How do we cope with drug resistant malaria?
Malaria updates for 2019 travellers
Professor Pamela Weathers cured drug resistant malaria in 2017 during an outbreak in the Congo. 18 fatally ill patients had not responded to drug treatments. Her whole leaf Artemisia tablets cured them all after 5 days
Q & A with healthcare researcher Sue Visser March 2019
Caution: do not take olive leaf or Artemisia products if you are breastfeeding or pregnant unless under the guidance of a doctor. Products containing these herbs may potentiate the effects of cardiovascular, thyroid, antimicrobial or anti-diabetic medications, so ask a practitioner to adjust the prescriptions accordingly.
Herbal treatments for malaria – are they original or alternative?
Doctors who use drugs that are made in a laboratory will claim that because of their scientific methodology they provide exclusively reliable, fully tried and tested legal treatments for diseases. They view what they call as “unscientific” alternatives such as herbs with suspicion and have tried to discourage their use, especially in the case of both preventing and treating malaria. Yet thousands of years ago – long before the era of modern medicine the herb Artemisia annua – a member of the wormwood family was the standard cure for malaria.
So what is the alternative to this herb? How about modern, “scientifically proven” pharmaceutical drugs? According to the April 24, 2017 edition of Science Daily: “Successful treatment of drug resistant cases of malaria with 100% dried leaf Artemisia annua suggests that it should be rapidly incorporated into the antimalarial regimen for Africa.” Further studies were recommended but as we will see from this discussion, Artemisia annua has been used to successfully treat and prevent malaria for thousands of years without any evidence of toxicity or drug resistance.
Our Traditional healers in South Africa can sell herbs to cure malaria and other ailments and are exempt from legislation. Here you can buy a bundle of Artemisia afra for next to nothing and yes – it dies cure malaria!
Are our modern scientific drugs winning the battle against drug resistant malaria? Are they safe?
Unfortunately, the recent and now widespread epidemic of drug resistant malaria has spread from Asia into Africa and is claiming many lives. There are no effective preventative drugs for travellers to take that can guarantee their safety anymore. Therefore we are all at risk of contracting malaria should we have to rely solely on what modern medicine has to offer. We can use mosquito nets and poisonous insecticides and gamble with our lives or refrain from visiting malaria infested areas.
We can choose from a number of standard prophylactic drugs that can prevent the onset of malaria but there is no guarantee that they are 100% effective against the latest strains. A further risk is death or debilitating illnesses as a result of taking amodiaquine and Fansidar because fatalities have occurred.
Many of the side effects from the drugs are so unpleasant that some travellers (including our family) refuse to take them anymore. The four most popular drugs used by travellers are: mefloquine, doxycycline, chloroquine-proguanil and atovaquone –proguanil (Malarone). These more recent formulations are a better option, but are not free of risks, side effects and contra-indications.
Melfloquine for instance is associated with neurological disorders that include headache, dizziness, confusion, vertigo and seizures. Peripheral neuropathies such as paraesthesia, tremors and ataxia have also been reported. The psychiatric disorders may include insomnia, strange dreams, restlessness, anxiety, depression, and psychosis. Doxycycline is an antibiotic and its long term use will obliterate entire colonies of beneficial gut flora – 80% of the immune system as well as the gut microbiome we need to aid digestion, produce neurotransmitters and prevent candidiasis as well as neural disorders in the first place! Malarone is basically the best option for long term use and has fewer side effects other than gastric upsets, so it should be taken with meals. But it is very, very expensive.
Is it safe enough to rely 100% on insecticides, sprays and mosquito nets?
Kinsley Holgate, the famous explorer who travels throughout Africa to distribute mosquito nets has had malaria over 30 times. Now doctors have no standard cure for drug resistant malaria so is it worth taking the risk? Mosquitoes don’t only attack people who sleep in beds. You may get zapped by a mosquito in the shower – after you have washed off all the insecticides! They love dark, damp places. Malaria plasmodia are developing a resistance to all the silver bullets, and will continue to do so unless we find a better solution.
What about the use of artemisinin and ACT – has that also failed?
Around the world, Malaria claimed over 407 000 lives in 2016 despite the ubiquitous use of artemisinin, an extract of Artemisia annua combined with partner drugs. These drugs were assessed for quality, safety and efficacy by means of the regulatory procedure known as Article 58 of the European Medicines Agency (EMA) at the time. The increasing death toll is due to the spread of partial artemisinin resistance combined with what they call partner drug resistance.
