Local Knowledge for World Market

Globalising Ayurveda
This article looks at some of the sites of contestation that mark the encounter of ayurveda with
globalisation, making it a marginal player in the medical market. With enormous pressures being
exerted by the dominant establishment including the pharmaceuticals industry, alternative medical
systems have been confined to marketing alternative products. The real challenge for ayurveda in
the global economy lies in defining the parameters and terms of those parts of its knowledge
system that are considered adaptable to the market. However, in the scramble to protect markets
and knowledge regimes, it is not yet understood that there is a deeper colonisation being played
out in the edging out of alternative world-views inherent in these medical systems.
MADHULIKA BANERJEE

Introduction significant new government policies and initiatives in the UK,

US and European Union in the past 20 years or so that have shaped

T
he story of globalisation of ayurveda does not fit either
of the two standard narratives that we have come to expect
in debates concerning globalisation. On the one hand, it
is not a simple story of the shrinking of domestic industry in
the face of a flood of global goodies. In fact, it is a story of Indian
products going abroad and posing a challenge in the global
market. The terms of trade are certainly an issue here, but this
is not an obvious case of unfair terms of trade in products. The
‘rolling back of the state’ and the withdrawal of state support
to domestic industry that one associates with globalisation is also
not present in this instance. The Indian state is more active and
interventionist now than ever before. On the other hand, the story
of globalisation of ayurveda is also not the story of opening up
of a new world of unlimited opportunities as a result of the rise
of the herbal products industry worldwide. A certain kind of
opportunities has certainly opened up, but by closing down some
other possible openings and by changing the very nature of what
was and has come to be recognised as ayurvedic medicine. The
change is certainly not for the better. Indeed, there is a case for
regarding these changes as downgrading of ayurvedic medicine
and reducing it to a more rudimentary form of herbal medicine.
This article presents fragments of this rather complex story by
looking at two sites of the contestation that marks the encounter
of ayurveda with globalisation. The first section goes back to
the first external encounter that defined modern ayurvedic
pharmaceuticals in the twentieth century India. A quick historical
overview of the developments in ayurveda in India during the
colonial and post-colonial periods allows us to identify the pro-
cesses that ayurveda put in motion in order to meet the challenges
it faced in the market for medicines and the realm of medical
knowledge. While ayurveda succeeded in retaining a presence
in the market, the terms of this presence were circumscribed by
the dominant discourses of the pharmaceutical industry and
modern medical science. Conformity to these terms made for a
truncation of the knowledge base, rather than the expected flow-
ering or developing expected from processes of ‘modernisation’.
A quick review of the developments in the past decade enables
us to recognise that the impact of the second external encounter
that we now call globalisation is not qualitatively different from
the first one. In the second section, we shift our gaze to the other
end of this encounter, namely, the global north. We discuss
the terms of export of ayurvedic products/medicines. Given the
size and attraction of these markets, the policies of these gov-
ernments have the power to reshape the internal structure of the
ayurvedic pharmaceutical industry in India. The conclusion
attempts to locate the role for agency in this seemingly irreversible
process of structural transformation by listing the responses of
civil society – practitioners, industry and grass roots organisations
– and identifying what I believe can still be done now.
