Medicinal plants have shaped healthcare throughout history and continue to underpin modern medicine today. Examples of some of the most important drugs originate from plants, including:

• Pacific yew (Taxus brevifolia), the source of the anticancer drug taxol
• Sweet Annie (Artemisia annua), which yielded artemisinin for malaria treatment
• Opium poppy (Papaver somniferum), the origin of morphine
• Autumn crocus (Colchicum autumnale), used to treat gout and inflammatory conditions

Beyond these well-known examples, many other medicinal plant species remain underexplored, representing valuable potential for future therapeutic discoveries.

Medicinal plants also play a vital ecological and social role. They support biodiversity, pollinators, and soil health (1-3), and form the backbone of traditional healthcare systems and local economies—particularly in rural and Indigenous communities (4). Knowledge passed down through generations has guided the use of plants, such as snowdrop species (Galanthus spp.), inspiring neurological treatments, and Chinese angelica (Angelica sinensis), which remains central to traditional Chinese medicine (5,6). Protecting medicinal plants, therefore, means protecting health, culture, and livelihoods — now and for generations to come.

Despite their importance, medicinal plants are increasingly at risk. Specifically, our analysis reveals clear and consistent patterns in how medicinal plants are responding to climate change. Drawing on a scoping review of 367 medicinal plant species, we found that the most common predicted impact is the loss of suitable habitat, affecting 131 species, largely driven by changes in precipitation patterns and elevation.

Range shifts were observed in 97 species, with many plants moving toward higher altitudes and latitudes. In comparison, 73 species showed an increase in suitable habitat—suggesting that climate change may create new opportunities for a limited number of plants (Figure 1) (7).

These distributional changes have direct implications for the pharmaceutical and cosmetic industries, with knock-on effects throughout herbal value chains. Many of the most studied medicinal plants — whether cultivated or wild-harvested — are susceptible to climate-driven changes in temperature and rainfall. This includes species such as jatamansi (Nardostachys jatamansi), chonglou (Paris polyphylla), chuan bei mu (Fritillaria cirrhosa), and ma huang (Ephedra sinica). As a result, regions once considered reliable sources may become less productive or unsuitable, leading to reduced yields, supply disruptions, and increased uncertainty in sourcing raw plant materials. At the same time, the loss of vulnerable species limits opportunities to discover new therapeutic agents, narrowing the future potential of plant-based innovation.

Climate-driven shifts also pose significant challenges for geographical indications (GIs), including traditional concepts such as Daodi and European notions of provenance and terroir, which link product quality to specific ecological and cultural conditions. As climates change, the environmental foundations that give these regions their distinctive phytochemical profiles may no longer hold. Established GI zones may therefore need to adapt, relocate, or be redefined — raising important questions about quality standards, authenticity, and regulation (8).

Global warming may significantly alter the production of bioactive metabolites and marker compounds in medicinal and aromatic plants by increasing potential evapotranspiration due to elevated temperatures, which in turn accelerates soil drying (9). The resulting changes in phytochemical profiles are highly variable and depend on the plant species, the specific type of compounds, as well as the intensity and duration of drought stress (10).

Moderate drought often enhances the accumulation of various secondary metabolites, especially those with antioxidant properties. This is attributed to the induction of mild oxidative stress, which triggers the biosynthesis of protective compounds such as phenolics and flavonoids to scavenge reactive oxygen species (ROS) (11). When drought becomes prolonged and severe, plant metabolic processes are significantly disrupted (12). This contrasting pattern was evident in several species reviewed. For example, under water deficit conditions, both balangu (Lallemantia royleana) and Persian lilac (Melia azedarach) exhibited increased phenolic and flavonoid content (13,14).

However, in broadleaved lavender (Lavandula latifolia), drought conditions resulted in decreased levels of specific metabolites such as coumaric and salvianic acids (15).

As a major contributor to climate change, elevated CO₂ and temperature exhibit mixed results; in certain cases, they can enhance the production of some compounds while suppressing others, due to complex carbon allocation and temperature sensitivities (81). High temperatures alone reduce the levels of several secondary metabolites, likely due to metabolic shifts that favour survival over defence (16).

Changes in precipitation also influence metabolite levels, with reduced rainfall often linked to a decline in compound diversity, particularly in drought-sensitive species (17). In addition, temperature stress elevates volatile organic compounds, suggesting an upregulation of stress signaling or defense responses (18). 

These fluctuations in secondary bioactive metabolite and marker compound profiles could impact the potential risks and benefits of medicinal plants. Increased levels of certain compounds could enhance antioxidant, anti-inflammatory, or antimicrobial activity, while a decline in key bioactive may compromise the potential effectiveness of traditional and plant-derived preparations (19,20).

Similarly, the pharmaceutical and cosmetic industries face significant challenges. Drought, for instance, alters the synthesis of essential oils, phenolic compounds, and flavonoids, key compounds in skincare, personal, and healthcare products. Changes in the levels of bioactive metabolites or marker compounds, such as linalool, linalyl acetate, α-pinene, and borneol in lavender (21) or camphor and linalool in basil (Ocimum basilicum), as well as various compounds in rosemary (Salvia rosmarinus), due to drought, and/or heat stress, could explain these biochemical shifts (22,23).

These phytochemical shifts (including changes in the levels of bioactive metabolites or marker compounds) can affect the quality (including the safety and efficacy of plant-derived medical products) and sensory properties of cosmetic and healthcare products (21).

Overall, climate-driven changes in bioactive metabolites raise important questions about quality, safety, and consistency. While some plants may benefit from moderate stress, others may lose critical properties. At present, simple predictions are not possible, highlighting the need for longer-term and comparative research.

Climate change is increasingly undermining both biodiversity and the traditional healthcare systems that depend on medicinal plants. For instance, in the Central Himalayas, rising temperatures and shifting rainfall have advanced flowering and fruiting times by several weeks, disrupting culturally rooted harvesting practices and reducing the availability and effectiveness of key medicinal species. Traditional healers report growing reliance on substitute plants, which are often significantly less effective (24).

Similar patterns are emerging in northern Thailand, where medicinal plants used by Karen communities — particularly in women’s reproductive healthcare — are projected to lose much of their suitable habitat in the coming decades (25). Comparable challenges are faced by the Shan people and forest-dependent communities near the Chunati Wildlife Sanctuary, where limited access to formal healthcare increases reliance on traditional medicine (26).

As climate change alters the distribution, timing, and potency of medicinal plants, the resilience of these community-based healthcare systems is coming under increasing strain.

Safeguarding medicinal plants in a changing climate requires coordinated action across policy, conservation, industry, and communities: 

• Climate-resilient cultivation and agroforestry: Diversified cultivation systems and agroforestry can reduce pressure on wild populations while strengthening ecosystem resilience, but wider adoption will require investment and integration into land-use planning.
• Genetic conservation and species management: Seed banks, tissue culture, and germplasm conservation offer critical insurance against loss, but must be paired with fair benefit-sharing and livelihood support.
• Community-led and participatory conservation: Recognising Traditional Ecological Knowledge and supporting local stewardship has proven more effective than top-down approaches.
• Stronger policy frameworks and incentives: Clear regulation and economic incentives — such as Payments for Ecosystem Services — can reduce illegal harvesting while supporting sustainable trade.
• Research, training, and capacity building: Knowledge gaps remain across many medicinal-plant-producing regions. Long-term monitoring, targeted funding, and specialist training are essential to translate research into meaningful action.

Medicinal plants are a shared global resource, but their future depends on the choices we make today. Climate change has transformed sustainability from an environmental concern into a health, cultural, and economic imperative. By supporting responsible sourcing, sustainable cultivation, and informed policy, we can help ensure that medicinal plants continue to support the well-being and health of people and planet.  

Protecting medicinal plants today safeguards healing possibilities that cannot be recovered once lost.”

1. Morton EM, Rafferty NE. Plant–pollinator interactions under climate change: the use of spatial and temporal transplants. Appl Plant Sci. 2017;5(6):1600133. https://doi.org/10.3732/apps.1600133 
2. Dybzinski R, Fargione JE, Zak DR, Fornara D, Tilman D. Soil fertility increases with plant species diversity in a long-term biodiversity experiment. Oecologia. 2008;158(1):85-93. https://doi.org/10.1007/s00442-008-1123-x 
3. Tomlinson TR, Akerele O, eds. Medicinal Plants: Their Role in Health and Biodiversity. University of Pennsylvania Press; 2015. 
4. Heinrich M, Ankli A, Frei B, Weimann C, Sticher O. Medicinal plants in Mexico: healers’ consensus and cultural importance. Soc Sci Med. 1998;47(11):1859-1871. https://doi.org/10.1016/S0277-9536(98)00181-6 
5. Heinrich M, Teoh HL. Galanthamine from snowdrop—the development of a modern drug against Alzheimer’s disease from local Caucasian knowledge. J Ethnopharmacol. 2004;92(2-3):147-162. https://doi.org/10.1016/j.jep.2004.02.012 
6. Lin HQ, Gong AG, Wang HY, et al. Danggui Buxue Tang (Astragali Radix and Angelicae Sinensis Radix) for menopausal symptoms: a review. J Ethnopharmacol. 2017;199:205-210. https://doi.org/10.1016/j.jep.2017.01.044 
7. Takubessi MI, Jalil B, Heinrich M. The impact of climate change on medicinal plants and natural products: a scoping review. Front Pharmacol. 2025;16:1697581. https://doi.org/10.3389/fphar.2025.1697581 
8. Brinckmann JA. Geographical indications for medicinal plants: globalization, climate change, quality and market implications for geo-authentic botanicals. World J Tradit Chin Med. 2015;1(1):16-23. https://doi.org/10.15806/j.issn.2311-8571.2014.0020 
9. Trenberth KE, Dai A, van der Schrier G, et al. Global warming and changes in drought. Nat Clim Chang. 2014;4(1):17-22. https://doi.org/10.1038/nclimate2067 
10. Tan U, Gören HK. Comprehensive evaluation of drought stress on medicinal plants: a meta-analysis. PeerJ. 2024;12:e17801. https://doi.org/10.7717/peerj.17801 
11. Ai Q, Dai A, Han M, Yang L, Liu C. Moderate drought stress interferes with the physiological state and promotes the accumulation of isoflavone in reproductive Iris domestica rhizomes. Agronomy. 2024;14(8):1730. https://doi.org/10.3390/agronomy14081730 
12. Li T, Tiiva P, Rinnan Å, Julkunen-Tiitto R, Michelsen A, Rinnan R. Long-term effects of elevated CO2, nighttime warming and drought on plant secondary metabolites in a temperate heath ecosystem. Ann Bot. 2020;125(7):1065-1075. https://doi.org/10.1093/aob/mcaa037 
13. Omidi H, Shams H, Seif Sahandi M, Rajabian T. Balangu (Lallemantia sp.) growth and physiology under field drought conditions affecting plant medicinal content. Plant Physiol Biochem. 2018;130:641-646. https://doi.org/10.1016/j.plaphy.2018.07.033 
14. Dias MC, Pinto DCGA, Costa M, Araújo M, Santos C, Silva AMS. Phytochemical and antioxidant profile of the medicinal plant Melia azedarach subjected to water deficit conditions. Int J Mol Sci. 2022;23(21):13611. https://doi.org/10.3390/ijms232113611 
15. Cáceres-Cevallos GJ, Albacete-Moreno AA, Ferreres F, Gil-Izquierdo Á, Jordán MJ. Evaluation of the physiological parameters in Lavandula latifolia Medik. under water deficit for preselection of elite drought-resistant plants. Ind Crops Prod. 2023;199:116742. https://doi.org/10.1016/j.indcrop.2023.116742 
16. Li ZG. Mechanisms of plant adaptation and tolerance to heat stress. In: Hasanuzzaman M, ed. Plant Ecophysiology and Adaptation under Climate Change: Mechanisms and Perspectives II: Mechanisms of Adaptation and Stress Amelioration. Springer; 2020:39-59. https://doi.org/10.1007/978-981-15-2172-0_3 
17. Prinsloo G, Nogemane N. The effects of season and water availability on chemical composition, secondary metabolites and biological activity in plants. Phytochem Rev. 2018;17(4):889-902. https://doi.org/10.1007/s11101-018-9567-z 
18. Midzi J, Jeffery DW, Baumann U, Rogiers S, Tyerman SD, Pagay V. Stress-induced volatile emissions and signalling in inter-plant communication. Plants (Basel). 2022;11(19):2566. https://doi.org/10.3390/plants11192566 
19. Kumar S, Yadav A, Yadav M, Yadav JP. Effect of climate change on phytochemical diversity, total phenolic content and in vitro antioxidant activity of Aloe vera (L.) Burm. f. BMC Res Notes. 2017;10(1):60. https://doi.org/10.1186/s13104-017-2385-3 
20. Kaur T, Bhat R, Vyas D. Effect of contrasting climates on antioxidant and bioactive constituents in five medicinal herbs in Western Himalayas. J Mt Sci. 2016;13(3):484-492. https://doi.org/10.1007/s11629-014-3380-y 
21. Jalil B, Heinrich M. Pharmaceutical quality of herbal medicinal products and dietary supplements—a case study with oral solid formulations containing Lavandula species. Eur J Pharm Sci. 2025;208:107042. https://doi.org/10.1016/j.ejps.2025.107042 
22. Kulak M. Recurrent drought stress effects on essential oil profile of Lamiaceae plants: an approach regarding stress memory. Ind Crops Prod. 2020;154:112695. https://doi.org/10.1016/j.indcrop.2020.112695 
23. Sarmoum R, Haid S, Biche M, Djazouli Z, Zebib B, Merah O. Effect of salinity and water stress on the essential oil components of rosemary (Rosmarinus officinalis L.). Agronomy. 2019;9(5):214. https://doi.org/10.3390/agronomy9050214 
24. Maikhuri RK, Phondani PC, Dhyani D, Rawat LS, Jha NK, Kandari LS. Assessment of climate change impacts and its implications on medicinal plants-based traditional healthcare system in Central Himalaya, India. Iran J Sci Technol Trans A Sci. 2018;42(4):1827-1835. https://doi.org/10.1007/s40995-017-0354-2 
25. Tangjitman K, Wongsawad C, Kamwong K, Sukkho T, Trisonthi C. Ethnomedicinal plants used for digestive system disorders by the Karen of northern Thailand. Songklanakarin J Sci Technol. 2015;37(3):369-379. 
26. Rahman MH, Roy B, Chowdhury GM, Hasan A, Saimun MSR. Medicinal plant sources and traditional healthcare practices of forest-dependent communities in and around Chunati Wildlife Sanctuary in southeastern Bangladesh. Environ Sustain. 2022;5(2):207-241. https://doi.org/10.1007/s42398-022-00230-z

One of the most persistent challenges is the overharvesting of herbs from wild populations. Many species, such as goldenseal (Hydrastis canadensis) and various orchids used in traditional medicine, have experienced dramatic population declines due to market pressure, while more common species, such as dandelion root (Taraxacum officinale) and raspberry leaf (Rubus idaeus), have faced recent availability constraints.

To mitigate risks related to supply insecurity, contaminants (pyrrolizidine alkaloids), and limited traceability, many operations in Albania, Poland, and Ukraine have begun supplementing wild-harvested material with sustainably cultivated stock, improving both environmental outcomes and stock availability.

The impact of climate change on herbal crops is ongoing. Fluctuating precipitation patterns, increasing drought frequency, heat stress, and extreme weather events have disrupted growing cycles and reduced yields. Habitat fragmentation has further undermined the ability of wild plant populations to adapt to these stresses. Research on cowslips (Primula elatior) has shown that fragmented habitats impair their evolutionary capacity to tolerate drought, thereby reducing resilience under warming climate conditions (2).

In response, herbal supply chains are increasingly diversifying sourcing regions and, where possible, selecting and breeding varieties better suited to local conditions. One example is the development of new basil (Ocimum basilicum) varieties, bred to maintain both yield and phytochemical richness under water-stress conditions (3).

Additional initiatives include increased investment in solar drying infrastructure and replacing fossil fuels with biomass for hot-air dryers. Herb drying has been shown to be one of the most carbon heavy operations in the supply chain and these measures are helping reduce carbon footprints while improving resilience to energy and climate-related disruptions.

The rural-to-urban migration in the herbal sector leads to the loss of traditional knowledge and reduced labour availability for both cultivation and wild harvesting. This trend places both supply continuity and sustainability at risk. Experienced harvesters who understand when, where, and how to collect plants sustainably are retiring or leaving for urban employment, while younger generations show declining engagement with these practices.

During engagements with rural communities in 2024 and 2025, several key drivers of migration were identified:

1. Income and job security: Unpredictable weather, fluctuating crop prices, and insecure sales channels make herb cultivation and wild collection high-risk and low-reward activities. Seasonal harvesting also leads to inconsistent income, often requiring collectors to supplement earnings with other work.
2. Image and self-respect: Wild herb collection is not always perceived as a successful or prestigious career path.
3. Access barriers: Knowledge of herb cultivation and collection is often transmitted generationally; those without family exposure face steep learning curves.
4. Work–life balance: Cultivation and wild harvesting rarely follow a standard 9-to-5 schedule. Younger generations tend to prioritise flexibility and personal time more than previous generations.
5. Policy and certification complexity: Permits, licensing, and certification requirements can be administratively burdensome, often favouring large, established operations over small entrants and individual harvesters.

Adequate Quality Control is critical in the herbal industry. Contamination with pesticides, heavy metals, pyrrolizidine alkaloids, tropane alkaloids, adulterants, or fillers remains common. Studies indicate that approximately 27% of commercial herbal products contain adulterants or are entirely substituted with incorrect species (4). While not always intentional, such issues may stem from insufficient plant identification knowledge or inadequate Quality Control within the supply chain.

The same study reported particularly high rates of adulteration in Brazil (68%), followed by Taiwan (32%), India (31%), the United States (29%), Malaysia (24%), Japan (23%), South Korea (23%), Thailand (20%), and China (19%) (4). Findings such as these emphasize the importance of robust Quality Control systems and accurate botanical identification.

While traditional macroscopic evaluation, complemented by chromatographic methods form the foundation of botanical identification, molecular techniques, including DNA barcoding, are available and becoming invaluable tools for ensuring authenticity throughout the supply chain.

The Sustainable Herbs Initiative (SHI) emerged as an important platform for coordinated action across the herbal sector. This coalition of producers, brands, scientists, and herbalists is developing best practices for wild harvesting, traceability, carbon-emissions tracking, and inclusive governance models that recognise nature as a stakeholder in supply-chain decision-making.

One of the most significant recent developments has been the establishment of the Scope 3 Herbal Foot printing Group, led by SHI. Through this pre-competitive collaboration, companies are working collectively to measure and reduce greenhouse-gas emissions across herbal supply chains, reflecting a notable shift in strategic thinking within the industry.

Economic sustainability is central to responsible herb sourcing. Certification schemes such as Fair for Life, FairWild, Fair Trade, and Organic require fair compensation, safe working conditions, and meaningful community engagement. These frameworks help ensure that communities benefit socially and economically from the plant resources they steward, moving beyond extractive models toward shared prosperity.

However, small-scale producers and processors often struggle to afford certification costs, limiting access to premium markets and reinforcing structural inequalities. In this context, group certification schemes continue to play a critical role in securing market access for smallholder organic growers. In 2025 there were over 1.1 million farmers registered under the Participatory Guarantee System (PGS) in India.

In 2024, FairWild implemented its Standard 3.0, expanding eligibility to a broader range of operators, from small-scale harvesters to global traders. While the number of FairWild-certified brands has remained relatively stable, adoption of the standard among operators and traders has increased substantially. This has amplified the standard’s impact and expanded the availability of FairWild-certified botanical ingredients (5).

The introduction of US import tariffs in 2025 had significant and multifaceted impacts on global MAP trade, affecting supply chains, pricing, industry profitability, and access to key botanical ingredients. To mitigate these effects, many US companies have sought alternative suppliers, raised shelf prices, or absorbed increased costs, often at the expense of reduced margins.

Trade and industry associations are actively lobbying for tariff exemptions for MAPs that are essential to the US herbal industry but cannot be commercially cultivated domestically. At present, only a limited number of botanical components are exempt from these tariffs.

For brands and operators in the herbal industry:

• Invest in the selection and breeding of MAP varieties suited to changing climatic conditions without compromising yield or active constituents.
• Diversify botanical sourcing geographically and supplement wild-harvested material with cultivated stock under organic or other sustainability certifications that support restorative ecology.
• Adopt tools and approaches to ensure species authenticity, safety and efficacy of herbal products. 
• Invest in community partnerships by working with local harvesters and cooperatives to secure fair wages and long-term resource stewardship.

For regulators and policymakers:

• Strengthen harvesting regulations by establishing science-based quotas, habitat protections, and effective enforcement mechanisms.
• Support access to certification by lowering barriers for small suppliers through funding and technical assistance.

For consumers:

• Choose certified products by seeking credible sustainability and Fair Trade certifications.
• Support transparent brands that disclose sourcing practices and demonstrate long-term commitments to ecological stewardship.

1. Herbal Medicinal Products Market Size & Share Analysis – Growth Trends and Forecast (2025 – 2030) Source: https://www.mordorintelligence.com/industry-reports/herbal-medicinal-products-market?utm_source=chatgpt.com 
2. Van Daele, F., Honnay O., Janssens S., De Korthttps Hanne. Habitat fragmentation affects climate adaptation in a forest herb. https://arxiv.org/abs/2303.15712v3
3. Rahimi, M., Mortazavi, M., Mianabadi, A. et al. Evaluation of basil (Ocimum basilicum) accessions under different drought conditions based on yield and physio-biochemical traits. BMC Plant Biol 23, 523 (2023). https://doi.org/10.1186/s12870-023-04554-8
4. Ichim MC. The DNA-Based Authentication of Commercial Herbal Products Reveals Their Globally Widespread Adulteration. Front Pharmacol. 2019 Oct 24; 10:1227. https://doi.org/10.3389/fphar.2019.01227 
5. FairWild Impact report 2024: https://www.fairwild.org/our-impact 

At the heart of the library is the Duke Ethnobotanical Archives (DEA), located at the welcome centre (1). This archive distinguishes itself by featuring materials on flora from around the world, including Duke’s alphabetised ethnobotanical files. These resources offer a thorough overview of global ethnobotanical research and studies, enriching the library’s offerings. 

Jim Duke was a brilliant, dedicated, and humble botanist whose love of plants and people inspired thousands of scientists and herbal enthusiasts. He authored hundreds of articles and three dozen books, compiled botanical data for his “Nature’s Farmacy” database. He was a big supporter of United Plant Savers and loved coming to the sanctuary and teaching.  Born in Birmingham, Alabama, in 1929, Duke earned his undergraduate and doctoral degrees at the University of North Carolina, then pursued postgraduate work in St. Louis, where he developed his lifelong interest in neotropical ethnobotany.

Duke’s career included significant work at the Missouri Botanical Garden, the USDA, and Battelle Memorial Institute, focusing on crop diversification and medicinal plants. He led USDA’s Medicinal Plant Laboratory and Economic Botany Laboratory, supported cancer research, and later established the Green Farmacy Garden at his home in Maryland. Duke retired from USDA in 1995 but remained active, receiving accolades such as the ACEER Legacy Award and being profiled by The New York Times. We are honored to have his library and archives at our Welcome Center at the sanctuary.

The research library is further enhanced by several unique and significant collections. The John Staba collection provides early pharmacy textbooks, presenting historical perspectives on herbal medicine. Stephen Buhner’s collection invites philosophical reflection on plant wisdom, while our most significant donation has been David Winston’s extensive collection covers a wide range of eclectic medical traditions and modern herbal practices.

Cascade Anderson Gellar’s collection is the most recent donation and brings a focus on folk traditions and herbal knowledge from the Northwest and Central America, deepening the library’s diversity and scope. We have kept the library organised and searchable by the individuals who have created the collections, we see their stories just as important as the books themselves.

As the library started to grow, we had the opportunity to purchase the historic Brick House Apothecary, located in Pomeroy, about ten miles from the sanctuary. Pomeroy is a beautiful town that overlooks the mighty Ohio River. The Brick House has several rooms we can rent out to visitors or to host visiting scholars and artists. This is also where we have expanded the library collections.

