Ayurveda occupies an unusual place in India’s health system. It is deeply familiar yet institutionally peripheral, widely used yet unevenly evaluated. Around half of Indians report using an AYUSH system, with Ayurveda the most common choice for everyday wellness and, at times, curative care. But can a medical tradition built around individualized treatment meaningfully serve population health, which depends on scale, standardization, and predictability?
Ayurveda has strengths in prevention, lifestyle, and long-term well-being. In an era dominated by chronic disease, stress-related illness, and over-medicalization, Ayurveda’s emphasis on diet, daily routine, and balance resonates with concerns Western medicine has only recently begun to address.
Yet population health is a different enterprise from individual care. It relies on interventions that can be delivered reliably, evaluated transparently, and scaled across diverse populations. Vaccination, sanitation, food fortification, and standardized treatment protocols work not because they are perfect for every individual, but because they are effective for most and can be implemented widely. The tension is obvious: Can a personalized system be reconciled with population-level needs?
Even at the individual curative level, many argue that Ayurveda cannot be rigorously evaluated. Because treatments vary by constitution, digestion, stage of disease, diet, and season, standard clinical trials are said to be inappropriate. But difficulty does not offer an exemption from finding a way. Allopathy already evaluates complex, heterogeneous interventions — stratified oncology trials, bundled mental-health therapies, and multi-component public-health programs. The challenge is not whether Ayurveda can be studied, but how to do so without flattening a complex system into a single pill — or placing it beyond question altogether.
Consider maternal anaemia, one of India’s most persistent public-health problems. According to the latest National Family Health Survey, half of pregnant women in India are anaemic. This matters because anemia in pregnancy is not a benign condition. It vastly increases the risk of maternal complications and death, contributes to low birth weight and preterm delivery, and is associated with poorer growth and developmental outcomes in children. In a country striving to reduce maternal and infant mortality and improve lifelong health, anemia is not a side issue — it is central.
The standard public-health response has focused on iron and folate supplementation, and for many women, this is essential. Yet its limits are well recognized. Not all women absorb iron efficiently. Not all convert synthetic folate into its biologically active form with equal ease. Differences in metabolism, gut health, diet, and genetic variation mean that increasing intake does not reliably translate into improved hemoglobin for everyone. And for women with beta-thalassaemia, a not uncommon condition in India, folate supplementation can be harmful because the body absorbs iron too easily. Programs designed for uniform delivery often struggle precisely because biology is not uniform.
The Ayurvedic understanding of anaemia— pandu roga, named for the pallor that marks the condition, and echoed in the figure of King Pandu, father of the Pandavas, in the Mahabharata — begins from human variability rather than treating it as statistical noise. Treatment is shaped by digestive capacity, dietary patterns, and overall physiological state, not solely by a laboratory value. Iron-containing preparations are often paired with measures aimed at improving absorption and assimilation: supporting digestion, correcting co-nutrient deficiencies, and adjusting diet and lifestyle factors that influence metabolism. In modern terms, this is a systems approach to a heterogeneous condition.
Ayurveda may not offer a ready-made solution to a population-level problem. But population health strategies may benefit from Ayurveda’s insights into why standardized interventions fail for many population subgroups. These insights can inform better public-health approaches tailored to regional needs or to population sub-groups.
These approaches require evidence — but evidence suited to complexity. Whole-system trials that compare Ayurvedic care as practiced against standard care, pragmatic trials that allow clinician judgment, and stratified analyzes that respect biological variation. These methods prioritize real-world effectiveness over theoretical purity. They are already accepted elsewhere in medicine.
Where Ayurveda has fallen short is not in principle, but in practice. Too many studies are underpowered, poorly designed, or selectively reported. Safety surveillance is uneven. Exaggerated claims — particularly around cancer, infectious disease, or vaccines — do lasting damage, not only to patients but to Ayurveda’s credibility. A system confident in its value should not need to overstate its reach.
For policymakers, the implication is clear. If Ayurveda is to contribute meaningfully to population health, it must do so on honest terms. That means investing in research designs sophisticated enough to handle complexity, tightening educational and regulatory standards, strengthening pharmacovigilance, and resisting the politicization of health claims. It also means being explicit about boundaries: where Ayurveda complements public-health programs, where it can inform them, and where it should step aside.
Our approach to Ayurveda needs to decide what role traditional medical systems will play in addressing public health challenges. In the case of Western medicine, those approaches were innovated elsewhere and we could easily adapt them. But in the case of Ayurveda, we will have to do that work ourselves if we are to successfully use it to solve our most pressing public health challenges. And that means asking tough questions of where Ayurveda delivers measurable benefit at scale — and being equally clear about where it falls short.
Ramanan Laxminarayan is president, One Health Trust. The views expressed are personal
