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1) The document discusses challenges and prospects for innovation in traditional medicine systems in India. It analyzes the traditional medicine innovation system through the framework of national innovation systems. 2) Key issues addressed include the limited accessibility of modern medicine, insufficient resources, and the potential for innovation in traditional medicine to improve healthcare. 70% of Indians use traditional systems like Ayurveda. 3) The objectives are to analyze actors in traditional medicine development, understand its socio-economic impacts, study intellectual property policies, and assess regulations. It examines universities, research centers, and companies involved in traditional medicine.

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CHALLENGES AND PROSPECTS OF INNOVATION IN TRADITIONAL MEDICINE SYSTEM IN INDIA M. Phil Dissertation Presented By Shivmohan Prajapati M. Phil/Ph.D. Research Student Supervisor Dr. Kunal Sinha Centre for Studies in Science, Technology and Innovation Policy, School of Social Sciences, Central University of Gujarat, Gandhinagar- 382029
Chapter 1 Introduction Overview • The accessibility of modern medicine is less in primary health care. • There are insufficient human resources in modern medicine. • Where is available medicine but out of reach that people. who doesn’t have capacity to buy it. • India 70% population are using traditional medicine. Which are multiple types e.g. Ayurveda, Unani, Homeopathy, Siddha and Yoga. • Innovation in traditional medicine can change the scenario of primary health care. • In term of carrier opportunity in TM opens up a new platform for its popularity and wide scale social acceptance. • Identification, manufacturing, process and diagnosis have had own science and technology of TM which was historically accepted. • New science and technology can increase its quantity and quality.
Continue.. • Poor service delivered has eroded people confidence in local herbal product in favour of the imported that are modern health care (Wario 2013). • Wario et al (2013) point out that rural communities access more TM due to the availability and cost effective in India. • Integration of innovative technology in this sector can improve human health in India. • WHO report (2012) pointed that 50% of people from the poorest countries and 33 % from the developing countries have no regular access of basic essential medicine. • In India the shortage of 52% Nurse, 76% doctor, 88% specialist, 58 % pharmacist only 72 state medical colleges are producing human resources (GOI 2012) • For covering total population and total health there will be need to innovation to integrate multicultural medicine system in India like Ayurveda, Yoga, Unani, Siddha, Homeopathy • In terms of resources for economic development, nothing can be considered of higher importance than the health of the people which is a measure of their energy and capacity as well as of the potential of man hours for productive work in relation to the total number of persons maintained by the nation (GOI, 1951).
• .Health is not an absence of disease. It is positive state of wellbeing in which the harmonious development of physical and mental capacities of the individual lead to the enjoyment of a rich and full life. • The World Health Organization (WHO) defines traditional medicine as “the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses” (WHO, 2000). Categorization of Indian System of Medicine Folk stream- It includes mostly the oral traditions practiced by the rural villages, herbal healers, Vaidya’s or the tribal physicians. This stream of inherited traditions is together known as local Health Traditions (LHT). Autonomous community supported health system of rural mass. It is still alive and runs parallel to the state supported modern health care system, but its full potential is still not fully utilized (GOI 2000). Classical Stream- At the second level of traditional health care system is the scientific or classical system of medicine. This comprises of the codified and organized medicinal system. The classical text are Charka Samhita, Sushrutasamitha, Bhelasamhita and hundreds of other including some in the regional language covering treaties of all branches of medicine and surgery (GOI 2000).
• Innovation of TM is to increase the quality, standardization, diffusion, skill development, conserve TM resources and ecological environment to supporting sustainable development. Structure of AYUSH • A well-developed infrastructure of AYUSH system exists in India which includes educational institutes, research organization, public and private hospitals, dispensaries and registered private practitioners providing health care. • At administrative level there is Department of AYUSH under Ministry of Health & Family Welfare, Government of India, and there are separate Directorates of AYUSH in 23 states. • Though culturally and socially interwoven network with the community AYUSH system have very deep roots healthcare delivery in India. • About 80-90 percentage of population in India is reported to use Ayurveda and other traditional systems of medicine to meet their primary health care needs.