The entire catalog, containing over 4,000 volumes, is searchable online through the United Plant Savers website. Members are encouraged to visit, explore, and immerse themselves in the rich information available, opening doors to new insights and traditions in the field of herbal medicine.

Expanding public access and the Duke Archives

United Plant Savers is dedicated to increasing public access to our sanctuary by providing lodging options and sharing the medicinal knowledge cherished by the community. The welcome centre has the largest collection of Jim Duke’s prolific herbal writings and Peggy Duke’s botanical drawings, along with their notes, slides, files, and herbarium. This central location preserves and showcases their extensive research, making it accessible to all.

Located at the centre, the Duke Library is curated in custom red oak bookshelves with locking glass doors, with additional materials stored in filing cabinets below. Plans are underway to catalog the slide collection, which features plants from the Amazon, Costa Rica, Appalachia, Maine, and other places. A small herbarium collection from Jim Duke and plants from the Sanctuary in Ohio is being curated as well. Looking ahead, we are planning a teaching garden and aim to announce ethnobotanical fellowship research opportunities. 

United Plant Savers was founded at the International Herb Symposium, which was also founded by Rosemary Gladstar and United Plant Savers is now the organiser. We have curated the classes taught at the International Herb Symposium over the years, which is now at the International Herb Symposium Learning Center.  It’s a wonderful resource to explore classes that can be purchased individually or in bundles.

International Herb Symposium and eclectic history

Last year, the International Herb Symposium took place in Cincinnati, Ohio, with a central focus on the history of the eclectics. Hosting the event in Cincinnati created a unique opportunity for collaboration with the Lloyd Library, an iconic institution known for its extensive medicinal book collections. This partnership highlighted the rich heritage of the eclectics and American herbalism, while also drawing attention to the often-overlooked aspects of conservation and social ethics from this influential period.

Library excursions and regional connections

The Lloyd Library and the United Plant Savers centre together offer a meaningful excursion into the heart of Appalachia, providing participants and visitors with direct access to the region’s deep-rooted traditions in medicinal plants and herbal practice.

Online resources and the magic of physical libraries

In addition to these physical centers, United Plant Savers actively supports resources like the World Herb Library, an online repository of scanned herbal books, and the Biodiversity Heritage Library, which provides free access to older herbal texts now in the public domain. While these online resources have made a wealth of information readily available, there remains something truly magical about being present in a library, physically holding a book that unexpectedly captures your interest.

Balancing online learning and hands-on experience

In our current era of online learning, it is important to maintain a balance between accessing digital knowledge and engaging directly with medicinal plants. Supporting gardens and centres that cultivate and preserve plant diversity is essential to sustaining the traditions and innovations of herbal medicine.

“If you have a garden and a library, you have everything you need.” ― Cicero

1. Duke Ethnobotanical Library. United Plant Savers. Published April 2, 2025. Accessed January 12, 2026. https://unitedplantsavers.org/dukearchives/

Ethnobotany is highly interdisciplinary and weaves together perspectives from botany, anthropology, ecology, medicine and history to understand plant and human interactions. It has a particular focus on traditional knowledge and uses of plants within specific cultures and regions. Through ethnobotany we learn how people use plants for a variety of uses — from shelter to food, ceremony, clothing, medicine, art and ritual.

Ethnobotany is also not just limited to understanding indigenous peoples knowledge, but how people from everywhere use and interact with plants (including in cities and amongst global diaspora).  For example, the paper Cross-cultural adaptation in urban ethnobotany: The Colombian folk pharmacopoeia in London investigates which plants the Colombian diaspora in London use, and how these uses have changed after migration (2). Ethnobotany also largely works with people from afro-descendant communities, traditional societies and local communities. 

Other fields of ethnobiology include ethnomycology (the study of people and fungi), ethnozoologists (people and animals) and ethnoecologists (people and their environment/ecosystem), amongst others.

The field of ethnobiology that focuses on medicines is called ethnopharmacology. 

“Ethnopharmacology is a multidisciplinary field of inquiry investigating the anthropological rationale and the pharmacological basis of the medicinal use of plants, animals, fungi, micro-organisms, and minerals by human cultures” (3).

Drawing on pharmacology, anthropology, biology, phytochemistry and pharmacognosy, ethnopharmacology researches all things surrounding herbal medicines. This spans from different medical systems and philosophies, to harvesting practices and preparation methods, ethnopharmacology archives and expands on traditional knowledge by researching it from different perspectives. 

In ethnopharmacology, ‘folk medicine’ is not limited to the kitchen or the premises of traditional preparation, but is also investigated in the lab, and plant specimens taken to the herbarium.

One could argue that herbalism is ethnobotany in action — the use of plants as medicine. Much of our herbal knowledge — particularly in the West — has come from an ethnobotanical exploration of our own native practices, and adoption and incorporation of those from afar. 

A Western example is echinacea (Echinacea spp.) — an immune boosting plant in Europe and was brought from America in 1952. Swiss herbalist Alfred Vogel spent several weeks with the Sioux people on the Pine Ridge reservation in South Dakota, where he met a medicine man called Ben Black Elk from the Lakota Ogala tribe. Black Elk shared knowledge on the traditional use of echinacea for coughs, wounds, infections and snakebites and generously gave Alfred Vogel seeds to bring back home. Now echinacea is one of the most popular herbs used in Europe. 

Ethnobotany also unveils the diverse ways that people from different cultures use the same species in herbalism. The same plants grow across different countries and regions, yet, how the people from these places use and prepare the plants often differ. This highlights alternative benefits of the phytochemistry of the plants, new leads for scientific research, and the diversity of approaches to work with these medicines. 

In Northern Europe, bay leaves (Laurus nobilis) are used for digestive disorders and wound healing. However, in Greece, bay leaves are used for metabolic health for example diabetes and cholesterol. In Cyprus, people put bay leaves in their cupboards to keep insects and cockroaches out, and interestingly phytochemical analysis of bay leaves show that the compounds in them have insect repellent activity (4). This is exemplary of how scientific insight can enrich traditional knowledge, here, supporting a means to reduce chemical use with pesticides. 

People from different parts of the world often also use the same plant for the same actions or conditions. It could be argued that the repetition of use of a plant across cultures strengthens the evidence that a plant is useful, and therefore warrants further investigation and scientific enquiry.

Another invaluable part of ethnobotany is traditional ecological knowledge (TEK). Ecologist Fikret Berkes defined TEK as “a cumulative and dynamic body of knowledge, practices, and beliefs that evolves through adaptive processes, which are shared across generations through cultural transmissions”. TEK is an accumulation of all of the observational knowledge gathered over years, on all species that reside within a community and most importantly, how the humans living there interact with them. TEK includes practices, skills and understandings of how to work with the environment in a way that is sustainable and facilitates an enduring and thriving species population.

TEK also includes growing, foraging and harvesting techniques, as well as adaptive mechanisms to deal with a changing environment; though, it must be noted that sometimes maladaptations do happen, and practices can in some cases be damaging. When describing TEK, herbalist Jonas Brab said the practices are “usually based on a holistic worldview, where humans are part of a living community and where everything has repercussions that have to be considered” (5).  

This knowledge is particularly crucial for the protection and longevity of herbal medicines now, as there has never before been so much interest in herbal medicines commercially. With people seeking alternative medicines and more natural ways of living, there has been an enormous increase in sales of supplements and medicinal plants and fungi these past few years. The global herbal medicine market was estimated at $70.57 billion in 2023 and is projected to reach $328.72 billion by 2030 (6). Many medicinal plants now endangered and facing extinction in the wild include popular herbs like rhodiola (Rhodiola rosea), cordyceps (Ophiocordyceps sinensis), chaga (Inonotus obliquus) and liquorice (Glycyrrhiza glabra). Read about species specific sustainability issues.  

Not only is this a major loss for all, but most importantly for the people who have stewarded this land and the herbs, and who depend on them for medicines. A well-known example of this is with the popularisation of the psychoactive brew ayahuasca, traditionally made from plants in the Amazon amongst a diverse array of traditional communities within the jungle. Now because of ‘spiritual tourism’, the vines have been exploited, and in many places it is very difficult or not possible for the local people to have access to the plants, which are so integral to their spiritual practices, ceremonies and rites of passage (6). The same thing happens with the medicinal herbs in popular supplements. 

Ethnobiology, ethnoecology and TEK offer us the opportunity to listen to and learn from people who know how to sustain and nurture thriving ecosystems. Collaboration and genuine partnership allow us to co-create systems with mutual benefits and equitable sharing where all species can thrive.  As stated in the Fungi Foundations Ethnomycology Ethical Guidelines 2025, “The knowledge underlying the resource management practices of the world’s Indigenous Peoples, Afro-descendant communities, traditional societies and local communities is directly tied to the maintenance of biological diversity” (8).

Whilst ethnobiology holds much value and gives hope for the world, it has a deeply problematic history. The indigenous peoples, local communities, farmers, and Afro-descendant groups who are commonly involved with ethnobiology projects have faced deep historical injustices, marginalisation and oppression. Ethnobiology has been used to exploit these communities many times, and with the founder of ethnobotany John William Harshberger in 1895 describing it as “the study of the plants used by primitive and aboriginal peoples”. The term “economic botany” has often been used in place of ethnobotany, indicating the highly capitalistic and often extractive ways these tools have been used. 

Now, there is a strong cultural shift and work being conducted to decolonise these practices. Any positives that these collaborations and the pursuit of ethnobiology may have, will only bloom if the value systems and practices are inherently different to the past. As stated in the Fundamentals of Pharmacognosy and Phytotherapy, “The ‘Western’ use of such information has come under much scrutiny, and the national and indigenous rights of this knowledge has been acknowledged by most academic and industrial researchers” (7). Initiatives like the Convention of Biological Diversity (CBD) and The Nagoya Protocol have been created to prevent repetition of the past and ensure equitable benefit sharing. 

The Fungi Foundation has created Ethnomycology Ethical Guidelines, where they have outlined critical principles for the future of ethnobiology. They stated that “Ethnomycology thrives when it is carried out in dialogue with communities, under principles of reciprocity, mutual respect, and co-production of knowledge (8).”

The principles in the guidelines include: 

• Principle of self-determination, prior rights and responsibilities 
• Principle of respect to Pachamama (nature or mother earth) and her rights 
• Principle of historical justice and respect for Indigenous Peoples and local communities 
• Principle of reciprocity, mutual Benefit and equitable sharing
• Principle of conservation of flora, fauna and fungi 
• Principle of respect to the elders and knowledge keepers
• Principle of acknowledgement and due credit 
• Principle of educated prior informed consent 
• Principle of support for social and indigenous projects 

Globally there is a deep shift in our collective relationship to nature, and this is in large part from listening to the stewards of the land, as well as deep disenfranchisement with the current system. In 2008 the Constitution of Ecuador. recognised the rights of Nature or Pachamama as a legal entity with the right to exist and be protected, reflecting indigenous and ecological principles embedded in the national legal framework.

“Nature or Pachamama, where life is reproduced and takes place, has the right to integral respect for its existence and the maintenance and regeneration of its vital cycles, structure, functions, and evolutionary processes. Every person, community, people, or nationality may demand the public authority to fulfill the rights of nature. To apply and interpret these rights, the principles established in the Constitution shall be observed, as appropriate. The State will incentivize natural and legal persons, as well as collectives, to protect nature and promote respect for all the elements that form an ecosystem” (10).

Whilst herbalism and ethnopharmacology are very important for the evolution of our healthcare systems, there is no doubt that ethnobiology can offer support for a lot more than just medicine. In fact, many would argue that it is remiss not to include indigenous-led value systems at the centre of our new way of being. Respect, reciprocity and harmony with nature are fundamental if we are to create an antidote to the troubles we face — thankfully, we have many people and species we can learn from. 

1. Wcmc. Championing Indigenous Peoples’ stewardship of biodiversity – UNEP-WCMC. UNEP-WCMC. https://www.unep-wcmc.org/en/news/championing-indigenous-peoples-stewardship-of-biodiversity
2. Ceuterick M, Vandebroek I, Torry B, Pieroni A. Cross-cultural adaptation in urban ethnobotany: The Colombian folk pharmacopoeia in London. Journal of Ethnopharmacology. 2008;120(3). https://doi.org/10.1016/j.jep.2008.09.004 
3. Leonti M, Casu L. Traditional medicines and globalization: current and future perspectives in ethnopharmacology. Frontiers in Pharmacology. 2013;4. https://doi.org/10.3389/fphar.2013.00092 
4. Jemâa JMB, Tersim N, Toudert KT, Khouja ML. Insecticidal activities of essential oils from leaves of Laurus nobilis L. from Tunisia, Algeria and Morocco, and comparative chemical composition. Journal of Stored Products Research. 48:97-104. https://doi.org/10.1016/j.jspr.2011.10.003 
5. Braab J. The relevance of traditional ecological knowledge for modern herbal medicine | History | Herbal Reality. Herbal Reality. https://www.herbalreality.com/herbalism/history/relevance-of-traditional-ecological-knowledge-for-modern-herbal-medicine/ Published August 28, 2024.
6. Herbal Medicine Market Size, Share & Growth Report, 2030. https://www.grandviewresearch.com/industry-analysis/herbal-medicine-market-report 
7. Heinrich M, Barnes J, Gibbons S, Williamson E. Fundamentals of Pharmacognosy and Phytotherapy. 2nd ed. Elsevier; 2012. http://cms.herbalgram.org/heg/volume9/files/Fundamentals_FM.pdf 
8. Ethnomycology Ethical Guidelines | Fungi Foundation. https://www.ffungi.org/campaign/ethnomycology-ethical-guidelines 
9. Oregon State University, College of Forestry. What is TEK? | Traditional Ecological Knowledge Lab. Published 2022. https://tek.forestry.oregonstate.edu/what-tek 
10. Ecuador: 2008 Constitution in English. https://pdba.georgetown.edu/Constitutions/Ecuador/english08.html

• Ethnomycology Ethical Guidelines- Fungi Foundation 2025
• EthicalGuidelines_English_2025.pdf 
• Ethnopharmacologic Search for Psychoactive Drugs- ESPD55- McKenna Academy
• Championing Indigenous Peoples’ stewardship of biodiversity – UNEP-WCMC

The term Nature Deficit Disorder (NDD) was originally coined by Richard Louv, a journalist and author of numerous books on the connection between family, nature and community, in which he investigates the relationship of humans and the natural world in both current and historical contexts. The possible outcomes that result from this disconnection or alienation from nature are varied, and may be identified or perceived by those whose lives are typically distanced from green spaces and experiences in nature.

NDD is a description of the human costs of alienation from nature. Note: that NDD is currently not a recognised medical diagnosis but a means to explain the link between health imbalance and nature deprivation and the possible outcomes. Some of the outcomes are understood to be both having a negative effect on physical and emotional health and may include symptoms such as; a diminished use of the senses, attention difficulties, dissociation and higher rates mental illness. In children symptoms are thought to sometimes include hyperactivity, low mood or motivation and lack of attention.

Humans have evolved in the natural world, we come from primitive beginnings where understanding and interacting with the natural environment was a necessity for survival and wellbeing. It is in the wild that we evolved physically, mentally and intellectually.

The relationship between mankind and nature is an oxymoron, mankind ‘is’ nature or is part of nature – we have just forgotten it. When we remember this fact, and remember our ancestors (even those not so distant as we may think), we can see how far removed we are from the world that we are part of. 

Now, in the modern world where our food, medicine, resources etc are produced or manufactured industrially, where we are able to access information at the click of a button – we ‘need’ less to have the connection to natural rhythms.

We can use the internet to check the weather (where we would once have understood the conditions and natural events). We can rely on technological world for almost everything that we would have once understood and depended upon from our direct understanding and connection to nature.

There are a number of reasons that we are spending more time away from nature. Louv describes that as of 2008, for the first time in human history, more people are living in cities than in the countryside. The issue is more the absence of nature and green spaces in cities, rather than the cities themselves. It has been shown that the wellbeing rates in communities where there are more trees and green spaces is higher (5). Among the above mentioned, the following are also factors that may be contributing to the cause of NDD:

Biodiversity and habitat loss

Of course it cannot be ignored that the loss of habitats and biodiversity is a factor. The decline in biodiversity directly reduces our exposure and consequently reduces our value in nature.

Biophobia

There are issues of ‘biophobia’ which is both linked to cultural fear of ‘risks’. There is also a link between biophobia and climate anxiety, where it is thought that children are conditioned at an early age to associate nature with environmental disasters.

Technology

Technology now dominates almost every aspect of our lives, children’s lives are over-programmed and immersed in the virtual world.

Louv describes that ‘as we spend more of our lives engaging in the technological world, our senses narrow; the more time we spend in the virtual world, the less alive we feel’.

The causes are rarely through fault of our own, all of the above are unfortunately side effects of the society that has been built around us, that we have grown up into. However, it is clear that this awareness is spreading and that changes need to be made on a wider scale to help change the course of our discord to nature, for the benefit of both people and the planet.

In most Western cultures we are now at our furthest point of disconnection from the natural world. Yet we have reached a point where we are starting to become acutely aware of the ‘symptoms’ created by this distance.

Many of us, who live in urban or suburban areas will have experienced the yearning that comes with time spent too long away from nature. However, now many are living in conditions so far removed from nature, in the depth of cities or towns, away from anything that resembles an undisturbed natural habitat, these simple experiences are directly inaccessible.

Often times people are so disconnected from nature they do not realize that is what they are actually missing. For example, a Londoner born and raised in the chaos of the city may not have had the privilege of spending extended time in nature and so may not know that this may chip away at their peace.

NDD can affect people whose work or personal life is distanced from nature. It is certainly a problem effecting children, arguably the most. Access to garden or outdoor space is a luxury, let alone having space to fully engage in hands on activities in nature such as growing food or foraging for medicine. Still even if one has a garden or local park, nothing can replace the experience of being in wild nature untouched and unkempt by humans.

Secondary to the more personal effects of NDD, there are of course implications with the wider issue of disassociation to nature and our value in the environment that essentially results in the disregard of it; what we do not connect to or understand we are less likely to care for. Therefore it could be argued that under-exposure to nature is also an environmental problem.

The initial questions asked by the scientific community are; how is this enhanced wellbeing by nature exposure measured, what are these wellbeing outcomes and then, what could the solutions to the health effects of under-exposure look like?

Much of the focus of research, particularly where children are involved, has been on both measuring connectedness to nature in an urban setting and related mental and cognitive functioning and wellbeing (4). The solutions are varied depending on demographic and who is being effected. However the research has identified that for those who are displaying symptoms of NDD, all forms and quantities of exposure are beneficial (1).

There are numerous papers that have evaluated the evidence and the findings are clear; Overall mental health, self-esteem, stress resilience, depression and overall health are found to have been improved by exposure to nature (2,3).

Learning settings that incorporate nature activities with accessible green spaces display significantly improved mental health outcomes in children (2,3), making a clear case for schools and other educational settings to improve access to nature activities and green spaces. See our articles for how forest schools can affect children’s development.

A mixed method pilot study of high school graduates attending a four-week wilderness camp was set up with the intention to investigate whether nature-based camp experiences would increase connection to nature and promote multiple elements of well-being. The study concluded that all well-being outcomes significantly improved, including perceived stress, relaxation, positive and negative emotions, sense of wholeness and social connections. These results can inform future research agendas and reinforce that nature immersion experiences could address the risk of nature-deficit disorder, improving health and social outcomes in young people (7).

In another paper, nine recommendations are drawn for addressing nature deficits at the population level. Some of these include bringing green everyday spaces and views closer to both work and educational settings, and bringing green activities and events into towns and cities. It also includes making green activity programs more accessible in communities, and to be considerate of barriers which can prohibit people starting green activities (1).

For the general population; the responsibilities for improving access to nature in towns and cities truly lies with the government and city/ town council to support better utilisation of public spaces for engaging in green activities and community growing projects. For workers; company owners may be encouraged to integrate nature into the work space or working life where possible, whether this be bringing indoor plants into offices or offering better working hours to allow for more time for workers to access and enjoy green spaces.

It is most clear that better nature education and improved green spaces in schools and educational settings is of upmost importance for the wellbeing of children.

As we have seen, there is a strong case for re-engaging with the outdoors, on a number of different levels- as a means of enhanced personal and environmental wellbeing. It is our natural biological connection to the surrounding ‘life’ that we are part of – which brings us wellbeing.

The issue of nature access is something we can all consider. As we can see, nature is not always directly accessible, particularly in heavily urban areas of cities. The first step is to spread the awareness of this issue whether you are directly effected or not, we can all play a part in supporting people in our communities.

Supporting or engaging with local community projects that offer forest school activities for children or community food growing projects in cities is a great way to help move nature closer to the communities that need it the most.

One can find out about projects that are bringing nature closer to cities by visiting the World Economic Forum ’15 innovations bringing nature back into our cities’ or contact your local school or council to find out if there is a way to support nature projects for children in your area.

We can see a clear link between the missing connection that is caused by a lack of interaction with the natural world and lower level of overall wellbeing, in both mind and body. When humans engage with the world more primitively through walking outdoors, gardening, community growing, foraging or working with natural resources; the value of the human – nature relationship also becomes more immediate, and its importance is realised.

The matter of nature connection is personal and societal but it is also environmental- with restored connection comes a true value for the natural world, a value that would mean we would want to care for it, because we are part of it – both preserving and sustaining it for the future generations and for all life on earth.

1. Ming” Kuo, F.E. (2013). Nature-deficit disorder: evidence, dosage, and treatment. Journal of Policy Research in Tourism, Leisure and Events, 5(2), pp.172–186. doi:10.1080/19407963.2013.793520.
2. Tillmann, S., Tobin, D., Avison, W. and Gilliland, J. (2018). Mental health benefits of interactions with nature in children and teenagers: a systematic review. Journal of Epidemiology and Community Health, [online] 72(10), pp.958–966. doi:10.1136/jech-2018-210436.
3. McCormick, R. (2017). Does Access to Green Space Impact the Mental Well-being of Children: A Systematic Review. Journal of Pediatric Nursing, 37, pp.3–7. doi:10.1016/j.pedn.2017.08.027.
4. Sobko, T., Jia, Z. and Brown, G. (2018). Measuring connectedness to nature in preschool children in an urban setting and its relation to psychological functioning. PLOS ONE, 13(11), p.e0207057. doi:10.1371/journal.pone.0207057.
5. Hunter, R.F., Cleland, C., Cleary, A., Droomers, M., Wheeler, B.W., Sinnett, D., Nieuwenhuijsen, M.J. and Braubach, M. (2019). Environmental, health, wellbeing, social and equity effects of urban green space interventions: A meta-narrative evidence synthesis. Environment International, 130, p.104923. doi:10.1016/j.envint.2019.104923.
6. World Economic Forum. (n.d.). 15 innovations that are bringing nature back into our cities. [online] Available at: https://www.weforum.org/agenda/2022/01/15-innovations-helping-cities-become-nature-positive-biodiverse-hubs/ [Accessed 9 Aug. 2022].
7. Warber, S.L., DeHudy, A.A., Bialko, M.F., Marselle, M.R. and Irvine, K.N. (2015). Addressing ‘Nature-Deficit Disorder’: A Mixed Methods Pilot Study of Young Adults Attending a Wilderness Camp. Evidence-Based Complementary and Alternative Medicine, [online] 2015, pp.1–13. doi:10.1155/2015/651827.

“I think I’ve accepted that the time has come to ask you for a prescription for antidepressants”, she said. “I never thought I’d be here; I’ve always managed but I’m in the depths of despair.” My heart went out to Penny, a private, thoughtful and generous woman who has been my patient for many years but who consults rarely.

Penny is in her early 80s now and was reeling in the aftermath of the death of her beloved daughter after caring for her overseas before she died from complications of cancer. Uprooted, unattached and disorientated, life no longer had meaning or any sense of purpose. “I knew one day the time would come, maybe this is it, the end of the line?”, she mused, more to herself. You may wonder how this story panned out.

If you work in primary care as I do you may know the likely path – perhaps a negotiation around a prescription, a referral to the local psychology service, ongoing attentive follow up, perhaps a resignation on all sides that this is how life will be. We have been there many times. But what if there is another way? What if we have what we need to do things differently, more imaginatively?

