India's G20 Presidency Presents an Opportunity to Foster India-Africa Collaboration on Traditional Medicines

After the G20 Summit in Bali, India took over the G20 presidency for one year, from December 1, 2022, to November 30, 2023.^[1] Indeed, this presidency is an opportunity for India to step up and provide some long-term sustainable solutions to the problems plaguing the world. India's G20 theme, "Vasudhaiva Kutumbakam," which translates to "the world is one family", therefore, amply conveys India's vision of unifying the world as a whole.^[2] Furthermore, India is also anticipated to take the lead in expressing the concerns of the developing world. It is in this endeavour India has planned to conduct 200 meetings with world leaders in more than 50 Indian cities covering 32 sectors.^[3]

So far, India has identified six thematic priorities for the G20 group:^[4]

1. Digital public infrastructure and tech-enabled development,
2. Accelerated inclusive and resilient growth
3. Accelerating progress on sustainable development goals (SDGs)
4. Green development and climate finance and lifestyle for the environment (LiFE),
5. Multilateral institutions reforms, and
6. Women-led development

Traditional medicine (TM) is also commonly known as complementary and alternative medicine (CAM). It is the oldest form of healthcare that has endured the test of time. The World Health Organisation (WHO) acknowledges that nearly 80% of the world's population uses traditional medicine in some capacity.^[5] In other words, for millions of individuals worldwide, traditional medicine serves as their first line of defence in the fight against a wide range of illnesses. And now a days, traditional medicines complement significantly to modern medicines.

There are several definitions of traditional medicine, but none is universally accepted, as indigenous healing methods have evolved in diverse ways throughout diverse civilisations. However, one of the most palatable definitions of traditional medicines was offered by the WHO. According to WHO, traditional medicine is "the collection of knowledge, abilities, and practices, whether or not they can be explained, that are based on theories, beliefs, and experiences from various cultures and are employed in preventing diseases as well as in the detection, improvement, and/or treatment of both physical and mental diseases".^[6]

Traditional medicine has a long history in India. In fact, Indian traditional medicine is one of the oldest branches in the history of medicine. India has always played a pioneering role in spreading the knowledge of traditional medicines across the world. While Egyptians learnt about it through sea trade with India, Greeks and Romans learnt through Alexander's invasion. Likewise, the knowledge of traditional medicine from India spread to the east with the spread of Buddhism.^[7] As India excels in this domain, India must play a more active role in its global development.

According to some studies, traditional medicine accounts for 70% of primary healthcare in rural India.^[8] Among others, Ayurveda is currently the most widely used form of traditional Indian medicine. Ayurveda is based on the notion that people can achieve physical, mental, and emotional healing by living in harmony with nature. Unsurprisingly, holistic care is the principle feature of Ayurveda, which addresses the body, mind, and spirit together.

India is one of the world's most natural resource-rich countries. India is home to 47,000 plant species, 15 agro-climatic zones, and 15,000 medicinal plants. About 7,000 of these species are used in Ayurveda, 700 in Unani, 600 in Siddha, and 30 in modern medicine.^[9] Recognising the importance of its bio-resources, the World Conservation Monitoring Centre (WCMC) has marked India as one of the 17 mega-biodiverse countries. ^[10]

On November 9, 2014, in order to promote alternative medical science, the Government of India delinked the Department of AYUSH from the Ministry of Health and Family Welfare and elevated it as a separate Ministry: Ministry of Unani, Siddha, Yoga, Naturopathy, and Homoeopathy (AYUSH).^[11]

As per the Ministry website, the Ministry of AYUSH seeks to accomplish the following goals^[12]:

• Raise academic standards across the country for colleges and institutes teaching Indian systems of medicine and homoeopathy colleges
• Bolster existing research institutions and establish a time-bound research agenda on illnesses for whom these systems have a successful treatment
• Design programmes for promoting, cultivating, and reinvigorating medicinal plants used in these systemsand
• Develop pharmacopeial standards for India

The Indian government first introduced the National AYUSH Mission as part of the 12th Five-Year Plan (2012 to 2017). The principal objective of the AYUSH Mission was to increase nationwide access to AYUSH services. This would be done by increasing the number of AYUSH hospitals and clinics, mainstreaming AYUSH by establishing AYUSH facilities at primary health centres, community health centres, and district hospitals, and ensuring the availability of AYUSH drugs and trained personnel.

