Artemisia annua: A Miraculous Herb to Cure Malaria

  • M. NaeemEmail author
  • Mohd Idrees
  • Minu Singh
  • M. Masroor A. Khan
  • Moinuddin


Artemisia annua L. (family Asteraceae) is the only source of a potent antimalarial drug artemisinin that has been used for centuries in Chinese traditional therapy for the treatment of fever and malaria. Artemisinin, a sesquiterpene lactone containing an endoperoxide bridge, has been proved as an effective and safe alternative remedy against the highly adaptable malaria parasite Plasmodium falciparum, which has already become resistant to many other drugs. World Health Organization (WHO) recommended artemisinin-based combination therapy (ACT) as the most effective one against the drug-resistant malaria. As it is highly desirable, various scientific strategies have been applied to enhance the production of artemisinin. Malaria is a vector-borne disease usually caused by Plasmodium species. It is reported that malaria threatens more than one-third of the global population, killing approximately 2 million people annually. A multidimensional approach is needed to control the malaria, and one of them is increasing artemisinin production in the plant concerned. The present review covers the information regarding A. annua cultivation, medicinal uses, artemisinin production, causes, consequences and control of malaria including strategies and policies.


Artemisia annua Artemisinin ACTs Malaria Parasites 


  1. Abdin MZ, Israr M, Rehman RU, Jain SK (2003) Artemisinin, a novel antimalarial drug: biochemical and molecular approaches for enhanced production. Planta Med 69:1–11CrossRefGoogle Scholar
  2. Aftab T, Khan MMA, Idrees M, da Silva JAT, Naeem M et al (2012) Exogenous nitric oxide protects Artemisia annua from oxidative stress generated by boron and aluminium toxicity. Ecotoxicol Environ Safe 80:60–68CrossRefGoogle Scholar
  3. Aftab T, Khan MMA, Idrees M, Naeem M, Hashmi N et al (2010a) Effect of salt stress on growth, membrane damage, antioxidant metabolism and artemisinin accumulation in Artemisia annua L. Plant Stress 4:36–43Google Scholar
  4. Aftab T, Khan MMA, Idrees M, Naeem M, Ram M (2010b) Boron induced oxidative stress, antioxidant defense response and changes in artemisinin content in Artemisia annua L. J Agron Crop Sci 196:423–430CrossRefGoogle Scholar
  5. Aftab T, Khan MMA, Idrees M, Naeem M, Singh M et al (2010c) Stimulation of crop productivity, photosynthesis and artemisinin production in Artemisia annua L. by triacontanol and gibberellic acid application. J Plant Interact 5:273–281CrossRefGoogle Scholar
  6. Allen PC, Lydon J, Danforth HD (1997) Effects of components of A. annua on coccidia infections in chickens. Poult Sci 76(8):1156–1163PubMedGoogle Scholar
  7. Anonymous (1982) Chemical studies on qinghaosu (artemisinine): China cooperative group on qinghaosu and its derivatives as antimalarials. J Tradition Chinese Med 2:3–8Google Scholar
  8. Anonymous (1992) Rediscovering wormwood: qinghasou for malaria. The Lancet 339:649–651CrossRefGoogle Scholar
  9. April (1989) Published by the National Institutes of Pharmaceutical Research and Development, Beijing, on Behalf of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, p 152Google Scholar
  10. Avery MA, Chong WKM, Jennings-White C (1992) Stereoselective total synthesis of (+)-artemisinin, the antimalarial constituent of Artemisia annua L. J Am Chem Soc 114:974–979CrossRefGoogle Scholar
  11. Basco LK, Ndounga M, Keundjian A, Ringwald P (2002) Molecular epidemiology of malaria in Cameroon. IX. Characteristics of recrudescent and persistent Plasmodium falciparum infections after chloroquine or amodiaquine treatment in children. Am J Trop Med Hyg 66:117–123PubMedGoogle Scholar
  12. Carrara VI, Zwang J, Ashley EA, Price RN, Stepniewska K et al (2009) Changes in the treatment responses to artesunate-mefloquine on the northwestern border of Thailand during 13 years of continuous deployment. PLoS ONE 4(2):e4551PubMedCrossRefGoogle Scholar
