Related: Artemisinin sparks hope and fear in COVID-19

Health officials are concerned about the promotion and use of these herbs for three main reasons. First, there is no evidence that artemisia annua extract can prevent or cure COVID-19. Not only does this give users false hope, it can foster a false sense of security and lead them to flout public health guidelines such as social distancing and hand washing.


Second, artemisinin preparations, such as teas, supplements or herbal capsules, in addition to artemisinin, contain a mixture of bioactive compounds that can cause side effects such as dizziness, hearing problems and vomiting.


Third, and perhaps most worryingly, the widespread use of artemisinin extract may enhance drug-resistant strains of malaria parasites such as Plasmodium falciparum. For people living in malaria-endemic areas, exposure to a subtherapeutic dose of artemisinin may be enough to kill some, but not all, of the parasites in their bodies. Clearing weak parasites provides more room for drug-resistant siblings to multiply, thus rendering important ACTs ineffective. “It’s a Darwinian effect,” said Karen I. Barnes of the University of Cape Town, who heads the Collaborative Center to Optimize Antimalarial Treatments.


In October 2019, WHO published a major review of these non-drug forms of artemisinin, concluding that “widespread use of artemisinin herbal medicines can accelerate the development and spread of artemisinin resistance.” About 90 percent of global malaria cases occur in Africa, where the herb Artemisia annua is easily available in tea and capsules.


Resistance to artemisinin is already a big problem in Southeast Asia, where 80 to 90 percent of parasites have mutations that allow them to survive ACT treatment, said Pascal Ringwald, head of resistance and response at WHO’s Global Malaria Programme. There were also signs of rising resistance in Rwanda, Guyana and Papua New Guinea.


Dyann F. Wirth, a malaria researcher at Harvard University, said there was great concern that the ACT would become useless. “If we lose this drug, the number of malaria deaths will rise dramatically because there is nothing to replace it immediately.”


Gilmore and his Max Planck colleague Peter H. Seeberger have A long history of collaborating with A. Annua. The pair had previously developed a mobile photochemical system to increase the production of artemisinin, which can be extracted from plants. The researchers partnered with the Kentucky Tobacco Research and Development Center in the United States to form a spin-off company called ArtemiFlow to develop the technology, where the company grows several acres of the crop. A few months ago Gilmore set up a sister company, ArtemiLife, to supply artemisia to the German-Danish consortium for cell research.

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