Valuing the pharmacopoeias of First Peoples: The benefits in an era of antimicrobial resistance

Introduction: Antimicrobial drug resistance is a major threat to public health. The available therapies for treating infections are rapidly shrinking and new alternatives are needed. Modern techniques such as "high throughput screening" for drug discovery have been unsuccessful in keeping up with resistance and so a change in approach is necessary. Objective: To present evidence for the benefits of valuing the medicinal plant knowledge of First Peoples as a potential source of novel antimicrobial therapies. Methods: Literature from multiple disciplines including ethnobotany, natural product chemistry, public health, indigenous health and microbiology are analysed. The review attempts to encompass views from multiple sectors and thus includes scientific studies, recorded oral histories, and governmental and international reports. Results: A growing body of evidence suggests that new antimicrobial lead compounds and therapies may be found when the medicinal plant knowledge of First Peoples are valued and explored. Examples include the well-known 'tea tree' (terpinen-4-ol rich 'Melaleuca alternifolia') oil and lesser studied compounds isolated from the 'Eremophila' (Emu Bush) genus. Despite the growing evidence there remain large gaps in the current research, especially with regards to safety and in vivo efficacy. In addition to pharmacological potential, there are benefits to First Peoples in having their knowledge celebrated. Conclusions: Looking at the pharmacopoeias of First Peoples as a source or lead for novel antimicrobial therapies is an option that deserves greater attention. An appreciation of such knowledge in the public health and research sectors is necessary to ensure resources are focused towards potential new discoveries.