Journal of Ethnopharmacology, 32 ( 199 1) 235-239 235

Elsevier Scientific Publishers Ireland Ltd.

Sociopolitical, economical and ethical issues in medicinal plant

research

E. Elisabetsky
Laboratbrio de Etnofarmacologia, Universidade Federal do Par& 66.000, Belem, Para (Brazil)

Medicinal plant research may be pursued with several goals: the understanding of a native medical system, the elucidation of the
rational basis for the medicinal use of a certain plant species, the development of low cost phytotherapcutics, the discovery of pro-
totypic drugs, and so on. More often than not, the research project starts with the collection of indigenous medical knowledge in
various parts of the world and generates a dissertation, a scientific paper or a drug. Usually, indigenous knowledge was crucial to
the development of such products; nevertheless, indigenous groups tend not to benefit from the achievements of research. Ethnophar-
macology involves a series of sociopolitical, economic and ethical dilemmas, at various levels. Most research projects involve more
than one country (e.g., field work in a remote part of an underdeveloped country). Frequently host country scientists. visiting scien-
tists, and informants disagree about these dilemmas. As a result, such research efforts are perceived as scientific imperialism: scientists
are accused of stealing plant materials and appropriating traditional plant knowledge for financial profit and/or professional advance-
ment. Many governments, as well as indigenous societies are increasingly reluctant to permit such research. Increasingly, funding for
field work utilizing indigenous informants is coming from industry. Historically, neither native populations nor host countries have
shared to a significant extent the financial benefits from any drug that reaches the market. Unless these issues are amply discussed
and fairly resolved, medicinal plant research runs the risk of serving ethically questionable purposes.

Introduction Most of the pharmacological or chemical studies

reported in the several journals relevant to the field
Medicinal plant research has been and continues start by quoting the traditional use of a given plant
to be considered as a fruitful approach for the search species promising enough to stimulate further
of new drugs (Svendsen and Scheffer, 1982; Balan- research. It is therefore reasonable to assume that
drim et al., 1985; Samuelson, 1989). The highly indigenous knowledge did play an important role
respected magazine Science calls attention in its in medicinal plant research and will continue to do
editorial of February 1990 to the potential of so, either in terms of plant selection for laboratory
medicinal plants in the search of new drugs scrutiny or as clues regarding the expected phar-
(Abelson, 1990) and expresses concern about the macological activity of a given species. Consider-
consequences that loss of biodiversity might have ing the results to date of medicinal plant research,
in this context. Since most of the chemically the most popular strategy evidently still involves
unknown flora and associated medicinal lore exist laboratory work carried out in developed countries
in Third World countries, especially those which still (where most chemical and pharmacological studies
possess extensive tropical forests, the rapid loss of are done) with field work in Third World countries,
biodiversity does indeed becomes an issue for the involving assistance of its native inhabitants (where
future of medicinal plant research. traditional use and the plant material itself are col-
lected). Nevertheless, it has become increasingly fre-
Presented at the First International Congress on Ethnophar- quent to encounter resistance to cooperation from
macology, Strasbourg, 5-9 June, 1990.
countries or indigenous groups where the knowledge
Correspondence to: E. Elisabetsky, Laboratorio de Etnofar-
macologia, Universidade Federal do Para, 66.000. Belim. Par& and use of the medicinal flora are still vigorous. Visa
Brazil. denials or diverse problems in transporting

0378-8741/$03.50 0 1991 Elsevier Scientific Publishers Ireland Ltd.

