HRT safe and perhaps beneficial in women treated for ovarian cancer, major trial shows

Women with the commonest type of ovarian cancer can safely take hormone replacement therapy (HRT), and it could have a beneficial effect on their survival, a long-term clinical trial reports.The 24-year, phase III international trial provides the strongest evidence yet that women with epithelial ovarian cancer – which accounts for 80-90 per cent of cases – can safely take HRT during or after their treatment.

Several major studies have found that HRT can increase the risk of developing some cancers, which is why there has been such interest in whether it is safe to take during cancer treatment.

The new study, published in the Journal of Clinical Oncology, was led by researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, and is the largest to investigate HRT’s effects on ovarian cancer survival.

It was funded by The Institute of Cancer Research and Cancer Research UK, and endorsed by the UK Co-ordinating Committee for Cancer Research.

Set up in 1990, the trial followed 150 women with epithelial ovarian cancer – half of whom were allocated to receive HRT during their treatment, and half of whom were not – and compared overall survival at a point in 2012, 22 years after the trial began.

Women were recruited from 19 different hospitals across the UK, Spain and Hungary, in a study co-ordinated by researchers at The Institute of Cancer Research (ICR).

53 of the 75 women (71 per cent) in the HRT arm of the trial – who were allocated to receive HRT for up to five years after the study began – had died, compared with 68 (91 per cent) of the 75 women who had not taken HRT.

The results are relevant to a large proportion of women with ovarian cancer because ovarian cancer treatments can trigger the menopause.

The study suggests that women with ovarian cancer can receive the known benefits of HRT on the side-effects of the menopause, without it reducing their survival chances. In fact, the results indicate that HRT might improve chances for overall survival.

The trial looked at women who already had ovarian cancer. Years of research have already shown that when healthy women take HRT their risk of developing breast, ovarian and possibly womb cancer can increase.

Study clinical lead Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, and Consultant at The Royal Marsden NHS Foundation Trust, said:

“We were really happy to be able to show that HRT is safe for women with the most common type of ovarian cancer. Whether or not to have HRT is a very important decision for a large proportion of women with ovarian cancer, who will often have to undergo the menopause due to the cancer treatment at the same time as coping with a cancer diagnosis.

“Our results not only suggest HRT is safe for women with this type of ovarian cancer, but that it may actually improve their chances of long-term survival. We hope our study will inform treatment for women with ovarian cancer, and the findings could have a big impact on their quality of life.”

Study scientific lead Professor Judith Bliss, Director of the Cancer Research UK-funded Clinical Trials & Statistics Unit at The Institute of Cancer Research, London, said:

“Our results should provide some reassurance to women with ovarian cancer who until now might have avoided HRT because of worries about its effect on their cancer. HRT does not seem to have a detrimental effect on survival in women with epithelial ovarian cancer, and there is even the intriguing suggestion that it may be improving their survival chances. We would like to see more research into this area in the future and hope to see other studies confirm this finding in larger numbers of women.”

Fiona Osgun, health information officer at Cancer Research UK, said:

“Years of research has shown that women taking HRT are at an increased risk of breast and ovarian cancer, as well as endometrial cancer for some forms of HRT. This research takes a different approach and looks at women already diagnosed with ovarian cancer.

“These results are a great first step in helping to understand if HRT is safe to take for women with ovarian cancer, but we need larger studies with more women to confirm them. HRT has been shown to be effective at reducing symptoms of the menopause and there are many factors that play into a woman’s decision to use it or not. If you are thinking of stopping or starting HRT speak to your GP.”

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For more information please contact the ICR press office on 020 7153 5582 /henry.french@icr.ac.uk. For enquiries out of office hours, please call 07595 963613.

Source: EurekAlert! 9/28/15

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When will the law change to decriminalize doctor-assisted deaths?

When will the law change to decriminalize doctor-assisted deaths?

