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1 WHO Collaborating Centre for International Drug Monitoring Dr. Mohamed Farah the Uppsala Monitoring Centre.

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Presentation on theme: "1 WHO Collaborating Centre for International Drug Monitoring Dr. Mohamed Farah the Uppsala Monitoring Centre."— Presentation transcript:

1 1 WHO Collaborating Centre for International Drug Monitoring Dr. Mohamed Farah the Uppsala Monitoring Centre

2 2 WHO Drug Monitoring Programme Founding Members 1968 AustraliaNew Zealand CanadaDenmarkGermanyIrelandNetherlands United States of America United Kingdom Sweden

3 3 WHO Programme for International Drug Monitoring

4 4 WHO Collaborating Centre the Uppsala Monitoring Centre established as a foundation 1978 based on agreement Sweden – WHO international administrative board WHO Headquarters responsible for policy

5 5 Signalling Procedure What should be achieved? Signals should not be missed Signals should be found early ‘False’ signals should be kept to a minimum

6 6 Process for joining WHO Programme 1.Ministry of Health (or equivalent) designates National Centre Ministry of Health National Centre the UMC WHO-HQ Geneva 1 2 3 4 5 2.Ministry of Health sends formal application to WHO- HQ, Geneva 3.National Centre sends sample reports to the UMC 4.UMC notifies WHO-HQ that reports are compatible 5.WHO-HQ advises Ministry of Health of admittance to the Programme

7 7 Official member Morocco (1992) South Africa (1992) Tunisia (1993) Zimbabwe (1998) Ghana (2001) Nigeria (2004) Mozambique (2005) Associate member Botswana Democratic Republic of Congo Eritrea Ethiopia Madagascar Sierra leone Uganda Zambia Algeria Egypt (2001) Tanzania (1993) Africa -WHO

8 8 Nomina si nescis, perit et cognitio rerum. (Carl von Linné, Critica botanica) If you do not know the names, the knowledge about the things vanishes as well.

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11 11 Isibhaha Syn: Warburgia breyeri Pott.; Warburgia ugandensis Sprague; Chibaca salutaris Bertl. f. Uses: Expectorant, Chest infections, Sinusitis, Malaria, Venereal diseases, Stomach ulcers, Toothache and Dermatological disorders Chemistry warburganalmuzigadialpolygodialmukaadial Warburgia salutaris (Bertol. f.) Chiov. Common names: Pepper bark tree, Pepperbasboom (Afr.), Shibaha (Tsonga), Amazwecehlabayo (Zulu), Isibaha (Z, V), Manaka (Venda), Sebaha (Sotho) Muthiga (Kikuyu), Sogdom (Amharic), Msokonoi (Swahili)

12 12 Artemisia annua L. leaf

13 13 Artemisia annuua L. The plant can grown in many places but it may not contain artemisinin. For example: Visitors of the ancient palaces in the forbidden city in beijing can find nice artemisia annua plants pushing left and right as weeds, but these plants do not contain artemisinin

14 14 Artemisia annua L. but a clone from China could contain up to 1.1 % artemisinin The average artemisinin concentration in plants of European origin range from 0.03 to 0.22 % (dry leaves weight basis) artemisinin,

15 15 Artemisia annua L. 1,8-Cineole: leaf pesticide, insectifuge, herbicide Alpha-Pinene: leaf herbicide, insecticide, pesticide, insectifuge, insectiphile Artemisic-acid: plant: pesticide Artemisinin: flower leaf antimalarial, pesticide, schizonticide, herbicide Beta-Pinene: plant: herbicide, insectifuge, pesticide Beta-Sitosterol: plant: pesticide, antifeedant Borneol: plant: herbicide, insectifuge, pesticide, insect-repellent Camphene: plant: insectifuge, pesticide Camphor: leaf antifeedant herbicide, insect-repellent, insectifuge, pesticide Caryophyllene-oxide: plant: antifeedant, insecticide, pesticide Cuminaldehyde: leaf: larvicide, pesticide Delta-Cadinene: plant: pesticide Deoxyartemisinin: plant: pesticide Menthol: plant: pesticide, termiticide Ocimene: plant: insecticide P-Cymene: plant: herbicide, insectifuge, pesticide Scopoletin: plant: herbicide, pesticide Terpinen-4-ol: plant: herbicide, insectifuge, pesticide