Intending to improve the standard of AYUSH education, the Mission also aims to increase the number of modern educational facilities, preserve the accessibility of high-quality raw materials, and promote the preservation of medicinal plants. A research site has also been developed by the National Institute of Indian Medical Heritage, overseen by the Ministry of AYUSH. This online portal aims to exchange information about AYUSH systems and research updates for scholarly purposes.^[13]

Indian traditional medicine has long attracted interest from the international community as well as funding for study and development. In fact, Indian conventional medicine is regarded as world's one of the most advanced alternative treatment method. In recognition of India's contributions to the field, the WHO has planned to open its Global Centre for Traditional Medicine in Jamnagar, Gujarat, on April 19, 2022.^[14] Beyond India, traditional medicines also have a lot of potential across the world. Currently, 170 of the 194 WHO Member States, representing more than 80% of the world's population, are using traditional medicine in some form or other.^[15] Through this centre, the Indian Ministry of Ayush would be able to assistall these member states across the world by gathering reliable information and data on diverse traditional medical practices.

Furthermore, India can use its G20 Presidency to foster the use of traditional medicines in other developing countries, particularly in various African countries. Many parts of Africa are already well-versed in traditional medicines. The World Health Organization (WHO) recognises African traditional medicine's significant contributions to the health and well-being of the continent. Since 2003, in recognition of its contribution to the African health system, WHO commemorates August 31 as African Traditional Medicine Day (ATMD).

Currently, more than 40 African nations have developed national traditional medicine strategies. Additionally, 30 of them have incorporated traditional medicine into their national strategies. Furthermore, 39 countries have created regulatory frameworks for traditional medicine practitioners.^[16] Traditional medicine research and development is an extremely promising field in Africa, with 34 research centres in 26 countries.^[17] If adequately promoted internationally, it also has enormous financial potential. Ghana, which has already established traditional medicine clinics in 40 regional hospitals, is one of the forerunners in this area.^[18] Similarly, the Standard Organization of Nigeria (SON) has expressed its dedication to ensuring that African Traditional Medicine (ATM) is standardised in Nigeria and beyond.^[19]

Most African Member States today cultivate medicinal and aromatic plants to promote continental efforts toward equitable access to medical goods and technologies. In 14 countries, more than 100 herbal medicines have been registered with national regulatory agencies, and 19 others have facilities for the domestic manufacturing of herbal medicines. Over 45 herbal medicines are registered on the national critical medication lists across Africa.

Further, 39 countries have established legal frameworks for those practising traditional medicine. Another 25 countries now teach traditional medicine as part of their health science curricula. Training programmes have been established for both traditional health practitioners and health science students to improve the human resource base for both primary healthcare and traditional medicine.

It has been found that many Africans go to hospitals as a last resort, as their first port of call is conventional or faith healers. And these traditional healers are well-trusted and extremely popular. Their popularity is ascribed to their thorough consideration of their patients' socio-cultural backgrounds. Many of the traditional medicines that they use can be found in India. Therefore, India-Africa collaboration on traditional medicine will augur well for both continents, benefitting billions of people.

India may start working with Africa to develop a roadmap for AYUSH partnerships and advance health, well-being, and patient-centred healthcare on both continents. Given the close relations between India and many African nations, India may considersigning MoUs at the national level between the Ministry of Ayush and the Health Ministries of the respective countries focusing on traditional medicine. And the G20 Presidency of India could be the ideal platform to launch this initiative.

