Recommending the need for integrating alternate and modern systems of medicine in India, an official report has asked the government to formulate standard responses and guidelines for critical areas where a combination of therapies can be used for treating patients.
It has asked the government to extend the Drugs and Cosmetics Act, 1940, to practitioners of alternate systems of medicine to enable them to prescribe modern medicines and deal with emergency situations.
The recommendations also include strengthening postgraduate education both quantitatively and qualitatively and encouraging rigorous and independent research, the quality of which needs to be judged by publications in reputed journals — something that continues to be ignored (with a few exceptions.). A joint Indian Council of Medical Research-AYUSH decision-making body with representation of all research councils should be constituted for promoting interdisciplinary research, it says.
“There is a need for independent surveys on the utilisation patterns of the alternate systems of medicine (ayurveda, yoga, unani, siddha and homoeopathy),” an official report on “Status of Indian Medicine and Folk Healing — with a focus on integration of AYUSH medical systems in health care delivery” suggests.
India is the only country in the world which officially recognises multiple systems of medicine. Prepared by the former Health and Family Welfare Secretary (Department of AYUSH), Shailaja Chandra, the report recommends the need for measuring the contribution of contractual AYUSH doctors when they perform AYUSH and modern medicine functions which is quite widespread.
Recognising the ground realities where AYUSH doctors recruited under National Rural Health Mission (NRHM) are quite often functioning as the sole in-charge of Primary Health Centres, particularly in remote areas, the emphasis in the report is on equipping them properly if they are expected to provide primary level acute and emergency care. However, the fact that they have been primarily recruited to provide AYUSH health care services has also been underscored.
A Task Force should be set up to address the ground realities relating to patients’ combined use of modern medicine and AYUSH drugs and therapies. Only the government can set up an expert group which can examine whether cases of adverse drug reaction or contraindications call for a cautionary to be issued. The group should have on it pharmacologists who have been working with the AYUSH sector as well as practitioners from ayurveda and unani medicine, who can describe the constituents of the drugs.
Guidelines need to be drawn in consultation with experts from all drug-based AYUSH systems to guide patients about the benefits and strengths available under each system of medicine, the report says.
Modern medicine doctors in the government health facilities also need to be provided with standard literature so that patients can gain basic information about options available without the doctor himself having to get involved. Apart from the doctors, the nursing and pharmacy staff working at the primary and secondary hospitals also need to be exposed to the strengths of the AYUSH systems. The introduction of short orientation modules on AYUSH in the nursing and pharmacy courses needs to be facilitated by the Department of AYUSH by holding discussions with the Nursing and Pharmacy Councils and degree/diploma granting bodies. This should be done through the Para-medical Services Division in the Union Ministry of Health to see that the strategy is followed systematically, Ms. Chandra says in her report.
As a long-term measure, a 10-year integrated MBBS/MD/PhD in integrative medicine needs to be introduced, wherein the essentials of all major healthcare systems can be incorporated. If this is linked with openings for research, it would generate much greater interest in the AYUSH systems.
In addition to strengthening AYUSH systems, the report says there is a need for greater refinement in the overall administration of Panchakarma therapies before eventually moving to the establishment of a Centre for Scientific Research in Panchakarma (CSRP) to undertake joint research, the report says.
