An antibiotic discovered on Easter Island in 1964 has led to a multi-billion-dollar success story in the pharmaceutical industry. However, the narrative surrounding this so-called “miracle drug” often overlooks the significant cultural and political context underpinning its discovery. Named after the island’s Indigenous name, Rapa Nui, the drug rapamycin was first developed as an immunosuppressant to prevent organ transplant rejection and enhance the performance of coronary artery stents. Its applications have since broadened to various cancer treatments, and ongoing research is investigating its potential for managing diabetes, neurodegenerative conditions, and even slowing aging. The volume of studies suggesting rapamycin’s potential to prolong lifespan and fight age-related ailments seems to grow daily, with over 59,000 journal articles mentioning it on PubMed, making it one of the most widely discussed drugs in contemporary medicine.
At the core of rapamycin’s effectiveness is its capability to inhibit a protein known as the target of rapamycin kinase, or TOR. Acting as a crucial regulator, TOR influences cell growth and metabolism in response to nutrients, stress, and environmental cues, affecting processes such as protein synthesis and immune response. This pivotal role links TOR mutations to an array of health issues, including cancer and metabolic disorders. Despite its significance, the public remains largely unaware of the complexities surrounding rapamycin’s discovery.
Many professionals recognize that the pharmaceutical firm Ayerst Research Laboratories isolated the molecule from a soil sample containing the bacterium Streptomyces hydroscopicus in the mid-1970s. However, the story often neglects that this sample originated from a Canadian-led initiative known as the Medical Expedition to Easter Island (METEI) in 1964. As a scientist focused on rapamycin’s cellular impacts, I felt a strong urge to uncover and share the human story behind its origins. Research by historian Jacalyn Duffin on METEI fundamentally altered how my colleagues and I view our field. Exploring rapamycin’s intricate legacy raises crucial questions about systemic biases in biomedical research and the responsibilities of pharmaceutical companies to the Indigenous lands from which groundbreaking discoveries emerge.
Overview of METEI
The Medical Expedition to Easter Island was conceived by a Canadian team, including surgeon Stanley Skoryna and bacteriologist Georges Nogrady. Their mission aimed to understand how an isolated community adapts to environmental stressors, believing that the planned construction of an international airport would lead to significant changes in the health and well-being of the island’s residents. Supported by funding from the World Health Organization and logistical aid from the Royal Canadian Navy, METEI arrived in Rapa Nui in December 1964.
During their three-month stay, the team conducted medical assessments on almost all 1,000 island inhabitants, collecting biological samples while systematically surveying local flora and fauna. It was within this framework that Nogrady gathered over 200 soil samples, including the one that would yield the Streptomyces strain capable of producing rapamycin.
Ethical Considerations of METEI
The expedition’s stated objective—to study the Rapa Nui people as a living laboratory—raises ethical concerns. Researchers encouraged participation through various means, including offering gifts and food, as well as leveraging the influence of a long-standing Franciscan priest on the island to aid recruitment. While their intentions might have been well-meaning, this scenario epitomizes scientific colonialism, as predominantly white researchers chose to study a mainly nonwhite population without their genuine involvement, resulting in a notable power imbalance.
From its inception, METEI exhibited intrinsic biases. The researchers presumed that the Rapa Nui had remained isolated; however, there is a documented history of interactions with the outside world spanning from the early 1700s to the late 1800s. Furthermore, METEI inaccurately believed the Rapa Nui displayed genetic homogeneity, disregarding a rich history of migration, slavery, and disease that influenced the island’s demographics. The current population consists of mixed-race individuals with both Polynesian and South American ancestry, as well as descendants of African slaves who were returned to the island, bringing diseases such as smallpox. This oversight potentially hindered METEI’s critical goal of understanding genetic influences on disease susceptibility.
Acknowledging Contributions
The gaps in the narrative surrounding rapamycin’s origins highlight significant ethical issues regarding the acknowledgment of scientific advancements. After returning from Rapa Nui, Georges Nogrady delivered soil samples to Ayerst Research Laboratories, where Surendra Sehgal and his team identified rapamycin and subsequently brought it to market in the late 1990s as the immunosuppressant Rapamune. Although Sehgal’s dedication played an integral role in its development, including safeguarding a culture in his home amid corporate challenges, neither Nogrady nor METEI received acknowledgment in his crucial publications.
Despite rapamycin generating substantial revenue—billions in profits—the Rapa Nui people have not benefited financially from this success. This raises significant questions regarding Indigenous rights and biopiracy, the commercialization of Indigenous knowledge. International agreements, such as the United Nations’ 1992 Convention on Biological Diversity, seek to safeguard Indigenous claims to biological resources by encouraging the ethical involvement of Indigenous communities in discussions and projects deriving from their lands. Unfortunately, these essential principles were absent during METEI’s operation, leaving the Rapa Nui largely unrecognized for their role in rapamycin’s discovery.
Some argue that because Streptomyces bacteria, the source of rapamycin, can be found in various regions, Easter Island’s soil was not uniquely critical to the drug’s development. Additionally, critics maintain that since the island’s population did not use rapamycin or even know of its existence, it cannot be considered a resource that was “stolen.” Nevertheless, it is crucial to note that the initial discovery on Rapa Nui laid the groundwork for all subsequent studies and commercialization efforts related to this molecule, a process made possible because the local population was involved in the research.
Recognizing and educating the public about the pivotal role of the Rapa Nui in rapamycin’s discovery is essential for ensuring they receive just compensation for their contributions. Recently, the pharmaceutical sector has begun acknowledging the need for fair compensation for Indigenous communities whose natural products have led to valuable developments. However, the companies profiting directly from rapamycin have yet to extend such acknowledgments to the Rapa Nui.
Ultimately, METEI serves as a complex case of scientific achievement intertwined with social dilemmas. While rapamycin’s discovery has revolutionized medical science, the expedition’s legacy for the Rapa Nui people remains layered with complexity. Addressing issues related to biomedical consent, scientific colonialism, and the underappreciation of contributions underscores the importance of a more nuanced understanding of the legacies surrounding groundbreaking scientific discoveries.