Statement of Problems • There are scarcities of skilled human resources and technology to integrate with TM system in India • Traditional medicine (TM) have seen as lack of integration of science and technology, • Health services of modern medicine are limited to the city, town and block level. Doctors give services within limited time not for night or whole day. • Lack of diffusion of medicinal plants is inefficient, informal, secretive and opportunistic. • Several constraints exist due to inadequate awareness, inadequate investments in research and development, manufacturer, exporter dissonance, lack of quality and standardization norms, and lack of adequate marketing and trade information.
Significance of the research • The enhancement of traditional medicine is one of the important factors to improve public health in India. • Its relation with NIS, and impact on health has become very significant. • India seems to be a suitable site for the research given that despite infrastructural growth of traditional medicine, the country has seen a decline continuously since the past few decades. • Most importantly, there is a need to understand the government strategies (or policies) for traditional medicine. For the betterment of traditional medicine, government policies and schemes are being implemented.
Theoretical framework • National innovation system has been applied to analyse the traditional medicine system in India. • According to freeman (1987), a national system of innovation has been defined as he network of associations in the public and private sectors whose undertakings and interactions initiate, import, transform and diffuse new technologies. • A national system encompasses elements and relationships, either located within or rooted inside borders of a nation state. • Systems of innovation in the traditional medicine consist of complex networks of universities, research institutes, industries and companies, equipment manufacturers and suppliers, government agencies and controlling bodies • For the purposes of this study and reflecting on the country nature of health, we consider NIS as including activities and organisations within the country. • NSI is appropriate however because it is sovereign governments that make policies and oversee patents, regulatory, institutions, budgets for R&D, the creation and operation of organisations and firms, etc.
NIS RIS SIS Main Actors industry Government Education Research Organization Universities Industrial enterprises Public research Organization Firms Non-firms Organizations Individuals Institutions National Policies Laws National Finance Support Informal institutions depending of trust and reliability among actors Standards Regulations Main Interactions Joint industry activities R & D Collaboration Technological diffusion Personnel Mobility Inter firms interactions Extent interactions for firms with research organizations R & D collaboration Inter industry interactions Interactions among firms and non-firms organizations Table No. 1.1 Innovation System Source: Hekkert, at. al. 2007
Objectives of Research 1. To analyse the role and activities of various actors for the development of traditional medicine systems in India. 2. To understand the current status of traditional medicine and its socio-economic impacts in India. 3. To study the role of IPR in Indian traditional medicine system. 4. To assess the regulatory policy of traditional medicine in India. Research Question 1. What are the factors affecting the practicability of traditional medicine system in India? 2. What is the role played by innovation in traditional medicine system through networking of institutions, actors and society? 3. What are the policies and strategies relating to making use of traditional medicine in India?
Research Methods • The research is based on secondary sources. • Secondary sources included government documents, national and international journals, articles, books and national and international reports, and various websites dealing with the innovation system in traditional medicine. • The study has gathered data and information from the annual reports, from the various organisations involved in research and development in the field of traditional medicine. Universe of the Study • The study has been conducted to get information in regard to traditional medicine innovation system in India from two Indian universities, four R&D centre and four Indian firms. There are following universe of studies: Universities • Gujarat Ayurved University, Jamnagar. • Homeopathy University, Jaipur
R & D Center 1) Central Council for Research in Ayurveda and Siddha (CCRAS), New Delhi 2) Central Council for Research in Homoeopathy (CCRH), New Delhi 3) Central Council for Research in Unani Medicines (CCRUM), New Delhi 4) Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi Firms in Indian Traditional Medicine 1) Dabur India Ltd., Ghaziabad 2) The Himalaya Drug Company, Bangalore 3) Hamdard Laboratories, Delhi 4) SBL Private Limited, Delhi
Chapter 2: Literature Review The following are mentions literature review on basis of three parts; • Traditional medicine • National innovation system • And Co-related with both above • Traditional medicine • Waldram (2000) Point out that the definition of TM remains problematic. Such medical system is often described under the banner of ethno-medicine. Biomedicines only cures disease and TM only heals illness are culturally constructed. Every medicinal system is a cultural system (Hondes 1996) • Foster (1987) stress that all ethno-medical system has a hot remedy for a cold illness or a cold remedy for a hot illness. Hippocratic Galence of ancient Greece, the Ayurveda of India and the Chinese author has described as naturalistic and they represent special cases of proto-scientific, philosophical, cosmological view of the universe.
