New malaria method could boost drug production

BERLIN (AP) — German scientists have developed a new way to make a key malaria drug that they say could easily quadruple production and drop the price significantly, increasing the availability of treatment for a disease that kills hundreds of thousands every year.

Chemists at the Max Planck Institute take the waste product from the creation of the drug artemisinin — artemisinic acid — and convert it into the drug itself.

The entire apparatus is compact, about the size of a carry-on suitcase, and inexpensive. That means it can be easily added to production sites anywhere around the world.

"Four hundred of these would be enough to make a world supply of artemisinin," said unit director Peter Seeberger, pointing to the machine on a table in his lab in Berlin's Dahlem neighborhood. "The beauty of these things is they're very small and very mobile."

A paper on the new technique was published this month in chemistry journal Angewandte Chemie.

Artemisinin is extracted from sweet wormwood, a plant that primarily grows in China and Vietnam and varies in its availability according to the season. In the extraction process, for every part artemisinin produced, there is 10 times the amount of artemisinic acid discarded as waste.

Past attempts to convert the acid using ultraviolet light to trigger the conversion have been unsuccessful because the process took several steps in a large tank of acid, making production inefficient and far too expensive.

So the Max Planck chemists thought small — creating a machine that pumps all of the required ingredients through a thin tube wrapped around a UV lamp in a continuous process that takes 4 1/2 minutes from start-to-finish to produce the artemisinin.

The technique can convert about 40 percent of the waste acid into artemisinin — producing four times more of the drug from what had in the past been discarded, Seeberger said.

Colin Sutherland, a malaria expert at the London School of Hygiene and Tropical Medicine who was not involved in the Max Planck research, said the development could be significant in boosting production of the key malaria drug. He noted that currently very little artemisinin can be made from a large amount of the sweet wormwood, which is also difficult to grow.

"If it's a simple process, given a certain amount of plant material, you can generate more drugs, that will make things cheaper and faster," he said.

Since the end product is the same molecule, there should be no decrease in effectiveness of the synthetic product, Sutherland said.

Seeberger said a commercial prototype of the Max Planck machine could be ready in about six months and that it could go into production in about a year. He said current price estimates are around euro100,000 (US$132,000).

When it's in production, the idea is to make it available for a minimal fee to cover costs, he said.

"The goal is to make sure that the drug is produced and made available to as many people as possible," said Seeberger, a former Massachusetts Institute of Technology professor who now teaches at Berlin's Free University.

Sabine Haubenreisser, a spokeswoman at the European Medicines Agency, said that if the new drug is close enough to the original, its producers could apply for it to be considered as a generic product or use older data proving artemesinin's effectiveness — which could speed the approval process.

Malaria cases and deaths have been dropping since 2004, due largely to campaigns to distribute bednets, spray homes with insecticide and make better drugs available. The World Health Organization estimates that at least 655,000 people die of malaria every year, mostly children under 5 in Africa.

At the moment, artemisinin-based therapies are considered the best treatment, but cost about $10 per dose — far too much for impoverished communities.

Former U.S. President Bill Clinton's Clinton Foundation currently has a program to purchase the treatments, then sell them at a deeply discounted 50 cents to communities where they're most needed.

Cutting the price further while increasing production could "make a big difference," said Sutherland.

"Many times more children will have access to the right drug early in their disease and that's likely to have an impact on mortality."

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AP Medical Writer Maria Cheng contributed to this report from London.

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Lawyer: 6 Austrians were injected with malaria

VIENNA (AP) — The number of people claiming they were injected with the parasite causing malaria at a Vienna psychiatric ward while teenagers grew to seven Thursday, with the lawyer representing six of them saying their accounts, given separately, are credible because they are similar.

Most — but not all — of the alleged victims were wards of Vienna foster homes in the 1960s. Lawyer Johannes Oehlboeck said one of his clients told him that her parents took her to the clinic "because she was rebellious," while the daily Kurier quoted another as saying that he was dropped off by his parents after he insisted on becoming an actor.

The allegations — and the growing number of people making them — casts renewed focus on past practices at publicly funded Viennese institutions less than half a year after municipal authorities set up an independent commission to investigate allegations of systematic rape of young girls more than five decades ago at a foster home run by the city. That probe is still ongoing.

Oehlboeck said eight people who say they were juvenile psychiatric patients at Vienna's University Clinic in the 1960s spoke of painful or debilitating methods, including six who described the "malaria treatments."

He said all six told him that they quickly developed a high fever which was treated on alternate days with a quinine dosed sufficiently to reduce the symptoms. He said the treatment was ended after 14 days with an injection of what he said was likely a high dose of quinine, but not before the child's "blood was drawn and injected into the buttocks of another child."

Oehlboeck quoted one of the alleged victims as saying "the doctor said 'we are carrying out tests.'"

He did not name his clients. But Kurier carried a large photo of another alleged patient and identified him as Peter Schleicher. He was quoted as saying that his parents brought him to the clinic for treatment on the advice of one of his teachers after he insisted on becoming an actor.

Several victims complained of recurring bouts of high fever and shakes for years after the treatment, Oehlboeck said.

Such injections were an accepted method in the early 20th century to treat syphilis, with the resulting high fever killing the bacteria that caused the disease, while the malaria was kept under control by doses of quinine. Austrian physician Julius Wagner-Jauregg received the 1927 Nobel prize for medicine for developing this treatment.

But there also were experiments with treating psychological disorders through shots of the malaria pathogen. More recently, some physicians have experimented with inducing malaria to kill the HIV virus in trials that have been skeptically received by the medical establishment.

