Annexe of Ayurveda in G-20 countries: A brief insight

The 21st century has witnessed global acceptance of Ayurveda, especially during the recent pandemic of SARS-CoV-2. The roots of this age-old science lie in India, and for the past hundred-odd years, practitioners from various states of India have been practicing Ayurveda in different parts of the world. It is important to know that despite all odds, Ayurveda is practiced in 77 countries, 26 of which have been mentioned in the WHO benchmark documents.[1,2] The key goals of WHO Traditional Medicine Strategy 2014–2023 are to support Member States in harnessing the potential contribution of T&CM to health, wellness, and people-centered health care and to promote the safe and effective use of T&CM through the regulation of products, practices, and practitioners.[3] Ministry of Ayush, Govt. of India, is playing a pivotal role in the propagation of Ayurveda by developing Ayush chairs and facilitating the export and import of Ayurveda medicines abiding by the drug regulations in India and abroad. Objectives for mainstreaming the Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy) system as a part of traditional medicine (TM) have been broadened in India’s National Health Policy 2017. The G20 or Group of 20 is an intergovernmental forum comprising 19 sovereign countries, the European Union, and the African Union (AU).[4] India holds the Presidency of the G20 from 1 December 2022 to 30 November 2023. The inclusion of the AU under the ambit of the G20 nations was a very proactive and all-inclusive move by the Honorable Prime Minister of India, Mr. Narendra Modi. This year, India has hosted the Presidency of the G20, which is the premier intergovernmental forum for international economic cooperation. India’s G20 Presidency theme was “One Earth, One Family, One Future.” Ayurveda, one of the oldest TM, follows the principle “yatpindetatha bramhande” and considered every living being, including humans, as the representative of the universe as all are composed of panchamahabhuta (five basic elements). TM was also at the forefront of G20 discussions, and its potential role in addressing health challenges was acknowledged. Propagation of Ayurveda in G20 Nations During the COVID pandemic, countries with the most incredible strongholds for TM, like India, China, and Sri Lanka from Asia, from the African continent like South Africa, Nigeria, and South American continent like Brazil have made a substantial contribution to envisage the potential of TM globally. These observations will surely pave the way for implementing interoperable policy mechanisms in TM to facilitate its smoother implementation at the grassroots levels. The success of the Global Ayush Investment & Innovation Summit has been instrumental in making the world aware of the impact of Ayurveda and other medicines in India on their reliability in healthcare and wellness services worldwide.[5] Further, the establishment of the WHO Global Centre for Traditional Medicine (GCTM) at Jamnagar, Gujarat, India, will help harness the potential of TM, which will naturally aid in the global acceptance of Ayurvedic sciences.[6] The Ministry of Ayush is also putting efforts through its International Cooperation cell to recognize and promote Ayush on the international platform. It has already initiated fellowship schemes for foreign national exchange programs wherein Ayush experts are deputed in foreign countries to participate in international meetings, conferences, training programs, seminars, and special assignments of the Government of India to promote and propagate Ayush Systems, including Ayurveda.[7] Further, efforts are being made for global recognition of Ayurvedic medicinal drugs for their registration with regulatory authorities of foreign countries. The Ministry of Ayush has also facilitated the admission of foreign students to Ayurveda graduate and postgraduate courses under the NRI quota with a scholarship allotted for the same. Around 250 foreign students are currently pursuing education in Ayurveda in various Institutes across India. Academic Status/Opportunities in G20 Nations The Ministry of Ayush has collaborated with Germany on some research projects. Certain organizations, namely Rosenberg European Academy of Ayurveda, offer a Master of Science in Ayurveda program in Germany, Austria, and Switzerland. Atreya Ayurveda School in France and Ayurveda Point School in Italy also offer courses in Ayurveda.[8] Maharishi Ayurved Foundation Vlodrop, Netherlands, and Maharishi European Research University (MERU) are the oldest organizations working for the propagation of Ayurveda and Yoga by offering different levels of courses.[9] Many organizations from Germany, including The Charite University at Berlin, have been keenly interested in Ayurveda. The National Institute of Complementary Medicine Health Research Institute, funded by the Australian Commonwealth Government and New South Wales Government, based at Western Sydney University, one of the area’s most extensive T&CM research facilities, has incorporated Ayurveda as one of the modalities.