  13. Carrington A (2001) Malaria: Its human impact, challenges, and control strategies in Nigeria. Harvard Health Public Rev 2:54–60 University Hall, Cambridge, MassachusettsGoogle Scholar
  14. Chang HM, But PPH (1986) Pharmacology and applications of Chinese materia media, vol 1. World Scientific Publishing, SingaporeGoogle Scholar
  15. Charles DJ, Simon JE, Wood KV, Heinstein P (1990) Germplasm variation in artemisinin content of Artemisia annua using an alternate method of artemisinin analysis from crude plant extracts. J Agr Food Chem 39:991–994Google Scholar
  16. Chen DH, Ye HC, Li GF (2000) Expression of a chimeric farnesyl diphosphate synthase gene in Artemisia annua L. transgenic plants via Agrobacterium tumefaciens-mediated transformation. Plant Sci 155:179–185PubMedCrossRefGoogle Scholar
  17. Cheng F, Shen J, Luo X et al (2002) Molecular docking and 3-D-QSAR studies on the possible antimalarial mechanism of artemisin analogues. Biorg Med Chem 10:1083–1091Google Scholar
  18. Dalrymple DG (2009) Artemisia annua, Artemisinin ACTs and malaria control in Africa. Tradition, Science and Public Policy. Politics & Prose Bookstore, Washington DC, USAGoogle Scholar
  19. Dash AP, Adak T, Raghavendra K, Singh OP (2007) The biology and control of malaria-vectors in India. Curr Sci 92:1571–1578Google Scholar
  20. Dash AP, Valecha N, Anvikar AR, Kumar A (2008) Malaria in India: challenges and opportunities. J Biosci 33:583–592PubMedCrossRefGoogle Scholar
  21. Das A, Anvikar AR, Cator LJ, Dhiman RC, Eapen A et al (2012) Malaria in India: the center for the study of complex malaria in India. Acta Tropic 121:267–273CrossRefGoogle Scholar
  22. Davis TM, Karunajeewa HA, Ilett KF (2005) Artemisinin-based combination therapies for uncomplicated malaria. Med J Aust 182:181–185PubMedGoogle Scholar
  23. Dondorp AM, Fanello CI, Seidlein LV, Day NPJ, White NJ (2011) Artesunate for severe malaria in African children, author’s reply. Lancet 377:2253CrossRefGoogle Scholar
  24. Dua B, Acharya AS (2013) Malaria: current strategies for control in India. Indian J Med Specialties 4(1):59–66Google Scholar
  25. Duke JA, Ayensu ES (1985) Medicinal plants of China. Reference Publications, Algonac. ISBN 0-917256-20-4Google Scholar
  26. Duke SO, Vaughn KC, Croom EM Jr, Elsohly HN (1987) Artemisinin, a constituent of annual wormwood (Artemisia annua), is a selective phytotoxin. Weed Sci 35:499–505Google Scholar
  27. Egan TJ (2004) Haemozoin formation as a target for the rational design of new antimalarials. Drug Design Rev Online 1:3–110Google Scholar
  28. Elfawal MA, Towler MJ, Reich NG, Golenbock D, Weathers PJ et al (2012) Dried whole plant Artemisia annua as an antimalarial therapy. PLoS ONE 7:e52746PubMedCrossRefGoogle Scholar
  29. Elford PC, Roberts MF, Phillipson JD, Wilson RI (1987) Potentiation of the antimalarial activity of qinghaosu by methoxylated flavones. Trans R Soc Trop Med Hyg 81(3):334–336CrossRefGoogle Scholar
  30. Enserink M (2005) Source of new hope against malaria is in short supply. Science 307:33PubMedCrossRefGoogle Scholar
  31. Ferreira JF (2007) Nutrient deficiency in the production of artemisinin, dihydroartemisinic acid, and artemisinic acid in Artemisia annua L. J Agr Food Chem 55:1686–1694CrossRefGoogle Scholar
  32. Ferreira JFS (2004) Artemisia annua L.: the hope against malaria and cancer. In: Proceedings of the Jan 15-17/2004 meeting. Mountain State University, Beckley, WVGoogle Scholar
  33. Ferreira JFS, Laughlin JC, Delabays N, de Magalhaes PM (2005) Cultivation and genetics of Artemisia annua L. for increased production of the antimalarial artemisinin. Plant Genetic Resour 3:206–229CrossRefGoogle Scholar
  34. Ferreira JFS, Simon JE, Janick J (1995) Developmental studies of Artemisia annua: flowering and artemisinin production under greenhouse and field conditions. Planta Med 61:167–170PubMedCrossRefGoogle Scholar
