by Geewananda Gunawardana, Ph.D.

The science behind the Ayurvedic system is far more sophisticated and ahead of its time than is often recognized. Our ancestors contemplated many of these principles centuries ago, but Ayurveda’s image has been tarnished by our tendency to embrace Western ways of thinking and judging.

Thanks to advances in modern science and technology, however, that attitude is beginning to change—not only in Sri Lanka but globally. There is a fundamental difference between Ayurveda and the Western medical system. Therefore, judging the two by exactly the same standards, or assuming that developing Ayurveda along conventional pharmaceutical lines is the only way forward, does not make sense in the 21st century.

Science, technology, and the Western regulatory environment are now shifting in ways that could favor plant-based therapies. This presents Sri Lanka with an important opportunity: to bring Ayurveda into the 21st century in a form that preserves its ancient roots while presenting it to modern populations within a scientifically rigorous framework. Doing so could enable us to reap the full benefits of this ancient knowledge.

The origins of plant-based medicine

Throughout known history, humans have used plants to treat illness. Some of the oldest written evidence of medicinal plant use comes from ancient Sumerian clay tablets dating back roughly 5,000 years. Among the plants recorded were the opium poppy and willow, the latter eventually providing the basis for the development of aspirin.

In 1806, German pharmacist Friedrich Sertürner succeeded in isolating morphine from opium. This was a landmark in pharmacology and one of the earliest examples of isolating a pure active pharmaceutical compound from a plant.

The development of modern pharmaceuticals was driven in part by the recognition that crude plant preparations could vary considerably in their composition and therapeutic effects. Standardization therefore became increasingly important.

Realizing this need, in 1888, Dr Wallace Abbott started making ‘pills,’ like those used by Ayurvedic practitioners, and distributed among his colleagues in Chicago. These pills became so popular he founded the company that became Abbott Laboratories. This eventually contributed to the development of the modern pharmaceutical industry. A little over a century later, this writer joined this company as a researcher.

The “magic bullet” concept

In 1916, German physician and scientist Paul Ehrlich proposed the idea that therapeutic compounds could act selectively on specific targets in the body. His famous “magic bullet” concept became one of the foundations of modern pharmacology and rational drug discovery. Ehrlich was awarded the Nobel Prize in Physiology or Medicine in 1908.

During the late nineteenth and twentieth centuries, this concept became deeply embedded in pharmaceutical research. Researchers attempted to identify the active ingredients in medicinal plants used by traditional medical systems such as Ayurveda and isolate them as individual compounds.

This approach produced many valuable medicines. Microorganisms eventually proved an even more productive source of drugs, with penicillin being perhaps the most famous example and revolutionizing the treatment of infectious diseases.

However, the search for new medicines increasingly shifted towards synthetic chemistry. Synthetic compounds could be produced in enormous numbers and screened systematically. As pharmaceutical research became increasingly chemistry-driven, interest in medicinal plants declined.

This development also contributed to traditional medicine acquiring a poor reputation in some scientific circles. Some researchers went as far as to argue that traditional plant preparations were little more than placebos—those patients believed they worked and consequently felt better.

Science, however, has continued to evolve.

The Human Genome Project changes the picture

When the Human Genome Project was completed in 2003, it produced a major surprise. Scientists had expected the human genome to contain perhaps hundreds of thousands of genes. Instead, the number of protein-coding genes was found to be only around 20,000.

The discovery challenged the assumption that genes alone could explain the extraordinary complexity of the human body.

Genes carry the instructions for producing proteins, while proteins perform most of the functional work within the body. Scientists subsequently discovered that a single gene could give rise to multiple proteins through different biological mechanisms.

An important realization emerged: proteins may have unique characteristics, but they can also interact with multiple biological processes. A protein may therefore perform different functions under different circumstances. Enzymes are not specific, as old textbooks state.

This began to challenge the simplicity of the “one drug, one target” concept.

From magic bullets to multiple targets

Two important observations became increasingly clear.

First, many drugs do not act on a single target. Second, particularly in chronic diseases, multiple biological pathways and proteins may be involved.