The Supreme Court of Canada gave the government of Canada one year to draft new laws, if it wishes, to govern physician-assisted death. In a legal sense, Parliament could just do nothing; politically, though, that is highly unlikely, as the Conservative government would be seen as abdicating its duty to Canadians.

If Parliament approves no new law on assisted death by next February 6th, the law would change on that date to permit assisted dying for some suffering adults. This is a very serious right — control over one’s life covering what the court called “the passage into the death.” It can’t be held back by government inaction. Government can’t limit this right more than the court will allow.

The government has not publicly said whether it will introduce and try to pass a new law before the election. “This is a sensitive issue for many Canadians, with deeply held beliefs on both sides,” Clarissa Lamb, a spokeswoman for the federal Justice Department, said in an email. “We will thoroughly and thoughtfully study the Supreme Court’s decision . . . and ensure all perspectives on this difficult issue are heard. We will consult widely with Canadians and review the decision comprehensively before deciding how to respond.”

The Supreme Court set the parameters for any new law on physician-assisted death for ill people, and they are wide. They do not just cover the terminally ill. And “intolerable” suffering needs to be seen through the eyes of the ill individual. This group includes those who are suffering psychologically. The court said that the assisted-suicide laws currently on the books will not be considered valid “to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

Provincial governments, too, may wish to draft laws on assisted dying, since health care is a shared responsibility with Ottawa. Quebec already has drafted one such law, which was almost certain to be found unconstitutional if the court had upheld the Criminal Code provisions on assisted suicide; the constitution bars provinces from legislating in areas covered by the criminal law, which is exclusively federal jurisdiction. As it is, the Quebec law on assisted death would likely run afoul of the Supreme Court ruling, in that it applies only to the terminally ill.

The February 6, 2016 deadline poses a challenge for the federal government, as summer recess is coming and an election is expected next October. Some had suggested the Justice Department would ask the court for an extension, but that seems highly unlikely, and it is not difficult to imagine how the court would treat such a request.

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blood sugar And Alzheimer’s disease?

COULD HIGH BLOOD SUGAR BE A CAUSE OF ALZHEIMER’S DISEASE?

Catharine Paddock PhD

While nobody knows exactly what causes the complex brain changes that lead to Alzheimer’s disease, scientists suspect one of the drivers is the accumulation of plaques of a faulty protein called beta-amyloid. Now, a new study of mice shows how too much sugar in the blood can speed up the production of the protein.

Could high blood sugar be a cause of Alzheimer’s disease

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Gene identified that drives aggressive form of breast cancer

GENE IDENTIFIED THAT DRIVES AGGRESSIVE FORM OF BREAST CANCER

Written by James McIntosh

team of researchers have identified a gene that drives one of the most aggressive forms of breast cancer. They hope that by finding a way to block the gene they may be able to make the cancer less aggressive.In their study, published in Nature Communications, the researchers found that the gene known as “inhibitor of differentiation 4” (ID4) not only indicates a highly aggressive form of triple-negative breast cancer but also appears to control it.

A team of researchers has identified a gene that drives one of the most aggressive forms of breast cancer.pdf

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Genetic engineering pioneer urges caution on editing human genome

GENETIC ENGINEERING PIONEER URGES CAUTION ON EDITING HUMAN GENOME

Written by David McNamee

Writing in the journal Science, a group of 18 scientists and ethicists urge restraint over the use of a groundbreaking new genome-editing tool, citing concerns that some changes to the genome could be passed on to offspring.

“Given the speed with which the genome engineering field is evolving,” write the authors of the article, “our group concluded that there is an urgent need for open discussion of the merits and risks of human genome modification by a broad cohort of scientists, clinicians, social scientists, the general public and relevant public entities and interest groups.”

Warnings over the potential misuse of genetic engineering have been issued several times since the inception of the technology in the 1970s. However, until now, the technology to fix genetic defects had not been easy to use.

