Nine out of 10 people living across India’s teeming cities and sprawling villages prefer allopathic treatment to alternative medicine, shows data from the National Sample Survey 2016. Yet India’s Ayush minister Shripad Yasso Naik spends time and money proving cow urine cures cancer, as does yoga.
Since the NDA declared Ayush — Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy – an independent ministry in November 2014, Naik has been active making groundbreaking claims about the miracles of traditional medicines and alternative therapies. With little to show for it, he stonewalls questions saying research is underway.
The good minister should not jump the gun and should talk about only clinically-tested alternative therapies because such claims have the potential to take lives. There is no doubt that plant derivates offer potent remedies in disease management. Curcumin, the active ingredient that also gives turmeric its characteristic yellow colour, for one, has a formidable array of anti-inflammatory and antioxidant properties that fight infections, inflammatory disorders such as asthma, multiple sclerosis, and inflammatory bowel disease, and some cancers. But making claims that are yet not scientifically proven may make the sick and ailing junk their prescription medication and head for the cowsheds in search of cure.
As it is, India is failing its sick multitudes in what appears to be a losing battle. Despite being a pharmacy for the world and a global destination for quality and affordable healthcare, India’s formidable ranks of doctors, nurses and paramedics are too few to treat its more than 1.2 billion population.
India has close to 960,000 doctors, 790,000 auxiliary nurse midwives, 1,800,000 nurses and midwives, and 160,000 dentists registered across the country. Given that only about 80% doctors are available at any given time – this is what Union health minister J P Nadda told the Lower House earlier this month – only 776,000 are on active duty, which makes the country’s doctor-population ratio a low 1:1,681. China’s doctor-population ratio is 1:950, UK’s is 1: 440, Sweden’s is an enviable 1:330.
Then, there is the issue of distribution of services. Though 70% of India’s population still lives in rural areas, specialised medical care is only available in and around urban hubs, which have three times more hospital beds than rural India, shows data in the annual report of Ministry of Health and Family Welfare 2015.
This mismatch in need and services leads thousands of villagers to move to cities for treatment each day, with the cost of travel, loss of employment and treatment driving 63 million into poverty each year. Already, the private sector provides 80% of outpatient and 60% of inpatient care, and with 86% of the rural India and 82% of the urban population without any health expenditure support, the out-of-pocket health spending will continue to be economically devastating for millions.
To meet this shortfall, the NDA’s draft National Health Policy (NHP) 2015 proposes to draw on traditional and alternative systems of medicine to strengthen primary care at the grassroots. Health minister Nadda has already begun including the 677,000 registered practitioners of traditional systems such as ayurveda, unani and homeopathy (AUH) in India’s health delivery system to improve the physician-population ratio to 1: 893.
Till Naik’s claims stand the test of clinical trials, alternative systems of medicines will continue to be used for primary care and disease management. There is no scientific evidence that they cure heart attacks, obstructive lung diseases, stroke and cancers that account for one in three deaths in India, reported researchers in The Lancet.
With people are living longer, the other challenge is to ensure people lead healthier lives. The top five causes of disability in India are anaemia, low back pain, major depressive disorder, lung disease and migraine, all of which can easily be prevented and managed if clinical care is available. Chronic diseases such as diabetes, lung diseases, and bone and joint disorders add to the years people live with illness, which makes disease prevention and management critical.
The way forward is to consolidate existing initiatives to make delivery efficient and work accountable. Overlapping policies and programmes – nutrition and sanitation, to name two -- run by different ministries such as health and family welfare, women and child development, water supply and sanitation, rural development, urban development, among others, need to be integrated to improve quality and reach.
Expanding health expenditure support, providing free medicines and diagnostics, promoting inexpensive generics, and strengthening primary health by engaging both public- and private-sector providers to deliver services paid for by universal health insurance will help make healthcare more inclusive.