The Fever Tree (3)
Improvements in the understanding of how to cultivate cinchona trees and the introduction of Ledgeriana cinchona, whose seeds and cuttings the Dutch East Indian Government were prepared to supply free of charge meant that it now became a viable proposition for private enterprises. This, however, coupled with the discovery of the Remija species in North Africa meant that by the 1890s production was exceeding demand.
There were wide variations in prices and with the Java planters concentrating on lowering the cost of production, many private plantations abandoned the cinchona, uprooting their plantations, in favour of tea, which was easier to grow and offered more certain profits. In 1913 an agreement was drawn up between the cinchona producers of Java and the quinine manufacturers in Java, the Netherlands, Britain, and Germany to put an end to the “great variation in price which jeopardised the security of the bark producers.”
By then Java controlled 97% of the world’s total production with British India supplying 2.5% and other parts of the world just 0.5%. Moreover, British India made no effort to supply to the rest of the Empire, the consequences of which were that, according to an article in Nature in 1929, “the direct loss sustained by the British Empire due to sickness and death caused by malaria is in the neighbourhood of £52 and £62 million per annum”.
Worse still, while the production of quinine “took into account the law of supply and demand” “millions of sufferers are [and continue to be] so poor that they would be unable to purchase quinine at even the approximate cost of production, a situation which led calls in 1931 for the League of Nations to take action on.
During the early part of the 20th century quinine was losing its preferred status amongst medical practitioners because of its unpleasant side effects, prompting efforts to produce synthetic antimalarials such as Atrabine and Chloroquine, the need for which was exacerbated by the outbreak of the Second World War. The major quinine producer, Java, fell to the Japanese and the majority of European quinine reserves, stored in Amsterdam, were taken over by the Nazis.
While synthetic antimalarials have improved by leaps and bounds, the World Health Organisation reported that in 2006 over 247 million people were affected by malaria, of whom almost a million died and recommended that “all countries facing shortages increase procurement of their second-line antimalarial treatment, which is generally quinine”.
For all our advances, it seems we are still reliant upon the medicinal properties of the bark of the cinchona tree to ward off malaria.
