There’s a tsunami alert: companies are racing to market a deluge of new medicines, aided by artificial intelligence (AI). Drugs listed in the British National Formulary (BNF) used by one generation of pharmacists are often obsolete by the next; new drugs bloat the BNF’s length. 

AI has the edge over humans in finding and developing new products, notably by trawling gargantuan electronic databases of clinical trials and libraries of chemicals, comparing patterns to test hypotheses in the virtual world and thinking in a "wider" way than humans have in the past.

My favourite illustration of this ability is AI AlphaFold for its ability to discover new drugs.

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Alphabet's (once Google’s) AI system, DeepMind, predicted the structure of 200 million proteins in 2021: immensely valuable for drug discovery. Previously, identifying just one structure had demanded three years of research by one PhD student. It's not that humans cannot undertake that but it’s that they do not live long enough.

AI may become so clever that not even 1% of humans can understand its process. Presently, AI experts do not fully understand what is occurring inside AI black boxes. Will we accept AI’s predicted gigantic gifts of improved health and wealth even if no human understands how it is done?

Moreover, drugs that have been developed with the help of AI are predicted to help humans live longer by providing, for example, novel interventions against cancer tailored to individual genetics. Progress would be even quicker if scientific papers published more negative as well as positive results.

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However, I have reservations. I may be seen as a luddite by demanding that somebody waving a red flag ride a horse before an (AI) steam locomotive. In my defense, in 1964 I was aware that the superb science fiction writer Arthur C Clarke predicted intelligent machines. Witnessing science fiction becoming fact thrills me.

But we need to keep our eyes wide open. The AI industry has requested more regulation; the European Medicines Agency (EMA), Food and Drug Administration (FDA), Medicines and Healthcare products Regulatory Agency (MRHA) and World Health Organization (WHO) have provided guidance.

However, AI is so gigantically funded, explosively developing and disrupting that guidance keeping up with practice is challenging. Meanwhile, the industry claims to have set up its own (voluntary) guardrails.

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Even humans’ cleverest AI luminaries cannot predict with certainty what properties will emerge from an AI trained on bigger data. Indeed, an emergent property is something (positive or negative) that emerges from a whole system. For example, a particular mix of individual players in a team may enhance or reduce performance.

AI guru enthusiasts in Silicon Valley predict extra abilities of GPT-5 when launched, perhaps in 2025, but are uncertain. It bears mention that, to them, AGI (Artificial General Intelligence mimicking the full range of human intelligence) is not a question of if but when. The West knows little about what may shortly emerge from elsewhere.

How can community pharmacists help? The vast majority of healthcare occurs in the community rather than, for example, hospitals. Community pharmacists have a whistleblowing role as one of the conduits for the completion of MHRA yellow cards. They are part of the phase four (post-marketing) monitoring of clinical trials; a crucial part of pharmacovigilance. Presumably an inverted black triangle symbol (▼) will identify them.

You are the human, with morality and a code of pharmaceutical ethics, in the machine. Your antennae are aquiver. Do you feel uneasy about side effects and so on? Does something feel not quite right, amiss in some fashion, with health systems especially medicines, invented with AI?

Then report it. You, together with other health professionals, would have done your bit. You would not do it for the money - there isn't any - but an appreciative government may even pay you more.

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.