Mixing medicines

Union Health Minister C.P. Thakur's move to introduce Indian systems of medicine into the MBBS curriculum raises a controversy.

FIRST it was Dr. Murli Manohar Joshi, the Union Minister for Human Resource Development, who bulldozed his way into the University Grants Commission (UGC) syllabus with a course in astrology. Now it is the turn of Union Minister for Health and Family Welfare C.P. Thakur to have his way with higher education - he wants to introduce a course in Ayurveda, Unani and Siddha in the MBBS curriculum. Impressed by the popularity of the Indian systems of medicine abroad, the Minister is all set to see his project through.

The move flouts medical ethics and a Supreme Court order which prohibits simultaneous practising of two systems of medicine. But that will not hinder the Minister's grandiose plans. "We are proposing wide-ranging changes in medical ethics for this," said a Health Ministry official. The Health Secretary will soon hold a meeting to evolve a consensus in this regard, the official disclosed. The government also proposes to approach the Supreme Court for a review of its judgment.

Consultations are under way with the Medical Council of India (MCI) to define the modalities of the order. In its letter dated November 30, 2000, the Ministry asked the MCI to "take necessary action to include the basic principles and concepts of Ayurveda, homoeopathy and Unani in the curriculum for MBBS students". The matter was discussed by the executive committee of the MCI on January 22 and a sub-committee was formed. "It is too important an issue to be decided by an individual; so a sub-committee consisting of two Vice-Chancellors and the principal of a medical college was formed," MCI secretary Dr. Manju Sachdeva told Frontline. The sub-committee got in touch with Vice-Chancellors and the principals of medical colleges across the country to elicit their opinion on the matter. Dr.Sachdeva said that in view of the importance of the issue, it would finally be decided only by the general body of the Council - which could take time.

Meanwhile, the Ministry of Health and Family Welfare has made necessary preparations to present the Minister's idea as part of the new health policy that will be unveiled in the monsoon session of Parliament. A meeting of State Health Ministers is scheduled to be held in New Delhi on July 12 to apprise them of the government's "look back to the roots" policy and discuss the changes proposed.

Disclosing this, C.P. Thakur told Frontline: "There is a need to sensitise students of allopathic medicine to Indian systems of medicine like Ayurveda, Unani and Siddha. We propose to include the teaching of Indian systems of medicine at the MBBS level in the All India Institute of Medical Sciences (AIIMS) on an experimental basis."

Since Dr. Thakur himself is a practising doctor, he is aware of the hiccups ahead, such as the problems that would be caused by medical ethics which prohibit the mixing of two streams of medicine by a doctor, and the Supreme Court order. "This was done to prevent quackery. But done properly, the two streams of medicine can be practised together with great results because the medicines prescribed in the Indian system do not have any side-effects", Dr. Thakur said. "We have sent a proposal to the MCI for an opinion. Once the government's proposal is finalised, the Supreme Court will be approached for a review of its judgment in this connection," he said. The plan could start unfolding by the end of this year and the Health Minister is confident of its success because as he says, "the Prime Minister himself is keenly interested in the promotion of the Indian systems of medicine."

According to Dr. Thakur, the Indian systems of medicine have a great potential but they have not been exploited to their full potential yet. Besides, there is a great demand for Indian medicines abroad. "In two-three years' time we can export medicines worth Rs.5,000 crores. The potential is such that in five years' time we can increase our export to Rs.10,000 crores," he said.

The Minister said that the government had decided to set up a medicinal plant board, which would be based in New Delhi. The board will be headed by the Health Minister and will have representatives from the agricultural and forestry sectors. It will identify areas where medicinal plants can be grown and encourage farmers to take up the cultivation of these. For instance, Dr. Thakur said farmers who grew tobacco or opium at present would be encouraged to shift to medicinal plants which would fetch them similar returns. The board would have a corpus of Rs.100 crores at its disposal, which would be utilised to strengthen the infrastructure for dissemination of knowledge, modernise units engaged in the production of Indian medicines to facilitate export, and so on. The government also intends to introduce Good Manufacturing Practice (GMP) for the standardisation of Ayurvedic medicines. At present there is no system for standardisation of medicines distributed by vaidyas and hakims. The Minister said this created a problem of credibility, which would not be there once the GMP came into effect.

The government also plans to grant more funds to the three existing Ayurvedic universities - Varanasi, Jamnagar and Jaipur - and strengthen colleges that are currently engaged in the teaching of Indian systems of medicine. The Minister feels that this stream of medicine has remained neglected by the medical fraternity. "There is great demand for our medicines in foreign countries," he said. He said that at an exhibition relating to alternative systems of medicine organised by the United Nations Health Conference in early May, in which 170 countries participated, the interest shown in the Indian system of medicines was overwhelming.

THE Minister's move has brewed a political controversy. Incensed faculty members of the AIIMS charge that they are being treated like guinea pigs. They have termed the proposal "yet another political gimmick" by the government to woo the votaries of Hindutva. "The Minister does not know what he is talking about. The two systems can never be mixed because they work on altogether different premises and different concepts," said a senior AIIMS official. Besides, the Minister cannot treat the AIIMS like his political laboratory; it is an autonomous institution created by an act of Parliament, and any changes in its basic structure would have to be approved by Parliament.

Officials of the AIIMS refer to the marathon debate in Parliament in February 1956 that led to the establishment of the institute. The then Health Minister, Rajkumari Amrit Kaur, had clearly and categorically said that the institute would teach only modern medical sciences. Replying to the suggestion by several members in the Lok Sabha on February 18, 1956 that the institute also take up the teaching of and research in Ayurveda and homoeopathy, she said: "This is an institute for the modern system of medicine and it cannot include any other system." But when several members, including Mohanlal Saksena from Lucknow-Barabanki, persisted with the demand to refer the Bill to a select committee, the Deputy Speaker had ruled: "Homoeopathy will have another institute. I am told by the Hon. Minister that similar institutions for Ayurveda have already been established elsewhere. Under these circumstances there is no purpose in referring the Bill to a select committee because it is a question of principle and policy."

Against this background, it is difficult to imagine how the Minister is going to implement his agenda. But he appears determined to go ahead. "The Director (of AIIMS) has been consulted and the process is on," said a Health Ministry official. The AIIMS administration, however, cites lack of funds to maintain the existing infrastructure and shortage of space to house its current manpower as also the fact that hazardous chemicals meant for its laboratories now lie in the corridors at great risk to people, to press the point that the idea of having more faculty members (to teach Ayurveda, Unani and Siddha) was not feasible.

The MCI too appears unsure about the proposal. "Understanding the basic principles and concepts of just one system takes so much time and effort. How will the students do it for two streams, which are based on different principles and concepts? It does not appear a very practical or feasible idea. It is more political in nature," said a senior MCI official.

THE votaries of the Indian systems of medicines, however, are delighted. "Better late than never," said a senior faculty member at the Jamia Hamdard University, where Indian systems of medicines are taught.

"This will remove prejudices about the system of medicine we practised and give us credibility. Besides, it will only be good for the patients because the two systems can actually complement each other without interfering with the line of treatment because Indian medicines have no side-effects," said Prof. Jameel Ahmad, Dean, Faculty of Unani Medicine at Jamia Hamdard. According to him and many others who think likewise, it is high time the government recognised the relevance and importance of the Indian systems of medicine and did something to promote them.