Global Centre for Traditional Medicine – Explained, pointwise

Introduction

The Indian Prime Minister laid the foundation stone of the World Health Organisation (WHO) Global Centre for Traditional Medicine (GCTM) in Jamnagar on April 19, 2022. Traditional medicines products abound globally and the Centre will go a long way in enhancing wellness in society. It aims to harness the potential of traditional medicine from across the world through modern science and technology. It will enable the utilization of this potential to improve the health of people and the planet. It is a welcome step but much more needs to be done in order to truly unleash the potential of the traditional medicine system.

What is traditional medicine?

The WHO describes traditional medicine as the sum total of the ‘knowledge, skills and practices that indigenous and different cultures have used over time to maintain health and diagnose and treat physical and mental illness’. Its reach encompasses ancient practices such as acupuncture, ayurvedic medicine and herbal mixtures among others.

What are the traditional medicine systems in India?

These include practices and therapies that have been part of Indian tradition historically such as yoga, Ayurveda, Siddha. It also includes other systems that became part of Indian tradition over the years such as homeopathy. 

Ayurveda and yoga are practised widely across the country; the Siddha system is followed predominantly in Tamil Nadu and Kerala; the Sowa-Rigpa system is practised mainly in Leh-Ladakh and Himalayan regions such as Sikkim, Arunachal Pradesh, Darjeeling, Lahaul & Spiti.

What is the Global Centre for Traditional Medicine (GCTM)?

The Global Centre for Traditional Medicine (WHO GCTM) has been set up by the Ministry of Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) and the WHO.

On November 3, 2020, the WHO director general announced the establishment of the WHO GCTM in India. The Union Cabinet in March this year approved its establishment in Jamnagar with the signing of a host country agreement between the Government of India and the WHO. 

India has committed an estimated $250 million to support the GCTM’s establishment, infrastructure and operations.

What would be the role of the Global Centre for Traditional Medicine?

First, It will aim to focus on evidence-based research, innovation, and data analysis to optimize the contribution of traditional medicine to global health. 

Second, Its main focus will be to develop norms, standards and guidelines in technical areas relating to traditional medicine. This will help countries create a comprehensive, safe, and high-quality health system.

Third, the GCTM will support efforts to implement the WHO’s Traditional Medicine Strategy (2014-23). The strategy aims to support nations in developing policies & action plans to strengthen the role of traditional medicine in pursuing the goal of universal health coverage.

Why should more research be undertaken in traditional medicine?

Huge Coverage: The WHO says 170 of its 194 WHO Member States have reported the use of traditional medicine. These member states have asked for its support in creating a body of “reliable evidence and data on traditional medicine practices and products”.

Biodiversity Conservation: The WHO has stressed the need to conserve biodiversity and sustainability as about 40% of approved pharmaceutical products today are derived from natural substances. For example, the discovery of aspirin drew on traditional medicine formulations using the bark of the willow tree, the contraceptive pill was developed from the roots of wild yam plants and child cancer treatments have been based on the rosy periwinkle.

Modernisation in studying Traditional Medicine: WHO has acknowledged the growing modernisation of the ways to study traditional medicine. Artificial intelligence is now used to map evidence and trends in traditional medicine.

Similarly, Functional magnetic resonance imaging is used to study brain activity and the relaxation response. This is also part of some traditional medicine therapies such as meditation and yoga which are increasingly drawn on for mental health and well-being in stressful times.

Other Benefits: (a) It is generally cheap and affordable. AYUSH medicines have lesser side effects than modern medicine.; (b) It has proven to be effective in lifestyle diseases like diabetes and hypertension; (c) It is used to provide healthcare in rural hinterlands where there is a shortage of allopathic doctors; (d) Many AYUSH medicines like AYUSH 64, Kabasura Kudineer etc. were used in tackling the Covid 19 pandemic.

What steps have been taken by India to promote traditional medicine?

AYUSH Ministry: A dedicated Ministry was created for traditional medicines named AYUSH ( Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy). In 2015, the Ministry of Ayush had also included Sowa Rigpa into the AYUSH system.

Statutory Regulatory Bodies: The Central Council of Indian Medicine (CCIM) and the Central Council of Homeopathy (CCH) are two statutory regulatory bodies. They are responsible for: (a) Laying down minimum standards of education; (b) Recommending recognition of medical qualifications; (c) Registering the practitioners and laying down ethical codes.

Collaborative Efforts: In 2016, the Ministry of AYUSH signed a project collaboration agreement (PCA) with the WHO in the area of traditional medicine. At least 32 MoUs for undertaking collaborative research and development of traditional medicine have been signed with institutes, universities and organisations of various countries. This includes the US, Germany, UK, Canada, Malaysia, Brazil, Australia, Austria, Tajikistan etc.

Technological Interventions: Ayush Clinical Case Repository (ACCR) aims at aggregating information about clinical outcomes achieved by Ayush practitioners on a large scale.

The Ayush Sanjivani app intends to generate a significant study and data regarding the efficacy of selected Ayush interventions. The data analyzed will be helpful for the further development of Ayush Systems.

What are the challenges surrounding traditional medicine?

Tussle with Allopathic care: Many allopathic doctors don’t believe in the traditional system. They question the credibility of AYUSH practitioners and are against their inclusion into the modern health care system. For instance, the Indian Medical Association objected to a recent gazette notification by the Central Council of Indian Medicine (CCIM). The notification allowed postgraduate Ayurvedic doctors to perform 58 basic surgeries.

Lacks in Validation: Scientific validation of AYUSH medicines has not progressed despite dedicated government expenditure. There are very few AYUSH treatments that have been successfully validated by well-designed randomised controlled trials (RCTs).

Poor Quality of Practitioners: The practitioners lack quality as Ayurvedic graduation and post graduation courses are often substandard and of poor quality.

Most AYUSH institutions would have to shut down if they were subjected to the same stringent norms that MBBS medical colleges are subjected to.

Further, due to poor economic opportunities, the AYUSH system fails to attract the country’s best talent.

Overuse of AYUSH medicine: They are sold as over the counter products and nutraceuticals to avoid regulation. Further, Ayurvedic stores do not even have a legal requirement of a pharmacist to dispense the medications unlike pharmacies selling modern medicine. This leads to greater consumption and enhanced self-medication.

What should be done?

First, the AYUSH medicines should be put through rigorous trials in order to be accepted as legitimate medications in the present times.

Second, the governments must stop treating AYUSH education and practice with an excessively liberal mindset. They should subject them to the same stringent norms and requirements expected from practitioners of modern medicine.

Third, the government should also focus on Capacity-building of licensed AYUSH practitioners through bridge training to meet India’s primary care needs. 

Fourth, Cross-pathy between the traditional and modern systems should be allowed to fill the lacunae in respective systems. However, this must be done after due deliberation with experts from the respective systems.

Conclusion

India has been a proven pioneer in the field of traditional medicine since time immemorial. The establishment of the GCTM with India’s support is an effort to bring synergy and cooperation in the domain of traditional medicine that would benefit all the member states. The GCTM will serve as a hub for other countries, and build standards on traditional medicine practices and products.

Source: Indian Express, Mint