The essential drug list for Siddha medicines (EDL 2013) revised and published by the department of Ayush as the guiding tool for procuring and stocking medicines in Siddha hospitals and dispensaries has come in for severe criticism by leading Siddha physicians and experts in Tamil Nadu.
Former assistant director of CCRAS, Vaidya S Usman Ali, who is currently serving as the director of the Centre for Traditional Medicines and Research (CTMR), a Chennai based NGO engaged in the research and study of Siddha and other traditional medicines, criticized the list, saying no in-depth study has been conducted to draft the new list.
The officials concerned have literally failed to elicit the opinions of the stakeholders and experts before formulating the List 2013, he alleged. CTMR has identified 15 major defects in the essential drug list for Siddha medicine published by department of Ayush in March this year.
While passing his comments on to the secretary of Ayush, v/s Usman Ali has alleged that the revised EDL 2013 does not cover all disease conditions for which people seek assistance through Siddha system; whereas for certain conditions, too many drugs are suggested. The letter of the Siddha expert says that the list lacks clarity on indication, pack size and dose and mode of administration.
The department published the list in the Ayush website in the last week of March 2013 and invited comments from all stakeholders and experts. Ayush EDL was last formulated in the year 2000. For the public health initiative programmes of CTMR, they are following the old EDL. But, when a detailed study on the revised list was conducted, the experts and researchers in the Centre found several imperfections.
CTMR declares that the use of the term ‘generic drug’ cannot be applied to herbal, poly-herbal and herbo-mineral drugs of indigenous system of medicine. In the disclaimer part of the list it is mentioned that while preparing the list, focus was given to include only generic medicines from pharmacopoeia, formulary, and authoritative texts. According to Usman Ali, instead of essential medicines, special medicines of higher prices are also indicated in the list whose purpose is to include cost effective and safe drugs useful for multiple conditions. The pack size suggested defies the seven day course mentioned in the preamble.
According to him, the list contains many herbo-minerals which have not been used for decades in any governmental hospital in India. “Then how can they be considered as safe drugs without proven records of earlier usage?,” he asked. In the column, precaution/contra-indication, for many medicines that contain mercury, arsenic and lead ‘nothing specific’ (NS) is mentioned, while original texts provide restrictions for these medicines, says director of CTMR.
Another anomaly he points out is that the list provides same indications for Muthu Parpam and Muthuchippy Parpam (item 13, 14). Muthu Parpam costs Rs.681.50 for 10 gms and Muthuchippy Parpam costs only Rs.20.90 for the same quantity. While seeking explanation from the department, he asks what is the use of listing both the medicines as essential.
Coming down heavily on the department officials, he said several medicines in the list are not manufactured by government or by approved private manufacturers, and the products are not available in the market. Use of ingredients of certain drugs is banned under various Acts including Wild Life Protection Act, but they are also included in the revised list. He said it will create legal problems to manufacture these particular medicines. Besides, no substitute is referred to these ingredients/ medicines in the new list.