The scientists write that “this limitation has been upended recently by the rapid development and widespread adoption of a simple, inexpensive and remarkably effective genome engineering method known as CRISPR-Cas9.”

“The simplicity of the CRISPR-Cas9 system enables any researcher with knowledge of molecular biology to modify genomes, making feasible many experiments that were previously difficult or impossible to conduct,” they explain.

The warning from the scientists has added gravity due to the presence of Jennifer A. Doudna among the team – the co-inventor of CRISPR-Cas9.

Genome engineering technology should be ‘performed safely and ethically’

As Doudna and her colleagues are still perfecting the technology that will allow genetic changes to be precisely targeted, she and the other authors wrote the Science article to:

“[…] initiate an informed discussion of the uses of genome engineering technology, and to identify proactively those areas where current action is essential to prepare for future developments. We recommend taking immediate steps toward ensuring that the application of genome engineering technology is performed safely and ethically.”

Currently, CRISPR-Cas9 is being used to correct DNA sequences in animals and cultured tissues generated fromstem cells. It is expected that these techniques can also be successfully applied to humans. Play the video below to find out more about the invention.

However, the authors are concerned that making changes to “germline cells” in sperm or eggs that can be passed on to offspring could have unintended consequences, as our knowledge of human genetics is still limited.

They write that “scientists should avoid even attempting, in lax jurisdictions, germline genome modification for clinical application in humans” until the full implications “are discussed among scientific and governmental organizations.”

“You could exert control over human heredity with this technique, and that is why we are raising the issue,” co-author Dr. David Baltimore, a former president of the California Institute of Technology, told The New York Times.

“We worry about people making changes without the knowledge of what those changes mean in terms of the overall genome,” added Dr. Baltimore. “I personally think we are just not smart enough – and won’t be for a very long time – to feel comfortable about the consequences of changing heredity, even in a single individual.”

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The Innovative Genomics Initiative and the Future of Genomics Research

THE INNOVATIVE GENOMICS INITIATIVE AND THE FUTURE OF GENOMICS RESEARCH

The Innovative Genomics Initiative at the Li Ka Shing Center for Genomic Engineering in Berkeley, CA, is defining the next-generation of genetic engineering and genomics research using CRISPR/Cas9 gene editing technology. CRISPR technology, discovered at UC Berkeley in 2012, enables scientists to learn about the specific functions of chromosomes by activating or inhibiting genes, and to change the functions of living cells and organisms by reprograming genetic information.

This introductory video provides an overview of CRISPR/Cas9 technology and describes some of the research applications the IGI and its collaborators will initially be investigating. Appearing in the video are Jennifer Doudna (IGI Executive Director; Professor, UC Berkeley; Investigator, HHMI), Mike Botchan (IGI Administrative Director and Professor, UC Berkeley), Jonathan Weissman (IGI Co-Director and Professor, UCSF; Investigator, HHMI), Jacob Corn (IGI Scientific Director, UC Berkeley), Jennifer Puck (Professor of Pediatrics, UCSF School of Medicine) and Janet Napolitano (President, University of California).

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Genome editing

Genome editing,( genome editing with engineered nucleases (GEEN))

is a type of genetic engineering in which DNA is inserted, replaced, or removed from a genome using artificially engineered nucleases, or “molecular scissors.” The nucleases create specific double-stranded break (DSBs) at desired locations in the genome, and harness the cell’s endogenous mechanisms to repair the induced break by natural processes of homologous recombination (HR) and nonhomologous end-joining (NHEJ). There are currently four families of engineered nucleases being used: Zinc finger nucleases (ZFNs), Transcription Activator-Like Effector Nucleases (TALENs), the CRISPR/Cas system, and engineered meganuclease re-engineered homing endonucleases.

