Building a golden triangle for the production and use of artemisinin derivatives against falciparum malaria in Africa

Abstract

Use of the conventional quinoline- and sulphanamide-based drugs for the symptomatic treatment of malaria is gradually being replaced by artemisinin-based combination therapies (ACTs) due to increasing resistance by the Plasmodium parasite. This development has drastically increased artemisinin demand worldwide, and Artemisia annua L. is currently the only commercial source for the
supply of this vital antimalarial drug to the international market. Recent advances, however, demonstrate that the production of isoprenoid precursors in microorganisms is a feasible complementary strategy that would help reduce artemisinin cost in the future. The key genes encoding for enzymes regulating the biosynthesis of artemisinin in planta are fully understood to enable metabolic engineering of the pathway, and results from pilot genetic engineering studies in microbial
strains thus far are very inspiring. This review, therefore, explores the current status of artemisinin derived drugs against malaria and highlights some implications of crop agronomy, biotechnology and
solvent extraction strategies in enhancing the total yield of artemisinin for the production of ACTs, which are responsible for saving the lives of countless numbers of patients in malaria-stricken societies and are currently in very high demand, especially in Africa.