Where Pseudoscience Is Spreading
The balance between modern medicine and traditional treatments is shifting in the wrong direction in India.
Soon after the Bollywood superstar Amitabh Bachchan tweeted that he had tested positive for COVID-19 and been admitted to a Mumbai hospital, the authorities declared his palatial residence in India’s business capital a “containment zone,” and several members of the Bachchan family were announced to have also tested positive. Bachchan is one of the world’s most recognizable actors, a celebrity with no peer in India, and his health was an issue of national concern. Ultimately, his case was a light one, and he was eventually discharged, allowed to quarantine at home.
Yet while the narrow facts of his case appear straightforward, the episode nevertheless spotlights a much broader problem in India: Its coronavirus caseload appears to only be worsening, hamstrung by decades of underinvestment in public health, poor medical infrastructure, and, more recently, a troubling official tolerance of pseudoscience, as well as a growing politicization of health care.
The mere fact that Bachchan tested positive—that he was tested at all—will focus minds in India on the coronavirus pandemic, which has been slowly but surely gathering pace in the country. More than 1.8 million people have so far tested positive, upwards of 48,000 are known to have died of COVID-19, and infections show little sign of abating. Arguably India’s most recognizable celebrity, Bachchan has starred in movies for decades, as have his wife, son, and daughter-in-law, and his high-profile announcement may spur many who were skeptical of getting tested to do so (if they are able) and to take greater precautions: He is quite literally cinematic royalty, some combination of Tom Hanks and Prince Charles (both of whose diagnoses made the virus very real for Americans and Britons, respectively).
Bachchan’s diagnosis is markedly different from Hanks’s (though perhaps not so much Charles’s) in one significant respect, however: In the months leading up to his infection, including during India’s draconian lockdown, the Bollywood star promoted homeopathic and pseudoscientific remedies for the coronavirus. His comments on the subject attracted the ire of medical experts on social media, where he was mocked for being anti-science and for potentially, given his outsize influence (he has nearly 80 million followers on Twitter and Facebook combined), encouraging other Indians to turn away from modern medicine in search of treatments for COVID-19.
Still, pointing the finger solely at Bachchan—who deleted some of his posts but nevertheless tapped into the issue of the use of long-standing alternative medicines—for publicizing these practices risks missing both their complex historical and political context and the more urgent problem of the Indian government’s willingness to suggest that so-called traditional medicine can address the coronavirus.
Alternative and traditional medicines exist on the same spectrum of treatments, and India is not unique in its use of them. Many countries that trace their history to ancient civilizations allow systems of treatment rooted in those bygone eras to be practiced today. Traditional Chinese medicine dates to about 3,000 years ago, whereas India’s own Ayurvedic tradition stretches back more than 5,000 years. These traditional systems have made significant contributions to modern medicine. Ancient Egypt, for example, is known to have influenced the Greek physician Hippocrates of Kos—considered the father of modern Western medicine, and the person after whom the Hippocratic oath was named. Ancient Egyptians used dried myrtle leaves to treat aches and pains and Hippocrates prescribed an extract of willow bark for fevers long before European scientists synthesized the active ingredient in both, salicylic acid. That helped lead to the development of one of the oldest, most effective scientifically proven drugs in human history, one that continues to be a popular pharmaceutical product today: aspirin.
And though traditional medicines have often been caricatured in the West as fringe or universally harmful, many countries—with the support of the World Health Organization—continue to use them. In a 2019 report, the WHO said that 179 countries (nearly 90 percent of its member states) acknowledged relying on traditional medicine in some form. Back in 2014, it outlined a strategy to help nations validate these practices. “Traditional medicine is an important and often-underestimated part of health care,” Margaret Chan, the organization’s then–director general, said at the time. “It is found in almost every country in the world and the demand for its services is increasing.” The strategy sought to formulate clearly defined national policies that ensured safety, quality, and regulation. The WHO would help countries develop standards that validated traditional remedies while integrating them with modern medicine, seeing them as affordable, low-tech interventions in underserved areas.
India offers an example of precisely this integration. Whereas homeopathy and traditional medicine are sometimes seen from afar as hawked in the shadows, in India they have offered an antidote to the rising cost of health care and the severe shortage of treatment facilities in rural and semi-urban areas. In the mid-’90s, India’s government formed a department within the health ministry to regulate traditional medicine, including homeopathy. (Though often lumped in with traditional remedies and associated most closely with India, homeopathy was in fact founded by the German physician Samuel Hahnemann in the 18th century, and introduced in India, then a British colony, by a doctor, John Martin Honigberger. It was legalized in 1948 and had backing from intellectual giants such as Rabindranath Tagore and Mahatma Gandhi.) In all, six different types of traditional medicine are institutionalized in India, and taught in more than 500 medical colleges. As of January 2018, nearly 800,000 traditional-medicine doctors were registered with the health ministry, compared with 1.1 million allopathic doctors. Even Indian medical professionals trained in Western-style programs will often prescribe homeopathic treatments, illustrating how bound together traditional and modern medicine can be in the country.