It is commonly practiced in genetic analysis that in order to understand the function of a gene or a protein function one interferes with it in a sequence-specific way and monitors its effects on the organism. However, in some organisms it is difficult or impossible to perform site-specific mutagenesis, and therefore more indirect methods have to be used, such as silencing the gene of interest by short RNA interference (siRNA) . Yet gene disruption by siRNA can be variable and incomplete. Genome editing with nucleases such as ZFN is different from siRNA in that the engineered nuclease is able to modify DNA-binding specificity and therefore can in principle cut any targeted position in the genome, and introduce modification of the endogenous sequences for genes that are impossible to specifically target by conventional RNAi. Furthermore, the specificity of ZFNs and TALENs are enhanced as two ZFNs are required in the recognition of their portion of the target and subsequently direct to the neighboring sequences.

Concept OF genom editing.pdf

GENESIS™ Precision Genome Editing with CRISPR and rAAV

GENESIS™ Precision Genome Editing with CRISPR and rAAV

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Scientists ‘incredibly excited’ by asthma treatment breakthrough

Scientists ‘incredibly excited’ by asthma treatment breakthrough

Written by Catharine Paddock PhD

breakthrough study has uncovered a potential root cause of asthma and a drug that reversed symptoms in lab tests. The finding brings hope to the 300 million asthma sufferers worldwide who are plagued by debilitating bouts of coughing, wheezing, shortness of breath and tightness in the chest.

The study – led by Cardiff University in the UK – reveals for the first time that the calcium-sensing receptor (CaSR) plays a key role in causing the airway disease.

The team used human airway tissue from asthmatic and nonasthmatic people and lab mice with asthmato reach their findings.

In the journal Science Translational Medicine, they describe how manipulating CaSR with an existing class of drugs known as calcilytics reversed all symptoms.

Calcilytics block the calcium-sensing receptor and were originally developed for the treatment ofosteoporosis – a condition that makes bones more likely to break – also referred to as “brittle bone disease.”

One of the crucial study results is that the symptoms the drug reversed include airway narrowing, airway twitchiness and inflammation – all of which make breathing more difficult.

Daniela Riccardi, principal investigator and a professor in Cardiff’s School of Biosciences, describes their findings as “incredibly exciting,” because for the first time they have linked airway inflammation – which can be triggered for example by cigarette smoke and car fumes – with airway twitchiness. She adds:

“Our paper shows how these triggers release chemicals that activate CaSR in airway tissue and drive asthma symptoms like airway twitchiness, inflammation, and narrowing. Using calcilytics, nebulized directly into the lungs, we show that it is possible to deactivate CaSR and prevent all of these symptoms.”

While the finding is likely to be welcomed by all asthma sufferers, it will particularly excite the 1 in 12 patients who do not respond to current treatments and who account for around 90% of health care costs associated with the disease.

COULD BE TREATING ASTHMA PATIENTS IN 5 YEARS – HUGE IMPLICATIONS FOR OTHER AIRWAY DISEASES

Calcilytics were first developed about 15 years ago for the treatment of osteoporosis, but while they proved safe and well tolerated in trials, results have been disappointing in patients with osteoporosis.

However, the fact they have already been developed and tested gives researchers the unique opportunity to repurpose them and hugely reduce the time it usually takes to bring a new drug to market.

Once funding is secured, the team hopes to be testing the drugs on humans within the next 2 years. Prof. Riccardi concludes:

“If we can prove that calcilytics are safe when administered directly to the lung in people, then in 5 years we could be in a position to treat patients and potentially stop asthma from happening in the first place.”

The researchers believe their findings about the role of CaSR in airway tissue could have important implications for other respiratory conditions such as chronic obstructive pulmonary disease (COPD), chronicbronchitis. There are currently no cure for these diseases, which predictions suggest will be the third biggest killers worldwide by 2020.

In the following video, Prof. Riccardi and colleagues talk about their findings and a patient with asthma describes her excitement about the potential implications.

Asthma UK, the Cardiff Partnership Fund and the Biotechnology and Biological Sciences Research Council (BBSRC) helped finance the study.

