The miracle of allopathy: A response to Baba Ramdev

Allopathic medicine has deciphered the genetic code of a novel infectious agent, developed a slew of new vaccines to protect humans, tested them in large population trials, and got them to the market, in just one year

Even as the pandemic reaps a grim harvest as it rampages through the country, one of our eminent citizens has shot a volley at allopathic medicine, the branch of medicine I was trained in and which has never enjoyed as much attention in the global spotlight as in the past year. This is no ordinary citizen: He uniquely straddles the seemingly contrarian characteristics of being a top-of-his-batch holy man and, simultaneously, a business titan who has created a corporate empire peddling everything from shampoo and toothpaste to noodles and Ayurvedic medicine. A true exemplar of our national aspiration to highlight the glories of Indian tradition and entrepreneurship, neatly blended into one mesmerising creature.

A barrage of questions from such a personality deserves careful scrutiny and a thoughtful response, notwithstanding the fact that he had to withdraw some of his accusations after being chided by the health minister himself. So, on behalf of my fellow physicians who labour for years to get into medical school, then many more tedious years to soldier our way through it, and then a lifetime of trying to practise allopathic medicine, I venture to respond. The primary challenge before me is to address the questions His Holiness raises about whether our medicines can provide “permanent relief” for a range of chronic and non-communicable health conditions, notably “hypertension, migraine, diabetes, thyroid ailments, arthritis, colitis, high cholesterol, infertility and asthma”. The short answer is yes, but with some caveats.

Allopathy does not have any cures for these conditions, and never claimed to have one either. But it does have medicines and, on occasion, surgical procedures, which have transformed the lives of people afflicted by them. More importantly, by applying its scientific methods to discover the fundamental mechanisms of these health conditions, it has identified targets for preventing them altogether. There is no better example than the discovery of how tobacco use, whether smoked or chewed, directly causes a range of chronic diseases, including several cancers. Such knowledge, when applied by governments which believe in science, has actually led to the reduction in mortality rates due to these conditions. In short, allopathy is much more than a simple drug or remedy: It is the application of a scientific tradition which believes in the interaction of social determinants and behaviour with biology to explain the origins of disease and in the empirical process of testing interventions. Thanks to this tradition, people around the world can enjoy longer and healthier lives. While I personally believe that each tradition of medicine has a role to play in human health, I also know that no other system of medicine comes remotely close to these achievements.

Indeed, one can justifiably ask what contribution allopathic medicine has made in the context of the current pandemic. While, with the benefit of hindsight, we can critique some of missteps that allopathy has made over the past year, from the initial zeal to deploy ventilators to the premature announcement of the effectiveness of some medicines, it is important to acknowledge that doctors were acting in the best interests of their patients, while confronting a completely new disease and volumes of very sick individuals such as never seen before.

On the other hand, witness the true miracle of this system of medicine which deciphered the genetic code of a novel infectious agent, developed a slew of new vaccines to protect humans, tested them in large population trials, and got them to the market, in just one year! A process of translation from the lab bench to the population which usually takes a decade or more was fast-tracked in record time and, thanks to this miracle, several countries (alas, not ours) are now beginning to open up and look forward to a safer tomorrow. I would plead to His Holiness that if he truly believes that his Coronil offering is “an immunity building medicine”, which is what a vaccine also intends to do, he should conduct an empirical study to demonstrate this.

There is no doubt that the quality of medical practice in India is woefully inadequate and that irrational use of medicines is all too common. This is more painfully evident than ever in the current pandemic when, instead of promoting low-cost evidence-based approaches to manage Covid-19 infections, many doctors have prescribed expensive treatments with no benefit or used them inappropriately. As if the resulting profiteering and panic-buying as these medicines ran out of stock wasn’t bad enough, deadly secondary infections such as mucormycosis have compounded the humanitarian crisis. But, it is important to remind His Holiness that blaming allopathic medicine because some of its practitioners fall short of the mark is equivalent to damning a religion if one of its practitioners profiteered through false cures. Surely he will understand this better than anyone else.

After all, some of the products manufactured by his “world-famous beauty and health product manufacturing company” where “all the products are manufactured under his expert supervision” can now be bought in the US, but with the legal disclaimer that “statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition” and, curiously, that it “is always better to consume products after reading the labels on the products or prescribed by the physician.” With these disclaimers in mind, customers can reassuringly shop online for a wide range of products, from “100% vegetarian” distilled cow urine capsules which are an “essential supplement” to tackle the impact of a “busy schedule, skipping meals and continuous work pressures” which have “made every one weak from inside” (at the bargain cost of just 22.97US$), to a cream which offers an “instant solution for wrinkles & glowing fair skin”, a testimony to His Holiness’ commitment towards dark-skinned and old people.

In closing, however, I must admit that allopathic medicine does not in fact have any cure for the condition of “bloating amnesia”. And this is for one simple reason: No such condition exists in allopathic medicine. Indeed, while I’ve been personally afflicted at various times in my life with either “bloating” or “amnesia”, I have never known of these two phenomena, which affect the stomach and brain respectively, to co-exist as one syndrome. Like Covid-19 itself, this condition has appeared out of the blue and, if I am ever struck by this mysterious ailment, I will have to resort to one of His Holiness’s magical cures for relief.

The writer is the Pershing Square Professor of Global Health at Harvard Medical School, and a member of the Lancet Citizen’s Commission on Re-imagining India’s Health System

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