  35. Ferreira JFS, Simon JE, Janick J (1997) Artemisia annua: botany, horticulture, pharmacology. In: Janick J (ed) Horticultural reviews, vol 19. Wiley, Hoboken, pp 319–371Google Scholar
  36. Firestone GL, Sundar SN (2009) Anticancer activities of artemisinin and its bioactive derivatives. Expert Rev Mol Med 11:32CrossRefGoogle Scholar
  37. Hamoudi and Sachs (1999) The changing global distribution of malaria: a review. Unpublished manuscript. Working Papers, Centre for International Development at Harvard University, Cambridge, Massachusetts, pp 1–31Google Scholar
  38. Hein TT, White NJ (1993) Qinghaosu. The Lancet 341:603–608CrossRefGoogle Scholar
  39. Hemskerk W, Schallig H, Pieter B (2006) The World of Artemisia in 44 questions. Royal Tropical Institute. The Netherlands PDF-EditionGoogle Scholar
  40. Hirt HM (2001) Document: Artemisia annua Anamed; a plant with anti-malarial properties. Anamed, WinnendenGoogle Scholar
  41. Hirt HM, Lindsey K (2000) Natural medicine in the tropics: experiences. Anamed, Winnenden, Germany. See also
  42. Hsu E (2006) Reflections on the ‘discovery’ of the antimalarial quinhao. British J Clinic Pharmacol 61:66–670Google Scholar
  43. James S, Miller L (2001) Malaria vaccine development: status report, NIAID, 9–13Google Scholar
  44. Jiang JB, Guo XB, Li GQ, Kong YC, Arnold K (1982) Antimalarial activity of mefloquine and qinghaosu. The Lancet 320:285–288CrossRefGoogle Scholar
  45. Juteau F, Masotti V, Bessire JM, Dherbomez M, Viano J (2002) Antibacterial and antioxidant activities of Artemisia annua essential oil. Fitoter 73:532–535CrossRefGoogle Scholar
  46. Karbwang J, Na-Bangchang IK, Thanavibul A, Bunnag D, Chongsuphajaisiddhi T et al (1994) Comparison of oral artesunate and quinine plus tetracycline in acute uncomplicated falciparum malaria. Bull World Health Organ 72:233–238PubMedGoogle Scholar
  47. Klayman DL (1985) Qinghaosu (artemisimin): an antimalarial drug from China. Science 228:1049–1055PubMedCrossRefGoogle Scholar
  48. Klayman DL, Lin AJ, Acton N, Scovill JP, Hoch JM et al (1984) Isolation of artemisinin (qinghaosu) from Artemisia annua growing in the United States. J Nat Prod 47:715–717PubMedCrossRefGoogle Scholar
  49. Martens P (1999) How will climate change affect human health. American Scientist; Research Triangle Park, (Nov/Dec 1999)Google Scholar
  50. Martens P, Hall L (2000) Malaria on the move: human population movement and malaria transmission. Emerg Infect Dis 6:103–109PubMedCrossRefGoogle Scholar
  51. Meshnick SR (2002) Artemisinin: mechanisms of action, resistance and toxicity. Int J Parasitol 32:1655–1660PubMedCrossRefGoogle Scholar
  52. MMV (2012) Coartem dispersible is now being distributed to 39 countries, MMV, Geneva, Press release, Feb 22Google Scholar
  53. Mueller MS, Karhagomba IB, Hirt HM, Wernakor E, Li SM et al (2000) The potential of Artemisia annua L. as a locally produced remedy for malaria in the Tropics: agricultural, chemical and clinical aspects. J Ethnopharmacol 73:487–493PubMedCrossRefGoogle Scholar
  54. NVBDCP Report (2011) Available at Accessed 15th October 2012
  55. PATH (2011) Staying the course? Malaria research and development in a time of economic uncertainty. PATH, Seattle WA, p 98Google Scholar
  56. Peters W (1987) Chemotherapy and drug resistance in malaria, vols. 1 and 2, 2nd edn. Academic Press, London, pp 670–682Google Scholar
  57. Rathore D, McCutchan TF, Sullivan M, Kumar S (2005) Antimalarial drugs: current status and new developments. Expert Opin Investig Drugs 14:871–883PubMedCrossRefGoogle Scholar
  58. Ridley RG (2002) Medical need, scientific opportunity and the drive for antimalarial drugs. Nature 415:686–693PubMedCrossRefGoogle Scholar
  59. Ro DK, Paradise EM, Ouellet M, Fisher KJ, Newman KL et al (2006) Production of the antimalarial drug precursor artemisinic acid in engineered yeast. Nature 440:940–943PubMedCrossRefGoogle Scholar
