Since the beginning of this year, the current government has consistently been pushing the promotion and use of Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy medicines. They are commonly known as AYUSH or Indian medicines. The celebration of International Yoga Day with much fanfare is a case in point. But the recent set of ‘Good Clinical Practice (GCP) Guidelines for clinical trials in Ayurveda, Siddha and Unani (ASU) medicines’ released by the Ministry of Ayush for public comments until 15 September could be crucial for Indian medicines to be scientifically accepted as alternatives to Western medicine. The Guidelines have been prepared incorporating inputs from Indian Council for Medical Research (ICMR), Central Drug Standard Control Organisation (CDSCO), Central Councils for research in ASU systems and even representatives of ASU drug manufacturing industries.
The AYUSH system of medicines is believed to be at least 5,000 years old. Compared to this, the Western medicine system is only about 500 years old. Aarathi Prasad in her recent book In the Bonesetter’s Waiting Room: Travels through Indian medicine (published by Profile Books, UK) roughly translates Ayurveda from Sanskrit as ‘the science of longevity’. It is based on a theory of medicine originating in Brahmanic tradition and set down in texts in the early centuries of the Christian era. She further mentions balance through moderation in all things, is the way of Ayurveda. So followers of the system are advised to take food, medicine, sleep, sex and exercise in moderation, so that the central process of the body are carried out smoothly.
Unani which travelled along with the intrepid travellers and different conquerors from the Middle East, and Siddha, a system of medicine found in Tamil Nadu, are similar to Ayurveda in theory of causes of diseases but different in origin; in the types of medicines used and in the ways they are processed. So if Unani has around 5,000 medical manuscripts there are around a 100,000 in Ayurveda on different aspects of medicine and surgery. But Western medicine permeates our treatments in quest for quick and short resolution to our ailments. There is little doubt that for acute diseases like cancer and surgery there is no alternative to allopathic medicines.
So why are these GCP Guidelines important and what do they mean for the system of Indian medicine?
Practitioners of AYUSH system of medicine don’t do research in the same way as the Western system. It doesn’t concentrate on the efficacy of a drug for a disease or a symptom. AYUSH remedies are a system of diagnosis and treatment. They even work on the prevention of ailments while helping maintain a healthy lifestyle. But in the past decade, this has changed. There is more research and testing on AYUSH drugs for psychosomatic diseases, lifestyle diseases like diabetes, blood pressure, even malaria, tuberculosis, dengue and gynecological diseases like Polycystic Ovary Syndrome. Professor K Shankar Rao, director, National Institute of Ayurveda says, “Clinical trials will help make AYUSH an evidence-based system of medicine, bringing it closer to Western medicine. Trials will help finding out the efficacy of a drug. The quality of medicines will be the same across the country. The dosage of drugs will also be standardised.” Rao thinks this is a beautiful system of therapy and further adds, “the aim should be to make Ayurveda an easily available cure for ailments, one without side effects.”
According to World Health Organisation reports, 70 percent of the Indian population is dependent on alternative and folk medicine. There are several reasons for such a scenario: Poor health system, remote facilities and availability in rural villages of Western medicine and unaffordability for most of the population. Professor Govindarajan Padmanabhan, former director of Indian Institute of Science, Bangalore and currently working on use of turmeric extracts in cure for malaria agrees “when a large portion of the population depends on a system, it should be properly validated”. He points out to the fact that Indian medicine has huge anecdotal data but there is little scientific proof for Indian medicine to be accepted by international market. According to him when the Chinese and the Koreans are able to sell their medicine to the rest of the world, India should be too.
In her book, Prasad mentions meeting Darshan Shankar who heads the Foundation for the Revitalisation of Healthy Traditions in Bengaluru. On being asked what needs to be done to make AYUSH more acceptable, Shankar says “Ayurveda needs to use modern tools to progress. Traditional theory must also grow in parallel otherwise it will lose its autonomy. If Ayurveda needs to come out of its imagination, one has to talk to the dominant medical system.”
Only a few days ago this week, the Ministry of Ayush signed a Memorandum of Understanding (MoU) with the United States Pharmacopeial Convention which will help improve the quality of traditional medicines. “The aim of this historic agreement is to promote the safety, quality and integrity of traditional medicines and botanical dietary dietary supplements,” says the official statement. The ministry and several agencies either have similar agreements in place with the European Union and several other countries or are promoting AYUSH medicines in regulation to laws of those countries.
Clinically tested scientific evidence will give an immense boost to AYUSH medicines being globally accepted. The current export of traditional herbs stands at US$ 250 million.
In the country itself, the Ministry of Ayush as per the National Ayush Mission is committed to set up AYUSH educational institutes in states and Union Territories where such centres are not present. On similar lines, the ministry has also committed to upgrade the medical infrastructure of AYUSH facilities from its present capacity of around 62,000 hospital beds in primary health centres, community and district hospital. The Minister of State for AYUSH, Shripad Yesso Naik has also pledged to set up a national level hospital on the lines of the All India Institute of Medical Sciences offering exclusively AYUSH treatments in the next few months after which it plans to open such centres in every state.
The writing is on the wall when it comes to Indian medicines. Sceptics may dismiss the system on lack of scientific grounds or the more affluent may choose to opt for modern medicines as the prefered choice of medication. But in a country like India with its long and rich history of traditional medicine, it probably makes sense to draw on its knowledge. If not all square, it surely makes sense to scientifically document the effects of traditional medicine in a modern world. This definitely will give a billion people multiple choices to choose for their ailments which are cheaper, effective and of good quality.