Despite the government’s push to popularise Ayush, some worrying questions are still swirling around the alternative schools of medicine in the country
NOT ALL’S well on the AYUSH front. Despite the government’s push to popularise Ayurveda, yoga and naturopathy, Unani, Siddha and homeopathy, or AYUSH in short—which was made a full-fledged ministry in November last year—people’s perceptions about the traditional forms of medicine are not that favourable, a trend underlined by the latest National Sample Survey Office (NSSO) data.
The genesis of AYUSH can be traced back to 1995 when the department of Indian systems of medicine and homeopathy was created under the ministry of health. It was later renamed department of Ayurveda, yoga and naturopathy, Unani, Siddha and homeopathy (AYUSH) in November 2003. It became a full-fledged ministry in November 2014 after the Narendra Modi-led government came to power.
As of March 2015, India had over nine lakh allopathic doctors and nearly eight lakh AYUSH practitioners—over 90% of whom are either homeopaths or Ayurveds. The ministry reportedly has a budget of R1,200 crore for this year.
In a reply to a question in Rajya Sabha in April this year, minister of state (independent charge) for AYUSH, Shripad Yesso Naik, said as per his ministry, the country has 7.37 lakh practitioners of alternative medicine streams registered with them and over 3,600 AYUSH hospitals—including 2,827 Ayurvedic, 252 Unani, 264 Siddha and
216 homeopathic—operating across the country. Among them, Ayurveda practitioners’ number is 3.99 lakh, while homeopathy practitioners amount to 2.8 lakh. There are 47,683 Unani, 8,173 Siddha and 1,764 naturopathy practitioners registered in the country.
The minister also said the number of AYUSH dispensaries in the country add up to 25,492, of which 15,520 are Ayurvedic, 7,439 homeopathic and 1,453 Unani.
A 2014 study conducted by the NSSO, an organisation under the Union ministry of statistics, found that people at large—around 90%—are still inclined towards allopathic treatment both in rural and urban India. Only 5-7% usage of ‘other’ type of treatment, including AYUSH, was reported.
Interestingly, a higher usage (1.5%) of AYUSH treatment by urban males than their rural counterparts was noted, while less usage (0.8%) by urban females as compared to rural females was observed.
The use of allopathy was also most prevalent in treating hospitalised cases of ailments both in rural and urban settings in the country irrespective of gender. Surprisingly, the use of AYUSH for hospitalised treatment in urban areas (0.8% for male and 1.2% for female) was more than rural areas (0.4% for male and 0.3% for female).
Also, recently, the National Health and Medical Research Council (NHMRC) of Australia concluded that homeopathy is not effective for treating any health condition. The top body for medical research in Australia found this after undertaking an extensive review of existing studies.
“People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness,” the study noted.
Calling the report incomplete, biased and misguiding, Dr Rajesh Shah, a homeopath, who chairs the scientific committee at Global Homeopathy Foundation (GHF), a non-governmental body working in the field of medicine, says there are a number of gaps in the study. “I had the opportunity of interviewing Dr Paul Glasziou, the chair of the NHMRC Homeopathy Working Committee in Australia, in March this year. I found from him that the committee did not have any homeopath member, which potentially makes the review biased. I also found that since the complementary medicine market in Australia has grown to $4 billion, certain lobbies were concerned about the growth of homeopathy and they were the ones who sponsored the study,” says Dr Shah, adding: “Another point found in my discussion with Dr Glasziou was that the review did not include many studies in fundamental research, which have proved the efficacy of homeopathy in laboratory experiments, as well as in animal models.”
Dr Shah runs Life Force Homeopathy, a chain of homeopathic clinics, and is also on the committee of the Central Council for Research in Homeopathy (CCRH), which comes under the ministry of AYUSH.
Agreeing with Dr Shah, Dr Mukesh Batra, founder and chairman of Dr Batra’s Healthcare, a leading name in homeopathic treatment in India, says: “There has been ample clinical evidence that homeopathy works. The Australian study is both flawed and biased. It ignores the fact that there have been more than 200 clinical studies, including double-blind random clinical trials (RCTs) and meta-analyses, that prove homeopathy works.”
Patients, however, had a mixed bag of stories to share. “A few years ago, I sustained head injuries as a result of an accident. The bad fall forced me to give up a long and successful career with an MNC. After years of conventional treatment—which did nothing for me—it was my good luck to have stumbled upon a homeopath in my locality,” says a Gurgaon resident who didn’t want to be named, adding, “I didn’t believe in homeopathy as I knew nothing about it, but made an appointment for a consultation and the results of the treatment were fantastic. I now have a satisfying and productive life. To put it succinctly, homeopathy has been the greatest blessing of my life.”
However, opinions differ. A New Delhi-based professional recounts her tryst with homeopathy: “Homeopathy is not scientifically tested or proven. Most of the practitioners have no actual training, thereby raising doubts about their credibility. Also, homeopaths ask weird questions during consultations, which make no sense at all.”
There is no credible evidence yet of the effectiveness of either homeopathic or Ayurvedic medicines and treatments.
Yet, both schools of medicine form an integral part of India’s public health system. Defending this, a senior official of the AYUSH ministry says: “How Ayurveda works is not very different from the modern systems of medicine. Most of these forms are derived from ingredients like roots or plants that are also extensively used in Ayurveda. However, applying the same parameters to different schools of medicine will not be right. The country has always had a pluralistic health system, and every form of medicine has its own philosophy, parameters and even testing criteria.”
