<div dir="ltr"><span class="" style>Dear all<br><br>I looked into this briefly and agree with the points already raised by Jeff. I think we would want to add these:<br><br>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.<br>
The problem is lack of political will, lack of regulation of the private sector and lack of training of health workers; not unavailable ACT.<br><br>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.<div>
<br></div><div>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?</div>
<div><br></div><div><br></div><div>With love</div><div><br></div><div>Natalie</div></span></div><div class="gmail_extra"><br><br><div class="gmail_quote">2013/4/11 Jeff Conant <span dir="ltr"><<a href="mailto:jefeconant@gmail.com" target="_blank">jefeconant@gmail.com</a>></span><br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div>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: </div>
<a href="http://newscenter.berkeley.edu/2013/04/11/launch-of-antimalarial-drug-a-triumph-for-uc-berkeley-synthetic-biology/" target="_blank">http://newscenter.berkeley.edu/2013/04/11/launch-of-antimalarial-drug-a-triumph-for-uc-berkeley-synthetic-biology/</a><br clear="all">
<div><br></div><div>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<span style="font-family:arial,sans-serif;font-size:13px"> replace the entire global production, which will put some 5500 farmers in East Africa out of work.</span></div>
<div><font face="arial, sans-serif">The media is already announcing this as</font><span style="font-family:arial,sans-serif;font-size:13px"> a great humanitarian advance, but it has real social justice implications.</span></div>
<div>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?</div>
<div>Thanks much!</div><span class="HOEnZb"><font color="#888888"><div>- Jeff Conant<br><br></div>-- <br><font face="arial, helvetica, sans-serif">Jeff Conant<font></font><font></font><br></font><div><div><font face="arial, helvetica, sans-serif">Skype: jeffconant</font></div>
<div><font face="arial, helvetica, sans-serif">Web/Blog: <a href="http://climate-connections.org/" target="_blank">http://climate-connections.org/</a></font></div><div><font face="arial, helvetica, sans-serif"><br></font></div>
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