Ministers and public figures must not be seen as endorsing drugs whose efficacy is in doubt
The presence of Union Health Minister Harsh Vardhan at a press conference to promote Coronil, an Ayurvedic pill promoted by Baba Ramdev’s Patanjali Ayurved, is objectionable on more than one count. Coronil is a concoction of common herbs known to Ayurveda. Since June, there have been attempts to deploy it into India’s COVID-19 management protocol. Dr Vardhan, alongside Cabinet colleague Nitin Gadkari, was at a press conference with Baba Ramdev and other promoters of Patanjali to announce a scientific publication describing the efficacy of Coronil in ridding volunteers, part of a clinical trial, of coronavirus. For one, Coronil is a product manufactured by a private company. Doctors — Harsh Vardhan is an ENT surgeon — are explicitly barred from promoting drugs of any sort. Though Dr Vardhan didn’t explicitly mention Coronil in his address at the function, what public functionaries are seen to be doing speaks louder than what they say. Baba Ramdev first claimed that his product was endorsed by the WHO. Following media reports, WHO South-East Asia tweeted that it hadn’t reviewed or certified the effectiveness of any traditional medicine for the treatment of COVID-19. What transpired was that India’s apex drug regulator had certified Coronil as a pharmaceutical product in “supporting COVID treatment and an immunity booster” and cleared it for export. It hasn’t recommended it as treatment for COVID-19.
The publication of a double-blinded, randomised clinical trial in a research journal isn’t an endorsement of a product, but an essential requirement of reporting the drug’s action to subject experts. The report reveals that the medicine was only tested on 95 of those asymptomatic and “mildly symptomatic” but confirmed as RT-PCR positive. The 45 patients who got the actual treatment (and not a dummy pill) tested COVID-19 negative significantly quicker. However, these numbers are small. A large proportion of those with mild or no symptoms are expected to clear out the infection without any external intervention. There was no information in the study on the number of days that elapsed before the patients tested positive, making the role of the drug in clearing out the virus unclear. True, allopathic medicine too has cut corners: an ICMR-led trial ultimately couldn’t justify the administration of hydroxychloroquine; the Drugs Controller General of India approved itolizumab by Biocon that was tested only in a sample of 30 but was advertised as a “breakthrough drug”; and Covaxin was approved before its efficacy was known. Processes are imperfect, but the government must demonstrate its scientific disinterest when evidence is wanting.