Before I share what happened next for Penny, let me tell you some other stories. Three ‘what if’ stories. First, how environmentalist Rob Hopkins co-founded Transition Town Totnes and the Transition Network.

He is the author of ‘From what is to what if: unleashing the power of the imagination to create the future we want (2019)’. Rob asked himself a ‘what if’ question when he founded Transition, a movement characterised by people self-organising to develop local projects which strengthen community resilience and reduce carbon emissions. It describes itself as a movement of real people coming together to reimagine and rebuild our world using ‘head, heart and hands’.

It began with two groups, in Kinsale in Ireland and Totnes in Devon, in 2006, growing to more than 1,300 initiatives across more than 50 countries. Initially focusing on concerns relating to climate change and peak oil, its remit has broadened to include groups working on food, energy, community relationships, engaging with the natural world, localising the economy, skill development and sharing. Writing in the Journal of Public Health, Rob suggests that Transition could help reduce the pressure on the NHS through reframing change, preventing disease, improving staff wellbeing and increasing local economic resilience (1,2).

Our second story is about Dr Michael Dixon, a GP in Cullompton, Devon. His numerous roles include National Clinical Lead for Social Prescribing, Medical Advisor to HRH the Prince of Wales and Chair of the College of Medicine. I heard about Michael as one of the growing number of GPs, who like Bromley-by-Bow’s Sir Sam Everington, had also asked himself a ‘what if’ question.

As a result, the green spaces around his practice are now used therapeutically and creatively for the benefit of patients and staff. Michael recalls: ‘No one had previously been in the medical profession in my family. I was keen to do a job that made a difference though my initial interest was more in the mind than the body.

My interest in complementary medicine developed after 10 years as a country doctor as I began to realise that there were so many gaps in what we could do for patients using only conventional medicine – for example patients with chronic tiredness, frequent infections, irritable bowel, premenstrual syndrome, depression, stress, back pain, neck pain and so many other conditions. It was frustrating to have such a limited range of options for treating conditions that I would see in surgery every day. It made my medicine more effective and colourful and restored my sense of self-worth as a doctor.’

The third ‘what if’ story, is my own, of a woman of mixed heritage, from everywhere and nowhere, a ‘mongrel’ as my father affectionately said. Since I first found my place in 1997 when I started working as a GP in Kentish Town, north London, I have witnessed a lot of change: progress through clinical advances and better technology certainly. But in stark contrast we find ourselves living in increasingly disconnected times, unmoored from a sense of place or belonging and exposed to bewildering arrays of consumerist choices that sometimes feel like no choice at all.

It seems we have lost a sense of who we are or what we should do; many people feel lonelier and more afraid. Like Michael, I see this expressed every day: in mental health problems, in the many chronic diseases born of our ‘modern’ lifestyles, addictions, persistent physical symptoms and chronic fatigue.

Sadly as a profession we may over-diagnose, and respond by supplying an expanding array of medications, unrealistic ‘magical’ cures or attempting to anaesthetise distress (3). Much is missing in the space humans now inhabit, whiplashed between extremes of passivity and constant unquestioning actions and reactions. No wonder we find solace where we can, getting lost in electronic worlds, overfed and undernourished, in bloated consumption whether of goods, gaming, gambling or chemical substances of one kind or another. If these ‘remedies’ are so good, why do so many people feel unhappy?

Can social prescribing be truly restorative? Perhaps help is at hand? Social prescribing is in vogue and huge hopes are being laid at the doors of the ‘growing army of social-prescribers’ tasked to help us on the frontline in primary care (4). But in primary care we are fatigued and sceptical, for we are used to empty promises. In reality though, is this sort of language helpful? Are we really in a battle, a fight with problems that needs fixing? Or might the notion of social prescribing act as an invitation to reflect, use our collective imagination and respond in other ways?

Change comes about at the margins. People in the centre are not going to be the big change makers. You’ve got to put yourself at the margins and be willing to risk in order to make change. But more importantly, you have got to approach differences with this notion that there is good in the other. That’s it. And if we can’t figure out how to do that – if there isn’t the crack in the middle where there’s some people on both sides who absolutely refuse to see the other as evil, this is going to continue.” – Frances Kissling, 2011

If it is to be used less like a traditional prescription, we have to be clear about the process of social prescribing and not focus only on its content. As an enthusiastic cook I see social prescribing’s content as the ingredients and the process as the recipe. And this recipe is just our starting point, for it’s when we cook together that we develop our skills.

So, when sipping from the cup of life, how do we want it to taste? What sort of an ingredient am I, are you: do we even know? And what part might we play in telling the story of cooking? All good recipes have been tried and tested, perhaps rooted in family and cultural history, but at the same time personalised so they become our own.

As an enthusiastic social prescription-maker, I have had to ask myself how to develop our own unique recipes for social prescribing. Perhaps we have to start by imagining what it would be like to be fully human and what we have lost along the way now that our social fabric is so threadbare. If we are to gather the yarn and start weaving together again we will need a safe base: places for integration and where we can reconnect to ourselves.

Places for re-embodying our minds, and understanding our thoughts and feelings so we can reconnect to each other, to our histories, to the world from which we have come. A place for embracing the wide mystery of our universe, so that we can hold life and its uncertainty with awe and wonder and not just fear.

This is not to say the journey will be easy. It will need courage, moral imagination (5,6) hospitality, humility, creativity and an openness to generous listening and adventurous civility in conversation. We need to hold our destination lightly, be open to possibilities, to change our minds at times, to develop the resilience and flexibility to negotiate the twists and turns that life inevitably holds.

We need to broaden our perspective, to look at what we are discarding and disregarding, moving from the linear to the circular. Nature can be our great teacher in this, the cycles of life, death and rebirth, the complexity of ecosystems, the fractals and patterns all around.

The Transition strapline is: ‘If we wait for governments, it’ll be too little, too late; if we act as individuals, it’ll be too little, but if we act as communities, it might be just enough, just in time.’ We need to move from a focus on ‘I’ to ‘we’ The African proverb reminds us: ‘If you want to go fast, go alone, if you want to go further, go together.’

My recipe for an NHS practice in transition

Nearly five years ago, we started a small project with big dreams. We called it The Listening Space. Inspired by the pioneers, Michael Dixon and Sam Everington, and with reference to the guiding principles of the Transition Network, we collaborated with patients, members of our local community and Transition Kentish Town. We crowd-funded, worked our own gift-economy, exchanging skills and time for food, good company and celebration.

We repurposed found objects and as we worked together to transform a large disused space in the courtyard of our urban general practice into a therapeutic garden, we found we had developed skills of many kinds, woven connections and made new relationships. We valued the journey, though we didn’t always know which way things would go, which can be anxiety provoking and threatening to those who like to have more concrete plans.

We decided to celebrate all the small gains along the way and not to be harsh about the things that have been less successful, seeing them instead as our good teachers. We are now so proud of our place of refuge and shelter, a place where we can free up our imaginations, a space where we can listen to what nature has to teach us.

And in opening up these possibilities, we have gained the confidence to generate new ideas, new branches from our roots. I am excited about the further possibilities opening up for our community in our latest collaboration with Jane Riddiford of Global Generation, expanding our reach by taking ‘story walks’ between the green spaces of north London.

A tree can be only as strong as the forest that surrounds it.” – Peter Wohlleben, 2016

When we started out, I felt like Penny – lost in a land without hope, burned out having been overburdened with mindless, misdirected work trapped within a system that increasingly cared for numbers rather than valuing care, in a climate of endless reorganisation, under relentless pressure from top-down initiatives.

I have found hope again by tending to the soil and working from the grassroots. I found myself ‘burning in’ to a more stable but energised place where my work regained coherence, meaning and purpose. The hours may be similar but the emphasis has shifted from the mechanistic pursuit of efficiency and outcomes, to a focus on real compassionate patient care. My joy has been restored.

In the greatest book ever written about general practice, A Fortunate Man (1967), John Berger (7) describes his friend John Sassall, a country doctor in the 1960s as ‘… a fortunate man because his work occupies and fulfils him; his work and his life are not separate’. Our project has grown, literally and figuratively. It expanded from our early gardening groups, into organised and impromptu gatherings and waiting room ‘crafternoons’, then came a poetry pharmacy and storywalking.

At the outbreak of the pandemic, galvanised by our knowledge of how to work as a good team, we were able to quickly set up a pop-up social kitchen, to feed staff and patients in need.

The role of the clinician has been to facilitate participation, to invite civility in conversation across diversity, to provide support and navigate difficulties when there is distress, or if inevitable tensions arise in group situations. Our social prescriber Jo, who facilitates and supports the various groups that have developed, acts as a true link-worker, a warm and welcoming connector between all of us in the practice. In this way our work can remain expansive.

We focus on working with our relationships and less transactionally, always aiming for more equal partnership with our patients, other community organisations, individuals and businesses. Through this participatory approach and by ensuring our activities are fun, inclusive and positive at their heart, we are growing the community we imagined, rather than building an army. As each participant finds their place we are learning to work supportively and to grow our resilience and ability to rise to the challenges we will all face.

We all, adults and children, have an obligation to daydream. We have an obligation to imagine. It is easy to pretend that nobody can change anything, that we are in a world in which society is huge and the individual is less than nothing: an atom in a wall, a grain of rice in a rice field. But the truth is, individuals change their world over and over, individuals make the future and they do it by imagining things can be different.” – Neil Gaiman, 2013

So, what of Penny? As I listened to her tale unfold and her self-diagnosis of depression, I gently suggested that perhaps in her situation, sadness was understandable. And sadness requires mainly gentle observant company and community. We talked of what once had nourished her, her love of nature, of gardening and of her teaching.

With our expanded outdoor ‘consulting room’ we were able to offer an alternative prescription. That evening, Penny and I met, wandered among the flowers, the herbs and the productive beds of The Listening Space. We spoke of other gardens, the power of nature to ground and to heal; and imagined together a different future path. Penny joined us the following day for a distanced, intergenerational gathering and walk between The Listening Space in Kentish Town and The Story Garden in King’s Cross.

I spoke to her in a follow-up appointment two weeks on from our more despairing conversation. ‘I can’t believe how different life looks. I didn’t think at this point in my life, there could be anything else. But I know where I am now and what I want to do with whatever time remains for me.’ Penny is now volunteering with us, a valued, worldly-wise elder in our community already sharing English conversational skills with those from other lands who are also growing roots in our re-generating and remembering community.

What if GP surgeries became catalysts for Transition? So how do we weave a stronger social fabric; how do we learn to mend, remake, grow it and sew it? I was fortunate enough to be in conversation with Rob and Michael as part of Rob’s podcast series ‘From What If to What Next’ (8), where we were given generous space to reimagine healthcare for the future and had carte blanche to suggest policies as ministers of the imagination. Perhaps you will listen and join us?

The system will collapse, if we refuse to buy what they are selling – their ideas, their version of history, their wars, their weapons, their notions of inevitability. Remember this, we be many, and they be few. They need us more than we need them. Another world is not only possible, she is on her way. On a quiet day, I can hear her breathing.” – Arundhati Roy, 2003

Penny is not my patient’s real name although she gave me full permission to share her story with you. She told me at our last meeting that she had spoken to her friends about what had happened to her and reported their collective wish to have care and treatment in practices like ours. Yet I do not believe we are all that unusual, though we have travelled into a less unfamiliar place.

Having explored the territory we are here to tell you about the wonderful view and invite you along. So I write this piece in ‘Penny’s’ honour and on behalf of all the future patients we may be better able to serve if only we free up our imaginations, let our compassionate, authentic human selves back into our work, knowing we too will find nourishment in the process. If we in general practice were to act as hubs and safe spaces for transition, what would our world be like?

1. Smith J, Hopkins R, Pencheon D. Could the Transition movement help solve the NHS’s problems?. https://academic.oup.com/jpubhealth/article/39/4/841/2631018. Published 2016. Accessed December 3, 2016.
2. Hopkins R. A healthy society is just as much about community as healthcare. The Guardian. Published 2014. Accessed August 17, 2022.
3. Heath I. Overdiagnosis: when good intentions meet vested interests–an essay by Iona Heath. BMJ. 2013;347(oct25 2):f6361-f6361. doi:10.1136/bmj.f6361
4. Support D. NHS England bids PCNs to hire ‘army’ of social prescribers. Pulse Today. https://www.pulsetoday.co.uk/news/workforce/nhs-england-bids-pcns-to-hire-army-of-social-prescribers/. Published 2022. Accessed August 17, 2022.
5. Sacks J, Sacks B. Morality: Restoring The Common Good In Divided Times. Hodder and Stoughton; 2020.
6. Novogratz J. Manifesto For A Moral Revolution.
7. Berger J, Mohr J. A Fortunate Man, The Story Of A Country Doctor. London: Penguin Press; 1967.
8. Myat J, Dixon M. From What If to What Next: Episode Four: What if doctors’ surgeries became catalysts for Transition?. SoundCloud. https://soundcloud.com/transition-culture/from-what-if-to-what-next-episode-four-what-if-doctors-surgeries-became-catalysts-for-transition. Published 2022. Accessed August 17, 2022.

Bibliography

1. Gaiman N. Neil Gaiman: Why our future depends on libraries, reading and daydreaming. the Guardian. https://www.theguardian.com/books/2013/oct/15/neil-gaiman-future-libraries-reading-daydreaming. Published 2022. Accessed August 17, 2022.
2. Heath I. Overdiagnosis: when good intentions meet vested interests–an essay by Iona Heath. BMJ. 2013;347(oct25 2):f6361-f6361. doi:10.1136/bmj.f6361
3. Hopkins R. From What Is To What If – Unleashing The Power Of Imagination To Create The Future We Want. Vermont: Chelsea Green Publishing; 2019.
4. Hopkins R. A healthy society is just as much about community as healthcare. the Guardian. https://www.theguardian.com/lifeandstyle/2014/jun/26/healthy-society-about-community-alongside-healthcare. Published 2014. Accessed August 17, 2022.
5. Kissling F. Frances Kissling — What Is Good in the Position of the Other. The On Being Project. https://onbeing.org/programs/frances-kissling-what-is-good-in-the-position-of-the-other-sep2018/. Published 2022. Accessed August 17, 2022.
6. Novogratz J. Manifesto For A Moral Revolution: Practices To Build A Better World. Henry Holt and Co; 2020.Rilke R. Letters To A Young Poet. Penguin; 2012.
7. Support D. NHS England bids PCNs to hire ‘army’ of social prescribers. Pulse Today. https://www.pulsetoday.co.uk/news/workforce/nhs-england-bids-pcns-to-hire-army-of-social-prescribers/. Published 2022. Accessed August 17, 2022.
8.  Wohlleben P, Flannery T, Billinghurst J. The Hidden Life Of Trees. Greystone Kids; 2016.

When I was in my early twenties, I spent several months living in an eco-community in the desert in the South of Spain.

A beautiful, run-down, sun-baked valley peopled with food growers, permaculturists, hippies, turtles and stray cats. In the garden there was a hand-painted sign.

Created long ago, now chipped, it read: If you want to know if something is sustainable, ask yourself – can I do this forever?

For me, this question cuts through the greenwash, the jargon, the myriad ways with which this word is thrown around, to the very heart of the issue.

The etymology of the word sustain speaks to the concept of ‘giving support’, and ‘holding up’. Also a sense of enduring. It is these readings of the word sustain that colours the work that we do with children in the woods.

At our Forest School nursery, children enrol for a minimum of a year. However, most children join at the age of 2 ½, and stay for two years, before they go to school. Spending this formative time immersed in the woods is an experience that embeds itself in their developing psyches. It is the most experiential way to teach children about sustainability that I know.

The children begin their time in the woods in September, in mushroom season. They learn to spot fungi at the base of trees, to let their friends know what they’ve found, to check a guidebook to see if they can identify it. They learn that we do not touch mushrooms with our hands, only poke them gently with a stick. They learn the hard way what a puffball mushroom is, and what it does!

As the seasons change they learn about the changes to the light and the effect this has on the leaves. They learn what deciduous means, and play in the falling leaves. And they discover the value of the evergreens: playing in the safety of Ivy Palace in the depths of Highgate Woods when all of the other trees are bare; climbing its ladder of horizontal branches.

The children learn that the birds eat berries in deepest winter, and so we gather a few blackberries but leave the rest for the robins, crows, magpies that they learn to name. A robin visits us each morning at snacktime, so we sprinkle a few crumbs each day.

We play in the snow, and the slush after the snow, then the mud left after the slush is gone. We pull on waterproofs so that we can play in the woods in any weather, and we celebrate the rain by jumping in the puddles. We notice the buds on the blackthorn before anyone else, because we are in the woods each day down at toddler level, and we spot the hawthorn leaves unfurling early in the spring.

The children learn to spot each small change and to celebrate the changing of the seasons. With change comes loss, and the woods teaches us this too. As the trees become leafy once more the children discover they can no longer see across camp, and the landscape changes completely. The playscape changes as they develop: suddenly they can hide behind the bushy foliage, and so we must grow our trust in them, as they become more confident.

We miss the fungus in the summer, and so instead we gather flower petals for hapa zome, practising our fine motor skills and experiencing the magic of natural dyes. As is the gift of foraging, we understand the brief season of each plant, its finite nature, and we take only a little of each. And in exchange for the many ways that the woods sustains us, giving us resources and opportunities for play, we teach the children to reciprocate their care.

We leave most of the berries for the birds, most of the flowers for the insects. We offer sleepy bees water and we turn over the bugs who we find struggling on their backs. We bury dead birds with ceremony, and we test the branches we climb on with a small bounce to make sure they are strong enough to hold us without breaking. These children learn that they are a part of the woods.

They do not yet know of the innumerous cases of humans destroying natural environments. Nor have they received the message, perpetuated by many contemporary conservation efforts – that humans must stay away and leave nature to itself. Instead they learn each day that we are a part of this environment – that we always were and we always will be, if we can sustain these ancient woodlands and protect them for the future. These children discover that the woods is a place that gives them shelter from rain, shade from sun, wild food, animal friends and endless invitations to play.

As a part of their natural and healthy development, children play with their power. They play with the creative drive, and the drive to destruction. This is a vital part of development, of growing up and discovering the impact you can have in the world. The woods is the place to learn this.

Each child at some point builds a den. Perhaps their friend builds a den. And each child at some point must knock down their den. Perhaps their friend’s den too. Just to see what happens. To experience the thrill of the clatter of the logs, the collapse of the delicate structure. Their friend’s tears, even. Each child too will snap a flower off its stem. Rip every leaf off a stalk. Run after a bird and scare it out of camp. And therein lies the learning.

The den can be rebuilt, the friendship too, in time. But the bird will have to be coaxed back into camp with breadcrumbs, and the flower will not come back this season. Actions have consequences, and the woods is an interactive place in which to learn this. Cree and Rob conclude: ‘the familiar song of the robin is part of the Forest School community, and while we value its company, we need to respect its home and take care of the community. The reciprocal feeling with the robin has the comparable worth of a rainforest or coral reef’ (1).

We can extend our engagement with the woodland, and our discoveries of our own powers to create and destroy, using tools. The sight of toddlers wielding saws, hammers and axes is a sight you will never forget. The sight of two toddlers helping each other to use a bow saw to cut a log in half, or using a froe to split wood for the fire, reminds us that these children are the environmental stewards of the future.

We use only hand tools in the woods – flints and steels to light fires for cooking, mallets to hit pegs when we create shelters. In doing so, we engage more deeply with the woodland as a resource that can be renewable only if we do not exploit it. We remember that wood can be fuel, that stakes and binders from coppice woodlands can be fences, that a hedgerow is a habitat. Each of these acts of tool use is an act of transformation.

Cree and Robb write that ‘being able to make an item from a tree that you can harvest and then used to produce something of utility, while consciously honoring this, provides access to, and gives voice to the more-than-human world’(2).

These simple tools enable us to work with the woodland in a way that is sustainable, that factors in the delicate balance of its ecosystem, but that allows for an interaction with the woods where so much more can be learned than if we simply left alone. Including children in that work develops their relationship with the woodland profoundly. By teaching children to look after the woodland in reciprocation of the ways in which the woodland cares for them, we give them a message that humans can be forces for good within a habitat, if we proceed with care.

At the ages of 2 and 3 our brains and neural pathways are still forming. In later life we can consciously recall very little, if anything, from these years. And yet, the experiences we have during these years, and in particular the attachments that we make, form a key part of our development.

If we experience the reciprocal care of a woodland during these formative years, we carry this sense with us for the rest of our lives. While talking about the transformative potential of Forest School for young children, we must take a moment to look around us at our context.

As a result of rapid urbanisation of environments and the population over the twentieth and twenty first century, children’s access to the natural world has been shrinking correspondingly.

A culture of outdoor play in urban areas has been replaced with ‘stranger danger’, fears of traffic and an unwillingness or inability to give children hours of unstructured time to explore (3). So often this has a socio-economic correlation: parents working long hours on low wages are unable to supervise their children, who must then stay indoors; families living in polluted or built-up areas do not have access to local wild spaces.

While acknowledging the importance of access to outdoor space, and to curated, long-term experiences of nature connection, we must also consider which children have access, and which do not. Bringing Forest School to all primary schools, so that all children can participate in their early lives, is a vital part of developing the breadth and potential of this educational method (4).

Education for sustainability is a critical part of the work that needs to be done in these times. One element of making education sustainable, is to pass this knowledge on to children. This generation will grow up to discover the damage done to wild lands at the hands of humans, and will be well served to act differently when it is their turn to act, with the inherent knowledge of how to exist peacefully within an ecosystem, embedded in them at the age of 2. As David Sobel so eloquently writes: ‘If we want children to flourish, to be truly empowered, we must first allow them to love the earth before we can ask them to save it’.

1. Cree, Jon, and Marina Robb. The Essential Guide to Forest School and Nature Pedagogy. Routledge, 2021. p. 13
2. Cree, Jon, and Marina Robb. The Essential Guide to Forest School and Nature Pedagogy. Routledge, 2021. p. 296
3. Wilson, RA, and D.A. Simmons. “Helping Children Learn to Love the Earth Before We Ask Them to Save It:.” Dimensions Educational Research Foundation, https://dimensionsfoundation.org/wp-content/uploads/2016/07/helpingchildrenlovetheearth.pdf. Accessed 9 August 2022.
4. Knight, Sara, ed. 2011. Forest School for All. SAGE Publication
5. Sobel, David. Beyond Ecophobia: Reclaiming the Heart in Nature Education. Orion Society, 1996

There is an important distinction to make between risky play and dangerous play. At no point during a Forest School session are children in any danger. But at many points during a Forest School session the children are supported to take risks.

In any risk-taking we meet children exactly where they are at, and ensure that they are ready for, and keen to move towards their next steps. This can look like a child who is terrified of climbing trees, practising clambering onto a stump, and jumping off, over and over, holding our hands. And then again, without needing to hold hands any more.

It can be a child who is a confident tree climber, practising climbing up to 3 feet, then 4 feet, then 5 feet above our heads, once they have the skills to do so safely. This can look like handing a 3 year old a hammer and encouraging them to hit a billhook to split a log for firewood. Children show us in their own time, and their own ways, that they are ready to develop independence, balance, strength, and skill.

The great-grandfather, aged 8 in 1919, was able to walk 6 miles alone to go fishing. His son, aged 8 in 1950, could walk about a mile alone. His daughter could walk half a mile alone. And her son, aged 8 when this map was created in 2017, can walk only 300 yards to the end of his street. It goes without saying that urbanisation has changed the landscape dramatically, both physically and socially.

However this map reminds us of the stories our parents and grandparents tell us, about days spent in the wild, picking blackberries, fishing, playing, roaming. So often our favourite childhood memories are spent in nature, and so often, these memories have a quality of timelessness. Time passing unmarked, an entire summer holiday spent by a river, nowhere to get to, and no adults to hurry us along. It is this that is lost for contemporary children, and it is this that we can hand back to them, at Forest School.

Of course we know where the children are during our Forest School sessions, and we do not send them 6 miles down the road to go fishing! But by running child-led sessions, we can offer the children the opportunity to become deeply engrossed in the flow of play. For the children, being given autonomy over their time, and choices over what to do with it, has the direct result of building self-esteem.

