Understanding the History of Hydroxychloroquine and Plaquenil

ByPrimary Researcher

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Executive Summary

  • Hydroxychloroquine or Plaquenil has a long-term history as an anti-malarial, which has been repurposed to fight against other ailments.

Introduction

The first precursor of Hydroxychloroquine was called Quinine, one of the most essential drugs ever discovered. However, in 2020, Trump made a statement in support of Hydroxychloroquine for use against covid. This led to an immediate backlash against HCQ. This article will provide an objective analysis of the history of Hydroxychloroquine.

This video provides some good history on Quinine. 

The Anti-malarial Wonder Drug

This information is a synopsis of the Wikipedia page on Quinine.

Quinine was officially isolated in 1920. However, it is part of a family of drugs called cinchona alkaloids that were used as early as the 1570s. The first use of Quinine is most likely not known, as it was used in Peru and other places, which would not have documented its usage.

Essentially Quinine is first traced to when Europeans found the indigenous population using it — Europeans did not discover it. This story illustrates this and is quite incredible.

The Jesuit Agostino Salumbrino (1564–1642), an apothecary by training who lived in Lima (now in present-day Peru), observed the Quechua using the bark of the cinchona tree to treat such shivering. While its effect in treating malaria (and malaria-induced shivering) was unrelated to its effect in controlling shivering from rigors, it was a successful medicine against malaria. At the first opportunity, Salumbrino sent a small quantity to Rome for testing as a malaria treatment.

In the years that followed, cinchona bark, known as Jesuit’s bark or Peruvian bark, became one of the most valuable commodities shipped from Peru to Europe. When King Charles II was cured of malaria at the end of the 17th Century with quinine, it became popular in London. It remained the antimalarial drug of choice until the 1940s, when other drugs took over.

What is curious is that this is not better known.

I usually have seen it presented that Europeans did not venture into Africa as they would die of tropical diseases. And that this stopped them from exploring Africa until around the 1880s — and that Quinine is what allowed them to do so, as is explained in the following quotation.

Quinine played a significant role in the colonization of Africa by Europeans. The availability of quinine for treatment had been said to be the prime reason Africa ceased to be known as the “white man’s grave”. A historian said, “it was quinine’s efficacy that gave colonists fresh opportunities to swarm into the Gold Coast, Nigeria and other parts of west Africa”.

However, Quinine was known to Europeans hundreds of years before this.

And the reason for this discrepancy is found in the following quotation.

Large-scale use of quinine as a malaria prophylaxis started around 1850.

So — Quinine was known for hundreds of years before 1850 but was not broadly manufactured before this time. Furthermore, the Dutch then moved manufacturing of Quinine from places like Peru to Indonesia and dominated its manufacture.

By the late 19th century the Dutch grew the plants in Indonesian plantations.

Soon they became the main suppliers of the tree. In 1913 they set up the Kina Bureau, a cartel of cinchona producers charged with controlling price and production. By the 1930s Dutch plantations in Java were producing 22 million pounds of cinchona bark, or 97% of the world’s quinine production.

If that did not drive home the importance of Quinine and why it was so widely demanded, the following quote will.

During World War II, Allied powers were cut off from their supply of quinine when Germany conquered the Netherlands, and Japan controlled the Philippines and Indonesia. The US had obtained four million cinchona seeds from the Philippines and began operating cinchona plantations in Costa Rica.

Additionally, they began harvesting wild cinchona bark during the Cinchona Missions. Such supplies came too late. Tens of thousands of US troops in Africa and the South Pacific died of malaria due to the lack of quinine.

Quinine was only removed from the essential medicines list in 2006, which ended a 430-year history of effective use. Quinine is still effective as an anti-malarial and for other purposes; however, the WHO concluded that other drugs had surpassed in having practical effects. These other drugs include Chloroquine (discovered in 1934), Mefloquine (discovered in 1970), and Atovaquone.