Notwithstanding, India and Africa have striking similarities in climatic conditions, biodiversity, physiognomy, people, cultures, and family values. Patients commonly receive care from traditional medical systems in both India and Africa. Several existing Indian traditional medicines can benefit Africa. For example, Ayush 64, a polyherbal formulation that has been effective in treating asymptomatic, mild, and moderate COVID-19 infection in India, can also be used on African COVID patients.^[20]

India has a robust industrial base, a thriving pharmaceutical industry, and a wealth of knowledge concerning the traditional medical system. India has successfully fused the best features of wellness practice and modern medicine. Today, India has one of the most accessible, affordable, and high-quality healthcare systems in the world. According to the Indian Ministry of Ayush, the market for alternative medicine in India stood at $18.1 billion in 2020, and it is anticipated to reach $70 billion by 2025.^[21] As both continents will benefit from active cooperation, there are ample areas for India and Africa to work together to foster the use of traditional medicine.

However, to work together more meaningfully, there is a need to develop standard operating procedures (SOPs). This would help to harmonise alternative medicines from India and African countries. A uniform regulatory framework will also be required to ensure compliance and coherence in research norms. Establishing fellowships, cross-disciplinary exchange programmes, a location for joint India-Africa conferences and/or symposia that provide training opportunities with both inside and across disciplines, and scholarships are also crucial to enhance this partnership. ITEC and EVAB can be helpful in this strategy. Finally, increased cooperation in traditional medicine is required between Indian and African universities and institutions.

Indeed, India's ascendance to the G20 Presidency comes at a very crucial stage of world history as the world is still scrambling through the post-pandemic recovery. According to WHO, India's presidency at the G20 is an exciting moment in history, and India's leadership in the Health Working Group meeting would strengthen the voice of the Global South.^[22] India may play a determining role in reframing the global health agenda for improving health and well-being for all people.

When the world desperately seeks a more sustainable and inclusive future, India has a unique opportunity as the current G20 president to set the trend. India can leverage its extensive indigenous medical knowledge to contribute to the global health agenda. Traditional Indian medicine, including Ayurveda, Yoga and Unani medicine, offers a wealth of knowledge and practices which can prevent and treat different physical and mental diseases. By promoting and incorporating these practices into the health system, India can preserve and expand this priceless knowledge for future generations. And a strong partnership with Africa is vital to transcend this knowledge to the next level.

Endnotes :

^[1]Akriti Anand “India takes over G20 presidency for 2023”. CNBC TV 18. https://www.cnbctv18.com/india/india-g20-presidency-2023-narendra-modi-logo-theme-top-focus-details-15181851.htm [3]

^[2] “India's G20 presidency unique opportunity to strengthen its role in world economic order”. Times of India. February 1, 2023. https://timesofindia.indiatimes.com/business/budget/indias-g20-presidency-unique-opportunity-to-strengthen-its-role-in-world-economic-order-nirmala-sitharaman/articleshow/97516303.cms?from=mdr [4]

^[3]Yogesh Gupta. “G20 presidency will showcase India to the world”. Deccan Herald. January 19, 2023. https://www.deccanherald.com/opinion/g20-presidency-will-showcase-india-to-the-world-1182517.html [5]

^[4]Lakshmi Puri. “India’s G20 Presidency: Forging global solidarity”. The Indian Express. January 7, 2023. https://indianexpress.com/article/opinion/columns/indias-g20-presidency-challenges-global-solidarity-8366260/ [6]

^[5] “WHO establishes the Global Centre for Traditional Medicine in India”. World Health Organisation. March 25, 2022.https://www.who.int/news/item/25-03-2022-who-establishes-the-global-centre-for-traditional-medicine-in-india

^[6] “Traditional medicine Report by the Secretariat ”. World Health Organisation. December 13, 2013. https://apps.who.int/gb/ebwha/pdf_files/EB134/B134_24-en.pdf [7]

^[7]Yu Shi, Y. Shi, Chao Zhang, C. Zhang, &Xiaodong Li, X. Li. (2021). Traditional medicine in India. Journal of traditional Chinese medical sciences, 8, S51.
doi: 10.1016/j.jtcms.2020.06.007

^[8]Mafuva C., Marima-Matarira H.T (2014). “Towards professionalization of traditional medicine in Zimbabwe: a comparative analysis to the South African policy on traditional medicine and the Indian Ayurvedic system.” Int J Herb Med. ;2:154–161.

