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Ayush Ministry: Is it worth your taxes?

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Satvik analyses different prisms as to why Ayush Ministry is or is not necessary. 

The incumbent government initiated a plan to revive India’s culture, as was before the British subdued it and introduced us to the West. Ayurveda, Unani, and Yoga form a major part of what Indian medicine was all about, and in hopes to strengthen these systems the Ministry of AYUSH was formed, succeeding the Department of Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). Yet how successful has it been in recreating an indigenous healthcare system and what scope does it have?

Homeopathy, Ayurveda and Yoga are estimated to be about worth 31459.6 million USD (2023, globally), 14620 million USD (2026, globally) and 11.6 billion USD (2020, USA) respectively, and India aims to be at the forefront of occupying the largest market share in these alternative healthcare systems. How possible is this for us and, more importantly, how does it affect you?

I start with a brief look at the AYUSH system and readers more interested in the analysis of the ministry’s performance have the freedom to skip this next section.

The AYUSH system

  • Ayurveda (literally: the knowledge to extend one’s life) in some forms is said to have begun around 8000 years ago in the Indian subcontinent, especially around the north-western region. It advocates that an imbalance in these elements caused by suppression of natural urges or having an improper diet leads to diseases. Interestingly, rhinoplasty and plastic surgeries were performed in India using methods that fascinated even the doctors from industrialised and technologically advanced nations. A strict decline in the practice was observed during the British colonial rule.
  • Yoga, in modern times, has generally come to refer to the asanas and the exercises but its definition goes beyond this narrow description. It involves a wide variety of schools of thought, lifestyles, goals, etc. It began in around 3000BCE and has been mentioned in the Rig Veda as well. In recent times, it was popularised by Swami Vivekanand who lectured across the world on the benefits of yoga, which started a massive global wave.
  • Naturopathy is an alternative school of medicine that uses “natural therapies” to heal wounds and treat disorders. It began in Europe in the 19th century and gained a footing in the USA in the early 20th It utilises pseudoscientific techniques that are sometimes shown to be more harmful than beneficial.
  • Unani (literally: Greek; as this system was based on the teachings of Hippocrates and Galen) is said to have been heavily practiced among South Asian Muslims during the Mughal period. It began after the Arabic medical practices were brought to the subcontinent by Islamic invasions and the influence of Ayurveda led to the development of Unani as a distinct form of medicine.
  • Siddha medicine is a traditional medicine originating in Tamil Nadu, India, and has been practiced over centuries. Siddha practitioners believe that five basic elements – earth, water, fire, air, sky – constitute food and “humours” of the human body, and herbal, animal, or inorganic chemical compounds, such as sulphur and mercury, can be used for treating diseases. Instances of Siddha in practice have been observed in 3000BCE as well.
  • Lastly, Homeopathy was created in 1796 by Samuel Hahnemann. Its practitioners, called homeopaths, go by the principle similia similibus curentur, or “like cures like”. Medicines used in homeopathy involve repeated dilutions which make the medicine almost entirely similar to the solvent. It faces similar criticisms as naturopathy for being pseudoscientific and lacking evidence in its therapies and cures. Most European governments have begun to withdraw funding or entirely ban this practice.

In my understanding, medicinal practices originating in the Indian subcontinent, which utilise herbs and medicinal plants, have shown greater efficacy than the newly born alternative health care systems, of the likes of naturopathy and homeopathy. A great deal of the alt Western medicine seems to operate on the principle of “amusing the patient while nature cures the disease”.

The formation of the Ministry

Plans to rejuvenate the indigenous healthcare system were existent right from the first 5-year plan. Numerous committees set up by the Government of India for the development of the healthcare sector (Bhore (1946), Mudaliar (1961), and Srivastava (1975)) emphasized upon the need for improvement of traditional systems of medicine in India.

The Central Council of Indian Medicine (CCIM), a statutory body established in 1971 under the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), monitors higher education in areas of Indian medicine including Ayurveda, Unani, and other traditional medical systems.

Later, the Department of Indian System of Medicine and Homoeopathy (ISM&H) was launched in March 1995, under the Ministry of Health and Family Welfare.

The ninth five-year plan (1998-2002) ensured for its integration with western medicine and was also the first to tackle different aspects of the AYUSH system in a standalone manner, focusing on an overall development ranging from investing in human resource development and preservation and cultivation of medicinal plants and outlining good manufacturing processes. The department was renamed to AYUSH in November 2003.

