringiensis subspecies Israelensis) is thenew drug being promoted by Xenorex, a Canadan-baseorganization, It has opened an African branch inKampala.Unlike the reported “ecological damage” about theapplication of DDT, Daily Monitor has learnt that BTIhas already been tested by the Uganda Virus ResearchInstitute (UVRI) and found effective without effects onthe environment.“We are working with the Ministry of Health andUniversity of Makerere to commit a multi-facetedapproach, to malaria control,” explains Xenorex’s chiefexecutive officer, Colin Rousseaux.Prof. Rousseaux, who is also a professor of pathologyand experimental medicine at the University of Ottawa,Canada, has been since around February making visits tothe country to work out a country wide programme foruse of BTI.BTI a biological material kills the larvae of the anophelesmosquito, which spreads the killer malaria, and blackflies, which carries river blindness, while DDT kills theadult mosquito. The drug, which was discovered in 1977and its use started in the early 1980s, is sprayed mostlyoutdoors in mosquito breeding places using a foggingmachines.State Minister for Health (General Duties) RichardNduhura confirmed the developments yesterday. “We arein touch with Xenorex for a biological method oferadicating malaria,” the minister said by telephone.“Tests of BTI were done by UVRI and I am told it cameout well. This will not be a substitute for DDT but acomplement. We intend to spray BTI outdoors in thewater bodies and footmarks, while DDT will be usedindoors.Mr. Nduhura said as soon as the National EnvironmentalManagement Authority (Nema) and the National DrugAuthority (NDA) endorses BTI, the government wouldimmediately start using it.Like for BTI, the use of DDT is still awaiting approval ofNema, which is expected before the end of December.Malaria is the biggest world killer, according to statistics.In Uganda, over 300 people reportedly die of malaria ona daily basis.The expert on BTI says malaria exists where there isaquatic environment like a wetland, the anophelesmosquito and the third is people, “which give us atriangle. If you remove anyone of those, the disease justdisappears. He said Xenorex and the Uganda MalariaResearch Institute are working out a multi-facetedapproach to see “quick eradication of malaria in thecountry.”☻☻☻☻☻☻NoteHistorical studies have shown that Anopheles funestusand Anopheles arabiensis are the principal malariavectors in southern Africa. The Anopheles funestus groupincludes nine African species: An. funestus, Anophelesrivulorum, Anopheles vaneedeni, Anopheles leesoni,Anopheles confusus, Anopheles fuscivenosus, Anophelesbrucei, Anopheles parensis and Anopheles aruni. Ofthese, An. funestus is the only member of the group that isrecognized as an important vector of malaria in Africa.Anopheles vaneedeni was experimentally infected in thelaboratory with Plasmodium falciparum but has not beenimplicated in malaria transmission in nature.☻☻☻☻☻☻-18- Traditional African Clinic July/August 2007

African Traditional Herbal Research ClinicVolume 2, Issue 7 NEWSLETTER July/August 2007FEATURED ARTICLESDDT: Survival Weapon or Threat?While it’s true that DDT can successfully killmalaria-causing mosquitoes and thus eradicatethe disease, environmentalists warn that thechemical is toxic not only to man but also tobirds, fish and mammalsThere can never be anything like indoor residualspraying of DDT in Uganda. The poor and temporarynature of the majority of houses countrywide will easilyenable DDT to find its way into the environment.This is how Dr. Vincent Muwanika of the MakerereUniversity Institute of Environment and NaturalResources argues over the recent decision by theMinistry of Health to start spraying DDT in an effort tocurb the spread of malaria.This follows an announcement by the World HealthOrganisation (WHO) allowing indoor residual spraying(IRS) of DDT (Dichloro-Diphenyl-Trichlorethane) inthe fight against malaria.The Director General for Malaria at World HealthOrganisation (WHO), Dr. Anarfi Asamoa-Baah, saysthat “scientific and programmatic evidence” has shownthat DDT could be safely be used indoors to fightagainst the malaria spreading mosquitoes.“(Outdoor spraying) has proven to be just as effectiveas other malaria prevention methods, and DDT presentsno health risk when used properly,” he says.The move puts annual indoor spraying of DDTalongside drugs and mosquito bed nets as one of thethree main tools for controlling the disease, whichclaims about a million lives every year worldwide mostespecially in Sub-Saharan Africa.The Malaria Programme Ciontrol Manger at theMinistry of Health, Dr. John Rwakimari says thattreatment of malaria has become more complicatedwith mosquitoes developing high resistance to commonmalaria drugs.“Chloroquine and Fansidar are no longer effectiveEmmanuel KihauleDaily Monitor, March 13, 2007against malaria,” he says. So to many countries, theWHO permission has brought a sigh of relief in the waragainst the disease.Following this, some African countries such asTanzania and Uganda decided to relax their bans onDDT use and the latter has officially announced that itwill start using the pesticide by June this year in thepioneer districts of Apac, Kanungu and in all internallydisplaced people’s camps (IDPs).However according to Dr. Muwanika, the fact that mostof the houses in rural Uganda and urban slums are builtout of poor and weak materials such as mud, wattle,grass, timber and iron scraps should force theproponents of the WHO decision to think twice.“Such structures are very temporary and can hardlystand throughout the period that DDT continues to beactive after spraying. So the so-called “indoorspraying” is virtually direct spray of DDT into theenvironment,” he says.He also says that a number of studies have shown thatDDT could remain persistent in the environment suchas in the soil or in water for many years afterapplication and thus endanger lives.He cites the findings of a 2005 research conducted inKanungu District, which found traces of DDT in soil,crops and fish from a nearby lake (Lake Edward),human plasma and urine 45 years after a spray hadbeen done. In 1959/60, a WHO malaria control teamsprayed DDT in dwelling houses and kraals in thedistrict with the aim of fighting malaria. The research,which was titled Determination of Short and LongTerm Residual Concentration of DDT and itsDerivatives in Man and Environment in Kihihi Sub-County, Kanungu District, also found DDT in areasmiles away from the sprayed areas.-19- Traditional African Clinic July/August 2007The research report itself admitted that this is in linewith the established persistence and slow degradationof DDT in the environment and fatty tissues in animalsincluding human beings. Continued on page 20

