|Year : 2023 | Volume
| Issue : 1 | Page : 86-90
Perspectives on Ayush sector: Innovations for future integrative health systems
K Madan Gopal1, Shobhit Kumar1, KS Uplabdh Gopal2
1 Health & Family Welfare Vertical, NITI Aayog, New Delhi, India
2 Medical Intern, Jawaharlal Nehru Medical College (JLMC), Wardha, Maharashtra, India
|Date of Submission||27-Aug-2022|
|Date of Acceptance||21-Nov-2022|
|Date of Web Publication||30-Dec-2022|
Dr. Shobhit Kumar
Health & Family Welfare Vertical, NITI Aayog, Parliament Street, New Delhi 110001
Source of Support: None, Conflict of Interest: None
Globally, traditional systems have experienced a resurgence in recent times. According to the World Health Organization (WHO), approximately 88% (170 of 194) of WHO member states report the use of traditional medicine (TM) among all WHO regions. Both in the governmental and private sectors, the Ayush system has grown significantly in recent years. However, there is substantial potential for further development and expansion in the Ayush sector. To promote growth and address difficulties that impede further growth, the Ayush sector needs innovations and research. This paper attempts to highlight the innovations that are necessary for the various potential fields of Ayush. It is essential to strengthen the Ayush systems further and increase opportunities and standards of various domains under Ayush to meet the current health needs. Essential areas for promoting innovations in Ayush include Education, Research, Clinical Practice, Health and Wellness, Public Health, Digital innovations and technologies, and pharmacovigilance. It is essential to create an ecosystem for innovation in these areas. There is a need for Ayush human resources capacity building, identifying young talents, and supporting them for innovations. Innovative ways that bring together Ayush systems and modern medicine can accomplish the promise of futuristic integrative health systems.
Keywords: Ayush, education, innovation, public health, research
|How to cite this article:|
Gopal K M, Kumar S, Uplabdh Gopal K S. Perspectives on Ayush sector: Innovations for future integrative health systems. J Drug Res Ayurvedic Sci 2023;8:86-90
|How to cite this URL:|
Gopal K M, Kumar S, Uplabdh Gopal K S. Perspectives on Ayush sector: Innovations for future integrative health systems. J Drug Res Ayurvedic Sci [serial online] 2023 [cited 2023 Jan 28];8:86-90. Available from: http://www.jdrasccras.com/text.asp?2023/8/1/86/366291
| Introduction|| |
Traditional systems have seen a renewed upsurge in recent times. World Health Organization (WHO) has reported that traditional medicine (TM) is used by approximately 88% (170 of 194) of the member states across all WHO regions. Approximately 65% of the population in rural India uses TM to help meet their primary health care needs. There are 15 agroclimatic zones, 47,000 plant species, and 15,000 medicinal plants, including 7000 Ayurvedic plants, 700 Unani plants, 600 Siddha plants, and 30 contemporary medicine plants in India, making India one of the world’s 12 mega biodiverse countries. WHO has also reiterated that countries aiming to integrate the best of TM and conventional medicine would do well to tackle the unique health challenges of the twenty-first century.
Traditional systems broadly practiced in India are Ayush systems. The growth of the Ayush system has been significant in the recent past both in the public and private sectors. For instance, the budget of M/o Ayush has increased from Rs. 1214.00 crores in 2015–2016 to Rs. 3050.00 crores in 2022–2023. In the last seven years, the total budget allocation to Ayush Ministry has increased over four times from 691 Cr to Rs 3050 Cr. As per the Ayush in India 2019 report, Ayush colleges have increased from 495 colleges in 2010 to 735 colleges in 2019. The number of National Institutes under the Ministry of Ayush has also increased recently. All India Institute of Ayurveda, New Delhi, is one such example.
Further, Institute for Post Graduate Teaching and Research in Ayurveda (IPGT&RA) has been upgraded to the Institute of Teaching and Research in Ayurveda (ITRA) as an Institute of National Importance. The National Institute of Sowa Rigpa was established in Leh in 2020. The establishment of the Satellite Institute of the existing All India/ National Ayurveda, Unani, and Homoeopathy Institutes is ongoing at Goa and Panchkula for Ayurveda, Ghaziabad for Unani and Narella, New Delhi for Homeopathy.