The National Rural Health Mission was subsequently launched in 2005 to integrate AYUSH practitioners in national health programmes esp. in primary health care (AYUSH medical officers at community health centres, para-professionals, etc.) and provide support for research in the field.

There has been a notable increase in focus on AYUSH healthcare after the 2014 Indian general elections, which brought the BJP to power.

On 9 November 2014, the department of AYUSH became a ministry in its own right.

Through the economic lens

In 2017–18, the allotted budget was Rs. 1428.7 crore and had more than doubled than that in 2013–14.

In 2018, the ministry had set a goal to triple the market share of its medicines and services by 2023 to USD 10 billion, while it was about USD 3 billion then. Due to the resurgence in the global demand for AYUSH and herbal products, the total value of export of such products had increased from USD 354.68 million in the year 2014-15 to USD 401.68 million in the year 2016-17 in the global market.

In the 2019-20 revised budget, the ministry received Rs. 1857.00 crore which was around a 19 percent hike in budgetary allocation from the previous fiscal. The 2020-21 budget further increased this to Rs. 2122.08 crores.

As of March 2015, India had just over nine lakh allopathic doctors and nearly eight lakh AYUSH practitioners, over 90 percent of whom were either homeopaths or ayurvedic.

The various institutes under the ministry have been working to create AYUSH medicines and treatments for ailments ranging from common colds to HIV. As of 2017, ayurvedic and homeopathic treatments for cancer, swine flu, and a range of other drugs and treatments for serious diseases had official sanction. It aims at developing low-cost dengue pills by 2021 in joint association with the Indian Council of Medical Research.

Yet, an NSSO survey in 2014 found that only 6.9% of the population favoured AYUSH (3.5% ISM and 3.0% homeopathy) over conventional mainstream medicine and that the urban population was slightly more likely to seek AYUSH forms of treatment than their rural counterparts; another survey in 2016 reiterated the same findings, approximately.

Low-income households exhibited the highest tendency for AYUSH followed by high-income households and an overall, AYUSH lines of treatment were majorly used to treat chronic diseases.

The ministry even runs multiple healthcare programs, primarily, aimed at the rural population. AYUSH is supposed to form an integral backbone of the Ayushman Bharat Yojana and the ministry had long worked for integrating the different systems of AYUSH with modern medicine, in what has been described as ‘a type of “cross-pathy”‘.

Reception & controversies

Well, let’s just say that the word “Reception” was there only to maintain a standard of formality. The academia is almost entirely critical of the efforts being put in by AYUSH in manufacturing drugs and promoting therapies, which have been long labeled “quackery” by the Indian Medical Association and the Supreme Court of India.

To cast an example of how ridiculous advisories issued by the ministry are, one issued in June 2017 advised pregnant women to abstain from eggs and non-vegetarian food and avoid sex and lust. The medical community lashed out on these suggestions vehemently, arguing that in a country where a great proportion of the population lives below the poverty line, is anemic and malnourished, asking them to abstain from food which is high in protein and iron – such as eggs and fish – is a rather counter-productive suggestion. Doctors also said how, for some women, hormonal changes make them want to have more sex and it’s generally not a problem unless it’s a high-risk pregnancy.

Major systematic reviews — one published by medical journal Lancet in 2005, and the other published in early 2015 by Australia’s National Health and Medical Research Council — found no evidence of homeopathy being any more effective at treating disease than a placebo. (source: The Hindu)

The UK House of Lords Committee on Science and Technology, in a comprehensive review of alternative medicine in 2000, found that “in the case of homeopathy, although it is covered by a separate Act of Parliament, we were not able to find any totally convincing evidence of its efficacy”, and “there is at present no credible evidence base to support the value of any of the therapies that we list in our Group 3”, a category that also included Ayurveda.

Global opinion on the efficacy of alternative forms of medicine is sharply divided among medical professionals on one side of the fault line and “quack doctors” on the other. For example, studies have highlighted the presence of toxic heavy metals in Ayurvedic medicines. Allopathic doctors have publicly argued that the treatments administered by these disciplines are not efficient. “We have to ask [the AYUSH ministry] on what evidence are they relying on for promoting these treatments [on dengue],” said Dr. Jayesh Lele, state secretary of Maharashtra’s Indian Medical Association. “These are old sciences and the medical conditions they are claiming to prevent through these prophylaxis doses are relatively new. How did they gather evidence?”

