Abstract: Traditionally, pharmacology and infectious disease research have approached therapy through a reductionist framework that emphasizes single molecular targets and pathogen-centered outcomes. While often effective, this approach frequently overlooks the ecological reality that drugs operate within host-associated systems shaped by evolution, where hosts, parasites, and resident microbiota interact across dynamic chemical and biological gradients. Here, I propose medicinal ecology as a conceptual framework that views therapeutics as ecological interventions—chemical perturbations that alter host–parasite–microbiome interactions within constrained biological niches. Using parasitic helminths as a central example, I argue that therapeutic success and failure are best understood through ecological principles such as physiological constraint, community mediation, and selection under sustained chemical pressure. Candidate interventions can be inferred from chemical control strategies that have evolved in analogous host–parasite systems. This perspective helps explain recurrent patterns in phenotypic screening and drug resistance that are not readily captured by target-centric models alone. By emphasizing conserved vulnerability axes rather than isolated molecular targets, medicinal ecology offers testable predictions for drug discovery, screening design, and resistance mitigation, and provides a natural conceptual bridge to One Health approaches that integrate human, animal, and environmental health.
Mostafa A. Elfawal (Thu,) studied this question.