Multi-Functional Phytotherapeutics for Health and Socio-Ecological Sustainability: A Critical Narrative Review of Evidence, Trade-Offs and Governance

Abstract

Plant-derived preparations are increasingly promoted as interventions that deliver therapeutic benefit while simultaneously supporting rural incomes, cultural continuity and habitat stewardship. This framing, described here as multi-functionality, has become influential in policy and commercial discourse, yet the evidence supporting each of its component claims has rarely been appraised together. The present review examines whether the therapeutic, socio-economic and ecological functions attributed to phytotherapeutics are supported by evidence of comparable strength, and where the assumed synergies between them break down. Literature was identified through structured searching of open scholarly indexes and citation tracking, followed by verification of bibliographic identity for every retained source. Five findings emerge. Clinical evidence remains concentrated in a small number of well-characterised preparations, while much of the wider literature is compromised by inadequate chemical characterisation of the material tested and by computational inference that recycles a narrow set of database-privileged molecules. Safety evidence is dominated by product-level failures, including adulteration and elemental contamination, rather than by intrinsic pharmacological toxicity alone. Ecological evidence indicates that demand-driven harvest pressure is real but unevenly documented, with extinction-risk assessment biased towards conspicuous and commercially prominent taxa. Socio-economic evidence shows that harvesters typically capture a minor share of final value, and that gendered participation is high where returns are lowest. Governance instruments addressing quality, benefit sharing and trade operate on different jurisdictional logics and are only weakly coupled to one another. The convergence of health and sustainability objectives is therefore conditional rather than automatic, and depends on supply model, species biology, market structure and regulatory capacity. Research priorities include harvest-response studies for high-volume traded taxa, chemically characterised pragmatic trials, and value-chain analyses that report distributional outcomes alongside conservation indicators.