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MALARIA TREATMENT - ARTEMISININ

Since 1998 Malcolm Cutler, Managing Director of FSC Development Services Ltd has been involved in the expansion of Artemisia annua production and its active ingredient artemisinin, which is the primary raw material (starting material) used in Artemisinin Combination Therapies (ACTs) for the treatment of uncomplicated malaria. FSC is presently working closely with Medicines for Malaria Venture (MMV), Geneva developing new and improved extraction, purification, crystallisation and analytical methods for the production of artemisinin, CNAP, University of York on new, high yielding, Artemisia varieties and with the World Health Organisation (WHO) and Roll Back Malaria (RBM) on ensuring the supply of Artemisia/artemisinin to meet ACT demands. FSC, together with WHO and MMV, recently organised and co-chaired in international artemisinin conferences in Bangkok, Thailand (2007) and in Guilin, China (2008).

In the course of the above work Malcolm Cutler regularly visits production and processing regions and companies in China, Vietnam, India and Africa as well as ACT manufacturers, research institutions and donors in Europe. These visits, together with the close liaison with industry through the organisation of the above international artemisinin conferences, has provided him with a detailed understanding of the industry, the personnel and its problems.

FSC is part of Assured Artemisinin Supply System, www.a2s2.org.

SPECIFIC EXPERIENCE REGARDING MALARIA/ARTEMISIA

  • DFID Artemisinin (1999) - “Artemisia, its use in the treatment of Malaria and the potential for production and manufacture in East Africa”. FSC put together a team including agronomists, processing experts (University of Surrey, UK) and representatives from the Malaria Consortium/London School of Hygiene and Tropical Medicine. The study involved a review of the market need and channels, present suppliers both of Artemisia based and other treatments, technical and viability issues. It also worked closely with African Artemisia in Tanzania ( now ABE/EABL) and included the organisation of trial crops with local plantations and small holders.
  • Technoserve in Tanzania (2004) to help develop a USAID supported project to increase the volume of Artemisia being grown in East Africa. The main role was in identifying agronomic assistance, assessing need and demand, working with the processing expert and in identifying present producers of Artemisia treatments in China, Vietnam, India and Africa. Pharmaceutical companies in Europe were also approached over their interest in the long term supply of Artemisinin and its derivatives, and extensive contacts made with WHO, MSF, MMV, Malaria Consortium etc.


EXPERIENCE REGARDING MALARIA/ARTEMISIA cont.

  • WHO Malaria-Artemisia workshop in Arusha, Tanzania (June 2005) Present experience of Artemisia work in East Africa. Chaired the Artemisia processing group discussions.
  • Work for WHO (and pharmaceutical companies) on establishing world production of Artemisia and required extraction of artemisinin, artesunate/artemether to meet demands (2005/6).
  • MMV Artemsisin Programme - initiated and managed project to develop “bench-marking” of present and new technologies for artemisinin extraction and identify best extraction processes for individual producers. This project received approval by WHO and funding through MMV (Medicines for Malaria Venture) from the Dutch Government. The initial study was undertaken in conjunction with Bath University, UK and the findings published in ‘06.
  • Advisor/consultant to the CNAP/York University programme (2006 – 2009) to produce high yielding Artemisia varieties. Assisted York in their application to the Gates Foundation for funding support.
  • Providing advice to MMV on their drug Access programme. Undertook a review of the pharmaceutical companies in Uganda (2007/8) producing malaria treatments (specifically ACTs) and attended MMV’s ACT access conference in Kampala, Uganda.
  • 2006 – 2009: Consultant to MMV managing their artemisinin programme (supported by the Dutch Government) which includes research into Artemisia post harvest (Mediplant); continued support for the development of HFC, Ionic Liquid and Ethanol extraction technologies (Bath University, Ineos Fluor, Bioniqs, Bremen/Graz Universities); Hexane safety/environmental revue (Bath University); artemisinin purification/crystallisation research (Rothamsted Research, Cranfield University, Bioniqs); development of common artemisinin test/assay procedures, monographs and laboratory certification (Bath University, Shimadzu, Rothamsted; derivitisation (Bremen/Graz Universities, Botanical Developments). Research has recently been initiated into the development of a fast, hand held devise to measure the artemisinin content of leaves in the filed (Cord 8)
  • Chairman, speaker and joint organiser of the MMV/WHO conference “Artemisinin Production and Marketing Needs: Meeting Global Demand” in Bangkok, Thailand – June 2007.
  • Coordinator and Co-Chairman of the WHO/MMV Artemisinin Forum in Guilin, China “Ensuring Sustainable Artemisinin Production” – Nov 2008.
  • 2009 - expansion of the MMV Artemisinin programme to identify urgent solutions to technical problems in the artemisinin extraction industry. This involves working closely with extractors in Asia and Africa and with key ACT manufacturers.

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