Welcome initiative: on quality human clinical trials and using ayurveda and modern medicine

AYUSH collaboration with the Indian Council of Medical Research for scientific validation is right step

In a welcome move, the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa, and Homoeopathy (AYUSH) and the Indian Council of Medical Research (ICMR) have at last joined hands to undertake quality human clinical trials to generate evidence on the benefits of using ayurveda along with modern medicine (evidence-based medicine) in treating certain disease conditions of national importance. With its decades of experience in conducting human clinical trials, it makes eminent sense to rope in the ICMR to design and conduct these trials. To begin with, the collaboration will be restricted to ayurveda. The other systems of AYUSH — yoga, unani, siddha and homoeopathy — may be included, and each system will be tested together with modern medicine when the central councils of the respective AYUSH systems are ready to work with the ICMR. An expert committee will soon decide the area/disease conditions to be included for detailed clinical testing using both ayurveda and modern medicine. Initially, clinical trials for each disease may have two arms — modern medicine as the standard of care as well as a combination of modern medicine and ayurveda. The arm that uses both ayurveda and modern medicine will, if at all, only be able to validate the superiority of combining the two for better outcomes. Scientific validation of superior outcomes of combined therapy using ayurveda and modern medicine will form the basis on which integrated medicine will be offered to patients. Encouraging trial outcomes might probably serve as a starting point to undertake further trials using ayurveda interventions alone to evaluate their effectiveness and understand the mechanism of action; this is currently not within the ambit of the agreement.

While the initiative may right away not provide scientific validation of ayurveda interventions in treating disease conditions when used singularly, it is the first major step in evidence-based approach of validating medical interventions. Though trials using ayurveda and other systems of AYUSH have been conducted in the country, they suffer from major limitations, thus making the outcomes meaningless. The ICMR’s expertise is sure to help in overcoming the major obstacle in scientific validation, which all systems of AYUSH currently suffer from. Evidence, as the practitioners of AYUSH refer to, is nothing but anecdotal, which is not an alternative to evidence-based approach. Lack of scientific validation, as a stand-alone intervention or as adjunct to modern medicine, has been the bane of alternative medicine in India. No sincere, large-scale attempts have been made to address this serious shortcoming. The collaboration with the ICMR is, therefore, a step in the right direction.