PHM-Exch> PHM concern about new snthetic-biology-based anti-malarial?

Fri Apr 12 07:29:51 PDT 2013

Dear all

I looked into this briefly and agree with the points already raised by
Jeff. I think we would want to add these:

1. This 'solution' does not address the problem. It is in line with a trend
that we have criticized before where medicines and technology are brought
forward to the neglect of prevention efforts focusing on the structural
determinants of health. In this press release it seems as if the
availability of artimisinin in world markets is the problem; which is not
the case. Even if it would be available at low prices, children would still
die from malaria. A recent report from ACTwatch (project by Population
Services International with LSHTM, ironically funded by BMGF but they have
good data) shows that, although ACT is now the WHO-recommended treatment,
the use of ineffective monotherapies remains widespread, both
non-artemisinin therapies as well as oral artemisinin monotherapy. WHO has
recommended a ban of this last one due to the potential to cause
artemisinin resistance. Their multi-country study showed that anti-malarial
medicines markets were dominated by the private sector (in Nigeria 98%, of
which only 2% were quality-assured ACT). "In six African countries,
quality-assured ACT accounted for less than 25% of total antimalarial
volumes, and private-sector quality-assured ACT volumes represented less
than 6% of the total market share (...) For most countries, non-artemisinin
therapies dominate the overall market, followed by ACT and then oral
artemisinin monotherapies. Exceptions to this finding were noted in Nigeria
and the DRC where more oral artemisinin monotherapies were sold than ACT in
the private sector" (see graph attached). In addition, first-line quality
assured ACT was found to be 5-24 times more expensive than non-artemisinin
therapies in each country. While the private sector is distributing most
drugs, the knowledge of the first- line treatment was significantly higher
in the public/not-for-profit sector than the private sector across all
countries: 44% to 96% of providers in the public/not-for- profit sector
could correctly state the first-line treatment, compared with 12% to 67% in
the private sector.
The problem is lack of political will, lack of regulation of the private
sector and lack of training of health workers; not unavailable ACT.

2. Who is in there and how they are benefitting. The big funder is the Bill
and Melinda Gates Foundation, that gave money to PATH's drug development
program "OneWorld Health". They 'shephered the drug’s development out of
Keasling’s UC Berkeley lab to Amyris for scale-up and then to
pharmaceutical firm Sanofi, based in France, for production". It has to be
noted that about half of the Bill & Melinda Gates Foundation’s stock
holdings are invested in Berkshire Hathaway and that Berkshire Hathaway
holds a stake in Sanofi. And Jay Keasling, the principle investigator, has
also profited from business deals with Monsanto, the investment favorite of
the Gates Foundation. Amyris, besides producing artimisinin also plans to
develop agrofuels, in which Monsanto is a major player. At the heart of the
problem, and I think FoE would highlight that anyhow, is that the
development of science is not serving the public interest but commercial
one's and that these people are at the highest level setting the research
agenda and shaping the public's view of problems and solutions.

I'm not a malaria expert, nor know much about WHO drug approval processes
so there is probably a lot more to be said. This is just one contribution
to a conversation which I agree with Jeff we should have. I don't think our
core concerns would differ so much from previous FoE or ETC Group
statements on these processes unrelated to medicines; so I think this could
work two ways: 1) us contributing some expertise on malaria, generic drugs
etc and 2) using this case to raise the more broad discussion on synthetic
biology in the health field, where it has not been very present to my
knowledge?

With love

Natalie

2013/4/11 Jeff Conant <jefeconant at gmail.com>

> Greetings PHM -- I'm writing to see if I can stimulate some concern or
> conversation about today's announcement of a new anti-malarial drug that
> mimics natural artemisinin. The announcement is here:
>
> http://newscenter.berkeley.edu/2013/04/11/launch-of-antimalarial-drug-a-triumph-for-uc-berkeley-synthetic-biology/
>
> The concern that I think PHM would want to weigh in on, is threefold: 1)
> that this new drug, being marketed by Sanofi, is produced using a new
> biotech process based in the genetic modification of microbes that are
> designed to 'excrete' substances such as the active ingredient in
> artemisia, 2) that the currently decentralized production of artemsisin
> will be captured entirely by a single company that owns the means of
> production, and 3) that this new production will replace the entire
> global production, which will put some  5500 farmers in East Africa out of
> work.
> The media is already announcing this as a great humanitarian advance, but
> it has real social justice implications.
> I am at Friends of the Earth and am working on a press statement about
> this with a number of groups critical of synthetic biology. I wonder if PHM
> has looked at this, if any PHM'ers would want to weigh in, and if there are
> any experts on generic drugs, WHO drug approval, malaria, ectetera, who
> would be able to provide some expertise and make some public statements on
> this?
> Thanks much!
> - Jeff Conant
>
> --
> Jeff Conant
> Skype: jeffconant
> Web/Blog: http://climate-connections.org/
>
>
>
>
>
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-- 
What will count are not our words, but our deeds
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