Encounters at Home
Globalisation in contemporary times is not the first occasion
when ayruveda is being forced to transform itself as a result of
an external encounter. In many ways, the story of globalisation
is a repeat of the encounter with colonial modernity that trans-
formed the ayurvedas of the pre-modern times into modern
ayurvedic medicine as we know it today. Ayurveda has undergone
a substantial change in the past 150 years or so in India, through
the colonial and then the post-colonial period. Contrary to popular
images, pre-modern ayurveda was marked by various levels of
multiplicity – multiplicity of texts, diversity of practice and social
differentiation, with continuous historical changes anchored in
an open-ended epistemology. Thus in the early phases of encoun-
ters with systems of medicine like unani, it was possible to adapt
and assimilate new ideas into the old without the danger of erasure
or being cast to the margins. The encounter with biomedicine
in colonial times was, however, qualitatively different. Ayurveda
was cast as biomedicine’s ‘other’, as the epistemological power
of biomedicine reinforced the power of the colonial state. There
were no doubt many nationalist contestations of the marginalisation
of ayurveda from civil society. There were the traditionalists who
wanted the pristine purity of tradition to be maintained as it was
and the neo-traditionalists who believed that the only way to save
tradition was to make it conform to specific modern requirements
of legitimacy. And then there was Gandhi, who believed that
ayurveda needed to be reflexive while maintaining its distance
from biomedicine. Eventually the neo-traditionalists’ view pre-
vailed, whereby ayurveda used the space of the market to mechanise
mass production of its medicines, the knowledge base for which
was created by collapsing the multiple traditions of ayurvedas
into the ‘great tradition’ of ayurveda. This is what resulted in

Economic and Political Weekly January 3, 2004 89

the birth of the ayurvedic pharmaceutical. However, in following
the logic of capitalist production and the new health choices of
the ‘consumer’, what ayurveda actually succeeded in doing was
to cast itself in the mirror image of biomedicine. The ‘other’ thus
became a ‘double’. Thus there was significant loss of its dis-
tinctiveness at this stage, a marginalisation of the knowledge
system despite its successes in the market and this moment was
also that of withdrawal. This was the first outcome of the encounter
of ayurveda with external forces.
The post-colonial state, committed to the dominant scientific
world view, nevertheless set up ayurvedic education, practice and
manufacture. Precisely because of its basic commitment, how-
ever, state policy could never provide a distinctive path of
development of the Indian system of medicine. Thus it mostly
fostered ayurveda’s persona of the double. The principal changes
in this period were led by the market driven pharmaceutical
industry. Two of these structural changes, processes of
commercialisation and standardisation, deserve to be mentioned.
Processes of standardisation implied standardising every stage
– the raw materials (mainly medicinal plants), the process of
manufacture and quality control of the products. One of the most
difficult areas of standardisation was that of raw materials, mainly
medicinal plants. Standardisation of the manufacturing process
of ayurvedic medicines required choosing between kinds and
levels of technology, negotiating between the provisions of the
texts and the logic of returns to scale dominated this choice in
this industry, as the history of most manufacturing concerns in
India show [Banerjee 1995]. The third aspect of standardisation
was quality control of the final product, where ayurvedic phar-
maceuticals followed the practice of controlled and randomised
clinical trials, the basic means of establishing medical conclu-
sions for drugs in experimentation and the main legal requirement
for biomedical products to be put on the market. It was assumed
by the market and accepted by manufacturers that they would
be the criteria for standardisation of ayurvedic preparations to
be accepted and marketed as ‘medicines’, despite the dissimilarity
in the knowledge base of the medical systems.
The three dimensions of commercialisation were product
profiling, positioning and packaging. Product profiling is sig-
nified by the different strategies adopted by ayurveda to juggle
with the form, content and importance of its products in order
to be a viable force in the market. Positioning involves identifying
the target consumer group for which the new ayurvedic products
are being made and creating the politics of images by which a
‘traditional’ product can be sold to a ‘modern’ consumer. The
changing patterns of packaging demonstrate the shifting locus
of the social character of any commodity, often involving vital
shifts in the trajectories of production. The standardisation of
various aspects of the manufacture of ayurvedic pharmaceuticals
coupled with commercialisation led it to become like any other
pharmaceutical, indistinguishable in any sense and devoid of its
specific identity based on its origins in a very different medical
system. Thus ayurvedic preparations moved from being drugs
to concepts, where the conceptual essence was distilled to the
active principle and delivered to the consumer without the burden
of the rest of the medical system. The full potential of this
encounter, during the colonial period and even after, whereby
ayurveda could have posed a real challenge to biomedicine, was
not realised and instead ayurveda settled for a marginal place
in the medical market and imagination.
The second encounter, under the conditions of what is de-
scribed as ‘globalisation’, is heralded in the dominant media as
marking a period when ayurveda overcame this structural
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marginalisation and arrived on the global centre stage. On this
reading, the effects of ‘modernisation’ and ‘globalisation’, the
two external encounters have been opposed to each other. The
first encounter was all about the domestic market while the second
concerns mainly external markets. The changes in the first were
crudely imposed from outside by political power, while the
changes this time are internally arrived at. The first encounter
displaced ayruveda from its position as the reigning system of
medical knowledge, while the second one promises to rescue
it from its marginal status and restore something of its lost
prestige. Yet a closer look reveals more continuities than ruptures
between the experience of these two encounters. Both involved
changes in the inernal structure of ayurvedic medicine to suit
the requirements of the external maket and conform to the
standards of an alien medical system, largely due to assymmetry
of political power.
