Key takeaways
- The malaria drug behind a 2015 Nobel Prize came from a detail in a Chinese remedy book written around 340 AD.
- The same broad tradition included Aristolochia herbs, which the FDA calls a potent cause of cancer and kidney damage.
- A 2024 WIPO treaty will require patent applicants to disclose which Indigenous Peoples or local community supplied the traditional knowledge behind an invention, but it needs 15 countries to take effect.
- As of October 2026, only four countries had ratified or joined that treaty, and the United States is not among the 143 parties to the related Nagoya Protocol.
- Before trusting a traditional claim, ask which plant, which part, which preparation, what testing shows, and who holds the knowledge.
In 1969, a Chinese researcher with no medical degree took charge of a national project to fight malaria1. Tu Youyou inherited a long list of failures: researchers had already screened more than 240,000 compounds without finding one that worked1.
So she went back to old books. One remedy, recorded by the scholar Ge Hong around 340 AD, steeped sweet wormwood (Artemisia annua) in cold water to get its juice and skipped the usual boiling2. That clue led her to a cold extraction method using ether. The new extract killed every malaria parasite in infected mice and monkeys2.
Before giving the drug to patients, Tu and two colleagues tested it on themselves1. That drug, artemisinin, earned her a share of the 2015 Nobel Prize in Physiology or Medicine2.
Now a darker story from the same shelf. In Belgium, at least 100 people, mostly middle-aged women in a weight-loss program, took a Chinese herb mixture that contained Aristolochia by mistake5. They developed a fast-moving kidney disease. When 39 of the women had their failing kidneys and ureters removed as a precaution, doctors found 18 cancers5.
Both stories began in traditional medicine. That is the honest picture of traditional knowledge: a huge library of human observation, with real treasures and real dangers, built by people who deserve credit for it.
This guide explains how that knowledge gets tested, what new global rules say about who owns it, and how you can respect it. Dedicated articles on traditional medicine research and on plant-derived medicines are coming later in this series.
Old remedies pointed the way to some of medicine’s most used drugs
The World Health Organization (WHO) says more than 40% of drug formulations are based on natural products4. It credits traditional medicine as the origin of landmark drugs, including aspirin and artemisinin4.
Artemisinin’s payoff has been enormous. Drug combinations built on it, along with mosquito control, helped cut global malaria deaths by 47% between 2000 and 2013, according to the Nobel Assembly’s scientific background report2.
Metformin, the most prescribed diabetes pill in the world, has a quieter herbal history. A 2017 review in the journal Diabetologia traces it to goat’s rue (Galega officinalis), a European folk remedy rich in a compound called guanidine3. In 1918, scientists showed guanidine could lower blood sugar3.
The path from herb to pill was not direct. Related compounds were tried in the 1920s and 1930s, then dropped because they were toxic and because insulin was becoming available3.
Metformin itself resurfaced in 1940s malaria research. A French doctor, Jean Sterne, reported its use for diabetes in 1957, and it reached American pharmacies in 19953.
Notice the pattern. Tradition supplied the lead. The medicine came from refining, testing and dosing. Tu’s early extracts gave inconsistent results until she changed the method2, and goat’s rue’s chemical cousins proved too toxic to use3.
Tradition also handed down remedies that hurt people
Several Aristolochia species were used in traditional Chinese medicine for joint pain, swelling and as diuretics, which increase urine flow5. In 2002, the International Agency for Research on Cancer, part of WHO, placed herbal remedies containing Aristolochia in its highest category: carcinogenic to humans5.
The FDA calls aristolochic acid “a potent carcinogen and nephrotoxin,” meaning it causes cancer and kidney damage6. Large doses can poison quickly. Small doses can go unnoticed for years before causing kidney damage that can’t be reversed6.
The FDA’s import alert lets the agency detain imported supplements that may contain it unless a lab test proves they are free of it6. The alert names Chinese formulas known to contain it, such as Dang Gui Si Ni and Xiao Qing Long Tang6.
Why did this happen? The FDA points to misidentified plants and to confusion over traditional Chinese herb names6. In the Belgian cases, the label named one herb, Stephania tetrandra, but the product contained Aristolochia instead5. Similar cases have been reported in at least five other countries in Europe and Asia5.
