Modern medicine is preposterously successful. It’s as successful as politicians would be if they actually fulfilled promises made to the electorate. Like, if we got a clean Ganga, and enough repatriated black money to give each Indian lakhs or rupees, and so on. Evidence-based medicine helps the rich as well as the poor (though admittedly it helps the rich more). It doesn’t take much money to boil water and milk, or make vaccines for infectious diseases. Here’s a four-minute visualisation of how well it has worked over the past decades, from the man who does such visualisations best: Hans Rosling.
The reputation of medicine, though, is in the gutter. All our talk is about negative complications, to the exclusion of helpful effects. The idea of cost-benefit analyses seems to have gone out of the window. Hordes of people, as a result, turn to treatments that create fewer adverse effects, neglecting that they have no proven benefits either.
The other day Shripad Naik, a senior minister in the Central government, promised a cure for cancer within 12 months. The so-called cure has been developed by the Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), and is being vetted by Naik’s ministry, which deals with Ayurveda, Yoga, Unani, Siddha and Homoeopathy or AYUSH. Here’s a hint: no such cure exists, and no yoga institution will find a cure for cancer, or for any disease, at any time in the future. And here’s a prediction: Naik will face no blowback for making absurd, unsubstantiated claims.
We’ve been through this before. Baba Ramdev, who believes cow milk and urine provide complete protection against cancer, and has a cancer cure ready for those benighted enough to have grown to adulthood without regularly imbibing cow urine, promised back in 2008 that he would allow clinical trials of his ayurvedic cancer treatment within three years. There’s no sign yet of any rigorous probing of Ramdev’s claim. Three years before that, in 2005, the Lancet published a meta-analysis showing homoeopathy provided no benefits greater than placebos. The Union Health minister at the time, Anbumani Ramadoss, defended the alternative treatment, promising, “We will counter this with scientific data.” The data never arrived, needless to say.
Convergence of conspiracy theorists
When faced with unputdownable arguments, defenders of alternative therapies often launch into an attack on science itself, condemning the method for being ideologically tainted, or the practice for being corrupted by Big Pharma. Identical arguments are used by right, left, and centre. Although Hindutvavadis lead the charge against reason, what I have called the Irrationalist Left isn’t far behind. What those who equate rationality with imperialism and neoliberalism fail to grasp is that forces of Big Capital do not always gather on the same side. Insurance companies would be happy to have inexpensive therapies replace expensive patented medicines and hospitalisation. The reason health insurance providers refuse to cover cheap alternative cures is that they are inefficacious, and lead ultimately to acute conditions that are more expensive to treat.
Why should India even have a ministry giving the stamp of approval to homoeopathy and naturopathy? These treatments are not only mystical rather than evidence-based, they aren’t even Indian. Unlike modern medicine, which has grown out of contributions from across the globe, homoeopathy is the late 18th century creation of a German physician named Samuel Hahnemann. Somehow, this entirely European system has been given honorary Indian citizenship, while a method to which many Indians have made substantive contributions is dismissed as "western" or "imperialist'. Naturopathy is a more recent form of quackery than homoeopathy, the term having been coined in 1895 by an American named John Scheel.
As for Unani, which draws from Greek, West Asian and Indian sources and is practiced mainly by Muslims; Siddha, which originated in Tamil Nadu and is popular in southern states; and Ayurveda, which reaches across the country and communities: all three systems partake of the same discredited idea of health and the human body, viewing them as a balance between different fluids or bioelements. These elements defy any rational examination: they cannot be viewed or isolated or studied. But that doesn’t prevent people from asserting their scientific nature. Further, Siddha and Ayurveda believe in the existence of the same "doshas", vata, pitta and kapha, but Ayurveda conceives kapha to predominate in childhood, pitta in adulthood, and vata in old age, while Siddha reverses the order. That doesn’t prevent people (and apparently the Indian state) from believing both systems to be valid. In the world of mystical medicine, a thing and its opposite can be true at the same time.
The kernel of truth
Unlike homoeopathy and naturopathy, Unani, Siddha and Ayurveda aren’t complete mumbo jumbo. Of the thousands of formulations used by practitioners, a few are almost certainly efficacious, even though the majority are useless at best. The problem is, we don’t know which remedies work, and which don’t, because there’s been precious little proper testing conducted despite an entire ministry supposedly dedicated to the task. What do I mean by proper testing? The paradigmatic example is the discovery of artemisinin, for which the Chinese scientist Tu Youyou was awarded the 2015 Nobel Prize for Medicine.
In 1967, the Peoples’ Liberation Army set up a research programme to discover a cure for malaria at the request of the North Vietnamese army and the order of Mao Zedong. Chinese scientists methodically went through the archives of traditional herbalists till Tu Youyou fixed her attention on an extract of sweet wormwood, first described in 200 BC and further explicated in a handbook of herbal medicine composed in 360 AD. She published favourable results in 1979, and after a few years of scepticism, artemisinin and its derivatives became the frontline treatment for the most dangerous form of malaria.
There may be no cure for cancer in the handbooks of Ayurveda, Siddha, and Unani, as also in the traditions of our tribal societies, but there are probably compounds rivalling artemisinin waiting to be discovered. What’s needed is a change in perspective, from a celebration of mysticism, and from jingoism masquerading as science, to an evidence-driven approach to all traditional treatments.