Debunking the Myth of Artemisia Annua for the Treatment of COVID-19

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African Forum for Research and Education in Health (AFREhealth) investigators from across the globe recently published a paper in the prestigious scientific Journal of Tropical Medicine and Hygiene assessing the bioactive compounds, pharmacological and immunological effects, and traditional uses for the derivative Artemisia annua (A. annua) found in the medicinal herb Artemisia spp. which has been proposed as a possible treatment for COVID-19.

UKZN’s pharmaceutical policy expert who was recently appointed to the Executive Committee of AFREhealth, Professor Fatima Suleman co-authored the study. She commented: ‘In an era where there is no proven remedy, and where treatments are becoming politicised, with no evidence of efficacy, it is important to ensure that the efficacies of proposed therapies are evaluated and communicated to the public carefully and factually, without exaggeration.’

The unprecedented COVID-19 pandemic caused by the novel zoonotic pathogen of humans, SARS-CoV-2, commonly presents as a severe respiratory tract illness. It causes multisystem disease and deaths have been attributed to cytokine storm, acute respiratory distress syndrome and excessive aberrant immunological responses. In South Africa, as at 22 October 2020, there were more than 725 500 cases of infection and 18 826 deaths.

Scientists around the world are desperate to find a possible cure, resulting in a number of randomised controlled trials. Of the recent and ongoing treatment intervention trials, only two randomised controlled trials have to date demonstrated the benefits of specific therapies. Many low-income countries are relying on herbal medicines as a possible cure; however, it is essential that there is conclusive scientific evidence proving the efficacy of these suggestions.

In April 2020 a herbal tonic derived from A. annua extracts by the Madagascar Institute of Applied Research and branded “COVID-Organics” was launched. Derivatives from the herb A. annua have been used as a traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. COVID-Organics has been promoted as a cure for COVID-19. However, reliable pharmacological and efficacy data is lacking, and there is concern that its widespread use for COVID-19 could result in reduced access to effective medicines as well as possible antimicrobial resistance by exposing patients to suboptimal concentrations of artemisinin when malaria cases are misdiagnosed as COVID-19.

A. annua is an annual herbaceous plant of the Asteraceae family native to Asia and Eastern Europe. It is the source for leading World Health Organization (WHO) approved antimalarials; hence, seed varieties have been adapted by breeding for lower latitudes and cultivation has been successfully achieved in many tropical countries. Since the beginning of the COVID-19 pandemic, formulations of A. annua have been used in Africa and China for COVID-19 prevention and treatment. In the Democratic Republic of Congo (DRC), herbal formulations have been used for the prevention and treatment of COVID-19 by fumigation, infusion, or decoction.

While the use of A. annua for COVID-19 is widely promoted by politicians and others in low-income countries, there is no scientific data to prove its efficacy. ‘It is essential that new drug discovery that builds on extracts from traditional medicinal plants is encouraged but this needs to be evaluated for efficacy through controlled trials, the development of formulations and dosing as well as defining the pharmacokinetics, toxicology, and safety,’ said Suleman.

Words: MaryAnn Francis

Photograph: Supplied