Last month, Medical News Today learned of another important study that uncovered new clues about overproduction of mucus in asthma and COPD in the behavior of ion channels – membrane-sited proteins that help regulate the flow of charged particles in and out of cells.

The researchers, from Washington University School of Medicine in St. Louis, believe their findings will lead to treatments for a range of diseases including asthma, COPD, cystic fibrosisand even certain cancers.

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Study finds increased risk of type 2 diabetes with statin use

Study finds increased risk of type 2 diabetes with statin use

Written by Honor Whiteman

Anew study published in the journal Diabetologia finds the use of statins – drugs commonly used to lower cholesterol – may significantly increase the risk of type 2 diabetes, and that this risk remains even after accounting for confounding factors, including age, smoking status and body mass index.

The link between statin use and higher risk ofdiabetes is not new. Back in 2013, for example,Medical News Today reported on a study published in The BMJ that found certain statins – particularlyatorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor) –raised the risk of diabetes by up to 22%.

But according to the researchers of this latest study – including Prof. Markku Laakso of the Institute of Clinical Medicine at the University of Eastern Finland and Kuopio University Hospital in Finland – such studies have had numerous limitations.

The team explains that many of these studies have included selective populations, such as those at high risk of cardiovascular disease. As a result, findings may not be applicable to the general population.

The researchers also note that these studies have often included participants whose diabetes has been self-reported or based on their fasting glucose measurements, which may underestimate the actual number of incident diabetes cases.

INCREASED RISK ‘MOST LIKELY LINKED TO STATINS THAT REDUCE INSULIN SENSITIVITY AND SECRETION’

For their study, Prof. Laakso and colleagues analyzed the effects of statin use on 8,749 nondiabetic Caucasian men aged 45-73 years who were part of the Finland-based Metabolic Syndrome in Men (METSIM) study.

During the 5.9-year follow-up, 625 men were diagnosed with type 2 diabetes, as determined by either an oral glucose tolerance test (OGTT), an HbA1c level of at least 6.5%, or the commencement of antidiabetic medication.

The results of the analysis revealed that men who were treated with statins were at 46% higher risk of diabetes than men who were not treated with statins.

This 46% increased diabetes risk was present even after adjusting for the men’s age, body mass index (BMI), waist circumference, physical activity levels, smoking status, alcohol intake, family history of diabetes and treatment with beta-blockers and diuretic medications.

The researchers also assessed changes in insulin resistance and insulin secretion among men who were treated with statins. They found that statins led to a 24% reduction in insulin sensitivity during follow-up, as well as a 12% reduction in insulin secretion.

For two statins – simvastatin and atorvastatin – the researchers found the associated risk of type 2 diabetes was dose-dependent, as were the reductions in insulin sensitivity and insulin secretion among the men taking these statins.

After accounting for the aforementioned confounding factors, the team found high-dose simvastatin was linked to a 44% higher risk of type 2 diabetes, while a lower dose was linked to a 28% increased risk. High-dose atorvastatin was associated with a 37% increased risk of type 2 diabetes.

Of the study participants, 53% were taking atorvastatin and 29% were taking simvastatin.

Based on their results, the researchers say:

“Statin therapy was associated with a 46% increased risk of type 2 diabetes after adjustment for confounding factors, suggesting a higher risk of diabetes in the general population than previously reported.

The association of statin use with increased risk of developing diabetes is most likely directly related to statins decreasing both insulin sensitivity and secretion.”

Prof. Laakso and colleagues say that while one strength of this study is its large size, the fact that all participants were male and Caucasian means the findings may not be generalizable to women or those of other ethnicities.

the most recent study about using statin and development type 2 diabetes published inDiabetes & vascular disease research journal (( Fasting plasma triglyceride concentration: A possible approach to identify increased risk of statin-induced type 2 diabetes )) in march 2015

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New treatment for drug-resistant breast cancer found

Researchers investigating the way in which HER2-positive breast cancer becomes resistant to treatment have made a surprising discovery concerning how this resistance develops. However, they may have also discovered a way to prevent this resistance from manifesting entirely.

