|Year : 2020 | Volume
| Issue : 6 | Page : 105-107
AYUSH for COVID-19: Science or Superstition?
Ritu Priya1, V Sujatha2
1 Professor, Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
2 Professor, Centre for the Study of Social Systems, Jawaharlal Nehru University, New Delhi, India
|Date of Submission||05-May-2020|
|Date of Decision||06-May-2020|
|Date of Acceptance||07-May-2020|
|Date of Web Publication||2-Jun-2020|
Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi - 110 067
Source of Support: None, Conflict of Interest: None
| Abstract|| |
There is a lot of discussion on COVID-19 control strategies from the mainstream approaches, but it is also necessary to examine the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) sector, which is now being brought into public health interventions nationally. Although the AYUSH sector had previously joined the management of dengue and chikungunya outbreaks in some Indian states, its participation has remained contentious and there is reluctance in mainstream public health discourses to seriously examine their interventions. This is a commentary on the efforts made by the Ministry of AYUSH, state AYUSH directorates, AYUSH research institutions, and public hospitals, based on official documents as well as official statements reported in the media, with the aim of bringing out concerns in the process of adapting traditional textual knowledge and practices to public health requirements of the current age.
Keywords: Epistemology, evidence generation, traditional health knowledge systems
|How to cite this article:|
Priya R, Sujatha V. AYUSH for COVID-19: Science or Superstition?. Indian J Public Health 2020;64, Suppl S2:105-7
| The Context|| |
The central government has, in April 2020, brought the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) into its COVID-19 management strategy, and efforts to engineer a coherent strategy are in motion. The challenges in this process are two-fold: first, engaging with the skepticism of hardcore “modern” rationalists who reject traditional knowledge as superstition and second, developing research and therapeutic protocols according to the parameters of modern laboratory sciences for traditional health knowledge systems that are holistic and multimodal.
| Traditional Health Knowledge and Epidemic Management|| |
Management of epidemics is not new to traditional Asian health systems. Janapadodhwamsa Vyadhi is a well-defined term for epidemics in the classical ayurvedic texts and siddha classifies fevers into 64 types distinguishing those from intrinsic and extrinsic causes. However, their approach and classification of fevers are not based on the germ theory. Presenting the siddha protocol for Dengue, Jain et al. point out how the Siddha etiology includes a combination of environmental and seasonal factors in the outbreak of epidemics. From the beginning of the 20th century, practitioners of Unani, Siddha, and Ayurveda have significantly contributed to the management of epidemic outbreaks. During the cholera outbreak in 1903, P. S Varier, founder of Kottakkal Ayurveda Sala, visited patients and studied their symptoms carefully, developed medicines for the same in his unit, and had distributed them in the community. Herbal remedies and Ayurveda have been used in Sri Lanka for the management of malaria, and we are aware that the Traditional Chinese Medicine remedy for malaria gave rise to the modern drug Artemisinin.
In the past 6–7 years, the AYUSH sector has contributed to the management of dengue and chikungunya in the states of Kerala and Tamil Nadu. The herbal decoction “Nilavembu Kudineer” was distributed on a large scale during the dengue outbreak in Tamil Nadu by state agencies and social organizations. While this was widely reported, it is surprising to find little attention given to these developments in mainstream public health discourse, and systematic studies are missing.
| The Role of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy in the Management of Covid-19|| |
The COVID-19 pandemic has provided another opportunity for the creation of AYUSH regimens for the management of an epidemic and in addition for the designing of clinical and field trials adapted to the traditional health systems under question.
Scientists have been responding rapidly to the threat of the COVID-19 pandemic, from projections and modeling of its possible dynamics to virological studies, vaccine production, and clinical therapeutic research. The AYUSH Ministry on its part had released a public advisory on preventive practices based on the AYUSH systems' knowledge on January 29 itself, the day the first case was detected in India.
“The traditional healthcare system of the country provides lifestyle advocacies to boost immunity which helps the prevention of various kinds of infectious diseases……The Ministry of AYUSH is issuing the advisory as a preventive measure and not claiming to be a treatment advice for the Corona virus infection.”
The advisory included preventive medicines of the various systems under AYUSH. However, this was met with criticism and disparaging remarks amounting to ridicule reportedly by public health experts, calling them “placebo,” myths, and “pseudoscience.” On March 6, the Ministry sent a second advisory covering the various systems to chief secretaries of all states and union territories, with an annexure of 33 published research studies providing evidence of their rationale; it seemed that the AYUSH Ministry was also working on improving its public communication after a few initial slippages.
While the hallmark of scientific attitude is the impartial examination of statements in terms of evidence and logic, in the case of such public health proposals from AYUSH systems, even a scientific curiosity to find out how they work appears to be missing. There is a blanket rejection without any examination or even basic background knowledge about these systems by some commentators.