Jain (2000) author did analysis of inter linkage between biodiversity and society. Different human societies have different biodiversity around them. They have different personal or social needs like in food, medicine, and in faith. Gaitonde (2005) pointed out that after 1970s three major changes has been occurred in perspective of medical education. Fist was the broader conception of human biology, individuals were increasingly recognized as part of complex system. Second change was the recognition of the limits of the curative biomedical model of health. Third change was health care system itself consisted of numerous components and institutions with elaborate sets of roles, beliefs and technologies. Harilal (2009), Author discusses practice in modern India which reflects a prolonged Ayurvedic history of standardisation and professionalization that transformed certain aspects of this medical tradition. This revival is marked by negotiations and compromises within and outside the system. The process started with educational reform in different parts of the country and lobbying with the central and state governments to divert policy attention towards qualified practitioners of the indigenous systems of medicines.
National Innovation system Herstatt et al (2008) authors have propounded that in recent years India has emerged as major destination for corporate research and development. India’s indigenous technology finally seems to have joined the global mainstream of innovation. innovation. Apart from that in India, there are many hurdles for gaining the speed of innovation, like poor infrastructure, red tape and corruption. Fromhold-Eisebith (2007) author has stressed on the conceptual discussion on innovation, emphasizing the importance of interaction between actors, institutions and policy element for supporting technology-based economic development. Liso (2006) suggest the economics of innovation and technological change has become one of the most important fields of economics. Since the 1990s a lot of attention has been dedicated, within this field, to systems of innovation and, more specifically, to national systems of innovation. The concept has maintained its strength even in a context of increasing globalisation.
Co-related with both above Singh (2011) has pointed that number of Sectoral Innovation Councils have been constituted. The latest in the series is the AYUSH Sector Innovation Council constituted by the Govt. of India. It warrants a national dialogue and debate on the perspectives and priorities of innovative activities in traditional knowledge practice in general and AYUSH in particular. Soares and Jose (2013) has discrive The research aimed at contributing to unfold innovation systems that move towards inclusive development, opening up the possibility for policies that may promote development alternatives which normatively aspire towards greater sustainability and social inclusion. Based on the research preliminary results, the paper aims at presenting and discussing empirical evidence and analysis of some experiences in the five countries regarding inclusive development at local level. The analysis comprises different health innovative systems covering the informal economy, micro and small enterprises and other local-scale actors, including ‘living pharmacies’, low-cost medical equipment; traditional Ayurveda medicine, among other
Research Gap • So, on the basis of literature review it can be said that these researchers and authors had more attention on the conservation of plants, ecological issues, and they have also focused environmental issues, some of them differentiate between modern and traditional medicine. • Very rarely literature found which talk about innovation in traditional medicine. Therefore very big research gap on the basis of science, technology innovation policy on the issue. • In the literature review found that most of the literature are written on the environment perspective. Some of them are defining the hegemonic character of modern medicine • TM have been remain under develop it live through the people support.
