Union health minister Harsh Vardhan. Photo: Facebook/Harsh Vardhan.
On February 19, at a packed event at New Delhi’s Constitution Club, a company announced the publication of a clinical trial’s results and launch a new indigenously developed treatment for COVID-19 infections. Sharing the platform with the company’s two founders were two senior members of the Union cabinet, health minister Harsh Vardhan and transport minister Nitin Gadkari.
The company in question was Patanjali Ayurved; the treatment, according to the blurb, was the “first evidence-based medicine for coronavirus”, named Coronil; and the two founders were Baba Ramdev, the well-known yoga guru, and Acharya Balkrishna, the company’s managing director.
Health minister Harsh Vardhan endorsed the drug and extolled Patanjali Ayurved’s research as establishing the role of Ayurveda in an integrated holistic system of medicine.
The study itself came in for criticism for the poor quality of the science, both on social media and elsewhere. The claim that the WHO had approved Coronil was shown to be false and was later confirmed when WHO’s South East regional Office denied on Twitter that it had granted an approval.
.@WHO has not reviewed or certified the effectiveness of any traditional medicine for the treatment #COVID19.
— WHO South-East Asia (@WHOSEARO) February 19, 2021
So where does this leave India’s health minister? Was he poorly advised when he accepted Patanjali’s invitation to lend the weight of his office to what was essentially a commercial launch of a drug of questionable value by a private company? Or was he simply championing Ayurveda because he fundamentally accepts it with all the faith of a devout believer?
Before we can answer that question, we need to delve into the recent history of the close and often intertwined history of Ayurveda, Patanjali and Harsh Vardhan’s political party.
India’s ancient medicine system has always had a fraught relationship with modern medicine. Its most ardent supporters promote it as India’s gift to the health and wellbeing of the world, while the votaries of modern medicine often believe it to be little more than dangerous, pseudoscientific quackery.
But in recent years, Ayurveda has enjoyed a resurgence in the popular imagination of Hindu traditionalists in India, a rise that has coincided with the journey to preeminent political power of the right-wing Bharatiya Janata Party (BJP). A common factor behind both these trends has been one man: Baba Ramdev, and his privately held company Patanjali Ayurved, with a turnover of $1.2 billion.
According to the New York Times, Prime Minister Narendra Modi and Ramdev are close and mutually helpful. The yoga guru endorses and directs his followers to vote for the BJP, and Modi’s government in turn pursues policies that benevolent towards the Patanjali business empire.
In light if this history, it is difficult to see how the health minister could have declined to grace the occasion when Patanjali was going to announce what they believed was a coming-of-age research publication to establish Ayurveda as a research-based discipline that deserved the world’s attention.
But the Indian Medical Association took a different view. They accused Harsh Vardhan of impropriety and unethical behaviour by standing alongside Baba Ramdev and endorsing a medicinal product of unproven value. On social media, scientists and doctors expressed dismay at one of their own – Harsh Vardhan is an ENT surgeon by training – endorsing an unscientific remedy.
This was not the first time the Indian Medical Association has clashed with the health minister. They challenged him with five questions when, in October 2020, the Union health ministry published a national clinical guideline to manage COVID-19 using Ayurvedic medicines.
Earlier this year, they announced a series of rolling hunger-strikes in protest of the government’s plans to allow Ayurveda-trained doctors to perform a limited list of surgical procedures.
Harsh Vardhan of course has many roles. He is first and foremost a BJP politician and a member of Modi’s cabinet. Promoting Ayurveda, indeed any and every claim of ancient Indian scientific achievement, however implausible, is part of the DNA of the BJP.
He is also a medical doctor trained in modern medicine. But then many doctors in India subscribe to the BJP’s view that Vedic India had all the knowledge that ever mattered – rocketry, in vitro fertilisation, genetic science, you name it.
And with India being elected to chair the executive board of the World Health Organisation, Harsh Vardhan, as India’s nominee on the board (not all countries on the board nominate their Health Ministers) has international exposure. It matters therefore how he is seen by the profession and by health commentators both in India and abroad. So it is not unreasonable to expect our health minister to exercise caution in his public pronouncements.
The Ministry of Home Affairs has a ‘code of conduct’ for Central and state ministers but it says nothing about speaking at company launches and endorsing a private company’s products. As a committed member of the BJP, Vardhan can always claim a calling to promote ancient Indian systems of medicine. There may not be scientific merit in it but that does not make Ayurveda illegal. Ayurveda is entitled to sell itself on faith so long as it desists from making unsubstantiated claims that it is backed by scientific research.
There remains one last consideration: the moral case for doing the right thing and holding oneself to a higher standard of behaviour in public life.
In 2010, the then health minister Ghulam Nabi Azad issued a warning to the Indian Medical Association to desist from endorsing products marketed with dubious claims. Two officers of the association lost their Medical Council license to practice for six months when, under their leadership, the body had negotiated lucrative fees to endorse Quaker Oats, Tropicana Juice and a brand of mosquito-repelling skin lotion.
In 2016, the Union consumer affairs minister Ram Vilas Paswan considered holding celebrities liable for endorsing commercial products and companies that made false and misleading claims. Cricket star M.S. Dhoni had to end a contract with a real-estate developer on this basis.
These are just two examples where people in positions of authority, influence and power were held to account for their association with products, services or businesses of dubious quality. In the case of a medicine, the question of quality and reliability can only be assessed on the strength of the research evidence.
For the Union minister of health to publicly endorse, even if only by association, a treatment of no scientifically proven value was clearly inappropriate. Political leaders must hold themselves to a higher standard.
Dr Jammi Nagaraj Rao is a public health physician, independent researcher and epidemiologist in the UK.