Just what the doctor ordered

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Just what the doctor ordered

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• Modern versus traditional: The 2020-21 Covid pandemic has brought into sharp focus the fault lines between modern medicine and traditional ones. The public fight between the IMA (Indian Medical Association) and Patanjali Ayurved (Ramdev) is for everyone to see.
• What Ramdev claims: His claims are straight - "modern medicine has nothing to offer in Covid-19 treatment, and vaccines cannot prevent infections. It's all a money making conspiracy." 

1. In response, the IMA has accused him of pseudoscience, and pushing vaccine hesitancy in Indian public.
2. So what's the fight about? They are making it a fight between merits and demerits of allopathic and ayurvedic systems. It should actually be about evidence or lack of evidence, that's acceptable to all.

• Since ages: All societies have used natural products to treat ailments, and modern medicine arrived recently. 

1. Many big drugs of 20th century rose from natural sources, after a long process
2. The process - identification of active ingredient(s), pre-clinical studies, mechanism of action (inside body), side-effects, large clinical testing

• Hypertension medicine: Till 1950, the only cure for hypertension was a low-salt diet; some practitioners from Calcutta in 1931 found that an alkaloid extracted from "sarpagandha" was a good treatment, leading to a Delhi doctor isolating five crystalline alkaloids from that herb and testing them on cats and frogs. That led to a Bombay cardiologist conducting a study on his patients and publishing a paper. The world was ready for a new cure!
• From sarpagandha to "brahmi": The CDRI of CSIR made a memory enhancer, using 'baccopa monnieri' extracted from "brahmi". A Chennai firm bought it, and sold it as Memory Plus drug. Two Prime Ministers endorsed it (PVN Rao and IK Gujaral). In a few years, CDRI revoked the licence as the drug was found useless.
• Evidence is king: Anything and everything written in ancient texts is not a magic cure unless proven by evidence on efficacy and safety, as per well-set criteria. That's what the proponents and followers of traditional system revolt against.

1. One B. Anandaiah of Andhra Pradesh has been distribution some herb-based Covid-19 cure to thousands, and the govt. hasn't stopped him (the herb has no side effects and no proven cure ability too)
2. Ramdev's Coronil - launched by Health Minister himself - came in as a cure for Covid-19, and then became just an immunity booster. There's no evidence for anything, or it's a dodgy evidence.

• What they demand: Anandaiah and Ramdev want their stuff to be labelled "scientific" but refuse to accept the process of science! Ramdev realised this problem, and has started publishing papers in some journals, via a newly set up "Drug Discovery and Development Division". 

1. The idea is to backup whatever Ramdev claims, with some paper
2. The papers published so far by him are not about Ayurvedic drugs, but about analytical methods and animal models! Most journals being used are not mainstream.
3. There's no clinical trials, no randomised control studies, but claims for curing everything from cancer to backache abound! Why does he not approach reputed journals for his claims?

• Science is evidence-based: Science is not static, but evolves, based on evidence. It's not dogmatic, like what followers of ancient texts to with those texts. That is why guidelines change with time. That's not weakness, but strength. 

1. Loopholes in modern medicine system allows unscrupulous firms to push fake products without sufficient evidence
2. Wrong combinations of medicines and antibiotics misuse is rampant
3. Regulators grapple with many such problems in this vast country

• Summary: India should not reject any system outright. Let all systems co-exist, based on evidence and scientific-process. Evolve standards for regulation, teaching, licensing and marketing that apply to everyone without exception. Evidence-based medicine is the way.

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