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150 The Journal of the Royal Institute of Thailand Volume III - 2011 150 Quinine and Quin-Ghao, Natureûs Two Most Important Anti-malarial Drugs Quinine and Quin-Ghao, Natu reûs Two Most Important Anti-malarial Drugs Sasithon Pukrittayakamee 1,2 and Arjen Dondorp 3 1 Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University 2 Associate Fellow of the Royal Institute of Thailand. 3 Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University Abstract Quinine and Quin-Ghao (artemisinins) both have a centuries old medical history as effective anti-ague remedies and remain natureûs two most important anti-malarial drugs. From ancient records of early discovery, it took less than a decade for quinine to be widely used in Europe in the 17 th century. In contrast, it took over a thousand years until the 20 th century for Quin Ghao (artemisinin) to become known and accepted outside China. These divergent timelines of the two drugs, partly reflect differences in the scientific heritage between the two civilizations i.e general publication in the West versus confidential ownership in the East. Quinine, but especially artemisinin derivatives, still play an important role in malaria control and treatment as witnessed in the WHO malaria treatment guidelines. Recent evidence shows that artesunate is superior to quinine in preventing death from severe falciparum malaria. Quinine is more wildly available and has remained the first line anti-malarial regimen for first trimester pregnant women. Key words : malaria, quinine, Quin-Ghao, artesunate Introduction Plasmodium, the malaria parasite, is a single cell organism in the class of blood protozoa. Its origin predates humanity and is estimated to be over half a billion years old (Kakkilaya, 2006). A large variety of Plasmodium species have evolved, all characterized by alternate cycles in mammals including humans and 150-159_mac9 5/10/12, 1:29 AM 150