WHO and Traditional medicine in India

In a positive development, the World health Organisation (WHO) and Government of India has finalised the establishment of Global Centre for Traditional Medicine (GCTM) in Jamnagar, Gujarat.

• It will be first one-of-its kind traditional medicine centre, supported by an investment of USD 250 million from the Government of India.

• Traditional medicine has a long history.
• Around 80% of the world’s population is estimated to use traditional medicine.
• Some 40% of approved pharmaceutical products in use today derive from natural substances, highlighting the vital importance of conserving biodiversity and sustainability. 
• The WHO’s decision to advance knowledge in traditional medicine stems from the fact that 170 out of 194 member states have reported the use of traditional medicine in their respective nations and have asked for the former’s support in the creation of a reliable governing body.
• The Indian government has committed $250 million to support the institute’s establishment, infrastructure and operations.

The new WHO Centre

• Location: Jamnagar, Gujarat, India.
• While Jamnagar will serve as the hub, the new centre is being designed to engage and benefit all regions of the world.
• It will concentrate on building a solid evidence base for policies and standards on traditional medicine practices and products and help countries integrate it as appropriate into their health systems and regulate its quality and safety for optimal and sustainable impact.
• Strategic area: The new centre focuses on four main strategic areas:
  • evidence and learning
  • data and analytics
  • sustainability and equity
  • innovation and technology

What is Traditional medicine?

• The term traditional medicine describes the total sum of the knowledge, skills and practices indigenous and different cultures have used over time to maintain health and prevent, diagnose and treat physical and mental illness.
• Its reach encompasses ancient practices such as Acupuncture, Ayurvedic medicine and Herbal mixtures as well as modern medicines.
  

Different types of Traditional medicine system in India

Traditional medicine has for long been the first port of call to treat a diverse set of ailments — a significant number of people in India still trust ayurveda, siddha, unani, sowa-rigpa and others.

• Ayurveda:The Ayurvedic System of Medicine evolved nearly 5000 years ago (3000 BC). The word Ayurveda means ‘Science of Life’ and employs treatment modalities, such as purification, palliation, prescription of various diets, exercises and the avoidance of disease causing factors.
• Unani Medicine:Unani Medicine originated in the Arab world. Unani medicine treats a patient with diet, pharmacotherapy, exercise, massages and surgery.
  • It was introduced in India around the 10th century AD.
• Homeopathy:The word ‘Homeopathy’ is derived from the Greek words, ‘Homois’ meaning ‘similar’ and ‘pathos’ means ‘suffering’. It originated in Germany and was introduced in India around1810-1839.
  • Homeopathy is based on the law of healing- “similia Similibus Curantur’ which means ‘likes are cured by likes’. It uses highly individualized remedies selected to address specific symptoms or symptom profiles.
• Siddha: This system has originated in India and is amongst the oldest systems of medicine in the country.
  • It takes into account the patient, his/her surroundings, age, sex, race, habitat, diet, appetite, physical condition etc. to arrive at the diagnosis. 
  • Siddha System uses minerals, metals and alloys and drugs and inorganic compounds to treat the patients. Unlike most T&CM, this system is largely therapeutic in nature.
  • Siddha literature is in Tamil Nadu.
• Sowa-Ripa:The word combination means the ‘science of healing’ and its considered one of the oldest living and well-documented medical traditions of the world. It originated from Tibet and is widely practiced in India, Nepal, Bhutan, Mongolia and Russia.
• Yoga & Naturopathy:The concepts and practices of Yoga are reported to have originated in India. Naturopathy or the naturophatic medicine is a drugless, non-invasive system of medicine imparting treatments with natural elements based on the theories of vitality, toxemia and the self-healing capacity of the body as well as the principles of healthy living.
  • The common naturopathy modalities include counselling, diet and fasting therapy, mud theory, hydrotherapy, massage therapy, acupressure, acupuncture, magnet therapy and yoga therapy.
• Siddha system-The term ‘Siddha’ is derived from the root word ‘Siddhi’ which means ‘an object to be attained’ or ‘perfection’.
  • The Siddha system of medicine owes its origin to medicinal ideas and practices of a class of Tamil sages called the Siddhars – ‘perfected’ or ‘holy immortals’.
  • They had firm faith in the ‘deathless’ physical body being in tune with the spiritual immortal ‘soul’.