The most obvious and noticable development associated with
the period of globalisation is a marked increase in the role of
the state along with a rapid expansion in the market for the
ayurvedic industry. This led to a series of policy initiatives in
the 1990s culminating in the Indian Systems of Medicine (ISM)
policy document. The amendment of the Drugs and Cosmetics
Act (1940) leading to setting ‘good’ manufacturing practices
(GMP) for manufacturers of ayurvedic medicines, was passed
in late 2000. The returns to these developments were limited,
however, the research not enabling Indian manufacturing to
become competitive in overseas markets, and the GMP only
slowly making a difference. The emphasis on competing in the
world market foregrounded two issues common to both govern-
ment and industry with respect to the Indian system of medicines,
medicinal plants and traditional knowledge. Over-harvesting and
regeneration of the former, in addition to prices and collection,
have been problem areas. It was only with the twin pressures
of rapidly growing international herbal medicine industry and
the sustainable development lobby that it was identified as a cause
for concern. An unprecedented response followed: attempts were
made to foster a new spirit of collaboration between government
and industry on these issues, in evidence at conferences and
forums organised between 2000 and 2003. The most tangible
outcomes have been both initiatives of the government: the
Central and State Medicinal Plants Board (September 2001), the
Tiwari committee report on the state of medicinal plants and the
computerisation of traditional Indian medicinal knowledge in the
form of the traditional knowledge digital library.
Most significant however, was the first separate policy state-
ment on the Indian systems of medicine in 2001. Hitherto a small
paragraph at the end of the larger health policy document, it
indicated recognition of the growing strength of this sector by
the state. This document identified both civil society actors and
the state as stakeholders in the interests of the ISM for the first
time, no doubt in the spirit of the new parlance of ‘governance’.
In attempting to accommodate and reconcile all the conflicts of
the last hundred years over ayurveda, however, it failed to
consolidate all the gains that had been made during this time.
For instance, there was recognition and provision for new areas
of research but its linkage with product development, with attractive
offers to industry that could have enticed them to investment,
was not explored. Thus it missed the opportunity to posit the
acceptable terms of globalisation for ayurveda, by strongly
advocating the possibility that state and civil society actors can
together be a formidable force in positing new terms of legiti-
mation for traditional medicine (TM) at the international level.
It allowed itself to be dictated by the overwhelmingly narrow
Economic and Political Weekly January 3, 2004
perspectives on profits and profitability that Indian industry
subscribes to in limiting its legislation. It did not persuade them
to creative alternatives that could have long-term implications
to protect and promote the Indian systems of medicine as a whole,
rather than just some of its products. The most damning evidence
of this belittling was in the fact that in the first WHO policy
document on traditional medicine that appeared nearly a year after
the Indian document, there was no mention of India’s position
or achievements in this sector
Notwithstanding this renewed attention to ISM, the basic blind
spots in state policy since independence continued. The govern-
ment was simply not ready to commit resources to the ISM in
the public health sector, despite platitudes to the contrary. It also
continued to neglect the condition of state pharmacies that were
meant to manufacture medicines to supply to the ISM state health
services. In fact, a possibility inherent in the earlier system of
state intervention, that of establishing parity with biomedicine,
was reversed now. This possibility was represented by new
research from a special working group in the Indian Council for
Medical Research and from some university departments of
pharmacology that demonstrated the real possibilities of alter-
native perspectives on validation and assessment of quality control.
This research had not yet reached a stage of product development,
which would have required a committed investment from indus-
try. Yet it had the potential to challenge the terms of cognitive
exchange between the two medical systems. Globalisation has
meant turning one’s back on such basic questions and on the
challenge of using ISM as an effective means of accessible and
affordable health service for ordinary citizens.
