Madagascar Periwinkles: The Flower of Death and Life

 

Image courtesy of Wikimedia user Devilal

Image courtesy of Wikimedia user Devilal

An ornamental pink flower, rights of indigenous residents, and conservation of biodiversity seem like phrases drawn randomly for a distinctly grim improv skit. The thread that draws them together is a story decades in the making, a line drawn between a desperate hunched parent and environmental issues that will determine whether the earth is any condition for creatures like us to live on. The plant that triggered this is at first unassuming. It’s pretty enough, pink or white, with five propeller blade petals attached to tube and dark green leaves clinging opposite each other up a slender stem. This plant catalyzed the medical discover that turned the children’s leukemia ward from a place with nearly all of the patients bleeding out within months to a largely outpatient care center with a 95 percent survival rate.

This flower is native to Madagascar but has been naturalized to many other tropical and subtropical areas. It has many names: The rosy periwinkle in several English-speaking countries, Shameless Maria in India, and, in Italy, The Flower of Death. The very quality that makes the flower so precious for relieving human suffering also makes it incredibly poisonous. It is widely considered fatal in anything but the smallest of doses.

Madagascar periwinkle fruit and seeds. Image courtesy of Museum of Toulouse.

Madagascar periwinkle fruit and seeds. Image courtesy of Museum of Toulouse.

Dr. Clark Noble, a Canada native, spent 1952 treating patients in Jamaica. He noticed that his patients would use leaves from this tiny flower to control blood sugar levels when insulin was unavailable, a sadly common problem. Since he was no longer a research doctor, he mailed 25 leaves from the plant to his brother, Dr. Robert Noble. Research showed that the leaves seemed to have no effect on blood sugar levels but had an unexpected effect: it inhibited white blood cell counts. In 1958 the more domestic Noble joined a research team that successfully isolated alkaloids (a class of plant-extracted compounds containing both nitrogen and carbon) and distilled them into a compound known as Vinblastine. When the drug entered clinical trials on cancer patients, the results, especially on childhood leukemia patients, were dramatic. Between Vinblastine and vincristine, another periwinkle extract, the odds of surviving the disease skyrocketed from 10 percent (slightly higher than the odds of surviving a gunshot to the head) to a staggering 95 percent.

Slide of chronic leukemia cells. Image courtesy of Dr. Erhabor Osaro

Slide of chronic leukemia cells. Image courtesy of Dr. Erhabor Osaro

This was nothing short of a godsend for the afflicted. However, it was also the best possible news for the bottom line of pharmaceutical companies. Worldwide sales are estimated to be worth over 100 million dollars annually today. Furthermore, stories like this one have prompted organizations such as the National Cancer Institute and many pharmaceutical companies to collect hundreds of thousands of samples of plants from many regions of the world.

Sadly, the money from these discoveries almost never makes it back to the community, often incredibly impoverished if tight-knit communities. Even worse, these tribes are depending on these plants for the only medicine they have reliable access to. When Western demand for that plant increases, it can limit the access the locals have to their plants. This situation has led to many of complicated ethical decisions, such as who owns a plant and how far we’re willing to go to ensure that medical progress, often unavailable in developing countries, continues. Some pharmaceutical companies have taken steps to reinvest in these communities. Many others have continued to focus on exclusively lucrative practices in true mustache-twirling supervillian style, despite pressure to do otherwise.

There are many lessons one might take from this kaleidoscope of a tale: That all life ought to be preserved, both for its own sake and on the distant but not impossible chance that a miracle lurks among its stems. Or perhaps that how we treat people who have no power to oppose us defines who exactly we are far more than what we do with what we’ve stolen from them. Or even that every avenue of inquiry should be pursued to its finish, just in case something beautiful and unimagined lies at the end.

Image courtesy of Tom Rulkens.

Image courtesy of Tom Rulkens.

 

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