Antimalarial Agents: Design and Mechanism of Action: Chapter 1 - History of malaria and its treatment

Elsevier, Antimalarial Agents, 2020, Pages 1-48
Morag Dagen

Malaria is a very ancient disease. In the past it occurred across much of the globe, inflicting a heavy burden of morbidity and mortality on affected populations. It remains endemic in much of the tropics and climate change could lead to its resurgence in regions which are currently malaria-free. The first effective treatment, an extract of the bark of the South American cinchona tree, was introduced to Europe by the Jesuits in the 17th century. The discovery of the malaria parasite in the late 19th century was followed by identification of the anopheles mosquito as vector. Understanding of the life cycles of parasites and vectors then led to improvements in disease control. Quinine, the active principle of cinchona, was isolated in the 19th century and remained the unrivalled malaria treatment until the 1940s. Many advances were made in the development of synthetic drugs and insecticides during the World War II, leading to the belief that complete eradication of malaria was an achievable goal. However, the subsequent evolution of drug-resistant parasites and insecticide-resistant mosquitoes led to the resurgence of malaria in areas where it had been controlled. Resistance remains a major challenge, and new drugs, treatment regimens, and vector control methods are urgently required due to the evolution of strains of malaria parasites resistant to all available treatments.