Bernd Kuefferle, a psychiatrist at the Vienna University Clinic during the 1960s, told the Austria Press Agency that some psychiatric patients were forced to undergo such "fever cures" to keep malaria pathogens alive for possible syphilis treatment.

New York internist Louis J. Morledge, whose focus includes travel medicine, said malaria could be transmitted by the method described by Oehlboeck. As for the symptoms described years later by the alleged victims he said they could be symptoms of other illness too but "they are certainly symptomatic of malaria."

Criticized last year for reacting too slowly to the mass-rape allegations, city officials have responded quickly to the malaria claims.

Vienna Mayor Michael Haeupl said Tuesday it is unclear if anyone underwent such treatment — and if so whether they were the victims of a crime or the targets of "outmoded medical treatment."

The federal Ministry of Science — which now runs the University Clinic together with the city of Vienna, said a hotline would be set up for those claiming to be victims.

"The accusations are being investigated very closely," ministry spokeswoman Elisabeth Grabenweger said.

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Lawyer: 6 Austrians were injected with malaria

VIENNA (AP) — The number of people claiming they were injected with the parasite causing malaria at a Vienna psychiatric ward while teenagers grew to seven Thursday, with the lawyer representing six of them saying their accounts, given separately, are credible because they are similar.

Most — but not all — of the alleged victims were wards of Vienna foster homes in the 1960s. Lawyer Johannes Oehlboeck said one of his clients told him that her parents took her to the clinic "because she was rebellious," while the daily Kurier quoted another as saying that he was dropped off by his parents after he insisted on becoming an actor.

The allegations — and the growing number of people making them — casts renewed focus on past practices at publicly funded Viennese institutions less than half a year after municipal authorities set up an independent commission to investigate allegations of systematic rape of young girls more than five decades ago at a foster home run by the city. That probe is still ongoing.

Oehlboeck said eight people who say they were juvenile psychiatric patients at Vienna's University Clinic in the 1960s spoke of painful or debilitating methods, including six who described the "malaria treatments."

He said all six told him that they quickly developed a high fever which was treated on alternate days with a quinine dosed sufficiently to reduce the symptoms. He said the treatment was ended after 14 days with an injection of what he said was likely a high dose of quinine, but not before the child's "blood was drawn and injected into the buttocks of another child."

Oehlboeck quoted one of the alleged victims as saying "the doctor said 'we are carrying out tests.'"

He did not name his clients. But Kurier carried a large photo of another alleged patient and identified him as Peter Schleicher. He was quoted as saying that his parents brought him to the clinic for treatment on the advice of one of his teachers after he insisted on becoming an actor.

Several victims complained of recurring bouts of high fever and shakes for years after the treatment, Oehlboeck said.

Such injections were an accepted method in the early 20th century to treat syphilis, with the resulting high fever killing the bacteria that caused the disease, while the malaria was kept under control by doses of quinine. Austrian physician Julius Wagner-Jauregg received the 1927 Nobel prize for medicine for developing this treatment.

But there also were experiments with treating psychological disorders through shots of the malaria pathogen. More recently, some physicians have experimented with inducing malaria to kill the HIV virus in trials that have been skeptically received by the medical establishment.

Bernd Kuefferle, a psychiatrist at the Vienna University Clinic during the 1960s, told the Austria Press Agency that some psychiatric patients were forced to undergo such "fever cures" to keep malaria pathogens alive for possible syphilis treatment.

New York internist Louis J. Morledge, whose focus includes travel medicine, said malaria could be transmitted by the method described by Oehlboeck. As for the symptoms described years later by the alleged victims he said they could be symptoms of other illness too but "they are certainly symptomatic of malaria."

Criticized last year for reacting too slowly to the mass-rape allegations, city officials have responded quickly to the malaria claims.

Vienna Mayor Michael Haeupl said Tuesday it is unclear if anyone underwent such treatment — and if so whether they were the victims of a crime or the targets of "outmoded medical treatment."

The federal Ministry of Science — which now runs the University Clinic together with the city of Vienna, said a hotline would be set up for those claiming to be victims.

"The accusations are being investigated very closely," ministry spokeswoman Elisabeth Grabenweger said.

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Vienna mayor promises redress for malaria victims

VIENNA (AP) — Vienna's mayor on Tuesday promised compensation for anyone injected with the parasite that causes malaria after two former foster home children claimed to have been given such shots in the 1960s.

Mayor Michael Haeupl told reporters it is unclear if anyone underwent such treatment — and if so whether they were the victims of a crime or the targets of "outmoded medical treatment."

But in a sign that he was taking the allegations of the two former foster home wards seriously, he said he has asked experts to report how anyone affected could be compensated.

Such injections were an accepted method in the early 20th century to treat syphilis, with the resulting high fever killing the bacteria that caused the disease, while the malaria was kept under control by doses of Quinine. Austrian physician Julius Wagner-Jauregg received the 1927 Nobel prize for Medicine for developing this treatment.

But there also were experiments with treating psychological disorders through shots of the malaria pathogen.

Bernd Kuefferle, a psychiatrist at the Vienna University Clinic during the 1960s, told the Austria Press Agency that some psychiatric patients were forced to undergo such "fever cures" to keep malaria pathogens alive for possible syphilis treatment.

The two malaria claims are already under investigation by two Vienna hospitals. They began looking for relevant medical records after the two men told state broadcaster ORF on Monday that they were injected with the malaria pathogen while living at a Vienna foster home in the 1960s.

One said he was given the shot at the Vienna University Clinic after running away from the home at age 16 and being diagnosed with psychological problems.

Neither of the men were identified in keeping with Austrian privacy laws.

"They took blood from someone else and injected it into a muscle," the first man told ORF radio. "A doctor told me they were doing experiments."

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