and Alternative Medicine to Enhance. Communication With Their Patients acupuncture, and alternative medicine in general were …
COVER STORY
Have you ever taken a teaspoon of ginger juice with honey or sipped a honey-pepper mixture for common cold Has someone ever asked you to try simple rice preparations to calm an upset stomach or have a nice massage? If so, then you have had some experience with alternative medicine In India, one might not think twice about taking a glass of turmeric milk or indulging in a relaxing massage, as these and other practices have always been a part of healthcare in India since decades This article offers an insight into the market trends and future of alternative therapeutic systems
30 Modern Pharmaceuticals December 2006 - January 2007
COVER STORY
Kavita Tate
lternative medicine, as the name suggests, describes health products, practices and approaches that are not a part of conventional medicine Many patients and healthcare practitioners use alternative treatments together with traditional therapies to complement them Therefore, this field of healthcare is often referred to
as complementary and alternative medicine CAM Further, the list of once alternative healing practices - accepted by conventional medicine - changes frequently, as new therapies and treatments are found to be effective This makes alternative medicine an expanding as well as a booming business
A
Alternative therapies
The National Center for Complementary and Alternative Medicine NCCAM, established by the National Institutes of Health NIH has grouped CAM practices into five major domains that include alternative medicine systems Examples of alternative medical systems include eastern medicine, ayurveda, homeopathy, naturopathy, unani, siddha, and yoga, among others The segment also includes biologically based treatments that rely on substances found in nature, including foods and herbs Herbal therapies made from a plant or a combination of plants often comes in the form of tea, capsules, and extracts
On the popularity front
Traditional medical systems that were once considered obscure,
esoteric and shrouded in mysticism are being integrated into mainstream healthcare as complementary systems Opines Dr Ashok D B Vaidya, chairman - medicinal plants ayurved committee, PHARMEXCIL and director, Bhavans SPARC,
Alternative medicines are now emerging as a mainstream self-care for health The emerging popularity of traditional systems of medicine is essentially due to the hazards of the blockbuster chemical drugs and also the prohibitive costs of high-tech medicine In the developing world, 80 per cent of the people rely on traditional systems of medicine Evidence-based ayurveda is certainly emerging as a reliable path to stay healthy and also mitigate chronic diseases He further adds that the technology of ayurveda and traditional Chinese medicine is attractive due to the innate simplicity, cultural appeal and affordability Bias towards allopathic medicines disillusioned even the developed countries as one in three Americans consult a practitioner of alternative medicine and
pays out-of-pocket This has given rise to growing concern amongst consumers regarding their wellness regimes Coupled with this is the growing need for information education in this era of free knowledge Herbal remedies, with their scientific backing, freedom from side effects and the preventive rather than curative approach, is hence fast gaining popularity amongst customers worldwide today, says Dr S K Mitra, executive director, research technical services, The Himalaya Drug Company According to Dr Vijay H Vaishnav, professor head, Materia Medica department, Smt CMP Homoeopathic Medical College honorary physician, Shree Mumbadevi Homeopathic Hospital, since the last decade, alternative medicines like homoeopathy have become popular This is because patients have seen the results of the treatment In the past, practitioners of most alternative medical therapies like ayurveda and homoeopathy were laypersons who had heard about these systems and dabbled in them as a hobby However, with
institutionalised training, the practitioners are now qualified doctors who have undergone similar training
as MBBS doctors Even practitioners of modern medicine have realised the scope of homoeopathy and have started referring many of their cases to us, adds Dr Vaishnav Speaking about the popularity of homeopathy in the country, Dr Akshay Batra, deputy managing director, Dr Batras Positive Health Clinics Pvt Ltd says, In India, the pharmaceutical industry witnesses an annual growth rate of 5 per cent annually,
while homeopathy is growing at a steady rate of 25 per cent every year This indicates an upsurge in the homeopathic system of medicine in the country The prime reason for popularity of homeopathy is that there are no side effects, when it comes to homeopathic treatment Further, today there is scientific backing to alternative system of medicine that was lacking earlier He further adds that there are several molecular, scientific among others which prove the efficacy of the
system as being transparent Also, lifestyle diseases like diabetes and psychosomatic diseases are on
