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Details of the project
What is the aim of the CNAP Artemisia Research Project?
This project aims to make artemisinin combination therapies (ACTs) for malaria more accessible by creating new robust varietiesof the medicinal plant Artemisia annua with increased yields of artemisinin. This will reduce the cost of artemisinin production, improve the crop for growers and help to stabilize supply. More on our aims can be found .
Who is doing this work?
The project is based at the Centre for Novel Agricultural Products (CNAP) at the University of York, which specialises in gene discovery with plant-based applications. Its research team is led by Professor Dianna Bowles and Professor Ian Graham and comprises over 25 scientists with expertise in plant breeding, plant phenotyping and molecular biology, as well as administrative and outreach staff.
How has this project been funded?
The CNAP Artemisia Research Project is funded by The Bill & Melinda Gates Foundation. In 2006 the project received a grant of $13.6 million. This was followed by a second grant of $12.49 million in 2009 to support late-stage development of high-yielding varieties and their delivery to Artemisia producers in Africa and Asia. The project builds on work financed by the Medicines for Malaria Venture and GlaxoSmithKline, and supported by core-funding to CNAP from the Garfield Weston Foundation.
Are there any other sources of artemisinin?
The manufacture of artemisinin through industrial fermentation is being commercialized by Sanofi-aventis, following development by a consortium led by the Institute for One World Health.
How long is the project expected to last?
The project started in June 2006 and the first new varieties are expected to be available in 2012.
What is the impact of malaria?
300 million acute cases of malaria occur worldwide annually. Around 1 million deaths, mostly children, are attributed to malaria each year.
What geographical areas are most affected?
Malaria is endemic in nearly 100 countries worldwide. 90% of the deaths caused by malaria occur in sub-Saharan Africa.
What is the problem with treatments for malaria?
The malaria parasite is developing resistance to older, inexpensive, single drugs (monotherapy) such as chloroquine, amodiaquine or sulfadoxine–pyrimethamine which have been effective in the past.
What can be used to treat drug-resistant malaria?
The World Health Organisation (WHO) recommends artemisinin combination therapies as the most effective treatment for malaria. Artemisinin monotherapies are not recommended as they can contribute to the development of resistance by the malaria parasite.
What is artemisinin?
Artemisinin is a highly effective anti-malarial drug
Why is artemisinin used as a combination therapy?
Combining artemisinin with another drug that has a different mode of action in artemisinin combination therapies (ACTs) delays the development of resistance to both drugs. Also, artemisinin drugs do not last long in the human body. Because of this, partnering them with another drug that persists for longer improves treatment efficacy and reduces the duration of the treatment course that is required.
Why are ACTs so important?
The malaria parasite is developing resistance to older, inexpensive, single drugs (monotherapy) such as chloroquine, amodiaquine or sulfadoxine–pyrimethamine which have been effective in the past. The World Health Organisation (WHO) recommends that all countries experiencing resistance to conventional monotherapies, should use combination therapies, preferably those containing artemisinin derivatives (ACTs).
Are artemisinin teas effective against malaria?
The use of artemisinin in teas to treat malaria is not recommended by WHO.
How much artemisinin is needed?
Around 80 million Artemisinin-based Combination Therapies (ACTs) were sold in 2006, but the Global Malaria Action Plan predicts that demand will roughly treble over four years, to around 230 million doses annually in 2010. This will require around 170 tonnes of artemisinin.
Where does artemisinin come from?
Artemisinin is made by Artemisia annua, a medicinal plant which has been used to treat malaria for over 400 years in China. Artemisinin produced by industrial fermentation is also now under development by Sanofi-aventis.
Why is artemisinin expensive?
The yield from Artemisia plants is low, making artemisinin expensive to produce. Also, mismatches between supply and demand periodically create shortages, driving prices up even higher
Are there other sources of artemisinin?
Artemisia will continue to be essential to supplies of ACTs for the foreseeable future. However, alternative sources are being developed as part of the solution to artemisinin cost and security of supply. For example; 1) The not-for-profit organization (MMV) is collaborating with a number of research partners on the development of a new class of antimalarial compounds with a peroxide bond similar to that found in artemisinin. 2) The manufacture of artemisinin through fermentation is being commercialized by Sanofi-aventis following development by a consortium led by the .
Is there any parasite resistance to artemisinin?
There is some evidence that parasites resistant to artemisinin may have emerged along the border between
Cambodia and Thailand and there is considerable effort to contain this possible emergence of resistance. There is also good experimental evidence from the laboratory that resistance can and will evolve if these drugs are misused (for example in monotherapies).
Creating new robust high yielding varieties
Will other approaches to artemisinin production make plant-derived artemisia obsolete?
It is anticipated that synthetic alternatives, fermentation and high yield Artemisia will all be needed to address the challenge of malaria. Plant production of artemisinin will continue to be essential for the foreseeable future.
Wouldn’t it be simpler to increase the area under cultivation?
Increasing the area under cultivation would help production keep pace with demand but it does not address the problems associated with the high costs of production and extraction and the low profitability for the farmer.
How much land will be required to grow Artemisia
It has been estimated that 20 - 30,000 ha are needed to meet global demand of ACTs.
What technology will be used to develop high yield Artemisia annua?
The CNAP project is applying fast-track breeding methods to develop new robust high-yield varieties of Artemisia. For more information see; http://www.york.ac.uk/org/cnap/artemisiaproject/research.htm
Will the new varieties be genetically modified (GM)?
The new varieties will not be GM. Genetic modification involves the transfer of DNA from one organism into the DNA of another organism. This technology will not be used in the new varieties.
Wouldn't it be quicker and more reliable to use GM technology to create the new varieties?
The use of GM would raise regulatory and acceptability challenges in the different growing regions for Artemisia. This would greatly delay the roll-out of the new varieties - with implications for the accessibility to ACT malaria medicines.
What are your targets for increased yields?
Any increase in yield will reduce production costs and help contribute to robust supplies. The target for the first new varieties is to significantly improve on the yield of Artemis (one of the highest yielding lines currently available). This would have a major impact on the economics of growing the crop.
How long will it take to produce the new varieties?
Seed from the new high-yielding varieties is expected to be available in 2012.
Where will the new varieties be grown?
The project is working with growers and extractors in Africa and Asia to ensure that the new varieties are suitable for cultivation in the world's main commercial cultivation areas.
How much will the seeds cost?
Seed will be made available at low cost to the ACT supply chain.
Will the artemisinin in the new varieties be suitable for ACT manufacture?
The new varieties are being developed in collaboration with growers, extractors and ACT manufacturers to ensure they are suitable for use.
Department of Biology