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As an ethnobotanist working with the traditional healers of Samoa in the 1980s, Paul Alan Cox learned of a potion that he described in his field notebook as a treatment for 鈥渁cute viral illness鈥�. It turns out that the active ingredient, prostratin, is a potent anti-HIV drug, at least in the lab. Now nearing clinical trials, prostratin works unlike any other HIV drug, by coaxing hidden virus out of immune cells. This is no tale of bio-piracy, though. Quite the opposite: pioneering agreements brokered by Cox will ensure that proceeds from the drug go back to the government of Samoa and to the village where Cox first encountered the drug鈥檚 source. Prostratin is just the start, he tells Brian Vastag: next he hopes to find plant treatments for diseases of the mind.

How did you become interested in ethnobotany?

When I was a Mormon missionary in Samoa as a teenager, I got very ill and a healer came and treated me. She made a potion and rubbed roots on my chest. Years later, after my mother died of breast cancer, I thought, 鈥淲ell, maybe there鈥檚 a chance these people have something to treat cancer.鈥� So I left my job and went on sabbatical so I could go back and study with the healers. I wanted to fight the disease that had taken my mother鈥檚 life.

Weren鈥檛 there less drastic ways of doing that?

I was thinking of going back to medical school. Then I thought, if I鈥檓 an oncologist I can treat hundreds of people but if I discover a new drug maybe I can help millions of people. I decided that if I had even a 1 per cent chance of success, that was enough to make it worth my while. So I took my family and we lived in this little village we picked off the map that had no running water or electricity. We lived for a year in a little thatched hut on the beach. This was 1985. I remember sitting on the beach getting a letter from the US National Cancer Institute that said that Robert Gallo had isolated HIV, and do you have any native treatments 鈥� plants 鈥� we can test to treat it? So I sent some samples to the NCI, including samples of the mamala tree (Homalanthus nutans), which I had learned about from the village healers.

Why did you think the mamala might work for HIV?

In the village they make a healing tea from this wood. What captured my attention was their assertion that it could heal a disease that I described in my notebook as 鈥渁cute viral syndrome鈥�. I thought it might be yellow fever, but later we found it was hepatitis. They could cure it with one or two doses. The healers, who are women, are very humble: they didn鈥檛 make astonishing claims about how it healed.

Did the NCI test it against HIV?

Yes. They isolated the active chemical, known as prostratin, and found it stopped healthy cells from being infected. They also found that it exposed the latent virus that existing drugs cannot get to. The current clinical thinking is that doctors could give the patient prostratin once or twice 鈥� which is interesting, because it鈥檚 how the healers did it in Samoa 鈥� then couple that with other drugs. The goal is to clear the patient of virus completely.

You have fixed it so that Samoa gets part of the proceeds from prostratin. How did you do that?

When I drove into the village where I first worked, the chiefs got together to welcome us. Everybody was very surprised I spoke Samoan. They said, 鈥淲hy are you here? What are your hopes?鈥� I told them I was there to discover new medicines and promised that if anything came of my research I would do my best to protect their financial interests. The same message went to the Samoan government.

鈥淚 promised that I would do my best to protect their financial interests鈥�

When the NCI applied for a patent, Gordon Cragg, the head of the natural products branch, agreed to help me keep my pledge. So I called the AIDS Research Alliance, which is trying to launch a clinical trial, and said: 鈥淚f you want to develop prostratin, you have to come with me to Samoa and you have to sit in a hut on a mat cross-legged, and you have to wear a skirt and listen to the old lady healers and listen to the chief and drink kava and eat a fish head and mind your Ps and Qs. If they trust you then they will probably agree.鈥�

Everyone involved in the agreement was resolute that if the drug worked, they wanted it provided to African countries at low cost or no cost. It was important to the Samoans, who view this plant as their gift to the world, and it was important to the AIDS Research Alliance. I was hearing both sides, one in English and one in Samoan, saying the same thing. I was really touched. As a result, growing this plant could become an industry for these little remote Samoan villages.

What was agreed in the end?

Thirty per cent of the patent royalties from the NCI go to the village. The AIDS Research Alliance has agreed to give back 20 per cent of any profits it makes, split between the government of Samoa and the village. And the University of California, Berkeley, which is trying to clone the prostratin gene, has agreed to give back 50 per cent of its proceeds; we came up with that scheme because cloning the gene would cut the legs out from under the plant cultivation industry. In addition, the AIDS Research Alliance has agreed to source the drug from plants grown in Samoa.

What other illnesses are you hoping to target?

Schizophrenia and depression. One per cent of all people in the world have schizophrenia. Somewhere there just might be a healer who knows how to treat it. I have this archive of maybe 400 or 500 samples from different species, and the way they are used by the healers and so on is very well documented. I鈥檇 like to go and collect new stuff, though as I get older I won鈥檛 be able to engage in the vigorous fieldwork any more. But I have this archive to fall back on.

Why are you so concerned about preserving this traditional knowledge?

Indigenous peoples and their knowledge deserve a place in the academy. When I was at university, the idea was that everything worth knowing was in the library and laboratory. What Richard Evan Schultes, the pioneering Harvard ethnobotanist, taught me was that there is a great deal of knowledge out with the healers and chiefs. My goal is to help the sick get better, but even if that doesn鈥檛 happen, I think we鈥檝e established that these indigenous people are sophisticated in their knowledge, and that their knowledge can be scientifically validated in the laboratory. It鈥檚 a different way of knowing, but it is a way of knowing.