On April 20, the president calls a press conference to announce a breakthrough in the fight against COVID-19. It’s a new use for an old malaria treatment, he says, one that is seeing miraculous results among the country’s most ill patients. It’s so safe that even schoolchildren could take it. In fact, he urges them to do so daily, as a preventative. He admits that he, too, is taking the medicine.

No, this is not the President of the United States touting an unproven remedy for a virus that has infected nearly 5 million people worldwide. It is Madagascar’s President Andry Rajoelina, who is just as willing to use the presidential platform to promote a hypothetical treatment as is his American counterpart. To prove the safety of his new discovery, he picks up a bottle placed prominently on the podium and takes a swig of the amber liquid. “This herbal tea gives results in seven days,” he avows. “Tests have been carried out—two people have now been cured by this treatment.”

Aides pass bottles of the herbal remedy, labelled “Covid-Organics,” to the assembled diplomats, ministers and journalists. They sip appreciatively, then break into applause as the president of this island nation announces that the first African cure for coronavirus, based on traditional African medicine, will be distributed countrywide, and, eventually across the continent.

According to the World Health Organization, there are no medicines that have been shown to prevent or cure COVID-19. That hasn’t stopped people—some of them presidents—from grasping at any potential treatment that might provide a way out of the devastating lockdowns that are collapsing national economies, or stave off the threat of mounting death tolls.

Back in Madagascar, the international uproar was met with bafflement. The use of traditional remedies there is so deeply ingrained that most Malagasies, as they call themselves, would just as likely reach for an herbal cure to treat a headache or a stomach-ache as they would a western pharmaceutical product, says Tiana Andriamanana, the executive director of local conservation NGO Fanamby. Andriamanana’s work often takes her to poor and rural areas where hospitals and pharmacies are hard to find, and conventional medicine is often unaffordable. “A lot of times there isn’t really a choice,” she says. “Traditional medicine is how we roll.” Nor are Malagasies alone in their reliance on traditional medicine: according to the WHO, 87% of African populations use it.

And the establishment that developed CVO, the Malagasy Institute of Applied Research [IMRA], is well-respected in the country for its work refining those remedies: some of that research has led to the discovery of internationally recognized pharmaceutical treatments such as Madeglucyl, which can help with diabetes management. It also helped identify the Madagascar periwinkle’s potential in cancer treatment; compounds isolated from the flower are now being used in treatments for breast, bladder and lung cancers.

When news first emerged in January of a mysterious influenza-like disease in China that didn’t respond to conventional treatment, IMRA’s director general, Dr. Charles Andrianjara, got to work. Since its founding in 1957, the institute’s researchers have catalogued thousands of medicinal herbs used by Madagascar’s traditional healers. Andrianjara wondered if some of the institute’s herbal knowledge might help fight the emerging viral illness. “Our hypothesis was that if we could treat the cough, the respiratory difficulties, the aches, the fever, then we could treat the virus.” He combed the database, seeking herbs with antioxidant and anti-inflammatory properties, as well as natural cough suppressants and fever reducers.

The institute had also been studying artemisia annua, or sweet wormwood, a common anti-malarial that had shown promising signs in the treatment of severe acute respiratory syndrome (SARS), another respiratory disease caused by a coronavirus, which emerged from China in 2002. “COVID and SARS are very similar in terms of their genetic structure,” says Andrianjara, “so our hypothesis was that artemisia might have an effect on COVID-19.”

Such low numbers are meaningless when it comes to a disease that is still so poorly understood and whose effects can range from asymptomatic to massive organ failure, but Andrianjara argues that the remedies themselves can do no harm. “They have been thoroughly tested for toxicity, and they have been on the market for 30 years, so we already know their efficacy.” He likens CVO to common Western treatments like painkillers, which some studies show do not work on everyone. “You can give 20 people paracetamol. It won’t harm any of them, but it won’t cure all of their headaches either. If CVO can cure 60% of the population, to me that’s good. It’s not the best, but it’s good.”

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