In January, a little boy joined our Forest School Club. He was 4 years old. I will refer to him as M.

M was recommended to us after starting primary school, and promptly leaving it again. He struggled with sensory overload, and the intensity of sitting down all day in an over-stimulating environment. He used to run out of class screaming. He didn’t make friends, and came to believe that he couldn’t ‘do’ school. The school found it difficult to cope with him, and by Christmas he had left his reception class, refusing to go back.

When he arrived at Forest School, he was withdrawn and anxious. He wouldn’t sit with the group, and if we approached him he would run away, hit and spit. Over time, he would sit at the edge of camp at the base of an oak tree, and permit me to hover nearby. As we would sit there peacefully, we would spot birds and insects. He was incredibly observant, and began to learn their names.

Still he felt uncomfortable in the group, and would only sit on the peripheries of the circle. A few sessions in we introduced him to the hammock, which he loved, and in which he could spend hours. He would stare at the leafy canopy and tell me ‘faster, faster!’ I spent hours with him, rocking him in the hammock, and slowly began to get to know him.

After some time he would hold a butterfly identification guide in his hands and watch to see which butterflies flew by. He became calmer, and more trusting, and began to sit with the group during lunchtime.

One day we sat at the base of a cherry tree, and he spotted the resin seeping out and hardening. He asked about it, and I explained about resin, and about how it forms amber when compressed deep under the ground. I showed him my amber ring, and he said that he wanted to make one.

The boy who had never entered the tool circle, never picked up a tool, felt the intrinsic motivation to walk across camp and pick up the tool bag. Having taken time to observe the other children, he knew exactly what to do.

He used a small hack saw to remove a piece of resin. He used a bow saw to cut a disc of wood, and a palm drill to make a shallow hole inside it. He used wood glue to secure the resin to the disc, and tied a knot in the twine to tie it around his neck. He then showed the other children the source of the resin, and how to use the tools to make their own jewelry.

Over time I discovered that he was exceptional at maths – able to calculate the number of children in camp each day almost immediately. We saw him develop teamwork – whittling the bark from a length of hazel with another child, turning the log each time they’d completed one side. And I discovered the depth of his empathy the day that I sneezed, copiously, as the willow pollen blew across the woods. He asked me why I was sneezing, and I explained that it was allergies. He asked me, are you going to sneeze all day? He disappeared, and returned with a pocketful of tissues, saying: I think this will be enough for the whole day.

This is only one case study of many, that demonstrates the ways in which Forest School can be transformational for children in their developmental pathways. So often, children who struggle in a classroom come to believe that the problem lies with them, and that they simply cannot learn.

Often these children are problematised and blamed, by teachers who are themselves struggling with a class of 30 children with diverse needs. When these children are offered an alternative learning space in which they are given the tools to self-regulate, the support to take risks, and the space to build their self-esteem, they come to discover that they are both able, and in fact love, to learn.

Since the pandemic, teachers and Early Practitioners internationally have noted a significant rise in the number of children arriving at school with speech and language delays and social and emotional difficulties (4). For many, when access to school was limited to teaching online, and our access to the outdoors curbed to one walk per day, there was a deep realisation of how much we needed and valued both our learning communities, and our time in wild spaces.

‘Of more than 200 forest schools surveyed by the Forest School Association (FSA), about two-thirds said demand for their services had increased since March 2020.’(5). As part of this study, Forest School providers were asked why they believed that attendance had rocketed in this way. Amongst the reasons cited were ‘increased awareness of the benefits of the outdoors, especially in relation to stress and anxiety, Covid safety, and dissatisfaction with the school syllabus after months of pandemic homeschooling.’

In their discussion of Forest School as an alternative pedagogy, Goodenough and Waite consider the difficulties of integrating Forest School within the current English Education system; so often a system in which ‘children, parents and carers are positioned as customers, while progress is expected for all children and judged through outcomes rather than prescribed pedagogical approaches’ (6).

In such a context, it is challenging to integrate Forest School, particularly as you travel up from Early Years into Primary and Secondary School. Indeed, it is the attempt to integrate Forest School that so often sees the dilution of the key principles; a creeping need to cover curriculum adds a pressure to the sessions that distracts from the core principle that the sessions are child-led.

We must begin to consider which skills the children of today will require most in the coming years, and which educational methods can best give them the resilience, self-esteem and grounded-ness that they will need.

It is clear to me, from my time spent working in Forest Schools, that these spaces in which we are in community with one another, with the seasons, with the creatures of the forest and with the trees, offer children time and space to develop at their own pace. At Forest School, everything is relational.

Children learn alongside their peers, they help friends who are still learning, and they develop in the areas that they individually need most. It is astonishing to observe children arrive in the forest in September, so quickly show us their needs, and then gravitate to their own developmental pathway to address those needs. When we give children the space to do so, they can lead their own learning.

In this way, they discover an intrinsic motivation to learn, unfettered by praise or punishment, instead embracing learning for learning’s sake. For the children who experience this formative time in the woods, there will forever be a connection and a gratitude to the forest, giving these children the skills and the care to become the next generations’ environmental stewards.

1. What is Forest School? | Forest School Association. Forest School Association. https://forestschoolassociation.org/what-is-forest-school/. Published 2022. Accessed August 24, 2022.
2. Cree J, Robb M. The Essential Guide To Forest School And Nature Pedagogy. Routledge; 2021:16.
3. Skenazy L. How Children Lost The Right To Roam. Freerangekids.com. https://www.freerangekids.com/wp-content/uploads/2017/02/how-children-lost-the-right-to-roam-map.jpg. Published 2022. Accessed August 24, 2022.
4. Impact of COVID-19 on Early Childhood Education & Care. Post Parliament UK. https://post.parliament.uk/impact-of-covid-19-on-early-childhood-education-care/. Published 2021. Accessed August 24, 2022.
5. Forest schools flourish as youngsters log off and learn from nature. The Guardian. https://www.theguardian.com/education/2021/oct/31/forest-schools-flourish-as-youngsters-log-off-and-learn-from-nature. Published 2021. Accessed August 24, 2022.
6. Waite S, Goodenough A. What is different about Forest School? Creating a space for an alternative pedagogy in England. Journal of Outdoor and Environmental Education. 2018;21(1):25-44. doi:10.1007/s42322-017-0005-2

With the rising popularity of essential oils in recent years, increasing biodiversity losses worldwide, and the very real impacts of climate change becoming ever clearer and more urgent, talk within the aromatherapy community has turned towards the sustainability of essential oils.

There are questions to be asked surrounding the environmental and social impacts of using these precious medicines. How sustainable actually is this natural form of medicine? Are there steps we can take to mitigate the impacts of essential oil use? Are there other factors at play that influence sustainability?

First, it’s important to put this into context. Of around 350,000 scientifically-known and documented vascular plants (1), those that are known to be medicinal represent roughly 25,790 and of those, around 1500 are aromatic, which is approximately 6% of all known plants. About four hundred species of aromatic medicinal plants are commonly traded for aromatherapy purposes worldwide, which includes essential oils, absolutes, and hydrosols (2).

The State of the World’s Plants and Fungi (SOTWPF) report published by the Royal Botanic Gardens, Kew in 2020 states that two in five plants are threatened with extinction. This means 40% of all recorded plant species, and should ring alarm bells for everyone, as human-led practices such as agriculture, climate change and biological resource use are amongst the primary reasons for this threat (3).

10% of aromatic plants are currently listed as threatened according to The International Union for Conservation of Nature (IUCN) (4). Practices such as deforestation, clearing and using plants with no or unsustainable plant regeneration practices, monocropping and overharvesting wild species all contribute to the unsustainable production and use of essential oils, and therefore increase the likelihood of more species being added to the red list of endangered species.

Simultaneously, these practices damage the biodiverse ecosystems which support the growth of our aromatic plants in the first place. The approach of destroying whole areas of forest to harvest just one aromatic tree does not make sense from a biodiversity standpoint, but there are adaptations we can implement in farming and production of essential oils which can reduce and mitigate the harmful effects of these practices.

Demand for medicinal and aromatic plants is undoubtedly on the rise. The world has seen “a threefold increase in global trade in medicinal and aromatic plants since 1999” (5) which is largely due to the growing popularity of spas, natural cosmetics, pharmaceuticals, and aromatherapy.

According to The Business Research Company’s 2022 report, the global essential oils market size is expected to grow from $12.36 billion in 2021 to $13.58 billion in 2022 at a compound annual growth rate (CAGR) of 9.90%.

The global essential oils market share is expected to grow to $21.85 billion in 2026 at a CAGR of 12.62% (6). This projected growth brings with it concern surrounding the profitability of the essential oil and aromatherapy sector for large companies that hold a large market share, many of whom have come under scrutiny for promoting dubious practices.

The 2020 Netflix documentary series “(Un)well” shed light on controversial practices within the essential oil industry (7), and should perhaps make us consider the lengths certain companies will go to in order to profit. It is unclear which, if any, environmental sustainability protocols are taken into account or adhered to by big players in the sector, and as such, extra care should be taken and due diligence carried out on any essential oil suppliers.

This, however, requires knowing which questions to ask them, what documentation or records should be available, and how to choose oils to minimise our impact as individual consumers or therapists.

The IUCN labels species as “critically endangered”, “endangered” or “vulnerable”, and as such, a good place to start when sourcing essential oils is to avoid any that come from plants which feature on this list. Agar wood (Oud) Aquilaria malaccensis , Spikenard Nardostachys jatamansi, Sandalwood Santalum album, Palo Santo Bursera graveolens, Atlas Cedar Cedrus atlantica and Rosewood Dalbergia sissoo are all examples of threatened species which should be avoided due to their precarious existence.

In general, harvesting essential oils such as those listed above, which are taken from the heartwood of the tree, has a particularly negative impact on habitats since the whole tree needs to be cut down in order to access the essential oil.

Frankincense (Boswellia carterii) is an extremely popular essential oil, yet its popularity, coupled with the effects of climate change, mean that this once-abundant oil is now in short supply (8). Boswellia forests aren’t able to regenerate fast enough to keep up with the current demand, and so due to over-harvesting, many have disappeared.

Unsustainable harvesting methods include “making a higher number of cuts per tree to extract as much sap as possible and tapping the trees all year round rather than seasonally” (9) which doesn’t allow sufficient time for trees to recover. Furthermore, these intensive practices “weaken the trees, impeding their regrowth and ultimately killing them” (10).

Also take a look at our article on the sustainability of frankincense.

Sustainability isn’t just an environmental concern, however. Frankincense comes primarily from Somalia, Africa, India, Oman, and Yemen (11) where climate change will hit hardest (12), and where harvesting is often one of the main livelihoods for local populations.

There are increasing reports of frankincense resin tappers risking their lives “by climbing up cliffs to find new sources”(13) of frankincense, and there have been “reports of people suffering injuries including breaking legs and in some cases death” (14).

Unfortunately, frankincense may quickly be becoming one of the most unethical and unsustainable essential oils available.

It is clear that wider socioeconomic factors such as safety, and the longevity of local livelihoods merit serious consideration as well as the adoption of more sustainable practices when it comes to the production and consumption of essential oils.

Initiatives such as the ‘Adapting Agriculture to Climate Change’ programme, led by the Crop Trust in partnership with Kew and others, will be key in addressing the environmental, social and economic changes which will be caused by global warming.

Essential oil production has a high mass-to-yield ratio, since in order to produce essential oil, large quantities of aromatic plants are required.

For example, 10,000 lbs of rose petals, 250 lbs of lavender, 6,000 lbs of melissa, or 1,500 lbs of lemons respectively are required to produce just one 1 lb of essential oil (15).

In terms of yield, this is extremely low, and so the question of whether the process and extraction of essential oils is wasteful warrants consideration.

Despite Calendula’s popularity in the cosmetic and pharmaceutical industries, a 2020 Colombian study of a supply chain for Calendula officinalis essential oil production found that “high amounts of exhausted biomass (more than 95% w/w) are produced and wasted” (16) in the course of its production.

However, the research revealed several key touchpoints within the supply chain where opportunity exists to reduce emissions (changing how the oils are distilled, for example) and also to contribute to the “social development of farmers” (17) in Colombia through using the exhausted biomass leftover from the plant matter as a “potential high-value “non-conventional agro-industrial feedstock” (18).

More research into using aromatic plants as feedstock for agriculture is needed, yet this does seem to represent a possible solution to one of the issues associated with essential oil production and waste.

Another study focused on the opportunity to use waste from the food industry to produce essential oils, namely citrus peel leftover from juicing (19). Whilst several extraction methods including steam distillation, cold-press and solvent extraction, were tested, solvent-free microwave extraction was identified as the most effective in this study.

This method would probably produce resulting essential oils which would be unsuitable for therapeutic use, but the trials do represent an interesting experiment and opportunity to close the gaps in food production cycles through potentially bridging industries and creating a more circular economy.

FairWild are also a fantastic initiative, and their mission is “to enable transformation of resource management and business practices to be ecologically, socially, and economically sustainable throughout the supply chain of wild-collected products. These include plants, fungi, and lichen – wild resources under enormous pressure worldwide.”

Using essential oils with respect is one way we can minimise our consumption of essential oils and therefore our impact on the environment. For most aromatherapy products we make at home, we only need to use very small amounts of essential oils. Despite their comparatively low yield of plant matter to essential oil, they are extremely concentrated plant extracts, so little is needed to produce excellent therapeutic and aromatic effects. If stored in an airtight bottle away from light and heat, they have a good shelf life – several years, in fact, which makes them a good investment.

Since essential oils can be used to make home-made cosmetics, therapeutic herbal remedies and cleaning products, they can be harnessed in this way to reduce the number of products we buy in single-use plastics from large corporations. This has a positive environmental impact in an indirect way, since by making our own products in reusable glass bottles, for example, we’re creating less waste from other sources.

Finding alternatives to endangered species is also a key way we can reduce our impact when using essential oils. In the podcast An Aromatic Life, during episode #13, Conservation and Sustainability of Aromatic Medicinal Plants, guest Dr. Kelly Ablard advises that we should look at the chemical composition of vulnerable aromatic plants, as well as their therapeutic and energetic factors.

She suggests that instead of buying essential oils from vulnerable plants, this information will allow us to choose a chemically, therapeutically and energetically similar essential oil to ensure we are not contributing to the precarity of vulnerable species. For example, Ho Leaf Cinnamomum camphora (Linalool ct.) is suggested as an alternative to Rosewood, Dalbergia sissoo, and even practices like choosing an oil which is taken from the leaf or branch of a tree as opposed to the heartwood, which requires cutting down the whole tree, would be preferable (20).

One of the very best ways to increase our understanding of how the use of essential oils affects sustainability is through education. Learning about our local aromatic plant species, and plants in general, is key to understanding the ecosystem of which we are a part, and therefore respecting it as a diverse network of intersecting factors that deserves respect. Rather than placing ourselves at the centre of the ecosystem, biocentrism (21) takes the view that humans are just one part of this system, yet it is clear that despite this, we have a great deal of power to influence the whole network substantially, for better or worse, through our choices on both an individual and collective level.

Below are some tips to help you ensure that your essential oil purchases are as informed as possible.

Organic vs non-organic: Which way to go?

Using organic essential oils is recommended, both for therapeutic and environmental reasons. Minimising the amount of harmful pesticides we are putting on our land and onto our bodies is key to public and planetary health. The Soil Association lists lower emissions, lower levels of pollution, and more stored carbon as just three key reasons that organic farming is beneficial (22).

Purchasing power: Know your facts

Asking your supplier the right questions is key to understanding where your oils come from, and how they are produced. A good supplier will often know their farmers and distillers personally, understand and be able to provide you with information on the farming and production practices, and take great care to make it clear exactly how they source essential oils sustainably. Beware of woolly, vague or contradictory information, and essential oils that seem cheap. If it looks too good to be true, chances are it is.

The COSMOS-standard has also been created as a criteria for sustainable cosmetics. Many large businesses subscribe to this, although more need to still.

Whilst individual consumers and therapists are not the main culprits when it comes to harmful essential oil production practices, by making small changes and demanding a level of accountability from our suppliers, we can effect positive change within the essential oil market.

Purchasing oils in small quantities, as needed, and choosing high quality, organic ingredients sourced from trusted suppliers is a good rule of thumb. Checking the IUCN red list before buying, and eliminating use of vulnerable species will also help.

There is no need to stop using essential oils, they are wonderful for physical, mental, and spiritual health – but do stay informed so you can use them responsibly.

1. Antonelli, A.*et al (2020). State of the World’s Plants and Fungi 2020. Royal Botanic Gardens, Kew. DOI: <https://doi.org/10.34885/172>
2. Galia, F. (2021). #13: Conservation and Sustainability of Aromatic Medicinal Plants with Dr. Kelly Ablard. [podcast] An Aromatic Life. Available at: <https://open.spotify.com/episode/4HBsd3PDhwJTzFZHkD7KJe> [Accessed 12th May 2022].
3. Antonelli, A.*et al (2020). State of the World’s Plants and Fungi 2020. Royal Botanic Gardens, Kew, p.14. DOI: https://doi.org/10.34885/172
4. Galia, F. (2021). #13: Conservation and Sustainability of Aromatic Medicinal Plants with Dr. Kelly Ablard. [podcast] An Aromatic Life. Available at: <https://open.spotify.com/episode/4HBsd3PDhwJTzFZHkD7KJe> [Accessed 12th May 2022].
5. Unknown. Cites.org. 2022. Medicinal and aromatic plants | CITES. [online] Available at: <https://cites.org/eng/prog/medplants> [Accessed 12 May 2022].
6. Unknown. 2022. With The Growing Spa Industry, The Essential Oils Market Is Set To Reach $21 Billion By 2026 As Per The Business Research Company’s Essential Oils Global Market Report 2022. [online] GlobeNewswire News Room. Available at: <https://www.globenewswire.com/news-release/2022/03/30/2413070/0/en/With-The-Growing-Spa-Industry-The-Essential-Oils-Market-Is-Set-To-Reach-21-Billion-By-2026-As-Per-The-Business-Research-Company-s-Essential-Oils-Global-Market-Report-2022.html> [Accessed 12 May 2022].
7. The Guardian. 2022. The dark side of wellness: behind a Netflix series on a murky industry. [online] Available at: <https://www.theguardian.com/tv-and-radio/2020/aug/12/unwell-netflix-series-dark-side-of-wellness-industry> [Accessed 12 May 2022].
8. Fobar, R. 2019. Frankincense trees—of biblical lore—are being tapped out for essential oils. [online] Available at: <https://www.nationalgeographic.com/animals/article/frankincense-trees-declining-overtapping> [Accessed 12 May 2022].
9. Unknown. 2019. Essence + Alchemy. Essential Oils – Ethical + Sustainability Issues — Essence + Alchemy. [online] Available at: <https://www.essenceandalchemy.co.uk/lab-notes/ethical-and-sustainability-issues-of-sourcing-essential-oils> [Accessed 12 May 2022].
10. Unknown. 2019. Essence + Alchemy. Essential Oils – Ethical + Sustainability Issues — Essence + Alchemy. [online] Available at: <https://www.essenceandalchemy.co.uk/lab-notes/ethical-and-sustainability-issues-of-sourcing-essential-oils> [Accessed 12 May 2022].
11. Fobar, R. 2019. Frankincense trees—of biblical lore—are being tapped out for essential oils. [online] Available at: <https://www.nationalgeographic.com/animals/article/frankincense-trees-declining-overtapping> [Accessed 12 May 2022].
12. Law, T. Time. 2019. Climate Change Will Impact the Entire World. But These Six Places Will Face Extreme Threats. [online] Available at: <https://time.com/5687470/cities-countries-most-affected-by-climate-change/> [Accessed 12 May 2022].
13. Unknown. 2019. Essence + Alchemy. Essential Oils – Ethical + Sustainability Issues — Essence + Alchemy. [online] Available at: <https://www.essenceandalchemy.co.uk/lab-notes/ethical-and-sustainability-issues-of-sourcing-essential-oils> [Accessed 12 May 2022].
14. Unknown. 2019. Essence + Alchemy. Essential Oils – Ethical + Sustainability Issues — Essence + Alchemy. [online] Available at: <https://www.essenceandalchemy.co.uk/lab-notes/ethical-and-sustainability-issues-of-sourcing-essential-oils> [Accessed 12 May 2022].
15. Yeager, N. 2017. Earth Island Journal. The Environmental Impact of Essential Oils. [online] Available at: <https://www.earthisland.org/journal/index.php/articles/entry/the_environmental_impact_of_essential_oils/> [Accessed 12 May 2022].
16. González-Aguirre, J.A., Solarte-Toro, J.C, Cardona Alzate, C.A, 2020. Supply chain and environmental assessment of the essential oil production using Calendula (Calendula officinalis) as raw material  [online] Heliyon, Volume 6, Issue 11, 2020, e05606, ISSN 2405-8440, https://doi.org/10.1016/j.heliyon.2020.e05606. Available at <https://www.sciencedirect.com/science/article/pii/S240584402032449X> [Accessed 12 May 2022].
17. González-Aguirre, J.A., Solarte-Toro, J.C, Cardona Alzate, C.A, 2020. Supply chain and environmental assessment of the essential oil production using Calendula (Calendula officinalis) as raw material  [online] Heliyon, Volume 6, Issue 11, 2020, e05606, ISSN 2405-8440, https://doi.org/10.1016/j.heliyon.2020.e05606. Available at <https://www.sciencedirect.com/science/article/pii/S240584402032449X> [Accessed 12 May 2022].
18. González-Aguirre, J.A., Solarte-Toro, J.C, Cardona Alzate, C.A, 2020. Supply chain and environmental assessment of the essential oil production using Calendula (Calendula officinalis) as raw material  [online] Heliyon, Volume 6, Issue 11, 2020, e05606, ISSN 2405-8440, https://doi.org/10.1016/j.heliyon.2020.e05606. Available at <https://www.sciencedirect.com/science/article/pii/S240584402032449X> [Accessed 12 May 2022].
19. Teigiserova, D., Tiruta-Barna, L., Ahmadi, A., Hamelin, L. and Thomsen, M., 2021. A step closer to circular bioeconomy for citrus peel waste: A review of yields and technologies for sustainable management of essential oils. Journal of Environmental Management, [online] 280, p.111832. Available at: <https://www.sciencedirect.com/science/article/pii/S0301479720317576?via%3Dihub> [Accessed 12 May 2022].
20. Galia, F. (2021). #13: Conservation and Sustainability of Aromatic Medicinal Plants with Dr. Kelly Ablard. [podcast] An Aromatic Life. Available at: <https://open.spotify.com/episode/4HBsd3PDhwJTzFZHkD7KJe> [Accessed 12th May 2022].
21. Pediaa.Com. 2022. What is the Difference Between Anthropocentrism Biocentrism and Ecocentrism – Pediaa.Com. [online] Available at: <https://pediaa.com/what-is-the-difference-between-anthropocentrism-biocentrism-and-ecocentrism/#:~:text=Biocentrism%20and%20Ecocentrism-,Definition,the%20ecosystem%20as%20a%20whole> [Accessed 12 May 2022].
22. Unknown. Soilassociation.org. 2022. Organic is Better for the Planet | Soil Association. [online] Available at: <https://www.soilassociation.org/take-action/organic-living/why-organic/better-for-the-planet/#:~:text=There%20are%20multiple%20benefits%20of,Capture%20and%20store%20more%20carbon> [Accessed 12 May 2022].

Over the course of my field work, aiming to observe the harvesting of medicinal plants at the “right times” for production of pharmacopoeial quality herbs, done in the “right ways” for sustainable resource management and trade, I can state that, in recent decades, predictability of harvest periods has become uncertain in some regions of the world. In some locations there has been notable fluctuation from year-to-year.

Anecdotally, plant harvesters have shared their observations of the changing climate, uncertainties of harvest times and yields, as these factors directly impact livelihoods and rural economies.

I have also observed some impacts of extreme weather on herb quality (e.g., stunted growth, lower yield, lower essential oil content) but also on the ability to even harvest herbs in some years due to, for example, torrential rains, flash flooding, and landslides (or conversely no monsoon at all). Changing or fluctuating growing seasons can also impact whether, or not, there will be sufficient labor available at harvest time.

