The cultivation of medicinal plants may affect the ecological balance and, in particular, the genetic diversity of the flora and fauna in surrounding habitats. The quality and growth of medicinal plants can also be affected by other plants, other living organisms and by human activities. The introduction of non-indigenous medicinal plant species into cultivation may have a detrimental impact on the biological and ecological balance of the region. The ecological impact of cultivation activities should be monitored over time, where practical.

The social impact of cultivation on local communities should be examined to ensure that negative impacts on local livelihood are avoided. In terms of local income- earning opportunities, small-scale cultivation is often preferable to large-scale production, in particular if small-scale farmers are organized to market their products jointly. If large-scale medicinal plant cultivation is or has been established, care should be taken that local communities benefit directly from, for example, fair wages, equal employment opportunities and capital reinvestment.