Though Ayurveda recommends bitter gourd for patients with diabetes in studies published in dubious journals,  a Lancet study, ‘Alternative medicines for diabetes in India’, said it is  ‘maximum hype, minimum science’ rejecting the associated benefits. “Based on current scientific data, there is a scant scientific basis for the use of these products in the management of diabetes,” concluded the report.

In the case of Ayurveda, there is extensive research, but rarely any RCTs. “I can count the number of RCTs on the fingers of one hand,” Dr. Bhushan Patwardhan, Professor and Director of the Interdisciplinary School of Health Sciences, Pune University, said. As a result, there have been no proper reviews of the trials.

The Ministry even recommended medicines during the COVID pandemic among which none of the medicines have ever undergone any form of clinical validation, Arsenicum album 30, for instance, has not been tested on people infected with the novel virus to study their ability to provide any kind of relief or prevent infection either. Yet, the AYUSH Ministry had no hesitation in recommending the untested medicines to treat the virus, about which not much was known then.

Well, maybe we could argue that a great deal of what alternative medicines do, is in fact, quackery, yet their effectiveness, even if attributed to placebo has been recorded over time.

So, if the medical literature mostly is in favour of labeling these systems and practices as quackery, must we vouch for the abolition of the ministry? Well, there is a strong reason to believe not.

Cultural propagation

One rather important aspect of pushing for Ayurveda, Unani, and Yoga is a rebranding of the Indian culture. A great deal of the craze has already been generated among NRIs, nationalists glorifying ancient India, etc.

Brands such as Aveda and Lush have already begun borrowing from Ayurveda to develop skin-care products, while trendy coffee shops and juice bars in American cities repackage India’s rural remedies into turmeric lattes and ashwagandha smoothies. Food bloggers are raving about ghee.

“All over the world, a parallel movement is going on for traditional medicine,” said Vaidya Rajesh Kotecha, secretary of Ministry of AYUSH, “India should lead, not just to earn money but also because it is our responsibility toward the world.”

To re-launch “Brand Ayurveda,” government agencies have filed dozens of international patents, started research programs at top Indian universities, and sent experts to develop Ayurveda courses at colleges around the world. Delegates in 25 countries have set up “information cells” to spread awareness about traditional Indian knowledge.

In rural India, an agricultural effort accompanies the Ayurveda push. Officials are running educational programs and providing seeds, saplings, and subsidies to farmers to meet the government’s target of increasing the cultivation of medicinal plants threefold, to cover 300,000 acres of land. Plants that farmers once considered weeds are being revived to cater to new demand for their medicinal properties.

Reviving Ayurveda is one of BJP’s flagship policies and part of their agenda of restoring India’s past glory. Cementing a strong cultural framework in the rest of the world might just turn out to be India’s way of becoming a global superpower.

Reclaiming and promoting Ayurveda has practical benefits, too, said Rajiv Vasudevan, chairman of the Ayurveda core group at the Confederation of Indian Industry. Promoting Indian expertise could bring foreign cash and has “soft diplomacy” benefits noting that it could introduce people all over the world to Indian traditions.

“We are a proud nation, we have a rich history, and we have something to share with the world,” he said.

Conclusion

In my opinion, the ministry has scope to progress but must adopt a more careful and evidence-based approach to recommendations and advisories. It is evident that demand for Indian-origin cultural goods and services exists across the globe, yet inadequate research may continue to ferment skepticism and opposition in the medical literature.

As citizens of India, it is our responsibility to explore the Indian culture and help in strengthening it, yet at the same time, it is our responsibility as rational individuals to not chase after “remedies” and “cures” obtained through WhatsApp and governmental ministries without doing further research into the recommendations. It’s important that we obtain complete knowledge about any medication advised and preferably consult qualified medical professionals before administering anything to ourselves or our close ones.

– Satvik Tripathi,

Writer, Bharat Bhagya Vidhata

 

Further reading

Lock, Stephen (2001). The Oxford Illustrated Companion to Medicine. Oxford University Press. ISBN 978-0-19-262950-0.

Shrinivasan, Rukmini (2017). Questions over science swirl, but AYUSH stands firm. The Hindu. https://www.thehindu.com/sunday-anchor/medicine-wars-homeopathy-allopathy-ayurveda-unani-in-india/article10792873.ece

Karel Werner (1977), Yoga and the Ṛg Veda: An Interpretation of the Keśin Hymn (RV 10, 136), Religious Studies, Vol. 13, No. 3, page 289–302

Bibliography

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India could have the solution to cure dengue by next year: an ayurvedic pill

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Click to access sbe4.pdf

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