In rural communities, where some villagers make some – or all – of their household income harvesting medicinal plants for trade, different herbs or mushrooms are targeted for harvesting in different months based on traditional ecological knowledge (TEK). Labor was traditionally organized accordingly. Climatic unpredictability may be impacting such TEK.

But these statements come only from my experiences and observations. The accumulated analyses of competent researchers worldwide are contributing to a growing body of scientific literature, that carries with it, I believe, urgency.

While shifting flowering and fruiting phenology (1,2), and altered phenological synchrony between plants and pollinators (3), is observable, measurable, and documented, less is known about changes that may be occurring in the composition and content of phytochemicals, so-called secondary metabolites, and phytonutrients where much of the medicinal properties lie (4,5,6).

Mismatches between plant and pollinator populations may lead to extinction of a plant species and/or its pollinator (7), especially in ecoregions of high endemism.

Plants are either adapting to changing weather patterns, and to the narrowing of suitable habitat, and/or are migrating to more suitable habitat areas (8). Or, if unable to adapt or migrate rapidly enough, some species may face a threat of extinction (9).

Endemic plants with a limited geographic distribution may be the most vulnerable (7). However, in their recent paper on endemism hotspots, Harrison and Noss (2017) concluded “Current knowledge suggests that centres of endemism will remain relatively climatically buffered in the future, with the important caveat that absolute levels of climatic change and species losses in these regions may still be large.”(10)

To inform species conservation strategies as well as the development of suitable agro-techniques for the successful cultivation of threatened wild medicinal plants, of a reproducible therapeutic quality, research on habitat range and secondary metabolites production under different climate models is still in its infancy.” (7,11) Not enough is known, yet.

Abiotic plant stresses such as elevated atmospheric carbon dioxide (CO₂), temperature and precipitation extremes, and changes in ultraviolet radiation exposure, among others, impact  phenology, physiology, and phytochemistry, which, in turn, could also impact a plant’s chemical defences against biotic stresses such as attacks by pathogens and insect herbivores (12).

Changes in phytochemical composition whether due to abiotic or biotic stressors, or both, could also have relevant implications for coevolutionary plant and pollinator interactions (13).

And it is not only insect herbivores. Arboreal folivores, such as the native Australian koala bear (up-listed from ‘vulnerable’ to an ‘endangered’ species in February 2022) (14), coevolved with eucalyptus trees, having a specialist diet, limited mainly to eucalyptus leaves (15).

Due to increasingly frequent extreme heatwaves and droughts, the koala may not be able to rely on eucalyptus leaf moisture for hydration, and, in the future, may need supplemental sources of water for survival (16). The leaves and distilled essential oil of the leaves and terminal branchlets harvested from Eucalyptus globulus trees, endemic to Victoria and Tasmania, Australia (17), are used in traditional medicines (18).¹⁸ Changes in a medicinal plant’s content and composition, if significant, “could” also impact posology and pharmacological action(s) (19).

Ghazghazi et al (2022), in their recent study on the effect of drought stress on physio-biochemical traits and secondary metabolites production in Pinus halepensis, the leaves of which are used in traditional medicines of the Mediterranean region state: “The capability of plants to respond to abiotic stress is associated with their plasticity as well as the adaptableness of plant traits to fluctuating bioclimatic conditions.”(20) According to the VILLUM Research Center for Plant Plasticity:

“Plant plasticity refers to a plant’s ability to adapt to and cope with changes in its environment. In contrast to animals, which are able to actively move away to avoid challenges such as predators or a changing climate, plants have acquired the ability to biosynthesize an unprecedented array of structurally complex bioactive natural compounds with specialized roles in order to cope with environmental challenges.” (21)

In a systematic review of papers published from 2015 to 2020, that analyzed climate change impacts on secondary metabolite production and accumulation in medicinal plants, Pant et al (2021) reported that impacts from environmental factors such as changes in temperature, elevated CO₂, elevated ozone, UV light, and drought were not only species-specific but different variables were associated with adverse impacts on plant growth and yield, as well as significant increases or decreases in secondary metabolite content (22).

Most of the following examples from the current literature concern medicinal plants used in China. This is not an intentional focus on traditional Chinese medicine (TCM), but rather an observation that much of the published climate change scenario research involving medicinal plants, that I have seen or have paid attention to, is focused on habitat suitability and quality of herbal drugs used in TCM. That is not to say that similar research is not being carried out involving medicinal plants of other regions – it is.

Using MaxEnt (maximum entropy) modelling, Zhan et al (2022) evaluated and predicted the distribution area of Panax notoginseng (san qi) under future climate scenarios, as well as the relationship between total saponins content (about 90% are ginsenosides) and habitat suitability.

They predict a gradual decrease in suitable habitat area with migration towards high-altitude areas of central-eastern Yunnan province, and decreased ginsenoside content in future highly suitable habitat areas for this species (8).

Also using MaxEnt ecological niche modeling, Shi et al (2022) predict a sharp decline in suitable habitat for Meconopsis punicea (hong hua lü rong hao) by 2050, with a likely upward migration to inhabit a narrower elevational range in the Qinghai-Tibet Plateau.

Other studies found the luteolin content of a related species Meconopsis quintuplinervia (wu mai lü rong hao) to be significantly impacted by changes in altitude. While these researchers predict that the secondary metabolites content will change as the distribution area shrinks and changes in altitude in the coming decade, no specific predictions in content levels or impacts on therapeutic use are made (23).

In a similar study on Gentiana rigescens (dian long dan), Shen et al (2021) predict that current highly suitable habitats in southwest China will turn into lowly suitable habitats or unsuitable habitat for this species. In their 2050 and 2070 models, migration to high elevations is predicted with an increased accumulation of bioactive constituents, i.e., iridoids including loganic acid, swertiamarin, and sweroside, showing a correlation between altitude and iridoid concentration (24).

Using ArcGIS (geographic information system mapping software) with MaxEnt, Yan et al (2020) predict that, by the 2050s, the unsuitable habitat areas for Gentiana macrophylla (qin jiao) in China would increase by 11.92% under the moderate greenhouse gas emissions/climate scenario, concurrently with significant losses of suitable habitat. Furthermore, an accelerated speed of fragmentation of most of the suitable habitat area for this species is predicted, threatening reproduction and long-term survival (25).

Using fuzzy theory and a MaxEnt model, Guo et al (2016) predicted the future distribution range of Schisandra sphenanthera (nan wu wei zi) in the Qinling mountains, under three different climate change scenarios, for the periods 2020s, 2050s and 2080s, as well as determining any associations with synthesis and accumulation of schisantherin A in the fruits with various climatic variables.

The Pharmacopoeia of the People’s Republic of China requires that dried S. sphenanthera fruits contain not less than 0.20% schisantherin A, while the Hong Kong Chinese Materia Medica Standards require that the dried fruits contain not less than 0.67% of the total content of schisandrin A and schisantherin A.

This study predicted that under the three future climate scenarios, the habitats of pharmacopoeial quality S. sphenanthera fruits will continue to decrease towards near extinction; suggesting that, at least in this specific study area in the Qinling mountains, highly suitable habitat areas for S. sphenanthera may disappear if the annual mean temperature begins to exceed 20 ºC and/or if the annual precipitation level should exceed 1,200 mm (26).

For some species, the suitable habitat area may expand with climate change. That is the case, according to Wang et al (2022) for Artemisia annua (qing hao), used in TCM but also the only plant source of the antimalarial drug substance artemisinin. In this study, the future suitable habitat for A. annua is projected to expand inland, perhaps significantly, although the effects of increasing temperatures differ in different time periods.

However, the authors raise uncertainty as to whether the expansion of A. annua habitat area will be beneficial, or not, to its medicinal value in terms of the content and yield of artemisinin secondary metabolites. For this reason, these researchers suggest implementing a system of protecting genetic resource reserves and experimental cultivation bases within the geographic origin areas of the species, particularly areas where the wild populations possess higher artemisinin content such as Sichuan, Guangxi, Guizhou, and Yunnan (27).

In traditional herbal medicine, safe and effective formulation and dosage can be based, in part, on accumulated knowledge, stemming from the clinical observations of many generations of practitioners, often monographed in the pharmacopoeias and formularies of the codified systems of traditional medicine.

Traditional pharmacopoeias generally describe the identification, composition, properties, and quality of each herbal drug based on an assessment of representative materials that have been observed to be effective for their intended traditional uses. In this way, traditional medicine is informed by local or traditional ecological knowledge (TEK) and traditional medical knowledge (TMK).

If, by the year 2050, or the year 2070, or the year 2100 (young herbalists reading this should still be around!), certain medicinal herbs have adapted or migrated and survived the predicted changes – but, in doing so, their composition and content have significantly changed, by comparison to their ancestors described in the traditional medicine literature, TEK and TMK will also necessarily evolve.

Traditional medicine is not stagnant, not stuck in time. It is reasonable to predict that medical herbalists will continue to be keen observers of nature and adjust formulations and dosage, if need be, in response to the changing environment, changes in herbal drug content, and patient response to herbal drug preparations.

Scientists have developed elaborate climate models, indeed useful to help predict changes in suitable habitat areas, and whether the plants and pollinators can or will migrate together, in time to survive, and whether different plants will respond differently in terms of secondary metabolite production.

Increasing uncertainty of continued access to certain medicinal plants, of traditional origins and qualities, may, however, cause the practice of herbal medicine to also adapt and change.

The full extent of impacts of the climate crisis on availability and quality of medicinal plants in general cannot be known at this point. Assumptions and variables, from any region, that could exhibit a global impact on climate predictions, are adjusted each time new data is published.

For example, while a study published in January 2019, in the journal Proceedings of the National Academy of Sciences, showed that Greenland’s ice was melting far more rapidly than scientists previously thought, (28) in February 2022, University of Cambridge scientists subsequently reported an unprecedented melt rate of the Greenland Ice Sheet that would change sea level rise projections, AGAIN (29). What happens in Greenland, doesn’t stay in Greenland.

1. Kharouba HM, Ehrlén J, Gelman A, et al. Global shifts in the phenological synchrony of species interactions over recent decades. Proc Natl Acad Sci U S A. 2018;115(20):5211-5216. doi:10.1073/pnas.1714511115
2. Vâtcă S, Gâdea S, Vâtcă A, Stoian V. Research trends in ecophysiology of medicinal plants. Hop and Medicinal Plants. 2020;28(1-2):178-188.
3. Wang C, Tang Y, Chen J. Plant phenological synchrony increases under rapid within-spring warming. Scientific Reports. 2016;6. doi:10.1038/srep25460
4. AbdElgawad H, Peshev D, Zinta G, van den Ende W, Janssens IA, Asard H. Climate extreme effects on the chemical composition of temperate grassland species under ambient and elevated CO2: A comparison of fructan and non-fructan accumulators. PLoS ONE. 2014;9(3). doi:10.1371/journal.pone.0092044
5. Zhang C, Yang D, Liang Z, et al. Climatic factors control the geospatial distribution of active ingredients in Salvia miltiorrhiza Bunge in China. Scientific Reports. 2019;9(1). doi:10.1038/s41598-018-36729-x
6. Gairola S, Mohd Shariff N, Bhatt A, Prakash Kala C. Influence of climate change on production of secondary chemicals in high altitude medicinal plants: Issues needs immediate attention. Journal of Medicinal Plants Research. 2010;4(18):1825-1829. doi:10.5897/JMPR10.354
7. Guru A, Saha P, Kumar V, Hidangmayum A, Dwivedi P. Medicinal Plants in India: Impact on Biodiversity, Pharmaceutical Industries and Production Chain Due to Climate Change. In: Arya A, Patel VS, Agrawal M, Murthy CN, Bhatt B, Padate G, eds. Environmental Pollution, Climate Change and Altered Lifestyle during COVID. Daya Publishing House; 2022.
8. Zhan P, Wang F, Xia P, et al. Assessment of suitable cultivation region for Panax notoginseng under different climatic conditions using MaxEnt model and high-performance liquid chromatography in China. Industrial Crops and Products. 2022;176. doi:10.1016/j.indcrop.2021.114416
9. Kougioumoutzis K, Papanikolaou A, Kokkoris IP, Strid A, Dimopoulos P, Panitsa M. Climate change impacts and extinction risk assessment of Nepeta representatives (Lamiaceae) in Greece. Sustainability. 2022;14(7):4269. doi:10.3390/su14074269
10. Harrison S, Noss R. Endemism hotspots are linked to stable climatic refugia. Annals of Botany. 2017;119(2):207-214. doi:10.1093/aob/mcw248
11. Harish BS, Dandin SB, Umesha K, Pallavi HM. Impact of Climate Change on Medicinal Plants – A Review.  5th World Ayurveda Congress 2012, Bhopal, Madhya Pradesh, India. 7-10 Dec 2012.
12. Bidart-Bouzat MG, Imeh-Nathaniel A. Global change effects on plant chemical defenses against insect herbivores. Journal of Integrative Plant Biology. 2008;50(11):1339-1354. doi:10.1111/j.1744-7909.2008.00751.x
13. Jamieson MA, Burkle LA, Manson JS, Runyon JB, Trowbridge AM, Zientek J. Global change effects on plant–insect interactions: the role of phytochemistry. Current Opinion in Insect Science. 2017;23:70-80. doi:10.1016/j.cois.2017.07.009
14. Department of Agriculture Water and the Environment. Increased protection for koalas. The Hon Sussan Ley MP Minister for the Environment Media Releases. Published online February 11, 2022.
15. Reckless HJ, Murray M, Crowther MS. A review of climatic change as a determinant of the viability of koala populations. Wildlife Research. 2017;44(6-7):458-470. doi:10.1071/WR16163
16. Mella VSA, McArthur C, Krockenberger MB, Frend R, Crowther MS. Needing a drink: Rainfall and temperature drive the use of free water by a threatened arboreal folivore. PLoS ONE. 2019;14(5). doi:10.1371/journal.pone.0216964
17. Fensham R, Collingwood T, Laffineur B. Eucalyptus globulus. The IUCN Red List of Threatened Species 2019 eT61912929A61912931. Published online 2019.
18. Committee on Herbal Medicinal Products (HMPC). Community Herbal Monograph on Eucalyptus globulus Labill., Folium. European Medicines Agency; 2013.
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20. Ghazghazi H, Riahi L, Yangui I, Messaoud C, Rzigui T, Nasr Z. Effect of drought stress on physio-biochemical traits and secondary metabolites production in the woody species Pinus halepensis Mill. at a juvenile development stage. Journal of Sustainable Forestry. Published online 2022. doi:10.1080/10549811.2022.2048263
21. VILLUM Research Center for Plant Plasticity. What is Plant Plasticity? University of Copenhagen, https://plantplasticity.ku.dk/what_is_sb/.
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29. Brackley P. ‘Unprecedented’ melt rate at Greenland Ice Sheet found by University of Cambridge scientists could change sea level rise projections. Cambridge Independent. Published online February 25, 2022.

Unfortunately finding good quality products can be difficult. Similar to food there are risks with contamination and spoilage.

There are potential risks in many areas; from microbial contamination (E.Coli, aflatoxins etc); heavy metal loads (lead, mercury, arsenic etc) either found at naturally high levels in the soil or from industrial contamination; potentially toxic extraneous materials harvested accidentally with the intended species (pyrrolizidine alkaloids, tropane alkaloids found in Boraginaceae, Asteraceae and Fabaceae and Solanaceae respectively).

Also our environment has unfortunately become polluted with many new-to-nature chemicals that are intentionally or unintentionally applied to crops; pesticides, fungicides and herbicides are persistent in our soils, water and atmosphere and high levels can occur due to over application or from wind-drift and floods.

Hence it is all too common for products to be contaminated. It is also possible that products have intentionally or accidentally been adulterated with incorrect species. The herbal industry faces similar challenges to the food industry; rice is often detected with high levels of arsenic, wheat with pyrrolizidine alkaloids, lentils with E. Coli – and all non-organic foods with pesticides.

Despite rigorous regulations across most countries all sorts of adulterants from sawdust to colouring dyes to pharmaceuticals have been found in over the counter herbal products. Another common problem is that botanical nomenclature is complex and plant names can be mixed up. This has led to poisonous plants being substituted in to products (1) which has lead to dangerous results.

Marker compounds

Plants have hundreds to thousands of secondary metabolites that make up the chemistry of their physiological effects; the essential oils, polyphenols, colourful pigments and array of other phytochemical families all combine to induce their effects. So just having the right species that is perfectly hygienic isn’t enough. You also need the right amount of the ‘actives’ to have an effect. This is where another difference in quality may come in.

What are food grade herbs?

Food grade herbs are typically used in food as the spice-mixes and teas you will find lining the shelves of supermarkets and natural health stores. They may also be used in some food supplements that are fine to use, but their contents and purity may or may not be pharmacopoeial grade.

What are pharmacopoeial grade herbs?

A pharmacopoeia is a collection of quality standards for herbs (as well as vitamins and drugs) that ensures the herbs are of the right quality and can meet the criteria to deliver their expected effects. For example, there is a European Pharmacopoeia, a British Pharmacopoeia, a United States Pharmacopoeia, and an Indian Pharmacopoeia.

How do herbs become pharmacopoeial grade?

To be classed as pharmacopoeial grade, further to the quality criteria mentioned above, the identity of the species must be verified using various microscopic techniques and specialist equipment, such as chromatography (you will all have done something similar to this in school chemistry lessons, using blotting paper).

High Performance Thin Layer Chromatography, Gas Chromatography, distillation, microscopic and organoleptic tests are all used to assess qualitative and quantitative measurement of the species. These methods ensure the right level of compounds, such as the active ingredients of essential oils, polyphenols or flavonoids. And it is these compounds that are associated with certain tastes and effects.

Here are some examples of the different quality if herbs available:

Standard Herb Name	Food Grade ISO 6571/1984	European Pharmacopoeia
Chamomile flowers (Matricaria recutita)	Min. 0.2% essential oil	0.4% essential oil Apigenin Min. 0.25%
Fennel seed (Sweet) (Foeniculum vulgare var. dulce)	Min. 1% essential oil	Min. 2% essential oil (with NLT 80% anethole and max 10% estragole and 7.5% fenchone)
Peppermint leaf (Mentha piperita)	Min. 0.6% essential oil	Cut Leaf Min. 0.9% essential oil Whole Leaf Min. 1.2% essential oil

It is a remarkable fact that 25% of the volume of herbs sold today are from the wild. Sadly much of this is unregulated trade with questionable sustainability or social welfare practices. The people that tend to collect herbs from the wild are often the most marginalised socially, economically and geographically.

It is important when buying herbs that you know that they are grown and harvested with the welfare of the ecosystem and the communities that are harvesting them in mind. Fortunately there are some very progressive action groups working on this; FairWild is the first wild certification organisation; United Plant Savers works to protect threatened medicinal species in the US; Plantlife promotes protection of plants in the UK. Find more information on sustainability in our article on Environmental Sustainability of Medicinal Herbs.

What to look for

Herbal supplement or Botanical supplements are regulated under Food Supplement regulations in the UK (Dietary Supplements in the USA). They have to meet all the standards you would expect any healthy food should meet; manufactured under hygienic conditions with tight specifications for microbial load, heavy metals, pesticides and other chemical contaminants. It should be what ‘it says on the tin’- the species should be correctly identified and it should be the correct part of the plant in the product.

Organically certified products that are organically certified have strict controls on traceability and on pesticide levels as well as human welfare standards.

FairWild certification ensures that wild plants have been harvested sustainably and the collectors and community paid fairly.

Some herbal products have a medical licence guaranteeing a level of quality. Across Europe the Traditional Herbal Registration certification mark is applied to products meeting.

Certification for Fair Trade also indicates a full-length value chain relationship enhancing the welfare of the workers and reflecting attention to detail in the ingredients.

Needless to say the world of e-commerce is a bit of a wild west so do be cautious when shopping online. For further information please read this excellent article on herbal quality by Roy Upton.

The body often metabolises herbs and pharmaceutical drugs through the same pathways. It is their influence on these systems that can affect their metabolism.

Interactions between herbs and drugs can occur in four different ways:

1. Additive: Increasing the effect of a drug
2. Reductive: Reducing the effect of a drug
3. Neutralising: Lessening the side-effect of a drug
4. Adverse: A herb and a drug can interact, mildly or severely, causing an undesirable effect

Pharmacodynamic interactions

Pharmacodynamic interactions occur between drugs and herbs in the body influencing how the drugs and herbs affect the body. If an interaction between a drug and a herb takes place then it may be synergistic or antagonistic resulting in an exaggerated or a lessened effect. Theoretically, drugs and herbs that have similar therapeutic activity have an increased potential of interacting.

The highest risk of interaction occurs when simultaneously using drugs and herbs that are anti-coagulant, anti-platelet, anti-diabetic, diuretic or sympathomimetic. Hence it is essential to speak with a herbalist and healthcare professional of taking such drugs and herbs together.

Other factors can be dangerous as well, specifically with gene interactions. For example, St John’s Wort, a herb commonly used for depression is known for interacting with the CYP450 enzyme family. This is very significant because it is this enzyme family that is responsible for metabolizing many drugs like warfarin and oral contraceptives.

Therefore, St John’s Wort inhibiting this enzyme family means that warfarin and oral contraceptives are not metabolized and their activity may be interfered with. Similarly because St John’s Wort is a selective serotonin reuptake inhibitor (SSRI) it should not be taken with Prozac, which is a pharmaceutical SSRI as this can lead to an excess of serotonin potentially leading to serotonin syndrome. Another example, finasteride and saw palmetto are both used to treat enlarged prostates, and so shouldn’t be taken concomitantly.

Pharmaceuticals or herbs with narrow therapeutic indexes can also be potentially dangerous to take together. When a drug has a narrow therapeutic index it means that the window between it not working at all, or becoming very dangerous or lethal is very small. Mixing herbs can disrupt how these are metabolised in the body, and even a slight increase of their levels in the body can be dangerous. Examples of these drugs include; lithium, carbamazepine, ciclosporin, digoxin, phenytoin, warfarin and theophylline.

Contraindications

Some herbs are contraindicated with certain illnesses and so one must check that a herb is safe to with a particular condition. For example, Panax ginseng root is controversial in hypertension, and in acute states such as mania and asthma attacks. Liquorice root is another herb associated with increasing blood pressure when used at high doses over long periods. Most herbs are fine, but each should be checked for their own toxicity and safety issues.  See our herb profiles for specific information. And always discuss with a qualified herbalist or your health provider if you have a specific condition.

It is strongly encouraged that when you are thinking of taking a herb or supplement that you check their interactions. There are some resources for this like books like Stockley’s Drug Interactions or our herb profiles.

Not all interactions have been investigated, but good guiding rules include: 

• If one is taking herbs and drugs for the same illness then discard one (e.g both to lower blood sugar).
• If one is taking herbs and drugs with opposite indications or effects (e.g one to increase and one to lower blood sugar), then do not take both.

When looking for quality products, there are some questions you can ask to help assure good quality. Firstly, a company should be able to tell you where the herbs have come from. If they do not know their supply chain, it leaves more space for contamination and adulteration.

They should also be able to tell you specifically which species are in their product. This means not just their common name (e.g Nettle) but the Latin binomial (Urtica dioica). Common names can indicate an array of different species hence why plant nomenclature is so complicated!

The Latin binomial assures that the correct medicinal species are being used, as some plants in the same family with similar names are not medicinal at all. A wonderful resource to be able to see a species different names, or a names different possible species is the Medicinal Plant Naming Services database. It is also important that the correct part of the plant is used and listed be it root, bark, leaf, flower, fruit or seed.

Additionally be mindful of the ingredients in the product. Many products are full of fillers such as anti-caking agents and bulking agents, synthetic colourings, and flavourings. Unnecessary ingredients indicate a poor-quality product and there is a good chance the plants in there are not good quality either.

Finally, we recommend seeing a qualified herbalist. Particularly if you are pregnant, breastfeeding elderly, seeking medicine foFinally, we recommend seeing a qualified herbalist. Particularly if you are pregnant, breastfeeding elderly, seeking medicine for a child or dealing with serious chronic conditions.

