During the three months of this most recent visit, it became clear to me that India can continue to build on its current momentum if the people and government coalesce around principles of responsibility, charity and restraint. To do so, they will need to successfully embrace a broad spectrum of issues-most particularly values that are personified by the father of independent India.

One critical press pundit concedes, "India has managed to stick together for 60 years, against all the odds. Given the record, anything is possible. Maybe we will make it!" Agreed.

 

Online Extra: India's Fast Diversifying Medical Sector

The Indian medical spectrum is as diverse as any nation's, if not more so. With multiple facets of it being aggressively developed across the country and abroad, the medical sector is becoming a significant foreign exchange earner. Keys to its fast-evolving success are the relatively low cost of services and products coupled with a high degree of professionalism-the latter importantly owing to thousands of Indian health practitioners who have studied and practiced in the United Kingdom, the United States, Australia and Germany. Paradoxically, a relatively new medical export that owes its rapid international growth to the ever expanding interest in natural health care is India's five thousand-year-old Ayurveda system of mind, body and spiritual care.

Medical outsourcing centers have been established in Chennai and Kolkata for the maintenance of records from doctors and hospitals in the United States, Canada and Europe. The successful archiving activity is now expanding to embrace diagnostic services. Taking advantage of the country's time differential, particularly with the western hemisphere, Indian firms offer professional analysis and overnight reporting, of examinations ranging from blood tests to MRIs, to client institutions and practitioners-at very competitive rates.

High quality, low cost hospitals specializing in western "allopathic" medicine and focused on caring for foreigners are springing up in Delhi and Mumbai, many of them staffed by doctors returning from years of practice in the United States and Britain.

The key selling point, particularly for British and Canadian patients with critical conditions, is prompt professional care. Relatively inexpensive charges allow thousands to bypass potentially fatal waiting periods in badly backlogged socialized systems. A leading position in this fast-growing sector has been taken by Apollo Hospitals group, the largest private medical group in Asia.

Apollo, which operates 41 hospitals plus a chain of retail pharmacies within India, is exploring acquisitions in Britain, including Capio UK's 21 hospitals. In addition, the group is pushing into other medical areas, including undertaking a joint study of the causes for India's high rate of heart disease with Johns Hopkins Medicare, and even hospital management as far afield as Yemen.

Ranbaxy Laboratories Ltd., the country's largest manufacturer of allopathic medications, ranks among the ten largest generic drug manufacturers worldwide. The company exports to some 125 countries and operates overseas manufacturing facilities in China, Ireland, Malaysia, Nigeria, Romania, the United States, Vietnam and, as of May 2007, South Africa. Ranbaxy made eight offshore acquisitions in 2006 but dropped out of the competition in March of this year for Merck of Germany's generics arm when the bidding exceeded $6 billion.

Dabur India Ltd., India and the world's largest herbal-ayurvedic manufacturer, boasting a portfolio of more than 250 products, has a 120 year history. The company does business in more than fifty countries and has rapidly expanding toiletries and food businesses. Aggressive international expansion in recent years has been a key factor in the spread of Ayurveda beyond India's borders.

Ayurveda, an ancient and uniquely Indian medical practice, has enjoyed marked growth both domestically and overseas, particularly in the last decade. The all-natural medical system has enjoyed a significant renaissance, particularly in Kerala and Tamil Nadu states, following nearly two centuries of severe restriction under the British Raj. The Kerala state government is preparing for an increase of foreign visitors for Ayurveda treatment to 100,000 in 2010, up from 15,000 in 2005. Of India's great innovative achievements, Ayurveda is certainly the most enduring and could potentially be a significant factor in the country's export drive.

P.R. Krishna Kumar, Managing Director of Arya Vaidya Pharmacy [Coimbatore] Ltd. (AVP), is energetically leading his organization into new activities, while simultaneously seeking to preserve the rich traditions of Ayurveda,Yoga and Kalari. One of the largest and most integrated Ayurveda groups with an extensive network of hospitals and clinics, AVP is currently building a 250-bed complex in Coimbatore that will expand operations at its home base. Major proposed projects in Karachi, Pakistan and Durban, South Africa, building on extensive existing programs in Malaysia, Singapore and Yemen, indicate the group's outreach commitment.

AVP exports selected natural health medications and oils to a dozen countries including the United States and Britain. Currently building a modern manufacturing and research complex for its 500 medicines and over-the-counter (OTC) products, AVP has recently moved its thirty- year-old Ayurvedic college to a new campus. The group was awarded a grant in 2004 by the U.S. National Institutes of Health, the first Ayurveda project NIH has undertaken a pilot clinical trial of rheumatoid arthritis, comparing ayurvedic treatment with standard medical treatment.

A particularly dynamic development is AVP's partnership with Hindustan Lever to create one hundred Ayush centers throughout India, with overseas expansion overseas planned to begin in 2010. Krishna Kumar considers the partnership "very important to attract a new generation of patients to Ayurveda".

Founder and managing trustee of the internationally recognized scholarly Ayurveda quarterly, Ancient Science of Life, AVP's managing director has contrarily launched a campus of the University of Seychelles' allopathic medical college. The Seychelles institution is one of several that prepare students to practice Western medicine in the United States, but virtually all students at the campus near Coimbatore plan to practice in India. Krishna Kumar's rationale:

The western system is dominant throughout most of the world. We need to have allopathic doctors with a basic understanding of Ayurveda, and Ayurvedic doctors conversant with Allopathy.

Western medicine is strong diagnostically and in treating acute conditions; Ayurveda excels in treating chronic conditions and is equally strong in diagnosis. We have established a committee of faculty from both our medical schools to create an integrated curriculum that gives students a solid grounding in both systems.

Delhi-based ayurvedic physician Dr. Akhilesh Sharma has spread the Ayurveda message to Europe and the United States for a decade. A Ph.D. in herbal medicine, Dr. Sharma has established close links with Sweden's Karolinska Institute, Britain's Prince of Wales Foundation for Integrated Health and Harvard Medical School, and is a visiting professor at the California College of Ayurveda.

"Our challenge is to convince western authorities of Ayurveda's validity", Dr. Sharma observes,

because there are too many areas of naturopathy that have little or no scientific track record. Ayurveda is the base from which Chinese medicine was derived 2,500 years ago and Germany's Dr. Samuel Hannemann, a Sanskrit scholar, established homoeopathy 250 years ago. We have strong opposition from much of the world's pharmaceutical industry, but they cannot dispute western medicines having on average four contra-indications for every indication, while Ayurveda has five millennia of successful practice, and no contra-indications.

With its broad and well-established medical sector flourishing as never before, India has a special opportunity to both increase its exports and foreign exchange earnings, and provide much-needed health services to millions at home and around the world. As one senior hospital administrator observed wryly, "Our work may not have the financial potential of the information technology sector, but it will surely save many more lives."

John R. Thomson, a geopolitical analyst, recently spent three months in India. He has regularly traveled to the country since 1967.

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