Artemisia annua and traditional medicine in Madagascar: Its history and challenges

Artemisia annua, known for its malarial properties, has been central to Madagascar's agricultural economy and traditional healing cultures for centuries. As demand for artemisinin-based treatments for malaria has continued to grow globally, Madagascar has emerged as a key supplier of Artemisia annua for global pharmaceutical markets, reinforcing the plant’s national significance. This paper explores the growth and evolution of Artemisia annua cultivation in the country, focusing especially on the recent introduction of synthetic artemisinin and the subsequent cultural, economic, and environmental impacts. It examines the challenges faced by Malagasy farmers and local healers with particular focus on issues such as artemisinin resistance, commercial exploitation, and the growing tension between traditional knowledge and modern biotechnology. Ultimately, this paper explores the complexities of balancing economic development, cultural preservation, and global health needs, offering insight into the broader implications for sustainable pharmaceutical sourcing and the future of traditional medicine in an increasingly globalized world.