NATIONAL COMMISSION FOR INDIAN SYSTEM OF MEDICINE

WHY IN NEWS:

• Lok Sabha on 14^th September 2020 passed the National Commission for Indian System of Medicine Bill.

BACKGROUND:

• The Bill seeks to repeal the Indian Medicine Central Council Act, 1970 and provide for a medical education system which ensures:
  • (i) availability of adequate and high quality medical professionals of Indian System of Medicine
  • (ii) adoption of the latest medical research by medical professionals of Indian System of Medicine
  • (iii) periodic assessment of medical institutions, and
  • (iv) an effective grievance redressal mechanism

KEY FEATURES OF THE BILL:

• Constitution of the National Commission for Indian System of Medicine:
  • The Bill provides for the establishment of the National Commission for Indian System of Medicine (NCISM)
  • The NCISM will consist of 29 members, appointed by the central government
  • A Search Committee will recommend names to the central government for the post of Chairperson, part time members, and presidents of the four autonomous boards set up under the NCISM.
  • These posts will have a maximum term of four years.
  • The Search Committee will consist of five members including the Cabinet Secretary and three experts nominated by the central government
• Functions of the National Commission for Indian System of Medicine:
  • (i) framing policies for regulating medical institutions and medical professionals of Indian System of Medicine
  • (ii) assessing the requirements of healthcare related human resources and infrastructure
  • (iii) ensuring compliance by the State Medical Councils of Indian System of Medicine of the regulations made under the Bill
  • (iv) ensuring coordination among the autonomous boards set up under the Bill.
• Autonomous boards:
  • The Bill sets up certain autonomous boards under the supervision of the NCISM.
  • These boards are: (i) the Board of Ayurveda and the Board of Unani, Siddha, and Sowa-Rigpa
    • They will be responsible for formulating standards, curriculum, guidelines for setting up of medical institutions, and granting recognition to medical qualifications at the undergraduate and post graduate levels in their respective disciplines
  • (ii) Medical Assessment and Rating Board for Indian System of Medicine:
    • It determine the process of rating and assessment of medical institutions and have the power to levy monetary penalties on institutions which fail to maintain the minimum standards  It will also grant permission for establishing a new medical institution
  • (iii) Ethics and Medical Registration Board:
    • It will maintain a National Register of all licensed medical practitioners of Indian System of Medicine, and regulate their professional conduct.
    • Only those included in the Register will be allowed to practice Indian System of Medicine
• Advisory Council for Indian System of Medicine:
  • Under the Bill, the central government will constitute an Advisory Council for Indian System of Medicine.
  • The Council will be the primary platform through which the states/union territories can put forth their views and concerns before the NCISM.
  • Further, the Council will advise the NCISM on measures to determine and maintain the minimum standards of medical education.
• Entrance examinations:
  • There will be a uniform National Eligibility-cum-Entrance Test for admission to under-graduate education in each of the disciplines of the Indian System of Medicine in all medical institutions regulated by the Bill.
  • The NCISM will specify the manner of conducting common counselling for admission in all such medical institutions.
  • The Bill proposes a common final year National Exit Test for the students graduating from medical institutions to obtain the license for practice.
  • Further, there will be a uniform post-graduate National Entrance Test which will be conducted separately for admission into postgraduate courses in each of the disciplines of the Indian System of Medicine in all medical institutions.
• National Teachers’ Eligibility Test
  • The Bill also proposes a National Teachers’ Eligibility Test for postgraduates of each discipline of Indian System of Medicine who wish to take up teaching that particular discipline as a profession

REGULATION OF INDIAN SYSTEM OF MEDICINE:

• In India, the national policy on traditional and alternative medicine was introduced in 1940
• In 1959, Govt of India recognized traditional Indian System of Medicine (ISM) and brought it under Drug and Cosmetic Act.
• In India, several legislative and administrative measures are in place to control the manufacturing and sale of Ayurveda, Siddha and Unani (ASU) medicine.
• Drugs & Cosmetics Act, 1940 describe the provisions for regulation of manufacturing, packaging, labelling and sale of ASU drugs
• A separate Ayurveda, Siddha and Unani Technical Advisory Board (ASUDTAB) was also formed which deals and advice the authorities on the technical matters involved in the regulation of ASU drugs
• The Central Council of Indian Medicine (CCIM) is constituted in the year 1970, which involved in the framing and implementing different regulations including the curricula and syllabi in ISM (i.e. Ayurveda, Siddha and Unani).
• In 2012, Sowa Rigpa system of medicine is incorporated in the CCIM.
• Department of Indian Medicine and Homeopathy (ISM & H) was formed with the objective to develop the ISM.
• In 2003, this Department was renamed as Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), and in 2014 separate ministry on AYUSH
• Traditional knowledge digital library (TKDL), an exclusive digital database regarding the medical knowledge mentioned in several ISM, was created and are made available in the public domain.
• The database consists the information about the medicinal plant, formulation of Ayurveda, Siddha, Unani, Yoga etc.
• TKDL is a collaborative project of CSIR and AYUSH, and the information's are also available in different national and international language.
• Recently government is utilizing the available facilities of ISM in rural health care mission (NRHM). Like, appointing Ayurveda doctors and paramedics in the primary healthcare delivery system and in National Health programs.