The emerging popularity of traditional systems of medicine is essentially due to the hazards of the blockbuster chemical drugs and also the prohibitive costs of high-tech medicine
Dr Ashok D B Vaidya chairman - medicinal plants ayurved committee, PHARMEXCIL and director, Bhavans SPARC
Modern Pharmaceuticals December 2006 - January 2007 31
COVER STORY
At present the herbal healthcare market is valued at 65 billion globally and the export market for the same is growing at 15-18 per cent per annum In India alone the ayurvedic/herbal business is estimated at 1 billion
Dr S K Mitra executive director, research technical services, The Himalaya Drug Company
the rise and homeopathy works wonders in such cases It is safe for children as it is noninvasive and does not involve any surgery, operation or injections founder of homoeopathy, allopathy meant treatment based on no fixed
principles If one studies the history of medicine from ancient times, he would realise that there were no fixed principle on which treatment was based However, homeopathy in simple terms means, any substance that can produce a set of signs symptoms in a healthy person can be used to cure a similar set of signs symptoms in a diseased person Elaborating further about the difference in approach to the homeopathic and allopathic treatments, Dr Batra says, Allopathy suppresses the symptoms of a disease or ailment and homeopathy believes in treating an ailment from its roots Here, we treat the entire body as a single unit unlike allopathy that treats by isolating the ailing part of your body Homoeopaths do not treat physical, emotional and mental illnesses separately, but regard them as intimately connected Conventional medicine is organ specific, hence ophthalmologists, cardiologists, nephrologists, neurologists, etc Alternative medicine, without exception, considers each person as a
unique individual and uses a holistic approach in treatment Commenting on the difference in dosage and form of medicines, Dr Vaishnav says, The homeopathic medicines are in a dynamic, molecular form compared to the quantity of medicines in milligrams in allopathy and grams in ayurveda Ayurveda uses substances in their crude form Even the dosage is different The quantity of action necessary to bring about a change is the least possible Hence the amount of medicine administered to the diseased individual should be just enough to arouse a reaction in the patient Thus, the homoeopath gives the minimum dose with the least repetition This helps in avoiding unnecessary aggravations during therapy Further, conventional medicine believes in aggressive intervention to treat disease and prefers quick fixes Alternative medicine believes in gentle, long-term support to enable our own innate powers to do the healing
Its different
While conventional medicine is preferred in the treatment of trauma
and emergencies, alternative medicine excels in the treatment of chronic disease Further, conventional medicine focusses on the relief of symptoms and rarely places emphasis on prevention or the treatment of the cause of a disorder, majority of alternative systems, strive to find and treat the cause of a disorder and frown on covering up the symptoms Alternative therapies are also much more focussed on prevention Explaining the difference, Dr Vaidya says that alternative medicine systems are based on the culture-centred holistic philosophy of the nature of man Allopathy is often bogged down by the dominance of material and reductionism paradigm Health and disease can never be totally understood merely at the cellular and molecular levels The suffering of the entire human body, mind and spirit has to be addressed The psychosocial and spiritual dimensions are very essential for the well- being and lasting cures of disease of man According to Dr Vaishnav, if one goes by an early
definition of allopathy, a term coined by Dr Samuel Hahnemman, the
A global trend
Not long ago most alternative medical practices were considered bizarre They were denounced by the medical establishment and not accepted by the public But as people across the globe travelled and read about alternative healing practices in other countries, and as immigrants practised their medical traditions abroad, the public and the medical establishment have started taking a serious look at alternative medicines While people have experimented with some alternative practices, researchers have studied their usefulness It is estimated by the Harvard Medical School, that one out of every two persons in the US between the ages of 35 and 49 years used at least one alternative therapy in 1997 That is a growth of 473 per cent since 1990 The trend to alternative medicine is repeated throughout western society In Australia, 57 per cent of the population then used some form of alternative medicine, 46 per cent
in Germany, and 49 per cent in France The growth of some types of alternative medicine is indeed astounding Between 1991 and 1997 the use of herbal medicines in the US grew by 380 per cent and the use of vitamin therapy by 130 per cent Today, in the US, the homeopathic drug market has become a multimillion-dollar industry In France, 40 per cent of the people use homeopathy and 39 per cent of the physicians prescribe homeopathic medicine In England , the royal family prefers homeopathy; it is included in the National Health Scheme NHS; over 40 per cent of
