Remedies in a homeopathic pharmacy in Varanasi, India. Credit: Jorge Royan / Wikimedia Commons, CC BY-SA 3.0.
Kochi: As the novel coronavirus repeatedly spread through populations around the world, in some countries in three waves, and governments responded by imposing lockdowns of varying degrees of stringency, people around the world became increasingly obsessed with their own immune system.
The COVID-19 pandemic has easily overwhelmed the health systems of most countries, including the United States and the United Kingdom, whose health spending is relatively much higher. Where there was a surplus of drugs that experts and politicians said could be helpful in taming the infection, only a few survived further examination, such as the steroid dexamethasone, and for cases of limited use. Around this time, complementary and alternative therapies also became more popular.
In India, entrepreneurs, businessmen and political leaders have strongly pushed Ayurvedic and medicines from other sources to people in the name of “better” or “stronger” immunity. The most popular of them, promoted by the country’s AYUSH ministry, included “Ayush Kwath” and “Arsenicum album 30”.
Thanks to such surges, pharmaceutical and consumer companies that supposedly manufacture Ayurvedic products have been able to significantly increase their sales.
P. Ramkumar, president of the Indian Organization of Ayurvedic Medicines Manufacturers, said that thanks to the lockdown, this year has been difficult for most drug manufacturers until the government of Kerala included Ayurvedic medicines in its list of “essential products”.
While “classic medicines” – the formulations described in classic Ayurvedic texts – are generally more popular, manufacturers of products marketing “immunity” had a field day last year.
High demand, high sales
Some Ayurvedic pharmaceuticals with effective marketing networks achieved higher sales last year than other years thanks to Ayurvedic products, said K. Sreekumar, marketing consultant for these pharmaceutical companies with 20 years of experience.
According to him, the turnover for 2019-2020 for Ayurveda products alone in Kerala was over Rs 500 crore. Kerala Ayurveda market including hospital products and treatments is estimated to be over Rs. 800 crore per year.
Saji Kumar S., former chairman of the Confederation of Indian Industries of Kerala and managing director of Dhathri Ayurveda, added that sales of Ayurvedic products are expected to increase by 20% in the current fiscal year – compared to 10-15% in the current fiscal year. previous years. . Besides “ immunity boosters ”, the demand for single drug extraction under Ayurveda has also increased, he said.
After the start of the COVID-19 epidemic, popular products included herbal masks, herbal handwashing, herbal sanitizers, herbal soaps and nutraceuticals ” enhancing immunity ”. Deputy Controller of Medicines (Ayurveda) in Kerala, Jaya V. Dev, said that almost all of the license holders for the manufacture of Ayurvedic medicines in Kerala – around 700 entities – can make “Ayush Kwath” and disinfectants.
COVID-19 has also affected drug availability and distribution channels, so companies have reorganized their operations to maximize sales of Ayurvedic products, Sreekumar said.
Some of the more successful businesses, aside from small local entities, included Himalayas, Dabur, Charak, and Zandu. Their products and those others that included the “immunity” label were available over the counter at allopathic pharmacies. Some pharmacies have also dedicated a separate shelf for their products.
But at a time when more and more people seek treatment in Ayurvedic clinics, Ayurvedic hospitals and resorts have had a hard time after the start of the pandemic, according to Dr Itoozhi Unnikrishnan, secretary general of the Association. management of Ayurveda hospitals.
The twist is in the costs. Unnikrishnan has estimated that if hospitals and resorts do not achieve 40% bed occupancy, they may not be able to break even – and this is difficult because many people are still hesitant to travel.
“We get a lot of requests, even from outside Kerala, but they don’t come true as the threat of the pandemic continues,” Unnikrishnan said.
Efficiency questions
Many of the doctors this correspondent spoke to said it was easy to generate data to show, on paper, that news products and therapies work. The challenge is to show what they are doing in real life.
Some have identified some over-the-counter products as well as some new offerings that do not have references in conventional texts as “unscientific”. Others have said that Ayush Kwath cannot be prescribed willy-nilly because its preparation includes herbs that may not be good for people with diabetes or high blood pressure.
Members of the scientific community have also raised the question of whether “immunity” pills could be placed under Ayurveda and whether classical texts refer to pandemics.