Continued from page 19 – DDT Survival Weapon or Threat?Although the research team concluded, by saying thatUganda may safely use DDT to control malaria using theKihihi model, environmentalists still fear that thedecision could have health, environmental and economicimplications.The former Chief of the European Union (EU) inUganda, Sigurd Illing, openly said that there could bedire consequences for Uganda’s exports to Europe ifDDT would be detected in export commodities such ashorticultural produce.At the moment, Uganda’s exports to Europe accounts forabout 40 per cent of the total exports. The EU still bansthe use of DDT and it has set strict minimum limits ofpesticide levels in products meant for animal or humanconsumption, most especially on prohibited chemicalssuch as DDT.However, the new EU chief to Uganda, Vincent DeVisscher says that the European Union will support thegovernment of Uganda in its fight against malariathrough indoor residue spraying of DDT.Cases of AbuseDr. Muwanika also notes that the absence of a properenforcement mechanism in the whole process of DDT usecould result into people misusing the pesticide for otherpurposes such as pest control in agriculture and thusaffect export of the produce.Through it is an undisputed fact that DDT couldsuccessfully kill malaria mosquitoes and thus eradicatemalaria like what it did in Southern Europe, NorthAmerica and the Caribbean in the 1960s,environmentalists warn that DDT is toxic to birds, fishand mammals. This is because it accumulates in the foodchain and stays there for many years.That is why in the 1970s, growing awareness of thesethreats led many countries to ban its use especially inagriculture. The conservation organization, WorldWildlife Funds says it has found “sufficient evidence ofhazards to human health and wildlife to justify a globalban on the production and use of DDT.”According to WWF, the pesticide could harm humanhealth by damaging the developing brain, causinghypersensitivity, behavioural abnormalities and asuppressed immune system.Vast ConsequencesDr. Muwanik adds that the non-selective nature of DDTposes a risk to the ecosystems (the mutual relationshipand dependency between living and non living things) inthat it could interfere with the activities of livingorganisms that uphold it.He gives examples of pollinators such as birds, butterfliesand bees as the likely victims which cannot withstandDDT effects. The chemical could cripple their activitiesof transporting pollen between plants to enable them (to)produce seeds or fruits.This means that DDT also poses a risk as far asproduction of fruits and other crops that are greatly reliedon by human beings and other animals for food ormedicine, is concerned.In 2004, the Stockholm Convention on Persistent OrganicPollutants (POPs), global treaty to protect human healthand the environment from the negative effects of POPsbanned DDT use.Although the treaty, to which both Tanzania and Ugandaare members, includes a opt-out clause for nations thatwant to permit the use of DDT indoors to protect publichealth according to WHO guidelines, few nations choseto use it.Dr Muwanika agrees that malaria is a big developmentchallenge to countries such as Tanzania and Uganda butmaintains that it was necessary for them to think ofalternative preventive measures that are friendly to bothliving organisms and the environment.“It’s about time the international community focused oncombating malaria, but this approach (DDT use) takes usexactly (in) the wrong direction,” he says.In his opinion, DDT use is a short-sighted response withlong-term consequences, and that WHO should behelping countries to fight malaria with safer and moreeffective alternatives.☻☻☻☻☻☻DDT Will Not Hinder Exportsto EUDiana ApioKampalaOctober 31, 2006Daily MonitorThe European Union has described as “unfounded,’recent allegations that Ugandan products would be totallybanned from the market as soon as the decision to useDDT is implemented.“These accusations are entirely unfounded and ignore thereality o the EU’s intensive efforts in the fight againstmalaria across the African continent,” a statement fromthe European Commission Press Officer in Brussels, Mr.Norbert Sagstetter, said recently.Continued on page 21-20- Traditional African Clinic July/August 2007

Continued from page 20 – DDT will not hinder Exports to EUThe pronouncement comes as a breather to exporters andproducers in Uganda, most of who have been worryingover the fate of their products.Earlier reports had insinuated that agricultural productsrisked being banned from the EU market once Ugandastarts using DDT, because of Europe’s zero tolerance forit.A ban from the EU, Uganda’s largest trading partner,would come as a blow to the export industry that isalready struggling with supply constraints to deliver tothe market despite a zero tariff regime to the EU underthe ‘Everything but Arms’ arrangement.Last month, the World Health Organisation (WHO)okayed the indoor use of DDT for malaria control, almost30 years after it phased out its widespread indoorspraying.Following this, the Ministry of Health (MoH) alsoannounced that Uganda would start using DDT in Junenext year, pending results from the NationalEnvironmental Management Authority’s investigationinto the potential harm of the insecticide.A cross section of stakeholders including the businesscommunity, environmentalists and some politiciansstrongly criticized the decision.But the statement says the EU, as a signatory to theglobal Stockholm Convention on Persistent OrganicPollutants (POPs) to which the US and 149 othercountries are party to defend the right of all nations to settheir priorities and plans for malaria control within thescope of international agreements.“Should food consignments from Uganda to the EU beaccidentally contaminated with DDT above acceptedresidue levels, only that particular consignment would bewithdrawn from the market,” it says.“Such an incident would certainly not automatically leadto a general import ban.”ConditionsThe EU says it permits low levels of DDT contaminationin some crops as long as the levels are shown to be safeto consumers and are not being abused by illegalsprayers.The Commission also says it recognizes eachgovernment’s choice of malaria control techniques,including DDT and has supported Uganda and othercountries’ poverty reduction and health strategies withover Euro310 million since 2003.But even with the assurance, Uganda should not take it-21- Traditional African Clinic July/August 2007for granted that DDT can be used at her own will.The EU delegation in Kampala last week said if thegovernment wishes to use DDT for Indoor ResidualSpraying (IRS), it should do so in strict accordance withthe provision of the Stockholm Convention as well asWHO guidelines.The Convention, signed in 2001, bans the use of DDTexcept for public health purposes while WHO also, in its2006 position statement contained in a publication:Indoor Residual Spraying recognizes that DDT is bannedfor agricultural use.However it justifies its use for IRS if used under WHOrecommendations alongside a clear national policy andadequate safeguards for storage, transport and disposal.