Note that this Topic Guide was produced for Debating Matters India, and looks at the issues from a specifically Indian perspective.

Alternative medicine is a major enterprise in India. In November 2009, the government’s Ministry of Health and Family Welfare announced the steps it would be taking to promote ‘Indian Systems of Medicine’ in the country, including spending Rs. 922 crore on the promotion of AYUSH (Ayurveda, Yoga & naturopathy, Unani, Siddha and Homoeopathy). Major claims have recently been made for alternative medicine – such as that Ayurveda can be used for anaemia or ano-rectal ailments, and that homeopathy can be used to prevent or cure swine flu, or to treat Aids and malaria.

In an era characterised by evidence-based science and politics, should official endorsement be given to remedies that cannot be scientifically proven? Is alternative medicine a form of quackery, which puts patients at risk? Or is the interest in alternative medicine a positive sign that we are beginning to move beyond a too-narrow approach to disease, towards recognising the more subtle relationship between mind and body and the need to find holistic cures? Do traditional medicines play an important role in preventive medicine, contributing to a more affordable and effective healthcare system than the Western medical model?

What is complementary and alternative medicine (CAM)?
Many discussions about alternative medicine today take place under the umbrella term ‘complementary and alternative medicine’ (CAM). This implies that alternative medicine should not be seen solely as something that can be used instead of conventional medicine, but can and should be used alongside it. CAM refers to treatments that differ from conventional, or ‘allopathic’, medicine – medicine based on scientific testing that is taught to medical professionals. Systems of CAM have often evolved apart from and earlier than the conventional medical approach used in the Western world. Some such systems, such as homeopathy and naturopathy, have developed in Western cultures; others, such as traditional Chinese medicine and Ayurveda, have developed outside of the West. 

Does CAM work – and if so, how?
Critics of CAM argue that the very term is problematic, giving mysticism more scientific credence than it deserves. As the editors of the prestigious Journal of the American Medical Association (JAMA) have argued: ‘there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine’. Advocates of CAM, however, argue that the lack of scientific evidence about the efficacy of CAM betrays too narrow an approach to the understanding and treatment of illness. They point to the failure of conventional medicine to cure certain serious diseases, such as cancer, and the extent to which patients suffering from these diseases can be helped by therapies like Ayurveda. They note that conventional medicine has itself moved towards a more holistic appreciation of the treatment of disease, and that some natural remedies or techniques, such as the use of quinine to treat malaria, have been adopted and accepted by practitioners of conventional medicine.

Even critics of CAM do not dispute that in many cases, alternative remedies can make patients feel better, despite not curing the disease – so isn’t this a worthwhile goal in itself? The importance of preventive medicine, including lifestyle modification, has been globally acknowledged: it is seen as better and more cost-effective to enable people to avoid physical or mental illnesses in the first place, rather than simply trying to treat the disease when it emerges. Alternative medicine, it is argued, has a crucial role to play in this. Furthermore, in a society like India, for which the affordability of healthcare is a major challenge, different models need to be sought that make the most of the country’s experience and expertise, including in the field of alternative medicine. Advocates argue that the orientation of CAM ‘towards self-healing and health promotion (salutogenesis rather than pathogenesis)’ make ‘alternative medicine approaches to chronic diseases especially attractive and affordable for the developing countries’.

The rise of CAM
One of the key aims of the government scheme the National Rural Health Mission is to ‘encourage a healthy lifestyle and alternative systems of medicine through AYUSH’. In November 2009, Chief Minister, BS Yedyurappa, told a conference that access and awareness of alternative medicines should be spread in rural areas. The officially-recognised status of alternative medicine in India is also indicated by the reach of the Indian Institute of Alternative Medicines and Indian Board of Alternative Medicines, established in 1991 by Dr.Suresh Kumar Agarwal; and the appointment of Smt. S. Jalaja IAS as secretary to the Department of AYUSH.

The growing interest in, and promotion of, alternative medicine by the political and medical authorities is not confined to India. Despite being at the forefront of advances in conventional, ‘Western’ medicine, the USA provides a significant market for traditionally Indian and Chinese remedies. Organisations such as the National Center for Complementary and Alternative Medicine contribute to the official status of alternative medicine in the USA. In the UK, a major debate took place in 2006 about whether CAM should be provided by the National Health Service (NHS). In the USA and UK, affordability of healthcare is also a key issue, raising questions about whether attachment to the Western model of medicine is appropriate even for Western societies, let alone other cultures.

A different kind of medicine?
These developments show that CAM is not an unregulated, maverick market, but is fast becoming subject to official and scientific research and regulation. Advocates of CAM argue that quacks can be weeded out by better training and standard-setting. Some also argue that criticism of alternative medicine arises from a Western bias, which distorts the facts about CAM and refuses to countenance its effectiveness. Critics, however, point to concerns about the safety of certain forms of alternative medicine. Discussions about the affordability of alternative compared to allopathic medicine lead to concerns that patients are being duped by irrational treatments that will not make them better. Shouldn’t a universal healthcare system ultimately seek to provide proven cures for illnesses, rather than taking the cheaper but less effective route of alternative medicine?