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Aug. 14, 2005. 01:00 AM

The anti-malarial miracle
CHINA | Herb brings the world of big business to rural Chongqing Province


Every five days, a country market converges in a horn-honking, pig-squealing clamour on the old stone bridge that spans the river coursing through here.

For as long as anyone can remember, this valley's biggest crop has been its tall, thick corn. But in the last two years, a new crop, qinghao, or sweet wormwood, has been crowned king, driven by the tropical world's desperate need for new malaria treatments.

The rugged valleys and steep gorges along the Apeng River in central China have long been a symbol of idyllic remoteness. Even China's dazzling economic takeoff had done little to change that, until the World Health Organization approved a malaria treatment using artemisinin, the active ingredient of the qinghao plant, in 2001.

Since then, the plant's market value has nearly quadrupled. In the process, qinghao has become an unlikely driver of globalization in these parts, sending peasants scouring mountainsides to harvest the wild bush.

Just as eager to cash in, farmers are replacing plots of corn, tobacco and potato with the herb, which is bought and sold from burlap sacks amid frenzied market-day crowds by dealers wielding brass hand-held scales.

Despite China's long history and ancient medical traditions, artemisinin-based drugs are the first Chinese pharmaceutical product (beyond traditional remedies like ginseng) to be broadly distributed internationally.

In antiquity, it was written that parts of this southeastern region of Chongqing Province were so isolated that people here did not know what dynasty they lived under. Today, mounting a full-court press driven in part by demand for the drug, the Chinese government is rushing to remedy that, building the first highways into the area, along with a rail line and an airport.

Confusion over dynasties seems to have given way nowadays to confusion over all the fuss being made over sweet wormwood, an ancient folk remedy for colds and fevers, even as trade in the herb begins to line people's pockets.

"I don't know what medicine this makes," says Sun Lingui, a 23-year-old qinghao dealer who staked out a prime position on the bridge here on a recent market day. He sells the herb along with a bushel full of dried beetles that he says were a remedy for respiratory problems.

"I know it is used to extract something called artemisinin,'' Sun adds. "Anyway, it is for some kind of medicine, and I hear that tropical countries all need it.''

Sun gleaned the little he knows about the plant from a television program, which spoke of the herb's rapidly increasing value and alluded to its health benefits. What those benefits were, he, like the peasants surrounding him, could not quite recall.

The fact that this traditional Chinese drug, which peasants of this village say is good for everything from sniffles to healing wounds, is the greatest recent hope in global efforts to fight malaria, which kills more than a million people each year, is scarcely appreciated here.

With established anti-malarial medicines rapidly losing their effectiveness, the World Health Organization recommended in 2001 that countries afflicted with the disease switch to a combination therapy based in part on the Chinese drug. After a slow start in adopting artemisinin-based drugs, demand has skyrocketed in the last two years, with projections that 300 million doses will be needed in 2006.

Ding Derong, a scientist with China's Southwest Agriculture University, says 27,000 to 36,000 tonnes of the crop would be needed to meet that demand, but that only 18,000 are likely to be harvested.

Jiang Yifei, spokeswoman of Holley Corp., the largest Chinese producer of artemisinin, says the biggest challenge in increasing production is "organizing farmers to start standardized cultivation.''

Holley supplies Swiss pharmaceutical giant Novartis with artemisinin. Novartis uses the herb's active ingredient to produce the drug Coartem, which it supplies at cost to the World Health Organization for distribution.

Holley is investing heavily in increased sweet wormwood production, as evidenced by hectare after orderly hectare of plantations draped across a sweltering valley not far from here. Efforts are being made to produce high-yielding seeds for distribution to farmers who agree to cultivate the plant in co-operation with the company.

Even peasants closely associated with these efforts, however, say they are being kept in the dark about the drug's uses, and grumble over what they say is the company's secretiveness.

Xu Qianmin, a farmer who gets his seeds from Holley, says his arrangements with the company prevent him from talking about the uses of sweet wormwood, probably, he says, because there may be more commercial hopes for the plant. Little by little, though, with his family gathered around in their simple farmhouse, he opens up.

"I hear there's a country in Africa with a population of 1.5 million people, and only 14 kilos of our qinghao cured all of their malaria," he says, touting his plants as a sort of miracle drug.

"Qinghao isn't only good for one disease," he adds. "We've heard it can be made into 300 different medicines.''

Asked for examples, he acts briefly as if he had committed an indiscretion, then muses that treating cancer might be one of the drug's future uses.

"The company has found a way to make money, and they want to keep things a secret," Xu says, when asked why one needed to keep things quiet. "They don't want others to come in and steal their business. They want it for themselves."