Many drugs once thought to be highly target-specific have subsequently been found to act on multiple targets. For example, the anticancer drug sunitinib interacts with numerous molecular targets, while the central nervous system drug clozapine also affects several biological targets.

In that sense, many modern drugs may be less like “magic bullets” and more like weapons acting on a cluster of targets.

This changed the way researchers look at medicinal plants and traditional therapies. There is now greater recognition that medicinal plants may contain multiple active compounds capable of acting on multiple biological targets.

But even this may not tell the whole story.

The human body maintains homeostasis through an extraordinarily complex network of biochemical reactions and pathways. These systems contain redundancies and compensatory mechanisms that help the body respond to disturbances.

By the time symptoms of a chronic disease appear, several pathways may already have become disrupted, dysregulated, or dysfunctional. Treating such conditions may therefore require intervention at multiple targets rather than attempting to correct a single pathway.

Ayurvedic philosophy has traditionally approached illness by considering the whole individual rather than focusing on a single biological pathway. Its approach is holistic and based on centuries of accumulated experience rather than laboratory-based single-target experimentation.

Modern Western medicine is increasingly recognizing the complexity that lies behind this approach.

What happens to a medicine after it is swallowed?

Whether a medicine is derived from a pharmaceutical laboratory or a plant, an orally administered compound must first be absorbed through the gastrointestinal tract and enter the circulation.

It then passes through the liver, where enzymes metabolize many foreign compounds. Some of these metabolites are subsequently eliminated by the kidneys. Only compounds that survive these processes, or their active metabolites, can reach their intended sites of action.

In conventional pharmaceutical development, researchers deliberately design compounds to overcome these biological barriers.

Plant-based medicines are different. Multiple compounds may interact with the biological systems responsible for absorption, distribution, metabolism, and elimination. These interactions can produce synergistic effects, in which the combined action of several compounds is greater than the effect of individual compounds acting alone.

This complexity creates a major challenge for conventional pharmaceutical regulation.

Drug developers are required to demonstrate that their products meet stringent requirements relating to absorption, distribution, metabolism, and excretion. They must also demonstrate safety, efficacy, consistency, and appropriate dosing.

Obtaining regulatory approval can take many years and require enormous financial investment.

For complex plant-based preparations, however, it can be difficult to identify precisely which compounds are responsible for therapeutic activity and how they interact. Without adequate characterization and quality control, meeting modern regulatory requirements becomes extremely difficult.

This has been one of the major barriers facing Ayurvedic and other traditional plant-based medicines. Preparations that may have therapeutic potential are often marketed as nutraceuticals or dietary supplements rather than as medicines at prices much below their true value.

That is a missed opportunity.

Technology provides a new opportunity

Both science and technology have now changed dramatically. This creates a unique opportunity for Sri Lanka to revisit its millennia-old Ayurvedic knowledge.

Following the Human Genome Project, scientific attention increasingly expanded beyond genes to a range of disciplines collectively known as the “omics sciences”. These include genomics, proteomics, and metabolomics.

Omics involves the comprehensive analysis of biological molecules and processes within an organism. Advances in analytical instruments, combined with enormous increases in computing power, now make it possible to analyze complex biological mixtures at speeds and costs that would have been unimaginable a few decades ago.

This is a potentially transformative opportunity for Ayurveda.

Among these technologies, metabolomics may be particularly valuable. It allows researchers to study large numbers of small molecules—the metabolites—present in biological systems.

Using such technologies, it may be possible to identify and characterize the compounds associated with the therapeutic activity of complex plant preparations. The same technologies can contribute to stringent analytical and quality-control systems required by modern regulatory authorities.

They may also help researchers develop new diagnostic and prognostic tools and identify potential therapies for serious unmet medical needs.

For example, chronic diseases such as Alzheimer’s disease may begin developing decades before obvious clinical symptoms appear. Chronic diseases are also biologically heterogeneous, meaning that patients with the same diagnosis may have different underlying mechanisms.