The Bill and Melinda Gates foundation promoted the use of an Artemisia annua extract combined with a number of anti-malarial drugs, called ACT. But the very expensive artemisinin extract proved to be unstable with a rapidly diminishing half-life. As a solo chemical, it is easier for plasmodia to develop a resistance to it. ACT tablets were sold to people who could barely afford food and clothing. The medication cost 20 US$ and families only earned a dollar a day. In terms of sustainability, the whole Artemisia annua or Artemisia afra plant can be cultivated in their own back yards and would save them from malaria and a host of other diseases. It does not cost 20 US$ per person per month and no drug resistance has ever been reported.
The malaria death toll is still rising and the use of Artemisia annua has been discredited by the WHO despite its efficacy when taken in adequate doses. Anamed recommends 20g of 100% dry leaf per litre of tea per day to be sufficient according to their evidence based methodology.
How did the Chinese treat malaria thousands of years ago?
The same Artemisia annua was used – as a tea or 100% leaf remedy. In other words not with unstable, very expensive and not very effective artemisinin! Ironically, it was the modern Chinese opportunists who developed artemisinin to supply to Bill and Melinda Gates for their very pricey ACT. However, Professor Pamela Weathers and her research team at Worcester Polytechnic Institute (WPI) produced the evidence we now so badly need as more recent – in situ proof of the efficacy of this treatment in the face of drug resistant malaria.
Artemisia consumption in the form of dose-related tablets, powder or capsules from the whole dried aerial parts has never led to any resistance in long duration trials. The Artemisia annua plant contains at least 20 active ingredients which work as a synergy. So it makes no sense to whip out an extract and mislead people in terms of stability or efficacy or cost effectiveness. Yet the WHO suggests that even if these constituents do act synergistically with artemisinin, these interactions are insufficient to eliminate Plasmodium parasites and cure malaria.
Traditional medicine embraces medicinal plants that are combination therapies. The 100% content guarantees the stability and bioavailability of their active substances. As opposed to a single extract, the combined anti-parasitic components of Artemisia can treat and prevent malaria. The rapid action of this herb against plasmodia means that travellers can start taking the product a few days before they leave. It is very affordable and side effects, if any, are minimal.
We often hear that the use of Artemisia is ineffective and can be toxic. Is this true?
No, there were many such attempts to discredit the use of Artemisia annua, saying it could contain toxic substances, it doesn’t work and its use against malaria was unorthodox if not unlawful. In 1998 a law even prohibited the use of Artemisia annua herbal tea in Belgium! Yet for two thousand years and among thousands of people using the herbal tea against malaria, the phenomena of resistance – let alone toxicity has never been established.
Pharmaceutical research institutes did their best to invalidate Anamed, (Action for Natural Medicine in The Tropics) the worldwide association that empowers low income groups of people with Artemisia annua DIY treatments. Anamed believe it is their God-given responsibility to share their expertise (over 30 years of it) with people who cannot afford elitist medicine for tropical diseases. In 2019 they aim to work on a project in South Africa to cultivate Artemisia for the treatment of malaria and HIV AIDS – despite opposition from controlling bodies.
Is there any scientifically acceptable research to justify the medicinal use of Artemisia?
All substances can be put through their paces to prove various points but many products fail to deliver results in a real life situation. A typical case being drugs involved with malaria. Extensive studies have been and still are undertaken to produce the evidence we need today, should we wish to use Artemisia as a medicine – not only to treat malaria. We can also consult the European Monographs in this respect.
African Universities that are studying Artemisia afra as opposed to Artemisia annua have found it to contain the highest concentration of the flavone luteolin, a molecule with demonstrated antiplasmodial, anti-inflammatory and anticancer properties. We also have well documented results on the effectiveness of herbal tea against leishmaniosis (sand fly bites) in Antioquia University in Colombia, against cancer at the University of Belgrade, against Trypanosoma cruzi at the University of Cumana in Venezuela, against diarrhoea and bilharzia in Senegal and against AIDS at the University of Leiden.
In South Africa, herbal remedies are preferred by 80% of the local population. Traditional uses for our local Artemisia afra include treatments for bacterial infections such as sore throats, ear infections and respiratory diseases. The aerial parts contain various phenolic compounds that have anti-bacterial and anti-viral infections such as measles and influenza and parasitic infections like malaria, worms and flukes. Non-pathogenic conditions traditionally treated with Artemisia afra include diabetes mellitus, gout and neuralgia, autoimmune conditions like rheumatoid arthritis, inflammation and asthma. It is now being scrutinized for its immune regulating effects.
