An FDA emergency measure cleared anti-malarial drugs for COVID-19 treatment, Forbes reported Monday. The drugs are already being used in clinical trials in New York, an American hotspot for the virus. They have been used for decades to combat malaria.
According to the Forbes article, the Food and Drug Administration approved chloroquine and hydroxychloroquine for emergency uses to treat the novel coronavirus. Chloroquine and hydroxychloroquine are “anti-malaria drugs touted by President Donald Trump despite inconclusive clinical proof of their effectiveness,” the article said.
“Scientists hope [the drugs] may be used to treat the coronavirus, but early studies have provided mixed evidence proving their effectiveness and the drugs may have risks such as vision problems or cardiac arrest. The Department of Health and Human Services said the emergency authorization was issued because the potential benefits of the product outweigh the risks.” Their original use is to treat malaria, where they’ve proven quite useful.
The 400-Year Road to Today
According to the World Health Organization (WHO), malaria is a parasite most often transported into humans by mosquitoes. In 2018 alone, 228 million cases worldwide of malaria resulted in 405,000 deaths, the WHO website said. So how do we treat it?
“A treatment for malaria was discovered in Peru in the 1600s,” said Dr. Barry Fox, Clinical Professor of Medicine at University of Wisconsin Medical School. “It came from the bark of the Cinchona tree, and has been used as an inexpensive cure in some parts of the world—we know it as quinine. Later, this ingredient was chemically modified into chloroquine, the first synthetic anti-malarial medication.”
That chloroquine is the same medicine recently approved to treat the novel coronavirus. However, quinine isn’t merely handy and useful. Dr. Fox said that during World War II, several battles between U.S. and Japanese forces were “solely for the purpose of securing islands that supported the growth of quinine.”
Additionally, he said, an ancient Chinese medical text, called 52 Remedies, describes a remedy for malaria derived from the Qinghao plant. “Its active ingredient is a compound we know today as artemisinin,” Dr. Fox said. “It’s a key ingredient in several current valuable anti-malarial treatment drugs today.”
As the Forbes piece pointed out, anti-malarial medicines may have limited effectiveness. This applies not only to the fight against the coronavirus, but also to malaria itself.
“All malaria used to be sensitive to chloroquine,” Dr. Fox said. “However, malaria adapted to chloroquine and developed resistance over the course of a few decades. Now there are only a limited number of geographic locations in the world—only the Caribbean and Latin America—where chloroquine is still effective.”
Fortunately, scientists have developed alternatives to chloroquine—and just in time. These other drugs focus on specific kinds of the malaria parasite that are responsible for higher numbers of the annual reported malaria deaths.
“Other malaria medications are available, and they’re mainly targeted towards the prevention of falciparum malaria since it’s the deadliest,” Dr. Fox said. “These include weekly treatments with Mefloquine, or daily Malarone, or doxycycline.”
Chloroquine may be phased out for malaria treatment and only have limited use in treating COVID-19, but for now, it’s been approved for use while the world waits for a more effective treatment or for a cure for the coronavirus.
Dr. Barry C. Fox contributed to this article. Dr. Fox is Clinical Professor of Medicine at University of Wisconsin Medical School. He received his undergraduate degree in Molecular Biophysics and Biochemistry from Yale University and his medical degree from Vanderbilt University.