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The World’s Largest Pharmacy: How the Rainforest Gave Rise to Modern Medicine

Inspired by Isle of Jasmine, this month’s Ignite story explores “the world’s largest pharmacy”: the rainforest. How has the natural bounty of the world advanced medical science, and how can we continue to benefit from this ecosystem in a sustainable way?

In 2019, the United States saw its worst measles outbreak in decades when 72 people in Clark County, Washington, came down with the disease.1 While the deadly illness had been virtually eradicated in the U.S. by 2000, declining vaccination rates in some communities have spurred a chilling resurgence.2

A number of motivations drive the modern anti-vaccination movement, including the belief that vaccines represent some kind of “unnatural” intervention in the human body. The anti-vaxxers, as they’re often called, aren’t the only people who see an opposition between modern medical science and the natural world. Alternative medicine has exploded in popularity in recent times, with many flocking to it in search of more “natural” means of treating illness. 3

But the binary between modern medicine and nature is a false one. Medical science — and the drugs and treatments it yields — is grounded in the natural world itself.


Hecogenin, a compound derived from the leaves of the sisal plant, is often used in the production of cortisone; Source: Wikipedia


Consider penicillin, one of the most powerful advances in the history of medicine. It was discovered almost wholly by accident in 1928 when Dr. Alexander Fleming returned to his office after a vacation. He found that some Petri dishes of Staphylococcus aureus, a pathogen that can cause a range of maladies from skin infections to meningitis, had been contaminated by the Penicillium notatum mold. Upon further examination, Dr. Fleming realized the penicillin was prohibiting the growth of the staphylococcus.4

This game-changing antibiotic wasn’t invented out of thin air in a sterile lab — it was a gift from nature itself, and far from the only one nature ever bestowed on medical science. Indeed, nature’s bounteous pharmacopeia is no more evident than in the rainforest, called “the world’s largest pharmacy” by some.

“This game-changing antibiotic wasn’t invented out of thin air in a sterile lab — it was a gift from nature itself.”


The natural diversity of the rainforest is unmatched by any other ecosystem; Source: Unsplash


Pit Viper Venom Saves Lives



Despite only accounting for about 6 percent of the world’s landmass, rainforests contain half of all terrestrial plant and animal species. It is this extraordinary biodiversity that makes the rainforest such a rich source of medicinal material. Partly, it’s a matter of statistics: With so many species concentrated in one place, you’re bound to find a lot of interesting things. But it’s also a matter of environmental pressure: To thrive in such a densely populated space, plants and animals must develop all kinds of novel defense mechanisms. Those defense mechanisms can also help us defend ourselves against illness.5

An estimated quarter of all medical drugs in use today come from wildlife found in the rainforests of the world.6 Take quinine, the first effective treatment for malaria. Long before the U.S. Army used quinine in World War II7, the Quechua people of Peru used the powdered bark of tropical cinchona trees to treat fevers. The remedy worked because that bark contains quinine.8


“An estimated quarter of all medical drugs in use today come from wildlife found in the rainforests of the world.”

In the 1600s, Jesuit missionaries to Peru took notice of how effective the Quechua people’s powdered bark seemed to be, and they sent samples back to Rome. There, doctors confirmed its powerful medicinal properties — and discovered it could be used to treat malaria.9 It was only in 1820 that French pharmacologists figured out how to isolate quinine and produce it in factories rather than using the bark.10

Then there’s captopril, an early but important type of heart medication. While not widely used today, its development in 1976 was a major breakthrough in the treatment of hypertension and heart failure — and it was all thanks to the rainforest-dwelling Brazilian pit viper.11


Studies of the Brazilian viper’s venom led directly to the development of the first orally active ACE-inhibitor; NatGeo


Victims of the viper’s bite were known to suffer rapid declines in blood pressure. While working as a researcher at the Ribeirão Preto Medical School in São Paulo, Brazilian physician Sérgio Henrique Ferreira discovered the compound in the snake’s venom responsible for lowering blood pressure. The work of Dr. Ferreira and his colleagues eventually led to the creation of a compound modelled after the snake’s venom, which could safely lower blood pressure in people with hypertension.12

Finally, there’s Madagascar periwinkle, a gorgeous pink flower that has been a key factor in developing treatments for acute lymphocytic leukemia, as well as testicular, ovarian, breast, bladder, and lung cancers.13 The Malagasy people of Madagascar long used a tea made of periwinkle to treat diabetes. When scientists at the University of Ontario were studying the periwinkle’s efficacy in lowering blood sugar in the 1950s, they discovered something surprising: It lowered white blood cell counts in mice.14


Madagascar periwinkle is the source of two of the most effective cancer treatments ever discovered; Source: Wikipedia


That’s because the periwinkle’s leaves produce vinblastine and vincristine, organic compounds that inhibit cell division. These compounds are such powerful cancer treatments that the World Health Organization lists them as “essential medicines” that should be available in every health system.15


The Natural World Gives — But Are We Giving Back?



