One of the core purposes of medicine is to relieve suffering. Medicine has been evolving over millennia to serve this purpose across the world. Some of the oldest systems of medicine continue to thrive across the world. While traditional systems evolved through experiential wisdom, faith and belief, modern systems evolved through reason, analysis, and experimental evidence. Patient health seeking behavior is influenced by prevailing culture, beliefs, prior experience, peer reference, ease of access, and the cost says Dr Krishna Reddy Nallamalla , President, InOrder & Country Director, ACCESS Health International.
Advances in modern medicine have significantly improved health status of populations. Despite these advances people continue to suffer from unrelieved chronic pains, unexplained physical symptoms, and growing burden of life long non-communicable diseases and mental illnesses. Costs of modern healthcare have been growing faster than economic growth across the world accounting for impoverishment and inequity.
There is a growing emphasis on improving social determinants of health, healthy living, and prevention of illness. Similar shift is happening towards a holistic approach to health and disease. Traditional systems of medicine are being increasingly subjected to experimental evidence to understand their safety and effectiveness so as to integrate these systems with modern systems of medicine. This evolution underlies the concept of Integrative Medicine, wherein the best of both systems of medicine are used as per patient’s choice and response.
Every system of medicine, whether traditional or modern, has to be safe and effective in promoting health, preventing disease, treating an illness, and in providing relief from chronic incurable diseases. Both the systems should also demonstrate that they are cost-effective. Scientific analysis of traditional drugs, formulations, and methods may yield newer drugs and therapies. Lack of evidence in traditional therapies is not equivalent to lack of efficacy.
India is home to Ayurveda, one of the oldest systems of medicine. There are formal education systems for traditional systems and are grouped as AYUSH (Ayurveda, Unani, Siddha, and Homeopathy). A separate ministry oversees AYUSH systems of medicine. There are nearly 800,000 professionals qualified in AYUSH systems of medicine. While majority practice their respective system of medicine, some of them choose to enter careers in public health, health management, and health informatics. Some even practice in allopathic settings as physician assistants. AYUSH professionals are also deployed as part of primary healthcare centers.
Increasingly AYUSH professionals are using same diagnostic tools being used by allopathy professionals to diagnose underlying conditions and monitor the efficacy of their treatments. Conversely, allopathic professionals refer cases to AYUSH systems of medicine for some of the chronic ailments for which allopathic drugs are considered not effective or safe. Patients suffering from chronic pain, allergy, bowel disorders, mental disorders tend to seek alternate medicines. Sizeable number of patients with diabetes and high blood pressure prefer treatment from traditional systems.
Some of the leading medical institutes in the West are starting departments for Integrative Medicine with adoption of some of the well-known traditional systems of medicine as part of providing holistic care to identified patients. Advanced research is being undertaken to validate the safety and efficacy of these practices and also to understand the possible mechanism behind their efficacy. Yoga and meditation are the most widely studied traditional systems of wellness.
Traditional systems of medicine are integral part of India’s health system. They have evolved over millennia and survived to meet healthcare needs of people. They continue to be the only source of healthcare in some of the underserved areas. There is a growing acceptance of some parts of these systems globally with increasing scientific validation of their safety and efficacy. A well-designed research study comparing yoga-based cardiac rehabilitation was comparable to the modern cardiac rehabilitation methods. Unlike modern system that requires elaborate infrastructure and manpower, yoga is simple to administer, amenable for home practice and is highly cost-effective.
More broad and rational integration of traditional systems of medicine into modern medical systems may aid in strengthening India’s health systems.
Dr Krishna Reddy Nallamalla
Country Director, ACCESS Health International.