Page 17 - GHES-3-3

Global Health Economics and
Sustainability
Sustainable therapeutic Artemisia

people call us “Mr. or Mrs. Artemisia” in the counterfeit Artemisia herbal tea. High-performance
street and to meet people who know about the thin layer chromatography (HPTLC) (Khan et al.,
plant. We have organized 10 training sessions, 2015) or TLC will each provide a visual phytochemical
mainly in Bangui, and obtained recognition and “fingerprint” of each plant extract; these methods yield
support from national institutions. At the same consistent results across multiple crops of the same
time, we are developing scientific research into cultivar grown in the same location (Gruessner et al.,
the plant, in particular with the Pasteur Institute 2019) and should be compared to certified reference
in Bangui. And we have entered into a number of material. While other methods such as high-performance
partnerships. ” liquid chromatography (HPLC) with ultraviolet (UV)
5
detection (HPLC-UV) may also be used, they are more
4.2. Treating children as well as pregnant and capital-intensive and may thus be unaffordable for small
lactating women
operations such as LMA. QC analysis should be performed
Malaria especially afflicts and kills children younger than for each batch of received and processed material. Indeed,
5 years old. Treating children with oral medications is if multiple crops arrive simultaneously and are validated
6
challenging; however, mixing with milk or other palatable to be within the phytochemical range of what has been
foods could enhance oral delivery (Bonati et al., 2011; determined to be acceptable for therapeutically active A.
Onimus et al., 2013; Weathers et al., 2014). Suppositories annua (or A. afra), then crops of a single genus, e.g., A.
made from powdered A. annua have also been developed annua, can be combined, mixed, powdered, and used in
using excipients such as shea butter, enhanced with 4% bulk for tablet or capsule formation.
colloidal silica; however, it is not clear whether they have
undergone clinical testing (Nague et al., 2022). While There are many different TLC mobile phases for
suppositories seem reasonable for very young children phytochemical fingerprinting. For the TLCs shown
who cannot ingest an oral therapeutic, diarrhea may in Figure 4, the method is briefly described as follows:
preclude administration. If shown to be efficacious, it 25 mg of dried leaves or leaf powder are extracted in 4 mL
would be possible to add suppository formation into the methylene chloride. Plastic-backed silica gel 60 F254
general process design illustrated in Figure 2. Although plates are used as the stationary phase. For terpenoid
it has been poorly studied, there is some preliminary and ART separation, the mobile phase is a 5:11:4
evidence suggesting that lactating mothers may transfer mixture of methylene chloride, hexane, and acetone.
ART to their infants (Jansen et al., 2006). Far less is For flavonoid separation, the mobile phase is a 10:5:4:1
known about the effects of Artemisia on pregnant women, mixture of hexane, acetone, ethyl acetate, and formic
however, anecdotal reports suggest that some pregnant acid. To visualize the terpenes, vanillin (6 g vanillin in
women in Africa drink a tea infusion of A. annua if they 100 mL ethanol and 1 mL sulfuric acid) will yield dark
contract malaria during pregnancy. Interestingly, the purple-blue spots and the ART retention factor (Rf) is
pharmacokinetics of DHA are not significantly different approximately 0.5 after heating at 100°C for 10 min, then
for pregnant and non-pregnant women (Rijken et al., viewed under visible light. Alternatively, p-anisaldehyde
2011). spray (Weathers et al., 2024) will stain terpenes blue-
purple and ART dark pink (Figure 4C). Flavonoids
5. Other concerns can be visualized using 0.5% (weight/volume, w/v)
5.1. Quality control 2-aminoethyl diphenylborinate (DPBA) in methanol
and viewing under UV light.
Quality control (QC) of both incoming plant material and
the end product can be easily and inexpensively achieved The advantages and disadvantages of incorporating
using two different thin-layer chromatography (TLC) either or both Artemisia species into any of the
assays for predetermined validation of phytochemical aforementioned modes of delivery for approved therapeutic
consistency, including the display of general terpenoids, regimens are summarized in Table 4.
ART, and flavonoid (Figure 4). This simple analytical 5.2. Counterfeit artemisia
procedure is also important to maintain vigilance against
The ACT antimalarial drugs suffer from counterfeiting,
fake drugs having little to no therapeutic efficacy (Feeney
5 https://maison-artemisia.org/en/car-a-quality-artemisia-
sector/ (accessed July 31, 2024) et al., 2024). Unfortunately, A. annua tea leaves are now
6 https://www.who.int/teams/global-malaria-programme/ also appearing as counterfeit as reported in a Benin study
reports/world-malaria-report-2023 (accessed August 6, where three commercially available samples were analyzed
2024) using TLC (Ganfon et al., 2019). Only two contained

Volume 3 Issue 3 (2025) 9 https://doi.org/10.36922/ghes.4927