32
Modern Pharmaceuticals December 2006 - January 2007
COVER STORY
physicians in France use homeopathy on their patients A survey conducted in India also showed that 40 per cent of Indians believe in homeopathy and use it to address their health concerns, says Dr Batra Peoples perception of health is changing dramatically Consumers are exploring ways to maintain both topical and internal wellness through treatments, which are
natural, safe and have no side effects This attitudinal shift is actually a global trend Moreover, since a lot of health problems stem from hectic lifestyles or unhealthy diets, one need medicinal options, which can help control his stress level, build his immunity and maintain overall health Ayurvedic science offers treatments that promote health and wellness, and is therefore becoming very popular with people across the world This has given rise to a sizeable shift in market trends with ayurvedic treatments gaining in popularity not just amongst NRIs but also the foreign consumers In fact, at present the herbal healthcare market is valued at 65 billion globally and the export market for the same is growing at 15-18 per cent per annum In India alone, the ayurvedic/herbal business is estimated at 1 billion, says Dr Mitra
as herbo-minerals, need to be properly detoxified in advanced laboratories It is advisable to launch these products in the market only after extensive clinical
research, which is a standard norm at Himalaya When it comes to homeopathy, the laboratory combines contemporary advanced technology with indigenous know-how and needs Need based micromodular approach has led to establishment of germ-plasm, seed-bank, a bank for back potency for nosodes homoeopathic bio-therapeutic agents, reference standard specimen bank for use in thin layer chromatography TLC, gas liquid chromatography GLC, high pressure liquid chromatography HPLC, ultra-violet, infra-red and atomic absorption studies UV, IR, AAS, pharmacological evaluation and screening As a result of continuous strenuous working of the Homoeopathic Pharmacopoeia Laboratory for laying down standards for identifying and testing of homoeopathic medicines, the Ministry of Health Family Welfare, Government of India has published eight volumes of Homoeopathic Pharmacopoeia of India HPI containing 180 monographs, says Dr Vaishnav
to the stringent norms and regulations laid down by the respective
health authorities, says Dr Mitra For the regulatory guidelines
RD
Ayurveda has a long history of several tests for the quality, safety and efficacy of the diverse modalities of management of a patient The criteria are not equivalent to those currently prevalent for the chemical drugs For natural and ayurvedic drugs there are official pharmacopoeial standards for manufacturing, heavy metals, microbes, etc These are being continuously refined Opines Dr Mitra, Manufacturing norms and processes are extremely strict for the production of ayurvedic medicine One has to adhere to quality standards as per the guidelines laid down by modern science The metals used in herbal medicine, classified
Regulatory compliance
The department of AYUSH is the stipulated regulatory body for the ayurvedic industry Moreover, when companies export their products to other countries, they are required to conform to strict international guidelines including those prescribed by the WHO Himalaya exports to over 70
countries including the US where it follows the regulations laid down by the US Pharmacopeia, Singapore follows guidelines of the HSA, the Health Sciences Authority of Singapore, Malaysia, Switzerland, Middle East, Russia and many others In each of these export markets, Himalaya conforms
for homeopathy, the Homoeopathic Pharmacopoeia Laboratory, Ghaziabad was set up as a national laboratory for the purpose of laying down standards and testing for identity, purity and quality of homoeopathic medicines It is recognised as a scientific technological institution by the department of science technology Standards of homoeopathic drugs are covered under second schedule of the Drugs and Cosmetics Act, 1940 DC Standards as worked out by the laboratory and approved by the Homoeopathic Pharmacopoeia Committee are published in the form of Homoeopathic Pharmacopoeia of India HPI Explaining the regulatory compliance for homeopathic medicines in India, Dr Batra says that all the homeopathic
medicinal preparations have to be as per the guidelines in HPI There are separate manufacturing guidelines set by every state Food and Drugs Administration FDA Further, DCGI has its own guidelines for the homeopathic preparations So, there are stringent quality norms laid down for manufacturing homeopathic medicines
Even practitioners of modern medicine have realised the scope of homoeopathy and have started referring many of their cases to us
Dr Vijay H Vaishnav professor head, Materia Medica department, Smt CMP Homoeopathic Medical College honorary physician, Shree Mumbadevi Homeopathic Hospital
Modern Pharmaceuticals December 2006 - January 2007 33
COVER STORY
In England , the royal family prefers homeopathy; it is included in the National Health Scheme NHS; over 40 per cent of physicians in France use homeopathy on their patients
