Transcript Research on Traditional Medicines used for the Treatment of Malaria

Africa Herbal Antimalaria Meeting
Nairobi, 20-22 March 2006
Research on Traditional Medicines used for the Treatment of Malaria
in WHO African Region
Traditional Medicine Programme, WHO Regional Office for Africa,
Brazzaville, Congo
Presented by Dr Mawuli W. Kofi-Tsekpo, PhD
Kenya Medical Research Institute (KEMRI)
Member of WHO Regional Expert Committee
on Traditional Medicine
Malaria Burden of Disease
1. The prevalence of malaria has been escalating at an alarming rate
and an estimated 300-500 million cases each year cause 1.5 to 2.7
• million deaths.
2. More than 90% of the deaths are in children under 5 years of age in
Africa.
3. Malaria (which accounts for 9% of global disease burden) ranks
third among major infectious disease threats in Africa after
pneumococcal acute respiratory infections (3.5%)
and tuberculosis (TB) (2.8%).
4. Malaria cases in Africa account for approximately 90% of malaria
cases in the world.
5. Between 1994 and 1996, malaria epidemics in 14 countries of SubSaharan Africa caused an unacceptably high number of deaths,
many in areas previously free of the disease. Adolescents and
young adults are now dying of severe forms of the disease.
Factors favouring the spread of malaria
• Resistance of parasite to drugs is confounded by
regional conflicts forcing mass migration of people
to or from infected areas, and migration of nonimmune people to infected areas for agricultural
reasons
Changing rainfall patterns favouring mosquito
breeding sites.
Adverse socioeconomic conditions leading to
inadequate health budget to fight malaria
Policy orientations and Commitment of
countries and WHO
Alma Ata Declaration, 1978
Adoption of
Regional Strategy
by – RC50
The April 2001-Abuja
Declaration on research
of traditional medicines
The July 2001 - Lusaka Declaration on
the decade of African TM (2001-2010)
Adoption of global TRM Strategy 20022005
Ouagadougou, 2000
Malaria, HIV/AIDS, TB and
Other Infectious Diseases
Adoption of Plan of
Action in 2003 in Tripoli
WHA56.13
The Regional Strategy
• Promoting the Role of Traditional Medicine
in Health Systems: A Strategy for the
African Region.
• AFR/RC50/R3:
• - Resolution of the Regional Committee 31
August 2000
Priority Interventions of the Regional
Strategy on Promoting the Role
of TM in Health Systems
AFR/RC50/R3 – Ouagadougou, Burkina Faso, 2000
DEVELOPMENT
POLICY
OF LOCAL
PRODUCTION
FORMUALATION
RESEARCH
PROMOTION
PROTECTIION OF
INTELLECTUAL
PROPERTY RIGHTS
AND TRADITIONAL
MEDICAL KNOWLEDGE

CAPACITY
BUILDING
Research Methodology
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General Objective
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Specific Objectives
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Preclinical Evaluation/ Retrospective Study /Ethnomedical
Evidence
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Methodology
 Criteria for patient selection (including
 Inclusion criteria and exclusion criteria)
 Sample size
 Screening Phase
 Serum chemistries
 Haematology
 Treatment Phase
 INFORMED CONSENT
Research Methodology
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Drug Administration
Traditional Herbal Remedy to be tested
Control treatment
Parasitaemia
Serum chemistries
Haematology
Physical examination and vital signs
Electrocardiogram (ECG) examinations
Assessment of Efficacy
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a) Primary outcome measures
b) Secondary outcome measures (optional)
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Assessment of Safety
Discontinuation from the study
Countries that are conducting research of
traditional medicines used for malaria
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Burkina Faso
DRC
Ghana
Kenya
Madagascar
Mozambique
Nigeria
South Africa
Tanzania
Zambia
Zimbabwe
The ability to conduct research and the tools and guidelines
do exist. However, there is need to build the culture for
research in the Region.
Role of TMs in the treatment of malaria
3
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A survey conducted by
RBM reported more than
60% of children with
high fever due to malaria
were successfully
treated with herbal
medicines in Ghana,
Mali, Nigeria and
Zambia, (WHO 1998)
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Artemisia annua in
China, Africa has to find
other medicinal plants
for malaria
Nascent pilot farms of Artemisia
annua in Zimbabwe (Source: WHO/AFRO, 2006)
Nascent pilot farms of Artemisia
annua in Zimbabwe (Source: WHO/AFRO,
2006)
Countries locally producing in small-scale traditional medicines for
Malaria and HIV/AIDS in WHO African Region (Source: WHO/AFRO, 2006)
Malaria
EMRO Countries Regions
Countries producing medicines for Malaria
Others countries
The Role of WHO in Research
To provide technical (and financial) support to research
institutions and WHO Collaborating centres for
research to produce evidence of TMs used for
malaria and other priority diseases
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To produce tools and guidelines on research
methodology for adaptation by countries:
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Clinical evaluation of traditional medicines in WHO
African Region, Brazzaville, (AFR/EDM/ TRM/04.04)
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WHO Guidelines on research methodologies and
traditional medicine, Geneva,
(WHO/EDM/TRM/2002.1).
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Monograph on Artemisia Annua (of which I was
chairperson during its review in China)
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Guidelines on Good Agricultural and Collection
practices of medicinal plants, 2004
Traditional Medicine is our own, if we Africans
do not develop it, nobody else will
Logo for African Traditional Medicine
5 Swedish Parliament - Stockholm, 2929-30 May 2002
World Health Organization