Vaidya R Kotecha | An integrated system of medicine to address India’s health care concerns

By: Staff Reporter
Vaidya R Kotecha, Secretary, Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy (AYUSH) discusses the scope of mainstreaming the traditional system of preventive and curative care and the proactive interventions by the Indian government.
Interviews

G’nY. Do you believe that integrated medicine systems have the potential to deal with health care problems in India?
Traditional systems of medicine, especially ayurveda, yoga and naturopathy, unani, siddha, sowa rigpa and homoeopathy (AYUSH) have a huge potential in addressing the health care needs of the society. Traditional medicines, in well codified systems can be integrated with modern medicines to provide holistic health. The systems all have their unique strengths and are being presently supported by governmental setups in primary health centre (PHCs), hospitals, colleges and many other institutions. Additionally, research is also being actively undertaken in dedicated research councils and post- graduate colleges, further strengthening the role of traditional medicines in providing health care services and generating tangible evidence of their efficacy
and safety.
India enjoys the distinction of having the largest network of traditional health care units, fully functional with a network of registered practitioners, research institutions and licensed pharmacies. As per the summary we have provided in ayush.gov.in, at present there are about 3986 AYUSH hospitals, 27199 dispensaries, about 8 lakhs practitioners, 711 colleges and 8954 manufacturing units across the country. It is now fairly well-established that traditional medicine is playing an important role in the cure of chronic diseases. Respiratory disorders such as asthma and bronchitis, cardiovascular disorders, osteoporosis in women, joint and connective tissue disorders like rheumatoid arthritis, degenerative diseases like early stages of amnesia, Parkinson‘s diseases, osteoarthritis, conditions of gastrointestinal tract,
skin diseases and mental health are areas of clinical competence of varied traditional systems.

G’nY. Is there any national level study to prove the success of complementary roles played by alternative medicinal systems in tackling the health issues in the country?
Various studies to understand the role of AYUSH systems in public health is underway. For instance, the inclusion of traditional medicines in primary health care through the National Rural Health Mission (NRHM)provides an opportunity to map its effectiveness. The National Programme for Prevention and Control of Cancer, Diabetes, Cardio-vascular diseases and Stroke (NPCDCS) wherein the introduction of AYUSH was initiated in 2015-2016 across eight districts pan India, through the Ministry of AYUSH’s research councils, shows promising results. Various lifestyle disorders—cardiovascular diseases, diabetes and obesity and osteoarthritis are addressed. Furthermore, the effectiveness of AYUSH systems in Reproductive and Child Health (RCH) programmes have been well documented.
Way back in 1987, the Central Council for Research in Ayurvedic Sciences (CCRAS) conducted a survey in 12 states on various aspects of health related demography, publishing a report wherein it was evident that about 70 per cent of India’s population uses the traditional system of medicine as the first line of treatment. In fact a pilot study in 2015 was conducted in two districts of Himachal Pradesh, as a part of CCRAS and Indian Council of Medical Research (ICMR) collaborative project which revealed that in the selected study area, 54 per cent of the head of the household recommended traditional medicines and about 65 per cent of women sought ayurvedic treatment for antenatal, post natal and gynaecological problems in addition to child health care. Following the successful integration of the programme in Himachal, a study of the effectiveness of ayurveda in the RCH programme has been initiated in the Gadchiroli district of Maharashtra. Also, studying the role of AYUSH and local health traditions under the NRHM in 18 states across India, outcomes revealed that 80-90 per cent households were aware about the utility of local health traditions and co-located services (along with allopathic health care) were well utilised in several states. In this regard the successful demonstration of integrating ayurveda with the modern system of medicine in a tertiary care hospital—Safdarjung, New Delhi, for the management of osteoarthritis of the knee, may be mentioned.
The analysis of the 2016 World Health Organisation’s study on global ageing and adult health (WHO-SAGE), marked 11.7 per cent respondents as frequent users of traditional medicine for health care. The study also suggested that those individuals with a lower socio-economic status and those living in rural areas were more likely to report the use of traditional medicines.

G’nY. What are the plans/schemes of the Indian government to popularise alternative medicine systems amongst the masses?
Various programmes have been undertaken by Ministry of AYUSH for popularising the traditional system of medicines in India—the Public Health Initiatives scheme, scheme for Revitalisation of Local Health Traditions, Midwifery Practices, central sector scheme for Promotion of Information, Education, and Communication (IEC) in AYUSH, besides various research oriented schemes and events—Arogya mela, International Yoga Day, and Ayurveda Day. The 12,500 health and wellness centres of AYUSH are being established in a phased manner at the grass-root levels with a special focus on preventive health care.
A national AYUSH morbidity and standardised terminology E-portal (NAMSTE), for uniform centralised collection of AYUSH statistics and to include these systems of medicine in the traditional medicine chapter of the International Classification of Diseases, WHO, was launched in 2017. This will help popularise AYUSH as a codified system of medicine globally. Also, the AYUSH Hospital Management Information System (A-HMIS) was launched in 2018. The Ayur Prakriti web portal—Standardised Prakriti Assessment Scale was also developed and launched, the copyright for which was recently obtained.
A project on reliability testing and validation of Ayurveda diagnostic tools focusing on development of Standardized Ayurvedic Case Taking Protocol (SACTP) has been undertaken. Moreover, dedicated research councils are working under the Ministry of AYUSH for each system of medicine, to back it with tangible evidence. The AYUSH research councils run research oriented health care services—Tribal Health Care Research Programme, Ayurvedic Mobile Health Care Research Programme under Schedule Castes Sub Plan, Swasthya Rakshan Programme in Assam, Sikkim and Arunachal Pradesh, to collect morbidity patterns and to determine the efficacy of the traditional treatments.
Dedicated to research publications, the AYUSH research portal has been functional since 2011, where more than 25,000 research abstracts contributed by research councils, national institutes and universities have been uploaded. Around 56,127 article downloads from 157 countries around the world have been recorded so far.
Thus there is considerable ongoing effort to recognise, nurture and develop the traditional alternative medicines in the interest of the health of mankind.

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