Kava shows a subtler lesson. Pacific Islanders have used kava drinks for thousands of years, in ceremonies and as medicine, according to the National Center for Complementary and Integrative Health (NCCIH)7. Yet kava supplements have been linked to rare liver injury, some of it serious or fatal7.
NCCIH lists possible reasons, including the wrong kava varieties or plant parts, mixing with alcohol, contamination and heavy use7. In other words, a long safety record may not travel with a remedy once it leaves the plant, the part and the preparation its tradition used.
Who owns a remedy? The patent fights that changed the rules
In 1995, the United States granted a patent for using turmeric to heal wounds8. India’s Council of Scientific and Industrial Research challenged it, arguing the use was already known. In 1997, the U.S. Patent and Trademark Office (USPTO) revoked the patent for lack of novelty, meaning the idea wasn’t new8.
A similar fight played out in Europe. In 1994, the European Patent Office granted W.R. Grace and the U.S. Department of Agriculture a patent on using neem oil to control fungus on plants8.
Indian farmers’ representatives and international nonprofits objected. The office revoked the patent in 2000 and rejected the patent holders’ challenge to that decision in 20068.
Critics call this pattern “biopiracy,” meaning outsiders claim legal ownership of knowledge or plants that communities developed. The problem is built into patent law. Patents reward inventions that are new, and traditional knowledge is old by definition. Much of it was never written down where patent examiners would look.
India’s answer was a searchable archive. Its Traditional Knowledge Digital Library holds about 290,000 medicinal formulations from Ayurveda, Unani, Siddha and Yoga, translated into five languages8. Patent offices in the United States, Europe, Japan, the United Kingdom, Canada, Germany, Australia, India and Chile can search it. If examiners can see the old knowledge, they can’t mistake it for a new invention.
Three global agreements now address who benefits
Defensive archives only block bad patents. They don’t send money or credit back to communities. Three newer agreements try to do more.
| Agreement | Adopted | What it does | Status, October 2026 |
|---|---|---|---|
| Nagoya Protocol on Access and Benefit-sharing | 2010; in force 2014 | Sets rules for access to genetic resources, such as plants, and for sharing benefits from their use | 143 parties; the United States is not one9 |
| WIPO Treaty on Intellectual Property, Genetic Resources and Associated Traditional Knowledge | May 24, 2024 | Requires patent applicants to disclose where a genetic resource came from and which community provided related knowledge | Not yet in force; 4 of the 15 countries needed have joined1011 |
| WHO Global Traditional Medicine Strategy 2025–2034 | 2025 | Sets four goals: evidence, safety and regulation, integration into health care, and value across sectors | Published October 202512 |
The WIPO treaty is the newest. When a claimed invention is based on traditional knowledge, the applicant must disclose where that knowledge came from, which usually means the Indigenous Peoples or local community that provided it10. “Based on” has a narrow meaning: the knowledge must have been necessary for the invention, and the invention must depend on its specific properties10.
The treaty takes effect three months after 15 countries ratify or join it10. Progress has been slow. Malawi went first in December 2024. As of October 2026, WIPO listed only four: Malawi, Uganda, Albania and Peru, which ratified in July 202611.
Once it is in force, the rule will apply to anyone filing a patent in a member country, including U.S. companies10.
The United States has not announced whether it will join. The USPTO asked the public for comments in January 2025 and held a hearing that April10. The window to sign closed May 23, 2025, and the United States did not sign1011. A country can still join later through a process called accession, as Albania did in 202611.
WHO’s strategy focuses on health systems. WHO founded its Global Traditional Medicine Centre in 2022 in Jamnagar, India13, and India has pledged an estimated $250 million to support it4. WHO says 170 of its member states report using traditional medicine4. Yet traditional, complementary and integrative medicine draws less than 1% of global health research13.
In mid-2026, WHO launched a framework for working respectfully with Indigenous Peoples on health, biodiversity and traditional knowledge, posting it as an unedited final draft in August14. Its principles include free, prior and informed consent, meaning communities agree before anything happens, with full information and no pressure. It also lists reciprocity, shared governance and Indigenous data sovereignty.
