India needs evidence-based, ethics-driven medicine

India needs evidence-based, ethics-driven medicine

News: The recent push to integrate ‘AYUSH’ medicinal systems into mainstream health care to achieve universal health coverage and ‘decolonize medicine’ is a pluralistic approach that would require every participating system to meet basic safety and efficacy standards.

Note – The editorial focuses on Homeopathy in general.

What is Ayush?
• It refers to Traditional & Non-Conventional Systems of Health Care and Healing which Include Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy.
• They are known for their diversity, flexibility; accessibility; affordability, a broad acceptance by a large section of the general public.
• Comparatively lesser cost and growing economic value and their potential to make them providers of healthcare that the large sections of our people need.

What are issues related to safety and efficacy of Homeopathy?
• Evidence on homeopathy’s efficacy is weak.
• Double-blind randomized controlled trial (RCT), the Nuremberg Salt Test (1835), noted that the symptoms or changes which the homeopaths claimed to observe as an effect of their medicines were the fruit of imagination, self-deception and preconceived opinion.
• Multiple systematic reviews and meta-analyses found that, across ailments, population groups (adults versus children), study types (placebo-controlled versus other trial types), and treatment regimes (individualized versus non-individualised) Homeopathic treatments lack clinically significant effects.
• Researchers demonstrated that more than half of the 193 homeopathic trials in the last two decades were not registered. Unregistered trials showed some evidence of efficacy but registered trials did not.
• There was reporting bias and other problematic practices, throwing the validity and reliability of evidence thus generated into doubt.
• The World Health Organization (WHO) has warned against homeopathic treatments for HIV, tuberculosis, and malaria, flu and diarrhoea in infants It has “no place” in their treatment.

Way Forward
• India’s path to universal health care must be grounded in evidence based and ethics driven medicine.
• The argument to reject homoeopathy is not just based on its coloniality, but mostly on the lack of evidence for efficacy
• All medicine practices should update themselves based on growing scientific evidence.