Yet in my 17 years covering health and science in India, including as health editor of the Hindu newspaper, I’ve seen good-faith attempts at reviving traditional medicine get overtaken by Hindu nationalist rhetoric of restoring India to some past glory. With that, opportunities to prove the credibility of traditional medicines, and use them as affordable medical interventions in India’s villages, have been lost. In the years since Prime Minister Narendra Modi and his Hindu nationalist Bharatiya Janata Party came to power in 2014, a system based around modern science, with traditional branches of medicine serving limited and supplementary roles, has markedly shifted, leaving little room for scientific temper. Ministers in Modi’s government have repeatedly proclaimed the superiority of Indian systems over modern medicine; the department overseeing traditional treatments has been upgraded to a full ministry; and godmen running multibillion-dollar empires sell unproven Ayurvedic products. The authorities have tolerated, if not encouraged, unscientific thinking, and made a virtue of anti-intellectualism. And they have more actively linked traditional medicine with religiosity, aiming to reclaim yoga’s Hindu provenance and using traditional systems as a vehicle for promotion of a Hindu nationalist ideology.
Even in normal times, these would be troubling developments, particularly in a country that spends far less than the recommended proportion of its GDP on health care, and where several diseases that have largely been defeated elsewhere remain prevalent. Faced, however, with a pandemic in which tens of thousands have already died in India alone, with little sign of the pace of infection abating, this science denialism is having a profound effect.
Take, for example, the reorganization of the government apparatus: Within three months of becoming prime minister, Modi transformed the department in the health ministry responsible for traditional medicine into a full-fledged ministry, the Ministry of Ayurveda, Yoga, Unani, Siddha, and Homeopathy, or AYUSH. One of its first decisions—shelved after uproar in the medical community—was to permit AYUSH doctors to conduct noninvasive abortions. In 2018, the government proposed (and later enacted) laws allowing certified AYUSH practitioners to prescribe allopathic medicines after a newly approved six month “bridge course” in modern medicine. Ostensibly done to address India’s doctor shortage, experts nevertheless worry that the new system might create a generation of quacks.
Then came COVID-19. On January 29, the day before India reported its first confirmed case of the coronavirus, the AYUSH ministry issued a health advisory recommending the homeopathic medicine Arsenicum Album 30 as a prophylactic to prevent contraction of the virus. In the northern state of Punjab, the ministry has been actively distributing the same treatment. Lower-level administrators loyal to Modi’s BJP have taken a similar tack. In May, when Mumbai was in the beginnings of a worsening COVID-19 crisis, two BJP officials in the city gave out thousands of bottles of homeopathic pills in their respective districts. Similar actions have been reported elsewhere in India, including in states such as Telangana, Uttarakhand, Tamil Nadu, Odisha, and Karnataka.
Other forms of traditional and nonscientific treatments have also been promoted. One BJP activist was arrested when someone fell ill after attending a party he organized in March that reportedly advocated the drinking of cow urine as a treatment for the coronavirus. And despite recommendations from the WHO to the contrary, the Modi government has revised its national guidelines to recommend hydroxychloroquine as a preventive medication for asymptomatic health-care workers, frontline staff working in coronavirus containment zones, and some paramilitary and police personnel.
This embrace of traditional—and untested—treatments is evident in the private sector too. In June, as coronavirus cases spiked, Baba Ramdev, an instantly recognizable face in India who has made a fortune selling health supplements, launched what he claimed was an Ayurvedic cure for the coronavirus. The AYUSH ministry issued a statement within hours, urging Ramdev’s company to stop advertising the product until its claims were verified by the authorities. Yet the ministry nevertheless permitted the company to continue selling the product, as long as it is advertised as an immunity booster and not a cure. The drug is currently on sale, despite the company facing legal action over it. (Ramdev is himself linked to Modi: In 2017, a Reuters investigation found that the godman’s company had received more than $46 million worth of discounts in land acquisitions in BJP-controlled states.) Ramdev’s company is by no means alone in these respects: The Advertising Standards Council of India found nearly 50 campaigns by Ayurvedic and homeopathic drug makers offering cures for COVID-19 in April alone. Modi’s government has yet to take action against them.
Just as India’s use of traditional and alternative treatments is not unique, neither is the use of misinformation by Indian faith leaders and right-wing politicians. India, Brazil, and the United States—all led by populist leaders who have dismissed the severity of the pandemic, resisted wearing masks, and engaged in science denialism—collectively account for nearly half of global coronavirus infections. Brazilian President Jair Bolsonaro and President Donald Trump have both supported anti-lockdown protesters, even as the virus has hit public-health infrastructure. It is not a coincidence that the pandemic infection curve is showing no signs of flattening in these nations.
As health services across India have struggled to deal with the coronavirus—hamstrung by limited testing, too few hospital beds, a low number of doctors in relation to the size of the population, and a shortage of personal protective equipment—the country has found itself racking up some 50,000 new infections every day, more than any other country except the United States and Brazil, and almost certainly an undercount of the true number. After a brutal three-week lockdown that began in March, major cities are once again having to close to try to limit the outbreak. Many restrictions remain in place. Endorsements of homeopathy such as Bachchan’s and the use of unscientific policies and treatments in a bid to address this growing epidemic have undoubtedly contributed to a failure to address it more fully.
Traditional medicine has played a valuable role in Indian health care for time immemorial, helping improve public health in rural and poor communities in tandem with modern science. But wrapping it up in religion and jingoism has proved to be a disservice to those who most rely on it.