Knowledge is also data, and data can be taken without asking
Today, traditional knowledge flows through databases, apps, books and websites. That raises a new question: who controls the record once it’s written down?
In 2020, an international group of Indigenous data experts formally published the CARE Principles for Indigenous Data Governance in the Data Science Journal15. CARE stands for Collective Benefit, Authority to Control, Responsibility and Ethics. The group worked within the Research Data Alliance and consulted Indigenous Peoples, scholars, nonprofits and governments15.
CARE was written to sit beside a set of research data rules called FAIR: findable, accessible, interoperable and reusable15. FAIR is about making data easy to share. CARE adds people and purpose, asking whether sharing serves the community the data came from. The authors’ short version: be FAIR and CARE.
For readers, the takeaway is simple. When an app, book or course presents “Native remedies” or “ancient healing secrets,” ask whose knowledge it is, and whether those people agreed to share it and benefit from it.
Six questions to ask about any traditional claim
Use this checklist when you meet a remedy described as traditional, ancestral or “used for centuries.”
- Which plant, which part, which preparation? Tu’s breakthrough hinged on cold water instead of boiling2. The Belgian tragedy hinged on one herb name standing in for another5. Details are the knowledge.
- Has it been tested in people, for this use? Long use earns a remedy serious study. It doesn’t settle whether it works.
- Is the product in front of you the same thing the tradition used? A pill or a concentrated extract is not a ceremonial drink. NCCIH says kava’s rare liver problems may involve undesirable varieties or plant parts7.
- Is there a safety warning? Search the plant’s name on NCCIH’s herb pages and FDA’s import alerts.
- Does it mix badly with anything you take? NCCIH warns against combining kava with alcohol or sedatives, for example7. Tell your clinician and pharmacist about every herb you use.
- Who holds this knowledge, and do they benefit? Look for products and teachers connected to the community that developed the practice.
Here is how some well-known traditional leads rate on our four-level evidence scale.
| Traditional lead | Evidence level | What the record shows |
|---|---|---|
| Artemisinin-based drug combinations for malaria | Prize-winning research; along with mosquito control, helped cut malaria deaths by nearly half from 2000 to 20132 | |
| Metformin, from goat’s rue, for type 2 diabetes | Now the most prescribed glucose-lowering medicine in the world3 | |
| Kava supplements for anxiety | May help some anxiety, not generalized anxiety disorder; rare liver injury7 | |
| A remedy with long use but no human trials | Worth studying; only a sliver of health research goes to it13 | |
| Herbal remedies containing Aristolochia | Kidney failure and urinary tract cancers56 |
Respect means crediting knowledge and testing it
Many natural-health readers value the wisdom of elders and of cultures that kept people well long before modern pharmacies. That respect is well placed. Some of medicine’s most important drugs started as someone’s grandmother’s remedy.
Taking that knowledge seriously means doing two things at once. It means crediting the people who built it, and it means testing its claims fairly. Tu Youyou’s story shows these goals work together: she read an ancient text closely enough to notice a step that others had missed12.
It also means accepting some limits. Not every tradition wants its knowledge published, sold or studied. Some practices are sacred or meant only for members of a community, and sharing them without permission causes real harm. Our companion article on avoiding appropriation covers buying and ceremony questions in more detail.
A few practical habits help:
- Learn from living practitioners of a tradition, not only from websites that summarize it.
- Ask permission before recording or posting an elder’s remedy, including in your own family.
- Buy from businesses owned by or partnered with the communities whose knowledge they use, and ask them how they share benefits.
- Never stop a prescribed treatment to try a traditional remedy. Use both only with your clinician’s knowledge.
If you have a bad reaction to an herbal product, stop taking it and contact your clinician. For a possible poisoning, call Poison Control at 1-800-222-1222. You can report problems with supplements to the FDA through MedWatch or the Safety Reporting Portal.
Questions readers ask
If a remedy has been used for a thousand years, isn’t that proof it works?
Long use shows a remedy mattered to people, and it is a good reason to study it. But Aristolochia herbs were also part of traditional formulas, and they cause kidney failure and cancer56. Age alone can’t separate the treasures from the dangers. Testing can.
