By: Vaidya Rajesh Kotecha
Dhanvantari Jayanti comes on Trayodashi of Aswin month which is popularly known as Dhanteras. Diwali festival starts from Dhanteras. Four years ago, this day was declared as AYURVEDA DAY by Ministry of AYUSH, Government of India.
The 5th Ayurveda Day on 13th November, 2020 will see the dedication to the nation of two future-ready Ayurveda institutions by Hon’ble Prime Minister Narendra Modi. These are: Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar as Institute of National Importance and National Institute of Ayurveda (NIA), Jaipur as Deemed to be University under De Novo category of UGC, Ministry of Education, Government of India.
Modern, state-of-the-art medical institutions in traditional disciplines are required to address the growing global demand for adopting the potential of traditional healthcare wisdom to address some of the pressing health care challenges of today. ITRA, Jamnagar and NIA, Jaipur in their revamped avatars will serve this purpose.
The Government of India has conferred the status of Institution of National Importance (INI) by an Act of Parliament to the erstwhile Institute of PG Teaching and Research in Ayurveda (IPGTRA), Jamnagar by conglomerating the cluster of Ayurveda Institutions at the Gujarat Ayurveda University campus, Jamnagar. Their conglomeration created the Institute of Teaching and Research in Ayurveda (ITRA) at Jamnagar, Gujarat. Elevation of the Institute to the INI status will provide it the autonomy to upgrade the standard of Ayurveda education, frame various courses as per national and international demands, adopt advanced evaluation methodology and excel in research to generate more and more evidences. The strengthening of Ayurveda could lead to cost-effective solutions, thanks to its preventive and curative approaches reducing government expenditure on health.
National Institute of Ayurveda, Jaipur has a proud legacy of more than 175 years. The seed of Ayurveda education under the ambit of NIA had started in Jaipur in the form of a Pathshala (school) of Indological studies in 1845. The then King of Jaipur appreciated the popularity and utility of this school and took over the patronage of this school in 1865 and it was renamed as Maharaja Sanskrit College in which Ayurveda started operating as an independent department. Ayurveda education in Jaipur shifted to Madhav Vilas Palace in the name of Rajakiya Ayurveda Mahavidyalaya, Jaipur in 1946. In 1976, when Govt. of India was exploring to establish Institute for higher and best quality Ayurvedic education, training and research, this college was selected and upgraded as NIA as an autonomous body under Government of India. Now, NIA is further elevated as Deemed to be University.
It is a good occasion to see and review about efforts and contributions of Ministry of AYUSH for mitigation of COVID 19 crisis which is one of the worst health challenges ever faced by mankind. Ministry of AYUSH has taken various steps to tap into the potential of AYUSH-based practices to contain the impact of the COVID-19 pandemic besides extending full support through contributing as COVID warriors and by infrastructure being used as COVID care centres in the fight against COVID 19. As an initial step, Advisory recommending self-care guidelines for preventive health measures and improving immunity has been issued which was endorsed by the Hon’ble Prime Minister, Sh. Narendra Modi through a tweet. Further endorsement from the Hon’ble Prime Minister came on 14.04.2020, in his address indicating seven steps among which, one was to follow the guidelines issued by Ministry of AYUSH for improving immunity. AYUSH COVID-19 Dashboard was launched to disseminate the merits of AYUSH, scientific information and guidelines pertaining to COVID 19 across the stakeholders, that has been successfully serving as a potential platform to meet this challenge. A notification in order to control any misleading advertisement or claim an order to stop and prevent publicity and advertisement of AYUSH-related claims for COVID-19 treatment was released on 1st April 2020 by Ministry of AYUSH.
An Inter-disciplinary AYUSH R&D Task Force chaired by Prof. Bhushan Patwardhan, Vice Chairman, UGC with representation from scientists from ICMR, DBT, CSIR, AIIMS and premier AYUSH Institutions was constituted to ascertain the role of AYUSH interventions in COVID 19 and to generate tangible evidences ensuring the robustness of scientific designs of study. This Interdisciplinary AYUSH R&D Task Force has formulated and designed various clinical research protocols for prophylactic studies, stand alone and add-on interventions in COVID-19 cases. Furthermore, Guidelines for Registered Practitioners of AYUSH systems of healthcare were developed under the supervision of this task force by renowned experts of respective area.
The Ministry has also pooled the experiences and inputs from stakeholders and public concerning AYUSH based measures for combating COVID-19 through crowd sourcing platform and more than 3000 suggestions were received, some of them have been supported to carry forward research through Extramural Research Scheme of the Ministry. As guiding principles for scientists and pharmaceutical sectors, the Ministry issued a Gazette notification on 21.04.2020 to facilitate undertaking of research on COVID-19 through Ayurveda, Siddha, Unani and Homeopathy Systems.
