Viewpoint by Manish Uprety*
NEW DELHI (IDN) – The quest for a healthy life has been an eternal one. In 1978 Alma-Ata Declarationexpressed the need for urgent action by all governments, health and development workers, and the world community to protect and promote the health of all people.
The World Health Organization (WHO) launched its "Health For All" campaign and defined Health for All as the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. However, almost two decades later, this goal still eludes many, especially in the developing countries.
Can Ayurveda be the solution? This ancient system of Indian medicine has greatly influenced all the ancient medical systems of the world. Indian Emperor Ashoka who had embraced Buddhism promoted the Ayurvedic system throughout the Mauryan Empire and its neighbouring countries in the 3rd century B.C.
Buddhist monks took Ayurveda to all the countries where Buddhism spread and it reached central Asia, Tibet, China, Japan, Sri Lanka, Sumatra and many other countries. It travelled eastward and westward through the universities at Nalanda and Taxila respectively.
What comes as a surprise is that the more things changed over the millenniums, the more they stayed the same but for the vocabulary.
The recently concluded Integrative Medicine and Holistic Healing Conference at the National Institute of Pharmaceutical Education and Research (NIPER) from 20-22 September 2019 in Mohali, India was a wonderful platform to explore developing cooperation between traditional and modern medicine practitioners to deliver effective, efficient and holistic healthcare to the people.
In his paper, Ayurveda, Lifestyle and Wellness, Prof. Adrian Kennedy of the Institute of Lifestyle Medicine, Harvard while discussing a healthy lifestyle ‘swasthavruta’ makes an interesting comparison between the past and the present. 5000 years ago, Ayurveda talks about the importance of pure diet, pure body, pure mind, pure life and pure devotion, which in the 21st century has been transformed to balanced diet, moderate exercise, stress management, dependencies management and spiritual health respectively.
Ayurveda essentially means "science of life", and its goal is to cure the peoples who are suffering from physical or mental diseases. Ayurveda’s vision of health is more encompassing as health, according to Ayurveda, is "a bio-physical and physiological state of equilibrium and a contended state of consciousness, senses and mind." This understanding is more all encompassing and broader than that of the most modern branches of healthcare today.
Charaka, one of the principal contributors to Ayurveda had been the earliest proponent of "prevention is better than cure" doctrine and is the first physician who presented the concept of digestion, metabolism, and immunity. His work ‘Charaka Samhita’ describes the goal of Ayurveda as - Swasthaysa Swasthya Rakshanam, Aaturasya Vikaarprashaman Ch - to defend the health of the healthy; and to counter any pathologies.
In the year 2019, the world population stands over 7.7 billion. Delivering affordable and quality healthcare to such a population base in itself is a Herculean challenge both in terms of policy and practice for the international community.
The cost of poor health to any state or society is enormous. At the start of the present decade, the medical budget of the U.S. stood at $ 1 trillion per annum or $ 3 billion per day, whereas it was AUD 50 billion per annum or AUD 100 million per day in Australia.
While rich countries have the wherewithal to make allocations for their medical budgets, it is the developing countries that have to bear the disproportionate brunt of poor health. Asia’s traditional healthcare models may provide an answer.
In 2015, Tu Youyou of China was awarded the Nobel Prize for medicine for her work in helping to create an anti-malaria medicine. The 85-year old Nobel Laureate from China doesn’t have a medical degree or a PhD but she consulted the ancient Chinese texts to study how best to extract the compound for use in medicine in the fight against malaria. In China, she is being called the “Three Noes” Winner – no medical degree, no doctorate, and she has not worked overseas.
When Tu started her search for an anti-malarial drug, over 240,000 compounds around the world had already been tested, without any success. Finally, the team she led found a brief reference to one substance, sweet wormwood (Artemesia annua), which had been used to treat malaria in China around 400 CE. It is to be noted that traditional Chinese medicine like other traditional medicine systems of the world is also heavily influenced by Ayurveda as it was carried to China along with the Buddhist monks like Dharmaratna, Kasyapa Matanga, and especially Bodhidharma who took Dhamma to the land starting from the 1st century CE onward.
