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National Policy on Indian Systems of Medicine & Homoeopathy-2002
1. INTRODUCTION
- 1.1 National Health Policy, 1983, refers to our rich, centuries - old heritage of medical and health sciences. The Policy outlines that although vast infrastructure is available in the Indian Systems of Medicine and Homoeopathy for addressing health care of our people, they are under utilized. The Policy suggested that it was necessary to initiate measures to enable each of these various systems of medicine and health care to develop in accordance with its genius. Simultaneously, planned efforts should be made to integrate their services, at the appropriate levels, within specified areas of responsibility and functioning in the over all health care delivery systems, specially in regard to the preventive, promotive and public health objectives. The Policy emphasized the need for a meaningful phased integration of Indian Systems of Medicines with the modern medicines, and also outlined the need to secure complete integration of all plans for health and human development, particularly agriculture and food products, rural development, education and social welfare, housing, water supply and sanitation.
- 1.2 In many places, the Indian Systems of Medicine & Homoeopathy continue to be widely used due to their accessibility, and sometimes, because they offer the only kind of medicine within the physical and financial reach of the patient. The Indian medicine system is also embedded in the beliefs of a wide section of the public and continues to be an integral and important part of their lives and for some, it is also a way of life.
- 1.3. Complementary and Alternative Medicine or Traditional Medicine is rapidly growing worldwide. In India also, there is resurgence of interest in Indian Systems of Medicine. People are becoming concerned about the adverse effects of chemical based drugs and the escalating costs of conventional health care. Longer life expectancy and life style related problems have brought with them an increased risk of developing chronic, debilitating diseases such as heart disease, cancer, diabetes and mental disorders. Although new treatments and technologies for dealing with them are plentiful, nonetheless more and more patients are now looking for simpler, gentler therapies for improving the quality of life and avoiding iatrogenic problems.
- 1.4 India possesses an unmatched heritage represented by its ancient systems of medicine which are a treasure house of knowledge for both preventive and curative healthcare. The positive features of the Indian Systems of Medicine, namely, their diversity and flexibility; accessibility; affordability; a broad acceptance by a section of the general public; comparatively low cost; a low level of technological input and growing economic value have great potentials to make them providers of health care that the larger sections of our people need.
- 1.5 A huge infrastructure already exists comprising thousands of hospitals and dispensaries, registered practitioners and twice the number of Indian Systems of Medicine & Homoeopathy colleges as available for allopathy. Many Post-Graduate institutions offer doctoral courses. Four research councils and several apex scientific institutions and universities have also contributed to clinical research, ethno-botanical surveys, pharmacological and pharmacognostical studies on plants and drug standardization of simple and compound ISM formulations. Clinical research studies covering the use of ISM drugs for a range of diseases and public health problems conducted over the last thirty years have led to many useful conclusions about the use of single and compound ISM drugs to treat numerous intractable problems. Although Govt. set up an independent Department in 1995 to give focus to these issues, ISM has not been able to play a significant role in health care delivery services for want of their legitimate involvement in public health programmes.
2. Policy support.
- 2.1 The Government has reiterated that Ayurveda, Homoeopathy, Siddha, Unani, Yoga and Naturopathy offer a wide range of preventive, promotive and curative treatments that are both cost effective and efficacious and there is need for ending the long neglect of these systems in our health care strategy. Budgetary support has been augmented and fiscal incentives and concessions that are available to modern pharmaceutical industry have been assured to ISM sector. The resurgence of interest in Ayurveda and other Indian Systems of Medicine in India and abroad and the opportunities created by such interest have been well perceived in the Government.
- 2.2 The Central Council for Health and Family Welfare in 1999 recommended, inter-alia, that at least one physician from the Indian Systems of Medicine & Homoeopathy (ISM & H) should be available in every primary health care centre and that vacancies caused by non-availability of allopathic personnel should be filled by ISM & H physicians. The Council also resolved that specialist ISM & H treatment centres should be introduced in rural hospitals and a wing should be created in existing state and district level government hospitals to extend the benefits of these systems to the public. It also resolved that expenses on treatment taken in ISM hospitals should be recognized for reimbursement for Central Government employees. In 2001, it further reiterated that the States must revisit the subject and identify specific areas where ISM practitioners can be entrusted with public health functions within the ambit of state legislations.