Chapter: 3 The Role and Activities of NIS Actors in Traditional Medicine System in India The structure of the health system in the country is important for the development of information about traditional medicine. This chapter national innovation system has been applied to analyse the traditional medicine system in India. Role of University in TM I. Gujarat Ayurved University Jamnagar II Homeopathy University in Jaipur a) Training activities a) Education b) Treatment Activities b) Research Research and Development Centres Central Council for Research in Ayurveda and Siddha (CCRAS), New Delhi Central Council for Research in Homoeopathy (CCRH), New Delhi Central Council for Research in Unani Medicines (CCRUM), New Delhi Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi
Components of traditional medicine System in India and their Activities Component/ determinant Names Activities Universities Gujarat Ayurved University, Jamnagar, Gujarat. Homeopathy University Jaipur. These Universities have been doing research & development related to traditional medicine. Industries and Companies Dabur India Limited, Kaushambi, Ghaziabad, Uttar Pradesh. Himalaya, Makali, Bangalore. Hamdard Laboratories. Dr. Willmar Schwabe India Pvt. Ltd. Uttar Pradesh. SBL PVT. LTD. Delhi, INDIA. Traditional medicine related production and R&D
Continue Institution Ministry of AYUSH, Government of India Roles and Norms Research and development Central Council for Research in Ayurveda and Siddha (CCRAS). Central Council for Research in Unani Medicines (CCRUM). Central Council for Research in Homoeopathy (CCRH). Central Council for Research in Yoga and Naturopathy (CCRYN) Research and Development funding for clinical research, literary research, Research and Development Collaboration Patanjali Research Foundation, Uttarakhand. KLINTOZ Pharmaceuticals Pvt. Ltd. New Delhi. Research & Development (essential for the development of traditional medicine) Sources: own compilation ,2015
I. Central Council for Research in Ayurveda and Siddha (CCRAS) New Delhi • It has been executing its research programmes with a network of 30 peripheral Institutes/centres/units with the headquarters office responsible for control, monitoring and supervision. • It conducting research in following areas Medicinal Plant Research, Drug standardization Research, Pharmacology Research, Clinical Research, Literary Research & Documentation, • Last five year plan (2011-15) 3 Research Projects completed, 6 are ongoing, 3 being approved for initiation. II. Central Council for Research in Homoeopathy (CCRH), New Delhi • The council has undertaken pharmacognostical studies on 272 drugs, physico-chemical on 265, pharmacological on 125 drugs and 117 drugs have been studies from all the three aspects.
III. Central Council for Research in Unani Medicines (CCRUM), New Delhi • The council is involved in multifaceted research studies through a network of 22 institutes functioning in different parts of the country. • Research programmes include preclinical safety and pharmacology, clinical research, cultivation of raw drugs, preparation of compound formulations and their standardization and historical and literary research. Presently council encourage collaborative research studies in the following areas • IV. Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi • Clinical Research: • Literary Research: The council provides financial assistance for translation, publication of ancient Yoga texts and other useful standard literature based on modern scientific research. The quantum of financial assistance under the scheme is decided by the SFC. • In House Research Cell: The council has started an in-house research cell to conduct in-depth research in Yoga and Naturopathy.
85% 7% 4% 4% Sales Ayurveda Homeopathy Unani Sidha Proportion of Manufacturing Units of Different Systems Source: Joshi 2008
Chapter: 4 Current Status and Impacts of traditional medicine in India • During the last decade, use of traditional medicine has expanded globally and has gained popularity. It has only continued to be used for primary health of the poor in developing countries; conventional medicine is predominant in the national health care system (Murugesa, 1988; Chelliah, 2014). • In the India context, all six traditional systems of medicine with official recognition (Ayurveda, Yoga, Naturopathy, Unani Medicine, Siddha and Homeopathy) have institutionalised education systems
Table no. 4.1Education and Training Institutes in India Facilities Ayurveda Unani Siddha Homeopathy Total Undergraduate College 154 32 2 118 305 Admission Capacity 6117 1239 155 4318 11829 Postgraduate Colleges 33 3 1 10 47 Admission Capacity 462 55 35 69 621 Source: World Health Organization, 2001.
