Light Theesko :Integrative medicine wing in all hospitals- audacious hope

union Health Minister Mansukh Mandaviya has declared that the Centre is working towards setting up a separate wing for ‘integrative medicine’ (IM), an approach that combines conventional medicine with complementary treatments, in all medical colleges and hospitals.To promote the integration of modern medicine with homeopathy and Indian systems of medicine, particularly Ayurveda, the National Medical Commission had made it mandatory for all medical colleges to have a Department of Integrative Medicine Research. So far, so good.

The limitations of modern medicine and the significant outcomes achieved by complementing it with Ayurvedic treatment methods during the Covid waves in certain parts of the world have whetted interest in the ancient system of medicine so much so that even the World Health Organization has green-lighted efforts to bring the broad spectrum of traditional medicine into the mainstream. Setting the tone for it, Prime Minister Narendra Modi, while addressing the recent World Ayurveda Congress 2022, commended the recent growth of traditional medicine in general and Ayurveda in particular. He gave a clarion call to “bring together medical data, research, and journals and verify claims (benefit) using modern science parameters.”

As things stand today, the roadmap to having integrative medicine units in all hospitals and medical colleges of the country is nebulous. The multi-disciplinary expert committee that was set by NITI Aayog in August 2021 to “formulate a futuristic policy on integrative health and medicalcare” is yet to come out with its draft document.

The Centre must come clean on the shreds of evidence that exist to support its own theory that traditional medicine modalities (such as those of Ayurveda or homoeopathy) can scientifically align with those of modern medicine for improved outcomes. Of course, bits of evidence based on two clinical models were presented at the WAC. These were based primarily on clinical practices at the Centre for Rheumatic Diseases, Pune (CRD) and the National Institute of Mental Health and Neuroscience (NIMHANS).

The Centre’s case is that a recently established Department of Integrative Medicine in NIMHANS has showed remarkable success in treating difficult neurological diseases with a team of Ayurvedic and modern medicine physicians working in line with a carefully planned and monitored integrative medicine strategy. Likewise, modern rheumatology practice in the CRD model includes critical elements of traditional medicine and Ayurveda that have shown unequivocal evidence in CRD research projects from 1995 to date. Supervised and monitored integrative medicine intervention (including Ayurvedic drugs) over several years showed a consistently superior and sustained clinical improvement in patients suffering from active rheumatoid arthritis. There was a measured improvement in arthritis,

functionality, health and well-being. In several cases, potent modern medicine (including steroids) was reduced and in some cases even stopped for prolonged periods. Standardized Ayurvedic drug showed excellent efficacy on par with standard modern medicine in the treatment of osteoarthritis under the auspices of a central research programme that won a global award in clinical research excellence in 2013.

The Union Health Ministry has previously indicated that the Modi govt wants to merge allopathy, homoeopathy, Ayurveda and the like into one health system for launch in 2030 as per its vision of ‘One Nation, One Health System’.The related policy would integrate modern and traditional systems of medicine in medical practice, education and research.

It aims to formulate an integrative health system, under which patients would get treatment from any of the systems, depending on the severity of what ails them. “If a patient comes to a hospital, they can be given allopathic treatment if their condition is serious, but they can also be given homoeopathic or Ayurvedic treatment in the same hospital if their condition can be managed with those,” an official told the media. A committee was formed to propose a framework for the integrative health system to achieve “inclusive, affordable, evidence-based, person-centric healthcare.”

The ‘One Nation, One Health System’ was envisioned in the 2017 National Health Policy, which “recognizes the need for integrated courses for Indian systems of medicine, modern science and Ayurgenomics (a combination of Ayurveda with the study of all the genes of an organism, called genomics)”. It also talks about getting AYUSH systems to contribute to “meeting the national health goals and objectives through integrative

practices.”Coordinated with this, the National Education Policy 2020 states: “Given that people exercise pluralistic choices in healthcare, our healthcare education system must be integrative, meaning thereby that all students of allopathic medical education must have a basic understanding of AYUSH and vice versa.”

With the rollout of ‘One Nation, One Health System’ scheduled for 2030, four working groups are operational in the core areas of education, research, clinical practice, and public health and administration. These groups would also study how countries elsewhere in the world – particularly the USA, China and European nations – have translated integrative medicine into their health system.

The WHO Global Centre for Traditional Medicine (GCTM), established recently in Gujarat’s Jamnagar, is going to be a repository and showpiece for a whole lot of projects related to integrative medicine. The rationale for the establishment of GCTM is that 88% of all countries are estimated to use traditional medicine such as herbal formulations, acupuncture, yoga, and indigenous therapies, among others. Traditional medicine is now part of the growing trillion-dollar global health, wellness, beauty, and pharmaceutical industries. Ayurveda has been accepted in more than thirty nations. The Ayush industry, estimated at Rs 20,000 crore in 2014, has reached a figure of around Rs 1.50 lakh crore now.

Over 40% of pharmaceutical formulations are based on natural products and landmark drugs that originated from traditional medicine. For example, aspirin was discovered from traditional medicine formulations using the bark of the willow tree. The contraceptive pillwas developed from the roots of wild yam plants. Child cancer treatments have been based on the rosy periwinkle. Nobel-prize winning research on artemisinin for malaria control started with a review of ancient Chinese medicine texts.