3. Financing ISM & H
- 3.1 It has been a concern for stake holders that the ISM&H; gets only 2% of the total health budget of the nation, while 98% is incurred on western modern medicine. A corrective and promotive policy needs to be initiated so that ISM can fully realize its potential and contribute more meaningfully to the health services. Keeping in view the need for consolidation and creation of infrastructure, making available ISM&H; drugs and replenish supplies, reorient the practitioners and teachers, upgrade inpatient facilities, build awareness about the efficacy of the systems, besides setting up laboratories and enforcement mechanisms for quality control, the allocation for Indian Systems of Medicine & Homoeopathy sector is meagre. At state level, the allocation is still abysmally low. Even allocated funds are either not released or utilized. Funds are also not available adequately to set up and operationalize Directorates of ISM which can give a direction to the policies and programmes aimed at making use of the systems.
4. Medical Education
- 4.1 Medical education in Indian Systems of Medicine & Homoeopathy has been a cause of concern. After enactment of Indian Medicines Central Council Act, 1970 and Homoeopathy Central Council Act, 1973, five-and-a- half years Under-Graduate course and three years Post-Graduate course were introduced, provisions for adequate clinical exposure and internship made. The number of Indian Systems of Medicine & Homoeopathy colleges have increased phenomenally to 404. The Central Councils have implemented various educational regulations to ensure minimum standards of education. Depite this, there has been a mushroom growth of sub-standard colleges causing erosion to the standards of education and harm to medical training and practice. Liberal permission by the State Government, loopholes in the existing Acts and weakness in the enforcement of standards of education have contributed to this state of affairs.
5. Drug Standards, Regulation & Enforcement
- 5.1 Our systems of medicine are of great antiquity. The drugs have been used for centuries. Drugs manufacture and related matters are covered under Drugs & Cosmetics Act, 1940 and Drugs & Cosmetics Rules, 1945. A large number of units exist in large, medium, small and tiny sectors. The safety, efficacy, quality of drugs and their rational use have not been assured. Though enforcement mechanism has been envisaged in the Act, and is also in place in most of the States, implementation of the enforcement laws leaves much to be desired. There is reluctance on the part of a large number of manufacturers to adhere to good manufacturing practices. Preparation of formularies and pharmacopoeial standards have been speeded up but a lot is yet to be completed. There is no assurance whatsoever that Formularies and Pharmacopoeial standards are being followed by the Indian Systems of Medicine & Homoeopathy drug manufacturers.
6. Medicinal Plants
- 6.1 Indian Systems of Medicine & Homoeopathy use predominantly plant materials for the preparation of their drugs. 8000 plants are stated to have medicinal properties although 500 of them are generally used. Most of these plants grow in the wild as natural component of vegetation of a particular region and the supply chain is carried out informally. This traditional base is shrinking due to over exploitation, unsustainable practices, biodegradation and population pressure. There are restrictions on extraction and procurement from the wild. The trade is secretive and exploitative leading to unsustainable practices in the quest for profit. In the absence of a scientific system for collection and fostering regeneration of such plants, several species have either been completely lost or become endangered. Industry constantly faces the problem of raw material supply and its quality. Adulteration and substitution of drugs is reported to be rampant in a near absence of assured supply of quality raw drugs and an enforcement system.
7. The ISM Industry
- 7.1 The ISM Industry has not been able to grow and develop optimally during the last five decades. Whatever growth has been achieved has been largely due to the industry's own initiative, undertaking its own Research and Development over the years. No special funding or incentives have been extended to this sector to help it realize its potential. The ISM industry has neither been declared a priority industry nor a green industry. Special packages for this sector to strengthen it and expand its outreach has not been addressed as a result it would be correct to call this sector nascent and in dire need of rejuvenation.
8. Intellectual Property Rights (IPR) of ISM
- 8.1 Our wealth of knowledge on formulations and medicinal uses of plants available in ancient texts and treatises have been attracting foreign interest and a large number of such medicinal uses have been patented by them claiming as innovations though these are already available in the public domain and therefore can not be patented. This has happened as such knowledge is not available in easily accessible form and in the language generally used by the patent examiners overseas. This has harmed our national interest as the process for retrieval and contesting patents is very costly and time consuming which we can ill-afford.