For all the good the rainforest has offered modern medicine, the modern world hasn’t treated the rainforest as kindly in return. The Amazon — the largest rainforest in the world — has already lost 17 percent of its original mass, thanks to climate change, development, logging, and cattle farming. If deforestation continues at current rates, 27 percent of the Amazon will be gone by 2030. Experts worry the process could move even faster: Since Brazilian President Jair Bolsonaro took office in 2019, Amazonian deforestation rates have skyrocketed by as much as 92 percent.16

The modern world has also been unkind to the Indigenous people whose knowledge directly contributes to modern medicine’s adoption of new drugs and treatments. Medical science is rife with biopiracy, the act of privatizing biological resources without sharing any of the gains with the communities in which those resources originated. Captopril — the heart medicine based on pit viper venom — is often pointed to as a clear case of biopiracy: The development of the drug was sparked in part by the Indigenous practice of applying viper venom to arrowheads, but Indigenous groups were never compensated.17

“The modern world has also been unkind to the Indigenous people whose knowledge directly contributes to modern medicine’s adoption of new drugs and treatments.”

An ayahuasca brew in the early stages of preparation; Source: Wikipedia


The case of ayahuasca offers a particularly stark example of how the rush to capitalize on the rainforest can do serious environmental and cultural harm. Long considered sacred among 75 different Indigenous communities in the Amazon basin, ayahuasca is derived from mixing two tropical plants, the Banisteriopsis caapi vine and Psychotria viridis leaves.18

Ongoing research into ayahuasca has found that it may make for a potent antidepressant and antianxiety medicine, as well as an effective anti-inflammatory drug.19 Alarmingly, some Westerners have taken up ayahuasca as a cure-all of sorts, touting its mind-opening benefits and paying thousands of dollars to attend ayahuasca retreats — often run by other Westerners.20


“The Indigenous people who use ayahuasca as a sacred substance are having a harder and harder time accessing it, while Western tourists who can afford it are buying all the ayahuasca for themselves.”


As a result of its en vogue status, ayahuasca supplies are threatened. The banisteriopsis vine is at risk of eradication in parts of Peru, and the price of the ayahuasca beverage itself has tripled to $250 per liter. The Indigenous people who use ayahuasca as a sacred substance are having a harder and harder time accessing it, while Western tourists who can afford it are buying all the ayahuasca for themselves.21


The Banisteriopsis caapi vine, one of the key ingredients in ayahuasca; Source: Flickr


The Best of Both the Medical and Natural Worlds


If modern medicine is to continue benefiting from the gifts of the rainforest, we have to find ways to use those gifts in environmentally sustainable and culturally appropriate ways.

That means letting Indigenous peoples take the lead and retain ownership over their biological resources and discoveries. As Lurino Pequeno de Souza, a member of the Katukina tribe, told Vice: "We cannot say ayahuasca is ours, because we don't have a patent. But we want to commercialize it on our terms. We want people to come to our land and do it properly.”22

We should also seek to holistically marry the methods of modern medicine with the gifts of nature. Rather than extracting medicine from nature, we could use nature as an inspiration in the development of medicine. While captopril’s biopiratical legacy is not an example to follow, its method of production may be. Captopril doesn’t require live pit vipers; the chemical is based on the structure of the viper’s venom, but it is synthesized in a lab.

Birds-of-paradise, found only in rainforests of Papua New Guinea and East Australia. As one of the most diverse biomes on the planet, the rainforest deserves our protection — not only for its medicinal value, but for its inherent worth as a part of the global ecosystem; Source: Just Birding

Similarly, scientists are researching ways to produce vinblastine without using so much Madagascar periwinkle. It currently takes approximately 500 kilograms of dried leaves to produce a single gram of vinblastine. Recently, a team of researchers led by Sarah O'Connor at the John Innes Centre identified the specific genes responsible for the plant’s vinblastine production. This breakthrough could allow scientists to yield higher amounts of vinblastine from fewer plants, preserving more resources in the process.23

This holistic approach of modern medicine and the natural world working in tandem offers a stirring vision of the future — not just of medicine, but of society itself. We can use scientific advancement to both benefit Indigenous communities and create new medicines, all while enhancing the natural world, rather than destroying it.

— The Keap Team



The Ignite Series

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