Encounters Outside India
Globalisation has opened another site of ayurveda’s encounter
with the world outside. This is reflected in recent developments
in the global north – the European Union, the United Kingdom
and the US – and policy changes in the World Health Organisation.
Consumer attitudes and demands have increased the significance
of their own complementary and alternative medicine (CAM)
and the presence of medicines/products from other medical
systems like ayurveda and Chinese medicine. This fast growing
market of nearly US $ 7 billion is making a dent in the dominant
biomedical pharmaceuticals market, which wields enormous
power over these governments. No wonder the pharmaceutical
giants have been able to get their governments to create new
policies and initiatives with respect to the CAM sector, mainly
in terms of the safety of products. The argument is that unlike
modern pharmaceuticals the products of these systems cannot
be called medicines because they have not passed the stringent
tests for safety and efficacy. Yet it is precisely these criteria that
we have demonstrated to be the axis of control over the character
of ayurvedic medicines in India, leading to their being formatted
afresh in the past 100 years. This axis acquired new power as
a result of the new initiatives being undertaken in the global north.
The WHO, which has all along been dominated in its perspective
on health care by the models of industrialised countries, with
grudging exceptions in its policies, is now additionally influenced
by the power of the Chinese presence in this sector. The Chinese
state has resolved the questions of safety and efficacy in ways
that the Indian state has never been allowed to do because of the
continuing contestations it has been subject to. Their dominance
in the WHO would naturally strengthen those trajectories within
the Indian state that visualise a ‘scientised’ trajectory of develop-
ment for ayurveda that has not been completely successful so far.
Economic and Political Weekly January 3, 2004
The combined power of this axis, then, could lead to two contra-
dictory developments at the same time: it offers great opportu-
nities to industry to supply ‘herbs’ and ‘supplements’ considered
safe and desirable for consumers, on the one hand, and reduce
ayurvedic medicines to a rudimentary form to meet standards
of safety and efficacy imposed by an alien tradition, on the other.
These terms are insidious, with the capacity to effectively
marginalise ayurveda as a system of medicine in the long run.
The WHO first recognised the significant role that traditional
medicine can play in improving health care as part of the landmark
Alma Ata (‘Health for All by 2000’) Declaration of 1978. Their
low cost, accessibility, and people’s faith in them made them
an ideal panacea for the public health care delivery programmes
of developing-country governments. It was assumed, however,
that these systems would be ‘integrated’ into the system such
that they followed the norms and structures of the modern medical
system. WHO left the detailed institutionalisation of this idea
to individual country governments, and kept its focus limited to
guidelines for the manufacture, assessment, clinical evaluation,
appropriate use and quality control of herbal medicinal products
and medicinal ‘plant materials’. Thus even in 2000, a workshop
in south-east Asia concluded with the recommendation that
traditional medical knowledge on wellness and prevention should
be distributed purposefully to conventional medical practitioners
and policy-makers [Bodeker et al 2000:3].
It was the radical changes in European and US markets and
subsequent policy developments effected by the EU, UK and US
governments referred to above, that transformed the status of
traditional medicine systems worldwide. These governments set
up task forces and advisory committees, instituted formal re-
search laboratories, and recognised herbalists and their associa-
tions as important stakeholders in the policy process, thereby
elevating these systems from the bottom rung policy option of
developing countries to those with great credence in the devel-
oped world. It was only by 2002 that the WHO found it important
to bring out a separate document on traditional medicine policy.
The politics of this document merits a detailed critical analysis
on each of the core aspects covered, i e, safety, efficacy and
quality, access and rational use. Here we will concentrate on the
ideas on efficacy and quality in the perspective of ‘integration’
of traditional medicine. “The ‘integration’ of TM/CAM with
national health care systems, as appropriate, by developing
and implementing national TM/CAM policies and programmes”,
is one of the stated objectives in the WHO document (2002:5).
In a footnote, the term ‘appropriate’ is explained to “refer
to TM/CAM health care that does not cost more and which is
no less safe and efficacious than recommended allopathic care
for the disease or health problem” (2002:43). There are two points
here: that of cost and the other of safety and efficacy. In the
political economy of developing countries on the whole, one
would be hard put to find the allopathic system offering cheaper
means of health care, except where the industry around TM/CAM
has to compete openly in the market with it, as is the case in India.
