By Dr. V. Sasi Kumar
People and governments all over the world are waiting for a drug that would cure the Covid-19 infection and the drug is sure to be found sooner or later. But people are afraid that it would be sold at an exorbitant price by whichever pharma company finds it. The fear was expressed by a reader some time back in a comment in The Guardian (https://www.theguardian.com/commentisfree/2020/apr/15/coronavirus-treatment-drug-companies) and eventually by governments (see: http://infojustice.org/archives/42350), with more than 140 world leaders, experts and elders coming together to make an unprecedented call for guarantees that COVID-19 vaccines, diagnostics, tests and treatments will be provided free of charge to everyone, everywhere. These examples are cited here only to demonstrate the importance of making medicine accessible to everyone.
Unlike most products and services, medicine and education are too important for everyone to be left to market forces. The health of each person depends not just on themselves, but on everyone around him also. This is another example of the well-known Nguni Bantu term, Ubuntu, meaning “humanity”, but implying in a sense, “I am because we are”―—in other words, no one can exist independently without society. This was realised by early African people who, therefore, always ensured the well-being of everyone around and also by some governments, like the government of the state of Kerala, India, who received global applause for the manner in which it tackled the corona pandemic recently and the Nipah infection earlier.
But modern medicine does not consider it so and is very much market-driven, with essential medicines sometimes being sold at astronomical prices that make it inaccessible to a large part of the needy. Examples are plenty, but it suffices to point to two of them here: namely, the matter of the AIDS drug that was kept out of reach of most patients in Africa and the more recent matter of the drug Daraprim to treat the parasite diseases toxoplasmosis and cystoisosporiasis, which went overnight from $13.50 a tablet to $750 after acquisition of the company by a start-up! Clearly, a system that considered that healthcare is best market-driven now stands exposed with thousands of times more deaths due to the coronavirus than a system that considered health-care to be a basic right, as in Kerala.
GNU is Not Unix
So, what could be the solution? This reminds one of a similar situation in computer software when hardware prices dropped like a stone in water but software costs rose like a helium balloon and became the dominant part of the cost for anyone wishing to use a computer. This was made possible by converting software into a product which offers only the right to use, as opposed to the prevailing practice of allowing the users to do whatever they want with it, as was done in the Unix world before software became proprietary. Thus was born Free Software, launched by a prominent hacker of the time at the Massachusetts Institute of Technology, Mr. Richard M. Stallman under the project he called GNU’s Not Unix (with the recursive acronym GNU). This is software that gives users the freedom to use, share, study and modify. With those rights, the software became freely downloadable at zero cost, enabling anyone to use even an old computer, and thus making it accessible to virtually anyone. Today the software has grown to be the dominant one among all computing devices.
Can this be a model for medicine too? Yes, indeed. It can. In fact, there are medical systems other than modern medicine that practised this kind of openness. All traditional medical systems were open, as the concept of the ownership of knowledge, such as copyright and patent laws came only very recently. In fact, the first copyright law was enacted only in 1710 by Queen Anne of England and was known as the Statute of Anne. It was actually meant to prevent publishers from controlling the printing and sales of books to benefit only themselves. The statute sought to benefit the authors in order to encourage them to write more for the good of society. That it eventually got to be controlled by publishers is another story altogether.
The point is that, before all that happened, all knowledge was free (well, almost1), and everyone could learn whatever they wanted. Thus, medicines were often prescribed not by just a name, but by giving the recipe to prepare them. This continues to be the custom in systems like Ayurveda, Siddha and Unani systems of medicine developed in India and the Arab world and the Traditional Chinese Medicines (TCM2). But these medical systems may not be acceptable to many who are looking for scientific validation. This, unfortunately, is a drawback of these systems that were created millennia before modern science was born. But it could be easily recified if some researchers in the medical field are open-minded enough to do experiments to validate their medicines and treatment protocols, which have many pieces of anecdotal evidence of success. Alternatively, the government of India could direct its own Central Council for Research in Ayurvedic Sciences (CCRAS) to validate Ayurvedic, Siddha or Unani treatment protocols using modern scientific methods.
But, let us leave that for now. There really is a strong movement towards modern Free Design hardware for medical prosthetics3 and other medical equipment and also Open Source Drug discovery4. Thus, if it is possible in the case of software and hardware, it is possible in the case of medicine too. What is needed is for us to promote such devices and medicines, and for researchers to look into the potential of these ancient systems with an open mind.
It is interesting that many people even in the West seem to appreciate the holistic medical practices of Ayurveda, as Ayurvedic treatment and even research is spreading in Europe and America. Witness the large number of Ayurvedic treatment centres in Germany5 or the Council for Ayurveda Research6 (CAR) in the United States.
At the same time, it is good to see that the government of India has launched an extensive study of Ayurvedic medicines for both prevention and cure of the corona infection. Let us hope to see some good results from the study that would reinstate Ayurveda as a mainstream medical system in India.
1. The notable exception being lower castes being denied access to certain kinds of knowledge in India and some restrictions on learning or doing certain things in Europe. A very good example of this is Hipatia of Alexandria who is said to have been killed for doing Mathematics, which women were not permitted to do in those times.
2. See: https://en.wikipedia.org/wiki/Traditional_Chinese_medicine
3. See: https://www.clusterlabs.org/pacemaker/ for example
4. See, for instance, http://www.osdd.net/ or https://en.wikipedia.org/wiki/Open_Source_Drug_Discovery
5. See for instance, https://www.ayurveda-deutschland.org/fountain-of-youth/
6. For example, http://ayurvedaresearchusa.org/
*The Author is a scientist, formerly at Centre for Earth Science Studies,