Harvesting a Division between Human and Environmental Health: Natural Ingredients in Pharmaceuticals
By Jackie Haytayan and Jacqueline Johnson
May 18, 2019
A glimpse at the ingredient list of a Tylenol bottle might overwhelm you with pharmaceutical jargon and chemical compounds with scientific names well beyond the average person’s understanding. The first component listed, carnauba wax, may seem innocent—at least you can pronounce it! However, a closer examination of this innocuous ingredient reveals a prime example of the detriments of using natural ingredients in medicine.
Everyday reliance on pharmaceuticals for things like instant pain relief has evolved into a cultural tenet of modern American life. Dr. Christine Vatovec, a professor of environmental studies at the University of Vermont who specializes in human health and the environment, explained the complexity of America's reliance on pharmaceuticals, saying “we spend more on healthcare in general, including both over-the-counter and prescription pharmaceuticals, than any other country and yet we rank lower… on standard health outcomes.” Brand name acetaminophen drugs, such as Tylenol, are the second highest selling over-the-counter pain medication, grossing over $335.3 million in 2018 in the U.S. alone. This is likely due to the fact that 23 percent of Americans consistently incorporate drugs containing acetaminophen into their weekly routine. Overuse of these drugs has become so normalized that acetaminophen overdose is responsible for approximately 458 deaths annually, and is currently the number one reason for Poison Control Center intervention. Overuse fuels high demand, which results in overharvesting of the natural materials needed to synthesize these common drugs.
Carnauba wax is a widely used medical ingredient that can be found in popular over-the-counter drugs like Advil and Motrin. It is derived from Copernicia cerifera trees grown exclusively in Rio Grande de Norte of Brazil. This region qualifies as a desertification-susceptible area, defined as a fertile region at risk of becoming barren due to excessive land use and loss of natural assets, two characteristics of carnauba wax extraction. Between six to eight fronds are usually harvested from the carnauba tree, but of the material taken from each tree, only 5 percent is viable for wax synthesis. Thus, a vast amount of trees are required to meet the global demand of 36 to 41 million pounds of wax per year. As we continue to harvest leaves that aid in protecting against climatic changes, future generations of the carnauba tree will decrease in germination abilities, and therefore, fewer overall trees will exist. Despite its widespread use and detrimental environmental impact, the wax is not used for any significant medical purpose. It is an inactive ingredient in most medicines that creates a smooth layer over the capsule which makes it easier to swallow. Another main ingredient of Tylenol is microcrystalline cellulose (MCC).
MCC is extracted from the pulp of the interior of the Sorghum caudatum stalk, which is cripplingly overharvested in its native country of Nigeria.
The destructive procurement of Copernicia cerifera and Sorghum caudatum are examples of only two drugs in a pool of over 120 pharmaceuticals that are produced from rainforest flora, including some which are administered to patients of cancer, malaria, and tuberculosis. These patients require access to these drugs to survive and cannot afford to contemplate the ethics of their environmental origin.
The drug Taxol is considered a major breakthrough for the cancer community. Chemotherapy regimens using taxol to combat breast cancer increase the chance of patient survival by 2.6 percent, and survival without recurrence of cancerous cells by 4.1 percent. Despite its immense contribution to cancer therapies, the debate surrounding the drug presents a moral dilemma between its medicinal use and environmental origins. Taxol is extracted from the bark of a rare and slow-growing yew tree, Taxus brevifolia, found in the Pacific Northwest. Development of Taxol requires large quantities of mature bark, roughly 5,000 to 15,000 pounds, yet each viable yew tree can only supply 10 pounds of dry bark. In 1995, 12,000 ovarian cancer patients collectively consumed 36 kilograms of taxol. Isolating 1 kilogram of taxol requires 25,000 pounds of dried yew bark - thus, in only one year of treatment, 90,000 mature yew trees were sacrificed.
Turning a blind eye to overharvesting threatens both the environment and the ability to keep synthesizing these critical drugs in the future. By 2100, experts posit that over 50 percent of all rainforest flora and fauna could become extinct due to anthropogenic factors resulting in extreme climate change. However, grassroots organizations, small businesses, and large-scale corporations are working to address the role of pharmaceuticals in this issue. According to Dr. Vatovec, once the cancer community realized the threat Taxol posed to yew trees, many advocated for a compromise. Dr. Vatovec said that “although not a perfect solution, listing the tree as an endangered species was a useful step in both helping to protect the ecosystem [and] bringing to light the challenge of providing conventional medical treatments within planetary boundaries.”
Changes are being instituted by those consuming medications and by those synthesizing them. Small-scale biochemical start-ups aim to develop anti-cancer drugs in the lab, utilizing rainforest components only as a chemical model. Many of these companies, such as Manus Bio in Cambridge, MA, focus on synthesizing drugs using methods that mirror plant-like functions in bacteria. Larger corporations such as Merck & Co, Pfizer, and Bayer agreed to international sustainability pacts that set standards for carbon dioxide emissions, biodiversity, and protection of threatened harvested areas. However, the effects of these pacts are mainly theoretical due to lack of globalized consensus, prioritization, and enforcement.
Preservation of the natural world and continued expansion of medicinal resources is a tricky scale to balance, and one that comes with moral obligations on both sides. The codependency the U.S. fosters with overutilization of over-the-counter drugs contributes to increasing environmental distress worldwide. This codependency is not easy to break. While some natural ingredients are a convenient luxury, others provide a medicinal remedy to those with limited options. But the degradation of the environment cannot be disregarded even in the face of pressing need to find medicinal solutions for severe diseases. With this issue finally being acknowledged, a variety of efforts inch closer to finding a balance between conservation and access to medicine. This balance may be unattainable, but considering both increasing environmental constraints and chronic medical needs is vital to decisions that will shape the future of both healthcare and the planet.
