Alternative medicine is a major enterprise in India. In November 2009, the government�s Ministry of Health and Family Welfare announced the steps it would be taking to promote �Indian Systems of Medicine� in the country, including spending Rs. 922 crore on the promotion of AYUSH (Ayurveda, Yoga & naturopathy, Unani, Siddha and Homoeopathy). Major claims have recently been made for alternative medicine � such as that Ayurveda can be used for anaemia or ano-rectal ailments, and that homeopathy can be used to prevent or cure swine flu, or to treat Aids and malaria.
In an era characterised by evidence-based science and politics, should official endorsement be given to remedies that cannot be scientifically proven? Is alternative medicine a form of quackery, which puts patients at risk? Or is the interest in alternative medicine a positive sign that we are beginning to move beyond a too-narrow approach to disease, towards recognising the more subtle relationship between mind and body and the need to find holistic cures? Do traditional medicines play an important role in preventive medicine, contributing to a more affordable and effective healthcare system than the Western medical model?
The debate in context:
What is complementary and alternative medicine (CAM)?
Many discussions about alternative medicine today take place under the umbrella term �complementary and alternative medicine� (CAM). This implies that alternative medicine should not be seen solely as something that can be used instead of conventional medicine, but can and should be used alongside it. CAM refers to treatments that differ from conventional, or �allopathic�, medicine � medicine based on scientific testing that is taught to medical professionals. Systems of CAM have often evolved apart from and earlier than the conventional medical approach used in the Western world. Some such systems, such as homeopathy and naturopathy, have developed in Western cultures; others, such as traditional Chinese medicine and Ayurveda, have developed outside of the West.
Does CAM work � and if so, how?
Critics of CAM argue that the very term is problematic, giving mysticism more scientific credence than it deserves. As the editors of the prestigious Journal of the American Medical Association (JAMA) have argued: �there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine�. Advocates of CAM, however, argue that the lack of scientific evidence about the efficacy of CAM betrays too narrow an approach to the understanding and treatment of illness. They point to the failure of conventional medicine to cure certain serious diseases, such as cancer, and the extent to which patients suffering from these diseases can be helped by therapies like Ayurveda. They note that conventional medicine has itself moved towards a more holistic appreciation of the treatment of disease, and that some natural remedies or techniques, such as the use of quinine to treat malaria, have been adopted and accepted by pract itioners of conventional medicine.
Even critics of CAM do not dispute that in many cases, alternative remedies can make patients feel better, despite not curing the disease � so isn�t this a worthwhile goal in itself? The importance of preventive medicine, including lifestyle modification, has been globally acknowledged: it is seen as better and more cost-effective to enable people to avoid physical or mental illnesses in the first place, rather than simply trying to treat the disease when it emerges. Alternative medicine, it is argued, has a crucial role to play in this. Furthermore, in a society like India, for which the affordability of healthcare is a major challenge, different models need to be sought that make the most of the country�s experience and expertise, including in the field of alternative medicine. Advocates argue that the orientation of CAM �towards self-healing and health promotion (salutogenesis rather than pathogenesis)� make �alternative medicine approaches to chronic diseases especiall y attractive and affordable for the developing countries�.
The rise of CAM
One of the key aims of the government scheme the National Rural Health Mission is to �encourage a healthy lifestyle and alternative systems of medicine through AYUSH�. In November 2009, Chief Minister, BS Yedyurappa, told a conference that access and awareness of alternative medicines should be spread in rural areas. The officially-recognised status of alternative medicine in India is also indicated by the reach of the Indian Institute of Alternative Medicines, established in 1991 by Dr.Suresh Kumar Agarwal; and the appointment of Smt. S. Jalaja IAS as secretary to the Department of AYUSH.
The growing interest in, and promotion of, alternative medicine by the political and medical authorities is not confined to India. Despite being at the forefront of advances in conventional, �Western� medicine, the USA provides a significant market for traditionally Indian and Chinese remedies. Organisations such as the National Center for Complementary and Alternative Medicine contribute to the official status of alternative medicine in the USA. In the UK, a major debate took place in 2006 about whether CAM should be provided by the National Health Service (NHS). In the USA and UK, affordability of healthcare is also a key issue, raising questions about whether attachment to the Western model of medicine is appropriate even for Western societies, let alone other cultures.
A different kind of medicine?
