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Ensuring sustained ACT production and reliable artemisinin supply
Jean-Marie Kindermans1, Jacques Pilloy, Piero Olliaro
1AEDES Foundation, 34, rue Joseph II, 1000, Brussels, Belgium. jmkindermans@aedes.be
Malaria Journal
|September 18, 2007
Summary
Artemisinin prices surged due to increased demand for Artemisinin-based Combination Therapies (ACTs). Coordinating donor purchases and broadening the producer base can stabilize artemisinin supply and prices for malaria treatment.
Area of Science:
- Pharmacology and Pharmaceutical Sciences
- Global Health
- Agricultural Economics
Background:
- Review of recent trends in the production, supply, and pricing of Active Pharmaceutical Ingredients (APIs) and finished Artemisinin-based Combination Therapies (ACTs).
- Analysis based on ongoing Artepal project data for production and cost, and a development project for rectal artesunate stability.
- Examination of the artemisinin supply chain, including raw material extraction and finished product manufacturing.
Discussion:
- Artemisinin raw material and derivatives exhibit high stability compared to finished ACT products.
- Significant price increase of artemisinin API in 2004 (from $350 to over $1000/kg) following a shift in donor funding towards ACTs.
- Expansion of artemisinin extraction companies in China and Vietnam, and initiation of commercial cultivation in East Africa and Madagascar between 2003-2005.
Key Insights:
- A steady and predictable demand for Artemisia annua can mitigate price fluctuations for the herb, API, and ACTs.
- Potential for sustainable cost reduction of artemisinin to US$250-300/kg with effective demand-side management.
- Risk of a new supply-demand imbalance due to potential reduction in planting if demand decreases.
Outlook:
- Need for better coordination among international donors to ensure consistent ACT and API procurement.
- Importance of broadening the base of quality-assured API and finished ACT product manufacturers.
- Potential for ACT program discreditation and hindered malaria control progress if artemisinin shortages recur.
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