Biotech opens door to affordable treatment

This was the message delivered by Victoria Hale, chief executive of the Institute for OneWorld Health, the first non-profit pharmaceutical company to be set up in the US, at the 8th International Biotech Summit in Berkeley, California.

Dr Hale said that diseases such as malaria and diarrhoea, which are endemic in the developing world, afflict hundreds of millions of people, but affordable medicines are a major barrier to treatment. With advances in biotechnology, industry could achieve humanitarian goals and contribute to strengthening economies that ultimately benefit everyone.

And steps are already being taken in that direction, with malaria medicines among the first drugs to be manufactured through an innovative process developed by fellow panellist Jay Keasling, professor of chemical engineering at the University of California, Berkeley.

Dr Keasling's team engineered a biotechnology process to make artemisinin, an anti-malarial compound, by combining genes from three separate organisms into a single bacterial factory. It is simpler and less expensive than today's laborious plant harvesting processes.

The drug, artemisinin, is one of the most promising next-generation antimalarials because of its effectiveness against strains of the malaria parasite now resistant to front-line drugs. It is now too expensive for broad use in countries in Africa and South America where it is most needed.

Moreover, this biotech process could be applied to several other kinds of pharmaceutical compounds which are otherwise expensive to synthesise or costly to extract from natural sources.

Keasling's technique for transplanting yeast and plant genes to construct an entirely new metabolic pathway inside bacteria can be used generally to produce a broad family of so-called isoprenoids - chemical precursors to many plant-derived drugs and chemicals of interest to industry, including the anticancer drug paclitaxel and various food additives.

Isoprenoids, found widely in microbes, plants and marine organisms, currently are very expensive for the chemical industry to synthesise from scratch and nearly as expensive to extract from plant material. Keasling's approach leapfrogs the bulk of the laborious synthesis necessary today, leaving only a few additional chemical alterations to obtain the desired drug or chemical.

"By focusing first on the developing world, especially children, a healthier generation leads to greater prosperity, less dependence on foreign aid, and ultimately, creates new markets,"​ Dr Hale said.

"The dynamics for significant change are underway for the private and public sectors, and business community to achieve mutually inclusive goals. We can all participant in and benefit from addressing global health inequities."​

The World Health Organisation recommends the particular use of drug combinations containing artemisinin, an ancient Chinese herbal medicine extracted from the wormwood plant. Artemisinin-based combination therapy (ACT) has been shown to be effective in treating malaria, but a treatment costs about $2.50 (€2.08) per cure.

For people who live on $1 per day, the choice is between buying either food or medicine, pointed out Dr Hale, noting that old antimalarial drugs cost 'about a dime' but are ineffective.

Every year in Africa, malaria kills about one million people per year, most of them children. Worldwide, about 300 million acute cases of malaria occur annually.