The COVID-19 pandemic has ignited a tug-of-war between India’s two co-existing systems of medicine—allopathy and Ayurveda. Drawing parallels with American President Donald Trump and Brazilian President Jair Bolsonaro’s support for hydroxychloroquine, Indian politicians have been seen extolling the unproven benefits of traditional remedies for the novel coronavirus. In fact, the government even released an official document prescribing turmeric milk and yoga to build up immunity against the virus. Although this advice was accompanied by repeated calls for social distancing and wearing masks in public, the official support granted by the Indian Health Ministry to Ayurveda, especially during a global pandemic, represents a worrying and drastic change in India’s health care policy towards the formal integration of traditional medicine.
The Narendra Modi-led government has not shied away from attempting to empower the AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy) regime. The vision and aims are clear: India wants to expand its scope as a destination for medical tourism to include both allopathic and Ayurvedic medical systems. In fact, in pursuance of this larger goal, in collaboration with the World Health Organisation (WHO), India announced the establishment of a “Global Centre for Traditional Medicine” in India on November 13, which coincides with the “National Ayurveda Day 2020.”
India already accounts for 18% of the world’s $19.7 billion medical tourism market due to its low costs and accessible medical facilities. The current pandemic has provided a unique opportunity for the government to further capitalise on this economic opportunity. During the ongoing pandemic, the healthcare industry has grown increasingly overwhelmed due to a lack of infrastructure, resources, and staff. This has incentivised the government to ease the pressure on medical practitioners by adding what it perceives to be a second line of defence through Ayurveda. Aside from the questionable medical benefits and efficacy of this form of alternative medicine, rather than strengthening the AYUSH regime as an independent arm of India’s healthcare industry, the Indian government has created an amalgamated system of medicine.
The desire to create what is being referred to by the Indian Medical Association (IMA) as a “mixopathy” medical system, is clear from the recent policies introduced by the Indian government. The aspiration to integrate the traditional and modern medical systems forms a crucial pillar of PM Modi’s 2030 “One Nation, One Health System” plan. In order to achieve this goal, NITI Ayog has formed four committees to establish a policy on “integrative medical education, practice, public health, and research.” Furthermore, the call for “medical pluralism” also features in the National Education Policy (NEP) 2020, the National Health Policy 2017, and the National Commission for Indian System of Medicine Act 2020.
The move towards “medical pluralism” was materialised recently through a notification by the Central Council of Indian Medicine (CCIM), which was published on November 19. This CCIM Amendment called for Post Graduate Ayurveda students to be trained in 66 surgical procedures, including several orthopaedic, ophthalmological, and dental procedures, all of which traditionally fall under the ambit of allopathic sciences.
Such measures have ignited unease amongst practitioners of modern medicine and have drawn into question the impact of this on the legitimacy and credibility of India’s medical industry. The IMA believes that the Amendment incorrectly portrays the techniques and skills of Ayurveda practitioners as being in line with allopathic doctors. They believe this to be “an encroachment” into the sanctimonious practice of modern medicine that has been developed over centuries of scientific research and deliberation.
By allowing Ayurveda students to be trained in, and eventually conduct, invasive surgeries, there is an unavoidable overlap of the two separate systems of medicine. For example, anaesthesia, which forms an integral part of any surgical procedure, does not have an Ayurvedic substitute. Hence, the practitioners will inevitably have to rely on allopathic remedies, which they are neither trained nor licensed to prescribe or administer. Another example of this is the mention of “cataract removal” in the notification. While Sushruta makes a mention of the procedure, there is no prescribed process for lens implantation. Hence, as admitted by Vaid Jayant Deopujari, the Chairman of the CCIM’s regulatory body for Ayurveda, during an interview with the Times of India, allopathic technology and techniques will be used for lens implantation procedures conducted by Ayurvedic practitioners too. This portends to create a situation in which skilled or unskilled Ayurvedic practitioners conduct complex medical procedures that require rigorous allopathic medical education. However, Ayurvedic educational institutions lack the infrastructure to train its students in allopathic skills and techniques.
Alongside the inadequacy of the infrastructure for formal training in the field, Ayurveda itself rests on scientifically shaky ground, as it is not presented with the same rigorous challenges as allopathic medications and procedures. Allopathic medicines are put through two tests before being made accessible to the public. The first is whether the claim or the effect of the medication can be reproduced. The second is through double-blind studies to whittle down any bias in the investigation. However, these tests are practically impossible to achieve in Ayurveda, as some dosages are tailor-made for individual patients. Moreover, the practice of Ayurveda also allows the prescription of remedies with unknown compositions. Hence, verifying the content and determining its efficacy before administering the medicines is often impossible to achieve.
The situation is even more concerning in rural areas, where the line between traditional and modern medicine is already blurred. Several studies have shown that Ayurvedic doctors in these areas often use allopathic steroids and antibiotics to treat respiratory and gastric issues, despite not being licensed or trained to do so. Moreover, Ayurvedic practitioners already claim to conduct the many procedures enlisted in the notification, which include complex surgeries that are carried out through allopathic technology and techniques. This has, on several occasions, had severe repercussions, including the death of patients. Hence, the CCIM’s Amendment, along with the Indian government’s ambition to mix the two practices, legitimise unregulated and dangerous practices.
If India is indeed committed to legitimising Ayurveda, then its focus must be on scientifically supporting the many unproven claims of the practice through greater and stricter regulations. At the same time, Ayurvedic institutions must be empowered with adequate infrastructure to implement a rigorous curriculum that matches the standards of modern medicine. Moreover, rather than ‘mixing’ the two forms of medicine, India must seek to create a situation in which the two practices complement each other to create a holistic, well-rounded approach, instead of creating competing interests between the two fields. By doing this, India can leverage its unique position as a world leader in both allopathy and Ayurveda and maintain its international legitimacy and credibility by developing a novel and well-integrated medical system.
Ayurveda vs Modern Medicine: The Dangers of “Mixopathy”
The recent notification allowing Ayurveda students to be trained in 66 surgeries is a major step towards integrating the traditional medical system with modern medicine.
December 17, 2020
Indian medical professions protesting the CCIM notification, which allows Ayurveda students to train in surgical procedures. SOURCE: PTI