“It is critical to ensure that adequate regulatory control isin place to prevent unauthorized use of public healthpesticides in agriculture,” WHO said.Information from the Uganda Mission in Geneva says theWHO is even willing to supervise Uganda free of charge.“If our government can arrange, WHO is willing to sendits officials to teach and prepare our leaders on how touse DDT the right way,” the Head of the mission, Prof.Asene Baliuta, said recently.However, the EU also clarified that their position doesnot guarantee the same reaction from their consumers.“The EU and its institutions have no power over thereaction by EU consumers and consumer protectionorganizations in the event Uganda would start usingDDT,” the Head of Economics, Trade and Social Sectorssection at the Kampala office, Mr. Tom Vens said lastweek.CriticsSome Ugandan critics have also argued that the biasagainst DDT is in the minds of consumers and thatwhether the EU officially continues to accept theproducts, the consumers might just stop buying them.“We need to consult widely on DDT. The consumers hereare sentimental. Some just have hysteria against DDT,” aUgandan living in Brussels said.One of the European consumers said he did not mindDDT content as long as the products are declared safe forhuman consumption by the EU. Another, however, saidhis reaction would depend on how others would react toit. “If others shun it, I will also not buy the products but ifthey continue to buy, why not?” he said.They argued that Uganda still does not have thenecessary capacity to do controlled indoor spraying andtherefore should not rush to implement it.Continued on page 22

Continued from page 21 - DDT will not hinder Exports to EU“Let us consider products like coffee, which most farmerskeep in their houses or cotton, even before we think offlowers and fish. How shall we ensure that these escape theDDT residues?” another critic wondered.Others say it is no guarantee that Uganda will meet therequirements in the short run therefore DDT would meanputting the stability of the export industry in balance.According to WHO, Maximum Residue Levels (MRL) forDDT in food products intended for human or animalconsumption in the EU usually range from five to ten timeslower than equivalent levels for other countries like Japanand the US.This means that to maintain the market for Ugandanagricultural products there, Uganda should meet the muchmore stringent EU standards.Ten sub-Saharan countries including South Africa arecurrently using DDT, according to WHO.☻☻☻☻☻☻Natural Pyrethrum the BestAlternative to DDTLeonard Bantura, UKSeptember 28, 2005Daily MonitorWhilst much emphasis in Uganda is being place on theprovision of insect treated nets, it would be much better tolook at a fully integrated mosquito control programmeinvolving: treatment of mosquito breeding sites withlarvicides; space spraying of urban areas with safe, buteffective, natural insecticides; residual spraying of houses;treatment of mosquito nets; provision of safe, natural, insectrepellants.In the context of space spraying, natural synergisedpyrethrum, together with the ultra safe pyrethroidspermethrin, can play a very useful role, as it is extremelyactive against adult mosquitoes.Similarly, the natural insect repellant for the application tothe human body is based on natural pyrethrins, which areconsidered to much safer than products containing DEET.Raw MaterialIn Uganda, we have Chrysanthemum cinerariaefoliumtanacetum from which pyrethrum is extracted.This can be utilized in the formulation of space sprays; forinclusion in insect repellants. The product needs to berefined, as the waxes and taraxasterol irritants have to beremoved.It makes good commercial sense to utilize Ugandanpyrethrum in malaria control campaigns, sine it is not onlyrelieving the strain on the health services, the disablementof family members through illness, but also providing muchneeded income for the farmer.AdvantagesThese are the true facts and advantages of naturalpyrethrum and its products:• Pyrethrum products rapidly knock down and killtargeted pests and have a powerful ability to flushcrawling insects such as cockroaches, fleas, bed bugs,lice, ticks, mites, etc. from their hiding places.• Environmentally, pyrethrum products biodegraderapidly after application and leave no residual depositsdue to sunlight, which causes a rapid breakdown of thepyrethrins. For this reason insect resistance to naturalpyrethrum formulations have been insignificant.• Pyrethrum insecticidal properties are usually enhancedby the addition of a synergist piperony butoxide. Theresulting synergy allows substantially reducedinsecticide concentration and application rates.Pesticide exposure and cost therefore is minimizedwithout adversely affecting efficacy.• The insecticidal constituents of pyrethrum are unstableto light and air and so have virtually no residual effect.• Pyrethrum and synthetic pyrethroids being very quickacting insecticides are of considerable value in theimmediate alleviation of biting nuisance frommosquitoes.• Pyrethroid insecticides from natural pyrethrins tophotostable analogues represent important weaponsagainst insects/pests of both economic and medicalimportance.• Natural pyrethrum insecticide is characterized by anegative temperature coefficient, knock down andkilling activity resulting from action against the sodiumchannels of the peripheral and central nervous systemof insects, cockroaches, fleas, bedbugs, lice, ticks,mites and others. The improved safety in use,biodegradability in the environment resulting into lessdetrimental effects on non-target organisms makenatural pyrethrum use pleasant for most people andnations.• Pyrethrum is locally grown in Uganda.The writer is a medical doctor and CountryRespresentative of Agropharm Ltd. Church Road, Penn,High Wycombe, United Kingdom☻☻☻☻☻☻-22- Traditional African Clinic July/August 2007

