Tamil Nadu with one of the worst dengue epidemics it has seen.
As part of its response, the government is freely distributing a herbal concoction called nilavembu kudineer.
What is nilavembu?
One of the core ingredients of the niluvembu kudineer is andrographis paniculata (AP).
It is used in herbal medicine systems across South Asia.
It is recommended for fevers under the ancient Siddha system of medicine.
Even though there is no evidence of their efficacy, nilavembu along with other alternative remedies such as papaya-leaf juice and goat milk are used by many during epidemics.
Is it really effective?
Some evidence exists for its potency against a range of illnesses.
AP is known to inhibit the dengue virus in animal cells in a laboratory, and to reduce symptoms of respiratory tract infections in small human trials.
But innumerable other herbal remedies also show such early promise.
But only a tiny handful of these remedies go on to prove their efficacy in large-scale, placebo-controlled human trials.
This is because the science of developing drugs from medicinal plants is complicated.
Poly-herbal remedies like nilavembu are a mix of several compounds, while most of modern medicine relies on single-compounds.
Plus, the amount of the active ingredient i.e the compound in a herb that acts against an illness, varies across plants.
So drug makers have to find a way to identify this ingredient and test it in large- scale trials.
This exercise requires not only massive financial investment but also intellectual honesty.
What are the risks?
As the studies are limited, the possible side-effects are not known completely.
At the best Nilavembu can only be a supplement.
But it is possible that people will misconstrue a supplement for a cure.
The risk of patients who need medical attention, such as those with dengue haemorrhagic fever, opting for this drug instead of rushing to a hospital should not be underestimated.
What should be done?
While it is hard for government bodies to curb such practices, they must never endorse them.
Unfortunately, too many attempts in India by the government to validate traditional medicine are driven less by honesty and more by blind faith.
e.g Last year the CSIR launched an anti-diabetic herbal pill called BGR-34 on the strength of what appeared to be very poor evidence.