A qualified herbalist will know which herbs are safe for you to take in which doses, as well as be able to source you quality herbs. They will also be able to give you the best treatment plan you need to nurse your way back to optimum health. Find one in our resources section.

1. Tankeu S, Vermaak I, Chen W, Sandasi M, Viljoen A. Differentiation between two “fang ji” herbal medicines, Stephania tetrandra and the nephrotoxic Aristolochia fangchi, using hyperspectral imaging. Phytochemistry. 2016;122:213-222. doi:10.1016/j.phytochem.2015.11.008
2. Schippmann, U. W. E., Leaman, D., & Cunningham, A. B. (2006). A comparison of cultivation and wild collection of medicinal and aromatic plants under sustainability aspects. Frontis, 75-95.
3. Uwe Schippmann, Danna J. Leaman and A. B. Cunningham  Impact of Cultivation and Gathering of Medicinal Plants on Biodiversity: Global Trends and Issues FAO. 2002. Biodiversity and the Ecosystem Approach in Agriculture, Forestry and Fisheries. Satellite event on the occasion of the Ninth Regular Session of the Commission on Genetic Resources for Food and Agriculture. Rome, 12-13 October 2002. Inter-Departmental Working Group on Biological Diversity for Food and Agriculture. Rome
4. Brinker F. Herb Contraindications And Drug Interactions. Sandy, Or.: Eclectic Medical Publications; 1998.
5. Mills S, Bone K. The Essential Guide To Herbal Safety. St. Louis, Mo.: Elsevier Churchill Livingstone; 2005.

We know that we are facing a catastrophic collapse in biodiversity whilst at the same time a large excess in pollution overshoot threatening our very livelihoods- and lives. An inflamed planet has led to an inflamed population. As a herbalist practising natural medicine the only analogy that comes to mind is a system whose digestion is completely disturbed, where the diversity in the microbiome is depleted causing a cascade of weakened immunity and excess inflammation leading to a raging fever from the systemic infection.

But I am still hopeful. Mainly because we know what many of the solutions are but also because we know the capacity of plants to regenerate the health of the soil, water, forests – whole ecosystems – as well as bring potent health benefits.

We know that if we want to solve Biodiversity we need to solve food. If we want to solve the Climate crisis, Plastic epidemic, Deforestation, Social justice, Health justice and the Net positive goals we all need to urgently achieve, if we really want to solve them, we need fix food. With agriculture generating about 3.5% global GDP yet 30% carbon emissions it just isn’t an equitable transfer of value (15). 

Of course, food needs to be affordable. It also needs to be good for everybody in the long-run. As you may know the word ‘economy’ means looking after your household’. And that is what all business governments and the herbal industry as a whole need to be much better at.

And for the herbal industry as a whole, we face high levels of risk to supply from unsustainable wild harvesting, habitat loss, species loss as well as the impacts of the climate crisis on growing regions, environmental stability as well as herbal quality. As approximately 25% by volume and around 75% by species numbers are harvested from the wild (17,18), we have to progress our relationship with the sustainability and the socially equitable aspects of sourcing. This disturbing knowledge we have, concerning that it is, gives us the opportunity to act collaboratively to engage swift change.

Organic certification is one scientifically verified solution to many of the challenges we face. The Soil Association say that is different from other farm assurance schemes in the UK because:

• it is supported by longstanding, independent and robust scientific evidence demonstrating the delivery of environmental and public benefits from organic systems;
• they are of the requirement of a detailed, independent, government-approved auditing process – all organic farms and food companies are inspected at least once a year;
• organic standards for food and farming are set out in legislation – currently the EU Organic Regulation.

The word organic is derived from ‘organism’. It is one of those words that gives me optimism. Like wholeness, balance, harmony. An organism must operate in a state of wholeness, balance and harmony to flourish. If ‘organic’ is too controversial, you can call it could say Agro-ecological system, and when coupled with organic farming, Regenerative Agriculture. Third-party certification is an essential part of turning the Nature Crisis into a Nature Success.

Organic has:

1. More wildlife: Organic farms have 50% more abundant wildlife, with a third more species on average, including almost 50% more pollinator species and 75% more plant species (1,2).
2. Healthier soils: Organically farmed soils have on average 44% higher levels of humic acid (3) – the component of soil that stores carbon over the long term – and perform better against other soil health indicators too, such as abundance of soil microbes and resilience against flooding and drought (4).
3. Climate mitigation: Organic soils sequester up to 450kg more carbon per hectare than non-organic farms, and soil organic carbon stocks are up to 3.5 tonnes higher per hectare than non-organic farms (2). Organic farming prohibits the use of manufactured nitrogen fertiliser – a major contributor to agricultural greenhouse gas emissions.
4. Protection against flooding: Healthy soil reduces the risk of floods and droughts by storing as much as 3,750 tonnes of water per hectare, the equivalent of one and a half Olympic swimming pools (6).
5. Clean water: 35-65% less nitrogen and no persistent pesticides leached from organic arable fields (7).
6. Lower pesticide use: Organic farmers can only use (under strict conditions) a small number of pesticides, all of which are naturally occurring and carefully selected and approved (8). If all farming was organic, research suggests that pesticide use would drop by 98% (9,10).
7. Low antibiotic use: The routine use of antibiotics is banned and measures aimed at optimising animal health and welfare mean that organic systems use far less antibiotics than non-organic indoor and extensive systems (11).
8. More jobs: Including for younger people, women and new entrants to the farming industry (12).
9. Food security: Modelling by the UN Food and Agriculture Organisation (FAO) concluded organic farming can play a major part in increasing global food security and feeding a global population of 9 billion sustainably by 2050 (13,14).

Organic farming literally feeds the soil, the digestive system of the earth, establishing a healthy Soil Biome. It builds Planetary Immunity through is regeneration of biodiversity, establishing a healthy Planetary Biome. Studies have shown that, coupled with a reduction in food wastage, all of Europe can be fed sustainably through a more ‘land-sharing’ rather than a ‘land-sparing’ approach. Read more about this topic in this fascinating article Ten Years for Agroecology in Europe by the Soil Association. What we eat matters and how it is grown matters.

FairWild certification is another progressive solution to ensuring that the  wild supply of herbs is both sustainable for the ecosystem and equitable for the collecting communities.

We know that there is a positive inverse relationship between eating plants rich in phytochemicals and HBP, Cardiovascular problems and Diabetes. Our hyper-separation from nature has led to our shopping baskets being filled with over 50% Ultra Processed Foods. There is good reason to include more phytonutrients rich plants in people’s diet.

Our beloved Camellia sinensis, otherwise known as Britain’s favourite cuppa, has potent effects on cardiovascular inflammation. But it is just one of the 30,000 plants that have been used for food and health. Current science shows eating 30 different plants a week is the best way to optimise your microbiome. Ginger, turmeric, milk echinacea, thistle, ashwagandha are all examples of very well researched herbal health solutions. We see the benefit of such diversity in the diet reflected from every organic farm, as the organic principles feed a farm teeming with plant and insect life.

One way to repay nature is to solve Nitrogen. Inspired by the historian Rutger Bregman, Being at a climate conference and not talking about Nitrogen is like being at Davos and not talking about taxes. With a 4x global overshoot it is the steroid drug modern agriculture is addicted to (16), leading to further widespread herbicide and pesticide use, driving volume up and costs down.

But why are businesses rewarded for growing unhealthy, unsustainable food? We have to find a way to reward business for making healthy sustainable food. For example, in the current climate isn’t it contradictory that you have to pay to be certified organic? Surely a way is to shift the value from subsidised fossil fuel inputs to subsidised healthy farming and food?

There is no doubt pollution must be charged for, oil subsidies in the form of tax breaks need to be transferred to help Refund Nature with climate positive agriculture and healthy, affordable food.

The question that we all face in the world of herbalism is how can herbal organisations, suppliers and herbalists stand as genuine champions of Nature?

1. Bengtsson, J., Ahnström, J., & Weibull, A. C. (2005) ‘The effects of organic agriculture on biodiversity and abundance: A meta-analysis’ Journal of Applied Ecology, 42(2), 261–269. http://doi.org/10.1111/j.1365-2664.2005.01005.x
2. Tuck, S. L., Winqvist, C., Mota, F., Ahnström, J., Turnbull, L. A., & Bengtsson, J. (2014) ‘Land-use intensity and the effects of organic farming on biodiversity: a hierarchical meta-analysis’, The Journal of Applied Ecology, 51(3), 746–755. http://doi.org/10.1111/1365-2664.12219
3. Ghabbour, E. A., et al (2017) ‘National Comparison of the Total and Sequestered Organic Matter Contents of Conventional and Organic Farm Soils’, Advances in Agronomy, 146, 1-35 https://doi.org/10.1016/bs.agron.2017.07.003
4. Müller, A. et al (2016) ‘Organic farming, climate change mitigation and beyond: reducing the environmental impacts of EU agriculture’ IFOAM EU and FiBL, available online at: http://www.ifoam-eu.org/sites/default/files/ifoameu_advocacy_climate_change_report_2016.pdf, pp 45-46
5. Gattinger, A., Muller, A., Haeni, M., Skinner, C., Fliessbach, A., Buchmann, N., Niggli, U. (2012). Enhanced top soil carbon stocks under organic farming. Proceedings of the National Academy of Sciences of the United States of America, 109(44), 18226–31. http://doi.org/10.1073/pnas.120942910
6. European Commission Joint Research Centre, ‘Key Facts About Soils’ available online: http://eusoils.jrc.ec.europa.eu/projects/Soil_Atlas/backup/Key_Factors.html  [Accessed February 2017]
7. Niggli, U. (2015) ‘Sustainability of organic food production: challenges and innovations’ Proceedings of the Nutrition Society, 74:1  83-88,  DOI: https://doi.org/10.1017/S0029665114001438 
8. 8) IFOAM States that the reason only natural pesticides are allowed is: The precautionary principle acknowledges that our understanding of the impact of synthetic pesticides on our agroecosystems, the wider environment and human health can never be exhaustive. In contrast to synthetic substances there is a longer experience of natural substance use within the natural environment. Therefore unpredictable risks coming from the release of molecules (e.g. “synthetic” pesticides) and organisms (from genetic engineering), not existing in nature, are rejected by the organic sector. As a result inputs in organic production are only limited to naturally occurring substances.
9. Jones, P., Crane, R., & Centre for Agricultural Strategy University of Reading. (2009). England and Wales under organic agriculture: how much food could be produced? CAS Report 18. Retrieved from http://www.soilassociation.org/LinkClick.aspx?fileticket=5vDDWGCb84U%253D&tabid=313
10. Over 300 different pesticides are permitted in non-organic farming and in 2015 over 17,800 tonnes of pesticides were applied on British farms (See: Fera Ltd (2016) Pesticide Usage Statistics (PUS STATS), available online at: https://secure.fera.defra.gov.uk/pusstats/mygraphresults.cfm).  In contrast, organic farmers are only allowed to use a tiny proportion of the full array of pesticides available to farmers, and organic farmers are not permitted to use any herbicides.  The small number of pesticides that organic farmers are permitted to use are naturally occurring and are carefully selected and approved by the EU.
11. Sustain (2015) ‘At least 10 times less antibiotics used in organic pigs’ published online on 30 March 2015 at:  https://www.sustainweb.org/news/20150330_132021/ or see:http://www.ft.dk/samling/20131/almdel/flf/spm/495/svar/1156714/1401964.pdf (Danish). See also Veterinary Laboratories Agency (2006) ‘Investigation of persistence of antimicrobial resistant organisms in livestock production’ Project OD2006, available online at: http://randd.defra.gov.uk/Default.aspx?Menu=Menu&Module=More&Location=None&C%20ompleted=0&ProjectID=9902
12. Soil Association (2006) ‘Organic Works: Providing more jobs through organic farming and local food supply’ 6
13. Scialabba, N. (2007) ‘Organic agriculture and food security’ Presented at FAO International Conference on Organic Agriculture and Food Security, Rome, 3 – 5 May 2007
14. Strategies for feeding the world more sustainably with organic agriculture, Nature Communications, 14 November 2017:  https://www.nature.com/articles/s41467-017-01410-w
15. Share of economic sectors in the global gross domestic product (GDP) from 2009 to 2019 | Statista. Statista. https://www.statista.com/statistics/256563/share-of-economic-sectors-in-the-global-gross-domestic-product/. Published 2021. Accessed November 26, 2021.
16. The nine planetary boundaries. Stockholmresilience.org. https://www.stockholmresilience.org/research/planetary-boundaries/the-nine-planetary-boundaries.html. Published 2021. Accessed November 26, 2021.
17. Schippmann, U. W. E., Leaman, D., & Cunningham, A. B. (2006). A comparison of cultivation and wild collection of medicinal and aromatic plants under sustainability aspects. Frontis, 75-95.
18. Lange, D. and Schippmann, U., 1997. Trade survey of medicinal plants in Germany: a contribution to international plant species conservation. Bundesamt für Naturschutz, Bonn.

Lastly, an often neglected or completely shunned aspect of modern traditional herbal medicine is the role medicinal plants can play in spiritual health. This is largely due to modern medicine’s attempt to be scientific, a paradigm that, when applied in a typical manner, tends to divorce human and material existence from any precept of spirit, whether spirit is defined from a creationist or evolutionary perspective, or from a perspective of humanity’s relationship with each other, and the relation of humans to the larger world or creation.

In many systems of traditional healing, spiritual well-being is the highest ideal to achieve. In a practical sense, this means an attainment of a sense of peace and harmony with self and one’s surrounding world.

In Ayurveda, for example, significant emphasis is placed on mental and emotional well-being through the incorporation of meditative practices, prayer (puja), and therapies such as pancha karma and shirodara, designed to promote a long life of physical, mental, and emotional well-being. Numerous herbs figure into a variety of spiritual practices. In India, the herb tulsi (Ocimum sanctum) is highly revered and by some is considered the wife of god Vishnu (Vishnupriya).

Tulsi is central in Tulsi Vivah, a ceremony marking the end of the monsoon season and beginning of the Hindu wedding season, the rites of which are described in Hindu scripture. Among some regions of India, households grow tulsi plants and perform ceremonies by circling the plant reciting mantra morning and evening. Also in India, the Hindi avatar Dhanvantari is depicted as Lord Vishnu with four hands, holding medical herbs in one hand and a pot containing a rejuvenating nectar called amrita in another. Dhanvantari is also considered the God of Ayurveda.

In Western herbal traditions stemming from ancient Greece, the botanical genus Asclepias (commonly known as milkweed) is named after Asclepias, the Greek God of medicine. Thus, in most all medical traditions, including those in the West, there was an innate relationship between physical and spiritual health that was connected through plant-based medicines.

In TCM, especially in Taoist practices, there was and continues to be great emphasis of aligning one’s life with the spiritual will of heaven. In the five phases (wu xing) theory of TCM, each of the five major organ systems is correlated with a spirit that both serves to guide one to one’s authentic self that can be cultivated through various physical and spiritual practices. In this regard, the use of herbs served to facilitate this cultivation.

In TCM principles, the shen (spirit or mind) is housed in the heart; the hun (ethereal soul) in the liver; the po (corporeal soul) in the lungs; yi (intellect or ideation) in the spleen, and zhi (will) in the kidneys. In turn, the physical manifestations of each of these organ systems affects these various “spirits” (wu shen). According to Chinese medical philosophy, the hun governs one’s nature. It drives and has the ability to nourish one towards their destiny. When in disharmony, the hun wanders aimlessly or perhaps violently, and in either case, cannot direct one to their greater good or expression.

The yi or intellect represents our ability to discern ideas and experiences and to form intent; intent of thought and action. When in disharmony, the judgment of the yi is clouded or misguided. The po most closely reflects human instinct, our inner knowing despite having all the facts; our gut senses, and is inherently limited to expressing our greatest self in one lifetime.

When in disharmony, the po can cause us to act on gross human desires without considering the larger consequences of such actions. The zhi or will, provides, or not, the motivation to accomplish and act on intent. When in disharmony, the ability to act according to what is in the best interest of the five spirits is impaired. Lastly the shen or mind (xin) is regarded as consciousness itself.

On a physical level it is our level of peace of mind, while on a more esoteric level it governs our ability to mobilize all the other shen to their higher purposes, imparting benevolence, compassion, and love when healthy, and muddled or erratic thinking and lack of the aforementioned positive qualities when in disharmony.

The shen, yi, po, zhi, and hun are said to be “housed” in the heart, spleen, lungs, kidneys, and liver, respectively and are therefore influenced either positively or negatively by the physical health or disease of these organ systems. As such, herbs and formula that support the health of these systems support the higher goals of spiritual self, compassion, and love for humanity for which humans are capable.

While some of these concepts may seem archaic and religious, possibly not worthy of inclusion in modern medical thought, in the context of human and social health, the attainment of mental, emotional, and social well-being is a central doctrine to most concepts of health as articulated by the WHO (1946) as:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Thus, any complete healing system must take into account how an individual can attain, or a practitioner can facilitate the attainment, of higher states of health and healing than simply the removal of symptoms. This is the highest ideal of traditional healing systems that has no foundation or construct in the current Western medical delivery system, pharmaceutical industry, or modern pharmacognosy.

It is only through traditional healing systems that such a level of health and healing can even be considered. Whether one is willing to apply what many consider to be spiritual aspects of healing to modern medicine is a matter of choice. In a more material sense, the recognition of the role pharmacognosy plays in human health was succinctly stated by DiPasquale (1984):

“Pharmacognosy is the science of drugs that originate from living beings and are studied to help other living beings.”

The benefits obtainable through the proper use of herbal medicines are inherently different than those attained through standard use of pharmaceutical medications and Western disease care paradigms. Because of this, a different paradigm for ensuring the integrity of traditional herbal medicines is to apply scientific investigation in a way that fully honors the unique characteristics of traditional healing systems.

First and foremost is, through human investigation, understanding the scientific basis of the theoretical healing principles of our varying healing traditions, pharmacologically, physiologically, and pathologically and with an emphasis on patient outcomes. All other experimentation is abstract and of limited utility. Second, and most importantly regarding herbal medicine, is intensive investigation of what constitutes a “quality” herbal medicine that would then drive the quality control guidelines and requirements of the supply chain so as to ensure appropriate quality of herbal medicines in a manner that is truly independent of commercial influence and has scientific integrity. Such investigation could include a myriad of testing parameters.

First of these would be proper identification of starting plant populations followed by morphological and organoleptic profiling of botanicals growing in their natural habitat and then to codify these characters in pharmacopoeias, GACP guidance documents, and in regulation or practice, as was done historically.

Chemical profiling of the botanicals can allow for making determinations of optimal harvest times, drying, processing, extracting, and storage conditions. Morphological, organoleptic, and chemical characterization can also help determine what species of plants can be used interchangeably, again, in manner that was similarly done historically. In the world of medicinal plant research, focus can be given, not only to Western pharmacological mechanisms but to how those mechanisms correspond, or not, to traditional characteristics such as taste, smell, and sensation of the botanical; or to make a scientific determination of what it really means for an herb to be classified as a ‘yin tonic’ or to ‘pacify vata’.

Clinical investigation could also look at the application of the traditional medicine within the context of the lifestyle recommendations that usually accompany such prescriptions, emphasizing the holistic approach typically employed by traditional healers versus the lack of emphasis regarding lifestyle changes that dominate in Western medical care.

Such investigation can open a world of therapeutic possibilities for health care that is greater than what either traditional or modern systems offer alone. Such inquiry could then more fully inform the practice of both paradigms of medicine, creating new opportunities for research and practitioner training, product development, and environmentally sustainable economies.

While developing countries continue to rely on traditional healing systems for their primary health care needs, there is an ever increasing recognition in developing countries of the value these traditional healing systems have in human health and as a part of modern health care systems. This is a phenomenon occurring internationally.

Herbal medicines serve an integral role in traditional healing systems and there is a need to preserve, promote, and continue to develop the traditional knowledge base needed for ensuring the identity, purity, and quality of botanical ingredients. Pharmacopoeias play a key role in these processes.

However, in most Western countries, pharmacopoeial monograph systems developed as chemistry was overtaking crude botanical medicine and drugs were evolving into pure, isolated, and then synthetic compounds, in contrast to the multiple compounds and broad array of pharmacological activities inherent in herbal medicines.

Because of this, modern pharmacopoeias, and subsequently regulatory systems, attempt to characterize botanical medicines in the same way they do pharmaceutical medications. Lacking in this system is a realization that traditional herbal medicine systems have a distinct way of understanding their materia medica that is vastly different than western pharmacological approaches. Rather, over several millennia, knowledge of plant-based medicines evolved based on the properties inherent in the plant, that includes a plant’s chemistry, and is reflected in the flavor, smell, and qualities as ascertained through sensory evaluation.

More importantly, in traditional; healing systems, botanicals are applied in a manner that is similarly distinctly different from the typical western model whose focus is on disease pathology and symptom suppression in contrast to the improvement of human health and the elimination of the underlying cause of disease. In traditional medical systems, herbs are used to promote health, vitality, and longevity, and treat disease, and ameliorate symptoms.

In conventional western medical practice, there is a single focus on pathology and almost no emphasis on health. Whereas there are hundreds of botanical medicines that are used to promote health, there is not a single pharmaceutical medication designed to promote health and vitality.

Driving the popularity in traditional herbal medicine is a desire on the part of consumers to be healthier. Another significant factor are the many failings of modern medicine in dealing with many diseases, most specifically, chronic degenerative diseases for which pharmaceuticals offer only palliative care, as well as the significant dangers posed by pharmaceutical medications, which are widely recognized as one of the leading causes of preventable deaths. Yet a last, but little recognized driving factor for the popularity of herbal medicine is its potential for environmental sustainability.

Preserving herbal medicine preserves cultural knowledge, cultural integrity, environmental integrity, and the integrity of human health. If herbal medicine is to survive and thrive for future generations it cannot simply be approached using the same models as those used for pharmaceutical medications. Similarly, pharmacopoeias and regulatory systems must evolve to take into consideration the unique philosophies and traditional systems in which herbal medicines are applied and not simply reduce herb quality assessment to a chemical test.

Rather, all aspects of the source of medicinal ingredients from the field to the pharmacy must be taken into consideration as was done historically by herbalists and early pharmacognosists. If modern pharmacopoeias and regulatory systems can evolve to integrate traditional healing knowledge and practices, herbal medicine can thrive and reach its full potential in serving humanity.

If not, it will continue to survive and be utilized by those who are more committed to the promotion of health and minimization of disease, but will continue to be marginalized in modernity that maintains the status quo of disease management to the detriment of individual and societal health.

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By the 2010’s, significantly increasing quantities of medicinal plants in global trade were becoming traceable to specific harvest sites, to the commercial enterprises managing the harvest, and the people who handle and process the herbs throughout the value chain.

This new reality was one of the positive outcomes of a consumer-driven market trend that had been growing slowly but steadily since the 1990’s, driving increased demand for herbs that are harvested, handled, processed, and traded sustainably, as determined by audits of independent third-party inspection and certification organizations (5).

In the 2020’s, while not common enough (yet!), it is also not rare for herbal medicinal raw material batches to be traded between companies with documentary evidence of sustainable production (albeit for discerning customers willing to pay the fair price), i.e., with certification(s) showing compliance with one or more VSS, such as the

• Organic Wild-crop Harvesting Practice Standard (6)
• FairWild^® Standard (7)
• Ethical BioTrade Standard (8)
• Fair For Life Standard (9)
• Fairtrade International Standard For Herbs, Herbal Teas & Spices (9,10)
• Fair Trade USA Agricultural Practice Standard (11)

as well as wildlife-friendly standards such as the

• Certified Elephant Friendly Standards (12)
• Giant Panda Friendly Products Standard (13)

While VSS certification logos are increasingly visible on consumer herbal healthcare product labels at retail, it is not as clear how practitioners and patients can participate in the sustainable herb trade in the clinical setting. If every medical herbalist were able to dispense safe and effective medicines, prepared from local native species, obtained from (verifiably) sustainable wild collection operations or from local medicinal plant farms that follow biodynamic (14), or permaculture, or regenerative organic agricultural practices (15) that would be awesome, would it not?