Cheap anti-Malaria DrugComing to AfricaLeonard Bantura, UKDaily MonitorJuly 21, 2007European medical authorities have approved modalitiesfor ensuring that a new, low-cost anti-malarial drug isfast-tracked and delivered to African countries includingUganda to curb the country’s number one killer as soonas possible.The drug, dubbed Eurartesim, belongs to the ArtemisininbasedCombination Therapies (ACTs) and is acombination of dihydroartemisinin (DHA) andpiperaquine, a combination that has been proven to clearthe malaria parasites from the body in just three days.Save the Children a British charity said in a press releaseThursday that the new drug had achieved orphan status inEurope at the 8 th meeting of the Committee for OrphanMedical Products of the European Agency for theEvaluation of Medicinal Products (EMEA) that tookplace late last month. The granting of the “orphan drug”status is designed to encourage the development of drugsthat are necessary but would be prohibitivelyexpensive/un-profitable to develop under normalcircumstances.Mr. Marco Corsi, the medical director of Sigma TauIndustrie Farmaceutiche Reunite S.p.A. (Italy), which isdeveloping the drug, said the achievement could allow aquicker submission to the health authorities in endemiccountries.“Therefore, this drug is likely to get onto national antimalarialdrug policies much quicker. This is very goodnews for sub-Saharan Africa but more so for Ugandabecause this drug is administered once a day for threedays and an adult dose is likely to cost less than one USdollar,” said Dr. Corsi.Dr. Ambrose Talisuna, field coordinator of the AfricanArtekin Malarial Trial that compared Eurartesim toCoartem said: “Any new, cheap and easy to administeranti-malarial drug is indeed good news.” He said recentassessments confirm the persistence of endemic malariawith an estimated 400 million cases and 1.5-2.7 milliondeaths per year. In sub-Saharan Africa alone,plasmodium falciparum, the parasite that causes malaria,is responsible for approximately 220 million cases andone million deaths per year, 75 per cent of them beingchildren under 5 years old.According to the press release, Eurartesim was firstdeveloped in China. A clinical developmentprogramme was agreed between HollykinPharmaceutical and Guangzhou University (China),The University of Oxford in the UK, the Medicines forMalaria Venture (MMV), and Sigma-Tau IndustrieFarmaceutiche Riunite SpA to support the internationalregistration of the drug.The drug is said to have a simpler dosing scheme thanCoartem, which experts say will aid better complianceto avoid the development of resistance.☻☻☻☻☻☻TZ to Get Cheaper MalariaDrugReuters, LondonDaily MonitorJuly 23, 2007Former US President Bill Clinton is launching aprogramme to make subsidized malaria drugs availablein Tanzania in a test scheme that could serve as ablueprint for Africa s a whole.The project, that was expected to be announced later onSunday in Dar es Salaam Tanzania, will make lifesavingartemisinin combination therapy (ACT) drugsavailable at 90 per cent less than the current marketprice to a national drug wholesaler, which will thendistribute them to rural shops.Malaria caused by a parasite carried by mosquitoes,kills up to 3 million people a year world-wide andmakes 300 million seriously ill.Ninety percent of deaths are in Africa south of theSahara, mostly among young children.Many of those lives could be saved with modern ACTdrugs, which are far more effective than oldertreatments such as chloroquine.But a price of up to $8 to $10 per treatment puts themout of reach for many people. Although drugmakersincluding Novartis and Sanofi-Aventis SA havereduced the cost of ACT medicines to around $1 whenthey are used in the public sector, the majority ofAfricans buy their medicine privately.In the case of Tanzania, around half of patients withmalaria seek treatment through private drug shopsinstead of public health facilities, and most are unableto afford the ACT drugs.Continued on page 24-23- Traditional African Clinic July/August 2007

Continued from page 23 – TZ to get Cheaper Malaria DrugInstead, they usually buy older drugs that are 20 to 30times cheaper but are often ineffective due to rugresistance. The pilot programmed by the ClintonFoundation HIV/Aids Initiative is designed to test thepracticality of subsidizing ACT drugs as a way toincrease their use, a foundation spokesman said.ACT treatments are derived from a medicinal Chineseplant and are costly to manufacture.International organizations and governments, includingthose from the Netherlands and Britain, are currentlyconsidering a multimillion-dollar global subsidy plan forACT medicines.☻☻☻☻☻☻ICRAF discovers WonderPlant for curing MalariaA single wild shrub - Artemisia annua has become thetouchstone for hopes that a successful battle can bewaged against Malaria in Southern AfricaSingy Hanyona5 May 2005At a time when funding to fight malaria is still sorelylacking, a kaleidoscope of research show unprecedentedgains over the fight against the killer disease. The WorldAgroforestry Centre (ICRAF) Southern AfricaProgramme has discovered a remarkable annual shrubthat will now be used to battle the malaria epidemic in theregion.As Zambia joined the rest of the world in celebrating theAfrica Malaria Day on 25 April, the traditional shrubjoined the conventional Coartem drug, recently approvedby the World Health Organization (WHO). In thetemperate regions of China, where Artemisia annuaoriginated, the leaves have been used to treat fevers formore than 2000 years, and published scientific studiesshow that the artemisinin content in the blood is highenough after drinking Artemisia tea to cure malaria.Malaria costs African countries US$ 12 billion every yearin lost Gross Domestic Product (GDP). The cost ofeffective malaria control in Africa would be just US$ 2billion per year, according to WHO. Malaria is one of thebiggest killer diseases in Africa but for those who cannotafford conventional drugs, there is still hope.ICRAF Communications Consultant Parkie Mbozi saysin rural Mozambique, women are already using tea madefrom the dried leaves to treat malaria in the nine mobile-24- Traditional African Clinic July/August 2007health clinics. Mbozi says for both the practitioners oftraditional medicine and the pharmaceutical companies,access to the plants is the biggest barrier to usingArtemisia to cure malaria.ICRAF-Southern Africa Programme, attracted by theusefulness of Artemisia as a medicinal species and itspotential to manage pests in agroforests, began growing aspecial hybrid of Artemisia, A-3, with seed provided bythe Pressure Group on Action for Natural Medicines(Anamed).A-3 is especially important for the natural treatment ofmalaria, because it is adapted for warmer climate. Whereas wild varieties of Artemisia grow to only 5 cm in thetropics, A-3 can reach heights of 3m and contains 20times more artemisinin. Mbozi says ICRAF is nowfacilitating the broad propagation of A-3 by