China's artemisinin research boosts global war on malaria

Chinese Nobel laureate Tu Youyou receives an interview with Xinhua at home in Beijing, capital of China, June 12, 2019. [Xinhua/Zhou Ning]

BEIJING -- Artemisinin-based Combination Therapies (ACTs) have been widely used to treat malaria over the past two decades, employing Chinese wisdom to save millions of lives around the world.

Malaria, an ancient acute infectious disease caused by plasmodium parasites, is still a threat to human health. According to the 2021 world malaria report released by the World Health Organization (WHO), approximately 241 million malaria cases were recorded globally in 2020, and of these, 627,000 malaria patients have died.

In ancient Chinese medicine, the sweet wormwood plant was used to treat various illnesses, including fevers typical of malaria. Around five decades ago, Chinese scientists identified its active ingredient, artemisinin.

In 2005, the World Health Organization recommended ACTs as the most effective malaria treatment available.

In order to achieve the WHO's goal of reducing malaria incidence and mortality by at least 90 percent by 2030 compared with 2015, Chinese researchers have spared no effort in conducting further artemisinin research.

Tu Youyou, who won the Nobel Prize in Physiology or Medicine in 2015 for the discovery of artemisinin, is leading a new research team, using new technologies to help artemisinin research play a greater role in malaria control.

The team is focusing on the treatment of the most harmful form of the illness, falciparum malaria. It is also studying artemisinin's mechanism of action and its drug-resistance mechanism. The team has published the relevant research results in a series of papers.

A staff member of a company shows artemisinin derived from the artemisia annua in Rongan County, south China's Guangxi Zhuang Autonomous Region, June 17, 2019. [Photo by Nong Guanbin/Xinhua]

The global malaria epidemic has rebounded in recent years, partly due to disruptions in prevention, diagnosis and treatment services during the COVID-19 pandemic.

Global demand for artemisinin has increased, but the quality and supply of the substance have not been stable.

The preparation of artemisinin still depends on extraction from sweet wormwood. The researchers have improved the varieties of sweet wormwood available for this purpose, increasing the artemisinin content to about 2 percent.

Another Chinese research team, from the Institute of Process Engineering (IPE) under the Chinese Academy of Sciences, has developed a new technology for producing artemisinin on a large scale.

Compared to the traditional process, the time required to produce the same amount of artemisinin concentrate is reduced by 87.5 percent. Meanwhile, the purity of the final product is greater, reaching more than 99 percent, with less energy consumed in the process.

"This technology solves the main shortcomings in the traditional artemisinin production process and could also provide ideas for the production of other natural products," said Zhang Suojiang, IPE director.

Used in conjunction with other prevention approaches, ACTs have contributed to the global reduction of malaria morbidity and mortality. According to the latest WHO data, the fight against malaria saved an estimated 10.6 million lives globally from 2000 to 2020.

Through developing ACTs, China has contributed its wisdom to the global battle against this disease.

China's contribution can also be seen in the practical application of treatment methods in places where malaria poses a serious health challenge.

It has built a malaria prevention and control center in the African island nation of Comoros, training over 4,000 medical workers there. The number of malaria cases has dropped by 98 percent in Comoros, while the number of deaths from the illness has been reduced to zero.

The experience of anti-malaria cooperation between China and Comoros has provided a useful model for other African nations, such as Kenya, Togo and Gambia.

According to Zheng Zhijie, an official with the Bill and Melinda Gates Foundation, the "Chinese experience" in anti-malaria cooperation is highly adaptable and has established an innovative malaria prevention and control model.