If artemisinin came from a plant, why not just use the plant?
The plant and the drug are not the same thing. Tu’s team got inconsistent results until it changed how the active compound was pulled out2, and today’s treatment uses measured doses in drug combinations. Malaria can kill, so anyone with a fever after visiting a malaria area needs prompt medical care.
Is it wrong to use a remedy from another culture?
The treaties described here focus on patents and on commercial use of plants and knowledge, not on what you brew at home910. Respect is mostly about credit, consent and context. Some knowledge is sacred or restricted, and the respectful choice is to leave it with the community.
Does the United States follow these agreements?
As of October 2026, the United States is not a party to the Nagoya Protocol9. It did not sign the WIPO treaty, and the USPTO had announced no decision on joining as of its last update in May 20251011. Once that treaty takes effect, though, U.S. inventors filing patents in member countries will have to follow its disclosure rule.
The bottom line
Traditional knowledge is neither a chest of guaranteed cures nor a pile of superstitions. It is a long record of human observation that has produced lifesaving drugs, preserved harmful mistakes, and often been taken without credit or payment.
The best way to honor it is to treat it the way Tu Youyou did: read closely, test fairly, and give credit to the people who kept the knowledge alive. New treaties are beginning to require that credit. Your own choices, about what you buy, share and trust, can require it too.
Related reading
About this article
This article was researched using official sources from WHO, the FDA, NIH, the USPTO, WIPO and the Convention on Biological Diversity, along with peer-reviewed research, all listed below. It was reviewed in October 2026. It is general education, not medical, legal or financial advice.
Sources
- NobelPrize.org. “Tu Youyou.” Women Who Changed Science, Nobel Prize Outreach, accessed October 2026. nobelprize.org
- Nobel Assembly at Karolinska Institutet. “The Nobel Prize in Physiology or Medicine 2015: Advanced Information.” NobelPrize.org, 2015. nobelprize.org
- Bailey CJ. “Metformin: historical overview.” Diabetologia, 2017. research.aston.ac.uk
- World Health Organization, Global Traditional Medicine Centre. “About.” WHO, accessed October 2026. who.int
- International Agency for Research on Cancer. “Herbal Remedies Containing Plant Species of the Genus Aristolochia.” IARC Monographs Volume 82, 2002 (INCHEM summary). inchem.org
- U.S. Food and Drug Administration. “Import Alert 54-10: Detention Without Physical Examination of Bulk/Finished Dietary Supplement Products Containing Aristolochic Acid.” FDA, 2020. accessdata.fda.gov
- National Center for Complementary and Integrative Health. “Kava.” NIH, updated April 2025. nccih.nih.gov
- Government of India, CSIR. “Indian Traditional Knowledge Digital Library (TKDL).” Presentation to the WIPO PCT Meeting of International Authorities, 25th session (PCT/MIA/25). wipo.int
- Secretariat of the Convention on Biological Diversity. “The Nagoya Protocol on Access and Benefit-sharing: Parties.” CBD, accessed October 2026. cbd.int
- U.S. Patent and Trademark Office. “WIPO Treaty on Intellectual Property, Genetic Resources, and Associated Traditional Knowledge.” USPTO, accessed October 2026. uspto.gov
- World Intellectual Property Organization. “WIPO Treaty on Intellectual Property, Genetic Resources and Associated Traditional Knowledge: Contracting Parties.” WIPO Lex, accessed October 2026. wipo.int
- World Health Organization. “Global Traditional Medicine Strategy 2025–2034.” WHO, October 30, 2025. who.int
- World Health Organization, Global Traditional Medicine Centre. “Overview.” WHO, accessed October 2026. who.int
- World Health Organization. “Participatory Framework for Respectful Engagement with Indigenous Peoples on Biodiversity, Health and Traditional Knowledge Systems.” WHO, August 11, 2026 (unedited final draft). who.int
- Carroll SR, Garba I, Figueroa-Rodríguez OL, et al. “The CARE Principles for Indigenous Data Governance.” Data Science Journal, 2020. doaj.org