The scourge of malaria is ancient, and many historians think that the introduction of malaria into the swamps around Rome contributed to the lethality of later epidemics, and by being highly lethal to children, a depopulation that led to it’s vulnerability to barbarian invasions.

The drug quinine, AKA Jesuit Bark, was one of the earliest cures, coming from a South American tree.

But it was the introduction of cheap and less toxic Aralen (Chloroquine) after World War II, combined with the destruction of breeding grounds for mosquitoes by draining pools or water, or by spraying them with insecticide, that led to a temporary victory over the disease.

Alas, like many diseases, the parasite of Malaria, especially it’s most lethal form, Falciparum Malaria, has become immune to Aralen and many of the more modern drugs one by one.

At the same time, the economic difficulties of independent African (and to a lesser extent, Asian) states has decreased the ability to drain and spray mosquito breeding grounds, especially since the ban on cheap and non toxic DDT has put the cost of more toxic and expensive insecticides beyond the budget of many of these countries.

The result has been a resurgence of Malaria deaths. Most occur in Africa and a lesser number in rural Asia, areas that harbor the more deadly form of the disease, Falciparum malaria.

A female mosquito (Anopheles gambiae) bites into human skin to extract blood

Parasites that cause malaria are carried from human to human by mosquito

Now two “old” treatments may reverse that trend.

The first is that some African nations are defying the DDT ban in order to protect the lives of their own people, a decision that now has the approval of the WHO (the UN’s World Health Organization).

The second is the reintroduction of an ancient Chinese herbal medicine that was credited with decreasing deaths from malaria in southwest China and Vietnam, and is now being promoted internationally.

The drug Artemisinin has been used by the Chinese for thousands of years to treat fevers that often were caused by malaria.
However, it’s modern use started ironically when Mao’s Cultural revolution led to Chou En Lai starting a research institute to examine the ancient Chinese remedies scientifically. placed doctors in rural areas without many modern drugs, the so called 532 committees.

One of these units found an ancient text from 340 A.D by Ge Hong that described how to process qinghaosususu to make an infusion to relieve fever. Further experimentation confirmed that a drug active against the malaria parasite, and it began to be promoted and used in Southern China by Doctor Li Guoqian, a doctor trained in moderThe scourge – Google Docs & Spreadsheetsn medicine whose father and grandfather were traditional Chinese physicians.

The drug’s use in Southern China and Vietnam started in the 1970’s but only came to the attention of the West in the 1990’s after the end of the cold war and the increased openness of China to the west.

The drug not only works faster than previous anti-malarial medicines but works against the most serious version of malaria that is resistant to other medicines.

Several things have slowed it’s widespread use in Africa.

First, since it is an herbal medicine, extraction is slow, the shelf life is only two years, and the availability of the herb is limited. Scientist hope that by synthesizing the chemical in the laboratory, the price will fall, allowing it to be afforded by African nations with a limited budget.

A second worry is drug resistance . This has not yet been found in Asia, but there is a danger that unsophisticated patients who do not take the many pills for several days correctly will lead to resistant parasites surviving and spreading. Right now this is being prevented by selling Arteminisin only in combination with other malarial drugs, and by releasing a twice a day version of the medication.

Ironically, one thing that might help in getting more funding for Malaria research is that the US military’s recognition of the need for anti malarial drugs to protect soldiers. Originally, Arteminisin was investigated then rejected due to worries about side effects. But after a dozen Marines were sent to Liberia in 2003 as peacekeepers developed Falciparum malaria. This Spectator article ridiculed the Marines for being afraid of taking their medicines, but as someone who developed a moderate case of malaria in Liberia while taking anti Malarial medications, I can assure you that the problem was drug resistance (my case of malaria was treated using a sulfa based medicine, which even in the 1980’s was starting not to work. In cases of Cerebral malaria, where treatment is a life and death situation, we still used injectable Quinine, despite the toxicity associated with that drug).

The hope is that the infusion of money into research by both the US Government and by private sources like the Gates Foundation will result in a vaccine that will eventually remove malaria from the list of diseases that are the scourge of humanity.


Nancy Reyes is a retired physician living with her husband and extended family in the Philippines. Her blog is Finest Kind Clinic and Fishmarket. She posts medical essays to HeyDoc’s xanga blog

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