Traditional Medicine on Trial
While traditional medicine system is based on our ancient wisdom, practices, and experience, there is a lack of rigorous clinical trials. This issue needs addressing. — Dr. Jaya Kakkar
According to WHO 170 out of 194 member states of the organization use traditional medicines but do not necessarily have reliable evidence and data on traditional medicine products and practices. Without that policy building and integration of these medicines into their health systems is not possible. Hence WHO has opened global centre for traditional medicine in India.
According to WHO a traditional medicine is the total sum of the “knowledge, skills, and practices indigenous and different cultures have used over time to maintain health and prevent, diagnose and treat physical and mental illness. Its reach encompasses ancient practices such as acupressure, ayurvedic medicine and herbal mixtures as well as modern medicines.”
In India these include practices and theraples involving Ayurveda, Siddha, Yoga and others (homeopathy, unani, etc.) that have been part of Indian traditions since ancient times. While Ayurveda and Yoga has spread countrywide, different regions have their own traditional medicine systems.
As on date traditional medicines are not integrated into national health systems and strategies. Nor there are accredited courses and health facilities. It is notable that nearly 40% of approved pharma products are derived from natural substances, such as contraceptive pills. Thus there is a need to rely on biodiversity and sustainable practices. In order to bring traditional medicines into mainstream their efficacy needs to be scientifically tested and validated. For this modern practices such as MRI (Magnetic Resonance Imaging), artificial intelligence etc. need to be increasingly deployed (these are already being used, though not on a wide scale, due to lack of systematic research) to establish their therapeutic and preventive values. Technology should aid the establishment of credentials of such medicines as also in their adoption and usage far and wide.
During the pandemic leading companies launched hundreds of natural and herbal products. However, post easing of the problem ayurvedic products share has either stagnated or declined. However, according to Research and Information System (RIS) the Ayush market – comprising Ayurveda , Yoga, Unani, Siddha, and Homeopathy – is estimated to have expanded to $20.6 billion in 2021 from around $18 billion in 2020. People’s belief in Ayurveda has increased over the years and the pandemic has helped accelerate it. Initiative like global centre should boost this acceptance across the world since these healing methods can go a long way in mitigating diseases. Many people around the world rely on herbal products for some part of primary healthcare. GCTM can act as an accessible, eco-friendly and interactive facility showcasing global traditions and advancements in traditional medicine.
Much of traditional medicine is based on received knowledge and home remedies. Faith and trans-generational anecdotal – as against scientific – support have been its mainstay. Anyone with persuasive skills has scope for practicing these medicines in an unregulated market. Thus even though the medicine may not be at fault, the practitioner’s ill baked knowledge makes the patient and potential users skeptical about their efficacy. The WHO GCTM seeks to change this. It will work on four strategic areas: one, gathering evidence and learning, two, deployment of data and analytics for experimentation and fastertesting; three, keeping in mind the environmental footprints and sustainability; and four, adoption of innovation and technology. Once the traditional medicine becomes evidence based – based on scientific testing – it will be treated at par with modern (aka allopathic) medicine.
The goal of an appropriate health system should not be merely to cure. Rather, it should work towards maintaining well being and health, prevent disease, and diagnose and treat it in most effective manner. The efficacy of the system needs to be measured in terms of time and cost of treatment, minimization of side effects, etc. Moreover, the health system should have universal access and acceptability. The idea is not to replace ‘modern’ medicine by traditional one; rather, to optimize the whole health system by integrating traditional medicine, which anyway has a very strong base in India, so as to search for best available solutions. The patient – indeed the whole general population – should have alternative choices for their health needs. Remember while Ayurveda is India born, Unani is a central Asian import, while Homeopathy was developed by a German practitioner, and Siddha has its base largely in south India.
Above all, traditional Indian medicine must meet global standards. This is the primary requirement since there are skeptics galore who associate the traditional medicine system with only quackery and fraud. It is a known fact that even established, large traditional medicine manufacturers escape scrutiny when they make tall claims like cure cancer, heart disease, and many such terminal diseases. Yet it is undeniable that in our country where an average person’s access to standard allopathic treatment is limited by both reach and expense, promoting alternative medicine choice which has more widespread access and relatively at a lower cost is an idea that needs extensive support.
Bharatiya Janata Party has come into power with a broad socio-cultural agenda. This includes reestablishing our ancient glorious part, be it ancient scientific wisdom, vedic math, rich historical traditions, or Yoga. In the same line the BJP government, immediately after coming to power decided to set up Ministry of Ayush in September 2014. While the idea was indeed laudable one must not shut eyes towards problems in promoting efficacious traditional medicine.
Firstly, there are no uniform standards nor effective monitoring mechanism in the area of traditional medicine. Consequently, as we sald earlier, fraud and quackery are widespread. This includes the use of harmful steroids and metals in homeopathic and Ayurvedic medicines and products. Even the government has been overzealous in promoting traditional medicine without underlying scientific basis for government protocol sanctioning Ayurvedic and yoga practices, the latest case being endorsement of their use for prevention and cure for asymptomatic and mild covid patients. While it may be true that these medicines may have been effective, the Indian medical association objected to non-availability of any scientific proof. Secondly, the sector is completely unregulated with presence of micro enterprises; everyone relies on traditional texts which have not been put under any kind of scrutiny.
Having said that the latest endeavour of setting up the GCTM, alongwith need to reduce the quack practices, should help in providing the seeker a reliable, low cost, free of side effects alternative on one hand and in freeing the poor patient from the clutches of profiteering multinational drug mafia on the other.
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