那羽中的温馨小屋

空间里的日志很久没有更新了。不知道朋友们最近是否都好？ 献上一篇最近听到的笑话，希望能给你们带来快乐。

While the US is contributing to the fight against malaria with high-profile publicity and Europe is taking the lead on funding, China has provided some of the most potent drugs for treatment – but in a way that could backfire.

No kiosk in rural Africa would be complete without a colourful array of antimalarials. Lucky patients can find and afford the most effective class of antimalarial, artemisinin combination therapy (ACT).

Artemisinin is a chemical synthesis of the antimalarial agent in an ancient Chinese herbal remedy for fever.

Since 2007, in an orchestrated effort to win hearts and business in Africa, the Chinese government has built a number of clinics and donated an estimated 3m of doses of Chinese ACTs throughout Africa.

Some 30 countries have received antimalarial donations including Nigeria, Liberia, Kenya, Tanzania and Uganda.

“These donations are a blessing,” says Dr Richard Ndyomugynyi, Uganda’s National Malaria Control Programme manager.

The donated drugs also often appear in pharmacies across Africa. Sold at premium prices even with evidence that they are donated clearly visible on the boxes, they are in direct competition with other ACTs, angering local marketing agents.

One donated ACT, Arco, is according to its maker, Kunming Pharmaceuticals, a one-dose or one-day cure. Other ACTs on the market require a three-day course.

Dr Ndyomugynyi says a clinical trial at the Mulanga Hospital in Uganda’s capital showed a high efficacy rate, but he could not comment on its long-term safety.

However, this one-day treatment is in direct conflict with World Health Organisation recommendation. The new WHO malaria treatment guideline, due out at the end of May, strongly recommends completion of three days of treatment.

“Particularly in a high transmission area, a drug like Arco, taken for only one day, is more prone to develop resistance because of its long half-life,” says Andrea Bosman, Medical Officer of the WHO’s Global Malaria Program.

He also indicates that although it has good potential as a new ACT, the efficacy and safety data for Arco is very limited.

Approved in China, Kunming has yet to apply for WHO prequalification for Arco, a required stamp of approval for donor funding.

Kunming has, however, gained approvals with nine national drug authorities.

Dr Timothy Wells, Chief Scientific Officer of Medicines for Malaria Venture (MMV), a non-profit organisation and a global leader in antimalarial development, estimates that to develop Arco up to international standards will take at least six years, if it is successful.

Dr Claude Faurant, a consultant to HolleyPharm, a majority shareholder of Kunming, admits that pharmaceutical development is still not very well understood by Chinese pharmaceutical companies.

MMV and its Korean and Italian pharma partners are now preparing two new ACTs for regulatory approval. Both of the drugs originated in China.

Today the Chinese-branded ACTs are mainly in private pharmacies. The number of treatments sold is less than a few million, a tiny market against the estimated public sector market of 150m ACT treatments needed in 2009.

HolleyPharm, one of the three main Chinese ACT manufacturers, sells its ACT across Africa and south-east Asia. It has also supplied 1m treatments, about half of its total sales, to the Chinese Ministry of Commerce over the past two years.

“This is an effort by the Chinese government to show the African people that ACTs are invented by Chinese scientist and it is our major contribution to the fight against malaria,” says Charles Lu, chairman of of HolleyPharm.

“We do not see donation as a tactic to penetrate the market,” Mr Lu says. “Our number one priority is to penetrate the GMP Club.”

Good Manufacturing Practice (GMP) is a term often used to describe drugs that are produced to international quality standards.

China has a number of GMP generic drugs, but only one patented drug that has gained international regulatory approval. It is, in fact, the most widely used ACT, Coartem, the product of a partnership between pharma giant Novartis and the Academy of Medical Military Sciences of China.

“Not only is the best antimalarial on the market now a Chinese drug, in the foreseeable future, all of the new antimalarials will also have originated in China,” says Rob Ridley, director of the WHO’s tropical diseases research arm, TDR.

“You cannot under-estimate the impact of Chinese science on malaria treatment. If we did not have that, we’d be in a big mess now,” he adds.

However, another factor in the battle against malaria is the counterfeit business. “Counterfeits and substandard drugs are widespread,” says Mr Bosman, “They are not only extremely dangerous to the patient, but also to the community because they contribute greatly to resistance.”

      据“中央社”13日报道，美国华府智库“战略暨国际研究中心”(CSIS)与日本《朝日新闻》针对亚洲9国外交专家进行调查显示，65.5%的受访者认为，10年后，中国将成世界上国力最强的国家。

　　这项以《10年后的亚洲》为主题、由美日联合进行的调查，从去年秋天到年底为止，针对美国、日本、中国、韩国、澳大利亚、印度、印度尼西亚、新加坡、泰国等9国的知名外交专家进行调查，有313人作答。

　　结果显示，受访者当中，认为10年后国力最强的是中国的达65.5%，居第一；认为是美国的有31.3%，居第二；接着是日本，5.5%；印度，2.9%；澳洲，1.1% 。

　　依国别来看，与美国结为同盟国的澳大利亚和韩国，认为美国10年后是最强国，但日本和其它国家则认为中国将成为最强的国家。

　　针对“对自国而言，最重要的国家是哪一国”的问题，日本除外，各国都回答“中国”；其中，澳大利亚认为美国和中国并列；日本则认为美国是对日本是最重要的国家，其次才是中国。

　　大多数的专家都认为，今后亚洲地区的权力均衡有向中国倾斜的趋势。但是问到“在维持亚洲的和平与稳定上，扮演最大角色的国家是哪一国”的问题时，回答“美国”的占40.1%，回答“中国”的占24.3%。

　　依国别来看，回答“美国”的比例，以韩国的94%居冠，其次是日本(59%)、新加坡(52%)、中国(49%)，都高于平均值。印度与泰国则是以回答“中国”者居最多。

　　《朝日新闻》指出，这显示今后中国的国力将逐渐壮大，对各国而言，对华关系的重要度亦将增加。

　　另外，针对“东亚共同体”的形成，包括“很支持”、“还算支持”者在内，约有81%的受访者赞成。但是其具体的角色，大多倾向于“促进信赖与相互了解”等较为松散的参与及合作。

　　2005年，东亚高峰会举办时未让美国参与，引起美国的疑虑。但这项调查显示，东南亚国家并无排除美国的意思。只是，对于美国、澳大利亚、印度等东亚地区以外的国家究竟要如何使其参与，东南亚各国脚步不一。

　　认为美国“很重要”、“算是重要”的受访专家平均达76%，但东南亚国家则低于70%。这与日本的91%、韩国的83%，有明显的差距。东南亚国家专家认为中国“很重要”、“算是重要”的达80%。

　　这项调查结果17日起，将在美国“战略暨国际研究中心”公布。