These developments show that CAM is not an unregulated, maverick market, but is fast becoming subject to official and scientific research and regulation. Advocates of CAM argue that quacks can be weeded out by better training and standard-setting. Some also argue that criticism of alternative medicine arises from a Western bias, which distorts the facts about CAM and refuses to countenance its effectiveness. Critics, however, point to concerns about the safety of certain forms of alternative medicine. Discussions about the affordability of alternative compared to allopathic medicine lead to concerns that patients are being duped by irrational treatments that will not make them better. Shouldn�t a universal healthcare system ultimately seek to provide proven cures for illnesses, rather than taking the cheaper but less effective route of alternative medicine?
Key terms:
Complementary and alternative medicine
Conventional medicine
Preventive medicine
Quackery
AYUSH
Ayurveda
Homeopathy
Placebo effect
Essential reading
Alternative System of Health Care Indian Government
Needed: �basic� doctors of modern medicine Meenakshi Gautham and K.M. Shyamprasad The Hindu 5 November 2009
When East Meets West: Why Consumers Turn to Alternative Medicine ScienceDaily 20 November 2009
In defence of scientific medicine Michael Baum Manifesto Club
Q&A: Complementary therapies BBC News Online 23 May 2006
Interview With Ashis Nandy: �Every tradition has its dark side� Parshuram Ray Humanscape January 2001
For:
'Alternative' Medicine Is Mainstream Deepak Chopra, Dean Ornish, Rustum Roy and Andrew Weil Wall Street Journal 9 January 2009
Reflections on Ayurveda Dr Mohana Krishnaswamy The Hindu 4 September 2001
Health Care Reform Should Include Preventive Medicine Navi Radjou Harvard Business Review 7 August 2009
Holistic medicine demystified Dr Hiramalini Seshadri The Hindu Magazine 15 May 2005
Against:
Where doctors fail Dr. Sudha Vidyasagar The Hindu 5 September 2009
Sticking a needle in alternative medicine Stuart Derbyshire spiked 28 November 2007
Ayurveda under the scanner Meera Nanda The Hindu Magazine Vol 23, Issue 07, April 08 - 21, 2006
Book review: Suckers � How alternative medicine makes fools of us all Eisha Sarkar Mumbai Mirror 5 November 2009
Further reading:
An interview with Dr. V. Sukumaran MBBS, MD (ped) health and mind science consultant Malini Suryanarayanan 14 June 2000 The Hindu: Opportunties
Role of Ayurveda in the Management of Cancer Dr. Joban Modha and Dr. Neha Modha Boloji.com 2 December 2007
Focus: Alternatives in holistic healing Pratibha Gadhalay The Hindu: Opportunities 14 June 2000
Skin Deep: Ancient, but How Safe? Abby Ellin New York Times 17 September 2008
Awash in Ancient Hindu Wisdom Peter Jaret New York Times 9 March 2006
Bottling Ancient Secrets Michele Orecklin Time Magazine 31 July 2000
Placebo effect Robert T. Carroll The Skeptic�s Dictionary
Sense About Homeopathy Sense About Science September 2006
All in the mind? Anjana Ahuja The Times (London) 24 May 2006
The Use of Complementary and Alternative Medicine in the United States National Center for Complementary and Alternative Medicine December 2008
Kerala's Crisis in Public Health C.R. Sonam Boloji.com 3 February 2007
Complementary and Alternative Medicine May Reduce Risk of Some Diseases US Disease Control Project June 2007
In the news:
Drugs for affordable health care sought The Hindu 21 November 2009
Ayurvedic methods to cure ano-rectal ailments Naveen Kumar Times of India 21 November 2009
Promotion of Alternative Medicine System Press Information Bureau: Government of India 20 November 2009
Anaemia treatment by ayurveda from December 8 Simran Virk Times of India 17 November 2009
CM bats for alternative medicine Expressbuzz 15 November 2009
'Need to combine Ayurveda with modern medicine' Times of India 15 November 2009
Medicine takes an alternative route Nikhila Henry Times of India 26 September 2009
'Homeopathy can prevent, cure swine flu' Times of India 18 August 2009
Alternative medicine to the rescue Chitra Nair Times of India 13 August 2009,
Boost for public healthcare Times of India 9 July 2009
�Rs. 4,000 crore for alternative medicine� The Hindu 22 March 2009
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