The market size of the AYUSH industry has grown approximately 17% from 2014 to 2020 with the increase in global and domestic demand. The number of Ayush dispensaries has increased from 24280 in 2011 to 29091 as of 01.04.2019 as per the Ayush in India 2019 report. Still, there is a vast scope of opportunities and growth in the Ayush sector and integration of the Ayush system into public health. There is a requirement for innovations and research in Ayush sector to enable growth and address existing issues that hinder growth. This paper aimed to highlight innovations required in the different potential areas of Ayush.
| Need for Innovation in Ayush|| |
Despite the tremendous growth of the Ayush system in recent times, there is a scope for further development. However, to further enable the change in the Ayush sector, it is essential to innovate in the public interest and bridge the gap between the contemporary conventional knowledge practice and Ayush systems. It is required to strengthen the system further and increase opportunities and standards of various domains under Ayush to meet the current health needs. It will also have a positive impact on the economy. Innovations in the Ayush sector need to be conceived from a different perspective as apart from prospective/outward creation, there are great opportunities for success through retrospective or inward exploration.
| Significant Areas for Innovation in Ayush|| |
The following broad areas require the utmost focus and innovations to strengthen the Ayush sector and make it a future-ready industry that is globally accepted and enhances its healthcare system. It has to be integrated with the conventional medicine method to fulfill the health need of the community.
There is a vast network of approximately 780 Ayush institutes with an intake capacity of more than 50,000 UG seats, including 412 Ayurveda colleges, 245 Homoeopathy colleges, and the remaining 123 colleges of other Ayush systems. The number of colleges has increased significantly in the past few years, especially in the Private sector. Central Government has established or under the process of launching many new All India or National Institutes in the Ayush system to provide high standards of teaching and training and tertiary healthcare services. The total number of such institutions is twelve. Among 780 Institutes, higher number of institutions are from the private sector, where it is essential to ensure quality and standards of teaching and training to ensure the production of skilled human resources. There were gaps in quality of education and training standards, and older regulatory bodies failed to serve their mandate over the period. In this regard, the government has enacted several transformative reforms to provide an affordable and quality medical education system that ensures the availability of high-quality Ayush professionals across the country. The most significant reform is the enactment of the National Commission for Indian System of Medicine Act 2020 and National Commission for Homeopathy Act 2020 and repealing the decades-old Indian Medicine Central Council Act, 1970 and the Homoeopathy Central Council Act, 1973.
Research is an essential tool for validating and globally accepting any system of medicine. High-impact research is required to develop and integrate the Ayush system with the conventional medicine system. Ayush has a good network of research institutions, including Research Councils and their peripheral Institutes of respective medicine systems under the Ministry of Ayush, having approximately 80 institutes. The Ayush Research Portal has more than 34885 research articles, which mainly includes 6328 Clinical, 13974 pre-clinical, and 8680 drug research articles related to Ayush systems. However, the number of Ayush clinical research articles in the PubMed database is much lower, which shows there is an urgent need of high-quality research and publications. Further, the classical texts and interventions of Ayush systems are thousand years old. There has been a change in the geo-climatic environment during these years. Ayush systems broadly use natural source substances as medicines, which may have undergone various changes during this long past period. Diseases have taken on a new form due to changes in lifestyle, food habits, genetics, and urbanization. This also highlights the need to revalidate the Ayush systems for a wider acceptance.
National Health Policy 2017 also advocates validated practices. It supports Pluralism: Patients who choose and when appropriate would have access to Ayush care providers based on documented and validated local home and community practices. These systems, among other things, would also have Government support in research and supervision to develop and enrich their contribution to meeting the national health goals and objectives through integrative practices.
It is common knowledge that there is a considerable variation in treatment modalities through the Ayush system in different parts of the country; the probable reason could be geographical, behavior, lifestyle, seasonal, and other variations in these specific regions. However, there is a need to standardize the practice by keeping the basic principles intact of these systems. Further, there is a need to report the success stories of traditional practitioners on scientific parameters to revalidate the efficacy and safety of these medicinal systems and disseminate knowledge for more significant benefits. There is a scope for developing tools for improving clinical practice.
Health and wellness
There is a need for a paradigm shift from disease management to health and wellness strategies. Ayush has excellent potential in terms of preventive medicine and maintenance of health. There are many advocacies like daily and seasonal regimens consisting of various dietary and lifestyle advisories, rejuvenating herbs, Yoga, meditation, moral conduct, the concept of suppressible and non-suppressible urges, and so on that contribute to maintaining health.
