Scenario of Products or Practices Claiming to be Ayurveda – Need for Awareness and their Regulation

Massages

Massages have been one the approaches to therapy. They also come with side effects [3]. Ayurveda has become a brand name for massages. Ayurvedic therapy prescribes massaging by application of oil only as a part of the treatment. Oil massage alone is not considered as a complete treatment. Due to the usage of the term ‘Ayurveda massages’ for commercial purposes in many places, the societal opinion reflected is that Ayurveda means only massages or massage parlors. This is a misconception about Ayurveda and has to be addressed to retain the sanctity of this medical practice. Abhyanga or massages are part of Panchakarma Therapies. The therapy is specific based on the indication. Specified oils and specific procedures are prescribed for the treatment. Abhyanga or massages are also classified body part wise like padabhyanga, ekangabhyanga, shirobhyanga, etc. These massages are done after the therapies like kati basti, janu basti, shirodhara, etc [4].

Ayurveda suggests the application of oil to the whole body after exercise followed by a warm water bath, as part of daily regimen. This helps in preventing body pains and lubricates the joint and in turn rejuvenates the body. The oil massage helps in rejuvenating the body. The issue in this context is about promoting Ayurveda meagerly as a massage system which is not a good reputation for this holistic science.

The name of Ayurveda massage parlours can disintegrate the traditional system of medicine which in turn can lead to devastation of the concepts of Ayurveda. Even more tarnishing is the scenario where in the name of Ayurvedic massage treatment flesh trade and drug trafficking is being carried out [5].

Therapy for Fertility and Libido Concerns

Second most common is, the name of Ayurveda camps are given by the one who claim themselves to be Ayurveda pandits and have their camps on road sides with many herbs in glass jars. In addition to all sorts of health maladies, they are mainly targeting male impotency and male fertility related products where they sell in high price. Such camps display a banner mentioning “Ayurveda camp” or such other terms and also photos claiming to treat male impotence [6].

In India, people generally hesitate to discuss about issues related to sexual health. Fake practitioners take advantage of this ignorance. They convince buyers by claiming that the herbs or minerals they recommend are obtained from the sacred mountainous regions. Such products may not even be cleaned and purified. The general health condition or the previous medical history of the of the person is not verified before giving the claimed medicinal products. Such kind of practice may not be of help to improve libido or potency but may also be harmful to health.

Social, cultural and religious practices in India influence the perspective on sexual health. India has been reported as the impotence capital of the world as published in Outlook magazine during February 2022. Nearly 25 out of every 100 patients in India with Erectile Dysfunction (ED) are below 30 years, as per a report of Institute of Andrology and Sexual Health, January 2022. Such men are falling prey to purchase products in the name of Ayurveda are charged very high price.

Some such medicines used for ED, if taken for longer time or at a higher dose may lead to cardiac vascular (CV) disorders. This could be due to the malpractice of mixing Viagra (sildenafil citrate) into Ayurvedic products. Viagra is known to lead to CV events and is unsafe in patient with history of CV issues. Apart from these the persons may go through depression or mental health problems when such (fake) medicines do not show expected therapeutic response.

Female infertility is also an exploited area for such practices [7].

Fake Practitioners

Considering the above mentioned concerns about massages and infertility treatment, the root cause is the surge of quacks claiming to be Ayurvedic practitioners. Many news reports mention such fake practitioners. Early this year such a fake racket was busted by STF in Uttarakhand, India [8]. Such falsified therapies have occurred via online consultation too where three culprits were held for cheating patients online in name of Ayurveda treatment [9].

Ayurvedic Ice Creams

Ayurveda has many principles about food. To mention a few, Ayurveda tells not to eat cooked foods which are left over night, not eat raw vegetables, to avoid sprouts, to have warm foods and drink. Cold foods are not recommended as they hamper the digestion activity. There are more than 30 regulations as such with regards to food selection, preparation and intake of prepared foods. Not only these regulations even Ayurveda guides about the places or season according to which we have to select our food.

In particular to cold foods, Ayurveda mentions that the food/drink which is warm or in particular season kept at room temperature is ideal for the body for good digestion. Cool foods or drinks will create indigestion and will harm the internal organs from functioning and further affect health due to or in other words it says cold foods and drinks are incompatible to digestion. In this theory it is clearly understood that ice creams are incompatible food for health. So when concept of ice cream only is not as per Ayurveda, naming a flavour by adding a herb cannot be an Ayurvedic ice cream. Eg. adding turmeric and naming as Ayurveda flavoured ice creams. Not only for ice creams but many food products are named after Ayurveda which has opposite theories to Ayurveda [10].

Misnomers and Fake Ayurvedic Products

Another concern is misuse of associating the word ‘Ayurveda’ with food or medicinal products. Many products are sold by adding just a single or more herbs to any combinations and naming it as Ayurveda products. Few to mention are: toothpaste, soaps, shampoos, water, milk, coffee and many more including ice creams as discussed above.

Additionally, Ayurvedic medicines themselves similar to allopathic medicines, are not devoid of adverse effects [11]. With quality medicines themselves posing some unwanted health issues, it is dangerous to consume Ayurvedic medicines that are fake and adulterated. Reports from across the country mention such criminal activities related to Ayurvedic products. A case on selling fake Ayurvedic orthopedic medicines was reported in 2021 from Karnataka [12] and May 2023 saw another such group arrested for selling fake ayurvedic medicines in New Delhi [13].

