Context: The WHO Traditional Medicine Global Summit 2023 in Gujarat, India, concluded with the “Gujarat Declaration”, a document that reaffirms the global commitments to indigenous knowledge, biodiversity, and traditional, complementary, and integrative medicine (TCIM).

1. What is the recently signed Gujarat Declaration on traditional medicine?

• The recently signed Gujarat Declaration on traditional medicine reaffirms global commitments to indigenous knowledge, biodiversity, and traditional, complementary, and integrative medicine (TCIM). 
• It emphasizes collaboration, research, and regulation of indigenous knowledge, biodiversity, and TCIM practices, along with scaling up evidence-based TCIM interventions and approaches.

2. What do you mean by traditional medicine?

• Traditional medicine, as defined by the World Health Organization (WHO), refers to the knowledge, skills, and practices that various cultures have developed over time to maintain health, prevent, diagnose, and treat physical and mental illnesses. 
• It encompasses a wide range of ancient and modern practices used in different regions around the world. 

3. What are some of the well-known traditional medicine systems in India?

• Ayurveda: Ayurveda is an ancient Indian system of medicine that focuses on balancing the body’s energies (doshas) to promote health and prevent diseases. It includes herbal medicines, diet, lifestyle modifications, and therapies like massage and Panchakarma.
• Yoga: Yoga is a holistic practice that originated in ancient India and includes physical postures, breathing exercises, meditation, and ethical principles. It is not only a physical exercise but also a mental and spiritual practice to enhance overall well-being.
• Siddha: The Siddha system of medicine is practiced predominantly in Tamil Nadu and Kerala. It is an ancient medical system that originated in Tamil Nadu and is based on the concept of maintaining a balance between the five elements (earth, water, fire, air, and ether) in the body.
• Sowa-Rigpa (Tibetan Medicine): Sowa-Rigpa is a traditional medical system practiced mainly in the Himalayan regions such as Sikkim, Arunachal Pradesh, Darjeeling, Lahaul & Spiti, and Leh-Ladakh. It is influenced by both Ayurveda and traditional Tibetan medicine.
• Homoeopathy: While not originally part of Indian tradition, homoeopathy has become an integral part of India’s traditional medicine practices over the years. Homoeopathy is based on the principle of “like cures like” and uses highly diluted substances to stimulate the body’s healing response.

4. What are the advantages of traditional medicine?

• Cultural Wisdom: Traditional medicine is deeply intertwined with cultural practices, beliefs, and experiences, making it a valuable repository of diverse healthcare insights.
• Holistic Approach: Unlike some modern medical systems that focus solely on specific symptoms or diseases, traditional medicine emphasizes the interconnectedness of the body, mind, and spirit.
• Natural Remedies: Traditional medicine often relies on natural ingredients such as herbs, plants, and minerals, which are gentler on the body and may have fewer side effects compared to synthetic drugs.
• Preventive Care: Traditional medicine places great importance on prevention rather than just treatment.
• Accessible and Affordable: Traditional medicine often uses locally available resources, making it more accessible and affordable, particularly in rural or underserved areas.
• Global Interest: Traditional medicine has gained recognition on the global stage, leading to research and scientific validation of its effectiveness.

5. What is the current market status of traditional medicine in India?

• The market for medicinal plants in India stood at Rs. 4.2 billion ($ 56.6 million) in 2019 and is expected to increase at a CAGR of 38.5 percent to Rs. 14 billion (US$ 188.6 million) by 2030. 
• The export value of ayurvedic and herbal products amounted to about $539 million from India in 2021. 
• Overall, AYUSH exports have reached $18 billion from $3 billion before 2014. AYUSH stands for Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy. 
• About 40,000 MSMEs are active in the AYUSH sector.

6. What steps have been taken so far by the government to promote traditional medicine?

• Ministry of AYUSH: The Ministry of AYUSH was established in 2014 with a vision of reviving the profound knowledge of our ancient systems of medicine.
• National AYUSH Mission (NAM): The government of India is implementing the Centrally Sponsored Scheme of NAM in the country through State and UTs for the promotion and development of AYUSH systems.
  • Grant-in-aid is being provided to State Governments for the development and promotion of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy.
  • NAM also supports cultivation of medical plants, production of quality and standardized ingredients for supply of AYUSH, integration of medicinal plants in farming systems, and increasing export of value-added items of medicinal plants.
• AYUSH Gram: Under the concept of AYUSH Gram, AYUSH-based lifestyles are promoted through behavioural change communication, training of village health workers towards identification and use of local medicinal herbs, and provision of AYUSH health services.
• Global partnerships: India has signed MOUs with 23 countries for cooperation in the field of Traditional Medicine and Homoeopathy in areas such as research, education, training, and more.
• 33 AYUSH Information Cells have been set up in 31 countries to disseminate authentic information about AYUSH systems.

