More questions about Keasling’s antimalarial drug

As noted earlier, the “cheap” antimalarial drug UC Berkeley genetic engineer Jay Keasling promised the Third World will cost just as much as the existing, plant-derived artemisin it was created to replace.

Now more questions have arisen, sparked by the Friends of the Earth report we noted yesterday and an August online article in the world’s premiere scientific journal, Nature.

• First, will the GMO drug displace farmers in Asia and Africa who rely on the plant Artemisia as a reliable cash crop?
• And, second, are the high costs for the drug due to the manufacturers’ prices or to the drug-buying habits of African consumers?
• And, if the latter, how will the Keasling project have any impact on the way the drug is consumed?

The Artemisia plant

Richard Van Noorden reported on the drug for Nature on 3 August, noting, “A decade ago, the compound — available only from the sweet wormwood plant Artemisia annua — was scarce and expensive. But by 2007, the market was wallowing in a surfeit of the drug as farmers flocked to grow the crop.”

As he reports, “The Global Fund to Fight AIDS, Tuberculosis and Malaria last month saw its first orders for cheap drugs under its Affordable Medicines Facility — Malaria (AMFm) initiative. Using subsidies, it plans to cut the price of artemisinin-based combination therapies (ACTs), which partner artemisinin with another drug to reduce the chance of malaria parasites developing resistance, as they have done to treatments such as chloroquine.”

The major issue affecting cost is that while government clinics sell the drug for a dollar a dose, most folks who purchase the drug prefer the convenience of buying from local merchants and pharmacists, paying many times what they’d pay at the clinics. There’s no explanation for the buying preference in Van Norden’s article, a critical point we hope someone else can explain.

Meanwhile, another program is underway in Africa and Cambodia to provide cut-rate doses to private sellers, with the goal of bringing prices down to fifty cents or less, less that the anticipated cost of the drug cranked out by Keasling’s genetically tweaked bacteria.

Keasling’s research, bankrolled by the Bill and Melinda Gates Foundation, was launched when prices were high and his promises of doses for pennies fell in line with an initiative by the World Health Organization to develop cheaper sources.

As Van Norden reports, Keasling and his researchers “successfully added or tweaked a dozen genes in yeast to make artemisinic acid, and gave a royalty-free licence to drug firm Sanofi-Aventis, headquartered in Paris, to make semi-synthetic artemisinin on a commercial scale. Four years on, the product is still two years away, says the drug company, which is scaling up production to 100,000-litre vats, financed by another $10.7-million grant from the Gates foundation, and with assistance from the Institute for OneWorld Health, a non-profit organization in San Francisco, California.”

While the Keasling crew was toiling away in their West Berkeley lab [the

company has since moved to nearby Emeryville], farmers in Third World countries began planting large crops of Artemisia, spurred on by NGOs like the Paris-based Nomad RSI [Research and International Aid].

By 2007, with hundreds of thousands of acres of Artemesia planted throughout the tropical world, prices crashed, and when the dust settled, a dose of the natural chemical had reached the same price level as the projected price [$200 per kilogram] announced by Sanofi-Aventis.

One bit of good news for the corporateers: Falling drug prices and soaring global prices for food seems to be turning farmers away from wormwood [the plant’s common name] and back to food crops.

Van Norden reports:

With food prices rising, the incentive to plant the crop this time is low, notes Malcolm Cutler, an artemisinin-industry expert and director of the consultancy FSC Development Services, near Gloucester, UK. His priority is to improve communication between growers, processors and drug companies, and to help farmers who must decide to plant Artemisia 14 months before that crop’s drug will be produced.

But in a dose of additional bad news for the GMO industry, Nature reports,

This year, the Assured Artemisinin Supply System (A2S2) initiative, supported by the international drug-purchasing facility UNITAID, began to give advance loans to the companies that extract artemisinin from plants, and to encourage drug firms to sign long-term contracts with them. About 10,000 hectares of Artemisia was planted this year, twice as much as in 2009.

In addition, new plant strains with a higher drug content are now available, capable of increasing the output per plant threefold. And it’s been done the old fashioned way: through selective breeding rather that genetic engineering, thanks to the efforts of Britain’s Department for the Environment, Food and Rural Affairs.

British GMO boffins have also joined the effort, tweaking the plant’s genes to double the artemisin output over even the best-bred varieties, Van Norden reports. Their plants will reach the market about the same time Keasling’s bioreactors are churning out their first doses.

One comment posted to the Nature article raises a the question about the impact of the Sanofi-Aventis drug on growers who have come to rely on the crop.

Ranjeet Singh Mahla of the Laboratory for Conservation of Endangered Species in Hyderabad, India, notes that “Farmers will be in huge loss after success of Keasling’s semi-synthetic Artemisinin project because no one will purchase the raw crop of Artemisia annua for production of drug Artemisinin.”

Meanwhile, the technological base built up with the help of Gates dollars for Amyris , Keasling’s corporate venture, have been reharnessed for the production of fuels — though, as note previously, even there costs of the final product proved so high that the output is being used for cosmetics and commercial scents.

Interesting questions, with answers yet to come. . .