In South Africa, over 80% of the local inhabitants prefer Traditional or herbal medicine. Remedies made from plants. They use Artemisia for many ailments especially HIV/AIDS
Can you give a specific, well documented example of how well Artemisia annua works?
A good example of how effective it is for drug resistant malaria comes from the Congo in 2017. Tablets made from the whole dried Artemisia annua leaves were used to successfully treat 18 cases of advanced malaria (symptoms that can include loss of consciousness, respiratory distress, convulsions, and pulmonary oedema and in this case, one child was already in a coma). The much publicised and over promoted ACT treatment had failed to cure them and none of the other standard drugs made any difference to what had become a near fatal situation.
None of patients even responded to artesunate, the frontline medication for severe malaria. Yet after five days on the Artemisia tablets all 18 of the patients fully recovered. Laboratory tests showed they had no parasites remaining in their blood. During 2017 over 100 other drug-resistant malaria patients were also successfully treated with the experimental Artemisia tablets, thanks to the pioneering work of Professor Pamela Weather and her lab team. Her research has shown that whole leaf Artemisia therapies are more effective and less expensive than standard malaria medications. They are a lot safer and do not have life threatening or debilitating side effects.
It is a pity that legislation does not allow these remedies to be offered at travel clinics throughout the world as an alternative for malaria-proofing travellers as well as their pets. The Artemisia pills help to ward off traveller’s gut bugs as a bonus!
We can buy Artemisia afra plants and wild olive trees from South African nurseries. These local subspecies are hardier and contain stronger active ingredients in many cases, according to analytical tests.
Are there any other plants growing in the garden that can ward off malaria?
Yes, if you have olive trees you can use the leaves! When quinine lost favour as the earliest treatment for malaria, olive leaf tea became a popular substitute in the 1820′s. Later on chemists isolated a compound they called oleuropein that protects leaves against the lacey-winged olive fly that attacks the fruit.
By 1906, scientists claimed that olive leaf extracts were superior to quinine , the primary treatment for malaria at the time. A case report from a clinic in Mexico announced a complete cure of a full-blown case of malaria in a 34-year-old woman after taking two 100% olive leaf supplements every six hours for six months. There are a host of other valuable phytochemicals present in whole olive leaf products, such as the anti-malarial agent cinchonine. No wonder it worked!
In 2002 my husband Jim was relieved of malaria within a few days using only whole olive leaf tablets. He was on holiday in China, and the breakout occurred on top of a high mountain we had just climbed. That night, in the remote hotel, his fever broke loose and he became delirious. Luckily we had olive leaf tablets with us and he took 2 every 2 – 4 hours. The next morning he was able to climb down unassisted. We did not use them to prevent malaria – we hadn’t discovered that yet! A few weeks later Jim’s malaria backlash was once again alleviated using only the olive leaf tablets. We were then at home and could get the proper diagnosis. He recovered fully.
Olive leaf, as in the case of Artemisia is more potent as a 100% dry leaf remedy. Ever since that bout of malaria, we have always taken our herbal remedies with us and have visited many malaria infested areas without further mishaps. Ironically people who take olive leaf tablets every day for blood pressure, candidiasis and so on have built-in malaria protection.
After visiting Thailand, Jim contracted malaria while climbing the Yuang Shan mountains in China. That night in the hotel at the summit he nearly died, until we gave him olive leaf tablets
So ideally one needs to consume the whole dried leaf to receive the most benefit?
Now that malaria has developed resistance to many of our present day drugs, clinicians may once again turn to olive leaf remedies in addition to Artemisia. Many scientific studies have been performed throughout Europe and the United States to show that olive leaf extracts have strong antiviral, antifungal, antibacterial, and anti-parasitic activity.
Alternative Medicine Review Monograph Volume 14, Number 1 2009, states that olive leaf can successfully treat bacterial, protozoan, and fungal Infections as well as viruses that include colds and flu as well as HIV/AIDS and of course, malaria. Olive leaf does not harm beneficial bacteria as is the case with regular antibiotics and they also help to eliminate biofilms that shield off colonies of bacteria, causing drug resistance.
Apart from preventing malaria for travellers, are there other benefits from using olive leaves?
Many people drink olive leaf tea to lower their blood pressure but heating up the leaves destroys many of their other active ingredients. For the equivalent of one standard 500mg whole leaf tablet you would need 7 dried and finely crushed and screened olive leaves. The powder can be mixed with a little honey or something similar to help it go down. Traditionally only European olive leaves were used for treating malaria but Olea afra, a local African species is also effective. Olive leaves are a potent cardiovascular medicine in their own right as they not only reduce blood pressure, they also help to thin the blood, clear out microbes and parasites and reduce inflammation.
