Malaria: Rediscovered cure

A crucial element of effective treatment of malaria is proper diagnosis of the disease. Thee is an urgent need for better rapid diagnostic tests. Rapid diagnosis will facilitate the move toward treating confirmed cases only, thus saving resources and helping prevent resistance.

Although artemisinin is being acclaimed as the most important new malaria drug by top international health authorities, artemisinin and its derivatives have been around for quite a long time.

Artemisinin and artemisinin derivatives are extracts from a plant, Artemisia annua.

The Artemisia plant is usually more known by its common names of sweet wormwood or Chinese wormwood. The medical benefits of an infusion of qinghaosu (the traditional name for artemisinin) were first discovered at least 2000 years ago by the Chinese, who used it to reduce fevers and other symptoms associated with malaria. However, the Chinese treatments using sweet wormwood were lost over time, and artemisinin was only recently scientifically identified as the active ingredient.

During the Cultural Revolution in China in the late 1960s, Chairman Mao Tse Tung charged Chinese scientists to investigate ancient Chinese herbal remedies. Ho Chi Minh also asked Mao to help provide new medicines to combat malaria, responsible for many deaths among Vietnamese soldiers during the Vietnam War. In the 1970s, an archaeological dig unearthed recipes for ancient medical remedies, including ones using artemisinin.

The Chinese studied many types of traditional malaria cures before hitting on a recipe for tea made from the Artemisia plant. Distilling the tea and adding chemicals to try to isolate the active compound in the plant, they developed the medical remedy.

The Chinese manufactured artemisinin in drug form and performed tests on malaria patients. It was discovered that artemisinin cleared malaria parasites from the host bodies faster than any other antimalarial.

Artemisinin derivatives have attributes that make them especially effective: they are highly potent, fast-acting (fever clearance is fast and people recover quickly), very well tolerated and complementary to other classes of treatment. Given that a minimum of eighteen months is needed to grow the Artemisia plant from which artemisinin derivatives are extracted, harvesting large quantities of the plant is critical for worldwide drug usage.

Currently, most of the cultivation, extraction and synthesis for the production of the drugs takes place in China and Vietnam, where the Artemisia plant is grown. Artemisinin production is also beginning in Tanzania and India but full-scale production will take time.

Drawn from "Health: Can a Chinese herb win the malaria war?" BBC Online Network, Thursday, October 15, 1998.