In total, there are over 450 different types of malaria parasites, inoculated by 70 of the 480 species of Anopheles mosquitoes. Only five affect human beings, but that is enough to kill one person every 30 seconds. So it is not surprising to say that mortality due to malaria has been higher than any other disease worldwide.
In 1964, Spain was declared free of malaria and received the official certificate of eradication, even though Africa is still a region where thousands of people die every year, especially children.
For a long time, quinine was the only defence against Parca species, which was disguised as a mosquito, which is why it came to be used as a strategy to win wars.
Quinine saved the North
From 1861 to 1865, the United States fought the Civil War. A bloody civil war in which quinine was so strategically important it became a major part of the ammunition in the Union's arsenal. The malarial fevers, however, took its toll on the opposing side so it was quinine, above all other factors, that saved the North.
To defeat malaria, the Union distributed 19 tons of refined quinine to its soldiers, a figure much higher than that counted by the rebels in the Confederation. This caused the price of quinine to rise astronomically, while at the same time smugglers found a business in it that was much more important than in any other material. Thus, only 30 grams of quinine came to cost about $4 in 1861, $23 in 1864 and up to $400 and $600 by the end of the war.
To introduce quinine smuggling among the Confederates, strategies similar to those now used in drug trafficking were used: quinine was stuffed into furniture, upholstery or dolls for girls; "mules" like those we now see at airports or border posts were also used, as quinine was sewn into women's skirts, into false bottoms of luggage or carefully packed into the rectum or intestines of cattle.
Quinine is the strongest of the four alkaloids found in the bark of trees of the genus Cinchona. It was isolated and named in 1820 by French researchers Pierre Joseph Pelletier and Joseph Bienaimé Caventou. For decades it was the only lifeboat from a disease that came in through the air and infected millions of people.
However, although quinine is still used today with good results for the most severe forms of malaria, it was after the Second World War that chloroquine was discovered to be more effective, cheaper and safer. The first malaria vaccine was approved in 2015 by the European Medicines Agency (EMA) and has been developed by the company GlaxoSmithKline, GSK. Although its effectiveness is limited (up to 40% of cases) and it only works for malaria caused by Plasmodium falciparum (the most common) it is an important percentage to be the first vaccine to prevent this pathology. Specifically, in the first 18 months of follow-up after three doses, malaria cases were almost halved in children aged 5-17 months at the time of first vaccination, and 27% in infants (6-12 weeks). After four doses, there was a 39 per cent reduction in cases in children aged 5-17 months and a 27 per cent reduction in infants (four-year follow-up). We are therefore gradually moving away from dependence on quinine, the drug that became as coveted like gold.