Public health is one of the areas where the role of Ayush systems needs to be strengthened. The proper integration of Ayush systems in public health faces numerous hurdles. The lack of Public Health Standards for Ayush systems is a major issue affecting the quality of service delivery through Ayush systems. The ongoing centrally funded scheme National Ayush Mission (NAM) primarily supports Infrastructure and pharmaceuticals. In contrast, the human resources component is not included, resulting in the difficulty of adequately implementing services under this scheme. The Conversance of Ayush products or services in conventional National Health Programmes is minimal.
Digital innovations and technologies
The WHO promotes using digital technology’s positive potential to promote and protect everyone’s health. Tele-health or Telemedicine, CoWIN App, Arogya Setu, Mobile health (m-Health), e-Sanjeevani, Health Information Technology, Drugs and Vaccine Distribution Management System (DVDMS), and personalized medicine describe the use of digital technology in health. Advanced medical technologies and electronic communication are part of the best practices in digital health, and they provide efficient healthcare services. Digital technology can contribute to achieving Sustainable Development Goals, health promotion, illness prevention, and enhancing health care services’ accessibility, quality, and cost.
Pharmacovigilance is essential for detecting, assessing, understanding, and preventing adverse effects or other drug-related problems. Considering the growing use of Ayush medicines globally, there is a need to establish a robust Pharmacovigilance system for TMs. In this regard, a nationwide program has been launched under the central sector scheme funded by the Ministry of Ayush, New Delhi, to establish and generate a system-wide adverse drug reaction (ADR) database and evolve evidence-based recommendations for the clinical safety of ASU and H Drugs. A portal, AYUSH Suraksha (portal), is also available to report suspected adverse reactions and misleading advertisements. The said scheme aims to teach the reporting culture among the consumers and ASU and H practitioners to facilitate ADR documentation. “SiddAR” (Siddha Initiative for Documentation of Drug Adverse Reaction) Android Mobile App is another initiative intended to document, report, and improve the communication of safety issues related to an ADR.
| Way forward|| |
- Education: There is a need to upgrade the existing institutions with the latest innovations and technology to improve the standards of teaching and training. It is also essential to innovate and redesign the Ayush Education system as per the public health needs of the current time and by keeping a view of future challenges. There is a need for better exposure to modern diagnostic tools such as magnetic resonance imaging, computed tomography scan, and so on, to Ayush scholars. Skill labs need to be developed to improve the standards of training. Young talent needs to be identified, and capacity building needs to be done. These young talent need to be supported and encouraged to innovate in Ayush. There is a need to develop of teacher’s training institute equipped with the latest technology for the training of Ayush faculties from time to time. Research outcomes and advancements need to be incorporated in the UG and PG curriculum. Apart from traditional teaching methods, various resources of different stakeholders like Ayush Research Councils, Central/State drug testing laboratories, and e-learning portals need to be utilized for better learning, capacity building, and hand-on training.
- Research: To leverage the goal of pluralistic health care envisaged in the National Health Policy-2017, the indigenous health systems of the country need to be mainstreamed. As part of the shared pool of knowledge, this would enhance other healthcare systems’ validity, evidence, and research. There is a requirement for robust research studies to validate/revalidate the Ayush system in the current scenario. It is necessary to conduct robust studies on the safety, quality, and efficacy of drugs and processes. The principles of Ayush need to be further explored using the latest technologies for better understanding. Innovative tools are required to understand better the concepts like Prakriti, Sapta Dhatu, Dosha, Marma, and so on for further development of Ayush systems for contemporary use in the more significant public interest. Integrated protocols need to be tested in different disease conditions. Innovative tools for verifying the standards of Ayush medicines need to be developed. There is an enormous scope for innovation in the Ayush pharma sector and the export of Ayush medicines. To foster a high-impact research ecosystem, Ayush research institutions need to be further strengthened and upgraded with the latest technology. There is a scope to innovate new research designs for testing Ayush drugs as these systems emphasize individualized care. Further, apart from drug testing, one of the innovative ways to test Ayush systems could be testing its treatment principles for a specific disease condition instead of particular drugs. The advantage of testing treatment principles would be that if a treatment principle for one particular disease is effective and safe, medication can be selected based on a person’s pathophysiology, type and stage of illness. Other scientific organizations such as Department of Health Resources (DHR), Council for Scientific and Industrial Research (CSIR), Department of Bio-technology (DBT) and Department of Science and Technology can contribute significantly in Ayush research and generating new knowledge. A whole government approach is required for fostering and strengthening research ecosystem in Ayush.
