by G Gachelin, P Garner, E Ferroni et al.
Journal of the Royal Society of Medicine; 2017, Vol. 110(2) 73–82 – First Published February 7, 2017
Although the use of quinine to treat and prevent malaria in individuals was dramatically successful, research in Italy in particular showed that scaling this up to prevent malaria in populations was unsuccessful, both because of poor compliance with self-medication, and because of the frequency of reinfection. This general conclusion applied except in circumstances – prisons and navies, for example – in which community self-discipline could be assured. It was not until the 21st century that any alternative antimalarial drugs were shown in well designed, large controlled trials to be superior to quinine, and then only in severe malaria. The enduring beneficial effects of Cinchona bark and quinine over three and a half centuries are remarkable.