The Origins of Antimalarial-Drug Resistance

There is a tendency to view the development of antimalarial-drug resistance as an inevitable outcome of the drugs' widespread use. Yet resistance has been accelerated by the way the drugs are used and by the social and economic conditions in which they are used. Drugs have been used to treat and prevent malaria for centuries. Bark from the cinchona tree, which contained an array of alkaloids with antimalarial properties, appeared in Western therapeutics in the 17th century. One of the alkaloids, quinine, was isolated in 1820 and became the drug of choice for treating malaria until World War II, when supplies of the drug for much of the world were cut off by the Japanese occupation of cinchona-growing regions in Southeast Asia. Efforts to create alternatives to quinine led to the search for synthetic antimalarial drugs. Chloroquine, first developed in the 1930s, became the . . .