Ministry of Ayush

Indian government ministry for alternative medicine systems

  • Sarbananda Sonowal, Cabinet Minister
  • Mahendra Munjapara, Minister of State
Ministry executive
  • Rajesh Kotecha, Secretary
Websiteayush.gov.in
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The Ministry of Ayush, a ministry of the Government of India, is responsible for developing education, research and propagation of traditional medicine and alternative medicine systems in India. Ayush is a name devised from the names of the alternative healthcare systems covered by the ministry: ayurveda, yoga & naturopathy, Unani, Siddha, Sowa Rigpa, and homeopathy.[2]

The Department of Indian Systems of Medicine and Homeopathy (ISM&H) was first established in 1995 under the Ministry of Health and Family Welfare.[3] ISM&H was renamed as the Department of AYUSH. The department was made into an official ministry by the Modi government in 2014.[2][3][4]

The ministry of Ayush has faced significant criticism for funding systems that lack biological plausibility and are either untested or conclusively proven as ineffective. Quality of research has been poor, and drugs have been launched without rigorous pharmacological studies and meaningful clinical trials on ayurveda or other alternative healthcare systems.[2][5] The ministry has been accused of promoting pseudoscience.[6][7]

History

Emphasis on indigenous healthcare models

Successive Five-Year Plans of India (produced by the Planning Commission of India and later the NITI Aayog) allotted considerable focus to alternative, especially indigenous, forms of medicine within the healthcare sector. The Government of India set up a number of committees for healthcare sector development, including Bhore (1946), Mudaliar (1961), and Srivastava (1975), that emphasized the need for improvement of traditional systems of Indian medicine.[8] The National Health Policy (1983), National Education Policy in Health Sciences (1989), and National Health Policy (2002) further elaborated on the role of the Indian System of Medicine (ISM) and Homeopathy (H) as a means to facilitate healthcare access in rural areas where many Indians lack adequate health services.[9]

Educational courses and ISM&H

A diploma course in ayurveda was launched in the third (1961–1966) five-year plan.[10] The Central Council of Indian Medicine was established in 1971.[11] followed by Central Council of Homeopathy in 1973.[12] The sixth (1980–1985) and seventh (1985–1990) five-year plans aimed at developing novel ISM&H drugs.[10] The eighth (1992–1997) five-year plan lent considerable emphasis on the mainstreaming of Ayush.[citation needed] The Department of Indian System of Medicine and Homeopathy was launched in March 1995, under the Ministry of Health and Family Welfare.[13][2]

The ninth five-year plan (1998–2002) ensured for its integration with western medicine.[citation needed] It was the first to tackle different aspects of the Ayush system in a standalone manner which focused on overall development including investment in human resource development, preservation and cultivation of medicinal plants, establish a more complete pharmacopoeia, and outline good manufacturing processes.[citation needed] The acronym AYUSH was devised in 2003.[2] The department of Indian System of Medicine and Homeopathy was renamed the department of AYUSH in November 2003.[13]

The National Rural Health Mission was launched in 2005 with the stated aim of integrating Ayush practitioners into national health programs, including in primary health care (Ayush medical officers at community health centers, para-professionals et al.) and to provide support for research in the field.[14] The National Rural Health Mission listed the mainstreaming of Ayush as one of its priorities.[15]

After 2014

Observers noted an increased focus on Ayush healthcare after the 2014 Indian general elections, which brought the Bharatiya Janata Party (BJP) to power.[4] On 9 November 2014 the previous government department for traditional Indian medicine was elevated by the administration of Narendra Modi into a standing ministry that includes the promotion of yoga practice and the use of Ayurvedic products.[16][2][4] The allotted budget for Ayush had more than doubled since 2013–14, and stood at ₹ 1428.7 crore for 2017–18.[17]

Activities

Healthcare

The ministry runs multiple healthcare programs; primarily aimed at the rural population.

Ayush is supposed to form an integral backbone of the Ayushman Bharat Yojana[18] and the ministry had long worked for integrating the different systems of Ayush with modern medicine, in what has been described as 'a type of "cross-pathy"'.[3] More than 50,000 children have been enrolled in 'Homeopathy for Healthy Child'.[19] It observes different days to raise general awareness about Ayush and promote each of the systems.[20]

The ministry had collaborated with the Council for Scientific and Industrial Research (CSIR) to set up the Traditional Knowledge Digital Library (TKDL) in 2001, on codified traditional knowledge on Indian systems of medicines such as ayurveda, Unani, Siddha and yoga as a means of preventing grant of "bed" patents on traditional knowledge and thus counter biopiracy.[21]

Institutions

The ministry is also at the aegis of several professional research institutes and academic faculties devoted to various forms of alternative medicine:[22]

The ministry also monitors two semi-autonomous regulatory bodies:-

  • Central Council of Indian Medicine (CCIM) - One of the professional councils under the University Grants Commission (UGC) to regulate higher education in Ayurveda, Siddha, Unani and Sowa-Rigpa. It suggests the professional benchmarks and practices for medical professionals in these systems, as well. The Central Council of Indian Medicine (CCIM) Act 1970 (48 of 1970) has been repealed and all the provisions of the National Commission for Indian System of Medicine (NCISM) has been come into force with effect from the 11th day of June 2021.[31]
  • National Commission for Homoeopathy - One of the professional councils under the UGC to regulate higher education in Homeopathy. Maintains central registers of homeopaths.

