East African farmers are key suppliers of the active ingredient in the most effective malaria drug available.
Although the Artemisia annua plant (sweet wormwood) is not native to the region, East Africa “is now the third most important growing region in the world”, said Nigel Bremner, commercial manager of Botanical Extracts EPZ Limited (BEEPZ), after China and Vietnam, where it is indigenous.
Speaking to IRIN from his office in Athi River, site of Kenya’s export promotion zone (EPZ), Bremner said cultivation of the herb started more than 12 years ago. Growing in earnest started in 2002 with three to four farmers contracted by BEEPZ to plant about 40ha. Artemisia annua cultivation now supports at least 4,000 smallholder farmers growing more than 4,000ha of the cash crop in 2009, from 2,000-3,000ha last year.
Artemisinin is a key ingredient in combination drug therapies recommended by the World Health Organization (WHO) for the treatment of uncomplicated multi-drug-resistant strains of falciparum malaria.
Elizabeth Juma, head of Kenya’s Division of Malaria Control in the Ministry of Health, told IRIN that between 16,000 and 20,000 children die annually from malaria, despite a scaling-up of prevention efforts. She estimates that between one and two million people sought treatment monthly.
“Artemisinin-based combination therapies are currently the first line of therapy,” she said.
The Artemisinin Enterprise, which aims to improve production to reduce the price of Artemisinin-based drugs (ACTs), said “market instability has led to extremely volatile Artemisinin prices that, in recent years, have ranged from US$180 to $1,700/kg”.
The Kenyan government buys 17 million doses of ACTs annually at 1.5 billion shillings ($24 million) for free use at government facilities. At private pharmacies, the cost per dose ranges from 450 to 650 shillings ($5.60 to $8.20).
Bremner told IRIN that with grants from the UK’s Department for International Development (DFID) and later Novartis, the Swiss multinational pharmaceutical company, large commercial cultivation of Artemisia annua began in 2004 in Kenya, Uganda and Tanzania.
In 2006, BEEPZ paid out US$1.7 million to farmers.
BEEPZ completed an Artemisinin extraction plant in Athi River in 2007 and supplied Novartis with enough Artemisinin for more than 22 million Artemisinin-based combination drug therapies, according to its website.
Novartis is just one of the pharmaceutical companies producing ACTs. Others include Sanofi-Aventis, Saokim Pharma and Lachifarma.
Photo: Nicholas Reader/IRIN
for malaria: Between 16,000 and 20,000 children die annually from
malaria in Kenya despite a scaling-up of prevention efforts (file photo)
BEEPZ pays between $550-$600/tonne of dry leaf to smallholder farmers. One hectare can bring in up to 2T of dry leaves and is usually cultivated without the use of much fertiliser or pest problems.
“I am very happy with this crop,” said Daniel Mathiaka a farmer in Nakuru in Kenya’s Rift Valley. Mathiaka used to grow wheat and maize but for five years now has scaled up his Artemisia annua cultivation. He said the income is double what he earns from maize or wheat and there is always a ready market for his harvest. Last year alone, he harvested 13 tonnes.
“This is a very easy plant to grow. After planting it does not need much work,” said another farmer. The only problem was the length of time it took to be paid. “Sometimes we wait up to one year,” he said.
According to Bremner, delays ensue because farmers are paid half upon delivery of the harvest and the rest in due course; moreover, “this is not a highly profitable business”.
Bremner told IRIN that although the quality of the cultivated crop from East Africa was much better than from China and Vietnam, BEEPZ was still in the process of improving its extraction expertise. The company is in technical cooperation discussions with Chinese firms.
In December 2008, the UN General Assembly adopted the New Draft Resolution on the Decade to Roll Back Malaria, urging “the financing and scaling-up of Artemisinin production and procurement, as appropriate, to meet the increased need”.
In last year’s World Malaria Report, WHO reported that an estimated 247 million malaria cases killed almost 881,000 people in 2006. By June 2008 all except four countries and territories worldwide had adopted ACT as the first-line treatment for falciparum malaria.