All species become extinct, eventually. Humans will—within only 10,000 years—unless scientists (presumably including pharmacists) do something about it quickly.
So suggests the palaeontologist Henry Gee in his remarkably cheerful book, “The Decline and Fall of the Human Empire”.
Prophets have long predicted doom. Today, people seem anxious about financial, international and personal situations. Scientific consensus is that humans are associated with climate change.
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Warming may flood low-lying, highly populated areas such as Delhi, Karachi, Los Angeles and Rome. The easiest-to-extract resources of the Earth have been depleted.
Humans rely on a narrow animal and plant diet. Western biomedicine (including pharmacy) encourages the unfit to survive and “weakens” human genes.
Population decline
In 1987, mitochondrial DNA studies suggested our matrilineal bloodline traced to one woman in Africa around 200,000 years ago.
In 2001, nuclear DNA studies mapped the complete human genome, corroborating the African origin.
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Humankind appears to have endured at least one evolutionary bottleneck so that we are all genetically extremely similar. A single African chimpanzee troop has more variety than the entire human population. We are inbred.
That is thought to be connected to our susceptibility to many infectious diseases. They include worms, protists, bacteria, fungi, viruses and prions, including transmissible spongiform encephalopathy.
Our total fertility rate (TFR) needs to be 2.1 per woman lifetime for replacement. It is reducing and will tip below replacement level by about 2034.
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The population, presently over eight billion, is still increasing. But we are near the cusp; after that, the population will start to decrease.
If that continued, humans would become extinct. Homo sapiens cannot “hide” traces of its genes within more fecund species of Homo because Homo sapiens is the last species of the genus Homo left standing.
The “unicorns”
Remember that outside Africa, Homo sapiens has traces of interbreeding with Neanderthals, Devisovans and others. Thomas Malthus, in 1798, predicted human decline. Various technical fixes proved him wrong.
Illustrations are the green revolution of crop breeding and genetic engineering. However, only the smartest individuals are likely to invent future technical fixes.
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An African proverb states that it takes a village to raise a child. But Gee emphasises that, “It takes … a civilization of hundreds of millions, even billions, to produce a Darwin or a Pasteur, a Gates or a Jobs, a Bezos or a Musk, a Newton or an Einstein”.
I will call such ultra-brilliant, exceptionally gifted, luminary geniuses “unicorns”. Only unicorns might produce technical fixes to save humankind from extinction.
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Such rare individuals, presumably, are connected with the random genetic shuffling that evolved two billion years ago: sexual reproduction. Gee’s killer message is that we will only have a big enough population to produce unicorns for about two centuries.
He suggests that humans will only survive by colonising space. For that, we need unicorns. Our moon and Mars are just the start.
Inclusion of women
A severe pandemic, potentially terminal to our severely limited genetic mix, is overdue. COVID-19 was just a rehearsal, a warning.
Think of the Medieval bubonic plague with a death rate in Europe of about 30%, the English sweating disease (1485-1551) that killed within hours and the 1918 Spanish Flu. Imagine, say, Ebola more easily airborne than measles.
What does this mean for pharmacy? It may contribute to a more earthbound technical fix. Admittedly, pharmacy helps (unfit) patients become as healthy as possible.
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But importantly, as part of a nurturing society, pharmacy benefits the public (whole population) health. Examples are health education and vaccination.
That may include to an ancestor of a crucial unicorn or the individual unicorn. That echoes apothecary shops displaying a rhinoceros or narwhal horn, inferring the mythical healing unicorn.
Today, infection identification using DNA tests and genetically targeted remedies are rapidly advancing. You can be proud if you practised during COVID-19. Consider refreshing your mind about what you learned.
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A social, rather than a technical, fix is the increasing emancipation of women, including educational. Only about 4% of science Nobel laureates in the sciences are female. All the unicorns on Gee’s list are men.
Humans cannot afford to lose half of their intellect. Emancipation may unleash, say, twice the unicorns. Pharmacy, with a predominantly female workforce, already plays its part.
Dr Malcolm E. Brown is a retired community, hospital and industrial pharmacist, and is a sociologist and honorary careers mentor at the University of East Anglia.