Dr Akshay Batra deputy managing director, Dr Batras Positive Health Clinics Pvt Ltd Retail marketing
With growing consumer interest in this stream
of medicine, the need to make it readily available and accessible to the consumer is now paramount An important aspect of this lies in the proper retailing of herbal products Modern retail formats rest on experiential marketing, a concept, which fits well with the changing perceptions attitude of the modern urban consumer The reasons for this attitudinal shift within retail can be attributed to the increase in consumer consciousness and change in lifestyle Increase in purchasing power, more cross-border travel experiences resulting in greater exposure, desire to make informed purchases and evolving tastes have all contributed to this awareness People want to have a conducive shopping environment, where they can look at the product, read up on it, interact with trained personnel get more information and finally be assured of quality and authenticity of the product Particularly, in matters relating to health, consumers want to take greater control of the decision to purchase a product,
feels Dr Mitra The Himalaya retail stores, with their warm ambience, attractive display of products, in-house doctors and electronically linked CRM cells equipped to answer a customers every query meets the need for experiential marketing, its modern format appealing to the sensibility of the scientifically inclined consumer The concept and method of marketing pharma products has undergone a drastic change in the past few years- from being a virtually ignored sector to one that is fast catching the attention of the industry at large Corporates recognise the immense growth potential and opportunities within pharma/ayurveda retailing Moreover, several companies foraying into this segment either have previous experience within healthcare or retail and extension into this extremely lucrative market segment seems a natural extension of their business model Himalaya has its own chain of exclusive outlets to keep pace with the surge in pharma retailing These stores showcase Himalayas
head-to-heel range of herbal solutions in both the personal care as well as the pharma range At present, Himalaya has 105 exclusive stores Himalaya products are also present across 600 multi-branded shopin-shops or SSs across the country as well as departmental stores and chemists These exclusive outlets help Himalaya reach out to consumers on a personal level, educate and inform them about the products and help instil in them a faith in scientific ayurveda before they buy the products, adds Dr Mitra research at the interface of ayurveda and life sciences, viz, ayurgenomics, cellular ayurveda, molecular pharmacology and ayusoft will revolutionise and accelerate this process of intergration Homeopathy has a limited scope in cases of emergency, mechanical ailments, accidents, or hernea that requires the rupture of the vessel Notes Dr Vaishnav, All systems of medicines have their scope as well as limitations Homoeopathy is a medical therapy and all purely surgical conditions are outside
the scope Malignancies, myocardial infarctions and AIDS are diseases where homoeopathy has a limited scope
Challenges faced
The biggest challenge in practicing alternative medicine is that the patients feel alternative medicine is a panacea for all their diseases Unfortunately, they literally believe it is an alternative therapy and not the initial therapy Therefore, by the time the patient goes to an alternative therapist, the disease progresses beyond the scope of cure Agrees Dr Vaishnav, A big challenge is the hostility that one faces from allopathic practitioners We have not faced this in Mumbai, but my colleagues and friends who are practising in small towns have had to bear the brunt of their ill will This is because the allopathic practitioners are unaware of what homoeopathy is unlike a homoeopath, who has been through the same training as an allopath and knows all about the scope and limitations of allopathy Since the allopaths do not understand the principles of treatment
in homoeopathy, they reject it The experts feel that the challenges faced by the alternative medicine practitioners are based on their inadequate education in the basic sciences and life sciences While side effects of conventional medicine and efficiency of plant-derived drugs have increased scientific interest in
Limitations in the system
Explains Dr Vaidya, The limitations of any system of medicine are the faulty worldviews of the human organism The anecdote of the blind and the lame can be applied Ayurveda is lame without the foundations of modern life sciences and diagnostic organ specificity Allopathy is blind without the concepts of prakriti, pragnyaparadha and panchkarma/rasayanas The disciplines of
34
Modern Pharmaceuticals December 2006 - January 2007
COVER STORY
medicinal plants, assurance of safety, quality and efficacy of medicinal plants and herbal products are key issues that need to be addressed, say researchers Notes Dr Mitra, The major challenges for alternative
