Why in the News?
A recent controversy on X (Twitter) between a hepatologist and an Indian chess Grandmaster has reignited the long-standing debate over whether practitioners of traditional medicine (such as Ayurveda and Unani) can legitimately claim the title of “doctor” and prescribe modern medicine.
What are the concerns with Ayurvedic doctors prescribing modern drugs?
- Lack of scientific training: Ayurvedic doctors often lack formal training in modern pharmacology and diagnostic methods, which may result in inappropriate prescriptions. For instance, there have been cases where Ayurvedic practitioners prescribed steroids or antibiotics without understanding their side effects or dosage.
- Violation of legal norms: According to the Supreme Court judgment in Dr. Mukhtiar Chand case, non-MBBS practitioners are not permitted to prescribe allopathic medicines. However, several states have passed conflicting executive orders, creating legal ambiguity.
- Consumer deception and litigation: When Ayurvedic doctors prescribe modern drugs, patients may assume they are consulting an MBBS-qualified doctor, leading to misrepresentation. This has led to consumer lawsuits, such as a case in Delhi where the doctor’s qualification was challenged in court.
- Endangerment in critical care: Some private hospitals employ Ayurvedic doctors in emergency wards to cut costs, risking patient safety. There have been cases where treatment by BAMS doctors during emergencies led to worsened outcomes due to delayed or incorrect interventions.
- Undermining rational drug use: The unregulated prescription of allopathic drugs by Ayurvedic doctors contributes to antibiotic resistance and irrational drug use. A Uttar Pradesh health audit found significant instances where AYUSH doctors prescribed modern medicines without oversight.
How has traditional medicine regulation evolved in India?
- Establishment of AYUSH systems: Post-independence, India formally recognized traditional systems like Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH). The Department of Indian Systems of Medicine and Homeopathy (ISM&H) was established in 1995, later upgraded to the Ministry of AYUSH in 2014 to promote and regulate these practices.
- Legal and institutional frameworks: The Indian Medicine Central Council Act, 1970 set up the Central Council of Indian Medicine (CCIM) to regulate education and professional standards. This was later replaced by the National Commission for Indian System of Medicine (NCISM) under the NCISM Act, 2020, to enhance transparency and accountability.
- Integration with mainstream healthcare: Over time, traditional medicine has been increasingly integrated into public health policies, like the National Health Policy (2017), and programs such as AYUSH Health and Wellness Centresunder Ayushman Bharat. This reflects a shift toward pluralistic healthcare governance while ensuring regulation and quality control.
Why is Rule 2(ee) of the Drugs and Cosmetics Rules debated?
- Rule 2(ee) defines “registered medical practitioners” who may prescribe modern drugs. It allows State governments discretion to include non-MBBS practitioners under certain conditions. This loophole is used to let Ayurvedic and Unani doctors prescribe modern medicine.
- The Supreme Court judgment (Dr. Mukhtiar Chand case) clarified this as unconstitutional, yet many states persist. The Indian Medical Association frequently contests such misuse in courts.
What is the impact of AYUSH on public health insurance?
- Inclusion in Ayushman Bharat: The AYUSH systems have been included under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), allowing beneficiaries to access treatments in AYUSH hospitals. This expanded the coverage of services, particularly in rural and underserved areas where traditional medicine is widely trusted.
- Cost-effective care delivery: Treatments under AYUSH are often less expensive than allopathic interventions. For instance, Panchakarma therapy for lifestyle disorders or Ayurvedic treatments for arthritis are cost-efficient, thus reducing the financial burden on insurance providers and the government.
- Increased utilisation and trust: With AYUSH covered under insurance, more people are opting for traditional medicine. This has led to higher utilisation rates of AYUSH healthcare facilities and promoted medical pluralism, contributing to a broader public health reach in India.
Way forward:
- Strengthen Evidence-Based Integration: Establish an independent regulatory body for traditional medicine that ensures scientific validation, clinical trials, and safety monitoring before public endorsement or inclusion in health schemes. This helps maintain credibility and public trust.
- Depoliticise Health Governance: Formulate traditional medicine policies through expert-driven committees with representation from all health systems, free from political interference. This ensures balanced development, equitable support, and harmonised integration into the national health framework.
Mains PYQ:
[UPSC 2024] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.
Linakge: The article highlights the consequences for public health when state governments allow registered Ayurvedic and Unani practitioners to prescribe modern medicine or perform surgeries, leading to friction with modern medical associations. This question directly addresses the role of the state in the public healthcare system and enhancing its reach at the grassroots level.
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