[10] Recognized Ayurvedic qualifications are provided by the Australasian Institute of Ayurvedic Studies in Australia and New Zealand, focusing on fundamental clinical training. Also, diplomas and advanced diplomas comprising clinical training in Ayurveda to become an Ayurvedic practitioner or therapist are available at the Australian Institute of Higher and Further Education. Graduates are eligible to attain membership in professional associations upon completion. The Australian Natural Therapists Association represents Ayurvedic practitioners in Australia.[5,11] The Health Institute Australasia in Melbourne and Gold Coast runs certain government-affiliated diplomas, advanced diploma courses, and distance courses in Ayurveda, especially for practitioners.[6,12] In 2019, the All-India Institute of Ayurveda signed an MOU with Western Sydney University and is in the process of also setting up the Ayush Academic Chair. In the United States, the first educational standards for Ayurveda were set up by the National Ayurvedic Medical Association, comprising 500 h of education. The California College of Ayurveda focuses more on Clinical practitioner training. Apart from complete training programs, the organizations also impart correspondence courses, weekend training, and short-term seminars.[13] As per the National Centre for Complementary and Integrative Health (NCCIH), Ayurvedic Medicine is considered one of the alternative and complementary medicines in the United States of America. Around twenty universities offer accredited Ayurveda programs, which include Maharishi International University, Bastyr University, Mount Madonna College of Ayurveda, and Southern California University of Health Sciences (SCUHS). Basically, Ayurvedic Education is available at three levels, namely Ayurvedic Health Counsellor (AHC), Ayurvedic Practitioner (AP), and Ayurvedic Doctor (AD) or Masters in Ayurveda.[14] Alternately, some certificate courses like Ayurvedic Yoga Therapist (AYT) and Panchakarma Therapist (PKT) are gaining popularity among learners of Ayurveda. The Maharishi International University has an accredited master’s degree program in Ayurveda recognized by the National Ayurveda Medical Association (NAMA). Though meager, yet an appreciable number of students pursue various levels of Ayurveda courses. The USA is the only country that has a National Examination for Ayurvedic Students. It also has distinct organizations like a Certification Board, an Accreditation Commission, and a professional membership organization. In Russia, the Ayurveda Russia India Association (ARIA) was established in 2005 to introduce certain credit courses in Ayurveda. Institute of oriental medicine under People’s Friendship University was established in 2013 with a separate Ayurveda department. Since then, considerable research, along with Indian pharmaceutical companies, has flourished. Also, Ayurvedic literature is being published regularly in Russia.[15] Some of the principles of Ayurveda are similar to traditional Korean medicine (TKM). The Government of Korea has established universities that impart skills and training in TKM. In Korea, Masan University is the pioneer in introducing the syllabus of Ayurveda.[16] In South Africa, Ayurveda Courses are offered by The Nelson Mandela School of Medicine in collaboration with Natal University, which has Ayurveda faculty at the University.[17] Ayurveda has gained importance since Kenyan Prime Minister Raila Odinga’s daughter Rosemary benefitted from Ayurveda treatment at Sreedhariyam to restore her vision. India also plans to set up an Ayurveda Chair in the Durban University.[18] In Canada, Toronto College of Ayurveda is the only institute in North America with Ayurveda physicians. The International Council for Ayurvedic Physicians (ICAP) is registered with the Canadian government and boosts the aspirants of Ayurveda to pursue Ayurveda as a profession.[19] In Brazil, Ayurveda is recognized as one of the 29 integrative health practices by the Ministry of Health of Brazil.[20] The Brazilian Academic Consortium of Integrative Health, along with the Indian Government, is developing research protocols for cancer, psychological disorders, and evidence mapping of Ayurvedic treatment in Brazil. The Suddha Dharma Mandalam is a private organization in Brazil that has been active over Brazil, South America, Portuguese, and Spanish-speaking countries in Europe for propagating Ayurveda through various online/offline courses of Ayurveda therapists of different levels. Many conventional medical doctors are interested in enrolling in these courses, and their number is increasing day by day. In Argentina, the “FundacionSalud de Ayurved Prema Argentina” has been active over many years in the field of Ayurveda. It runs courses in two of the country’s major medical schools—at the School of Medicine of the University of Buenos Aires and the National University of Cordoba’s School of Medicine.