The WHO document, however, refers also to the large numbers
of people in developing countries who have access to the practice
of TM that is not dependent on the market at all, which would
certainly be cheaper than allopathic medicines. Tying in the safety
and efficacy factor of the alternatives, however, targets those that
have entered national and international markets for competition
and would not be accepted until the standards set by biomedical
and pharmaceutical research have been met. This is evident in
the way some challenges in this aspect are outlined, namely, “lack
of research methodology, inadequate research base and lack of
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international and national standards for TM/CAM products and
lack of registration and regulation of practitioners” (2002:20).
However, this is simply not true. The history of research and
the contestations of the terms of research in both India and China,
to take but two examples, is more than half a century old. In
both countries, these contestations have been recognised, but
different resolutions have been arrived at by both the scientific
community and the TM practitioners and researchers. What is
interesting is that the Chinese pattern is recognised by WHO to
be a possible yardstick for its standards, along with the newly
established research centres and programmes of the US and UK.
This, we argue, is related to the larger point on integration.
China’s model of integration of its TM into the public health
system reflects an acceptance of the framework of research and the
world view of the treatment of biomedicine rather than battling
the differences, than has been the case for instance in India. It makes
a space for traditional medicine in practice, but on the terms set
by biomedicine and has surrendered its perspective and philosophy
of healing, while simply continuing the use of the remedies. This
is most amenable to WHO’s capacity for actively taking tradi-
tional medicine on board. It allows for the hegemony of biomedicine
to continue while making a respectable space for the traditional.
Insisting that the latter should be evidence-based, must be ac-
cessible and be governed by principles of rational use makes the
space for the dominant establishments of science, industry and
regulators respectively, to continue to exercise their power. In
addition to years of successful implementation of this model,
China is the world’s largest exporter of medicinal plant materials
and products in the past 50 years. This demonstrated might in
the international market sets up a trap: the more you adapt to
the dictates of the dominant scientific and market trends, the more
you are likely to succeed. In the light of the enormous pressures
from the dominant pharmaceuticals industry in Europe and the
US, which would be willing to make hay as long as the sun shines
on herbal medicines, this position would be crucial. Not only
would it not affect their basic infrastructure of research and
product development, they would be able to exploit it for profit
very easily. This is substantiated by the policies and regulations
being initiated by the EU, US and UK, which we will discuss now.
The most important point that needs to be made with respect
to EU or the US/UK is that the issues their governments are
grappling with are somewhat different from those of India. They
are dealing with a range of therapies and therapeutic systems, many
of which are oral traditions and not bound by the codification
in texts. This welcome space made for oral histories and traditions
once again in Europe brings back the very first clash and process
of marginalisation that the Enlightenment must have wrought in
Europe – the canonisation and sanctification of knowledge that
can be verified and validated by palpable criteria, and a denial of
any other. This is in evidence in the urgency of the European Union
to pass strict norms of medical products and practice, causing
great difficulty to the many CAM systems operating there. This
of course includes the medical traditions indigenous to Europe.
Europe has had a long herbal medical tradition, functioning
mainly on Galenic principles. Many herbalists of these traditions
practise to this day and are as much at a disadvantage as those
from other cultures. Hence the response of appeal and defiance
has come from both kinds of practitioners, in an organised and
unorganised fashion. ESCOP (founded in June 1989) is an
umbrella organisation representing national phytotherapy asso-
ciations across Europe, especially in their discussions with
European medicines regulators. Since 1996 it has been a company
limited by guarantee in the United Kingdom, to advance the
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scientific status of phytomedicines and to assist with the
harmonisation of their regulatory status at the European level.
Since 2000 the EU has drafted a series of directives that
seriously restrict the practice of herbal medicine, with the intent
of a suitable balance on consumer choice and public safety. This
would require the proving of efficacy and regulating and licensing
practice. It is clear that state power views herbal traditions as
too much outside the system and have therefore created alter-
native frames for describing medicines as ‘well established
medicines’, which in principle gives greater flexibility in the use
of bibliographic data for this category of medicines to meet the
requirements to demonstrate safety and efficacy. Another cate-
gory, ‘traditionally used medicines’, is under consideration.
