Another First: Health Minister Pushes Unproven Covid Drug

The Bharatiya Janata Party (BJP) government at the Centre is at it again: making itself look ridiculous and the whole country along with it; and announcing to the world its authoritarian, sectarian proclivities.

Let us begin with the bit that is part ridiculous and part gravely improper. On 22 February, the Indian Medical Association (IMA) accused Union Health Minister Harsh Vardhan, who is a qualified doctor, of breaching medical ethics by participating in a programme held by yoga guru Baba Ramdev’s Patanjali Ayurved that was promoting a herbal cocktail as anti-Covid medication.

A banner at the event held on 19 February suggested that the drug—a tablet named Coronil—had certification from the country’s drug regulatory authorities in a format specified by the World Health Organization (WHO). The precise wording of the banner was “Announcement of First Evidence Based Medicine for Covid-19 (COPP-WHO GMP certified)”.

Decoded, this suggested that Coronil had a “certificate of pharmaceutical product” from the Indian drug regulator relating to “good manufacturing practices” issued according to a format prescribed by WHO.

After this generated a controversy, Acharya Balkrishna, Patanjali’s managing director, issued a tweet which said that the company wanted to “clarify to avoid confusion that our WHO GMP compliant COPP certificate to Coronil is issued by DCGI [Drugs Controller General of India], Government of India. It is clear that WHO do not approve or disapprove any drugs”.

On 19 February, however, soon after the event WHO’s South East Asia Regional Office had tweeted in its own clarification: “WHO has not reviewed or certified the effectiveness of any traditional medicine for the treatment of Covid-19.” Neither news reports nor any statement from Indian authorities make it clear what Balkrishna’s tweet exactly means, though it claims DGCI has issued the certification.

In any case, the IMA has questioned Vardhan’s involvement in what can only be called a mendacious campaign. In a statement it said that the “false and fabricated projection of an unscientific medicine by the health minister”, followed by the disavowal by WHO was a “slap and insult” to the people of India. IMA officials, national president Johnjose Austin Jayalal and general secretary Jayesh Lele, questioned the necessity of Vardhan’s presence at the event, especially in the middle of the pandemic.

The IMA also underlined that doctors are bound by a code of ethics prohibiting them from approving, endorsing or certifying drugs or medicines “in any form or manner of advertising”. Lele further explained that GMP has nothing to do with the efficacy of a product, which has to be established through “randomised double-blind placebo-controlled trials”. “Why don’t they do such a trial?” he asked.

To begin with, of course, the point is that Vardhan is not just a qualified doctor, in which capacity principally he has been pulled up by the IMA. He is also the Union Health Minister. His endorsement of unproved medication, like former US President Donald Trump’s, can have much greater repercussions than that of an ordinary doctor, because more people have access to his utterances and are perhaps influenced by them.

It is this that provides the proper context to the event attended by Vardhan and Union Surface Transport Minister Nitin Gadkari (as chief guest). And it is this, too, that provides context to a tweet by Vardhan that said he was pleased to have joined the event to mark the release of “a scientific research paper on the first evidence-based medicine for Covid-19 developed by Patanjali”.

Therein, as they say, lies the rub. The event held on 19 February was not directly one for promoting Coronil. It was a programme held to release a “scientific paper” that purportedly provides the evidence on which the efficacy of Coronil is predicated. Before we get to the merits of the case, without getting too intricately involved in the minutiae of drug trials, we need to focus on Vardhan.

In what appears as an explanation for his presence at the event, Vardhan had suggested that the government and Ramdev had shared dreams about ayurveda. “Regarding Ayurveda, whatever dream Baba Ramdev has, that is the government’s,” Vardhan had tweeted after the event. If that is not an abject and improper endorsement of one of India’s many equal citizens (and a company), one wonders how further supplicatory cronyism can go.

But apart from that, the obscurity of the paean makes it utterly inexplicable. Assuming that the government’s aims and conceptions, or “dreams”, with regard to ayurveda are completely aligned to Ramdev’s, how is that apropos in this connection. Does that mean that the health minister will tacitly promote an unproven drug by attending an event in breach of medical and ministerial ethics?

It appears so, because despite the fact that there was a clinical trial for Coronil involving 100 patients, the results of which were published in a peer-reviewed journal called Phytomedicine, the entire process has been rubbished by a number of scientists both on the registers of methodology and results. The criticism centres on several features of the study. First is inconsistency: at one point it claims patients were asymptomatic, at another that they were “mildly symptomatic”.

Second was the charge of extraordinary results: mainly the claim that by the seventh day all those in the group who had received the treatment had recovered, while only 60% of the group given a placebo had done so. One doctor pointed at design flaws, unrepresentative samples, and flawed methods of analysis and interpretation. Another explained this charge in terms of “lead time”. In other words, the study did not make it clear how long it might have taken for the largely asymptomatic patients to have been cleared of the virus. To make any sense of it all, we would have to know the amount of time it took between infection and clearance. The difference in time taken to recover could be a result of the time the infection was acquired, which was not specified in the paper.

The final word on the whole episode must go to John Travis, a US-based complementary medicine specialist, who said: “The rush to get the above out heavily endorsed by ministers sounds like drug company blurb and is science-free promotional guff.”

Patanjali’s questionable claims and practices are one thing: to be investigated and punished in case of infringement according to appropriate law. But Vardhan’s participation and paeans point to a deeper systemic problem: the “anti-science” mental frame of the ruling party and the regime it incompetently runs.

I could go into the attempts made by the University Grants Commission to nudge or coerce colleges and universities to make absurd studies of the properties of cow dung, urine, milk, and ghee individually or in combination, as in the recent passing of an order for a national cow science exam. Unfortunately, space does not allow us to go into this hilarious stream of anti-science consciousness.

So we could end with a question: What better can we expect of a government that through its culture ministry tweeted high praise for the second leader of the Rashtriya Swayamsevak Sangh—MS Golwalkar—last week? Not only did he buy into Hitler’s ideas of eugenics, he firmly laid the basis for the sectarian and obscurantist state India is soon to be. Rejecting science and the humanism it engenders is central to that agenda.

The author is a freelance journalist and researcher. The views are personal.