INDONESIA: Home-grown Artemisinin to boost malaria fight
Malaria continues to remain a serious health concern in Indonesia
JAKARTA, 17 March 2009 (IRIN) - Indonesia has been able to successfully grow Artemisia annua, the active ingredient in the most effective malaria drug available, and is ready for large-scale cultivation of the herb, government officials said.
Artemisinin is a key ingredient in combination drug therapies recommended by the World Health Organization (WHO) for the treatment of multi-drug-resistant strains of falciparum malaria.
The herb is native to China and Vietnam, but is also grown in East Africa.
The plant has been cultivated since 2006 at a field managed by the Health Ministry’s Agency for Research in Medicinal Plants and Traditional Medicines in Tawangmangu, Central Java Province, after Indonesia obtained the seed from China, said the agency's director, Indah Yuning Prapti.
"We are ready with the seed once local farmers are ready to replace their crops with artemisia annua," Indah told IRIN.
She said farmers in Tawangmangu, where the soil was suitable for artemisia annua, traditionally grew vegetables and needed assurances that switching to the herb would bring them more benefit.
She expected Indonesia would be able to produce its own Artemisinin by 2010.
About 45 percent of Indonesia's 230 million people live in areas where malaria is endemic and in the east of the country more than five in 1,000 people had malaria, Health Minister Siti Fadilah Supari told a parliamentary hearing on 16 February.
According to the World Malaria Report 2008
, more than 2.5 million Indonesians were infected with malaria in 2006, the latest year for which figures are available, with a known death toll of 3,480.
Under a programme launched in April 2008, Indonesia aims to halve by 2010 the number of villages where more than five in 1,000 people are infected with malaria and eliminate the disease by 2030.
Malaria will be eliminated from Batam and Bali islands by 2010 and Java and Sumatra islands by 2019, said Rita Kusriartuti, director of vector-borne diseases at the Ministry of Health.
In eastern provinces such as Papua, where malaria is highly endemic, Indonesia hopes to eliminate the disease by 2030.
"We are taking serious steps and we can see that cases have declined dramatically. Even in Timika [Papua], our workers said it is now hard to find malaria cases," Rita said.
Steven Bjorge, team leader for malaria and vector-borne communicable diseases at the WHO Indonesia office, told IRIN the country was making headway in the fight against malaria.
However, he said: "Availability of Artemisinin is helpful but not the whole solution." Artemisinin-derivatives had to be combined with a second long-acting drug such as amodiaquine, lumefantrine or piperaquine.
Bjorge said the malaria situation in Indonesia was complex. The disease had been almost eliminated in Java and Bali, with only pockets of malaria risk either in coastal areas of brackish water- or forest-breeding anopheline species, he said. But elsewhere, especially in five provinces in the east, including highly-endemic Papua, incidence was severe, even though cases had been reduced under a programme supported by the Global Fund for AIDS, Tuberculosis and Malaria
, he said.
"The eastern provinces are the worst areas for malaria, with the highest incidence," Bjorge told IRIN. "Malaria control is a 20-year effort to make real progress, so the work has begun but needs sustained effort to solidify and expand gains made."
In the 2008 World Malaria Report, the WHO reported that of an estimated 247 million malaria cases, 881,000 people died in 2006. By June 2008 all except four countries and territories worldwide had adopted Artemisinin-derivative Combination Treatment (ACT) as the first-line treatment for falciparum malaria.