Page 15 - GHES-3-3

Global Health Economics and
Sustainability
Sustainable therapeutic Artemisia

or tableting of powdered dried leaves of A. annua. These (Ferreira et al., 2018; Thu et al., 2011) and preparation
options are described in the next section. of the plant (Hsu, 2013) can alter its efficacy. Thus,
consistency is imperative. According to WHO Director-
3.5. A semi-Western biomedical approach for using General, Dr Margaret Chan:
intact Artemisia for therapeutics
“…traditional medicines, of proven quality, safety, and
While there is a broad effort afoot to standardize the efficacy, contribute to the goal of ensuring that all
production and the use of A. annua as a traditional tea people have access to care. For many millions of
infusion (as described in Section 4.0), there is a semi- people, herbal medicines, traditional treatments,
Western biomedical alternative: formation of compressed and traditional practitioners are the main source
dried leaf tablets or encapsulation of powdered dried of health care, and sometimes the only source of
leaves with a small-scale processing operation envisioned care. This is care that is close to homes, accessible,
as shown in Figure 2. Briefly, an insulated freight container, and affordable. It is also culturally acceptable
used in other localized production systems (Diaz, 2023), is and trusted by large numbers of people. The
equipped with a dry leaf stripper to remove major stems; affordability of most traditional medicines makes
the remaining small stems and leaves are ground into them all the more attractive at a time of soaring
a powder, which is then either compressed into tablets health-care costs and nearly universal austerity.
without the need for excipients (N’Guessan et al., 2019; Traditional medicine also stands out as a way of
Weathers & Towler, 2014) or compacted into 00 capsules. coping with the relentless rise of chronic non-
Tablets or capsules are then de-dusted and packaged into communicable diseases.” (WHO, 2013)
blister, bottles, or plastic bags to contain sufficient quantities
for a full course of malaria treatment (exact dosage yet To treat malaria diagnosed using the rapid diagnostic
to be determined). Paper bags are not recommended for test (RDT) or bilharzia (schistosomiasis), the tea is made
long-term storage because in high-humidity environments using 5 g dried leaves per liter of boiling water and infused
the plant material will likely degrade. for 15 min before filtering the leaves. Adults drink 1 L/day,
divided into 3 aliquots, and repeated for 7 days. Children
4. NGO efforts and successes at providing of 5 years or younger drink half the dose for 7 days. The tea
ART via A. annua traditional tea infusions is prepared fresh each day. LMA has a treatment page with
an infographic showing how to use dried leaves or even
There are well-established and expanding grassroots efforts fresh leaves, measured as one and four handfuls of leaves,
to provide a standardized traditional Artemisia medicine. respectively. 3
While there are a number of different non-governmental
organizations (NGOs), such as ANAMED and Fight the As stated on the LMA website, the LMAs are
Fever (FTF) (Staub, 2023), who have been supporting “multidisciplinary centers of expertise, responsible for
the use of A. annua tea infusions, efforts by La Maison de overseeing the rational distribution of Artemisia in
l’Artemisia (LMA) have been particularly successful with malaria-endemic countries according to an ethical charter
4
9 million people treated at approximately 95% efficacy (ecologically, economically and socially responsible).”
(Dr. Lucile Cornet-Vernet, personal communication, Sept. Within each country, the LMAs are organized into a National
6, 2024). As of July 2024, LMA has 130 Houses of Artemisia Artemisia House, which aims to influence and shape
in 28 countries. LMA Paris is gradually obtaining approval national malaria control policies. Its objectives include
2
for the use of A. annua and A. afra in LMAs within each lobbying national authorities to recognize Artemisia as an
country, but there is often reticence to approving the use of effective local therapy for malaria, applying for Marketing
a tea infusion as a recognized therapeutic option. Indeed, Authorization (MA) for Artemisia within the country,
there have been both local and international efforts to organizing local small stakeholders into an efficient and
impede such efforts (Weathers et al., 2024). competitive value chain, stabilizing the national prices of
Artemisia herbal tea, and coordinating the purchase of
4.1. The approach of LMA official packaging (Figure 3). LMA also has worked with
Begun in 2014, LMA has since standardized the agronomists and plant biologists to select cultivars of A.
production and use of A. annua tea infusion for treating annua that grow well in the equatorial photoperiod where
malaria. Medicinal tea is consistent with African culture malaria is prevalent. Thus, LMA organizes all the supply
(Mahomoodally, 2013), but differences in the cultivation chains-related to cultivation and distribution, according

3 https://maison-artemisia.org/en/science-innovation/
2 https://maison-artemisia.org/en/houses-of-artemisia/ last dosage/ (accessed September 7, 2024)
accessed July 31, 2024 4 https://maison-artemisia.org/en/home/ (accessed July 31, 2024)

Volume 3 Issue 3 (2025) 7 https://doi.org/10.36922/ghes.4927