While I am a proponent of local self-reliance, especially local food, in the case of herbal medicine, I think it may be a bit more complicated for the busy clinician serving an urban population. Of course, the situation varies by region. In the United Kingdom, some medical herbalists do maintain dispensaries of 100 to 200 herbs, prepare their own tinctures and mixtures of dried herbs for preparation as decoctions or infusions.

On the other hand, here in California, many (possibly most) herbalists, whether they practice as a licensed acupuncturist (LAc), Ayurvedic doctor (AyD), naturopathic doctor (ND), or certified nurse midwife (CNM), do not generally stock dried herbs in their private practice. Generally, they stock a small range of packaged “professional products”, supplied by selected trusted brands that primarily service practitioner’s clinics – with products that are not commercially available in retail shops. Practitioners also recommend selected commercially available herbal products that the patient can pick up at a natural food store or purchase online for home delivery.

Furthermore, there are TCM compounding pharmacies, which enable the LAc to login, enter the prescribed formula with the patient’s details, for same day pick-up or delivery. While such practices are understandable, they can place a greater distance between the herbalist and the herbs – and the ability to know, with any degree of certainty, when, where and how the herbs were harvested, by whom, and under what conditions.

In reality – many practitioners are serving urban patient populations, and do not live in a megadiverse ecozone – one that could keep their dispensaries stocked with the possibly hundreds of medicinal plants needed for formulations. The fact is that apothecaries and clinics in Europe and the Americas have relied on a range of imported herbs for many hundreds of years.

Even China, where most herbs used in TCM, until recent years, were harvested within China, has become an importer of some herbs. Due to dwindling plant populations, certain herbs are being imported into China from neighboring countries, especially from Vietnam (16), Bhutan, Nepal (17), Kazakhstan, and Russian Federation (18).

I hesitate to recommend a practice that I could not practice myself. Most of the medicinal plants that I choose to use – as healthy food or as medicine (or both!) – do not occur in Northern California, nor would many of them grow well here if transplanted. If I insisted on using only local herbs for food and medicine, I would need to move, far away! To illustrate this point:

• Firstly, food and beverage: The CNS stimulant Arabica coffee that I drink in the morning is native to tropical forests of Ethiopia and Sudan (19) (but introduced and grown in forests of Central- and South America). The carminative and stomachic cardamom seed that I mix in the coffee, is native to rainforests of the Western Ghats region of South India (20). And, the carminative and stomachic cinnamon tree bark, sprinkled on morning toast, comes from forests of Indonesia, Vietnam, and Southern China (21).
• Secondly, preventive medicine: The extract of wild bilberry fruit, that I take to improve microcirculation, is native to forests of Europe. And the turmeric rhizome, taken as an anti-inflammatory, originates from the Indo-Malayan Region of southern and southeastern Asia.
• Thirdly, treatment: When a sore throat is coming on, I rely on a Chinese preparation ‘chuan xin lian’ antiphlogistic pills (andrographis herb, isatis root, and Mongolian dandelion herb). And for allergic rhinitis symptoms, I experience good results with a 12-herb formulation ‘bi yan pian’ nose inflammation pills (magnolia flower, xanthium fruit, phellodendron bark, forsythia fruit, liquorice root, schisandra fruit, anemarrhena rhizome, chrysanthemum flower, schizonepeta herb, platycodon root, fragrant angelica root, Siler root).

None of the aforementioned daily – or occasional – use botanicals in my cupboard or home medicine chest are produced anywhere near my neck of the woods. What is the herbal practitioner and patient to do? – to have some certainty, that the herbs, having travelled from distant deserts, meadows or forests to the clinic or pharmacy (or kitchen), have been harvested non-destructively, without detriment to the survival of the species, or its pollinators, or to any of the flora and fauna that share habitat.

How do the practitioner and patient know if the herbs were valued fairly and traded ethically, not dependent on exploitive labour of marginalized people to keep the prices low?

Likely an overwhelming feeling, for an individual practitioner, to aim towards dispensing herbal medicinal preparations, composed only of herbs that possess documentary evidence of sustainable production.

Firstly, you are not alone in this. Fortunately, much (but not enough) progress has been made in recent decades with the advent of VSS that have been designed with medicinal plants in mind, whether wild-collected or grown on farms.

Secondly, be curious enough to ask your bulk herb and herbal product supplier(s) tough questions about the herbs.

Thirdly, be insistent enough to encourage answers. You can also ask your preferred supplier(s) to begin stocking certified fair and organic dried herbs and herbal medicinal products on your behalf – bolstered by your commitment to pay the premium that covers the cost of sustainable production.

Uncertified, undocumented, non-traceable herbs will, of course, cost less. The assurance of sustainable and ethical production is important in my view, in part, because I believe that the medicine is impacted in some way by every person who has handled it on its journey from the alpine forest or the semi-arid steppe to the urban clinic.

No person in the natural medicine value chain should be struggling in abject poverty or be subject to exploitive labor and trade practices, nor should the natural environment be damaged, in the course of bringing medicinal herbs to the clinic for the health and wellbeing of the client or patient.

Today, there are increasing numbers of small-to-medium-size distributors, making some visible level of commitment to sustainable herbs, that service cottage industry, small health food or herb shops with bulk bins, and individual practitioners. The practitioner can find these progressive handlers in the databases of the standards-setting-organizations. For example, one can find information on the certified producers and registered processors and traders operating in the FairWild trading system.

Certificate holders in the Union for Ethical BioTrade Programme can be found on UEBT Sourcing. And details on certified operations in the Fair for Life – Social & Fair Trade Certification Programme are provided by FairForLife. However, for “voluntary” sustainability standards to be part of the solution, clients, consumers, patients, everyone, must also “voluntarily” agree to pay higher prices to cover the true costs of sustainable production, equitable and ethical trade. It is not free. The costs for an herb production operation to implement standards with annual audits and fees for inspection and certification, and the additional personnel needed to manage standards compliance, is not insignificant.

You may not be able to prescribe certified sustainable herbs and formulations straight away. Be pragmatic, start small and build gradually. Pick one herb at a time, to get better acquainted with, then another, and so on. In my experience, once I started looking into this fascinating area of sustainable resource management in the botanical supply chain, it was not long before I was hooked. No turning back! Enjoy the journey.

1. Brinckmann JA. The long road to sustainable licorice. Journal of Medicinal Plant Conservation. Spring 2020:19-21. Available at: https://unitedplantsavers.org/ups-journal-2020/.
2. World Health Organization. WHO Guidelines on Good Agricultural and Collection Practices (GACP) for Medicinal Plants. Geneva, Switzerland: World Health Organization; 2003. Available at: https://www.who.int/.
3. Brinckmann JA, Morgan B. Linking a wild medicinal plant cooperative to socially responsible companies: Experiences from China and USA. In: Asen A, Savenije H, Schmidt F, eds. Good Business: Making Private Investments Work for Tropical Forests. Wageningen, the Netherlands: Tropenbos International; December 2012:54: 73-80.
4. Larson B. ACTCM meets with delegates from China to discuss innovative herbal curriculum pilot. American College of Traditional Chinese Medicine Blog. 01 February 2011.
5. Brinckmann JA. Sustainable Sourcing: Markets for Certified Chinese Medicinal and Aromatic Plants. Geneva, Switzerland: International Trade Centre (ITC); 2016; Available at: https://www.intracen.org/publication/Sustainable-Sourcing/.
6. United States Department of Agriculture. NOP 5022 Wild Crop Harvesting Internal Rev01 07 22 11. Washington, D.C.: United States Department of Agriculture; 22 July 2011. Available at: https://www.ams.usda.gov/sites/default/files/media/5022.pdf.
7. FairWild Foundation. FairWild Standard: Version 2.0. Weinfelden, Switzerland: FairWild Foundation; 2010; Available at: https://www.fairwild.org.
8. Union for Ethical BioTrade. Ethical BioTrade Standard. Amsterdam, The Netherlands: Union for Ethical BioTrade; 2020; Available at: https://www.ethicalbiotrade.org/resource-pages/standard.
9. Ecocert SA. Fair for Life Certification Standard for Fair Trade and Responsible Supply-chains. L’Isle Jourdain, France: Ecocert SA; 2020; Available at: https://www.fairforlife.org.
10. Fairtrade International. Fairtrade Standard for Herbs, Herbal Teas & Spices for Small Producer Organizations and Traders. Current version: 01.05.2011_v1.2. Bonn, Germany: Fairtrade International; 2011; Available at: https://www.fairtradeamerica.org/app/uploads/2020/08/HerbsHerbalTeasSpices_SPO_SP.pdf.
11. Fair Trade USA. Fair Trade Agricultural Production Standard. Version 1.1.0. Oakland, CA: Fair Trade USA; 2019. Available at: https://www.fairtradecertified.org.
12. Wildlife Friendly Enterprise Network. Certified Elephant Friendly Standards. Bainbridge Island, Washington: Wildlife Friendly Enterprise Network; 2019; Available at: https://wildlifefriendly.org.
13. Brinckmann JA, Luo W, Xu Q, et al. Sustainable harvest, people and pandas: Assessing a decade of managed wild harvest and trade in Schisandra sphenanthera. J Ethnopharmacol. 2018;224:522-534.
14. Biodynamic Federation Standards Committee. Production, Processing and Labelling. International Standard for the use and certification of Demeter, Biodynamic and related trademarks. Darmstadt, Germany: Biodynamic Federation – Demeter-International e.V.; 2021. Available at: https://www.demeter.net/.
15. Regenerative Organic Alliance. Framework for Regenerative Organic Certified. Ventura, CA: Regenerative Organic Alliance; 2021. Available at: https://regenorganic.org/.
16. Cunningham AB, Brinckmann JA, Bi YF, et al. Paris in the spring: A review of the trade, conservation and opportunities in the shift from wild harvest to cultivation of Paris polyphylla (Trilliaceae). J. Ethnopharm. 2018/08/10/ 2018;222:208-216.
17. Cunningham AB, Brinckmann JA, Schippmann U, Pyakurel D. Production from both wild harvest and cultivation: The cross-border Swertia chirayita (Gentianaceae) trade. Journal of Ethnopharmacology. 2018;225:42-52.
18. Brinckmann JA, Cunningham AB, Harter DEV. Running out of time to smell the roseroots: Reviewing threats and trade in wild Rhodiola rosea L. Journal of Ethnopharmacology. 2021;269:113710.
19. Moat J, O’Sullivan RJ, Gole T, Davis AP. Coffea arabica (amended version of 2018 assessment). The IUCN Red List of Threatened Species 2020: e.T18289789A174149937. https://dx.doi.org/10.2305/IUCN.UK.2020-2.RLTS.T18289789A174149937.en. 2020.
20. ICAR-Indian Institute of Spices Research. Cardamom – Extension Pamphlet. Kozhikode, Kerala: ICAR- Indian Institute of Spices Research; 2015.
21. Oketch-Rabah HA, Marles RJ, Brinckmann JA. Cinnamon and Cassia Nomenclature Confusion: A Challenge to the Applicability of Clinical Data. Clinical Pharmacology & Therapeutics. 2018;104(3):435-445.

“Everybody had the same terrible, terrible fatigue. So I just told everybody about the ‘trial’ and everybody… and, and those who signed up… you know, just, just got better. Really, really quickly.” – JSP service user

The Jade Screen Project (JSP) offers immune-enhancing and anti-viral herbal formulae for people working in the NHS, care homes, and those providing essential support services, that might reduce the risk and potential severity of infection.

We want to step forward to help those who are on the front line at greater risk of infection from Covid-19, by offering free CHM. We want to give it for free because we feel they deserve this level of support, as they are putting their lives on the line.

The Jade Screen is taken from the name of an ancient formula, which was used to protect people from infection. The formula’s name was derived from the Feng Shui practice of placing a screen made of the jade stone in rooms to protect people from draughts, the reference to jade reflects value and strength, and screen indicates a barrier – together it is considered something both protective and precious to have around the home.

The Jade screen, both the formula and the metaphor of protection, is our inspiration to offer our support to people working in environments where there is an increased risk due to high viral load.

The Jade Screen Project (JSP) was set up in April 2020 by a small group of Chinese herbal medicine practitioners in response to the rapidly developing healthcare crisis caused by Covid-19, and its potentially devastating effect on frontline workers. The name of the project was derived from a famous 13^th century Chinese herbal formula designed to protect against infectious disease.

Our aims were to replicate findings in Hong Kong from the 2002-3 SARS epidemic and anecdotal reports from Wuhan, China, in 2020, that described the use of immune regulating and anti-viral herbal medicines in helping to protect healthcare workers from contracting disease.

Our second aim was to provide herbal support for people who had contracted the virus and were managing the disease at home, and our third objective was to use herbal medicine to promote recovery from the chronic symptoms of disease now known as ‘Long Covid’.

Setting up the project was exciting and exhausting. We conducted rapid reviews on all the English and Chinese language literature describing the treatment of Covid-19 and similar coronaviruses with Chinese herbal medicine (CHM). Most of the data described the treatment of acute disease and various protocols that had been tested or were biologically plausible as preventative interventions.

We quickly formulated this review into treatment guidelines and ran three training seminars to inform our herbal colleagues of our findings. Seminars were free and were conducted via Zoom. Over 100 herbal practitioners attended, 50 of whom then signed up to provide a network of herbalists prepared to treat frontline workers.

We now had a theoretical framework we could apply to treating Covid and a group of practitioners prepared to treat frontline workers free of charge. In parallel to these encouraging developments we approached Balance Healthcare Ltd, who agreed to provide heavily discounted herbs for the project.

We desperately needed funding to enable to project to become operational and this was generously provided in the form of two £5000 grants from the Earthsong Foundation. Chinese herbal medicine in the UK now had a portal which it could use to make a contribution to the fight against the pandemic.

We saw our first patient, a policeman with acute Covid symptoms, on May 1^st 2020, and we have now treated 230 frontline workers coming from an astonishing array of occupational backgrounds including surgeons, care workers, teachers, GPs, youth workers, nurses, mental health workers, pharmacists, train and bus drivers, and physiotherapists. Initially our treatments tended to focus on providing preventative herbal formulae with a smaller number of people presenting with acute disease.

Over time there has been an increasing emphasis on helping people with the debilitating chronic symptoms of Long Covid. In light of the recent introductions of the vaccine we decided that from January 2021 we should focus our limited resources on supporting people with acute disease and with Long Covid.

In addition to the generous support of Earthsong we have raised over £10,000 in donations from professional bodies and individuals who have want to help the project, or who have been the recipients of JSP treatments. This is fantastic but unfortunately it is not enough to enable us to continue providing free herbal care-especially to patients with Long Covid who require complex and expensive interventions to help restore them to good health and enable their return to work. We need to find new sources of funding to enable us to continue to provide herbal support to frontline workers who have risked their health to provide vital services that we all depend on.

We are a group of experienced practitioners and researchers of Chinese herbal medicine (CHM) who want to make a positive contribution during the current pandemic. We are committed to providing accessible, high quality, evidence-based care using herbal medicines.

We are very moved by the response from the CHM community, who have registered as JSP practitioners and are all offering their services free of charge.

As a measure of our offering the best service we can, we have elected to choose practitioners for our service who are registered members of their professional association, so we can be sure of the high standard of the treatment we are offering.

These practitioners have also undergone specialised training in Covid-19 infection management based on research from Chinese treatment protocols currently used in the pandemic.

We also carried out our own survey of experienced practitioners based in different countries to find out their own clinical CHM experience with patients who have been affected by COVID-19.

Chinese herbal medicine (CHM) is an ancient system of medicine developed and refined in China and other East Asian countries over the past 2000 years, using the active compounds available from hundreds of different plants. Although they are not refined and isolated as they are in modern drugs these plants enable what has been described as a polypharmacy that allows many compounds to operate together to generate a therapeutic effect.

CHM herbal formulas are normally between 10-15 different herbs containing plant extracts that have immune-regulating, anti-viral, and anti-inflammatory effects. These individualised formulas are worked out after the practitioner notes down the precise nature of the symptoms, as well as any underlying health conditions and medication being taken.

CHM has demonstrated a preventative effect in previous coronavirus epidemics – a large study from 2003 during the SARS outbreak in Hong Kong compared 1,063 healthcare workers taking CHM with 36,111 who did not, and found that those who did had a much lower infection rate.

CHM is part of an array of support and advice that a qualified herbalist can offer. Having seen the evidence from both our clinical practice and research into the benefits of herbal medicine, we feel strongly about stepping forward to support those who are putting their lives on the line, and helping them during this incredibly difficult and stressful time.

We have seen in our clinics the results of the support we offer our clients, and through researching treatment protocols used over centuries in response to pandemics, infectious respiratory diseases and rehabilitation from chronic illness, we strongly believe that our skills and experience will be useful for those right at the edge of the crisis. 

A final word on how we are evaluating the project. In April we submitted a research proposal on preventative care to St Thomas’s Hospital and over the summer we had discussions with the Department of Primary Care in Southampton University about a research project treating patients with Long Covid.

Sadly, for reasons that to be frank escape me, neither project was considered to be worth developing. In the absence of formal academic support we have used MYMOP (a validated patient centred outcomes measure) to assess the results of our interventions and we have also conducted a number of in-depth interviews with JSP patients to explore their experience of the project.

We are currently conducting a service evaluation to look at all aspects of what we do that will hopefully result in quantitative and qualitative data being written up and published. We hope that this might provide a rigorous rationale to persuade funders and professional researchers to investigate the project.

There are studies on the front page of the Jade Screen Project website, for those interested in the science behind CHM being able to supress viral replication, and inhibition of the SARS protein entering the cell’s receptor sites, which is how the virus enters the cells. There are also studies showing how herbs may have anti-inflammatory and immunoregulatory effects by reducing cytokine levels and enhancing immune mechanisms.

Several studies have confirmed the ability of mushrooms in general to increase the effectiveness of both our innate and adaptive immune response to a range of pathogens, including viruses. Reishi has a strong anti-inflammatory activity, as well as the quality to curb viral replication. Covid-19 enters cells via angiotensin-converting receptors, which the triperpenes and proteins from Reishi have been shown to block.

Herbs such as Patchouli and Japanese Knot Weed are considered to have anti-inflammatory and immune-protective qualities, that are amongst a wide range of herbs available to herbalists. These three herbs in particular are very useful in our formulae, where we call them by their Chinese names of Ling Zhi, Huo Xiang and Hu Zhang.

“Good luck with the project and everything. I hope that would be great to see it more in the mainstream and helping more and more people because I know it can do that now.” – JSP service user

In the meantime we soldier on, making a small but meaningful contribution in the fight against Covid-19. My experience, and that of my colleagues, is that CHM can help manage acute disease and significantly speed up recovery from Long Covid. I hope we can find a way to continue and develop the support we provide to frontline workers and to extend it to the growing numbers of people who have been laid low by this disease.

We’re not asking the people on the frontline to pay for either the herbs, or the consultations, as we feel they deserve our support and have put their lives on the line for all of us.

All donations we receive will go towards paying for their herbs. Our time, research and consultations are being gifted as a token of our thanks for their courageous work. We are hopeful that our support will help to protect those who are in such a perilous situation.

All the money donated via our donation pages goes directly to paying for the herbs, which have been provided at a generous discount, allowing your money to go even further.

All admin costs are covered by internally generated donations, meaning all our fundraising from the public can go directly to covering the cost of the herbs.

Please help us to support those who really deserve it! If you can’t support us financially, please do share our page on Facebook and Instagram, and let your friends know, especially if they are working on the front-line and you feel they would benefit from our support.

All donations that were received by the Jade Screen Project went towards funding herbal medicine for our frontline workers.

You can use the following resources to learn more about sustainable herbal medicine and sustainable herbs:

• What do you need to know about sustainability as a consumer
• Best sustainable practices toolkit for companies

Let’s have a quick look at some of the reasons medicinal plants are so important to human culture and health.

• In health terms the use of plants is unsurpassed; they have the function of safely strengthening the tissues, immunity and integrity of the body whilst also offering the potential to safely cleanse, detoxify and clear wastes from the body.
• Cutting edge science suspects that one of the reasons for the rise in chronic degenerative diseases is our reduction in the use of plants in our diet. All traditional societies have used plants for healing and their high levels of protective ‘phytochemicals’ such as flavonoids, carotenes and essential oils have all been shown to protect our cells from environmental damage caused by pollution, stress and nutritional deficiencies.
• Herbs are an integral part of nature. They help to protect and increase the biodiversity of an ecosystem.
• They are a valuable part of the human relationship with nature and enhance our connection with the planet. The WHO states that up to 80% of the world’s population depend on herbal medicine as the primary form of medical healthcare.
• They offer health benefits in the form of traditional medical systems, folk medical systems and shamanic healing systems.
• They form a major resource for the healing of known and unknown diseases.
• They offer great financial benefits with the global market being estimated at £12 billion per annum.
• They offer spiritual benefits as guides and symbols of power.
• They protect indigenous cultural values and promote cultural integrity. Having knowledge of local herbal medicines promotes cultural uniqueness, respect and value.

It is estimated that the Ayurvedic pharmacopoeia includes upwards of 1250 species with approximately 300 of these in regular demand. Similar figures exist for Chinese, Physiomedical and Western herbal medicine. In India and Sri Lanka most herbs come from the wild. That is, in excess of 90% of herbal material used in Ayurveda comes from the forests, mountains and plains of the Indian sub-continent and are sourced in an unregulated manner. That is a heavy burden for nature to bear (Schippman 2004).

In other parts of the world there is similar pressure with 80% of species coming from the wild in China and up to 99% in Africa (Schippman 2004, Williams 1996). There is the well understood increasing pressure on natural habitats as global population increases. And, at the same time, there is increased financial pressure on low income communities and as herbal medicines offer a viable source of income this can lead to over-harvesting. It is estimated that global demand for herbals has sky rocketed in the last decade with demand increasing by 10-20% per annum.

The problem is that that is very difficult to monitor herbal collection. I have been involved with large scale cultivation and collection programmes for the last fifteen years and believe me it is difficult to monitor and manage. This problem is compounded by the fact that there is relatively little cultivation of herbal medicines.

Some examples of some species that are threatened:

• Liquorice (Glycyrrhiza glabra anduralensis) is a delicious sweet herb used to strengthen the adrenal glands, reduce inflammation and tonify the lungs. It grows all over the world. In the UK, Pontefract ‘licorice’ was famous in the last century. A large portion of that global supply has come fromaround the world such as China and Turkey. Its increased popularity and lack of controls on harvesting mean that Turkey is now suffering a shortage of wild Licorice.
• Jatamansi (Nardostachys jatamansi) or Indian spikenard only grows in the Himalayas between 3500-5000m altitude and is highly valued for its aromatic calming properties. Apart from its limited growing habitat it also takes three years to grow to full maturity and it has been thoroughly plundered to the extent that it has been listed on the CITES list as a species to be protected from international trade unless it has been cultivated. Despite this it can frequently be seen in some Ayurvedic products in the UK.
• Echinacea (Echinacea angustifolia), goldenseal (Hydrastis canadensis) and American ginseng (Panax quinqufolium) have all become endangered in the wild in America due to overharvesting due to consumer demand.

It might seem obvious but that is where they naturally grow. They often require very specific habitats and may be difficult to cultivate. Another reason is that herb prices are actually very low and so there is a lack of incentive for farmers to grow herbs as they can receive a greater income from conventional food crops.

Conversely, they are a relatively accessible source of income for poorer sections of society, to people without land or a regular job. In the higher altitude region of Nepal 100% of the families harvest herbs and it can account for 15-30% of their income.

Another piece of ‘herbal folklore’ is that some authorities consider herbs grown in the wild to be more potent and this is reflected in the higher price of up to 30% more being paid for wild collected American ginseng (Panax quinqufolium) in China as opposed to cultivated.

This makes sense if you consider that the healing properties of plants are often associated with their own abilities to protect themselves from invading bacteria and funguses that are rife in the wild. (It’s also why organic food is better for you but more about that another time.)

I think that cultivation of medicinal species should be encouraged on a massive scale to ensure that extra burdens on the wild are reduced. It could change farming. It could change how our world looks (most herbal medicines are stunningly beautiful).