Studies show that olive leaf helps reduce symptoms relating to age-related disorders, such as dementia and Alzheimer’s disease. As an antioxidant it helps to combat the damage caused by free radicals and protects the brain from memory loss. Olive leaves help reduce blood sugar as well as “bad” cholesterol. Chronic swelling, inflammation and pain that are associated with osteoarthritis can be reduced. As an antioxidant, olive leaf reduces the production of cytokines and enzymes that are markers for the inflammatory process.
Tablets and tinctures are easier to take. The choice is yours and according to the monographs there are no serious side effects. Olive leaf has not been officially tested for pregnancy but for over 20 years, many ladies have taken them to good effect, after the third trimester. It is best to ask a doctor. As a treatment for yeast infections such as candidiasis they can help to cure long-term patients who have given up on diets and medications.
In a 2003 study of the antiviral activity of olive leaf against HIV-1 infection and replication, it was found that that olive leaf extract inhibits acute infection and cell-to-cell transmission. HIV stands for human immunodeficiency virus. It harms your immune system by destroying the white blood cells that fight infection. In a 2016 study it was found that olive leaf extract can modify the response of white blood cells called peripheral blood mononuclear cells (a class of immune cells which includes T cells, B cells, natural killer cells, and monocytes). It was able to influence the expression of genes in inflammatory and metabolic pathways. This helps to explain why we call olive leaf an immune booster.
Jim back home, fully cured of malaria in 2002. No plasmodium parasites were found after 5 days of taking the olive leaf tablets for his relapse 3 weeks later.
Are there problems with taking Artemisia or olive leaves if you are on medications?
Please bear in mind that herbal remedies can duplicate the effects of medications, so ask your doctor about using them as part of your protocol. Due to the hypotensive and antiplatelet aggregating properties of olive leaf extract, using them with the full dose of blood-pressure lowering medications and blood thinners may exaggerate the effect; so caution is advised. Refer to the monographs for more details.
Some people have weaned themselves off hypertensive medications and take 2 olive leaf tablets in the mornings and evenings. They say it is cheaper and are happy to have no unpleasant side effects and it also helps to prevent colds and flu. Some practitioners of Natural Medicine use them to ward off colds and flu – especially those who no longer believe in vaccinations. Olive leaf seems to zap all strains of “latest” colds and flu bugs, as it does with drug resistant malaria!
Olive leaf Monograph http://www.altmedrev.com/archive/publications/14/1/62.pdf
They say that monotherapies are not effective for malaria. How about herbs, could we combine them?
Now that we have discovered just how effective 100% olive leaf and Artemisia leaves are as very versatile remedies, combining them would provide an even wider therapeutic spectrum. However, sufficient quantities must be present – lest we fall into the trap of making claims and not delivering enough of the active ingredients per dose.
For Traditional Medicine in South Africa, no strict regulations or efficacy testing is required. For the average supplement manufacturer however, the cost of undertaking efficacy, safety and drug interaction trials of herbal combinations is exorbitant – if not crippling. Here is a typical example: for the past 20 years a 4 – part combination of Artemisia afra, olea Europa / afra, cloves and ivy leaf is sold in pharmacies and health shops as a Parasite Remedy*.
When taken as capsules or a tincture, the herbal combination has helped many people suffering from respiratory ailments, HIV / AIDS and tropical diseases such as malaria, leishmaniosis and malaria. It has also been used by travellers to prevent malaria on many occasions – even to places like Mozambique and Zanzibar. It was also used by a team of cyclists who travelled from Cape to Cairo.
In all cases, the parasite remedy also helped to prevent traveller’s diarrhoea, colds and flu. Yet the manufacturer may not even say what the product does on the label! Apart from dosage guidelines, the compulsory warning must be visible in English and Afrikaans: this product has not been evaluated by the Medicines Control Council and is not intended to diagnose, treat, cure or prevent any illness.
Meanwhile on the pavement one can buy a huge range of wild harvested herbs from our local “inyanga” medicine men. They are practitioners of Traditional Medicine and seem to be exempt from MCC regulations. They harvest their medicines – usually without supervision, at the expense of threatening plants that are nearly extinct. Their packets of herbal tea are freely distributed and are sold as a – z remedies for many common ailments. You can buy bundles of Artemisia afra cuttings from them – plus a bag of tea leaves to treat diabetes, gut problems and drive away evil spirits*.
* These statements have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure or prevent any disease.