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Demand for anti-malaria drugs to fight Covid-19 set to revive cinchona cultivation in Darjeeling

SAM SPECIAL-ENG-01-04-2020-1

As the world races to find treatments for the novel coronavirus, there is talk of using two anti-malaria drugs, chloroquine and hydroxylcholoquine. Both are synthetic derivatives of quinine, which in 1820, French chemists isolated from the bark of the cinchona tree found in South America, where Peruvian tribes were using it to cure fever. 

Quinie, which had lost the pride of place as the foremost drug in the treatment of infectious diseases, is now back in demand with a bang.

Renewed demand for the “wonder drug” has galvanized the handful of cinchona plantations that exist in the picturesque hills of Darjeeling and Kalimpong districts of West Bengal in India.

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Over the last week, the four state-run cinchona plantations have been receiving bulk orders for cinchona bark, says Dr Samuel Rai, Director of Cinchona Plantations at the Directorate of Cinchona and other Medicinal Plants in Kalimpong district.

“There has been a renewed interest and demand for the cinchona bark, from which organic quinine sulfate is extracted, from a number of individual buyers as well as a herbal medicine makers in India after the 21-day nation-wide lockdown was declared on March 25,” Rai told South Asian Monitor over phone from Mungpoo.

The first cinchona plantation was established by a British botanist and the then Superintendent of the Royal Botanical Gardens in Calcutta, Dr. Tomas Anderson, in 1862 at Mungpoo. The chinchona plantations had became the economic backbone of the Darjeeling hills in the latter part of the 19th.Century, Rai said. Quinine, was referred to as the "Jesuits' bark," "cardinal's bark," or "sacred bark,” may well make a comeback as a “miracle drug”, he added.

There are now four government-run plantations spread over the rolling hills at an altitude of 2,000 to 4000 ft. They are spread over 7000 acres in Darjeeling and Kalimpong districts and employ over 6000 workers. 

Though owned by the government of West Bengal, they are presently administered by the Gorkhaland Territorial Administration (GTA), an autonomous district council for the Darjeeling and Kalimpong districts. 

The renewed curiosity and demand for anti-malarial drugs in the fight against the Covid-19 pathogen, will help in reviving the centuries-old organic cinchona industry, only one of its kind in India, Rai said.

Both cinchona growers and drug makers acknowledge the huge shortage of organic quinine across the world.

“We are the only producers of natural cinchona alkaloid in India and there is a huge demand for the quinine, the cinchona alkaloid—the main alkaloid used in anti-malarial drugs. This is a game changer,” Rai said.

A senior official at the Kolkata-headquartered Bengal Chemicals & Pharmaceutical Ltd, the country’s oldest drug manufacturer, said: “Since no literature from either the Indian Council of Medical Research or the World Health Organization is there about the benefits of the anti-malarial drugs that Bengal Chemicals manufactures, we are not in the picture right now.”

WHO had given the green signal to hydroxycholoquine better known as HCQ, the official told SAM. But Bengal Chemicals manufactures only two anti-malarial drugs, chloroquine phosphate and quinine sulphate, not HCQ, the official said.

Rai, on the other hand, is positive that once the 21-day nation-wide lockdown is lifted or relaxed, his plantations will be able to sell more than 880 metric tons of cinchona bark.

“Quinine as a drug has a long track record in medicine, having been used since the 1940s as an anti-malarial. We are optimistic about the revival of the cinchona industry as modern anti-malarial drugs are synthetic,” Rai said.

An agricultural scientist, Rai said that he would like to see the once thriving quinine factory at Mungpoo reopen. The factory was closed in 2001, following a decline in the global and domestic demand for organic quinine. The Mungpoo quinine factory, set up in 1960, used to be the only quinine sulphate manufacturing unit in the country. It even made anti-malaria quinine tablets, Rai recalled.

“The natural extract from an alkaloid from the bark of the cinchona tree, is a potent drug to treat malaria. The plant was taken as an herbal remedy by indigenous Peruvians four centuries back to treat fever,” Rai said.

There are some early indications it could work against SARS-CoV-2—or the Covid-19 pathogen— according to the US Centre of Disease Control and Prevention, and as doctors and hospitals are turning to decades-old anti-malarial drugs to treat patients infected with the new coronavirus. 

“There is a huge shortage of synthetic quinine the world over,” adds the Bengal Chemicals’ official added. However, he declined to comment on why the federal government owned drug manufacturer does not procure the natural cinchona alkaloid from the Bengal government-owned cinchona plantations, which has an abundance of stock of the natural quinine.

‘We are a government of India enterprise, and follow the Union ministry of Health guidelines.” the official said.

Quinine remained the mainstay of malaria treatment until the 1930s, when more effective synthetic anti-malaria became available. The most important of these drugs was chloroquine, which was extensively used since the 1940s.

But since 2006, the drug had not been recommended for use in severe malaria because of problems with resistance, particularly in the Oceania region, according to WHO. However WHO includes quinine on its list of "essential medicines," meaning it should be kept affordable and accessible at all times.

According to Rai, another factor that has hampered the industry, is the high transport cost of the bulky cinchona bark from our god owns in the remote hills,. Drug manufacturers prefer to buy cinchona from traders rather than transport it from the plantations themselves.

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“Though there are a number of smaller buyers, our product is mainly purchased by a bulk buyer based in Siliguri, the Mahakal Exporters, who lift nearly the entire produce and sell it to a Baroda-based dealer—Prism Industries,” Rai said. The cinchona is not directly sold to drug manufacturers.

“Over the last week since quinine has become a point of conversation, we have received orders from two new buyers, a Madhya Pradesh-based pharmaceutical firm and another from an herbal product manufacturer from Kanpur in Uttar Pradesh.”

“We will meet the orders once the lockdown is relaxed or lifted as the work in the plantations have been stopped in view of the lockdown,” Raisaid. The plantation also sells cinchona bark through e-auctions.

“But, there is one condition, a customer has to buy at least 200 kg of cinchona in the auctions. Retail buyers can purchase lesser amounts but they have to pay the auction price along with GST,” he stressed.