Economics

As of March 2015, there were nearly 800,000 Ayush practitioners, over 90 per cent of whom practiced homeopathy or ayurveda.[3] A 2018 study by the Confederation of Indian Industry (CII) estimated the market share of Ayush medicines at around US$3 billion and that India exported Ayush products of a net worth US$401.68 million in the fiscal year 2016–17.[32]

The Department of Pharmaceuticals had allocated a budget of ₹1.44 billion to the ministry for 2018-2020 for manufacture of alternative medicines.[33] The average expenditure for drugs on Ayush and scientifically based medicine has been found to not vary widely.[9]

Cabinet Ministers

  • Note: MoS, I/C – Minister of State (Independent Charge)
# Portrait Minister
(Birth-Death) 		Term of office Political party Ministry Prime Minister
From To Period
1 Shripad Naik
(born 1952)
MP for North Goa
(MoS, I/C) 		9 November
2014 		30 May
2019 		6 years, 240 days Bharatiya Janata Party Modi I Narendra Modi
31 May
2019 		7 July
2021 		Modi II
2 Sarbananda Sonowal
(born 1962)
Rajya Sabha MP for Assam 		7 July
2021 		Incumbent 2 years, 285 days

Ministers of State

# Portrait Minister
(Birth-Death) 		Term of office Political party Ministry Prime Minister
From To Period
1 Mahendra Munjapara
(born 1968)
MP for Surendranagar 		7 July
2021 		Incumbent 2 years, 285 days Bharatiya Janata Party Modi II Narendra Modi

Criticism

Pseudoscience

A strong consensus prevails among the scientific community that homeopathy is a pseudo-scientific,[34][35][36][37] unethical[38][39] and implausible line of treatment.[40][41][42][43] Ayurveda is deemed to be pseudoscientific[44][45][46] but is occasionally considered a protoscience, or trans-science system instead.[47][48] Naturopathy is considered to be a form of pseudo-scientific quackery,[49] ineffective and possibly harmful,[50][51] with numerous ethical concerns about the practice.[52][53][54] Much of the research on postural yoga has taken the form of preliminary studies or clinical trials of low methodological quality;[55][56][57] there is no conclusive therapeutic effect except in back pain.[58] Unani lacks biological plausibility and is considered to be pseudo-scientific quackery, as well.[59][60]

There is no credible efficacy or scientific basis for any of these forms of treatment.[61]

Research

Two systematic reviews, one by The Lancet in 2005 and the other by the Australian government's National Health and Medical Research Council (NHMRC) in 2015, found no evidence that homeopathy was more effective than a placebo.[3] In a comprehensive review of alternative medicine (including ayurveda and homeopathy) conducted in 2000, the UK House of Lords Committee on Science and Technology was unable to find evidence to support the value of these treatments. Randomized control trials or RCTs for ayurveda and homeopathy have been extremely limited as of 2017.[3] Multiple systemic reviews have highlighted several methodological problems with the studies and trials conducted by Ayush and its associates in relation to developing an ayurvedic drug for diabetes.[62] A tendency to publish in dubious predatory journals and non-reproducibility by independent studies has also been noted.[63][64] The Hindu reported in 2015 that India had yet to conduct a systematic review of any of the systems of medicine under the purview of Ayush.[3]

Drugs

The ministry (in conjunction with other national laboratories) has been subject to heavy criticism for developing, advocating and commercializing multiple sham-drugs (BGR-34, IME9, Dalzbone, Ayush-64 et al.) and treatment-regimes for a variety of diseases including dengue,[65][18][66][67] chikungunya, swine flu,[68] asthma, autism,[69] diabetes, malaria,[70] AIDS,[71] cancer,[72] COVID-19.[73][74][75] and others despite an absence of rigorous pharmacological studies and meaningful clinical trials.[63][64][76]

A 2018 systematic review of traditional and AYUSH medicine noted the existing regulations to be inadequate for ensuring the safety, quality, efficacy and standardized rational use of these forms of treatment. Researchers also noted a lack of monitoring for adverse effects from the usage of these drugs and of contraindication trials.[8]

The ministry recommended the herb giloy as an "immune booster against" COVID-19[77] and issued multiple press releases during the COVID-19 pandemic claiming the herb was safe. Later, multiple studies in different Indian cities found cases of liver damage in those with a history of giloy consumption.[78]

