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ARTEMISININ PRODUCTION

ENSURING SUSTAINABLE ARTEMISININ PRODUCTION

MEETING GLOBAL DEMAND19 Mars 2008

Antananarivo, MadagascarAuthor :Jacques PILLOY / OTECI-ARTEPAL

Presenter :Charles GIBLAIN / Bionexx-Innovexx

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ARTEPAL et OTECI présentation

1. Artépal : projet AEDES/Oteci financé par l’UnionEuropéenne pour aider à la production d’ACTs debonne qualité à un prix optimum.Site internet : www.artepal.org

2. Oteci = Office Technique d’Etudes et de CoopérationInternationale.Association de bénévoles seniors provenant dedifférentes industries dont pharmacie

3. AEDES Fondation: issue de l’Association Européennepour le Développement et la Santé

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Artemisia annua

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ACT Production cycle

R.M. Artemisia Annua Plantation

Starting Mat Artemisinin Extraction-Pur.

DHA Hemi-synthesis API

Artesunate Artemether

ACT AS/AQ AL Drug Product

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ACT Production cycle

Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Artemisia

Artemisinin

API

ACT

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From Artemisia annua to Artemisinin: Estimates

Quantity of dried leaves A.A /ha:1.0 – 2.5 T average 1.5 T/ha

Average Artemisinin content in the leaves:0.4 – 1 % Average at extraction stage: 0.6%

Extraction –Purification process efficiency:40 – 65 % Average: 50%

Quantity of Artemisinin/ Ha: average 4.5 Kg

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Artemisinin per treatment

AS/AQ

Age (years) < 1 1-6 7-13 > 13Artesunate (mg) 75 150 300 600

Artemisinin eq. (mg) 5% loss

77 153 306 613

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Artemisinin per treatment

Artemether/Lumefantrine

Weight (kg) 5-14 15-24 25-34 > 34Artemether (mg) 120 240 360 480

Artemisinin eq. (mg) 5% loss

210 419 629 839

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Artemisinin per treatment

The « average treatment » is the result of the weighting of the different dosages based on the CHAI forecast:

Dosage 1 2 3 4

AL 32% 22% 14% 32%

AS/AQ 8% 36% 20% 36%

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Artemisinin per treatment

Considering the artemisinin quantity per dosage and the repartitition of the different dosages, the average quantity per treatment is: AL= 0.51 g artemisinin AS/AQ= 0.34 g artemisinin These figures may change according to

evolution in the repartition between dosages.

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Artemisinin per treatment

Split between AL and AS/AQ treatments is about 70/30 %.

After all theses calculation, we can roughly consider the following figure:1 treatment = 0.5 g Artemisinin.

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From Artemisia annua to treatments: Estimates

1 ha Artemisia annua corresponds to: 14 700 to 29 400 AS/AQ treatments 9 800 to 19 600 AL treatments.

OR 1 Million treatments needs:

For ASAQ: 34 to 68 ha For AL: 51 to 102 ha

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ARTEMISININ PRODUCTION ESTIMATES

2003 2004 2005 2006 2007 2008Artemisia

annua Surface

(ha)

2 000 3 000 9 500 26 000 14 500 4 500

Artemisinin Quantity

(T)

8-10 30-40 60-80 180-200 100-110 30-40

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Marché de l’artémisinine: Les prix Prix contrats assez stables 325 – 350 $/kg

(estim.) Prix ($/kg) sur le marché spot très fluctuants

0

200

400

600

800

1000

1200$

S1-2

003

S2-2

003

S1-2

004

S2-2

004

S1-2

005

S2-2

005

S1-2

006

S2-2

006

S1-2

007

S2-2

007

S1-2

008

S2-2

008

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ARTEMISININ PRODUCTION ESTIMATES FOR 2008

Following figures do integrate stocks from previous campaigns.

China Vietnam Others Total

Surface (ha) 2 000 1 000 1 500 5 000

Artemisinin(T) 12 – 20 6 – 8 10 - 15 30 – 40

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Artemisinin needs forecasts2009-2011

Needs concerns: ACT public sector ACT private sector AMFm Artemisinin based monotherapies even if

they are banned by WHO. Following figures wants to be simple to

memorize:

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Marché de l’artémisinine:AMFm(2)

Atteindre 60% des patients du secteur privé.

Négociation des prix avec producteurs d’ACTs.

Co-paiement aux acheteurs Qualité: standard commun OMS,

UNICEF, Fonds Global applicable à tous.

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Marché de l’artémisinine:AMFm

AMFm= Affordable Medicines Facility malaria.

Mécanisme financier de co-paiement des ACTs pour réduire le coût de traitement pour les malades.

Financement par Fonds Global, Banque Mondiale, donateurs, gouvernements…

Atteindre 360 millions de Traitements/an à terme de 5 ans.

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Artemisinin needs forecasts 2009-2011

2 009 2 010 2011

Nb of treatments(millions)

160 240 260

ArtemisinineNeeded (T)

80 120 130

Surface to be planted (ha)(4.5kg Art/ha)

Too late 26 500 29 000

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Artemisinin needs forecasts 2009-2011

To cover the needs of 2009 and beginning 2010, there is a risk of shortage.

It will be then necessary in 2010 to reconstitue safety inventories in the supply chain.

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Artemisinin needs forecasts 2009-2011

This will needs probably around 30 to 40 MT more of artemisinin for 2010 ! and about 8 000 ha more !

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Artemisinin needs forecasts 2009-2011

ARTEMISININ PRODUCERS WILL FACE A HUGE CHALLENGE;

THANK YOU