Developing a stable malaria drug supply

World Malaria Day, set for April 25, comes during a time of great hope this year. Death rates worldwide—while still at more than 650,000 a year—are down significantly due to advances in prevention and control, and we’re closer than ever to a vaccine. This month, we’re taking a look at PATH’s work in malaria, starting with our new affiliate OneWorld Health, a nonprofit drug development program.

Woman extends hand to health worker.

A woman in Zambia is tested for malaria. Photo: PATH/Gena Morgan.

In 2004, when OneWorld Health formed a partnership to develop an alternative source of the malaria drug artemisinin, supplies of the plant used to make the drug were distressingly low. Shortages were forecast, and global health advocates worried that the drug at the heart of the best available treatment for malaria wouldn’t make it to those whose lives it stood a good chance of saving.

Search for an alternative

Since then, the market for the plant that produces artemisinin, called Artemisia annua or sweet wormwood, has soared and plunged and soared again due to imbalance in supply and demand.

At the same time, OneWorld Health, which became an affiliate of PATH late last year, quietly forged relationships with public and private partners, creating the Artemisinin Project to take the work from research to commercialization. Supported by the Bill & Melinda Gates Foundation, the partners worked toward providing an affordable and reliable source of high-quality artemisinin—one not dependent on planting schedules, the weather, or the fluctuating market.

An answer in the lab

A crucial piece of the solution originated in research labs at the University of California, Berkeley, and a nearby biotech company called Amyris, where scientists were working on synthetic biology technology. At the Canadian National Research Council Plant Biotechnology Institute, researchers discovered two additional genes in the artemisinin pathway of sweet wormwood that were key to the project.

Simply put, the technology creates microbial strains that produce artemisinic acid, a precursor to artemisinin. Artemisinic acid, in turn, is used to make a semisynthetic version of the drug—quickly, inexpensively, and independent of the harvest season.

Onward to production

In 2008, OneWorld Health partnered with Sanofi to translate the research project into industrial-scale production. Sanofi developed chemistry and manufacturing processes that enabled the team to announce on April 18, 2011, that they were ready for the production of semisynthetic artemisinin.

Distribution is set to begin as early as this year, moving the world closer to ending the threat of malaria.

 

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