Ayurveda Influence in Foreign Countries like USA

The USFDA does not regulate the Ayurvedic system of medical practice. “Ayurvedic products and their product labels are not approved by the agency, and FDA cannot ensure the safety of these products” [14] Yet the country has been interested in this Eastern traditional health practice for over two decades. The NAMA National Ayurvedic Medical Association was founded in 2000 to support Ayurvedic education and the resulting professional practices [15]. National center for complementary and integrative health (NCCIH) of the National discusses about Ayurveda [16] National Ayurvedic Medical Accreditation Council (NAMAC) is the body under NAMA looking into quality Ayurvedic education in the USA. The California College of Ayurveda was Established in 1995 by Dr. Marc Halpern, is the first state- approved school for Ayurvedic medicine.

In India where Ayurveda has been the traditional medicine, people are being victims to various malpractices in the health care profession. Thus in most of foreign countries where claims are being made to be Ayruvedic system greater caution is necessary. Though institutions are available to impart Ayurvedic education in the USA, only those who have undergone proper training could practice well. Public have to be watchful about claims to be Ayurveda practioners just by undertaking some short term courses. Persons with such half knowledge are disrupting some of Ayurvedic practices E.g. employing curcumin extract rather than using turmeric, prescribing celery juice for detox and describing it as Panchakrma therapy, adding neem in toothpaste and calling it ayurvedic toothpaste, consuming one teaspoon of extra virgin coconut oil early morning and announcing that is it an Ayurveda lifestyle [17].

Awareness and Education

In the light of the above mentioned malpractices under the mask of Ayurveda, it is the need of the hour to impart awareness and education to the general public about Ayruveda viz. information about the right educational qualifications, how the Ayurvedic products (medicnes and food) are being regulated and what care is being imbibed into conducting research in Ayurvedic sciences.

Educational Qualification and Regulations

Ayurvedacharya (Bachelor of Ayurvedic Medicine and Surgery- B.A.M.S.) qualifies an individual to practice Ayurveda In India, which includes four and half years of course curriculum and one year of intense training. Ayurveda also has post graduate course in 16 specialization and it will be another three years of extensive training programs. The National Commission For Indian System of Medicine is the statutory body constituted under NCISM Act, 2020 to provide for a medical education system in Indian system of medicine to ensure transparency and enhance quality of educational institutions of Ayurveda, Siddha, Unani, Sowa-Rigpa and Homeopathy [18].

Certificate Courses/Online Courses

In addition to undergraduate, post graduate and doctoral programs in Ayurveda, short term certificate courses are being offered by many institutions [19]. Many online courses are also available for learning the Ayurvedic life style.

Research

Research in Ayurvedic sciences is also attend to and overseen by the Government to ensure quality scientific practices. Accordingly under AYUSH Ministry the Central Council for Research in Ayurvedic Sciences (CCRAS) oversees the promotion of research in Ayurvedic sciences [20].

Ayurvedic Medicines Regulation in India

As per the Drugs and Cosmetics (D&C) Act 1940 and Rules 1945, Quality Control and issuance of drug license of Ayurveda, medicines is vested with the Central Drugs Standard Control organization (CDSCO). Regulatory Officers of the Central and State Governments enforce the legal provisions for Ayurvedic medicines. Rule 158-B in the D&C Rules 1945 provides the regulatory guidelines for issue of license to manufacture Ayurvedic medicines. Pharmacopoeia Commission for Indian Medicine & Homoeopathy (PCIM&H), under Ministry of AYUSH lays down Pharmacopoeial Standards and Formulary specifications for Ayurveda, drugs within the ambit of D&C Act, 1940. There are presently 55 Drug Testing Laboratories for quality testing of Ayurvedic medicines and raw mate rials [21]. Certification for Ayurvedic medicines as per WHO/CDSCO/ Quality Council of India (QCI) guidelines is facilitated respectively. Pharmacovigilance system for safety monitoring of Ayurvedic medicines has also been initiated in India National AYUSH Mission to strengthen quality control.

Ayurvedic Food

Ayurvedic food quality and safety is also under monitoring. The Food Safety and Standards Authority of India (FSSAI) released the Food Safety and Standards (Ayurveda Aahara) Regulations, 2022 notified in the Gazette. All India

Institute of Ayurveda (AIIA) conducted lectures and camps to educate, create awareness and propagate significance of Ayurveda Ahara in nutrition. This is a milestone in the field of Ayurvedic sciences in India wherein regulations have been framed for Ayurvedic foods prepared as per the receipes, ingredients and processes described in authoritative Ayurveda books [22].

Ayurveda Day Observation

To create awareness of Ayurvedic system of medicine, promote and globalize this ancient practice towards holistic health, the National Ayurveda Day was declared to be observed for the first time in 2016 on the 28th of October. Dhanwantari Jayanthi is being observed as National Ayurveda Day. The Ministry of AYUSH celebrated 10th November 2023 as Ayurveda Day this year with theme ‘Ayurveda for one health – Ayurveda for everyone on every day’.

Thus by the awareness and education, people would choose wisely the correct ayurvedic products and practices and be conscious/cautious of about misleading ones. Vigilance Apart from the awareness measures mentioned in the previous section, the other strategy to address fake Ayurvedic practices/ products is by implementation of regular and strict monitoring to nab culprits involving in such rackets. The central and state Regulatory bodies Secondly, any centre claiming to provide Ayurvedic therapy or services should be made mandatory to be associated with a registered Ayurvedic practitioner. The license of the registered practitioners too has to be renewed on a regular basis. Inspections for personnel, facilities and products should enable removal of fake or substandard and harmful ones. Thus it would help uphold quality ayurvedic medicine.