Many Ayurvedic texts mention characteristics of diseases which are synonymous with infectious and / or transmissible conditions. For example, the Charaka Samhita contains the term ‘janapadoudhamsam”, Meaning“ disintegration of the colonies ”. The Sushruta Samhita talks about fevers that cause odor loss, fevers caused by “strangers” and illnesses that are spread when people kiss or use other people’s clothes. The texts also prescribe certain personal hygiene practices that could contribute to prevention.
At the same time, income reports indicate that the secular population is not concerned about whether or not evidence is available.
According to the WHO guidelines on “ General guidelines for methodologies for research and evaluation of traditional medicine ”, published in 2000:
“The concepts of using traditional medicine should also be taken into account with its cultural aspect. … When there is no documentation of the long historical use of a herbal medicine, or when there are doubts about its safety, additional toxicity studies should be performed. “
In light of this, let’s consider “Ayush Kwath,” which AYUSH’s ministry has promoted.
“ Food as medicine ”
According to Dr P. Rammanohar, director of the Amrita Advanced Ayurveda Research Center and member of the AYUSH Ministry Working Group for COVID-19, “Ayush Kwath” has never been promoted as a drug against the disease.
Instead, in its account, the ministry urged “Ayush Kwath” to deal with the panic among the people without sowing a false sense of complacency.
Dr S. Gopakumar, Head of Etiology Department at Government Ayurveda Medical College, Thiruvananthapuram, said that food as medicine has been a mainstay of Indian cuisine for many centuries. According to him, the underlying concept is that the ingredients in food act as immunomodulators – substances that regulate the immune system – and revitalize the body’s organs. Ayurveda captures this in the concept of sarira balam (‘body strength’).
It’s another problem that many drug companies are exploiting with their own versions of “immune” drugs, he added.
However, the consensus in the medical research community – Ayurvedic and otherwise – is that you cannot gain better immunity overnight. Dr Gopakumar said that such strength is the product of a person aahara (food), Vihara (diet), Achara (habits) and Vikara (emotions). This holistic approach to health care, he suggested, is reflected in the study of modern medicine on psychoneuroimmunology.
Dr Sharmad Khan, chief medical officer of one of the 810 Ayurvedic dispensaries in the government of Kerala, added that an Ayurvedic concept called vyadhikshamatvam deals with preventive care, and here the drugs are only part of the sarira balam picture. According to him, a person’s “ immunity ” can be violated by a disturbance of his three doshas (vata, pitta and kapha). Axiomatically, it is also said that the organism which manages such a disturbance better is better equipped to deal with diseases.
COVID-19 care in Kerala
In Kerala, the state government distributed a “COVID Care” kit to people in quarantine. The kit contained drugs known as indukantam, sudarshanam, vilwadi gulika, shadangam and aparajitha choorna dhoopamSaid Dr V. Rajmohan, the coordinator of the Ayurveda COVID-19 State Response Unit (SACRC). Since the Ayurvedic approach is specific to the individual, and if a person reported a specific condition, the constituents of the kit would be changed accordingly.
Dr Rajmohan said the state had obtained consent “digitally” – via WhatsApp – “from people who were open to Ayurveda before sending them the kit. The response to the kit developed gradually. “
While COVID-19 mainly manifests in the form of respiratory problems, Ayurvedic practitioners in Kerala have focused on treating its effects on the gastrointestinal and respiratory systems. Practitioners also organized “immunity clinics” in the state.
But a significant problem with Ayurvedic treatments so far has been the lack of documentation on care recipients, according to Dr Rajmohan. The SACRC has filled this gap to some extent by recording observation data of people in quarantine as part of a project called “Amrutham”. Later, his “Punarjani” project followed a rehabilitation program for those who had recovered from COVID-19.
According to Dr Rajmohan, the reports are “encouraging” and have been submitted to the state government. However, they have not yet been released.
KK Shailaja, the state health minister, told this correspondent that Ayurveda had a good prognosis in the “Amrutham” and “Punarjani” projects, and that the government would release the results soon. “It is the lack of time and not the lack of intention that is delaying the release of the data,” she added.
This report was supported by a grant from Thakur Family Foundation. The foundation has not exercised any editorial control over the content of this report.
Shyama Rajagopal is a freelance journalist in Kochi. She previously worked with The Hindu as a health correspondent for 20 years.