teachingthousands of farmers in its extensive network how tocultivate Artemisia from stem cuttings.The programme has extended to four districts in TeteProvince-Angonia, Moatise, Tsangano and Makangalocatedin North Western Mozambique - and is soonexpected to extend to Malawi, Tanzania, Zambia andZimbabwe, the other countries where ICRAF SouthernAfrica Programme is working.In Zimbabwe vegetative reproduction of the Artemisiacommenced in October 2004 at Domboshaba ResearchStation with a single plant from which 200 stem cuttingswere planted on-station."The cuttings have further multiplied through vegetativepropagation and the plant is responding very well to theZimbabwean weather conditions," says Dorah Mwenyeof ICRAF-Zimbabwe. Ms Mwenye says a number ofrural families will soon receive cuttings of Artemisia formultiplication and use at household level.Thousands of Artemisia plants can be propagated from asingle stem cutting. This makes for a lot of cheap andeffective medicine. The daily adult dose of anti-malariatea requires mixing just 5g of dried A-3 leaves in 1L ofwater. This tincture is split into four parts and taken onceevery six hours. This is repeated for seven days. Giventhat each plant yields 200g dry weight, 1000 shrubs cancure malaria in 5700 adults.Artemisia treatments for malaria create big savings at thepharmacy for cash-strapped farmers. Money spent onmalaria medication can be spent elsewhere. Thereis also an untapped potential for getting much-neededincome from selling Artemisia medicines.Anamed- Angonia in cooperation with ICRAF, Medicinssans Frontiers (MSF) and the Mozambique Ministry ofAgriculture and Rural Development (MADER) are train-Continued on page 25

Continued from page 24 – ICRAF discovers Wonder Planting farmers how to process and manufacture Artemisiamedicines. Harvesting and air-drying the leaves, as wellas the production of medicines, is a straight forward, nonlabourintensive project. Even after three years, driedleaves retain practically 100 percent of their artemisinincontent, suggesting that under proper conditionsArtemisia medicines can be stored for a long time.When asked about the scale of Artemisia farming inSouthern Africa, Dr Patrick Matakala, RegionalCoordinator of ICRAF Southern Africa, replies: "Iwouldn't call it large scale production for profit yet, butthat is where we are heading as a programme."Nonetheless, for the ambitious farmers there is a definitepossibility of scaling up Artemisia production for sale topharmaceutical companies in the future. There willcertainly be a market. WHO estimates that of the 40countries-20 in Africa-using Artemisinin-based drugs,five are expected to have shortages due to lack of rawplant extracts. This includes most of the countries in theSouthern Africa Development Community (SADC)region. However, scaling up for pharmaceuticals willrequire resolving a few proprietary issues surrounding A-3, the rights to which are controlled by an undisclosedpharmaceutical player.Meanwhile, various organizations around the worldcelebrated the successes of Partnerships as theycommemorated Africa Malaria Day 2005. Under thetheme "Unite Against Malaria", celebrations focussed onthe importance of partnership at the national, regional andglobal levels for fighting malaria."Working with partners has allowed Zambia to makegreat strides in the fight against malaria, which includeexceeding our 2005 target for providing malariaprevention for children under five," said Zambian HealthMinister Dr Brian Chituwo, during this year's mainregional Africa Malaria Day event.The Zambian government's roll Back Malaria Initiativeintends to achieve reduced deaths due to malaria by 50per cent, by the year 2010.http://www.newsfromafrica.org/newsfromafrica/articles/art_10249.html☻☻☻☻☻☻-25- Traditional African Clinic July/August 2007Case Study: SyntheticBiology’s Poster Child –Microbial Production ofArtemisinin to Treat Malaria”Excerpts from Extreme Synthetic GeneticEngineering, An Introduction to Synthetic Biology,January 2007, ETC GroupOver 90% of malaria deaths occur in sub-Saharan Africa.Global health initiatives have failed to deliver on simpleprevention measures such as mosquito netting, and theworsening crisis has led the World Health Organization(WHO) to reverse a 30-year policy – it now backs the useof a 20th-century silver bullet, the controversial pesticideDDT, as a malaria prevention strategy.WHO regards artemisinin-based drugs as the best hopefor treating over one million people – most of themAfrican children – who would otherwise die of malariaeach year.However, a global shortfall in the supply of naturalartemisinin, which is extracted from sweet wormwoodplants (Artemisia annua), has kept the price of this muchprizedcompound out of reach for poor people.Using synthetic biology to combat malaria is compelling:a technological fix comes to the rescue when investmentsin malaria prevention and control in Africa are declining,and failing.In April 2006, Professor Jay Keasling of the University ofCalifornia-Berkeley and 14 collaborators announced inNature they had succeeded in engineering a yeast strainto produce artemisinic acid, which is a necessary step inthe production of artemisinin itself.Using sophisticated bioinformatics and screeningtechniques, the team claims to have discovered the genesinvolved in Artemisia annua’s natural production ofartemisinic acid, and managed to insert and express themin a modified yeast strain. The microbe thus behaves likea miniature factory to produce artemisinic acid.According to Keasling, what’s left to do is to increase theyields of artemisinic acid, and then use “high-yieldingchemistry” to convert artemisinic acid to artemisinin.The promise of unlimited supplies of a drug that can rollback a global killer has become the raison d’être forsynthetic biology and given the field a philanthropicsheen – reminiscent of biotech’s much-heraldedgenetically engineered, Vitamin-A rich “Golden Rice” tofeed the poor.Continued on page 26

