Role of AYUSH during pandemic and its challenges – Explained, Pointwise

Introduction

The COVID-19 pandemic has emerged as a public health challenge. The burden of disease and mortality is steadily increasing in many parts of the country. Several social and economic factors are leading to devastating situations. Effective management to address this infection is still evolving and attempts are being made to integrate traditional interventions along with standard care. 

In this regard, India is using the AYUSH system of medicine to provide relief and alleviate some symptoms of COVID-19. The AYUSH system is not seen as a cure, rather it is being used for the management of asymptomatic and mild cases of Covid-19 and for prophylactic (preventive) care. But despite that the Role of AYUSH during the pandemic is indispensable. 

What is AYUSH?

• AYUSH stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.
• These systems are based on traditional medical philosophies. They represent a way of healthy living with established concepts on prevention of diseases and promotion of health.
• In 2015, the Ministry of Ayush had also included Sowa Rigpa into the AYUSH system.
• Benefits of AYUSH system:
  • It is generally cheap and affordable
  • AYUSH medicines have lesser side effects than modern medicine.
  • It has proven to be effective in lifestyle diseases like diabetes and hypertension
  • It is used to provide healthcare in rural hinterlands where there is a shortage of allopathic doctors. 

Institutional Framework for AYUSH

• The Ministry of AYUSH is at the apex. It promotes and propagates Indian systems of Medicine and Homoeopathy.
• The National Medicinal Plants Board (NMPB) coordinates activities relating to conservation, cultivation, marketing, export and policy-making for the development of the medicinal plant’s sector. 
• The Central Council of Indian Medicine (CCIM) and the Central Council of Homoeopathy (CCH) are two statutory regulatory bodies. They are responsible for – 
  • laying down minimum standards of education, 
  • recommending recognition of medical qualifications, 
  • registering the practitioners and laying down ethical codes.
• There are five research councils that undertake officially sponsored research activities.
• The country also has eight National Institutes for teaching the AYUSH system. This includes the National Institute of Ayurveda, Jaipur; the National Institute of Siddha, Chennai etc. 
• Four different Pharmacopoeia Committees work for preparing official formularies/pharmacopoeias(An official authoritative listing of drugs). They aim to evolve uniform standards in preparation for drugs in Ayurveda, Siddha, Unani and Homeopathy.

Role of AYUSH medicines used during pandemic

The role of AYUSH medicines increased significantly during the pandemic. The AYUSH medicines and techniques used during the pandemic are,

• Ayush-64: It is an Ayurvedic drug developed by the Central Council for Research in Ayurvedic Sciences(CCRAS). It is the apex body for research in Ayurveda under the Ministry of Ayush.
  • The drug was originally developed in 1980 for the management of Malaria. It has now been used for Covid-19 as its ingredients showed notable antiviral, immune-modulator, and antipyretic (anti-fever) properties.
• Kabasura Kudineer: It is a Siddha medicine for the treatment of fevers. It is now being used to treat asymptomatic, mild, and moderate COVID-19 infection cases.
  • It increases immunity and acts as an immune-modulator as this virus adversely affects the immune response.
• Habb-e-Bukhar: It is an Unani drug given to Covid-19 patients who are undergoing high fever.  
• Arsenicum album: It is a homoeopathy drug considered correcting inflammation in the body. It takes care of diarrhoea, cough and cold.
  • It is recommended for prophylactic (preventive) use against Covid-19. Further, it is also found to be useful in treating mucormycosis (fungal infection).
• Yogic Protocols: They are used in the Covid-19 treatment centres to improve respiratory and cardiac efficiency, reduce stress and anxiety and enhance immunity. Asanas like Pranayama, Shavasana etc. are extremely beneficial in this regard.

Challenges faced by AYUSH medicines and practitioners

• The 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). As it 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.
  • There have been numerous cases of terminal liver failure and irreversible organ damage due to over consumption of herbal preparations.

Suggestions to improve the role of AYUSH

• Firstly, AYUSH practitioners should follow the instructions issued from time to time by the WHO, Ministry of Health & Family Welfare and Ministry of AYUSH. They should mould their advice as per the changing guidelines in order to administer proper treatment.
• Secondly, the AYUSH sanjivani app’s data must be regularly assessed and evaluated in order to include/exclude the usage of traditional medicines in tackling the pandemic.
  • Sanjivani is a mobile app for impact assessment of the effectiveness, acceptance and usage of the different AYUSH advisories. 
• Thirdly, the AYUSH medicines should be put through rigorous trials in order to be accepted as legitimate medications in the present times.
• Fourthly, 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.
• Fifthly, the government should also focus on Capacity-building of licensed AYUSH practitioners through bridge training to meet India’s primary care needs. 
• Sixthly, 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.
• Seventhly, the government should create courses that produce qualified pharmacists trained in AYUSH pharmacopeia, who can then be placed on thousands of AYUSH stores across the country.
• Lastly, every formulation of AYUSH medicine must carry a label detailing its ingredients, side effects and other important information as is mandated for modern medicines.

Conclusion

The pandemic has made us realize that no single health care system can provide satisfactory answers to all the health needs of modern society. There is a need for an inclusive and integrated health care regime that could guide health policies and programs in the future. Medical pluralism is here to stay and the role of AYUSH sector has a critical role to play in the new and emerging situation.