Alongside this increase in cultivation, sustainable collection systems need to be established. This will help protect local communities and eco-systems.

I strongly believe that certification is needed to protect the future of herbal medicines. This certification would inform the consumer if these herbs have been sustainably grown and harvested.

At present organic certification along with FairWild certification are two solutions offering some objective assessment of control within the supply chain. If you buy uncertified products there is a chance that they come from an unsustainble source. A simple solution to this is to look for the Soil Association and/or the FairWild symbols on products.

The Fairwild certification is a recent scheme created by WWF, TRAFFIC, IUCN (International Union for the Conservation Nature) and the BfN (German Federal Agency for Nature Conservation) to ensure sustainable wild collection of herbs.

It is an example of incentive based conservation that has developed through the pioneering work of experts in managing sustainable livelihoods and eco-systems. It includes the principles of FairTrade, to ensure collectors are fairly treated and appropriately paid, with the practice of sustainable wild collection, ensuring the long-term survival of the species and the community. It ensures that the whole is considered: that people, the plants and the eco-system are all equally important. In this way FairWild certification can transform potentially destructive wild-harvesting practices into a powerful tool for conservation.

It is now well documented that organic foods and herbs have higher levels of secondary metabolite compounds than conventionally grown crops. It is these secondary metabolites that give the plants their therapeutic energetic effects.  For example, many alkaloids are bitter, polysaccharides are sweet and mustard glycosides are pungent. This means that in organic plants the ‘energetic qualities’ are more potent and thus more effective. When comparing organic to non-organic food, the mean positive difference in flavour of organic food between the following nutrients is known to be:

• Protein + 12.7%
• Beta-carotene + 53.6%
• Flavonoids + 38.4%
• Copper + 8.3%
• Magnesium + 7.1%
• Phosphorous + 6%
• Potassium + 2.5%
• Sodium + 8.7%
• Sulphur + 10.5%
• Zinc + 11.3%
• Phenolic compounds + 13.2%

A recently concluded European Union research programme concluded that, “Levels of a range of nutritionally desirable compounds (e.g. antioxidants, vitamins, glycosinolates) were shown to be higher in organic crops”. Conversely “Levels of nutritionally undesirable compounds (e.g. mycotoxins, glycoalkaloids, Cadmium and Nickel) were shown to be lower in organic crops”. The 2014 meta-analysis at Newcastle University by Leifert further validated these findings.

The Soil Association UK says “Organic farming and food systems are holistic, and are produced to work with nature rather than to rely on oil-based inputs such as fertilisers. Consumers who purchase organic products are not just buying food which has not been covered in pesticides (the average apple may be sprayed up to 16 times with as many as 30 different pesticides) they are supporting a system that has the highest welfare standards for animals, bans routine use of antibiotics and increases wildlife on farms.” Organic farming offers very clear health and environmental benefits.

I have found that another side-benefit of organic certification is that it necessitates a deeper relationship between the farmer and the trader. Because of the legal requirements, including testing for contaminants (microbiology, mycotoxins), Toxic Elements (heavy metals) and pestidicide residues, it is necessary to have a very close contact with the source of the plants to ensure that Good Agricultural and Collection Practices (GACP) are in place. This is really Good Manufacturing Practice (GMP) for farmers. It ensures quality, consistency and documentation. It ensures ‘transparency’ so that we as consumers know how each species is handled, what inputs have been added and that appropriate checks on quality have taken place.

At Pukka Herbs, we have spent the last fifteen years directly involved in establishing a detailed GACP and organic certification system that brings benefit to the farmer, plant quality and the end user. Through this system we know the name of the farmers, the exact location of cultivation and the date of harvest for all the organically certified species that we produce. It is an evolving process that has led to a much deeper confidence that nature is respected, that the farmers are well treated and the Ayurvedic plants that we produce are of the highest quality.

Traditional Herbal Medicine offers a multi dimensional solution to many of today’s health and ecological issues. One way of healing human suffering as well as reducing ecological destruction is to integrate traditional healing systems within primary health care.

The demand for herbal medicines will spur a whole range of herbal growing projects around the UK and the rest of the world which would employ hundreds of thousands of people, protect local ecosystems, absorb millions of tonnes of carbon, and create safe and effective medicines helping to make the UK and the world a healthier and happier place.

It would also ease the pressure on stretched NHS resources and redress the balance to an integrated medical system. This will reconnect us with the natural healing patterns of nature as well as heal the endemic destruction of the natural world.

So, despite the concerns mentioned above, I think that with the correct government supported conservation and cultivation efforts the preservation of our traditional herbal medicines is at the heart of the regeneration of an integrated health system as well as the regeneration of our ecosystem.

We can make this happen by demanding that we have access to natural herbal healthcare. We know that it is safer than pharmaceutical medicine. We know that it is effective. The herbal tradition is a time-tested and a positive solution for today’s chronic problems of weakened immunity. As our bodies face a radically new set of stressors herbal remedies are here to help us adapt and heal. Make herbs your first choice in healthcare for your own benefit and that of the planets.

We could follow the example of the Vrikshayurveda (the Science of Plantlife), a circa 16 Century CE text by Surapala:

“Knowing this truth one should undertake planting of trees since trees yield the means of attaining dharma (life duty), artha (wealth), kama (pleasure) and moksha (enlightenment).”

Protecting nature protects us.

The story of life is really one of sharing and reciprocation. Ever since the earliest blue-green cyanobacteria such as spirulina ‘learnt’ 2 billion years ago to harness the sun’s energy, green plants have been generating the energy of life.

We have been interacting, communicating and growing with our environment since time began with plants and animals developing into the incredible life-forms they express today because of this incessant sharing.

As we evolved together with the plant kingdom we both learned how to use each other for mutual advantage. For example, its testimony to the success of this evolutionary relationship that our body is able to recognize and benefit from the natural phytochemicals developed within plants.

A relationship so successful that the health of our cardiovascular, digestive, immune, respiratory, nervous, endocrine and psychological systems is largely dependent on plants. As we shall see, it’s two-way all the way, and a relationship that we ignore at our peril.

Because of their innate creative desire, plants have developed strategies that attract insects, animals or the wind to carry their procreative-pollen far and wide. A spectrum of colours, tempting aromas and the reward of some sweet nectar lie in fair exchange for this fertile foray. We have all seen bees buzzing from lavender flower to lavender flower collecting nectar and spreading pollen far and wide.

However, in more defensive modes plants have developed protective compounds that help guard them against damage from a plethora of microbes, such as peppermint which has developed powerful essential oils to ward off fungal invasions.

However, these little microbes have an agenda of their own and over time have evolved new challenges to threaten the plant’s defences. And so the dance continues; the plant develops novel and useful compounds to respond to the microbes’ ever-evolving reproductive intentions and visa versa.

Mankind’s use of these botanical species over millennia suggests that bacteria, fungi and viruses have less ability to develop resistance to a broad-spectrum botanical pharmacy than to a narrow pharmaceutical one as used in our modern health system. Plants long used by cultures all over the world, such as andrographis, neem and elderberry, all display a potent ability to ward off infections and avoid creating the dread of antibiotic resistance.

After the longest waltz in history, plants have developed a plethora of these healthful phytochemical compounds, empowering them with broad-spectrum protection; for example, essential oils, polyphenols or steroids that help to protect and strengthen the plant. Many species have 1,000-plus compounds at very low levels of concentration.

Animals and humans have discovered how to use these plants for a wide range of health benefits and over the years we have learned how to use 50,000 of the 250,000 flowering plants. The history of medicine is largely the history of herbal medicine, with the great cultures of medicine from the Americas, Europe and Asia collated by such giants as Hippocrates, Galen, Culpepper, Charaka, Sushruta, Huang Di and Li Shi Zhen, harnessing these insights into codified and systematic scientific medical traditions. As we learned to tap into nature’s innate healing vitality we also learned one of the great secrets of life; that plants help our body and mind heal; they help us fulfill our potential.

Flipping everything on its head, some evolutionary biologists think that plants have used humans to spread their seed, piggy-backing on our own evolutionary adventure. You can trace the spread of many species across the planet by following human migration and trade; apples, cannabis and mushrooms walked with us side by side as we globe-trotted over the face of the earth.

Mutually beneficial reciprocity, sharing and learning are found at the heart of most symbiotic relationships. It’s the idea of being selfishly wise and wisely selfish; you look after yourself so you are well enough to look after others, and look after others so they are well enough to look after you, be you bee, butterfly, blueberry or human-being.

Not to say it’s all one happy ‘love-in’, because some species are certainly dangerous, but if we can heighten our already remarkable knowledge of how certain plants can benefit our health, they will flourish and so will we.

Until about 100 years ago we used to keep healthy by eating over 100 species of plants, but for most people today it’s down to around 10-20. It means we are exposed to much less of nature’s phytochemical health-soup everyday. Because the variety of plants and herbs in our diet has radically diminished we are no longer bathing our cells in as broad a spectrum of plant protection as we have done through all of our earlier evolution, and this is one of the reasons our society’s health is suffering today.

A study illustrating the benefits of a broader plant-based diet was carried out a couple of years ago by the perfectly named Professor Blanchflower; it showed how our happiness is directly connected with the amount of vegetables we eat, peaking at about seven a day. The work of Paul Clayton and Judith Rowbotham describing how our diets have declined in nutritional diversity since the Victorian 1870s when chronic disease rates were 90% lower than today also exemplifies the value of diversity. One way of broadening our nutritional horizons is including more of the less well-known plants in our diet, such as those used in the herbal tradition such as licorice, lemon balm, limeflower.

For example, a cup of herbal tea has the approximate equivalent in beneficial plant-ness that half a portion of vegetables does. It’s a simple way to sip our way to happiness.

The ability that plants have learnt to protect themselves from invading microbes and extreme climates is remarkable. That these same evolutionarily familiar qualities can help our life flourish is plain common sense.

Just as the spicy compounds, aromatic terpenes, and colourful flavonoids that you can find in ginger, tulsi or turmeric help the plant flourish, they also interact with our whole mental-emotional-immune network to optimise our response to just about everything. They can help stop a virus replicating, they can kick-start our nervous system to ameliorate pain, boost our fertility and they can lift our mood when we feel threatened. As they interact with our genes, cells, tissues, organs and spirit, plants literally help us to influence our destiny.

This is no simple thing. We have an extraordinary and complex physiology, and yet minute levels of plant compounds can profoundly influence our health. Our human genome has evolved by selecting a vast array of low-level plant compounds to benefit its progress. Over the last 10 million or so years our human genetic experiment has been the story of how we utilize infinitesimally small amounts of phytochemicals to help us thrive. Conversely, the last 100 years has been a health experiment in how we use high-dose single chemicals resulting in some, albeit isolated, remarkable success stories as well as some more infamous tragedies.

As we face an explosion of system-wide disorders, such as diabetes, cancer and emotional disorders, imbalances that do not hugely benefit from the single chemical approach, it’s not a big leap to reflect on the story of life and conclude that we need a more developed system-wide approach to healing. Billions and billions have been spent to tell us the obvious; that the basis of good health is good diet, exercise and lifestyle. Billions more have been spent trying to prove that single-molecule medicine works.

But the ‘truth will out’ and despite all the corruption within so-called Evidence Based Medicine’s skewed results, the dangers of the ‘magic’ bullets of modern pharmacology are rearing their ugly heads, with modern medicine now known to be one of the biggest causes of death today and antibiotics implicated in the alarming increase in Type 1 diabetes, allergies, respiratory disorders, psychological imbalances and inflammatory bowel diseases. With drug companies routinely fined for illegal marketing, covering up life-threatening side-effects and blatant result fixing, it’s time for the magic ‘web’ to take back centre stage; the plants and the tradition of herbal medicine are all around to help.

On a softer note, and beyond just their compounds, plants have a character unique to themselves expressing a knowable personality. We don’t just need to know what’s ‘in it’, we need to know ‘who’ it is. Quantum physics lauds the value of observation as the keystone to understanding reality; Einstein, Bohm and Goethe, in contrast to Descartes and Dawkins, all champion the value of the phenomena above the theory, and this makes each of us the most important scientist in the world.

Experiment for yourself and see; some plants are lively (chew some ginger) and some are much more mellow (sip some chamomile). Some awaken our hearts (just look at a rose) and others make us damn happy (too many to mention, but lemon balm and tulsi sing from the treetops). Whatever they do, plants share life with us and we have developed complex physiological systems to understand them. We just need to open our hearts and minds as we see, smell, taste, touch and listen.

Traditional health systems, such as Ayurveda, teach us to open our senses and read the language of nature; their insights offer an amazing way to tell the story of plants and how we can benefit from them. How one plant, like ginseng, surviving through the harshest winters, can bring us warming strength or another, like aloe vera, thriving in the hot desert, can soothe our burns.

Or we can appreciate for a moment that just as cinnamon thrives in the humid jungle, its drying heat can help protect us from drizzle and damp, or how sweet elderberry fruits help soothe us through the winter. Understanding more about how plants cope with extreme conditions can tell us a lot about their beneficial health properties. Observing nature, as opposed to just measuring her, teaches us that our perception is more important than anything else; our life is literally ours to perceive.

As we experience the power of nature, and we come to terms with the awe of her magnificence, we end up in a place of mystery and wonder. How we live together as a community, how we perceive our environment, as we engage on a global level with all the plants, people and planet, is the story of life…not one of the selfish-gene but of one of sharing and reciprocation as part of the wholeness of the universe.

• A paper from the European Herbal and Traditional Medicine Practitioners Association (EHTPA) for the House of Commons Select Committee on Science and Technology’s antimicrobial resistance (AMR) inquiry.
• Buhner, S. The Lost Language of Plants. The ecological importance of plant medicines to life on earth. Chelsea Green Publishing, 2002.
• Clayton P and Rowbotham J,  An unsuitable and degraded diet? Part one, two and three: public health lessons from the mid-Victorian working class diet, Journal of the Royal Society of Medicine. 2008 Jun 1; 101(6): 282–289.
• Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med. 2004 Apr;70(4):293-8. 
• Hemaiswarya S, Kruthiventi AK, Doble M. Synergism between natural products and antibiotics against infectious diseases. Phytomedicine. 2008 Aug;15(8):639-52.
• McIntyre, M. Managing the menace of antimicrobial resistance with herbal medicine. Herbal Exchanges in celebration of the National Institute of Medical Herbalists 1864-2014. Strathmore Publishing, 2014.
• Mondal S, Varma S, Bamola VD, Naik SN, Mirdha BR, Padhi MM, Mehta N, Mahapatra SC. Double-blinded randomized controlled trial for immunomodulatory effects of Tulsi (Ocimum sanctum Linn.) leaf extract on healthy volunteers. J Ethnopharmacol. 2011 Jul 14;136(3):452-6.
• Pollan, M. The Botany of Desire. Bloomsbury 2002.
• Poolsup N, Suthisisang C, Prathanturarug S, Asawamekin A, Chanchareon U. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther. 2004 Feb;29(1):37-45. 
• Robertson, K. Learning From Plants. Herbal Exchanges in celebration of the National Institute of Medical Herbalists 1864-2014. Strathmore Publishing, 2014.
• Sharma SM, Anderson M, Schoop SR, Hudson JB. Bactericidal and anti -inflammatory properties of a s tandardi zed Echinacea extract (Echinaforce): dual actions against respiratory bacteria. Phytomedicine. 2010 July;17(8-9):563-8.
• Vanka A, Tandon S, Rao SR, et al. The effect of indigenous Neem ( Adirachta indica) mouth wash on Streptococcus mutans and lactobacilli growth. Indian J Dent Res. 2001;12:133-144.
• Wagner H, Ul rich-Merzenich G. Synergy research: approaching a new generation of phytopharmaceuticals. Phytomedicine. 2009 Mar;16(2-3):97-110. 
• Zakay-Rones Z, Varsano N., Zlotnik M, Manor O., et al Inhibition of several strains of influenza virus in vitro and redution of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B in Panama. Journal of Alternative and Complementary Medicine. 1995;1(4):361-369.

Put simply, in the same way we can’t do without water, we can’t do without plants. Our metabolic systems and our genetic code – our DNA – has co-evolved with plants over millennia. Much more than food or medicine, plants are themselves complex substrates that supply energy and information to the body, which in turn controls almost all the metabolic pathways that keep us functioning.

Without enough information – a situation that might arise when we don’t consume a sufficient diversity of plants – we can start to malfunction, suffering from fatigue, becoming less resilient in the face of stress and more susceptible to disease. It’s not just the human side of us that needs plants; it’s also the microbial side.

A healthy adult gut harbours a complex community of around 100 trillion microbial cells, referred to as the gut microbiome. That’s about 10 times the number of human cells we have in our bodies. These gut microorganisms use plant compounds that we’ve consumed to regulate a wide range of critical functions including our appetites, our immune systems, our brain function and the way we store and use energy. Traditionally, thousands of different species of plants have been used as foods or medicines.

Today however, when it comes to foods, there has been a trend, one that’s run alongside industrialised agriculture, food processing and globalisation, that involves a quite dramatic simplification of our diets. Most of us now consume, in the main, a narrow range of vegetables, often less than 10 types, and an equally narrow range of fruits. The genetic stock, and hence the phytochemical diversity, of these is often very limited, and these same, limited varieties of fruits and vegetables are being prioritised for commerce all over the world.

Many crops are harvested early and then shipped to the other wide of the world, being artificially ripened with ethylene gas before they hit the supermarket shelf. Culinary herbs and spices may be added for some flavour, but these herbs are often irradiated and have lost a lot of their bioactivity before they reach our cooking pots and dinner tables.

For our bodies, plants have three main components and many different functions:

1. Macronutrients: (i.e. carbohydrates, proteins or fats), which are present in varying ratios and qualities in different plants and plant parts. These supply energy and a wide range of information that drives or regulates metabolic pathways in the body.
2. Micronutrients and Phytochemicals: (i.e. vitamins, minerals, amino acids, phenolics, glycosides and alkaloids), used by the body for communication between cells and organs, for defense and repair, for nutrient assimilation, for biotransformation and elimination (detoxification), and as cofactors in a wide range of metabolic processes.
3. Fibre: (either soluble or insoluble), that helps processes such as transit and gut function In some cases, we might use the fruits, leaves or other aerial parts, and in others, the underground parts, such as the roots, tubers or rhizomes.

But whatever the plant part, our bodies use the information coded in their genes to inform our own genes. This is how we have co-evolved with plants – they have literally made us what we are today!

Although labels can be useful, it’s doubtful that any single label will ever give us the full story behind our purchases.

Shopping by labels is a frustrating process that has come about in part because of how we have learned to produce goods (by strangers in faraway countries) and shop for them (disconnected from the producer and the production process).

The complexity of the global marketplace means there is still no all-encompassing label to guarantee, for instance, that our clothes and other non-food items are not made with sweatshop or slave labour. Likewise, although organic produce commands a higher price at the checkout, there are still no guarantees that workers on organic farms are benefiting.

Buying fairly may help support industry in the developing world, but it can leave local communities in tatters, produce pollution through air miles and manufacturing effluent and emissions, and promote waste in the mountains of primary, secondary and shipping packaging required to move goods around the globe and get them on the shelves.

Now there is a new wiggle in the story.

We know that producing goods – any goods – can require serious resources. Every year we are using up more than one planet’s worth of resources (3), and like spending more than you earn, this is creating deficits in non-renewable resources such as minerals and fossil fuels – and even fresh water.

Even those who aspire to a more natural way of life may be contributing to the problem of resource depletion without really knowing it. If you use herbs for health and wellbeing you are using a natural resource.

Many herbs used for teas or medicines are still wild collected in fact it is estimated that more than 50,000 species of wild-collected medicinal and aromatic plants contribute to health and livelihoods world-wide (4). Over-collection of many species, combined with habitat loss, threatens this valuable resource.

In Europe it is estimated that about 2,000 plants are traded commercially, of which 60-70% are native species. Up to 90% of these are still collected from the wild, creating an important market and genetic base for many essential drugs.

In fact, at least 25% of our prescription medicines (5) (some put the figure as high as 40%) use naturally occurring substances from plants.

Europe has a tremendous diversity of wild plants that have been sustaining our health for centuries and to continue to enjoy their benefits we need to protect them.

As our consumption of herbs – in herbal teas, spices, foods, dietary supplements and cosmetics – goes up so do the challenges of ensuring that there is enough to meet current needs, but also to ensure that these valuable resources are still there for our children and children’s children and beyond.

The biggest threats to wild plant life include over harvesting and habitat loss.

According to the conservation group FairWild traditional knowledge of wild harvesting techniques is also being lost as people move away from rural areas – drawn to the promise of easier and more prosperous life in cities.

The FairWild Standard (6) aims to tackle all these things by protecting habitats and providing a fair income for collectors in rural communities.

Established in 2010, Fairwild’s goal is:

“To ensure the continued use and long-term survival of wild plant species and populations in their habitats, while respecting the traditions and cultures, and supporting the livelihoods of all stakeholders, in particular collectors and workers.”

For instance, to obtain FairWild certification, collectors, who may have habitually dug up an entire plant, are required to leave some of the root in the ground so that the plant can regrow the following year.

Instead of clearing all of the herbs out of a particular area, collectors are also be required to leave a percentage – which varies according to the plants but can be as high as 40% – untouched so that the seed can mature plants can naturally regenerate (these are important principles for weekend foragers as well!).

Collectors also have to work within specified areas which have been identified as able to support wild collection.

But given nature’s abundance, is the problem really that bad?

A recent report from the International Union for Conservation of Nature (IUCN) suggests it is.

The IUCN European Red List of Medicinal Plants (7) provides information on the status of all major medicinal plants native to Europe. Its 2014 report looked at 400 plants which grow widely throughout Europe. These include common and widely-used species such as Arnica (Arnica montana), St. John’s Wort (Hypericum perforatum), Rosemary (Rosmarinus officinalis) but also the Common Heather (Calluna vulgaris).

Around 31% of the plants assessed in the study were considered to be declining (including the Arnica and Common Heather) and 2% are on the verge with extinction.

While the percentage of plant species threatened with extinction is relatively low compared to other species groups, the number of species on the decline is high and growing. Active conservation measures need to be in place to ensure their long-term survival.

Among the main threats to Europe’s medicinal plants identified by the assessment is the collection of plants from the wild – for their medicinal value and for the ornamental and horticultural plant trade. This was found to affect nearly half (48%) of the plants designated as Threatened or Near Threatened.

Loss of habitat, through residential and commercial development, and impacts from agriculture were identified as other important threats to medicinal plants, affecting 48% and 67% of threatened and Near Threatened species respectively. Any further habitat loss therefore threatens their survival, said the authors.

For example, the pasque flower (Pulsatilla vulgaris) used in homeopathic and herbal medicines, has been assessed as Near Threatened. Although it is widespread throughout western and central Europe, its population has declined and is fragmented.

For those of us who love herbs and appreciate all the benefits they bring into our lives, the path is clear. If we want to continue to enjoy the benefits that wild herbs bring us, then we must pay attention to these statistics and think ahead.

Companies that source ‘fair’ products carry ‘fair’ certification marque on their products. These companies are supporting more than our right to keep on consuming. They are supporting diversity and resilience, viable alternatives – in health, well-being and environmental management.

1. Ethical Consumer – Markets Report 2014, See: http://www.ethicalconsumer.org/portals/0/downloads/ethical_consumer_markets_report_2014.pdf
2. Forum for the Future, Consumer Futures 2020 – Scenarios for Tomorrow’s Consumers, 2011. See https://www.forumforthefuture.org/sites/default/files/project/downloads/consumer-futures-2020-full-document.pdf
3. Global Footprint Network. See: http://www.footprintnetwork.org/en/index.php/GFN/page/world_footprint
4. Figures from Traffic. See: http://www.traffic.org/medicinal-plants
5. Medicinal plants for forest conservation and health care, UN Food and Agriculture Organization, 1997. See: http://www.fao.org/3/a-w7261e.pdf
6. FairWild Standard. See: http://www.fairwild.org
7. European Red List of Medicinal Plants, 2014, IUCN. See: http://cmsdata.iucn.org/downloads/iucn_european_red_list_of_medicinal_plants_web.pdf?dm_i=2GI3,9N1D,40EOD6,LR6Z,1