The study, published in Cell Reports reveals a new combination therapy involving the commonly-used drug lapatinib and a novel experimental drug called a BET bromodomain inhibitor whose role is to disrupt the expression of certain genes.

BET bromodomain inhibitors were demonstrated to prevent the development of resistance to lapatinib in cell lines of human HER2-positive breast cancer.

“The combination treatments are currently being tested in different mouse models of breast cancer,” explains senior author Gary Johnson, PhD. “Our goal is to create a new kind of therapy that could help oncologists make the response to treatment more durable and lasting for breast cancer patients.”

Around 15-20% of breast cancer diagnoses belong to the HER2-positive subtype. Standard therapy only works well in one-third of patients with this form of cancer, and even then resistance eventually develops in most of these patients.

This is a typical problem faced by treatments that target kinases – specific proteins that are essential for cellular activities such as movement and division, and also drive the growth of tumors. In this form of cancer, HER2 is the primary kinase responsible for tumor growth.

Lapatinib works by blocking HER2, but when it does, cancer cells use other kinases to find a way around the blockage. First author of the paper Tim Stuhlmiller, Ph.D, set out to determine kinase activity across a group of cells and assess what happened when HER2-positive cancer cells were treated with lapatinib.

Each cell line developed a resistance to the drug, but the manner in which it happened was surprising. Stuhlmiller explains:

“It was amazing. We found this massive up-regulation of many different kinases that could either reactivate the main HER2 signaling pathway or bypass it entirely. In fact, we discovered that nearly 20% of the cell’s entire gene expression profile was dysregulated when we treated the cells with lapatinib.”

The kinases that responded were not the same kinases from cell line to cell line, suggesting there is a variety of ways HER2-positive cancer cells can react and overcome blockage of HER2. The involvement of such a large number of different kinases is problematic for the researchers trying to develop effective forms of treatment.

‘We blocked it before it could happen’

“Because of toxicity concerns, you couldn’t inhibit all these kinases that potentially help cancer cells compensate in the face of an HER2 inhibitor,” Stuhlmiller explains. “The more drugs you try to use, the more toxic that would be for patients and the lower the dose people would be able to tolerate.”

However, this was not the end of the story. The researchers found that they could use an entirely different drug to prevent the kinase response to lapatinib before it had even begun. BET bromodomain inhibitors belong to a new class of drug that target proteins involved in gene transcription – a process that leads to the creation of enzymes such as kinases.

The researchers tested a number of BET bromodomain inhibitors, with one already being utilized in clinical trials for drugs to treat blood cancer and leukemia. During these tests, they discovered that the drug disrupted the gene transcription of many of the kinases involved with resistance.

When a BET bromodomain inhibitor was combined with lapatinib, not only was the HER2 kinase blocked but the massive kinase response that had previously been observed did not occur, leading to the deaths of the cancer cells.

“We blocked it before it could happen,” explains Stuhlmiller. “In all five cell lines we tested, there were no cancer cells left because the combination therapy blocked their growth. Essentially, we made the activity of lapatinib durable.”

The researchers are now attempting to replicate these findings in animal models of HER2-positive breast cancer. In addition, the team are studying the effects of BET bromodomain inhibitors on other forms of breast cancer including triple-negative breast cancer, which is notoriously difficult to treat.

“We believe epigenetic enzyme-targeting drugs will be key to preventing resistance rooted in kinome reprogramming, thus making the action of kinase inhibitors durable,” conclude the authors. “With at least four BET bromodomain inhibitors in clinical trials, testing of a BET bromodomain inhibitor to block adaptive responses induced with kinase inhibitors is a possibility.”

