Artemisinin production - Conférence de la 7e édition du Cours international « Atelier Paludisme » - GIBLAIN Charles - Madagascar - cgiblain@yahoo.fr

1. 1
ARTEMISININ PRODUCTION
ENSURING SUSTAINABLE ARTEMISININ
PRODUCTION
MEETING GLOBAL DEMAND
19 Mars 2008
Antananarivo, Madagascar
Author :Jacques PILLOY / OTECI-ARTEPAL
Presenter :Charles GIBLAIN / Bionexx-Innovexx

2. 2
ARTEPAL et OTECI présentation
1. Artépal : projet AEDES/Oteci financé par l’Union
Européenne pour aider à la production d’ACTs de
bonne qualité à un prix optimum.
Site internet : www.artepal.org
2. Oteci = Office Technique d’Etudes et de Coopération
Internationale.
Association de bénévoles seniors provenant de
différentes industries dont pharmacie
3. AEDES Fondation: issue de l’Association Européenne
pour le Développement et la Santé

3. 3
Artemisia annua

4. 4
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

5. 5
ACT Production cycle
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Artemisia
Artemisinin
API
ACT

6. 6
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

7. 7
Artemisinin per treatment
 AS/AQ
Age (years) < 1 1-6 7-13 > 13
Artesunate (mg) 75 150 300 600
Artemisinin eq.
(mg) 5% loss
77 153 306 613

8. 8
Artemisinin per treatment
 Artemether/Lumefantrine
Weight (kg) 5-14 15-24 25-34 > 34
Artemether (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%

10. 10
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 2008
Artemisia
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

14. 14
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
$
S1-2003S2-2003S1-2004S2-2004S1-2005S2-2005S1-2006S2-2006S1-2007S2-2007S1-2008S2-2008

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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 forecasts
2009-2011
 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.

18. 18
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
Artemisinine
Needed (T)
80 120 130
Surface to be
planted (ha)
(4.5kg Art/ha)
Too late 26 500 29 000

20. 20
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 !

22. 22
Artemisinin needs forecasts
2009-2011
 ARTEMISININ PRODUCERS WILL FACE
A HUGE CHALLENGE;
 THANK YOU