7. What are the challenges for the adoption of traditional medicine in India?

• Trust-Deficit: There is a major trust-deficit in the soundness of Ayurvedic theories and the fruitfulness of its practices. Ayurveda is not the medical system of first choice for many people.
• Lack of Scientific Validation: Ayurveda has failed to keep pace with the intellectual and scientific advances of the times. So, it has diminished evidence-based quality.
• Sub-Standard Courses: Ayurvedic practitioners’ graduation courses are often substandard and the post-graduate courses offered at most of their institutes are of extremely poor quality.
• Lack of Practice: While MBBS graduates and postgraduates from public hospitals must mandatorily serve a specified bond period in rural areas, graduates and postgraduates from AYUSH public hospitals are not subjected to any such restrictions.
• Lack of Ecosystem: Ayurveda lacks a vibrant ecosystem of science and research.
• Trial and Error Methods: Ayurvedic practitioners must discover treatments and approaches that work. It involves a lot of trial and error with patients and leads to an erosion of the practitioner’s reputation.
• Lack of Investment:  Despite numerous efforts made by individuals and organizations to conduct research, the lack of investment into Ayurvedic research has been a major setback.
• Less Integration with Modern Medicine: Ayurveda can be used safely and efficiently only in about 60%-70% of primary-care illnesses. For rest, Ayurveda needs to be integrated with modern medicine.

8. Can you provide some measures to increase the adoption of traditional medicine in India? and How might India position its traditional medicine heritage as a global healthcare leader and contributor?

• Enhance Scientific Research: Government should invest in scientific research to validate the safety and efficacy of traditional medicine practices and remedies which will help build a stronger evidence base and increase confidence among both practitioners and the public.
• Education and Training: Improve the quality of education and training for traditional medicine practitioners by enhancing curriculum standards, and offering advanced courses, etc.
• Integration with Modern Medicine: Promote the integration of traditional medicine into the broader healthcare system to leverage the strengths of both systems.
• Regulation and Licensing: There is a need to establish clear regulations and licensing requirements for traditional medicine practitioners to ensure quality services.
• Telemedicine and Digital Health: Utilization of technology to expand the reach of traditional medicine. 
• International Collaboration: Collaborating with other countries and international organizations on research, education, and the promotion of traditional medicine. 

9. Why did it take so long for our government to understand the utility of traditional medicines?

• Historical Bias: Traditional medicines were often marginalized in favor of modern allopathic medicine due to historical biases and a perception of traditional practices as less scientifically validated. The initial focus was on Western medical approaches.
• Lack of Scientific Validation: Traditional medicines were not initially subjected to rigorous scientific scrutiny. It took time for researchers and policymakers to appreciate the value of traditional knowledge and to conduct studies validating the efficacy and safety of traditional remedies.
• Global Recognition and Demand: As global interest in alternative and holistic healthcare practices grew, and as traditional medicines gained recognition internationally, there was a subsequent reevaluation within the Indian government about the potential benefits of integrating traditional healing systems.
• Comprehensive Healthcare Approach: Recognizing the limitations of a purely allopathic healthcare system, there has been a realization that a comprehensive healthcare approach should include traditional medicines. This shift in perspective has contributed to the government’s evolving understanding of the utility of traditional healing practices.

10. Do you think ayurvedic medical practitioners must be allowed to do allopathic practice? 

Arguments in Favor:

• Integrated Healthcare: Advocates argue for an integrated healthcare system where practitioners from different traditions collaborate to provide comprehensive and holistic care. This approach can leverage the strengths of each system.
• Addressing Shortages: Allowing Ayurvedic practitioners to practice allopathic medicine might help address shortages of healthcare professionals, particularly in rural areas where access to doctors is limited.
• Patient Choice: Patients may appreciate having more choices in healthcare providers, and some might prefer practitioners who are knowledgeable in both Ayurvedic and allopathic approaches.

Arguments Against:

• Safety Concerns: Allopathic medicine and Ayurveda have different philosophies and diagnostic methods. Allowing crossover without proper training could raise concerns about patient safety and the potential for misdiagnosis or inappropriate treatments.
• Educational Standards: Allopathic medicine requires specific educational standards and training that differ from Ayurveda. Critics argue that maintaining the integrity of these standards is essential for ensuring the quality of healthcare.
• Lack of Standardization: Integrating the two systems without clear standards and guidelines could result in a lack of standardization and consistency in healthcare delivery, potentially compromising patient care.