Bharat Jhunjhunwala and Narendra Nath Mehrotra
The NDA Government has placed the draft National Health Policy, 2015 in the public domain for discussion. It is stated that efforts would be made to revitalize the alternate systems of medicine known as Ayurveda, Unani, Siddha and Homeopathic, “AYUSH” in short. The step is welcome.
The Policy has stated that a “phased integration” of Ayush with the dominant Allopathic system of medicine will be undertaken. It is also said that efforts will be made to make India the world leader in the discovery of new drugs based on AYUSH systems. This task would require promoting joint research with the Allopathic systems. Ayurveda, for example, excels in the treatment of certain diseases like those relating to the stomach; while Allopathic system excels in infectious diseases and surgery. There is a huge area in between where both systems have contributions to make. There is a need to undertake an ambitious programme to undertake joint studies for treatment of various diseases by the two systems so that a new approach can be formulated that integrates the best of both systems.
The Policy has also committed to standardization of AYUSH practices and medicines. Presently, many patients suffer due to the use of substandard AYUSH medicines. The cost of AYUSH medicines is often high because certified raw materials are not easily available especially to small manufacturers. The cost of certification of small batches of raw materials is exorbitant leading to the use of uncertified inputs of poor quality. The Government could provide certified raw materials in small lots to enable small manufacturers to compete. There is also a need to undertake cost effectiveness studies of the alternate treatments. For example, certain Ayurvedic medicines are prescribed to be taken with honey. But that is expensive. So there is a need to study its effectiveness when taken with water.
There is a need to go beyond the “health” systems, however. The target of the Government should be to integrate the good practices of AYUSH into the overall lifestyle management. The basic premises of the AYUSH and Allopathic systems are different. AYUSH focuses on lifestyles-food, exercise, mental makeup, etc. It believes that health problems arise because of imbalance in lifestyle. The role of medical treatment is limited to providing immediate relief. For example a person who wakes up late, does no physical exercise, eats heavy food and is always fighting with others is likely to suffer from BP or other psychosomatic diseases. The AYUSH practitioner would prescribe early rising, morning walk, yoga and light food. That would be the basic treatment. This approach is codified in the “Vata, Pitta, Kapha” classification of the bodily processes in the Ayurvedic system. For example, if the veins have got blocked, the AYUSH practitioner would check the Vata, Pitta and Kaf and try to recreate a balance between them. Effort would be to eventually correct the bodily processes that led to blocking of the veins instead of merely removing the blockage. Assumption is that removal of blockage will not be successful if the underlying processes for their occurring are left unattended. The allopathic system focuses more on the anatomy. A stunt is placed in the veins and the blockage is removed even though the veins may soon get blocked again.
The difference between AYUSH and Allopathic system is similar to the difference between International Standards (ISO) and British Standards (BS). The ISO focuses on the processes. An ISO certification for paper factory, for example, will look at the systems in place in a factory for measuring variations in weight and colour; and the control systems for determining the amount of chlorine added for bleaching. It is assumed that the paper will be of good quality if these processes are in good shape. This is like the AYUSH focus on Vata, Pitta and Kapha. The BS, on the other hand, focuses on the physical measurements of the paper such as weight, colour, and strength. This is like the Allopathic system that focuses on the physical parameters of anatomy. World over there is a movement from BS to ISO. As a corollary we may expect a movement from Allopathic medicine to AYUSH for achieving ‘Holistic Health.’
There is a difference in the underlying purpose of life in the two systems. The objective according to AYUSH is “inner” peace. Ayurveda is best practiced along with the disciplines of astrology, vaastu, and yoga. The inner desires of a person may be indicated by astrology, for example, and vaastu and yoga may help in attainment of those inner desires. The role of Ayurveda gets limited to providing stop gap treatment until the deeper realignment takes place. The objective of life according to the Allopathic system, on the other hand, is increased consumption. A person drinking expensive wines is considered to be great even if he is tense and suffering from several diseases. Therefore, the area of joint studies should be limited to the positive contributions of allopathy.
How do we then explain the huge improvement in average life expectancy that has come about due to the use of Allopathic medicine? There is no doubt that the inventions of Penicillin and Antibiotics have made a great contribution in controlling diseases. However, we have simultaneously seen the emergence of new diseases like AIDS, Mad Cow Disease, Sars and Ebola. Therefore, while recognizing the seminal contribution of Allopathic medicine, there is need to be cautious in becoming dependent on Allopathic medicine alone. There is a need to take the dimension of physical processes and inner happiness on board.
The agenda for the Government has to be made in this backdrop. The main point is that Government should focus not merely on the treatment of the ailments but on the holistic redirection of the individuals as well as the society in its various dimensions. Health must not be looked at in a stand-alone way but as a part of the larger human predicament. The Government should work with the Information and Broadcasting Ministry to make a policy to educate the viewers that disease arises mainly to the wrong lifestyles and processes. The anatomical problems are only a symptoms of the underlying malfunctioning of the processes. The Government should work with the Sports Ministry to introduce Yoga as one of the streams in games competitions. The Government should work with the Ministry of Human Resources to introduce the different principles of AYUSH and Allopathic medicine in the curriculum at the High School level. The Government must work with the Ministry of Urban Development to adopt the principles of Vaastu in city planning. The benefits of AYUSH will accrue only if these various messages are given to the society to move towards a healthy lifestyle.
(The authors are formerly Professor of Economics at IIM Bengaluru; Scientist with Central Drug Research Institute, Lucknow)
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