CHALLENGES OF INDIAN SYSTEM OF MEDICINE:

• Quality issues:
  • Adulteration, misidentification of plant, faulty collection and preparation, incorrect formulation process are the main problems that reduces the effectiveness of herbal preparation and can be considered as key factors affecting quality and purity of herbal medicines.
  • Presence of heavy metals in Ayurveda, Siddha and Unani (ASU) drugs are a major cause concern
• Processing and harvesting issues:
  • Indiscriminate harvesting, poor agriculture and propagation method, poor pre and post-harvest practices, lack of processing techniques leads to the substandard quality of herbal drugs.
• Quality control related issues:
  • Standardization, poor quality control procedure and lack of Good Manufacturing Practices (GMP) are the main hurdle to maintain the quality of herbal drugs.
  • Lack of awareness regarding the guideline among growers and manufacturers, lack of implementation and regulation of the guideline are also frequent in small and medium scale industries.
• Administrative issues:
  • Lack of regulation and controlling authority in traditional medical sector, lack of proper monitoring and controlling are absolute need for the quality of drugs.
• Infrastructure related issue:
  • Lack of processing technique, trained personal, sophisticated instrument, utilization of modern techniques, facility to fabricate instrument locally are the major problems.
• Pharmacogivilane:
  • Proper pharmacogivilane in herbal sector is the need of time to find the toxicological data and adverse drug reaction of herbal drugs. Adverse reactions, contraindications, interactions with other drug, food and existing orthodox pharmaceuticals need to be monitor properly.
• Clinical trial:
  • Since the safety continues to be a foremost issue with the use of herbal remedies therefore, clinical trials are necessary to understand the safety and efficacy of these drugs before introduced them in global market.
• IPR and biopiracy:
  • Biopiracy is the major difficulty in promotion of herbal traditional medicine.
  • Documentation of folk knowledge thus important for our future.
• Irrational use:
  • It is generally believed that herbal products don't have any side effects, interaction, but unfortunately is not true.
  • Thus, irrational practice of these drugs can lead to various problems which can hinder the promotion of such drugs.
• R&D:
  • Research and development on dosage, processing, techniques are the key need for any drug, but in traditional medical sector it is quite less compare to allopathic medicine.
  • Although in recent years, the trend is changing. Research to understand the mode of action and pharmacokinetics phenomenon, improvement/creation of monographs and reference standards for marker-based analysis are necessary of time.
  • Decisive gap in current ethno pharmacological and modern medicinal plant research is another problem for sustainable, socio-culturally equitable and safe supply of herbal medicines.
• Unethical practice of herbal medicine
• Lack of qualified physician
• Exposure of unreliable and misleading information
• Lack of sufficient fund, absence of focused marketing and branding, lack of knowledge sharing also hold back the global promotion of herbal medicine.
• Lack of protection of biodiversity and protecting the traditional medicinal plants.

CONCLUSION:

• Traditional medicine particularly herbal medicine considered as a major healthcare provider around the globe particularly in rural and remote areas.
• A large section of people depends on such medicine for their primary healthcare mainly in underdeveloped or developing countries
• In recent years there is a huge upsurge in the use of traditional and complementary medicine around the glove.
• In Africa nearly 80% of population uses such medicine for their primary healthcare. In China, it was estimated that traditional herbal medicine account for 30–50% of the total medicinal consumption.
• Evidence based incorporation of Indian traditional medicine in clinical practice will help to provide quality healthcare to all.

PRACTICE QUESTION:

Q. “Integration of Ayurvedic and others Indian traditional medicine in clinical practice will helpful to promote the health of the people who are unable to access the modern medicine properly”. Comment