After Dubious BGR-34 Claim, AYUSH Ministry Pushes Homeopathy for Diabetes

There is no justification for the Ministry of AYUSH’s reliance on an invalidated practice, which could lure patients of diabetes into a false sense of security.

Purchasing and consuming homeopathic medicines could lure patients into a false sense of security and divert resources, problematic when scarce, into securing means of treatment that may not work. Credit: richard_craig/Flickr, CC BY 2.0 (AYUSH)

Purchasing and consuming homeopathic medicines could lure patients into a false sense of security and divert resources, problematic when scarce, into securing means of treatment that may not work. Credit: richard_craig/Flickr, CC BY 2.0

On January 16, the Ministry of AYUSH (an acronym of Ayurveda, yoga and naturopathy, unani, siddha and homeopathy) announced a writing contest on the topic ‘Diabetic Care Through Homeopathy’, with the tagline #Homeopathy4Diabetes. Holders of BHMS degrees have been invited to submit a 300-500-word article on it by January 31, 2017, to [email protected] From the entries, the ministry has said it will shortlist five based on their “quality and popularity” for cash prizes and feature them on its Facebook page. The first prize is Rs 20,000. BHMS stands for bachelor of homeopathic medicine and surgery, equivalent to an MBBS.

Homeopathy is a widely discredited medicinal system that relies on the administration of very diluted solutions of natural or synthetic substances, with the belief that the more diluted a solution, the more potent it is. It has persisted in many parts of the world as an alternative system of medicine, often with state support in the form of national insurance – such as in Switzerland, France, the UK and Denmark, apart from India. At the same time, medical bodies from around the world have classified homeopathy as pseudoscience. Various studies and meta-studies have found that the effects of homeopathic concoctions are no better than a placebo.

In India, the Department of AYUSH was created in March 1995, under the Ministry of Health and Family Welfare, as the Department of Indian Systems of Medicine and Homeopathy (the name would be changed in 2003). In November 2014, it was given its own ministry. In the 2016 Union budget, the Ministry of AYUSH was allocated Rs 1,326.20 crore (a 17.8% hike from 2015). Despite this show of support, the ministry has never been interested in organising a large-scale critical evaluation of the systems of medicine it stands for. When faced with criticism, however, scientists on both sides of AYUSH have raised some concerns about evaluating the efficacy of these systems in the same way allopathic medicine is: through double-blind randomised clinical trials (RCTs).

In a double-blind RCT, patients who are going to receive treatment with the medication being tested are divided into two groups. One will receive the actual medication while the other will receive the placebo – though no patient will know which group they belong to. Secondly, the doctors and nurses who will be administering the medication will not know which group is receiving the real thing and which group, the imagined. This way, many biases can be eliminated while the medication’s effects can be measured by comparing how differently the two groups respond to their treatment.

Also read: UCL cancels homeopathy event by Indian docs after complaints

A double-blind RCT of this form can’t be used to test for the specific effectiveness of yoga, as a recent report from the influential Cochrane Library of Reviews showed. And Ayurveda’s case is more complex. It is hinged on the provision of holistic treatment and individual improvement – not in curing specific diseases upon application. As a result, and even if some of its tenets are rooted in astrology, Ayurveda’s rejection has been founded upon a non-empirical rejection of its diagnostic methods, while the issue of not being able to accommodate Ayurveda in procedure-based RCTs is seldom addressed. Many researchers also blame a lack of funds, not a lack of intent, in carrying this conversation forward.

At the same time, the more pronounced this divide has become over the years, the more many Ayurvedic practitioners have retreated into increasingly pseudoscientific territory.

One sign of pseudoscience is the absence of concrete evidence to back up what are being presented as concrete claims – as in the recent case of BGR-34. BGR-34 is an anti-diabetic Ayurvedic drug jointly developed by the National Botanical Research Institute and the Central Institute for Medicinal and Aromatic Plants. Its commercial production and distribution was hived off to a private company, AIMIL Pharmaceutical, even as it was endorsed by Prime Minister Narendra Modi in October 2016. However, no evidence for its purported effects has been published, either in the form of peer-reviewed publications or patents. Its researchers have also claimed that BGR-34 was approved by the Ministry of AYUSH but the law defines no basis for these approvals. They also claimed that they had conducted phase III RCTs – but using only 48 patients instead of the 500 required by the Drugs & Cosmetics Act, 1940.