- Clinical practice: Ayush practitioners need to be encouraged to document their clinical observations and findings to facilitate great knowledge sources regarding the response of Ayush medicines and practices in different disease conditions in the present time. The practitioners need to utilize advanced diagnostic tools. Digital tools can play an important role in improving traditional practitioners’ knowledge base, disseminating knowledge and success stories to them. More initiatives such as Siddha–NIS app have to be taken; launched in 2018 by the National Institute of Siddha (NIS) and has basic Siddha-system-related information such as medicines, education, and research status. The innovations need to be done to improve and support practice. Prakriti Assessment Scale, developed by the Central Council for Research in Ayurvedic Sciences, is one such attempt. Another initiative designed by the Ministry of Ayush is the NAMASTE Portal. It is a comprehensive web portal for WHO-ICD-10 and ICD-11 Standardized Terminologies and National Morbidity Codes of Ayurveda, Siddha, and Unani Systems of Medicine. Periodic capacity building of Ayush practitioners is also important.
- Health and wellness: There is a need to innovate simple disease prevention and health maintenance packages considering the current work culture, lifestyle, and urbanization. These packages can be designed based on the feasibility of adoption by different cohorts. Innovations must disseminate Ayush knowledge to the masses and make it part of their lifestyle. Good use of information technology and artificial intelligence is necessary for achieving the same. Medical Value Tourism (MVT) is also one of the area, where Ayush provides edge to India over other counterpart countries. Ayush based MVT can be promoted by framing a roadmap for its implementation by Central Government including role of different stakeholders like Central Ayush and Tourism Ministries, States Ayush and Tourism departments, standards of services, categorization of facilities, Standard Operating Procedures, multi-lingual facilitation centers, capacity building of Ayush HR and so on.
- Public health: There is an urgent need to develop Ayush Public Health Standards, which will provide a uniform structure and standards for required Infrastructure, facilities, and services as per the population norms. It will enable the better implementation of National programs in the Ayush sector. Further, robust scientific studies regarding efficacy and safety are required to conversance Ayush products or services in conventional National Health Programmes. Innovative methods need to be adopted in healthcare service delivery. The COVID-19 pandemic has resulted in many innovations; one such innovation is the greater use of telemedicine for contactless patient care. Many States/UTs have developed their mobile application to accelerate this mode of consultation mother Ayush therapeutic packages need to be developed which are easily implementable. Integrative program protocols need to be designed to provide the most-effective comprehensive care. Integrated programs like NPCDCS are excellent examples of cost-effective and comprehensive integrative services models. Another such initiative is NTEP- AYUSH collaborative activities to end TB. Further, Ayush needs to be integrated into various programs related to nutrition, and senior care.
- Digital innovations and technologies: Ayush grid is one of the initiatives of the Ministry of Ayush. It is a massive digital platform that connects all Ayush-related institutions/hospitals to generate various types of data for information gathering, sharing, and other processes. Ayush grid needs to be seamlessly integrated with National Ayush Digital Mission. There is a vast potential in the Ayush system for digital innovation and technologies. A-HMIS (portal), Namaste Portal, e-charak, e-aushadhi portal, Yoga locator application, WHO m-Yoga app, TKDL, and Ayush Research Portal are the best examples. Integration of digital innovations and technologies in various schemes of Ministry of Ayush can help in real-time monitoring, transparency and better implementation.
- Pharmacovigilance: The states need to propagate and use initiatives like AYUSH Suraksha (portal) to establish data regarding the safety of Ayush drugs, which will help increase the credibility of the Ayush system. Ayush practitioners have a tremendous moral responsibility to use these initiatives to strengthen the pharmacovigilance system in Ayush.
| Conclusion|| |
It is essential to create an ecosystem for innovation in different areas of the Ayush system comprising education, research, clinical practice, public health, and pharmacovigilance. There is a need for Ayush human resources capacity building, identifying young talents, and supporting them for innovations. There is a need to create a mechanism for supplementing and complementing therapeutics. Startup culture and Ayush Park need to be built to facilitate new innovations, use technology, and promote research. Innovative ways that bring together Ayush systems and modern medicine can accomplish the promise of futuristic integrative health systems. However, significant efforts and leadership are required to achieve the same.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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