A novel route to artemisinin
Artemisinin-based combination therapies (ACTs) are the first-line treatment recommended by the World Health Organization for the most deadly form of malaria caused by the Plasmodium falciparum parasite. Since 2005, demand for ACTs, in the public and private sectors, has increased exponentially. In 2013, 392 million ACT treatment courses were procured by endemic countries—up from 11 million in 2005.1
The world’s supply of artemisinin, the key common compound in the manufacture of ACTs, has traditionally been derived from the sweet wormwood plant, Artemisia annua, which can be volatile. Supply volatility has led to fluctuations in the price of artemisinin, complicating supply planning and risking a global shortage. Among other factors, fluctuations in price, along with long growing and harvesting cycles, competing crops, political instability, and weather conditions have all contributed to instability in the availability of artemisinin.
With the goal of soothing these market volatilities, PATH set out to create an additional source of artemisinin that could help contribute to a stable and sustainable artemisinin ecosystem and provide key stabilizing support for the ACT market. Promoting a steady supply of high-quality artemisinin that is reasonably priced is a critical part of PATH’s comprehensive approach to malaria elimination.
Key milestones for semisynthetic artemisinin:
2013: World Health Organization prequalified ssART as a pharmaceutical intermediate and artesunate is manufactured with a new ssART derivative as an active pharmaceutical ingredient.
2014: PATH and Sanofi announce the delivery of the first large-scale batches of antimalarial treatments manufactured with ssART derivative; 1.7 million treatments are delivered to 23 malaria endemic-countries in Africa: Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Democratic Republic of the Congo, Gabon, Ghana, Guinea, Ivory Coast, Kenya, Liberia, Malawi, Niger, Nigeria, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, South Sudan, Tanzania, Togo, and Zimbabwe.
2015: An estimated 51 million treatments containing artesunate derived from ssART were shipped to endemic countries in sub-Saharan Africa. Production capacity stands at 60 tons.
1. Malaria: Q&A on artemisinin resistance page. World Health Organization website. Available at: http://www.who.int/malaria/media/artemisinin_resistance_qa/en/. Accessed July 19, 2016.