Together with the EU, the medicines control agency of the
department of health of the British government is important in
these interventions. Its work was supported by the setting up of
the Lord Hunt commission on traditional medicines, which has
set up dialogues with a great many members of the herbal sector,
including that of ayurveda. There was public outcry over its
infamous declaration in January 2001, when it listed ayurveda
among those traditional medicines as ‘unscientific’. In response,
many groups of both scientists and industry have made repre-
sentations to the committee, revealing the deep differences and
fissures within them as well; but for the first time, this issue is
openly in the realm of international politics as it never has been
before. Another UK government agency that is associated with
the work is the herbal medicine regulatory working group, set
up to report the form that herbal medicines regulation should
take for the statutory profession and negotiate with all the dif-
ferent stakeholders identified by the UK government. These
recommendations would hold for imported herbal medicines as
well, beginning with the very definition of ‘herbal’. This would
not be technically an inaccurate description for the entire range
of ayurvedic medicines, and would severely restrict the market
in Britain for Indian manufacturers. This is being fought hard
by some groups of ayurvedic practitioners and lobbyists, but not
with a great deal of success. What is significant is that the lack
of success is because of the perception within the ayurveda
industry that fighting the terms at this stage might mean a loss
of even a corner of the market that may be possible yet.
This is complemented by the development of what authority
in Europe wishes to define as ‘borderline products’, those that
the industry worldwide is happy to position as neutraceuticals
and cosmeceuticals, simply names for dietary supplements and
cosmetics. For some time now, herbal products, even medicines,
have been marketed in this category, because the legal structures
of their definition allowed benefit to the ayurveda companies.
But this going to have a serious impact on the export orientation
of ayurvedic companies, inasmuch they would not be exporting
‘medicines’ at all. For reasons different from the national level
therefore, ayurveda will be losing credibility in the international
market as a medical system and will have to become a supplier
of neutraceuticals and cosmetics simply in order to remain viable.
Both political lobbying and legislation progresses in this sector
will thus outline the character of development of these systems
as a whole for a long time to come.
In the US, there are two broad institutions of government
responsible for fresh research and regulation for herbal medi-
cines. They are the Agency for Health Research Quality (AHRQ)
and the National Centre for Complementary and Alternative
Medicine (NCCAM), both under the department of health and
human services (HHS). The AHRQ essentially works with the
public and private sectors to “build the knowledge base for what
Economic and Political Weekly January 3, 2004
works – and does not work”. NCCAM, one of the seven national
institutes of health established and funded by Congress in 1998,
supports rigorous research on complementary and alternative
medicine, to train researchers in CAM, and to disseminate in-
formation to the public and to professionals on which CAM
modalities work, which do not, and why. Their four primary areas
of focus are research, research training and career development,
outreach and integration. To integrate scientifically-proven CAM
practices into conventional medicine, they announce published
research results, study ways to integrate evidence-based CAM
practices into conventional medical practice and support
programmes to develop models for incorporating CAM into the
curriculum of medical, dental, and nursing schools. The pattern
of research in these organisations will profoundly affect perspec-
tives on standardisation of herbal medicines everywhere in the
world. While these are different from earlier studies, inasmuch
as they attempt to be sensitive to the worldview of the systems
they analyse, some basic shortcomings remain. Interestingly, the
most important of these – that the medicine or supplement should
be studied in the form and context in which recommended in
the traditional practice system – is what has been overcome in
new protocols fashioned by the ICMR research group on tra-
ditional medicine in India referred to above. What it demonstrates
definitively is that while costs of research are much higher,
scientifically speaking, such protocols are eminently viable. Where
does this revelation leave us? That doing a limited trial is better
than not at all, since that way we can at least sell garlic in the form
of a dietary supplement. But for that conclusion to be acceptable,
we have to agree that being able to sell is more important than
being able to treat in accordance with a particular system.
There are of course counter-currents. In the same world that
hosts the globalising forces there are scientists (from the National
Institute of Medical Herbalists in the UK) who are trying to argue
for using a Goethean perspective to offer a clear alternative
perspective on the terms of evaluation of herbal medicines, in
order to respect their healing perspectives. Whitelegg argues that
“even if hundreds more trials were performed along orthodox
lines we would not necessarily be substantially nearer to defining
non-conventional medicine adequately” (1997:1). However, in
the matrix of power, with respect to the decision-making on agendas
for research that will influence policy, it is the various bodies in
the governments of the US, UK and EU that continue to play the
most important role. The voice of the NIMH scientists is in a sense
as lost in this political wilderness as that of the scientists in India.
