From Professional Medical Assistant, May/June 1993

THE "GREENING" OF THE PHARMACY
The Environmental Role of the Pharmaceutical Community
by Dan Wagner

We all want to believe that children still trust us. They trust that we will leave them in a world where the skies are clear, the air is fit to breathe, the water is safe to drink and that some forests will remain. It is not too late to save these elements of nature.

Things have changed, and we have changed. No longer are we trusting of our leaders after such disconcern for the environmental abuses of the eighties. Now the majority of people are cognizant of a real environmental stewardship and our message is a powerful indictment for healthier living on a cleaner planet.

Perhaps it was concern about an impending change in global climate, or worldwide awareness of the destruction of the rain forests, or the Valdez oil spill in Alaska, or communities learning that their water supplies had been contaminated with toxic waste-something ignited public awareness. During the late eighties and early nineties people began to question how we care for our fragile world and resolved to act before it was too late.

What is pharmacy's relation to this global environmental awareness, which is quickly becoming a bigger political issue than war and peace? Pharmacy does have a place in the environmental movement. First, pharmacy's shelves must adjust to the "greenwave" of products that will be in demand in the nineties. Many manufacturers will be wooing Mother Nature so their products will be more "natural" in content, with fewer preservatives and toxic chemicals and additives. Their packaging will be recyclable or biodegradable. Second, the number of pharmaceutical scientists studying natural products and drugs that can be derived from plant and anirnal sources, will continue to grow. Since nearly 25 percent of the prescription drugs that US pharmacists dispense daily are still derived from natural sources, the nineties may bring a shift from synthetic-drug research back to "natural-drug" research. Finally, the biodiversity issue will continue to become more important with the pharmaceutical profession having a direct impact on how reduced preservation of the Earth's biological diversity will have serious consequences for human welfare and health.

Responding to consumer demands
Of the myriad items on the shelves of American pharmacies, many may change in form or content as environmental retailing evolves toward the next century. Counter items such as personal care products, cosmetics, natural foods and beverages, and diapers and incontinence products will change in accordance with the public's concern for the well-being of the environment. As customers' awareness of the need to make environmentally responsible choices grows, the volume of drugstore sales may be related to the number of such items on the shelf.

For example, certain manufacturers are making personal care products intended to promote environmental, as well as personal, well-being. Toothpastes, deodorants, mouthwashes and shampoos containing only natural ingredients (such as honeysuckle, peppermint and coriander) are beginning to sell. More companies are using recyclable toothpaste tubes and boxes, and biodegradable paper towels and tissues are becoming more popular. In addition, it is becoming more imperative that manufacturers clearly state that their products are not tested on live animals, or a humane-conscious public will turn away viewing once-popular products as being unnecessary. More and more, pharmacists will be required to impart information to consumers concerning the ingredients in the products on their shelves. Patients will want to know what dyes, fragrances or preservatives are in the products they buy.

Leaders in nutrition are beginning to offer all-natural and non-allergenic formulations to help stimulate a healthy body and protect it from exposure to toxins and pollutants. All-natural vitamins have been available for years, but new marketing strategies are geared more toward the enhancement of the body, emphasizing natural nutrients for hair, teeth, nails, skin and bones. Today, more foods that are natural, without additives or preservatives, are selling better than ever. Health drinks are more organic, and even snacks contain more quality herbs and spices, and less fat and salt. The sparkling-water market is mushrooming as local, state and national governments wrestle with environmental pollution in our drinking-water supplies.

Disposable adult and baby diapers are creating a serious environmental problem. Diapers are a major component of our overused landfills. Worse yet is that a single-use disposable diaper takes 5,000 years to decompose, with a potential to spread 1,000 viruses that can ]each out and contaminate groundwater. Though most people favor disposables because of the convenience, there may soon be a push toward increased use of reusable cotton diapers, and better biodegradable, flushable diapers and liners.

It is evident that health and beauty aids offering healthy alternatives without harming the environment are being produced and promoted by a growing number of prudent manufacturers. A recent survey revealed that 80 percent of all Americans say their buying decisions are affected by environmental responsibility. Pharmacists can play a pivotal role in educating customers on environmental compatibility. The pharmacist remains America's most accessible health professional and is available to answer product-related questions and concerns.

Pharmaceutical research
What stake does the science of pharmacy have on the environment? The continued research on drugs derived from natural sources proceeds at a vigorous pace, and we are on the eve of many new discoveries in the nineties founded on extensive research done during the eighties. The search for new drugs includes the plant kingdom as well as the oceans.

