Artesunate: Restoring an Attacked Hologram

Raising the Standard Artesunate: Restoring an Attacked Hologram David Pizzanelli and Paul Newton

Artesunate: Anti-Malarial Artesunate is an anti-malarial drug used against the Plasmodium falciparumspecies of malaria parasite1.

Artesunate: Anti-Malarial Plasmodium falciparum a particularly invidious species of malaria that has grown resistant to traditional remedies. Malaria Endemic Countries Approximately 40% of the world’s population is at risk of contracting malaria. • It is the most widespread and most dangerous species of malaria. • Untreated it can be fatal: 2.5 million people die every year. • 300 million people • Worldwide each year

Artesunate: Anti-Malarial Artesunate is the Key drug in the treatment of Plasmodium falciparum,and is sold widely in southeast Asia6-9. Samples were purchased in Cambodia, Laos, Myanmar, Thailand and Vietnam, fakes were found in all five countries1. Counterfeit Artesunate was first found in 1998.

Artesunate: Counterfeit A 500%increasein the number of people seeking treatment for malaria, up from 40 per month to 200 per month, in the north Cambodian town of Anglong Veng2. One laboratory reported that “nearly two-thirds” of the Artesunate they tested was counterfeit2.

Artesunate: Counterfeit Investigators can test for the active ingredient by using the Fast-RedDye test10. 2001 – 2002 38% of Artesunate tested in South East Asia were found to be counterfeit with no active ingredient.

Artesunate: Counterfeit 2002– 2003 53% of Artesunate packstested in South East Asia were found to be fake.

Artesunate: Counterfeit 2005 The death of a man in a hospital in eastern Burma revealed that the hospital had purchased a large stock of fakeArtesunate. Artesunate is being counterfeited on an industrial scale and from multiple sources.

Artesunate: Genuine Hologram • Very basic hologram made with 2 two beam setups. • “2D” surface graphics, (rather than a “2D-3D” with 1 or more deeper levels of artwork). • Both “classical” gratings, made in a studio, not made by Dot-Matrix technology.

Artesunate: Genuine Hologram • Diffuse grating • Direct gratings

Artesunate: Genuine Hologram Covert Feature: Diffractive Micro-text “GUILIN PHARMA” (double exposed).

Artesunate: Genuine Hologram Covert Feature: Ultra Violet ink printed onto the hologram surface.

Artesunate: Genuine Hologram Simulations: Not holograms. Assorted types of self-adhesive label.

Hologram Simulations Simulations: Most of the fake labels do not have any diffraction.

Hologram Simulations Simulations with diffractive rainbow colour in the image.

Counterfeit Hologram Counterfeit Hologram #1 [3]

Genuine Holograms?

First Line Authentication Most consumers in rural areas are very poor and cannot read. An unambiguous visual authentication device is essential. Overtsecuritydevices allow the consumer to choose not to buy the fake product. Thus reducing the counterfeiters’ market share.

First Line Authentication The fake tablets are sold for half the price of the genuine product. The large number of different fake holograms has rendered the existing hologram useless as an authentication device.

Raising the Standard • Size of the hologram should be much bigger: 30 mm X 40 mm. • Image should have 3DEither 3D solid model or 3D computer model or3D from parallax video. • Image should be full colour. • Image should have animation. Windows ‘95 Hologram • Hot-stamping foil on the pack face or tamper-evident seal. Unique image of a young boy. • Hologram on the foil of the blister pack for additional authentication.

New Crisis Ahead 2005 / 2006:Dr. FacundoFernández, “The counterfeiters are now adding small doses of real Artesunate to the fakes, trying to fool chemical tests now widely used in Southeast Asia. This could trigger a public health disaster, because if malaria patients take fake drugs that contain traces of the real drug, the real drug could lose its effectiveness.”11

New Crisis Ahead "The way to create resistance in parasites is by administering low doses of any drug. If you administer low doses, you might start to select some parasite-resistant strains that are not sensitive to Artesunate, and create resistance to this drug." "What's extremely worrying is that malaria parasites have a long history of developing drug resistance in Southeast Asia and then spreading that resistance to Africa...“11

Restoring an Attacked Hologram Only by depriving the criminals of revenue can the trade in counterfeit Artesunate be stopped. That can only be achieved by enabling the consumer to visually determine the genuine product from the fake. In view of the great importance of this drug to millions of people in Asia and Africa, a new effective hologram is urgently required to preserve the efficacy of this vital medicine.