Early diagnosis and personalized treatment are therefore likely to become increasingly important in future medicine. Combination therapies are already standard practice for many diseases.

Quality control is critical

One of the greatest challenges facing plant-derived medicines is consistency.

The chemical composition of a plant can vary according to its age, season, geographical location, soil conditions, harvesting practices, and processing methods. Simply confirming the identity of the plant is therefore insufficient when the objective is to develop a reliable medicinal product.

This is a major challenge for clinical trials involving plant-based medicines. It is not reasonable to assume that every preparation made from the same plant will have an identical chemical composition or therapeutic effect regardless of its origin and history.

To achieve predictable therapeutic outcomes, stringent quality control is essential—just as it is for conventional pharmaceutical products. To do so all compounds that are responsible for therapeutic activity must be identified.

Metabolomics and related analytical technologies could play a key role in addressing this problem.

A sustainable alternative

There is another reason to explore plant-based healthcare.

The modern pharmaceutical industry is heavily dependent on complex chemical manufacturing processes and, directly or indirectly, on petrochemical resources. As the world faces increasing pressure on natural resources and the environmental consequences of industrial production, sustainable sources of medicines deserve greater attention.

A stronger plant-based healthcare sector could potentially create employment across agriculture, research, manufacturing, quality control, and education while also encouraging the cultivation and sustainable use of medicinal plants.

Sri Lanka’s opportunity

All of this is technically possible. The challenge is whether Sri Lanka has the knowledge, institutions, and vision to take advantage of the opportunity.

Many Western researchers are understandably focused on synthetic pharmaceuticals, biotechnology, and other established areas of investment. Previous attempts to develop traditional medicines using conventional approaches have often produced disappointing results.

China, however, provides an important example of a country that has invested heavily in the scientific investigation and modernization of traditional medicine.

For Sri Lanka, one of the major obstacles is the knowledge gap. Omics sciences are relatively new fields, and our academic system has not yet fully caught up with these rapidly developing disciplines.

Therefore, any serious national programme to develop Ayurveda must be accompanied by equally serious education reform.

Education must change too

Our science education remains heavily dependent on traditional “pure” or theoretical sciences. We need to move towards more applied, practical, and problem-based science education.

This is critical for national development.

Closing this knowledge gap would not only strengthen the economy but also make science education accessible to a much wider section of society. People should be able to use scientific knowledge to develop practical skills, businesses, and innovations rather than simply memorizing information with little practical application.

Consider, for example, the science behind solar tunnel dryers. With the right knowledge and technology, how many cottage industries could be established to produce dried mangoes, bananas and papaya, or dried spices such as chili, pepper, and cinnamon?

Similarly, if demand for high-quality medicinal plants is created, local industries could emerge to cultivate, process, and supply them.

This is what vocational education should be about. It should not be restricted to traditional pathways such as medicine and engineering.

Despite the enormous success of synthetic pharmaceuticals, demand for plant-derived medicines has not disappeared. Taxol, for example, remains an important anticancer drug and demonstrates the enormous commercial potential of plant-derived therapeutics.

The time to act is now

Time is of the essence. Other countries are better positioned than Sri Lanka to enter and dominate this emerging field.

Sri Lanka possesses something that many competitors do not: a long and rich tradition of Ayurvedic knowledge and practice. What is needed now is to combine that heritage with modern science, technology, rigorous quality control, and appropriate education.

The government should therefore promote research into the scientific development of Ayurvedic medicines and create opportunities for universities, researchers, traditional practitioners, and industry to work together.

This should not be viewed simply as government expenditure. It should be regarded as an investment in Sri Lanka’s future.

If approached strategically, the modernization of Ayurveda could create new industries, employment and export opportunities while preserving an important part of our cultural and scientific heritage.

More importantly, it could allow Sri Lanka to contribute to a new generation of healthcare—one that combines the accumulated knowledge of traditional medicine with the analytical power of modern science.

The opportunity is before us. What is required now is the vision and courage to seize it.

(The writer can be reached at omixscience@gmail.com)