^[9]Gopal, K., Kumar, S., & Gopal, K. S. U. (2022) Perspectives on Ayush Sector: Innovations for Future Integrative Health Systems. July 30. https://doi.org/10.31219/osf.io/ymjx2 [8]

^[10] “10% of the Earth's surface houses 70% of the planet's terrestrial biological diversity”. Iberdrola. https://www.iberdrola.com/sustainability/megadiverse-countries [9]

^[11] “Union Budget 2022 | Overview of Ayush Ministry and its budget allocations” Deccan Herald. January 21, 2022.https://www.deccanherald.com/business/union-budget/union-budget-2022-overview-of-ayush-ministry-and-its-budget-allocations-1073284.html

^[12]Brijender Singh Panwar. “AYUSH -The way to a healthy life. Daily Pioneer. July 14, 2022. https://www.dailypioneer.com/2022/columnists/ayush--the-way-to-a-healthy-life.html [10]

^[13] “FRAMEWORK FOR IMPLEMENTATION OF NATIONAL AYUSH MISSION” (NAM)”. Ministry of Ayush, Government of India. https://cdn.ayush.gov.in/wp-content/uploads/2021/03/National-AYUSH-Mission-.pdf [11]

^[14] “PM Modi to visit Gujarat on April 19, 20; to attend WHO event in Jamnagar. The Indian Express. April 18, 2022. https://indianexpress.com/article/cities/gandhinagar/pm-to-visit-gujarat-on-april-19-20-to-attend-who-event-in-jamnagar-7860784/ [12]

^[15] “Integrating Traditional Medicine in Health Care” World Health Organisation. January 30, 2023. https://www.who.int/southeastasia/news/feature-stories/detail/integrating-traditional-medicine#:~:text=More%20than%2080%25%20of%20the,and%20acupressure%2C%20and%20indigenous%20therapies [13].

^[16] “African Traditional Medicine Day 2022: Message of WHO Regional Director for Africa, Dr MatshidisoMoeti”. World Health Organisation. August 31, 2022. https://www.afro.who.int/regional-director/speeches-messages/african-traditional-medicine-day-2022 [14]

^[17]Kasilo OMJ, Wambebe C, Nikiema JB, Nabyonga-Orem J. “Towards universal health coverage: advancing the development and use of traditional medicines in Africa.” BMJ Glob Health. 2019 Oct 11;4(Suppl 9):e001517. doi: 10.1136/bmjgh-2019-001517. PMID: 31673437; PMCID: PMC6797325.

^[18] “Traditional healers broaden health care in Ghana. World Health Organisation. December 12, 2019. https://www.afro.who.int/photo-story/traditional-healers-broaden-health-care-ghana [15]

^[19]Jennifer Inah Abuja, “Nigeria Creates Standard For Production Of Traditional Medicine” Voice of Nigeria. January 19, 2023. https://von.gov.ng/nigeria-creates-standard-for-production-of-traditional-medicine/ [16]

^[20] “Ayush ministry to distribute free ayurvedic drugs for covid patients in Delhi from Monday” Live Mint. May 9, 2021.https://www.livemint.com/politics/policy/free-distribution-of-ayush-64-at-seven-delhi-locations-from-monday-11620560915375.html

^[21]Anuradha Mascarenhas. “Huge demand for Ayush products, services; market size has crossed $18 billion: Ayush Secretary”. The Indian Express. February 1, 2023. https://indianexpress.com/article/lifestyle/health/huge-demand-for-ayush-products-services-market-size-has-crossed-18-billion-ayush-secretary-7876349/ [17]

^[22]Paurush Omar “WHO officials hail India's G20 Presidency, call it 'exciting moment in history'. Live Mint. January 20, 2023. https://www.livemint.com/news/who-officials-hail-india-s-g20-presidency-call-it-exciting-moment-in-history-11674204007250.html [18]

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