9. Revitalization of Local Health Traditions
- 9.1 In addition to the documented knowledge, indigenous traditional medical knowledge available with the individuals, communities, tribals have not been fully tapped, documented and validated. Such knowledge over the years gets eroded causing irreversible harm. Our Research Councils have documented over 10,000 such folk medicine but tens of thousands of such knowledge remain to be documented. The providers of such knowledge have not been given due acknowledgement, financial benefit and support to patent their knowledge.
10. Medical Tourism and Export of ISM Practitioners
- 10.1 The interest in our systems overseas for gentler and plant based treatment has been growing rapidly. More than that certain therapies are becoming extremely popular and tourists/visitors come to India for such therapies like Panchkarma and Yoga. Medical tourism not only popularises our system but offers good avenue for foreign exchange earning. Little has been done to create a chain of Panchkarma Centres and establish centres of excellence for yoga therapy, meditation and teaching.
11. Ancient Medical Manuscripts
- 11.1 There is at present no complete catalogue of Indian medical manuscripts which lie scattered in oriental libraries and private custody not only in India but also in other parts of the World. In India, ancient manuscripts are often found in a poor condition with the families of the old Vaidyas and non-descript libraries. This knowledge will be lost forever unless remedial action is taken urgently. Their retrieval for posterity is important for the preservation of this ancient wisdom and experience which will provide a wealth of knowledge and impetus to research and clinical application. Government has not implemented any scheme for the systematic collection and preservation of this information and the selective utilization of this knowledge This intervention brooks no delay.
12. Research in ISM
- 12.1 Our systems have been practised over centuries, and some of these are treatment, therapies and drugs have unbroken traditions of acceptance and practice. Whereas it is not desirable to subject all these to validation on modern scientific parameters, the need for fundamental, clinical and drugs research can hardly be over emphasized. Evidence for safety and efficacy is being demanded by the users. The Research Councils have been conducting research for the last 30 years, yet a lot remains to be done. Research has not kept pace with the times, it has not been re-oriented and prioritized.
13. Access to information
- 13.1 The medical profession and the Western educated public has been relatively restrictive in its approach to ISM, limiting the extent to which ISM physicians can employ their drugs and therapies and the extent to which the practitioners can “encroach” on areas falling within the purview of mainstream medicine.
- 13.2 The modern pharmaceutical industry has influenced health policy and health care systems the world over and India is no exception. The deep interest in the biomedical model of health has often been prompted by considerations which are not always rooted in concern for the health of citizens. Consumers are systematically led into believing that the biomedical model and its treatment options are the only alternatives and unfortunately most people are not willing to look beyond this model, leaving little attention and space for Indian Systems of Medicine and health care options, often shown to be both cost effective and enduring. These conflicts of interest and ethical dilemmas in a health care system, which advocates freedom of choice, have not been addressed.
14. Veterinary Medicine
- 14.1 Indian medicine is not reflected merely in the treatment of human beings but other important dimensions like veterinary medicine are addressed in detail through these systems. This represents a whole new spectrum of knowledge and opportunity. This area has not been exploited at all.
15. OBJECTIVES
- (a) To promote good health and expand the outreach of health care to our people, particularly those not provided health cover, through preventive, promotive, mitigating and curative intervention through ISM&H.;
- (b) To improve the quality of teachers and clinicians by revising curricula to contemporary relevance and researchers by creating model institutions and Centres of Excellence and extending assistance for creating infrastructural facilities.
- ( c) To ensure affordable ISM&H; services & drugs which are safe and efficacious.
- (d) To facilitate availability of raw drugs which are authentic and contain essential components as required under pharmacopoeial standards to help improve quality of drugs, for domestic consumption and export.
- (e) Integrate ISM&H; in health care delivery system and National Programmes and ensure optimal use of the vast infrastructure of hospitals, dispensaries and physicians.
- (f) Re-orient and prioritize research in ISM&H; to gradually validate therapy and drugs to address in particular the chronic and new life style related emerging diseases.
- (g) Create awareness about the strengths of these systems in India and abroad and sensitize other stakeholders and providers of health.
- (h) To provide full opportunity for the growth and development of these systems and utilization of the potentiality, strength and revival of their glory.
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The basic objectives of this Policy are :
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