Recently, Medical News Today reported on a study in which a team of researchers identifies a gene responsible for driving triple-negative breast cancer.

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Antimalarial tea — from herbal remedy to licensed phytomedicine

ANTIMALARIAL TEA — FROM HERBAL REMEDY TO LICENSED PHYTOMEDICINE

Malaria is a critical health problem in West Africa, where traditional medicine is commonly used alongside modern healthcare practices.

An herbal remedy derived from the roots of a weed, which was traditionally used to alleviate malarial symptoms, was combined with leaves and aerial portions from two other plants with antimalarial activity, formulated as a tea, and eventually licensed and sold as an antimalarial phytomedicine.

The fascinating story and challenges behind the development of this plant-based treatment are presented inThe Journal of Alternative and Complementary Medicine, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on The Journal of Alternative and Complementary Medicine website until May 14, 2015.

Dr. Merlin Willcox (University of Oxford, U.K.), Dr. Zéphirin Dakuyo (Phytofla, Banfora, Burkina Faso), and coauthors discuss the antimalarial and pharmacological properties of the herbal medication derived from Cochlospermum planchonii (a shrubby weed known as N’Dribala), Phyllanthus amarus, and Cassia alata. The authors provide a unique historical perspective in describing the early evaluation, development, and production of this phytomedicine. They present the ongoing research and challenges in scaling up cultivation and harvesting of the plants and in production of the final product. The article also describes other traditional uses of the medication, such as to treat hepatitis.

WHY IS WHO OPPOSED TO AN EFFECTIVE ANTI-MALARIAL TEA

Which is why you may be surprised to learn that the World Health Organization and a majority of malaria researchers are adamantly opposed to it. To be fair, there are compelling reasons not to endorse an herbal tea in a fight against a potentially deadly disease. After all, conventional single-molecule drugs are honed through chemistry to be safer, more specific, and more effective than their herbal progenitors. More critically, malaria experts worry that unregulated use of this tea could cause the malaria parasite to develop resistance to artemisinin drugs.

But the tea’s mere existence and its rapid spread challenges the view that conventional pharmaceuticals are the best and only way of managing Africa’s health care problems. After all, experts in the international aid world talk a lot about sustainability, and nothing is more sustainable than a drug grown on a shrub… The story of artemisinin demonstrates that even the best malaria drugs are worthless if they are not getting to the people who need them. …

The tea has become widespread enough that last year the WHO published a statement opposing it for either treatment or prevention of malaria, and an online survey of malaria experts found that 72 percent were opposed to its use in prevention. Their view is that low-dose, persistent use could breed resistance, which would be disastrous. But we’re not talking about pumping pigs full of unnecessary antibiotics. We’re talking about desperate people trying to live normal lives. And, in Wagagai, after years of preventive use, resistance has not sprung up. Ogwang says that may be because the tea, like other herbal products, contains multiple active compounds besides artemisinin. Cinchona bark is still effective after hundreds of years even though chloroquine (a derivative) is not. The Chinese have been using wormwood for more than 1,500 years for a variety of ailments, but the only place where we’ve seen signs of artemisinin resistance is on the Thai-Cambodian border, where conventional ACT artemisinin drugs are used….

Ogwang is now trying to test whether the tea remains effective for prevention even if the artemisinin is eliminated, an idea that sounds crazy but that could eliminate the objection that the tea could stimulate resistance. …Some herbs do have medically active compounds, albeit with varying levels of efficacy, and Africans are choosing to go that route because they know that drug supply won’t be cut off by war or corruption or bureaucratic incompetence. Herbs are not always going to be the right strategy, but the data about these unconventional interventions should be shared and discussed. In the case of malaria,…there have long been indications that using a cruder, cheaper whole-plant extract could potentially be more effective and cheaper..

In a study conducted in rats last year, University of Massachusetts researchers compared a single dose of pure artemisinin to dried whole leaves, and found that the whole plant was better at killing malaria parasites…

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