In the last few years, there has been a push towards traditional medicine. And interest in indigenous medicinal systems has witnessed a boom in the ongoing Covid-19 pandemic. A big reason for this shift in public opinion can be credited to the massive promotion done by the Ministry of AYUSH. AYUSH was once a mere department under the Union health ministry and got promoted to a full ministry in 2014. Although there has been some anecdotal evidence that suggests that ancient forms of medicine such as Ayurveda, Unani, and Siddha are effective in treatment of a variety of diseases, there is dearth of reliable research to support such claims. There have also been countless incidents that prove that harms caused by the traditional treatment are sometimes more than their supposed benefits. As we move towards achieving healthcare for all, it becomes extremely important that only evidence-based medicine is promoted and allowed.
Irrational perceptions lead to harmful consequences
Giloy was recently popularized by the Ministry of AYUSH for its ability to act as an immune booster against the coronavirus. The herb, which has been used for centuries in the form of powder or tablet, had an exponential increase in consumption during the last two years. Despite evidence that it can cause liver damage, the government extensively advocated for it. They even put it in the Covid immunity booster kit. A scientific study released last year in the Journal of Clinical and Experimental Hepatology found that the reckless intake of giloy during the pandemic was leading to liver injury. Furthermore, there have been reports of jaundice and, in some cases, death as a result of excessive giloy consumption.
Leaving aside the claimed benefits, a lot of harm was caused to patients. Instead of acknowledging this and warning practitioners and patients, the ministry started cracking down on people warning against frequent and unsupervised use of the herb. Dr Abby Philips, a hepatologist based out of Kochi was threatened with legal action when he pointed out the hepatotoxic potential of giloy. Compare this with the response of modern medicine vis a vis the drug remedesivir. Initially, remedesivir was advised but as new evidence emerged, the recommendations of modern medicine were changed to reflect this. That is the scientific and correct method.
Coronil Kit, an Ayurvedic medicine for fighting coronavirus launched by Baba Ramdev’s Patanjali, had received both praise and criticism. The kit was endorsed by the Narendra Modi government and it also made claims of being approved by WHO. These claims later turned out to be false. There were far too many issues with the trials. Clinical trials for Coronil included just 100 asymptomatic people, with only 18 of them being women. Furthermore, Coronil has not been found to be effective. Government’s continued support for unproven and untested treatments make all of us worse off.
Support by Ministry of AYUSH
Since its inception in 2014, the AYUSH Ministry has consistently endorsed Ayurvedic, Homeopathic and Unani treatments even when they are not based on scientific or clinical evidence. The research cited by the ministry for various drugs has been criticised and proven to be lacking in various aspects. In most case, there have been no rigorous pharmacological investigations and/or substantial clinical trials for the drugs endorsed by the ministry. Furthermore, the studies used by the ministry to support drug efficacy and safety were either published in dubious journals or co-authored by a stakeholder involved. Despite these facts, the ministry has continued to back such products and therapies. If this wasn’t enough, the ministry has actively pursued action against people standing up to these dubious treatments.
Current regulations don’t require drugs which are mentioned in Ayurvedic tests to undergo clinical trials. Regulations on newly discovered drugs are also quite lax and there is no extensive testing. We rely on knowledge that is thousands of years old and has not been updated.
It is important to understand that a lot of drugs we use today are derived from substances we use in traditional medicine. For instance, aspirin, the popular drug now being used in prevention of heart attacks and as a painkiller, has been derived from the bark of the willow tree. The bark has been in use for centuries for medicinal purposes. The bark when ingested is very irritating for the stomach, so it was improved and aspirin was synthesised from it.
The strength and validity of any kind of medicinal system lies in its evidence and scientific backing. Researching drugs, therapies and treatments help in setting up parameters which in turn help in standardisation. For a medicinal sector to gain prominence, it is important that the claims made are supported by some extensive research. Validation from trials and studies gives credibility to practice. Modern medicine has been able to gain significant popularity because of its research backing.
Research in AYUSH
Research in traditional medicine can generally go into two directions. The first one is what India is doing. In 2014, Council of Scientific and Industrial Research (CSIR) announced a new Ayurvedic anti-diabetic drug called ‘BGR-34’. It was advertised as a miracle drug with no adverse effects. CSIR published no good data to substantiate their claims. Compare this to the way China has undertaken research, which gave us the drug artemisinin, which has been derived from Chinese traditional medicine . The drug Artemisinin has become part of the standard treatment of Malaria. Dr Youyou Tu won the Nobel Prize in 2015 for the same.
While we are not doing research in traditional medicine, other countries have tried to grab our resources. Common Indian herbs and drugs like turmeric and neem were patented in the US and EU respectively. India had to challenge the patent to get it canceled.
Unless the Ministry of AYUSH reforms its policies, prioritises research and makes traditional medicine evidence based, we will not be able to utilise our traditional knowledge. In the race to compete with modern medicine, questions of efficacy and safety shouldn’t be forgotten.
Dr. Harshit Kukreja @harshitk43 is a physician and Research Analyst, and Mahek Nankani @maheknankani is an Assistant Programme Manager, at The Takshashila Institution. Views are personal.
(Edited by Anurag Chaubey)