These governments also control international trade regimes, the
legitimising trends of consumer products, as also the markets
for herbal medicinal products. Therefore it means that the scientific
and commercial parameters for the participation of the Indian
herbal medicine industry, or indeed that of other parts of the
developing world will be firmly set by them. So the government,
academia and industry in India, as indeed in parts of the world
where traditional medical systems still have strong roots, must
garner every single resource they have to influence the structures
of power, if they are to survive as independent entities at all.
Bringing People/Politics Back In
The real challenge for ayurveda in the global economy lies in
defining the parameters and terms of those parts of its knowledge
system that are considered adaptable to the market. Even if its
products do well in the market, it needs to be recognised that
the knowledge system is being viewed simply as a source of
pharmaceuticals, a bag of recipes to be taken out and in isolated
Economic and Political Weekly January 3, 2004
instances. This is related to the idea of the herbal or the natural,
as it has evolved in the west in the past 20 years or so, which
is more than the label for a certain variety of products. There,
it had stemmed from the dissatisfaction with modern biochemical
products, both medicinal and cosmetic. Recognition, however,
that this was not simply because the products were limited, but
that an alternative world view, a systemic overhaul was required,
had very limited currency. Over time, alternative products have
come to occupy the entire space for alternative medical perspec-
tives. This way, the existing structure of science is not disturbed,
yet people can feel that they are accessing the goodness of ancient
medical systems. So while it seems that the presence of these
systems has increased in contemporary society, in real terms it
has not, the products cannot be confused for the systems. So what
ayurveda needs to worry about (together with all other better-
known concerns, with respect to natural resource use by new
trading regimes and knowledge of their process by new patent
regimes) is in fact a more deeply political takeover, not yet being
fully appreciated. In the scramble for protecting markets and
knowledge regimes, each a very laudable and necessary political
agenda, it is not yet understood that there is a deeper colonisation
being played out in the edging out of alternative world views
inherent in these medical systems. And the reason for this lies not
only in the overwhelming hegemonic forces of dominant science,
technology and trade at the global level, but the very policies
of ‘standardisation and scientisation’ undertaken by post-colonial
states. This is the process whereby the real process of exploring
multiple/alternative/diverse modernities has been quelled.
Yet, there is hope because this political project has been kept
alive by some political movements on the fringe. Viewing the
poor as the intellectual carriers of knowledge of medicinal plants,
for instance, would transform the perception and the reality of
intellectual property rights. That corporations, both global and
local, use them is now exposed, but it is important to proffer
a concrete challenge to this system. Groups that are documenting
and helping people to enter the market in an organised fashion
serve as the base for this. The more successful have been the
viable production of medicines at smaller scales for health needs
rather than just markets. The most ambitious of these is a project
that awaits articulation – to bring poor persons’ perception of
illness and wellness together with new efficacy studies referred
to above – and newly designed laboratory studies of treatment
entities and not just drugs, and locate this at the centre of the
discussion of standardisation. It is only when anthropologists and
scientists working together within the larger framework of public
health in development deploy this can it be successful. No doubt
this will entail vigorous politics from the fringe that believes that
another world is possible! EPW
Address for correspondence:
madhulikab@vsnl.net
References
Banerjee (1995): ‘Power, Culture, Medicine: A Study of Ayurvedic
Pharmaceuticals in India’, PhD thesis awarded by the Department of
Political Science, University of Delhi.
Bodeker, G, R Jenkins and G Burford (2000): Proceedings of a Parallel
Symposium on Traditional Medicine at the International Conference on
Health Research for Development (Cohred) held at Bangkok, Thailand,
October 9-13.
Whitelegg (1997): ‘An Alternative Science for Herbal Medicine’, European
Journal for Herbal Medicin, Vol 2:1-7.
WHO (2002): Traditional Medicine Strategy 2002-2003, World Health
Organisation, Geneva.
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