Need for Revival of traditional Medicines

• In search of better alternative: Variety, flexibility, easy availability, religious/social acceptance, relative low side effect and cost are the key factor for the need of revival of traditional medicine.
• Increasing burden on modern medicines: In 21st century, tremendous advances in healthcare sector coexist with inequities in accessibility, availability and affordability of the healthcare facilities in many parts of India.
• Integration of Ayurvedic and others Indian traditional medicine in clinical practice will helpful to promote the health of the people who are unable to access the modern medicine properly.
• Rural reach: A study in rural area of West Bengal shows that folk medicine play a key role to prevent common diseases likes small injuries, skin disease, fever, dehydration, diabetes, high BP, liver disease etc in better way.
• In rural areas, indigenous medicine play significant role in primary healthcare for prevention/management of common ailments.
• Less side-effect: the traditional medicines have less side effects with respect to modern allopathic medicines as they are made from natural substances.

Traditional medicine vs Modern medicines

• Technical challenges: Instruction and practice of traditional medicine have increasingly embraced the principles of modern medicine, practitioners of this system are reasonably acclimatized with the latter.
• But the same cannot be said about their modern medical counterparts. An integrated model would need to educate modern medical doctors about holistic, non-reductionist approaches that are typical of traditional systems.
• Such a holistic approach endorses interaction between patient and physician. They would also have to be taught about the need to strike the right balance between the disparate approaches.
• Conceptual incompatibility: Conceptual incompatibilities between modern and traditional medicine present yet another formidable challenge.
• Medical education will need to embrace a pluralist paradigm of understanding.
• Evidence from Korea indicates that integrated teaching and practice of both systems by the same individual can overcome problems arising out of such incompatibilities.
• Evidence-based inequality:  Demand for ‘evidence’ by the modern medicine’s doctors is a challenge. However, the demand for evidence should not undermine the considerations of public welfare.
• The need for evidence should be balanced against other factors, such as the prevailing public satisfaction with traditional systems, cost-effectiveness, and the long-established empirical efficacy and safety of certain interventions.

How India is promoting ‘traditional medicines’?

• For supporting traditional medicine in India, the first full-fledged department for Indian Systems of Medicine and Homeophathy (ISM&H) was created under the Ministry of Health and Family Welfare, in 1995.
• This department was, in November 2003, renamed as Department of Ayurveda, Yoga and Nauropathy, Unant, Siddha and Homeopathy (AYUSH).
• The current National Health Policy of India has proposed functional linkages of AYUSH at all levels of health systems, including service delivery as well as work force.

What measures are required?

• Effective planning: The modernization of traditional and complementary medicines would require extensive scientific research, diligent screening and strict regulatory measures.
• Modernisation: The facilities of the GCTM must be used to encourage the induction of scientific and ethical practices within traditional medicines and modernize them.
• Transparent policies: Governing bodies, too, must be transparent about the safety and the efficacy of such treatments. But the encouragement of alternative medicines must not mean State disincentives for allopathy.
• Supplementary care: The aim of institutes such as the GCTM should not be to replace allopathy but rather plug the gaps and provide supplementary care.

The stand of WHO and GOI for establishing a Global health centre, an integrative model will be needed. A greater share of public funds for traditional medicine will be required as it becomes a significant component of the healthcare agenda. But the rise in investment would need to be justified against the limited evidence of traditional medicine. Financing disparate medicine systems under a universal insurance plan would lead to complexities, particularly in deciding the terms of reimbursement, when both systems are practised together.