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Friday, August 07, 2020

When one manufacturer pushes an untested product in an unethical manner, why does it vilify Ayurveda as a whole?

With this enormous effort available, and given that the spirit of inquiry guides science, it could well have been expected that communication between science, these worlds of Ayurveda and the public would be fostered. This would have been a great contribution to medical knowledge, for humanity as a whole.

Written by Madhulika Banerjee | Updated: July 2, 2020 9:05:27 am
yurveda, ayurveda India, ayurveda medicine, ayurveda study, covid fight, ayurveda pandemic, ayurveda coronavirus, ayurveda healthcare, baba ramdev, patanjali ayurved, coronavirus cure, The only sphere where Ayurveda seems to have succeeded is in the manufacturing sector. (Illustration by C R Sasikumar)

Baba Ramdev has done a disservice to Ayurveda. He puts out Coronil, a drug in the market that claims nothing short of being a “cure” for the worst public health crisis we have faced in a long time. Soon, it turns out that the drug had failed to meet both scientific protocols and regulatory requirements. This episode reinforced all the modern stereotypes of traditional medicine — that of mumbo-jumbo peddled by charlatans and quacks. Specifically, it buttresses an old but ill-informed scepticism about Ayurveda, that while it might have a strong knowledge of plants and their medicinal value, it is not evidence-based, that it has unstructured concepts that are not believable, and that it cannot explain how it knows what it knows.

Hundreds of practitioners, researchers and manufacturers that I have met over the last three decades while researching Ayurveda have taught me otherwise. Yes, I know and have written about popular medicines that Ayurveda is today known for — Liv-52, Septilin, Hajmola (did you know this is a candy version of Kshtudhavardhak bati?). Yes, I know the underbelly of Ayurveda too — BAMS doctors prescribing allopathic drugs, and worse, Ayurvedic practitioners mixing steroids in their prescriptions. But my research has shown me several other worlds of Ayurveda — the world of the practising Ayurvedic doctor, the teachers in the scores of colleges and universities of Ayurveda and researchers in different institutes. These worlds are much bigger and deeper, beyond that of Patanjali, Dabur and Himalaya. That world is vibrant, has integrity and it is important that it be known, respected and valued.

Thanks to meticulous research by historians and anthropologists, we know that Ayurveda functioned in a dynamic and proactive state for a very long time. “Tradition” is not the best way to describe it, because that makes it seem like a static wisdom of one time. In reality, the canonical Ayurvedic texts were complemented by hundreds of commentaries — adapting, modifying, even challenging principles by stating evidence to the contrary. Also, there were exchanges of knowledge between practitioners of the broad traditions of Unani, Ayurveda and Siddha, acknowledged until the colonial period, which brought in the hegemony of modern bio-medicine. Under the influence of colonialism, we tethered the language, the institutions and the systems of Ayurvedic knowledge production to the margins of our learning and education. We closed many doors and windows of scientific practices within and around traditional medical systems. But in a trick of inversion, we say they do not follow the language and methodology of science.

Contrary to popular opinion, there are thousands of Ayurvedic practitioners who are true to their education and confidently prescribe only Ayurvedic medicines. They have found ways, for instance, to complement surgery with support in recovery. They stay up to date with the latest investigations and molecules entering the market so that they can support their patients. Most often, they have to do this while being judged on the basis of rank ignorance and false pride from practitioners of modern medicine.

Despite Ayurvedic knowledge being rooted in a different philosophy, teachers have found ways of keeping up the process of adapting learning from the texts to contemporary education, fitting into modern classifications of anatomy, physiology and higher specialisations at a deeper level. They have both adapted to and adopted new knowledge, widening their horizons unhesitatingly, true to their tradition. Yet they have to face unhappy students, struggling with low self-esteem, under immense pressure to compromise their knowledge.

Researchers like Ashok Vaidya have taken the responsibility of explaining the meaning of Ayurveda to modern scientific research. They have systematically, faithfully and often with very little recognition, done the difficult job of getting the languages of science and Ayurveda to speak to each other. They have learnt and used their methods, while also thinking carefully of credible translations between two languages, methods, and indeed world-views. From this, they have produced credible evidence that corroborates and complements modern medical research. Despite this hard work and brilliance, they struggle to publish in the mainstream and those that do, never make breaking news.

With this enormous effort available, and given that the spirit of inquiry guides science, it could well have been expected that communication between science, these worlds of Ayurveda and the public would be fostered. This would have been a great contribution to medical knowledge, for humanity as a whole. Sadly, though, with honourable exceptions, this has not been the case. So, it is Ayurvedic doctors, teachers and researchers who have made it their business to inquire, implement, investigate and innovate with these knowledge systems in communication with science. Without waiting for reciprocity, confidently carrying the double burden of understanding the Ayurvedic as well as modern scientific knowledge, they are possibly contributing more to the greater common good.

The only sphere where Ayurveda seems to have succeeded is in the manufacturing sector. Not prepared to take marginalisation like the other actors in this play, the manufacturers have tried to win this game by taking innovation to another level. They have found that with the right kind of packaging, positioning and pricing, any Ayurvedic medicine can be transformed to an FMCG and be sold as well as, or even better, than products of modern pharmaceutical companies. This success comes with a price. Ayurvedic manufacturers have to enter the race to create new products, of “matching” the capacity of biomedicine to make new products; and of “matching” the capacity to mine the market for equally huge profits.

The worlds of Ayurveda have long debated some of the fundamental flaws built into this apparent success. When two knowledge traditions have two completely different perspectives on body and disease, then why compete on the medicine and cure? And when parameters of treatment and expected outcomes are of different kinds, then how can the protocols of biomedicine be used for evaluating Ayurvedic medicines? Why can Ayurvedic manufacturing not focus on creating a different world of diagnosis, treatment and cure in keeping with its perspective, expanding the range of choices patients have? The commercial success of Ayurvedic manufacturers enables them to be the emblem of Ayurveda in the public imagination. Thus, when one of the rogue manufacturers pushes an untested product in an unethical manner it vilifies Ayurveda as a whole. But on the flip side, even when the editor of The Lancet, the venerable journal of medicine, admits that he was under immense pressure from the pharma industry to publish unreliable data on Remdesivir, it was considered an exception, and did not malign the modern medical system as a whole. I think Ayurveda deserves better.

This article first appeared in the print edition on July 2, 2020 under the title “Ayurveda deserves better.” The writer is professor of political science, University of Delhi and author of Power, Knowledge, Medicine: Ayurvedic Pharmaceuticals at Home and in the World.

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