Antimalarial Therapy

The line of drug treatments developed against malaria, beginning with quinine, an alkaloid extracted from the bark of the South American cinchona tree and used by Jesuit missionaries in Peru from the 1630s onward, centuries before the parasite it acted against was identified. Quinine remained the only effective antimalarial for nearly three hundred years; the alkaloid itself was isolated in pure form by the French chemists Pierre Joseph Pelletier and Joseph Bienaime Caventou in 1820. Synthetic successors, chloroquine foremost among them, largely replaced quinine through the twentieth century until spreading parasite resistance eroded their effectiveness. Artemisinin, extracted from the sweet wormwood plant Artemisia annua by the Chinese chemist Tu Youyou in 1972 during the secret Project 523 program, restored a highly effective option and, combined with a partner drug as artemisinin-based combination therapy (ACT), is now the World Health Organization-recommended first-line treatment for uncomplicated malaria worldwide.