medicine and therapies are absence of standard regulations that translates into self-regulation by players, absence of proactive government efforts to promote ayurveda internationally as is the case with TCM and presence of too many unorganised players Therefore, the need of the hour is government regulations for alternative practices
Combination therapy
Globally, healthcare is moving towards an integration of complementary and alternative medicine with allopathic medicine For certain ailments herbal medicines work better while for others one needs to rely on allopathic medicines The combination of alternative and conventional medicine has to be evolved systematically and judiciously Any hotch-potch admixture would be quite counter-productive The undergraduate medical students have to learn the diagnosis and management has to carefully study ayurvedic/allopathic pharmacoepidemiology There has to be an openness and humility to learn mutually by the practitioners of both the systems
Only then will an integrative medical care system arise, complimenting the best healing modalities from relevant systems, says Dr Vaidya Seconds Dr Vaishnav, At the outset, I wish to state that there is no harm in taking both allopathic and homoeopathic medicines together There are no issues of drug reactions/inter-actions as both act on different planes If a patient of hypertension or diabetes comes to me for treatment, it would be foolish on my part to suddenly stop his anti-hypertensive or anti-diabetes treatment And it could be suicidal for the patient to do so on his own I would begin homoeopathic treatment without discontinuing the allopathic medicines and gradually taper off the dose so that over a period of time, he would have shifted to a purely homoeopathic therapy The biggest problem that we come across includes patients who are on corticosteriods These patients take a longer time to respond to homoeopathic treatment Dr Batra feels that every medicine system has its own plus
and minus points that work for or against it So, one should not treat alternative therapies and allopathy in isolation For example, double blind trial conducted in Athens for diabetic patients, showed that the percentage of improvement among the patients who were given the combination therapy of allopathy with homeopathy was 94 per cent as against the 50 per cent in the patients who were treated solely by allopathic medication Further, it has been proved that the recovery time is cut down to half after surgery, when patients are given the homeopathic treatment
modes of treatment grows amongst the people and the allopathic doctors, there will be a further shift in the percentage of patients who opt for alternative medicine The media, both print and electronic, have contributed a lot towards the growth of alternative medicine People also search on the internet for alternative therapies as they hunt for answers for their diseases, says Dr Vaishnav Moreover, since a lot of our health
problems stem from our hectic lifestyles or unhealthy diets, we need medicinal options, which can help control our stress level, build our immunity and maintain overall health Ayurvedic science offers treatments that promote health and wellness and is therefore becoming very popular with people across the world Gradually, government and regulatory bodies across the world are recognising the immense potential as well as the benefits of this system of medicine and integrating it with the allopathic system Himalayas products, for example, are endorsed by over 2,50,000 doctors around the globe, opines Dr Mitra Alternative and complementary adjectives of medicine will vanish A universal medicine will emerge integrating the best of the theory and practice of all the systems of health
Conclusion
While there is little doubt that allopathic medicine works well in the case of trauma and emergency, it is much less effective when it comes to prevention, chronic disease, and in addressing the
mental, emotional, and spiritual needs of an individual These are precisely the areas where alternative medicine excels After all, traditional Indian medicine has a 5000-year-old history and has been used by millions, while modern medicine is merely 150 years old Although traditional medicines cannot replace modern medicine as far as diagnosis, investigation and emergency care are concerned, certain alternative systems which focus on overall health, have shown remarkable and swift results even in chronic illnesses like diabetes, leucoderma, cancer as well as hard to cure diseases like arthritis, asthma and even AIDS
The way forward
In a developing country like India, alternative therapeutic systems have a definite role to play in alleviating sickness, both chronic and acute The costeffectiveness, efficacy, low toxicity, ease of administration and relative safety few adverse effects renders them invaluable as viable alternatives to conventional medicine In fact, the World Health
Organisation WHO has assessed the total world market for alternative medicine at a whopping Rs 51,210 crore The market for herbal remedies alone is pegged at 5 trillion with an annual growth of 11 per cent I see a bright future for alternative medicine As the awareness about the other
Modern Pharmaceuticals December 2006 - January 2007
35
Source:drvaishnav.com
