The emergence of multi-drug resistant strains of malaria which has accompanied each new class of antimalarial drugs, may be viewed as one of most significant threats to the health of people in tropical countries. While there is widespread agreement that a fresh approach to the prevention and treatment of malaria is urgently needed, solutions have tended to focus on the development of new classes of drugs. More recently, there has been an emphasis on promoting combination therapy of existing drugs as a means of preventing resistance.
Historically, however, local communities in tropical regions have used local flora as a means of preventing and treating malaria (Kirby, 1997). It can be argued that these traditional medicines, based on the use of whole plants with multiple ingredients or of complex mixtures of plant materials, constitute combination therapies that may well combat the development of resistance to antimalarial therapy.
Cost burden of malaria.
It is estimated that the global prevalence of malaria infection is 300 - 500 million cases annually. Sub-Saharan Africa alone accounts for 90% of cases (Butler, 1997).
The poorest countries thus bear the greatest burden of morbidity and mortality from this disease. Malaria accounts for 30-35% of persons seeking health care at rural dispensaries (Kengeya-Kayondo et al., 1994), and 20-50% of all admissions in African health services (Brinkmann & Brinkmann, 1991).
The human and financial cost burden falls heavily on rural communities and the poorest members of these. In malarious areas, where adults experience 1-2 attacks per year, and children 1-7 attacks (Brinkmann & Brinkmann, 1991), people with uncomplicated malaria are incapacitated for an average of 3.5 days (5 days in children). This in turn takes up the time of other family members who must look after them, resulting in further loss of household income. In Sri Lanka, it has been found that the average loss of earnings was over 16 wage days per year.
