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Discrimination via Drugs: The dark side of India’s indigenous preparations

Navodita Jain

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`    (Photo: Leo Reynolds, CC BY-NC-SA 2.0, https://www.flickr.com/photos/lwr/3799725677)

While pharmaceutical formulations are regulated for their chemically defined compounds, traditional medicines circulate on the foundation of faith and desire. The use of these uninvestigated indigenous preparations (IPs) forms an integral part of an alternative health care system that targets a vulnerable chunk of the population. These preparations are often put to unethical use and serve a big blow to our long fight against social evils. A striking example is the consumption of IPs in the form of sex-selection drugs by expectant mothers in the hope of a male child. Though the Pre-Conception and Pre-Natal Diagnostic Techniques Act has been in place for almost 24 years, the country still grapples with prenatal sex selection and female foeticide, posing a risk to the health of newborns and mothers.

Sutapa Bandopdhyay Neogi, Indian Institute of Public Health - Delhi, Public Health Foundation of India, and her team have been studying the causes of congenital malformation in the state of Haryana for several years. The researchers had earlier found that consumption of sex-selection drugs by women during pregnancy was associated with 25% of children being born with structural abnormalities.

“We were quite convinced of the harmful effects of the IP,” says Neogi, “While we initiated animal model studies, we also thought it would be fruitful to start investigating the chemical components contributing to the effects”. The group found alarming quantities of lead and mercury in three traditional drugs containing Shivalingi (Bryonia laciniosa), Majuphal (Qtuercus infectoria) or Nagkesar (Mesua ferrea) as their major components. Quite infamously, Haryana suffers from a severely skewed female to male ratio of 832:1000 (compared to the national average of 898:1000).

Exposure to heavy metals is a cause of major concern for pregnant women. In the aforementioned indigenous preparations, lead quantity was roughly tenfold higher while mercury was four hundred-fold higher than the recommended FDA levels. Such high maternal loads of heavy metals can cross the placental barrier and damage the developing fetus, especially in the first trimester, when these drugs are usually consumed.

The presence of heavy metals is not the only concerning factor. An earlier study by the same authors reported the presence of phytoestrogens in these formulations, which are chemicals that mimic natural hormones and can cause hormonal imbalances in pregnant women, potentially even leading to sterility. A few samples even contained testosterone, a hormone strongly contraindicated during pregnancy.

Neogi’s team previously explored the demographics of consumption of such sex-selection drugs in a population-based study. Approximately 40% of the mothers who consumed these drugs had received primary education while most fathers were manual labourers. The paper reported that the risk of having a child with congenital malformations was increased threefold among mothers who had a history of IP intake. Moreover, the statistics from the study suggest that the risk of malfunction is stronger for a family with a prior girl child.

The claims of these alternative drugs are brazened and can be misleading. Even a quick internet search leads to websites like this which propound the use of Shivalingi seeds as “putr jeevak” (male birther). Shivalingi is also touted as a sexual prowess enhancer. While published experiments using male rats indicate that Shivalingi can increase testosterone levels, this may have unintended consequences. “With the overload of steroidal hormones, the drugs can potentially influence the reproductive fertility in adults. However, they are detrimental to the development of reproductive organs of the fetus,” says Neogi. “More research is needed to scrutinize and verify the biological effect of individual components. To investigate at a molecular level, we need funding and are actively looking for collaborations,” she adds.

It is imperative to state here that sex of the developing fetus cannot be altered by any drug. The chromosomal combination that determines the sex of the fetus is sealed at the time of fertilization. An informational video about this process, created as part of a project supported by the Department of Science and Technology can be found here.

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Science Education and Communication Coordinator