Experts fear Madagascar’s organics could accelerate malaria resistance
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President Muhammadu Buhari, yesterday, at the State House, Abuja, received the Madagascan native formulation against the Coronavirus Disease (COVID-19), and reiterated that he will listen to scientists before allowing traditional or any new medicines to be administered on Nigerians.
While receiving a sample of COVID-Organics from the President of Guinea Bissau, Umaro Sissoco Embalo, Buhari said his position on all such herbal or traditional medicinal postulates had remained the same, stressing that he would not allow the solution, or any other drug to be administered on Nigerians without scientific instructions.
It would be recalled that President of Madagascar, Andry Ranoelina, recently dispatched consignments of the drug to African countries, some of which were sent to Guinea Bissau for onward delivery to West African countries.
According to Buhari: “We have our institutions, systems and processes in the country. Any such formulations should be sent to them for verification. I will not put it to use without the endorsement of our institutions.”
Embalo said one of the reasons he was in the country having stabilized his country after the crises that attended the general elections won by him, was to come and seek counsel from his “father,” President Buhari, on his plan for a “government of national unity,” and a proposed war against corruption in his country.
He also said that his new government met a country beset with a number of issues and problems, the resolution of which would require tremendous assistance from “big brother,” Nigeria.
“Problems of Guinea Bissau are problems of Nigeria. I have come to you as your son. I need your help and assistance to make the people happy. I will not let you down, neither will I put you in any difficult situation,” the visiting leader told President Buhari.
In response to these demands, the Nigerian leader commended “General“ Embalo on his confirmation as President and for stabilising the country.
“I commend your political dexterity in getting the opposition to join the proposed unity government,” he said, adding that Nigeria was determined to keep West Africa politically stable and promised to support the new government in Guinea Bissau. “I will cooperate and help in every way possible,” assured the Nigerian President.
But as Buhari promised not to allow the Madagascan solution, or any other drug to be administered on Nigerians without scientific instructions, some experts have warned that the misuse of Artemisia, one of the main plant extracts in the tonic (from Artemisia annua), could accelerate malaria resistance to artemisinin-based drugs, used as treatment for malaria.
Already, Artemisia annua, which is a source of artemisinin, a significant component of modern anti-malarials, has been the subject of some international research looking at possible Coronavirus treatments.
Scientists at Germany’s Max Planck Institute, in Potsdam are among a group of researchers from Germany and Denmark collaborating with a United States company, ArtemiLife to explore whether Artemisia plant can be used against the raging contagion.
Recently, the Minister of Health, Dr. Osagie Ehanire, during Presidential Task Force (PTF) briefing on COVID-19, in Abuja, also said that samples of plant from Madagascar would be compared with the ones that grow here in the country.
He said, “The cure from Madagascar has been making the news and we have promised to get samples of the herb or the botanical products that is there for analysis and (also) use (that) as an opportunity to speak with the health authorities, particularly the scientific community, on how they use it.
“We will give that to the research community with us here to examine and see what they can do with it. We understand that it is something called Artemisia annua, which also grows here but if we get it, we will like to compare it with the strain here whether they are identical or whether they are similar, and see what properties they have. Things like that are subjected to analysis.
“All countries in the world are interested in finding a cure and we are no different, and we will look at all options, possibilities, and promises that were made. But before we give them to our people, we will ensure they are safe and make sure they work.”
The WHO recently also warned against using untested herbal therapies to treat COVID-19 patients without first “establishing their efficacy and safety through rigorous clinical trials” in step with global standards.
The United Nations agency in a release this month acknowledged that medicinal plants such as Artemisia annua, were “being considered as possible treatment of COVID-19,” but stressed that they “should be tested for efficacy and adverse side effects.”
The organisation added that efforts were underway to find treatment for COVID-19, but cautioned against misinformation, especially on social media, about the effectiveness of certain remedies.
