BJP, Ayurgenomics, and the dangerous mixing of science & politics
Indian elections are insipid when it comes to debates and discussions around big, futuristic ideas. Neither political parties discuss their vision in any meaningful detail nor does the public ask for it. But a few days ago some publications picked up an exotic-sounding term, “Ayurgenomics”, from the BJP manifesto. It said:
“We will start integrated courses for Indian System of Medicine (ISM) and modern science and Ayurgenomics. We will set up institutions and launch a vigorous program to standardize and validate the Ayurvedic medicine.”
To be fair, it was The Caravan magazine that first wrote about it. Then a few others expanded on it. The attribution is important here because the term Ayurgenomics itself, which people generally relate to IGIB’s (a CSIR institute) work, was, as a trade name, registered in 2002 by Bhushan Patwardhan. Patwardhan, who first spoke about it in a review paper in 2000 and published a proof of concept in 2003, is now professor and director of the Interdisciplinary School of Health Sciences at the University of Pune. He holds the copyright on â€œAyugenomicsâ€ which was granted to him in 2005.
The two terms differ in one letter: R
What’s in a letter, one could argue. Not much, except that it reflects the precise reason why Ayurveda potential has remained only potential. (More on this in a bit.) In the absence of any national strategy or vision from AYUSH, Indian traditional medicine programmes have been wasting public money in repetitive, non-imaginative and non-productive research. (In a Current Science paper in 2012, Patwardhan discussed India’s quest for evidence-based Ayurveda.)
BJP’s stress on Ayurgenomics, which forms only a tiny part of the entire integrative system, is a bit puzzling. The term refers to unraveling if there is a genetic basis to the phenotypic classification of the Ayurvedic system of three constitutional types — Kapha, Vata, and Pitta. The ideal concept to promote would have been “Ayurvedic Biology”, as proposed by the eminent surgeon and visionary Dr MS Valiathan, also famous for developing Chitra-TTK heart valve. To pick on one foreign-sounding term and patronise a part of traditional medicine without a long-term vision will only do more harm. It again wonâ€™t come anywhere close to the rigours of modern evidence-based medicine.
My own experience in writing an article for the biomed journal Cell in 2007 was interesting. While one of the editors in the US was keen on carrying an article on curcumin, the pharmaceutically active ingredient in turmeric which has shown extremely promising results in many disease conditions, the larger editorial team was not quite convinced. Finally they carried the 3000 odd word article along with an accompanying essay on the Indian and Chinese systems of medicine by two local academics T W Corson and C M Crews.
Scepticism runs high for Ayurveda in the modern scientific world, and rightly so. Indian researchers and practitioners just havenâ€™t been able to garner the scientific evidence on how this system works. In fact, when the BJP manifesto says it’ll start integrated courses, experts must dust off their apathy and pay attention because integration in any which way will not fix the problem. As Darshan Shankar and Dr Valiathan have argued, new conceptual frameworks for models of integrating the modern and the traditional systems are needed. Ayurveda is systemic and holistic; modern medicine is theory-based and reductionist.
More than half a dozen good research institutions work in this area across the country but there’s no synergy. In the absence of a national leadership, people work in silos. Back in 2007, I remember, there was a palpable sense of excitement and optimism among researchers working with herbal medicine under CSIR’s NMITLI programme. They had several rounds of talks with the US FDA which was keen to fast track a few IND (Investigational New Drug) applications in botanical drugs, or herbal medicines as they are called in India. Indian researchers were hopeful of two polyherbals for indications in osteoarthritis and rheumatoid arthritis. For writing this blog I checked if those INDS were filed or not. A few patents were filed, but no INDs. The latter has a cost associated with it and is decidedly tougher to file. It’s have also required a close coordination with the industry which, in the absence of any serious leadership/ownership (or accountability?), it ended in a non-productive alley. As Patwardhan says, “People are interested in their [narrow] discipline and want only their disciples to prosper.”
This happens too frequently in Indian science, traditional or modern. A pertinent example that comes to mind is of Leroy Hood, president of the Institute of Systems Biology in Seattle. When I met Hood in 2008 in Hyderabad, he spoke about his 4Ps of medicine “ Predictive, Personalised, Preventive, and Participatory“ which he was vigorously championing. (The second P here corresponds with patient-oriented therapy that Ayurveda too practices.) Hood also mentioned, in passing, about his ambition to run a large Wellness project using his 4P theory. Barely five years later in March 2014 Hood started a pilot: A Hundred Person Wellness Project which will run for nine months and if shown to be working, will be expanded to cover 100,000 persons to be monitored over 25 years. With a new protocol for clinical trials — doing away with randomised and blinded features of the existing clinical trials- this project aims to control for peoples’s different genetics and environments.
Patwardhan remembers having submitted a proposal to AYUSH several years ago where he wanted to study Shat Kriya Kal, the six stages of disease progression in Ayurveda, which, he says, somewhat corresponds with what Hood is trying to do in his new study. AYUSH never showed any interest and we know where Ayurveda stands today: in critical need of evidence. Indian research publications have certainly improved– from JACM in 2005 to PNAS in 2010, but that’s a slow and modest progress.
:In my mind more CLINICAL TRIALS with well standardized Ayurvedic preparations is needed for India to make it in this business. EVIDENCE, EVIDENCE, EVIDENCE is required,” says Bharat B Aggarwal, Professor of Cancer Research and Cancer Medicine, and Chief Cytokine Research Laboratory at the University of Texas, MD Anderson Cancer Centre. An eminent scientist in the field of experimental therapeutics, Aggarwal was the first to show that curcumin can be effective in cancer treatment. His 2011 book, Healing Spices, has turned out to be a bestseller.
As BJP and Ayurgenomics engage in a public tango, it’s amusing to see how some scientists are rushing to add that even UPA I and II supported it. Clearly, science can do without party politics.
Let the new government create a national leadership institute which can plan long term studies, document them and publish in high quality journals. To think of it, why even create a new institute and waste time and resources. The new government can designate an existing one as the apex centre. How about the Institute of Ayurveda and Integrative Medicine in Bangalore? After all it has already begun integrating the two systems through its new 100-bed hospital — IAIM-Healthcare.
But here lies the rub: the hospital is an initiative of FRLHT Trust which was founded in 1993 by Darshan Shankar and Sam Pitroda and is now supported by the Tata Trust. And Pitroda is known to be close to the UPA, the Congress party to be specific.
Aggarwal says India has to go from OM (traditional) to OMICS (modern). But for that politics must be left behind.