16 16 Artemisia annua L., flower, leaf ARTEMISININ Antitumor Antiviral Calcium-Antagonist Cytotoxic Herbicide Immunomodulator Neurotoxic Pesticide Plasmodicide Schizonticide Teratogenic Antimalarial

17 17 Artemisia annua L. leaf Dihydroartemisinin Arteether Artesunate Artemether Artemisinin 青蒿素

18 18 Artemisinin Synthesis

19 19 but synthetic compound is unlikely to be economically competitive with the naturally produced compound Artemisinin can be synthesized,

20 20 Case report WHO Record number: Country: Ghana Type of report: Spontaneous report/Hospital Age: 54 YearsSex: Female Adverse Reaction(s): Face oedema; Oedema periorbital Outcome: Not recovered Suspected Drug:Artesunate Drug administration data: 200 Milligram Oral Total Indication: MALARIA Concomitant Drug(s):Nifedipine 20 Milligram Oral per Day Rechallenge action: Rechallenge Rechallenge outcome: Reaction recurred Nifedipine: 17 Face oedema 29 Oedema periorbital

21 21 Artemether Total number of reports 44 Agitation 6Headache 9Paroniria Anorexia Hypoplasia cerebellar Stomatitis Ataxia cerebellar FraInsomniaSweating increased 2 ConfusionJaundiceUrine abnormal 2 Confusion Fra Nausea 2Vision abnorma Dizziness 9NeurosisVomiting 2 Eye malformation Zaf

22 22 Artesunate Reports 22260 Anxiety 8Alopecia 8 Agitation 341Face oedema, GhaAbdominal pain 11 Ataxia 2Cheilitis 29 Anorexia 513Fever tha,VnmAllergic reaction Zaf DeliriumCoughing 2 Asthenia GhaGingival bleeding 2Dizziness Gha, 1439 Th DyspnoeaNausea 990 Bullous eruptionHallucination 20Hypoaesthesia Tza 0anaemiaEpistaxis 3 Confusion 195HyperventilationOedema periorbital Gha Insomnia 6Flatulence Depression 53Hypotension GhaParanoid reaction 6 NaevusHaematuria Diarrhoea 207Palpitation 241Paroniria 52, Gha 1 Rash 2Jaundice 61 Headache 1161Spasm generalizedRash maculo-papular 6 Pallor 85Melaena Stomatitis 40Urine abnormal 2Rash erythematous 24 PurpuraPharyngitis vomiting 720Urticaria 3, 1 VnmSweating increased Pruritus 47Tachycardia Anaemiah aemolytic 2Thrombocytopenia 2 Tinnitus 3 Vision abnormal 168

23 23 Artemisinin and derivatives There is a fear that improper use of artemisinin and its derivatives will spur the malaria parasite to evolve to resist treatment with the compounds, something that has happened to all previous malaria therapies Spread of chloroquine resistance of Plasmodium falciparum

24 24 Natural Mosquito Repellents *It is ten times more effective than DEET at repelling mosquitoes Agastache cana (Hook.) Woot. & Standl. Azadirachta indica Juss f. Cymbopogon nardus (L.) Rendle Melissa officinalis L. Nepeta cataria L.* Pelargonium citrosum Vanleenii Pelargonium graveolens L'Her. ex Ait.

25 25 Mosquito’s natural enemy Mosquitofish Bat 600/h

26 26 If you think you're too small to be effective, you have never been in bed with a mosquito!

27 27 Thank you for your attention!

28 28 Is it acceptable that an African child dies of malaria every 30 seconds when safe and effective treatment is available.

29 29 ”Pull out, Bettyl Pull out...You’ve hit on artery”

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31 31 Mystic Herbal balm ?

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