Published and Printed in Ireland
236
botanical material are frequent. The purpose of this
paper is to discuss some of the issues that can be
given as the cause of this resistance for cooperation.
Situating the problem
In his essay on the ethics of ethnopharmacology,
Boom (1990) divides the ethical issues relevant to
this field into two domains: (a) the relationship bet-
ween researchers and host countries (and/or
organizations, instjtutions, colleagues and infor-
mants) and (b) the relationship between researchers
and commercial concerns.
As for the first domain he highlights the need for
appropriate interaction between visiting scholars
and local colleagues, which should include setting
time aside for clarifying research goals (e.g., by
presenting seminars), keep in touch with ap-
propriate officials (to prevent accusations of steal-
ing resources), sharing relevant literature (since
no~ally local scientists lack easy access to the most
recent literature), including colleagues and students
in the research (as a means of improving training)
and finally giving feedback of research results (by
au~enting local herbaria and local inventories~.
These steps, he argues, should help soften the fre-
quent resentment felt toward visiting scientists. This
resentment, although sometimes aggravated by in-
dividual behaviour, is felt regardless of the inten-
tions or the behaviour of particular visiting
scientists, but rather derives from the fact that they
are often better trained and supported by more am-
ple funding than their local counterparts. Boom
( 1990) also points out that in this domain the rela-
tionship with informants cannot be treated as
“ f . . plot of forest to be inventoried or a pollina-
tion event to be observed and photographed”. If a
position of trust is important to acquire informa-
tion about traditional uses of medicinal plants ac-
cumulated in that culture over generations, it is only
fair to expect that this trust is extended after
research results are collected, especially if results
should eventually present commercial value.
The second domain is concerned with the role
that, willing or not, an ethnopharmacologist might
play in making available data that can be used to
develop products of signi~cant commercial value.
As he points out, since academic-corporate interac-
tions have become an important part of research
funding, research results achieved in academia no
longer merit the mantle of academic freedom.
The following sections describe the context one
finds in developing countries related to the problems
broached by Boom (1990).
Natural products, economics and health care
Although largely ignored by the general public
and, surprisingly, by the majority of medical and
paramedical professionals, as much as 25% of
prescriptions in the U.S.A. contain natural products
extracted from plants (Famsworth and Morris,
1976).
Principe (1989) added to this figure the plant-
based medicines sold over the counter, exclusively
in hospitals, and the rapidly growing market of her-
bal medicines, estimating the market of plant-based
drugs to have been on the order of US$l 1 billion
in 1985 in the U.S.A. alone and about US$43 billion
for countries of the Organization for Economic
Cooperation and Development (amongst which 70%
of the world prescription drug market is consumed).
If the plant-based market value is by itself rather
impressive, the contribution of natural products to
the world is more difficult to quantify: in Brazil for
instance, 60% of all processed drugs are consumed
by 23% of the population (Gerez and Pedrosa,
1987), leaving the majority of the Brazilian people
with the option of plant-based homemade medicine
as the principal source of medicines. Unfortunate-
ly, this picture is not only seen in Brazil. The World
Health Organization (1978) estimates that as much
as 80% of the world’s population (Asia, Africa and
Latin America) rely on plants used as medicines
directly from nature as the main source of health
related products. We can therefore say that although
indigenous groups of developing countries receiv-
ed from the modern world modern diseases, they
do not share to a significant extent in the benefits
of the modern pharmacopoeia.
In discussing the significance of the flora as a
source of medicines, the substitution of drug imports
by underdeveloped countries must be included. In
Brazil 84% of all drugs are imported, and 78% of
the drugs processed locally are processed by
multinational companies (de Mello, 1987); the pic-