The central government, seized with the imperative to press all available resources into the challenge of tackling COVID-19, has given a go-ahead to the AYUSH sector, for “scientific, evidence-based solutions from the AYUSH systems,” with an exhortation also to curb false claims in the name of AYUSH.
On April 1, the Ministry set up an online channel for receiving suggestions based on scientific AYUSH explanations, therapies, and procedures that could restrain the spread of COVID-19 or to manage the disease. An Interdisciplinary AYUSH Research and Development Task Force for COVID-19 was constituted on April 2. The mandate of the Task Force included “identification of potential preventive therapies and therapeutic approaches from AYUSH systems for different stages of treatment of COVID-19 as standalone and/or add-on interventions to conventional care” and to collaborate with other research bodies such as the Indian Council of Medical Research, Council of Scientific and Industrial Research, AIIMS, Defence Research and Development Organization, Department of Biotechnology, Department of Science and Technology, AYUSH industry, Pharmaceutical Industry, information technology industry, and state governments after vetting by a mechanism to coordinate among science agencies, scientists, and regulatory bodies. It was also to formulate national ethical guidelines for integrative management (AYUSH/conventional) of COVID-19 in human participants for prevention in healthy individuals, interventions for milder symptoms, management of severe COVID-19, and as adjuvant/add-on therapy for severe stages of the disease.
To facilitate operationalization of research, development, and intervention efforts, a Notification to be published in the Extraordinary Gazette of India was put out on April 21, providing the approval and mandatory compliances for any AYUSH research in human for COVID-19: “based on the consultation with CDSCO, the Ministry of AYUSH with the approval of the Minister of State Independent Charge notifies that scientists, researchers, clinicians of any recognised systems of medicine under IMCC Act, 1970, HCC Act 1973 and NMC Act 2019 (formerly IMC Act 1956) can undertake research on COVID-19 through Ayurveda, Siddha, Unani and Homeopathy systems including prophylactic measures, interventions during the quarantine, symptomatic and asymptomatic cases of COVID-19, public health research, lab based research, etc., to generate evidence.”
These measures have galvanized efforts of AYUSH doctors across the country who were a couple of weeks earlier asked to vacate their hospitals and beds and hand them over to their biomedical counterparts. They had been denied an independent role in the management of the ailment and were only to work under instructions. A large number of networks of AYUSH researchers and practitioners who were already contributing to the anti-COVID-19 efforts could now apply for official support.
| Traditional Health Practices and Immune-Modulation|| |
At present, Kerala has set up State/Regional/District Ayurveda COVID-19 Response Cells, Ayur Raksha Clinics for preventive work and, operationalizing Swasthyam regimens with lifestyle, dietary, and medicinal components for different age groups and risk categories, and Niramaya, an official virtual platform for effective utilization of AYUSH strategies for COVID-19 patients. The Siddha sector has also come up with protocols for COVID-19 management that include use of various herbal decoctions at different stages of the disease. These are low cost, easy to prepare and to distribute, and have been implemented in Tamil Nadu since April 2020. In any case, since the onset of news of the virus in March 2020, herbal decoctions had been prepared and consumed by the general public and avidly purchased as testified by press reports of long queues in front of siddha pharmacies and clinics. There is certainly room for false claims from various quarters about miracle cures but that does not take away the fact that properly formulated and validated regimens have a significant role to play at mass level. Despite the large number of cases of COVID-19, Kerala has had the lowest rates of mortality. This is attributable to its superb public health infrastructure and multipronged intensive response, but there could have been other factors such as the role of ayurvedic health practices. This could also be true of the siddha interventions in Tamil Nadu that has till this moment that the article is written, maintained a low mortality rate in comparison to other states. It is high time we investigate these trends with an open mind.
The AYUSH inputs come in terms of strengthening general immunity so that a larger proportion of the number of exposed are able to remain asymptomatic or experience only mild disease, and fewer proportions move to become severe cases. When infections occur and they do become severe, the AYUSH therapeutics can also be more specific depending on how the pathophysiology of severe cases leading to sudden decline and death is conceptualized. In the management of COVID-19, the two approaches of suppression and mitigation, “flattening the curve” and “allowing herd immunity to develop,” can either be viewed as oppositional or as complementary and to be built into a holistic and dynamic response. Similarly, the epistemologically diverse approaches of traditional systems and modern biomedicine can be either viewed as one being “rational” and the other “irrational,” or that the two are complementary to each other. If the innate immunity can be strengthened through an intervention at mass level and in a short period of time, then it certainly must be part of a holistic public health response.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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