Continued from page 25 – Case Study- Microbial Productionof Artemisinin to Treat Malaria(Since 2000, the biotech industry has used the promise ofGolden Rice in public relations campaigns designed towin moral legitimacy for its genetically engineered crops– but the controversial product is not yet available.)Though they’ve produced only tiny quantities ofartemisinic acid so far, Jay Keasling’s bacterial factoriesare already churning out copious amounts of priceless PRfor the fledgling synbio industry.The December 2006 issue of Discover names theBerkeley professor its first-ever Scientist of the Year andthe magazine’s editors ooze with admiration: “Throughhis significant synthetic biology advancements, Keaslingis changing the world, making it a better place with everynew discovery he makes.”But will betting on synthetic biology’s medicinalmicrobes to tackle malaria (backed by $42.5 million fromthe Bill and Melinda Gates Foundation) divert attentionand resources from other approaches that are less frontpagefriendly, but nonetheless sustainable and decentralised?Will promising options for addressingmalaria be cast aside in single-minded pursuit of synbio’ssilver bullet?The current situation: WHO requires that artemisinin bemixed with other malaria drugs (a drug combinationknown as Artemisinin Combination Therapies or ACTs)to prevent the malaria parasite from developingresistance.Novartis’s proprietary ACT drug (known as Coartem) isthe only one that has received pre-clearance from WHO(meaning that it is approved for procurement by UNagencies), giving Novartis a virtual monopoly on ACTdrugs. According to a 2006 study on artemisia conductedby the Royal Tropical Institute of the Netherlands: “Thismonopoly-like situation has created an imperfect marketdefined by scarcity of raw materials, speculation andextremely high retail prices.Under contract to WHO, Novartis provides Coartem atcost (US$ 0.90 to treat infants; US$ 2.40 to treat adults)to the public sector in malaria-endemic countries in theSouth.A two-tier pricing system allows Novartis to sell theirACT compound for ten times the cost to Northernmarkets and international travelers. Other drugcompanies are developing ACT drugs, with Sanofi-Aventis closest to having a marketable product.Novartis currently buys almost all of the world’swormwood crop, sourcing from thousands of smallfarmers across China, Vietnam, Kenya, Tanzania, India,Uganda, Gambia, Ghana, Senegal and Brazil.-26- Traditional African Clinic July/August 2007In East Africa, an estimated 1,000 small-scale farmers(average 0.3 hectares) and 100 larger scale farmers(average 3 hectares) currently grow artemisia. In light ofglobal demand and recent campaigns to reinvigorate thefight against malaria, that figure is expected to grow toapproximately 5000 smallholders and 500 larger-scalefarmers.The report by the Royal Tropical Institute of theNetherlands concludes that the current Artemisia shortfallcould be met solely by increasing cultivation ofwormwood, especially in Africa. Increasing localproduction is attractive as a sustainable and decentralisedapproach.“From a technical point of view, it is possible to cultivatesufficient artemisia and to extract sufficient artemisininfrom it to cure all the malaria patients in the world. AnACT could be made available at an affordable pricewithin just 2-3 years.”The report estimates that between 17,000-27,000 hectaresof Artemisia annua would be required to satisfy globaldemand for ACT, which could be grown by farmers insuitable areas of the South.The Institute’s report warns, however, that the prospect ofsynthetic artemisinin production could destabilize a veryyoung market for natural artemisia, undermining thesecurity of farmers just beginning to plant it for the firsttime: “Growing Artemisia plants is risky and will not beprofitable for long because of the synthetic productionthat is expected to begin in the near future.”Sold on synbio’s synthetic vision:Keasling’s team believes that using synthetic microbes tomanufacture artemisinin could increase supplies morequickly and reliably than planting new crops. “Youwould need to plant the state of Rhode Island to meetdemand,” quips Jack Newman, co-founder – along withKeasling – of Amyris Biotechnologies, the company thatwill bring synthetic artemisinin to market.Amyris predicts that microbial production will lower thecost of artemisinin to 25 cents per dose.The company’s non-profit partner, OneWorld Health,will steer the product through the regulatory process andconduct preclinical studies to determine the safestartemisinin derivatives.However, large-scale production of synthetic artemisininstill faces significant technical difficulties. OneWorldHealth explains that “the yield of artemisinic acid wouldneed to be improved several hundred fold to beeconomically acceptable for large-scale manufacturing.”Continued on page 27

Continued from page 26 – Case Study- Microbial Productionof Artemisinin to Treat MalariaMeanwhile, WHO notes that “clinical trials have not yetbegun, and filing for regulatory approval will probablynot occur before 2009 to 2010.”Keasling, too, sees late 2009 or early 2010 as the earliestrealistic target for mass distribution.If microbial production of synthetic artemisinin iscommercially successful, pharma giants like Novartiswould benefit because it will allow them to replace adiverse set of small suppliers with one or twoconveniently located production factories. The RoyalTropical Institute notes that, “pharmaceutical companieswill accumulate control and power over the productionprocess; artemisia producers will lose a source of income;and local production, extraction and (possibly)manufacturing of ACT in regions where malaria isprevalent will shift to the main production sites ofWestern pharmaceutical companies.”Could artemisia be a viable crop for small farmers insub-Saharan Africa?Are local production, extraction and even manufacturingof ACTs possible in regions where malaria is prevalent?The Dutch researchers who studied this possibilityconclude that it won’t be easy – requiring not only a heftycapital investment, but also “a total redesign of the supplyand distribution chain.” They suggest a number ofpolicies that could be implemented to promote cultivationof Artemisia annua while at the same time protectingfarmers from un-due risk. For example, a procurementfund could be established in Africa to stabilise the marketfor artemisia; quality seed could be made available toAfrican farmers; other medicinal crops could bepromoted to reduce the economic risk to farmers; a taskforce could be established to enhance transparency,coherent policy making and knowledge sharing.Where ACT drugs are not accessible or affordable,community-based efforts are focusing on local productionof artemisia plants for use in herbal tea to treat malaria.Conventional health systems such as WHO do notsanction the use of Artemisia tea because of the difficultyof establishing a standard dosage and quality control.However, Anamed (Action for Natural Medicine), aChristian-based group of scientists and health workers,believes that the tea is effective in treating upwards of 80percent of malaria cases. Anamed’s ‘grow your own’approach to fighting malaria provides artemisia seeds,community workshops and agronomic support for smallscaleplots based on mixed farming methods across Asiaand Africa.Anamed promotes a method of combining the tea