ture is the same or worse for all Latin American
countries. The reduction of drug imports by detec-
ting native species that could be cultivated and local-
ly processed as local sources of medicinal
compounds would not only be a critical step in mak-
ing drugs available at lower cost (and therefore ac-
cessible to more people) but would play a significant
role in minimizing significant drains on hard cur-
rency (Antezana, 198 1).
Why would a developing country (or info~ant
or tribe) resist cooperating in a research effort that
could lead to the discovery of a drug, one that in
principle could eventually be beneficial for all who
need it? The situation described above explains why
the results of many research projects will simply
lengthen the list of inaccessible medicines. In this
context, it is understandable that informants or
governments will ask themselves why they should
cooperate with yet one more research effort that,
considering past experience, will not benefit all par-
ties involved in the cooperation.
New plant drugs
Discussing the role of plant drugs in the 21 st cen-
tury, Tyler (1986) stresses the diseases for which
satisfactory cures remain to be found, including viral
diseases (herpes, AIDS and certain cancers), “self-
inflicted” diseases (drug dependency, obesity, etc.),
diseases of unknown etiology (arthritis, some
cancers, muscular distrophy and Parkinsonism) and
genetic diseases. Since 1967, the top four categories
of new chemical entities acquired through drug
development efforts in the U.S.A. were analgesics,
antiinfectives, cardiovasculars and psychophar-
macologicslneurotropics (Mattison et al., 1988).
These nosological categories are therefore the ones
that wit1 be more intensively examined in the com-
ing years in medicinal plant research. The World
Health Organization (1978) nevertheless, indicated
malaria, diarrhea1 diseases, tuberculosis, leprosy and
sexually transmitted diseases as the major health
problems of developing countries. Between funded
research projects in developed countries and
epidemiology of developing countries, one can
perceive a discrepancy.
This discrepancy between research objectives and
local needs adds another dimension to the problem
237
of cooperation. The reasons why known effective
drugs are not available for most of those who need
them, obviously cannot be blamed on nor elucidated
solely by ethnoph~acolo~. These reasons include
major political and economic trends. In other
words, the prevalence of these diseases are inex-
tricably linked to general living conditions and
widespread poverty. Hence, from the perspective of
those who are expected to cooperate, the issue of
what kinds of drugs will be developed, clearly
matters.
Value of technology
Boom (1990) asks: What are the ethics behind
utilizing traditional knowledge without adequate
compensation to the societies from which it
originates? This is not an easy question to answer.
To begin with, what compensation would be ade-
quate? Certainly, a great deal of expertise and funds
are used in the research process that eventuafly
transforms a plant into a commercial medicine. The
monetary value of technological development as a
whole cannot be neglected, yet the actual cost of
each step in a research and development program
is by no means easy to quantify.
The traditional role of developing countries in
plant drug production has been as suppliers of raw
material. Of 76 compounds from higher plants pre-
sent in U.S. prescriptions, only 7% are commercially
produced by total synthesis (Farnsworth, 1989). a
scenario that keeps the plant trading alive as a ma-
jor commercial enterprise. Imports of medicinal
plants worldwide was estimated to be on the order
of UEJ3.55 million in 1976, increasing to US$ 551
million in 1980 (Principe, 1989).
These figures can be evaluated differently if one
compares prices of raw material and prices of final
products. Oldfield (198 I), quotes the The US. In-
teragency Task Force on Tropical Forests estima-
tion of US$ 25 million/year as the wholesale value
of medicinal compounds imported to the U.S.A.
from tropical forests. The alkaloid Pilocarpine, ex-
tracted from several Brazilian ~~~~cffr~~~species,
might be used as an example of a typical item that
contributes to this figure: estimated sates of Pilocar-
pine in the U.S.A. in 1989 was US$ 28 million -
the price paid in 1989 for a kilogram of dried
238
Pilocarpus leaves was US$ 0.28, maintaining the
trend found in the last decades: 808 tons were ex-
ported in 1962, at a price of US$0.22lkg, and 1.290
tons in 1970 at a price of US$0.36/kg (IBGE, 1985).
Due to the enormous difference of wealth
generated by supplying versus the purified chemi-
cal compounds, the traditional role of developing
countries as suppliers of raw material is in our times
insufficient to guarantee new cooperative ventures.
Could or should this picture be modified? Posey
(1990) calls for legislation to secure intellectual pro-
perty rights (IPR) for indigenous people. Is there
a basis for such a call? There is some indication that
traditional use does indeed play a somewhat more
important role in the technological process of plant
drug development than it has been credit for.
Analyzing plant based products today on the mark-
et, Farnsworth (1989) shows that 74% have the
same or related use in Western medicine as original-
ly used by indigenous curers. Current research
strategies in search of drugs for areas of therapy in-
clude the analysis of traditional use in the search
for immunomodulators (Labadie et al., 1989), an-
titumor compounds (Duke, 1986) analgesics
(Elisabetsky and Castilhos, 1990) and bactericides
(Caceres et al., 1990).
If traditional knowledge is considered to be the
basis for selecting plants for laboratory analysis, and
therefore promoted a research strategy, it could be
seen as an implicit genuine claim for compensation.
The legal basis and quantitative aspects for com-
pensating indigenous groups or countries for their
intellectual input in these technological
achievements should be a matter of concern to those
seeking cooperation with developing countries.
Conclusion
In reviewing the past three decades of medicinal
plant research, Tyler (1988) states “the most pro-
ductive period of medicinal plant research lies ahead
of us”. Behind this statement is his considerations
that the development of bioassays and analytical
methods available today are the means to solve what
he considers to have been the main problems en-
countered so far. It would be rather unfortunate if,
at the same time we seem to have overcome major
technological obstacles, we also lose cooperation of
those who can point out promising species for
screening and are left with no option but random
screening.
Medicinal plant researchers in general and
ethnopharmacologists/ethnobotanists in particular,
are not the source of the resistance increasingly
found in developing countries for scientific coopera-
tion. They are faced, nevertheless, with a context
in which they play and are expected to play an im-
portant role. By calling attention to the origins of
these problems it is hoped that more of us can act
in such a way as to minimize conflicts, preventing
the obstacles to the research strategy that has so far
been adopted by most researchers.
Acknowledgments
The author wishes to thank William Balee for
editing and discussing the original manuscript and
Laurent Rivier and Robert Anton for having includ-
ed discussion of ethical issues in the First Interna-
tional Congress on Ethnopharmacology.
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