Traditional medicine refers to the knowledge, skills and practices that indigenous and different cultures use to maintain health, encompassing forms such as herbal medicine, Traditional Chinese Medicine (TCM) and acupuncture. While 80% of the world’s population practices some form of traditional medicine, according to the World Health Organization (WHO), the practice is regularly discredited due to a lack of scientific support and regulation as well as evidence of negative side effects with certain medicines.

However, the reality is that traditional medicine has been the source of lead identification in modern drug discovery. As healthcare confronts challenges such as antimicrobial resistance and the spread of previously geographically constrained diseases as a result of climate change, research into natural products used in traditional medicine, referred to as ‘ethnopharmacology’, could help in finding new, clinically effective drugs.

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Ethnopharmacology has been an important basis for modern medicine

The estimated percentage of pharmaceutical drugs available today that are sourced from natural products varies. For example, a widely referenced study from 2012 reported that up to 50% of approved drugs between 1981 and 2010 were directly or indirectly from natural products, while according to the WHO, 11% of drugs considered basic or essential originated from flowering plants. Without the knowledge from ethnopharmacological work, many drugs would not be available today.

Aspirin is a famous example, and originated from salicin, a compound in willow tree bark, with some still using pieces of willow bark as an alternative herbal medicine. Other well-known drugs derived from traditional medicine include the pain-relief medication morphine, from the opium poppy and the antimalarial drug quinine, from cinchona tree bark.

Ethnopharmacology is still an active field in drug discovery

There are many other natural products derived from traditional medicine techniques currently being researched worldwide. For example, indigo naturalis is a dye created from fermented plants and has been used in TCM for centuries as a treatment for a variety of diseases such as psoriasis, gastrointestinal diseases and even forms of cancer. In the past few decades, a compound from the dye indirubin has been shown to display early clinical effectiveness as an anti-cancer drug. A recent pre-clinical study published in Cell Reports Medicine in April 2023 found that a chemical derivative of indirubin could offer new hope in treating patients with glioblastoma, for which the current treatment consists of radiation, chemotherapy and surgery.

Meanwhile, in Europe, traditional medicine from rural Italy incited research into the medicinal properties of European chestnut tree leaves as locals would rub the leaves on infected wounds. Researchers discovered that the leaves contained a compound, referred to as ‘Castaneroxy A’, which can disarm methicillin-resistant Staphylococcus aureus (MRSA) strains. MRSA causes antibiotic-resistant infections, which according to the WHO will become a much bigger problem in the future, with up to 10 million deaths per year by 2050.

Another important natural product found because of TCM was artemisinin. TCM recipes for treating fever included extracts from the sweet wormwood plant after researchers in the 1970s identified the extract’s antimalarial properties. Artemisinin was crucial in global healthcare battles against malaria as parasites began to appear with resistance to the previous class of the antimalarial drug quinoline. According to GlobalData’s Pharmaceutical Drugs database, there are over 450 artemisinin-derived branded drugs on the market today.

Nature offers a realm of possibilities in drug discovery

Alongside leads arising from traditional medicine, the natural world still has a lot to offer in drug discovery processes. Studying the behaviour of animals can aid in drug discovery research too. For example, chimpanzees have been seen to use plants to self-medicate, while studies of three-toed sloth fur found fungi with antibacterial and antimalarial properties. Drug discovery is already one of healthcare’s biggest challenges. Harnessing the knowledge of traditional medicine and the world around us could help to alleviate the pressure, saving time, money and lives.