On the other hand, homeopathy has been rigorously tested for with little to no evidence of its effectiveness emerging from these efforts. The Lancet published a review in 2005 that concluded thus: “Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homeopathic remedies, but strong evidence for specific effects of conventional interventions.” The Australian government’s National Health and Medical Research Council’s review in 2015 concluded that “there are no health conditions for which there is reliable evidence that homeopathy is effective” and that “homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious.”

In light of all this information, the Ministry of AYUSH is endangering the lives of those whom the entries of its writing contest will appeal to: patients of diabetes. Purchasing and consuming homeopathic medicines could lure patients into a false sense of security and divert resources, problematic when scarce, into securing means of treatment that may not work. India’s dispensing of allopathic medication is also to blame: clinic/hospital visits and medicines are often unaffordable, especially outside cities. There is also a marked shortage of qualified doctors. The World Health Organisation recommends one doctor for every 1,000 people; India has one for every 1,700, and fully four-fifths of them work in urban centres. All of this makes quacks more available to patients in rural India.

A poster accompanying the Ministry of AYUSH's writing competition announcement. Credit: Twitter

A poster accompanying the Ministry of AYUSH’s writing competition announcement. Credit: Twitter

However, none of this can justify the Ministry of AYUSH’s reliance on an invalidated practice. In fact, only five days after the competition was announced, the ministry signed a memorandum of understanding with the Advertising Standards Council of India to investigate and shut down misleading ads. In an accompanying statement, Ajit Sharan, secretary to the ministry, said, “It is yet another important step taken by the AYUSH ministry to ensure that Indian consumers have access to safe and effective medicine.” On January 16, the ministry’s announcement had been accompanied by a poster (above). Though it makes no claims as to homeopathy’s efficacy, the tagline #Homeopathy4Diabetes and the cash prizes (totalling Rs 55,000) are telling.

Where does this leave those who wish to complain against the ministry’s public endorsement of ineffective medicine?

Note: The line “Many researchers also blame a lack of funds…” was added on January 23, 2017.

  • Rohini

    there is some merit in regulating a system of medicine that is widely used by is homeopathy. Wherever its results so far, there is enough personal evidence from patients of it having workd..for w.g., for colds, nails on the feet etc. So, it cannot just be written off for ALL disease areas and of course, this dismissive approach of traditional medicines is ridiculous.

    it is interesting to note that the author relies ONLY on txt studies conducted by scientists who specialise in allopathy.
    so, rather than dismiss entire bodies of medicine based on a couple of studies, it would be more in the scientific spirit of enquiry if the author were to argue for more funds that can test such treatments across large samples using rct.
    i hope he realises that these traditional methods have no money to do the sort of trials that allopathy can afford. Therefore, without enough money being spent, no one can say for sure it does not work. Perhaps it does in many cases, perhaps not in other areas..only large scale trials will tell.
    finally, do recall the chinese lady who used traditional chinese medicinal ingredients to win a nobel in the area od malaria treatment. Do also recall that chinese medicine is regularly vilified and dismissed by western scientists and media. we are. Finally, on ayurveda, it isn’t without reason that the west wanted to patent turmeric and neem.

    • The Wire

      Agreed about the lack of money. The Current Science editorial I’ve linked to also mentions that as a leading cause. Apologies for not including it. –VM

  • Sreevals Menon MD

    The authors one sided tirade amuses me for few reasons … One that his brazenly obvious biased views being showcased by a responsible media like in spite of him being so blatently unaware about how a system like homeopathy work including its peculiarities at the level of therapeutic intervention where the individualization play a key role unlike conventional medicine where DBRCT application and its interpretation make sense due to the drug to disease application directly ! …Another being his understanding of some authorities branding homeopathy effects as placebos after their studies which were entirely designed in total contradiction with the philosophy and fundamentals of homeopathy which was due to substantiate its inefficacy ! Instead those studies which primarily was conducted by allopaths in panel which had a clearcut goal about the desired outcome when they did not even consider a single homeopath in it when there are thousand available among homeopaths worldwide who have transformed themselves from allopaths into homeopathy practise !….Yet another is again his unawareness about the major projects in homeopathy fundamental and clinical research taken up by scientists from molecular biology, nanotechnology, physiologic chemistry, high dilution research, immunology, new drug discovery etc who have come up with remarkable evidence of action of homeopatjy medicines at genomic levels, cell line and pathologentic trials and what is even special is that none among them are Homeopaths !!! This is apart from the studies conducted by Govt research councils like CCRH which has documented studies and results from those conducted at its pan India units in specific clinical conditions.