withother compounds (either cheap medicines or locallyadapted herbs) to mimic the combination effect ofpharmaceutical ACTs, but without using proprietarydrugs. Anamed believes that compounds found inArtemisia leaves, including 36 different flavonoids,enhance the anti-malarial properties of the tea (whichthey say are lost when the compound is purified for druguse).While the use of artemisia tea may be controversial, theneed to increase the world’s supply of Artemisia is not.Anamed has developed a variety of artemisia adapted toAfrican conditions known as Artemisia annua anamed(A-3) and the group has introduced over 715 artemisiagrowing projects in 75 countries.Their partners include the World Agroforestry Center(ICRAF) in Mozambique, which has taught thousands ofsouthern African farmers in their network how to growartemisia from stem cuttings.Anamed’s seeds are sold for $.01 per seed and each plantcan treat up to eight malaria sufferers. Those plants canthen be further propagated by taking stem cuttings.No one knows if synthetic biology will ultimately deliversafe and sufficient quantities of low-cost artemisinin forcontrolling malaria in the developing world. The GatesFoundation should insure that its focus on a synbio antimalarialdrug does not foreclose options for communitybased,farmer-led approaches.http://www.etcgroup.org/upload/publication/602/01/synbioreportweb.pdf☻☻☻☻☻☻Scientists Toll to TransformBug’s Fatal BiteTweaking mosquito’s genes could prevent it fromspreading malariaOctober 6, 2006Washington PostBy Michael E. RuaneBlood stains the walls of the cage where the deadlycreatures are kept.They look agitated and eager to escape, but they've justbeen fed, and David A. O'Brochta figures it's safe to stickhis hand inside. Normally they would bite. Especially ifyou're a person. Put yourself in a room full of cows, andthese things will single you out, O'Brochta says.Continued on page 28-27- Traditional African Clinic July/August 2007

Continued from page 27 – Scientists Toll to Transform Bug’sFatal BiteNot on this day, however, and not in this new Universityof Maryland biotech laboratory in Rockville. At themoment, the hundreds of captive Anopheles gambiaemosquitoes, the kind that most often infect people withdeadly malaria parasites, are not hungry.But they will be soon. And that will never change. SoO'Brochta, head of the lab's new Insect TransformationFacility, is trying to change something else aboutAnopheles gambiae to prevent it from claiming a millionlives a year.O'Brochta creates mutant insects.Not the kind in the horror movies that grow 30 feet talland menace the city.He's trying to create the kind whose genes have beentweaked just enough, in just the right way that the insect'sbad habits are made benign. Just enough so that it can'tharbor the parasite.That is not easy: Anopheles gambiae is about as small asan eyelash. Hundreds of its minute, gray, banana-shapedeggs resemble a pinch of gunpowder.But the state-of-the art lab, which made its debut lastmonth, is designed and equipped for the microscopictasks of gene-tweaking. Injections into mosquito eggs aredone with a quartz glass needle the size of a strand ofhair.‘We’re building a bug’"We're building a bug," in much the way inventors woulddesign a new airplane, says O'Brochta, 51, an insectmolecular geneticist. "We know we can do it."The new lab, the only one of its kind in the world, hasbeen designed to perfect the process.The lab has an insectary where mosquitoes such asAnopheles gambiae and Aedes aegypti, which can carryyellow fever, are reared in warm, humid chambers thatlook like walk-in freezers.There's also a vivarium, an enclosure in whichtechnicians raise the lab mice used to feed themosquitoes. "We used to use graduate students,"O'Brochta jokes.A mouse is first anesthetized, then laid on the mesh coverof a mosquito cage for about five minutes so the insectscan dine. The technicians are careful. If the mouse is lefttoo long, or if there are too many mosquitoes, the mousecould be "exsanguinated," or drained of blood.Female mosquitoes — the ones that bite — require"blood meals" every few days to nourish their eggs, and itis their excretions that stain the plastic buckets in which-28- Traditional African Clinic July/August 2007they are kept. After the feeding, the mouse is removed,revived and "given a two-week vacation" to replenish itsblood supply, O'Brochta says.‘Flying syringe’None of the feeding mosquitoes is infected withpathogens that cause disease, he says. And the mice don'tdevelop mosquito "bites" as humans do. But Anophelesgambiae remains a "flying syringe," O'Brochta says, anda superb vector for Plasmodium falciparum, the deadliestform of the parasite that causes malaria.The mosquito picks up the parasite by biting an infectedperson. The parasite mates and produces offspring thatare deposited in the next person the insect bites. Theinsect's taste for people is baffling. "They smell us,"O'Brochta says. "They specialize on us." It is not clearwhy.But the cycle is devastating. Malaria is believed to havekilled more people than all the wars and other illnessescombined.The Washington region, now malaria-free, once harboredthe disease, and George Washington and AbrahamLincoln are believed to have had it. Malaria is thought tohave killed Dante, Saint Augustine and Genghis Khanand to have sickened Mother Teresa, Ho Chi Minh andChristopher Columbus."Nothing really tops malaria in terms of an insect-bornedisease, in terms of deaths," O'Brochta says, sitting in aconference room near his lab. Nowadays, those it kills are"mostly kids in Africa, under the age of 5."‘It’s getting worse’"The magnitude of the problem really hasn't changed indecades," he says. "In fact, it's getting worse. The numberof deaths from malaria is actually going up worldwide,not going down, which is kind of a startling statistic inthis day and age."Although drugs to combat the disease exist, economicsand politics, along with drug and insecticide resistance,have hampered the fight, O'Brochta says. There is nomalaria vaccine, he says. Scientists at Walter Reed ArmyInstitute of Research in Silver Spring and scores of theircolleagues elsewhere are seeking to develop one.O'Brochta's work, along with the work of others aroundthe world, has focused on breaking the disease cycle byaltering the characteristics of the mosquito. And much ofthat focus is on the mosquito's ability to harbor theparasite."Most mosquitoes in Africa do not serve as a host forPlasmodium falciparum," O'Brochta says. "The ability toserve as a host for malaria parasites is a very narrow,Continued on page 29