Miscellaneous

The Washington Post noted the efforts behind the revival of ayurveda as a part of the ruling party's rhetoric of restoring India's past glory to achieve prosperity in the future.[4] It also noted of the ayurveda-industry being largely non-standardized and that its critics associated the aggressive integration of ayurveda into healthcare services with the Hindu nationalist ideology of the ruling party.[4] There have been allegations coming out of right-to-information requests that it is the Ayush ministries official policy to not hire Muslims as trainers.[79]

Some researchers have argued that the provision of Ayush services is an example of "forced pluralism" which often leads to disbursal of incompetent healthcare services by unqualified practitioners.[8][80] Ayushman Bharat has been noted to increase privatization of state healthcare facilities and compel rural populace into preferentially choosing alternative medicine, raising concerns about ethics.[17][81] The proposal of integrating Ayush with western medicine has been criticized.[82] The Indian Medical Association (IMA) has expressed strong opposition to integrated medicine,[3][83][84][4] often by using the term "mixopathy".[85][86] In 2020 and 2021, the IMA held nationwide protests to demonstrate against federal changes issued by the Ministry of Ayush that permit ayurvedic practitioners to perform minor surgical procedures.[87][88][89]

The ministry had attracted widespread criticism after publishing a pamphlet titled Mother and Child Care through Yoga and Naturopathy which asked pregnant women to abstain from eating meat and eggs, shun desire and lust, hang beautiful photos in the bedroom and to nurture spiritual and 'pure' thoughts among other advice.[90][91] In the aftermath of the COVID-19 pandemic, the ministry recommended Arsenicum album 30 as a preventive drug; the claim was without any scientific basis or evidence, and was widely criticized.[92][93][94]

Response

The ministry rejected the NHMRC's 2016 study on homeopathy which was regarded as the most rigorous and reliable investigation into homeopathy to date.[95][96] In 2017, the ministry set up a committee at the Central Council for Research in Homeopathy (CCRH) to counter claimed western propaganda against homeopathy; the committee was ill-received.[19][97][76]

Reception

A NSSO survey in 2014 found that only 6.9% of the population favored Ayush (3.5% ISM and 3.0% homeopathy) over conventional mainstream medicine and that the urban population was slightly more conducive to seeking Ayush forms of treatment than their rural counterparts; another survey in 2016 reiterated the same findings, approximately.[98][9][99] A 2014 study did not report any significant difference between the usage of Ayush services by rural and urban populace, after adjusting for socioeconomic and demographic variables.[9] Low-income households exhibited the highest tendency for Ayush followed by high-income households and on an overall, Ayush lines of treatment were majorly used to treat chronic diseases.[9] The treatments were more used among females in rural India but no gender-differential was observed in the urban populations.[9] Chhattisgarh (15.4%), Kerala (13.7%), and West Bengal (11.6%) displayed the highest Ayush utilization levels.[9]

A 2018 review article noted that the states exhibited differential preference for particular Ayush systems. Ayurveda and Siddha respectively show greater popularities in Kerala and Tamil Nadu. Unani was well received in Hyderabad region and among Muslims whilst homeopathy was highly popular in Bengal and Odisha. It further noted that the preference among the general population for usage of Ayush revolved around a perceived "distrust or frustration with modern medicine, cost effectiveness, accessibility, non-availability of other options and less side effects of Ayush medicines".[8]

References

  1. ^ "DEMANDS FOR GRANTS, 2023-24 MINISTRY OF AYUSH" (PDF). Union budget of India. 1 February 2023. Retrieved 1 February 2023.
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    • Shrinivasan, Rukmini (26 April 2015). "Questions over science swirl, but AYUSH stands firm". The Hindu. ISSN 0971-751X. Retrieved 22 January 2019.
    • Krishnan, Vidya. "AYUSH Ministry rails against global study on homeopathy". The Hindu. Retrieved 24 May 2017.
    • Kumar, Ruchi (12 December 2018). "Indian academia is fighting a toxic mix of nationalism and pseudoscience". Undark Magazine. Retrieved 31 January 2019 – via Quartz India.
    • Kaufman, Allison B.; Kaufman, James C. (12 January 2018). Pseudoscience: The Conspiracy Against Science. MIT Press. p. 293. ISBN 978-0-262-03742-6.
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  69. ^ Shaikh, Sumaiya (15 May 2018). "Do the AYUSH based treatments for autism stand up to scientific scrutiny?". Alt News. Retrieved 22 January 2019.
  70. ^ Mittal, Shivani (29 January 2019). "The inefficacy of AYUSH-64, the anti-malarial Ayurvedic drug developed by Ministry of AYUSH". Alt News. Retrieved 31 January 2019.
  71. ^ "A homeopathic experiment gives hope for treatment of AIDS". Business Standard India. 5 April 2015. Retrieved 23 January 2019.
  72. ^ "Ministry of Ayush Develops drugs for Dengue, Cancer". United News of India. 8 August 2017.
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