Prashant Tandon, founder of health app 1mg.com, says, “There are many studies and researches that point to the efficacy of homeopathy and its working principles. In a study conducted by IIT-Mumbai, it was concluded that homeopathic dilutions contain nano-particles. With this finding, homeopathy may well be considered as a nano-medicine. Further, vaccines also work on the same principle that if we expose a human body to a small amount of the attenuated pathogens, the body has an in-built capacity to develop immunity against those pathogens in due course of time.”
1mg.com recently entered the alternative medicine space with the acquisition of Homeobuy.com, a Web platform for homeopathy medicines. With this acquisition, the website was rebranded from Homeobuy.com to 1mgAyush.com to make homeopathic and Ayurvedic medicines available to customers in the National Capital Region (NCR).
“There was a time, about five-seven years ago, when we did not have proof of the efficacy of homeopathic medicines.
Now, the situation has changed,” offers Dr Shah of GHF. Recently, GHF organised the World Homeopathy Summit in Mumbai, an international conference dedicated to scientific research in homeopathy, where scientists from many countries, as well as from reputed institutions like IIT-Mumbai, Tata Institute of Fundamental Research, Bhabha Atomic Research Centre, Haffkine Institute for Training, Research and Testing, Institute of Chemical Technology, and the Council of Scientific & Industrial Research, among others, presented their research in homeopathy.
“In brief, the research by IIT-Mumbai proved the presence of nano-particles in homeopathic medicines. The research by scientists from Brazil, and by Indian scientists demonstrated that homeopathy works in controlled animal studies, as well as in human trials. Other studies by molecular biologists from India, Brazil and Italy demonstrated working models of the mechanisms of the action of homeopathic medicines,” adds Dr Shah.
Basking in the success of organising the International Yoga Day on June 21, creating two world records in the process, the Narendra Modi-led government at the Centre has now decided to take yoga to villages. The government will soon appoint trained yoga instructors at primary and community health centres in villages and at district hospitals. In a recent move, the government also made yoga compulsory in CBSE curricula for classes XI and XII, while for students of other classes, it would be held ‘at least’ twice a week as part of their physical activity programme, it said.
Recently, AYUSH minister Naik announced that a first AYUSH University will be set up in Delhi, while five All India Institute of Medical Sciences (AIIMS) of AYUSH would be established in Odisha, Delhi, Karnataka, Jharkhand and West Bengal. The university will later give accreditation to AYUSH colleges after analysing their infrastructure and teachers.
Naik also announced that a task force of experts of different systems of treatment like Ayurveda, yoga and naturopathy, Unani, Siddha and homeopathy has been formed to study the infrastructure and manpower available in these streams across the country.
Naik said the task force will submit its report in the next three months and then a roadmap for the promotion of AYUSH will be prepared and implemented. He also said yoga experts from different non-government organisations with certification from the Quality Council of India (QCI) will be appointed to work as instructors at hospitals.
This is a step in the right direction, feels Dr Batra of Dr Batra’s Healthcare. “That the government has given Rs 1,200 crore for homeopathy and formed a separate ministry for AYUSH is a welcome move. Standardising homeopathic medical education should be the next step that the government should undertake along with reimbursement of homeopathic treatment expenses through insurance companies. In Dubai, seven insurance companies reimburse homeopathic treatment,” he says.
Ayush: The systems
Ayurveda (‘life knowledge’) is a system of traditional Hindu medicine native to the Indian subcontinent. Ayurvedic practices include the use of herbal medicines, mineral or metal supplementation (rasa shastra), surgical techniques, opium, and application of oil by massages. Ayurveda names three elemental substances—Vata, Pitta and Kapha (called doshas)—and states that a balance of the doshas results in health, while imbalance results in disease. Although laboratory experiments suggest it is possible that some substances in Ayurveda might be developed into effective treatments, there is no evidence that any are as effective as currently proffered.
Yoga is a physical, mental and spiritual practice or discipline, which originated in India. There is a broad variety of schools, practices and goals in Hinduism, Buddhism (including Vajrayana and Tibetan Buddhism) and Jainism. The best-known are hatha yoga and raja yoga. Many studies have tried to determine the effectiveness of yoga, as a complementary intervention for cancer, schizophrenia, asthma and heart disease. The results of these studies have been mixed and inconclusive.
Unani-tibb, or Unani, is a form of traditional medicine practised in West and south Asian countries. It is based on the concept of the four humours: phlegm (balgham), blood (dam), yellow bile (safra) and black bile (sauda). As per Unani medicine, management of any disease depends upon its diagnosis. In the diagnosis, clinical features—namely, signs, symptoms—laboratory features and mizaj (temperament) are important. Unani medicine has similarities with Ayurveda. Both are based on the theory of the presence of the elements (in Unani, they are considered to be fire, water, earth and air) in the human body.
An ancient form of traditional medicine, Siddha originated in Tamil Nadu through the work of siddhars, or scientist-saints. Siddha shares many principles with Ayurveda, including the belief in humours, elements and imbalance. Most of the practising Siddha medical practitioners are traditionally trained, usually in families and by gurus (teachers). They make a diagnosis after a patient’s visit and refer to their manuscripts for the appropriate remedies, which a true-blue physician compounds by himself or herself from thousands of herbal and herbo-mineral resources. The methodology of Siddha thought has helped decipher many causes of disorders and the formulation of curious remedies, which may sometimes have more than 250 ingredients.
Homeopathy is a form of alternative medicine created in 1796 by German physician Samuel Hahnemann based on his doctrine of ‘similia similibus curentur’ or ‘likes are cured by likes’, whereby a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people. Homeopathy is a pseudoscience, a system that asserts itself to be a set of scientific doctrines, but that is not effective for any condition. Large-scale studies have found homeopathic preparations to be no more effective than a placebo, suggesting that positive feelings after taking homeopathic medicines are due to the placebo effect.