Continued from page 28 – Scientists Toll to TransformBug’s Fatal Biterestricted trait." So the question is: Could Anophelesgambiae be made to resist the parasite?"That's kind of the big idea," he says. Science haslearned how to alter the mosquito's genome and haslearned, roughly, which gene to add to make it resistthe parasite, O'Brochta says.But this new mosquito must also be made able totransmit the beneficial traits rapidly among the rest ofits population. And that part has been difficult toengineer. "With mosquitoes, we've had virtually nosuccess," he says.One day last week, O'Brochta and his researchcolleagues, Robert A. Harrell II, 39, and ChannaAluvihare, 40, were running tests to make sure theirprocedures and equipment worked. They were injectingmosquito eggs with genetic material that would makethe mature mosquitoes glow under ultraviolet light. Ithad worked before, and they hoped to repeat theprocess.Aluvihare used a plastic tube to suck about 20mosquitoes out of a cage. He placed them in a vial andput the vial in a darkened incubator, where they wouldlay eggs. Harrell then performed the injections.Predictable outcome — in partAs the men peered into microscopes, a mosquito trapwhirred on a counter nearby. Although none of theinsects is infected, the workers didn't want escapeesbuzzing around. No transgenic insects have ever beenreleased in the wild.It's not that the mutants would be dangerous. "You'renot going to just, all of a sudden, produce huge, hugeinsects out of these," Harrell said.The scientists pretty much know the outcome of thegenetic changes they're making. "It's not just, throwsomething in, and 'Let's see what this does,' " Harrellsaid. "We're not really creating monsters."But the bug builders can't know everything."As a scientist, you're never going to know all theoutcomes," O'Brochta says. "We need to know what therisks are, and then we need to be able to manage thoserisks. . . . Unfortunately, people demand that we oftenknow everything. But when you think about it for morethan really just a minute, I think, we realize that . . .[with] everything we do, there's a degree of uncertainty,and there's risk involved."http://www.msnbc.msn.com/id/15163360/☻☻☻☻☻☻Uganda: Chimps Eat Herbs toCure Malaria – ExpertNew VisionJanuary 19, 2007Gerald TenywaKampalaCHIMPANZEES eat plants similar to the ones used bytraditional healers to treat malaria and diarrhoea,researchers have said.Sabrina Krief, a researcher at Kibale National Park said:"The chimps and human beings around Kibale use similarplants to overcome sickness."She was speaking at Makerere University's Faculty ofScience at the launch a memorandum of cooperationbetween the university, the Uganda Wildlife Authorityand French institutions.In her five-year research at Kanyawara research station atthe edge of Kibale, Krief found that chimps carefullyselect plants like mululuza, that do not have nutritivevalue but have medicinal properties that help themovercome malaria, diarrhoea and expel worms from theirintestines. Her research included analysing the dung andurine of the chimps.She also monitored the chimps' behaviour to find out ifthere was an improvement when sick chimps ate theplants."It was stunning to see that traditional healers use thesame plants to treat the diseases. Studies on great apes,the closest relatives to humans, will help us discoverplants with medicinal properties."☻☻☻☻☻☻Did You Know!Due to a lack of Duffy antigens, most Africans andBlacks from the Diaspora are resistant toPlasmodium vivax, a mosquito parasite that causesrecurring malaria. Duffy antigens are race sensitive.Black people, depending upon ethnicity and region,are 68% to 90% immune to the recurring malariainfection caused by Plasmodium vivax.People that have Type O Blood are relativelyresistant to the severe malaria caused byPlasmodium falciparum infection. AnophelesFunestus and Anopheles Gambiae, carriers of P.falciparum, are both present in Uganda.☻☻☻☻☻☻-29- Traditional African Clinic July/August 2007

Mission StatementOur aim at The African Traditional HerbalResearch Clinic is to propagate and promote theawareness in Afrikan peoples at home and abroad oftheir health, biodiversity, history and culturalrichness. We gather pertinent information on theseissues and disseminate these freely to our people inUganda, the rest of the continent, and anywhere inthe Diaspora where Afrikans are located…. One ofthe main ingredients for increasing poverty, sickness,exploitation and domination is ignorance of one'sself, and the environment in which we live.Knowledge is power and the forces that control ourlives don't want to lose control, so they won't stop atanything to keep certain knowledge from the people.Therefore, we are expecting a fight and opposition toour mission. However, we will endeavor to carryforward this work in grace and perfect ways.“Where there is no culture, there is no indigenousknowledge. Where there is no indigenousknowledge, there is no history. Where there is nohistory, there is no science or technology. Theexisting nature is made by our past. Let usprotect and conserve our indigenousknowledge.”C ALENDAR OF E VENTSSPECIAL EVENT: CLINIC OPENINGPLACE: AFRIKAN TRADITIONAL HERBAL RESEARCH CENTRETIME:Herb of the MonthAfrican WormwoodArtemisia afra (Asteraceae)COMMON NAMES: WormwoodPARTS USED: Berries, fruits, flowering tops and leaves.MEDICINAL ACTIONS: Analgesic, Purgative,Stomachic, Antimicrobial, Antioxidative, Decongestant,Antihelminthetic, AntihistamineArtemisia is one of the most extensively used herbalmedicines by indigenous populations. This is the bitterestof herbs. Wormwood's name is derived from its medicinalproperty of expelling intestinal worms for which it has beenwell known since ancient times. An Egyptian papyrus dated1,600 years before Christ describes this bitter herb. It isbeen used for coughs, colds, chills, flu, croup, whoopingcough, loss of appetite, dyspepsia, stomachache, for goutand as a purgative. It is usually used in the form of either adecoction or an infusion, and often this is made into syrupby adding sugar, especially as a remedy for bronchialtroubles. Infusions are also used as a lotion to bathehaemorrhoids, in the ear for earache and as a hot bath tobring out the rash in measles. It is used in the mouth to easethe pain from gumboils and is taken for fevers and "bloodpoisoning". Artemisinin, developed in China from thewormwood plant, is the leading pharmaceutical treatmentfor malaria.☻☻☻☻☻☻Afrikan Traditional Herbal Research Centre1175A Mukalazi Road, P.O. Box 29974Bukoto, Kampala, Uganda East AfricaPhone: +256 (0) 41 530 456Email: clinic@blackherbals.comBULK RATEUS POSTAGEPAIDPERMIT00000NO.ADDRESS CORRECTION REQUESTEDMailing AddressStreet Number and NameCity, Country, etc.-30- Traditional African Clinic July/August 2007