A significant increase in the costs of treating lifestyle-related chronic diseases has necessitated a paradigm-shift towards a more holistic approach from the model for health service delivery from a strictly biomedical model. This is an approach that stresses on prevention as well as cure and offers integrated services that address the multiple determinants of health.
China is the only country in the world where Western medicine and traditional medicine are practiced alongside each other at every level of the healthcare system. Traditional treatments include herbal remedies, acupuncture, acupressure and massage, and moxibustion, which have evolved over thousands of years and presently account for over 40% of all health care delivered in China.
Recently Singapore also pioneered some good policies that aim to promote traditional medicine. For example, patients are referred for traditional treatments, like acupuncture, by doctors trained in the Western medicine. Countries like Singapore aim to integrate the best from traditional and modern medicine and look at those areas where both converge to help tackle the unique health challenges of the contemporary times.
In India, at the governmental level, the Department of Indian System of Medicine and Homoeopathy (ISM&H) was launched in March 1995, under the Ministry of Health and Family Welfare, Government of India.
The 9th Five-Year Plan (1998-2002) ensured for its integration with the western medicine. The plan also focused on an overall development of Ayurveda ranging from investing in human resource development and preservation and cultivation of medicinal plants to completing a pharmacopoeia and outlining good manufacturing processes. The department was renamed to AYUSH in 2003 and in November 2014 the department of AYUSH became a ministry in its own right.
However there remains a lot to be done at the levels of institution, society and individual to mainstream the application of Ayurveda to deliver health and wellness to people. The governments should allocate more funds for research and development, alongside creating necessary infrastructure and conditions that would lead towards innovation and entrepreneurship in field.
The developments in the field of Ayurveda are very promising. In “first of its kind in the world,” a group of Ayurveda doctors and surgeons successfully operated upon an 83-year-old man removing a massive 240 gm of prostate, without using antibiotics. The four-hour long operation in Meerut was conducted on the 1st of March 2016.
The unique thing about the operation was that the surgeons only used anaesthesia but no antibiotics were used before, during or in the post-operation recovery of the patient. Traditional Ayurvedic medicines like Amalaki, Haridra, Shigru, Giloy and Guggulu were instead utilized in the process. The team of Ayush Darpan Foundation Trust was part of the procedure.
It is to be noted that standard Ayurvedic texts mention about medicines, which have significant anti-microbial properties and can be used in surgery and to keep the antibiotics away. Antimicrobial resistance is a looming health crisis we face today, and the use of Ayurveda should be explored in the field by the medical fraternity.
Another area in which Ayurveda has great relevance is to provide cost-effective and non-invasive alternatives to the patients through Marma Chikitsa. Marma points are the vital areas of the body and their stimulation through regulated pressure application helps in ailments like body aches, faulty spinal alignment, pain in the joints, Frozen Shoulder, Brachial Plexus injury, Cerebral Palsy, Post Paresis cases, Osteoarthritis Induced Disability etc. What is amazing is the fact that Marma is a zero-cost therapy, and Ayush Darpan Foundation is also involved in training doctors across India and South Asia in Marma Chikitsa.
A country like India has over 800,000 knee replacement surgeries every year, and each one costs over half a million Indian rupees. One can imagine how many surgeries can be avoided, the monies which can be saved, and healthcare provided to patients who suffer because of knee problems without spending a single penny through Marma Chikitsa.
In 2009, the United Nations Economic and Social Council (ECOSOC) President Ms. Sylvie Lucas while launching the 54-member body’s first panel discussion in connection with the 2009 Annual Ministerial Review theme said: “We cannot ignore the potential of traditional medicine in the race to achieve the Millennium Development Goals and renew primary health care for those who lacked access to it.”
Over the years, as more research studies show the clinical effectiveness of traditional medicine system, an integrated approach to disease using a combination of Western medicine and traditional medicine becomes a possibility for the future. The need is to have a proper strategy and its careful implementation to provide local and affordable health solutions.
And that’s where Ayurveda comes in. To complement Western medicine and address the issue of costs, efficacy, availability, affordability and side effects. And it makes a special sense for developing countries to provide sustained and affordable healthcare to its citizens despite rising healthcare costs.
* Manish Uprety F.R.A.S. is an ex-diplomat and co-founder of the Ayush Darpan Foundation Trust, India. [IDN-InDepthNews – 25 September 2019]