Natural compounds: the future of anti-malarial treatment

n the run up to World Malaria Day on the 25th April 2011, BioMed Central's open access journal Malaria Journal takes a long hard look at the development of natural compounds for use in the fight against malaria.

There are over 200 million cases of malaria each year with 85% of all cases being children under five years old and, according to the World Health Organisation, in 2009 malaria was responsible for 781,000 deaths worldwide. Low cost treatment is available, 100 million children a year are treated with Artemisinin combination therapy at a cost of about 30 cents per child, but resistance of the parasite to this treatment is increasing. In the face of this resistance, researchers are turning to traditional medicine to provide a starting point for the development of new drugs. 

Traditional remedies are widely used especially in areas of poverty or where there is no access to medical treatment. The combination of artemisinin, flavanoids, and other compounds which occur naturally in the leaves of Artemisia annua, increases the effectiveness of the treatment and decreases metabolism of the active ingredient. Circumin (from turmeric) has anti-malarial properties and is being tested for use against cerebral malaria. Adding piperine (from black pepper seeds) to circumin increases the effectiveness of circumin 2000 times. Plant extracts such as lemon eucalyptus, citronella, and neem oil also have use as insect repellents but are not as yet recommended for use by the Environmental Protection Agency.

Researchers suggest following the Research Initiative on Traditional Anti-Malarial Methods (RITAM), which shows a consensus of observational and laboratory results with clinical clearance of parasites. They also advocate the inclusion of native healers for the review of disease surveillance, ethnobotanical treatments, and changes in health care policy to increase the validity of these traditional medicines.

However, there is currently no concerted research into the effectiveness of natural compounds as anti-malarials or as malaria prophylaxis. Consequently, there is a need for partnership organisations, such as African Network for Drugs and Diagnostics Innovation (ANDi), to promote standardisation in observing traditional remedies and the subsequent pharmacological purification and testing of compounds and combinations in the clinic.