Yesterday morning, my office received a phonecall from Geneva. It was Doctors without Borders (MSF) that requested us to send out a corrective statement to the global malaria community via our platform (MalariaWorld) regarding inaccurate information that was distributed by the Chinese company Artepharm.
Artepharm, in a press release dated 19 July, stated ‘The Company is very pleased to report that Doctors Without Borders/Medecins Sans Frontieres (MSF), a Nobel Peace Prize winning humanitarian organization, will monitor and analyze the results of the current project.’ MSF, however, denies any collaboration with Artepharm and firmly distances itself from any involvement with Artepharm’s activities in East Africa.
Moheli (or Mwali) is a small island belonging to the Comoros archipelago in the Indian Ocean. Malaria is one of its biggest health problems for its 36,000 inhabitants. But beyond the radar of western science and without the go-ahead of the World Health Organization, China crafted an unconventional and now widely disputed approach to eliminate malaria from the island.
Using an artemisinin-based combination therapy, Artequick, for which Artepharm holds the patent, the Chinese dosed every inhabitant of the island twice with the drug over a 40-day period. Everyone. The approach is called mass drug administration. The concept is simple: By clearing the parasites from the bodies of all Mohelians, the disease would be wiped out. The Chinese reasoned that the remaining malaria mosquitoes would be harmless as there would simply be no parasites left to transmit.
On 16 July, Artepharm declared victory over the disease on Moheli. And to avoid humans bringing in new parasites, everyone entering the island in future will have to take a mandatory dose of the drug.
China vs WHO
China is not just conquering Africa in search of its resources. China gives back, and uses an approach to malaria elimination that would be a hard sale in any democratic setting where people cannot be forced to take a drug without their consent. But then, do the inhabitants of Moheli care about this? Probably not – the ancient scourge has been removed from their island.
But western science and the World Health Organization alike, were not all that thrilled by the Chinese success. Richard Feachem of the Malaria Elimination Group in San Francisco warned that ‘It falls way short of a peer-reviewed scientific publication’. Apparently the Chinese declared victory without seeing the need for some high-profile article in a medical journal like the Lancet.
East meets West
‘These results will be very very scientific’ argued Professor Song Jiangping when interviewed on the island. He went on to say: ‘Because it was a new technique, many experts were doubtful when it was first introduced. To them, it would be impossible to eradicate malaria. They thought that could only be an illusion’.
Jiangping should have known that his approach on Moheli was not new and novel. Already in 1991 a similar approach proved successful on the island of Aneityum in the Solomon archipelago, albeit on a smaller scale. Only 718 people were drugged back then, again with malaria elimination as the end result.
All of this will not be of interest to the inhabitants of Moheli. They’ve seen the end of malaria and don’t care what Geneva’s WHO thinks of this. They also don’t wait anxiously for some high-profile publication.
Jiangping now wants to move on to other islands and even talks of the whole continent of Africa. ‘We can eradicate malaria from the whole continent within a decade’, he argued passionately.
I guess the time has come that the giant from the East will start showing the world how diseases like malaria can be tackled ‘Chinese-style’. Malaria elimination is not an exclusive ‘right’ of WHO and the Chinese ignore the concept of ‘double-blind, randomised, placebo-controlled trials’. They move in and get the job done.
No surprise that Africa is embracing China.
[The quotes in this blog originate from interviews that can be seen here: ]http://www.artepharmglobal.com/news_events/news_videos.php]