The next breakthrough in the treatment of an incurable disease may come from a tubar that grows in the Amazon rain forest or an exotic chemical secreted by a starfish in the Pacific Ocean. No one knows for sure.

Many pharmaceutical scientists are deeply committed to the preservation of the world's rain forests. Today's pharmacists frequently dispense plant-related drugs such as digitalis, quinine, reserpine, codeine, morphine, atropine, ephedrine or salicylic acid. Almost 90 percent of the plants used in pharmaceuticals come from the rain forest. The preservation of this medicinal storehouse and natural pharmacy is therefore of paramount importance.

Early in 1993 this type of research has already paid great dividends. The FDA has approved the production of taxol, a scarce but promising anti-cancer compound derived from the bark of the Pacific yew tree. Taxol elicits tumor shrinkage in 30 to 40 percent of women with advanced ovarian cancer. It has also shown promise in treatment of metastatic, or spreading, breast cancer. This drug was developed by the National Cancer Institute in Bethesda, Maryland. Each year the NCI screens 10,000 natural substances for antitumor activity and up to 40,000 for their ability to fight AIDS. Obviously this type of research is difficult and laborious for there are many more "misses" than "hits." Scientists have regarded the pure chemical synthesis of taxol as a scientific feat akin to climbing Mount Everest. The availability of taxol is limited because the Pacific yew is an uncommon tree located in old-growth forests which are home to the spotted owl and other endangered species. French pharmaceutical giant Rhone-Poulenc is developing a related compound, taxotere, derived from yew needles.

The biodiversity issue
The genes and chemicals found in nature are not only unique for many reasons but some of the products and drugs derived from plants, animals and minerals cannot be "manufactured' synthetically in a laboratory.

Governments and industries are realizing only recently that these resources are important to the economy As mentioned, almost 25 percent of all drugs used in this country are still derived from natural products. This fact, along with recent advances in biotechnology have enhanced pharmaceutical companies' interest in screening plants and animals for new drugs. Worldwide, there are more than 200 companies and medical research institutions scouring the wealth of plant and animal species, primarily from the world's rain forests, for new drug entities.

In 1991, the world's largest drug manufacturer, Merck & Company, signed a pioneering agreement with Costa Rica that could serve as a model for halting destruction of the world's rain forests. The US drug company agreed to give $1 million plus unspecified royalties in exchange for the right to develop drugs from plants and animals discovered in the Central American nation's tropical forests. Costa Rica will use the money to train people to inventory plants and animals and to support the nation's conservation effort.

Also in 1991, the US Congress initiated two bills that would establish a national policy for the conservation of biological diversity, and to support environmental training and research necessary for the sustainable use of our biotic natural resources. Although progress in this area was derailed by the poor showing of the US at the Earth Summit in Rio, there is hope that the Clinton Administration will show renewed vigor for this most worthy cause.

For the first time, pharmacists are getting involved in this impending biodiversity issue. Pharmacists are recognized as the "drug experts" and since nearly every drug class was discovered from natural products, it is incumbent that they take direct action by strongly supporting such bills via their local and national associations. It is becoming more evident to scientists, environmentalists, and now pharmacists, that a comprehensive and coordinated federal strategy is needed to arrest the loss of biological diversity, and also, where possible, to restore biodiversity through active and efficient management and natural recovery.

It is evident that pharmacy will change in this decade as it has changed in the past, but with a higher, more sophisticated level of education. Environmental pharmacy is one aspect of the world to which community and institutional pharmacists must adjust. As health professionals we can broaden our philosophy on life and reaffirm our commitment to the disease-free longevity of the human race. Indeed, environmentalism is also a commitment to the preservation of the roots of the pharmaceutical profession itself. Thousands of years ago, alchemists experimented with roots, herbs and plants to concoct drugs for physical ailments. Centuries later, these rudimentary beginnings have evolved into today's elaborate and advanced medical success phenomena.

So, as health professionals we can take bolder and stronger action to protect the fragile biodiversity of our planet. Such action is akin to our chosen profession and essential for the future of humanity. Let us not forget the greatest rule of all life on Earth: Extinction is forever.

Daniel T. Wagner, RPH, is adjunct professor of pharmacy at Duquesne University in Pittsburgh, Pennsylvania. Mr. Wagner is also the head pharmacist and owner of Medi Pharmacy in Allison Park, Pennsylvania.



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