[21] In the UAE, there is an increasing demand and interest in Traditional Complementary and Alternative Medicine (TCAM), including Ayurveda. Ayurveda is an approved “Medical System” in Gulf countries Saudi Arabia, Oman, Bahrain, and Qatar, except Kuwait, and licensed practitioners and therapists are authorized to practice.[22] Legal status of Ayurveda in G20 Nations In Latin America, since the last 50 years, many efforts have been put forth to introduce Ayurveda. This is evident from the establishment of Ayurved therapy centers across these countries. Ayurved courses are now being taught at the university level after obtaining official recognition in Argentina, Brazil, and Mexico. Colombia has shown interest, and a joint working group has been formed for bilateral talks. Ayurveda is also adopted as a medical system by the national health systems in Brazil. Besides this, Ayush chairs have been established in Argentina and Mexico.[23,24] In Australia, the regulations for clinicians of the Ayurveda stream are not well-defined. Here, Ayurveda lies under the category of complementary medicines and is governed by the Therapeutic Goods Administration (TGA), which maintains all the details of licensed companies in a central register. Thus, due to the heavy metal content and other issues, accepting herbo-mineral formulations is very tough.[25] Still, many companies like Blackmores, Life Space, and Integria Healthcare have certain herbal products registered under TGA. Ayurveda chair has been established at Western Sydney University. In Europe, Ayurveda is still not acknowledged as an official medical system. In some countries like Germany, doctors have a free choice of therapy; thus, BAMS graduates practice Ayurveda under the ambit of Complementary and Alternative Medicine (CAM) after obtaining a license as a “Heilpraktiker,” i.e., a practitioner in natural medicine. Regarding drug regulations in Europe, Ayurvedic medicines fall under the category of dietary supplements. To sum up, legalities in education, clinical practice, and regulatory framework for drugs in Ayurveda are not demarcated to date.[8] Basically, Ayurveda has no independent legal status in the USA. Some states allow the practice of complementary and alternative healthcare by unlicensed practitioners. Still, the USA does not have formal regulations available for clinical practice and education. California, Idaho, Minnesota, New Mexico, and Rhode Island are the five states where Ayurveda practice has been safeguarded under special laws, i.e., Health Freedom Acts.[13] In Canada, Ayurveda is still not recognized as a separate medical system, but the Canadian Government offers and allows BAMS graduates and postgraduates to practice.[19] In Russia, in 1990, Ayurveda started to take root after the Chornobyl disaster, which resulted in the development of the first Ayurvedic Medical Centre in Minsk. Shortly after this, a special department of the Ministry of Healthcare was formed wherein Ayurveda was integrated into the Russian healthcare system due to positive results in pediatric care. Ayurveda is also included in the state register of practices.[26] South Korea has a TM system named Haanyak, with a license to practice since the 1950s. Korea has a dual medical system wherein doctors possess both Western and traditional medical licenses.[27] In South Africa, the import of Ayurvedic medicine is allowed to a certain extent. Ayurveda practice is also recognized and has representation on different Boards of the South African Ayurveda Liaison Committee and the African Allied Health Professional Act. In the UAE, Ayurveda consultations, medicines, and therapies are covered under medical insurance. The G20 platform is a further golden opportunity for India to captivate all these nations’ attention toward understanding and implementing Ayurveda doctrines in their respective health systems and health policies. Many countries, such as Japan, Indonesia, Turkey, and China, have their own recognized strategies of medicine that their respective governments are adopting. The present efforts taken will surely be fruitful for nurturing the fundamentals of Ayurveda globally, leading to its worldwide recognition and legal acceptance in many countries. However, India is making efforts to become a leading destination for Medical and Wellness Tourism through its “Heal in India” initiative. The Ministry of Ayush and the Ministry of Health and Family Welfare have established a Medical Value Travel Digital Portal to help foreign patients seeking treatment in India, providing comprehensive healthcare across various medical specialties. “Heal by India” aims to make traditional systems of medicine easily accessible and affordable, both domestically and globally. This initiative includes training programs, research collaborations, and awareness-building activities to promote the benefits of Ayush medicine. The fruits of this initiative will surely take some time to ripen but will surely boost academics, legal acceptance for practice, research, and products of TM, especially Ayurveda. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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