References • 1) “Fake Artesunate in southeast Asia” Paul Newton et al. The Lancet, Vol. 357. June 16, 2001. • 2) “Fake malaria pills haunt Asians” Thomas Crampton International Herald Tribune, Monday August 25, 2003 3) United Nations. World Health Organization. "Fact Sheet No 94: Malaia."Geneva: 1998. Web page accessed 15 August 2007: http://www.who.int/mediacentre/factsheets/fs094/en/index.html • 4) http://www.everything2.com/index.pl?node=malaria [accessed on 15 August 2007] • 5) “Fake Artesunate in southeast Asia” Paul Newton et al. The Lancet, Vol. 362, page 169, July 12, 2003. • 6)“Fake antimalarials circulating in Cambodia” Rozendaal J (2000). Bull Mekong Malaria For 7: 62–68. • 7) “Fake artesunate in southeast Asia”. Newton P, Proux S, Green M, Smithuis F, Rozendaal J, et al. (2001)Lancet 357: 1948–1950. • 8) “Counterfeit artesunate antimalarials”. Newton PN, Dondorp AM, Green M, Mayxay M, White NJ, et al. (2003) Lancet 362: 169. • 9) “Why be concerned about the quality of antimalarial and ARV drugs?” Phanouvong S, Reiss S, Smine A (2005) Poster presented at 7th International Congress on AIDS in Asia and the Paciﬁc, Kobe, Japan, 1–5 July 2005. • 10) “Authentication of artemether, Artesunate and dihydroartemisinin antimalarial tablets using a simple colorimetric method”. Green MD, Mount DL, Wirtz RA. Trop Med Int Health 2001; 6: 980–82. • 11) Malaria Part 3: The Danger of Counterfeit Drugshttp://www.theworld.org/?q=node/4290 Image references Mosquito: http://www.michigan.gov/images/mosquito_65147_7.jpg Malaria blood: http://www.expedition360.com/journal/archives/images/red_blood_cells.jpg Malaria cycle: http://www.malariavaccine.org/images/malaria-life-cycle-SML.gif Malaria world Map: http://outreach.eos.nasa.gov/EOSDIS_CD-03/images/malaria_world_2000.gif Malaria treatment: http://www.aerzte-ohne-grenzen.at/img/layout/uploaded/the_krank_malaria.jpg Malaria ward: http://blogs.webmd.com/tanzania-travel/uploaded_images/in-malaria-ward-719744.jpg Colorimetry test: http://www.cdc.gov/malaria/images/lab_tests/colorimetry_artesunate_300w.jpg Field workers: http://www.transitionsabroad.com/publications/magazine/0309/ngo1.jpg Woman farmer: http://www.dgfoundation.org/uploads/pics/vietnam-farmer-woman.jpg Medicine shop: http://www.nilestyle.com/photography/vietnam/hanoi/enlarge.lasso?image=5186&index=5 Street seller: http://www.scidev.net/pdffiles/nature/434132a.pdf Street seller: http://news.bbc.co.uk/media/images/40627000/jpg/_40627495_medicines_afp.jpg Mini-Lab kit: http://www.scidev.net/pdffiles/nature/434132a.pdf Malaria parasite http://www.broad.mit.edu/news-images/20061210_malaria.jpg Malaria parasite: http://www.px.nsls.bnl.gov/x26c/images/1zrl.pdb1-500_neg.jpg Malaria victim: http://www.kenyamedical.com/images/Malaria_Victim.jpg All other images by Paul Newton or David Pizzanelli Many thanks to: Paul Newton

Artesunate: Restoring an Attacked Hologram