The Task Force has developed robust Research Protocols in association with eminent clinician Dr Arvind Chopra, CRD Pune, on which the Ministry has initiated four studies on AYUSH interventions on COVID 19 in collaboration with CSIR and technical support of ICMR at different centres across the country like KGMU Lucknow, MGIMS Nagpur, AIIA New Delhi, Medanta hospital Gurugram etc. The Ministry has also initiated preclinical, experimental studies in collaboration with DBT for furtherance of evidence-based research. Taking forward the recommendations of the Interdisciplinary task force, at present 88 research studies have been undertaken at about 112 centres across the country by Research councils and National Institutes under Ministry of AYUSH which includes Prophylactic intervention studies (including population based prophylactic studies on 80000 Delhi Police personnel and over 20000 participants through each Research councils and National institutes), stand alone and add-on AYUSH intervention studies and retrospective studies of AYUSH interventions in COVID 19 as well as observational studies and survey studies over a large cohort, as intra mural and in collaboration with reputed organisations like DBT, AIIMS Jodhpur, MGIMS Wardha, KGMU Lucknow, Medanta Gurugram etc.
Clinical research studies are being conducted on AYUSH interventions such as Ashwagandha, Guduchi-Pippali, Yashtimadhu, Guduchi ghan vati, Chyavanprash, AYUSH-64, Ayush Kwath as prophylactic interventions in high risk population, as add-on treatment to standard care and as standalone treatment in COVID 19 positive cases. Outcome analysis of completed studies and Interim trends of ongoing studies have demonstrated the prophylactic and therapeutic potential of AYUSH interventions. The core outcomes of the studies demonstrated clinical safety and efficacy such as the protection against COVID-19 as good prophylaxis (Guduchi, Ashwagandha, Chyavanprash, Ayush Kwath); early recovery and achieving negative RT-PCR results, improvement in quality of life and stress, reduction in the duration of hospital stay and prevention in further progress to complications (Guduchi ghan vati, AYUSH-64). To ensure Data Safety and safety of participants and proper study conduct, Data Safety and Monitoring Board (DSMB) was also constituted. Ministry of AYUSH has also taken initiatives to conduct clinical study on Ayurvedic medicine with countries like USA, Brazil, South Africa, Ghana, UK, Germany etc.
The observations at Covid Care Centre of All India Institute of Ayurveda, Delhi are very encouraging. In this centre, more than 400 patients have been treated successfully without a single mortality and none of them required ICU support. The average hospital stay is much lesser than national average at this centre. 93% of these patients did receive only Ayurveda and Yoga interventions. It is also interesting to know that no healthcare workers got infected with COVID who is serving at this centre. Till now, more than 200 such health workers were exposed and they all found negative after their weekly roster duty with COVID patients. These all health workers were following strict guidelines for care of COVID patients but in addition to that, they all were taking AYUSH prophylaxis like Giloy, Chayanprash and Ayush Kadha.
AYUSH Sanjivani mobile app based study was launched by Hon’ble Minister of Health and Family Welfare Dr. Harshvardhan and Hon’ble AYUSH Minister shri Shripad Naik. The study was conducted on acceptance and usage of AYUSH advocacies and measures among the population and its impact in prevention of COVID-19. The cumulative data of 1,47,89,827 health seekers from all across the country were gathered through the study by this mobile app. Among the data of 723459 individual respondents, 85.1% reported of using the AYUSH measures for prevention of COVID-19, out of which 89.8% reported to have benefitted from it. Improvement in parameters of general well being such as appetite, bowel habit, sleep, mental well-being was reported by 63.4% of the users. Around 74,567 physicians had reported their pattern of utilization of AYUSH measures through the app.
To crystallize the outcomes and interim trends, the Ministry has setup an Interdisciplinary Committee for Integration of Ayurveda and Yoga Interventions in the ‘National Clinical Management Protocol: COVID-19, chaired by Dr V M Katoch, former Director General, ICMR and group of experts from eminent institutions across the country. The Committee has formulated its First Report & Recommendations based on the interim trends of ongoing and completed AYUSH studies on COVID-19 and acceptable experimental and clinical published data indicating potential benefits and safety of AYUSH interventions. Based on recommendations on the basis of committee report, the Ministry of Health and Family Welfare has issued the National Clinical Management Protocol based on Ayurveda & Yoga for management of COVID -19. It was released jointly by Dr. Harsh Vardhan, Union Minister for Health & Family Welfare and Shri Shripad Yesso Naik, Union Minister of State (IC) for AYUSH, Govt. of India on 6th October, 2020 enabling uniform clinical management. Further the Government of India has issued Post Covid management protocol wherein Ayurveda and Yoga interventions are also included.
Author is Secretary, Ministry of AYUSH Government of India