“Many plants and substances are being proposed without the minimum requirements and evidence of quality, safety and efficacy. The use of products to treat COVID-19, which have not been robustly investigated can put people in danger, giving a false sense of security and distracting them from hand washing and physical distancing, which are cardinal in COVID-19 prevention, and may also increase self-medication and the risk to patient safety,” the agency wrote.
Worries Over Artemisia Annua
One of the earliest concerns about accelerate malaria resistance to artemisinin-based drugs was raised by a Professor of Pharmacological Science and Experimental Medicine at Stony Brook University, New York, Dr. Arthur Grollman, who speaking to CNN said: “Widespread use of Artemisia annua in the pandemic will accelerate resistance to it, endangering people in countries, including Madagascar, where artemisinin-based drugs are being used to treat malaria.
“The product won’t work and will result in more people dying from Coronavirus due to the false sense of security created by the advertisement and also more people dying from malaria due to artemisia resistance,” Grollman said.
Reacting to this, a clinical pharmacist and public health expert Kingsley Chiedu, said: “In treatment of malaria, if artemisinin is used as monotherapy (that is alone without combining with an additional antimalarial medicine, then resistance could develop to it. That is why the World Health Organisation (WHO) insists on artemisinine being combined with other anti-malarial medicines. When the product is used alone at sub-optimal doses, resistance could develop. When used at higher than recommended doses, toxicity or adverse drug reactions can set in.”
The plant artemisia is found to be effective in treatment of malaria, but according to Chiedu, if used in sub-therapeutic dose, could lead to years of treatment failure.
Malaria is endemic in many African countries, and as many as 400, 000 people died of it globally in 2018, according to WHO.
In terms of side effect, Chiedu said, “Artemisia herb is known to be quite safe. Safer than some orthodox medicine, but the problem is standadisation of dose. People tend to use such drugs as they like. In terms of efficacy tests, it is trial and error.”
Regarding injecting higher than recommended therapeutic doses, Chiedu said this could lead to toxicity and adverse reaction. “But for now, it is too early to speculate that it can lead to drug resistant. What we need to do now is to encourage our own local herbal products up to the point of testing,” he said.
Another pharmacist, Olumide Akintayo, said when people begin to misuse herbs, they are exposed to consequences like ulcer, and gastrointestinal diseases. “Before you get to the stage of drug resistance, you must have abused the drug over and over again. If you begin to abuse lime for instance, within a week, I can assure you that you will come up with a gastrointestinal issue.
“There is no prophylaxis for the virus. The best people can do is to use supplements like Vitamin C- a high dose for a short period then substitute with fruits and vegetables. Avoid crowded areas, avoid air-conditioned areas were you have lots of people, this is why you have lots of people contracting it through flying in aircraft. People should focus on these preventive measures instead of focusing on herbal preparation,” he said.
Akintayo stressed the need to evaluate the safety profile of the drug saying: “It’s important that pharmacists embark on national dialogue with NAFDAC, to agree on the necessary pharmacological tests of some of these herbal preparations.
Artemisinin is not the first malaria treatment to gain attention in the search for a treatment for COVID-19. The malaria drug hydroxychloroquine has also been hyped in recent months despite little data supporting its effectiveness against coronavirus infection.
The Co-Chair, Presidential Taskforce on COVID-19 in Kano, Prof. Abdulsalam Nasidi, yesterday, said there was urgent need for Nigeria to search inward for a veritable treatment and cure for the pandemic.
The professor of infectious diseases and public health, who spoke in Kano, noted that it was high time Nigeria and Africa focused more on local scientific research and development in a bid to finding homegrown treatment for the virus.
Although, Nasidi disclosed that several clinical tests on vaccines for the cure of COVID-19 pandemic were presently at advanced stages, he reminded that such vaccines when finally certified may be difficult to access in Africa, even as he alleged that world powers may make it extremely expensive and reserved for their citizens first, before thinking of Third World countries.
Nasidi, who expressed the belief that Nigeria and Africa have the scientific and alternative medicine competence to finding a cure for the virus, urged government to increase funding for research centres in the country.