  60. Sanella ER, Messori L, Casinin A, Vincieri FF, Maiori G et al (2007) Modulation of the in vitro antimalarial effects of artemisinin by selected flavonoids and by reducing agents. Planta Med Abstr 73:865–P135Google Scholar
  61. Schmid G, Hofheinz W (1983) Total synthesis of Qinghaosu. J Am Chem Soc 105:624–625CrossRefGoogle Scholar
  62. Shetty P (2004) Global fund switches to artemisinin. Lancet Infect Dis 4:477PubMedCrossRefGoogle Scholar
  63. Shetty P (2005) Malaria parasite could develop resistance to key drug. Sci Dev Net, June 6, News (
  64. Singh B, Kim Sung L, Matusop A, Radhakrishnan A, Shamsul SS et al (2004) A large focus of naturally acquired Plasmodium knowlesi infections in human beings. Lancet 363:1017–1024PubMedCrossRefGoogle Scholar
  65. Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI (2005) The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434:214–217PubMedCrossRefGoogle Scholar
  66. Weathers PJ, Arsenault PR, Covello PS, McMickle A, Teoh KH et al (2011) Artemisinin production in Artemisia annua: studies in planta and results of a novel delivery method for treating malaria and other neglected diseases. Phytochem Rev 10:173–183PubMedCrossRefGoogle Scholar
  67. White NJ et al (1999) Avoiding a malaria disaster, The Lancet, 353:1965–1967 June 5Google Scholar
  68. White NJ (2008) Qinghaosu (Artemininin): the price of success. Science 320:330–334PubMedCrossRefGoogle Scholar
  69. WHO (1983) Development of mefloquine as an antimalarial drug, Bull. World Health Org 61(2):169–178. Based on the report of the Section Meeting of the Scientific Working Group on the Chemotherapy of Malaria held on 28–30 May 1981Google Scholar
  70. WHO (1998) The use of artemisinin and its derivatives as anti-malarial drugs (Report of a Joint CTD/DMP/TDR Informal Consultation, Geneva, June), World Health Org., Division of Tropical Diseases, Malaria Unit, Geneva, p 24Google Scholar
  71. WHO (2001) The use of antimalarial drugs; report of an informal consultation, 13-17 November 2000, World Health Organisation, Geneva, 3, 17, 19, 69–80 (WHO/CDS/RBM/2001.33)Google Scholar
  72. WHO (2010) World malaria report. World Health Organization, GenevaGoogle Scholar
  73. WHO (2012) World Malaria Report. Geneva, 17 December, 2012Google Scholar
  74. Wilcox M, Bodeker G, Bourdy G, Dhingra V, Falquet J et al (2004a) Artemisia annua as a traditional herbal antimalarial. In: Wilcox ML, Bodeker G, Rasoanaivo P (eds) Traditional medicinal plants and malaria, vol 4. CRC Press, Boca Raton, pp 43–59Google Scholar
  75. Willcox M, Bodeker G, Rasoanaivo P, Addae-Kyereme J (2004b) Traditional medicinal plants and malaria. CRC Press, Boca Raton 464Google Scholar
  76. World Health Organisation (2006) Bulletin: Monograph on good agricultural and collection practice for Artemisia annua WHO library GenevaGoogle Scholar
  77. Woster PM (2003) New therapies for malaria. Ann Reports Med Chem 38:203–211CrossRefGoogle Scholar
  78. Xie DY, Zou ZR, Ye HC, Li GF, Guo ZC (2001) Selection of hairy root clones of Artemisia annua L. for artemisinin production. Israel J Plant Sci 49:129–134CrossRefGoogle Scholar
  79. Xu X, Zhu J, Huang D, Zhou W (1986) Total synthesis of arteannuin and deoxyarteannuin. Tetrahedron 42:819–828CrossRefGoogle Scholar
  80. De Yao W, Qi-Zhong Z, Jie-Sheng W (1992) Studies on the antimalarial action of gelatin capsule of Artemisia annua. Chung Kuo Chi Sheng Chung Hsueh Yu Chi Sheng Chung Ping Tsa Chih 10:290–294Google Scholar
  81. Yeung Him-Che (1985) Handbook of Chinese herbs and formulas, 2nd edn. Redwing Book Co., Institute of Chinese Medicine, Los AngelesGoogle Scholar
  82. Zamiska, N, McKay B (2007) Global health, China’s price in malaria clash. Wall Street J A1, A14Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • M. Naeem
    • 1
    Email author
  • Mohd Idrees
    • 1
  • Minu Singh
    • 1
  • M. Masroor A. Khan
    • 1
  • Moinuddin
    • 1
  1. 1.Plant Physiology Section, Department of BotanyAligarh Muslim UniversityAligarhIndia

Personalised recommendations