Unlocking potential of traditional medical knowledge

Compound in turmeric may treat colon cancer: study” read a headline in a prominent newspaper. This discovery might be great news if you use turmeric in your cooking every day.

Published: 17th February 2019 01:00 AM  |   Last Updated: 17th February 2019 08:02 AM   |  A+A-

Compound in turmeric may treat colon cancer: study” read a headline in a prominent newspaper. This discovery might be great news if you use turmeric in your cooking every day. Indeed, such discoveries may not come as a surprise to those who have relied on these traditional remedies for their survival. Nevertheless, the observation raises some important questions. Why do alternative traditional remedies remain alternative, especially after people gain access to allopathic treatments? Why are traditional remedies not our first choice when faced with life-threatening diseases?

Your doctor qualified in Western medicine is unlikely to recommend a turmeric-based treatment for cancer because, for him (or her) any evidence of its effectiveness comes only from established systems; and the efficacy of a turmeric-based treatment for cancer has not been proven in people in clinical trials. Moreover, it is possible that turmeric powder may not be your best option and you might need turmeric tea or turmeric injection. Perhaps, it’s only turmeric grown in the Himalayas that can keep cancer away? In the lack of such information derived from research and trials lies one problem that keeps alternative medical systems alternative. The traditional remedies are often poorly characterized and lack quantitative data identifying important parameters such as the optimal dose (1 spoon once a day vs 3 spoons three times day) and means of administration (pill vs oil vs injection). 

A second, more important problem is the fact that traditional remedies are not subjected to blinded clinical trials that prove their efficacy. Holding traditional remedies to a lower standard of quality and requiring a lower burden of proof for their effectiveness poses two drawbacks. Firstly, patients may opt for potentially ineffective treatments and suffer adverse consequences, including premature death. Secondly, the lack of proof allows a sceptic to write off traditional remedies as “imaginary remedies”. In this context, a reasonable strategy to address the shortcomings associated with the development of traditional remedies would involve subjecting traditional treatments to modern research and development as well as approval processes used for allopathic treatments. 

A useful example of the scientific development of a traditional remedy is artemisinin, an anti-malarial drug developed in China that has saved millions of lives in the past few decades. Artemisinin started out as Qinghao, one of several thousand traditional Chinese herbal remedies for fever. Even after being identified as an anti-malarial drug, the application of Qinghao was limited by the fact that the ability of traditional recipes to kill the malarial parasite varied from 12 per cent to 40 per cent1. Scientists were left wondering if this variability was due to factors such as the geographic origin of the plant, season of harvest, plant parts used to make the extract and the method of extraction. It is at this juncture that the use of modern science ensured that artemisinin would become a blockbuster drug worthy of a Nobel prize. Modern chemistry was vital in optimizing the chemical extraction of artemisinin from the leaves and this compound showed 100 per cent efficacy as opposed to the 12-40 per cent efficacy of the traditional extract. Beyond helping us identify the active ingredient, developments such as x-ray crystallography helped us determine the chemical structure of the compound.

This helped chemists to develop variants of the original artemisinin that were even more effective and easier to administer. Then followed clinical trials that were vital in identifying the correct dosage, frequency and route of administration (pills versus injections) necessary to cure patients effectively. Thus, a herbal remedy that languished in rural China for hundreds of years was transformed into a vital drug that has saved several million lives around the world thanks to the wisdom of leveraging modern science for the advancement of traditional knowledge. 

The development of artemisinin is a good example to consider in any discussion of the future of traditional remedies in India. The best strategy to maximize the utility of these easily accessible traditional remedies would be to subject them to the modern systems of approval used for allopathic medicines. Such a strategy would serve four purposes.

Firstly, it would ensure that proven remedies that improve patients’ well-being are promoted and sub-optimal remedies are removed from routine use. Secondly, stringent clinical research is likely to improve the potency and efficacy of traditional remedies as it did in the case of artemisinin. Thirdly, the strategy may lead to the discovery of new therapeutic and medical procedures that may otherwise be lost to the world. Lastly, in the process of developing new standards for traditional treatments, we may also advance the effective but still imperfect standards used for regulating modern treatments. 

It seems unfortunate that many traditional remedies that are thought to be of significant benefit by local communities remain underutilized due to the lack of scientific development of these remedies. Subjecting traditional remedies to the development and approval processes used for allopathic treatments is a good strategy to validate traditional remedies and bring out their full potential. Such a constructive approach will help develop novel therapies, enhance technical expertise in India and help groom a new generation of scientific leaders in the field of medicine. It may seem late, but it’s never too late!

(1) Su, X.-Z.; Miller, L. H. The Discovery of Artemisinin and the Nobel Prize in Physiology or Medicine. Sci. China. Life Sci.2015, 58, 1175–1179.

Sriram Vaidyanathan, Ph. D.

Postdoctoral scholar at Stanford 

University working on gene editing to treat cystic fibrosis

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