  • – Homeopathy considers Arsenic Oxide, a toxic inorganic substance to be an active healthy compound. It is not organic.
    – There are also Indian universities teaching Astrology, and American universities teaching that the Earth is 6000 years old. Doesn’t make either of them correct or scientific.

    >Homeopathic doctors of India are highly qualified to diagnose disease properly

    From my experience, they’ll ask you to drop the real medicines, and wait for 3 months as the disease runs its course.

  • >You can keep popping those sugar pills as much as you like, we set a slightly higher bar on what the State should do with public funds.

    THIS! A million times. I’m not paying my taxes for this.

  • Rohini

    “Is it so hard to realize that colds and nails on the feet are things that usually heal themselves?”
    Colds and ‘nails’ are two examples. There are many more anecdotes of people who have been helped by homeopathy – that is the reason even educated people tend to use it in preference to allopathy. The point is that these are ONLY anecdotal. Hence, there is no scientific large scale study that have proven the effectiveness of those drugs beyond doubt.
    Which is why I have been very objective in calling out the fact that unless there are large scale studies, which require huge funds, one cannot dismiss it the way the article is doing.
    “Asking to prove that a treatment does not work is like asking to prove that there is no God. So yes, no one can say for sure that it does not work and no one will *ever* be able to say that. ”
    Well..this statement is priceless. Of course the whole objective of clinical trials Phase 3 is to PROVE that a particular treatment either works or DOES not. The whole ‘there is no evidence that the treatment works’ is just statistical language that is used to say that Ho or null Hypothesis could not be rejected in favour of the new hypothesis…that’s technical jargon on DBRCTs, right?
    So, one or two tests said that on which population? and for wht disease and for which compounds? Can a few tests be extrapolated to ALL disease areas and ALL homeopathic drugs?

  • Rohini

    There is so much to refute in your ill-informed rebuts to my post, I am having to write more than one. So here goes :
    “s it so hard to realize that colds and nails on the feet are things that usually heal themselves?”
    Look up ‘colds’ and their variety. Except virals, nothing else ‘resolves on its own’.
    As for ‘nails’ – allopathic doctors always advice minor surgery to remove it.

  • Big pharma scandal? Seems a paid article. One sided and doesn’t speak the truth. Do you think 150 million Indians using homeopathy are fools? You only see what your eyes want to see. If you wanted to report neutral, you should have discussed and included some comments from scientists like Kudha Buksh or Jayesh Bellare.

  • Geeta Arora

    Ministry is not biased about any science but is trying to bring possiblity of each science to a platform where its right scope and limitations can be brought to public and people can make an informed choice.. As today conventional medicine also has its limitations and there are thousand of people suffering and many dying so govt. Is trying to explore more options to find other ways to treat lifestyle disorders, people need to be open… All these science under ayush have tremendous scope, but needs work to define scope and limitations of each

  • Rohini

    wrt to the use of arsenic as an example in homeopathy. Yes, arsenic can be dangerous at certain concentrations or over long periods of time. But, also, remember that arsenic occurs at miniscule concentrations in ordinary things like some fruit etc. In homeopathy, the dilutions are so high that it is practically the way you describe it where a molecule is hard to detect in some cases – so , if prepared correctly, arsenic is not harmful. However, if prepared incorrectly, yes, arsenic can be dangerous.
    So, since making the medicine right is important for safety, the WHO is taking things seriously and is beginning to push for regulated and standardised pharmacopaeias, Good manufacturing practices (GMP) and quality standards on TCAM medicines. This can only help the patients who want to use them. And that is the aim of the WHO.

  • The Wire
    • Rohini

      Thank you for the reference. It explains my point about the Chinese breakthrough very clearly.

  • Deepak

    As an allopathic physician turned scientist, the comments’ section should be enough preliminary evidence so as to indicate a dire need for funds for research into the efficacy of AYUSH treatment modalities. I do not appreciate belittling any of these medical systems designed with a sole purpose of healing the human body and mind. There has been an utter lack of research investigating AYUSH treatment modalities and medicines and that needs to be changed.