0 2000 4000 6000 8000 10000 12000 14000 Undergraduate colleges Admission Capacity Postgraduate Colleges Admission Capacity Educational and Training Institute in India Ayurveda Unani Siddha Homeopathy Total Source: World Health Organization, 2001
Table no. 4.2 Some well-known Indian medicinal plants and their uses Botanical Name Parts used Therapeutic uses Acorus calamus Linn (Araceae) Rhizome Nervine tonic, anti- spasmodic (Satyavati et al .,976; Bose et al., 1960) Aegle marmelos (L.) Corr. (Rutaceae) Fruit Hypoglycemic; chemopreventive (Vyas et al., 1979; Dixit et al., 2006) Allium sativum Linn (Alliaceae) Bulbs Anti-inflammatory; anti- hyperlipidemic, fibrinolytic (Dixit et al., 2006) Source: Ravishankar and Shukla, 2007.
Usage of TCAM in Developing and Developed Countries Developing Country Usage of CAM Uganda 60% Tanzania 60% Rwanda 70% India 70% Benin 80% Ethiopia 90% Developed Country Usage of CAM Belgium 31% USA 42% Australia 48% France 49% Canada 70% Source: Unnikrishnan 2010
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Usage of TCAM in Developing and Developed Countries Source: Unnikrishnan 2010
. Annual Budget Allocation To MOHFS As Department Wise In 2011-12 To 2013-14 Department 2011-12 2012-13 2013-14 Total expenditure Total Percent Total expenditure Total Percent Total expenditure Total Percent Department of health and family welfare 24355.08 89.54 30702.00 89.02 33278.00 89.14 Department of AYUSH 783.18 2.87 1178.00 3.41 1259.00 3.37 Department of health research 746.43 2.744 908.00 2.63 1008.00 2.70 AIDS Control 1313.86 4.83 1700.00 4.92 1785.00 4.78 Total 27198.55 100 34488.00 100 37330.00 100 Source: Kamakshi and Subhash, 2014.
. 0 20 40 60 80 100 120 Dep. Of health and family welfare Dep. Of AYUSH Dep of health research AIDS Control Total Annual Budget Allocation Department Wise 2013-14 2012-13 expenditure percentage 2011-12 Source: Kamakshi and Subhash, 2014
Registered Medical Practices Under AYUSH System Number of Practices Percent Total Ayurveda 453661 62.54 Unani 46558 6.41 Siddha 6381 0.87 Naturopathy 888 0.12 Homeopathy 217850 30.03 Total 725383 100 Source: Kamakshi and Subhash, 2014.
63% 6% 1% 0% 30% Percentage of registered practices Ayurveda Unani Siddha Naturopathy Homeopathy Source: Kamakshi and Subhash, 2014
Chapter 5: Role of IPR in Conservation of Traditional Medicine in India • Intellectual property rights are ownership right of creators, which is legally acquired by the owner. It is concern to industrial, scientific, literary and artistic fields. • Generally, IPR described as legally protective rights which established for innovative or inventive ideas. • IPR divided into two group 1) Industrial properties covering IPRs such as, patents, trademarks, geographical indications and industrial designs 2) Copyright and related rights cover artistic and literary works, performances, broadcasts and the like. Protection of TM under IP in India Patent Law Trademark Law Anti-Unfair Competition Law Regulation on Protection of TCM Law on the Administration of Pharmaceuticals
Traditional Knowledge Digital Library (TKDL) • It is a database with a tool to understand the codified knowledge existing for the Indian traditional medicine system, which include Ayurveda, Siddha, Unani and Yoga as prior art. In other words the project TKDL involves documentation of traditional knowledge available in public domain. • The books on Indian traditional medicine system are the prior art which act as the source of information for TKDL. • Two lakh formulations are in the TKDL which have been taken from Ayurveda, Unani, Siddha and Yoga texts. • It is dynamic database, updated according to the inputs from the users of the database and formulation will be continuing added. The existing medicines in TKDL with following main components: i. Name of the drug ii. Origin of the knowledge iii. Constituents of the drug with their parts used and their quantity iv. Method of preparation of the drug and usage of the drugs. TKDL is making communication between traditional and modern knowledge. India evolved Traditional Knowledge Resource Classification (TKRC) was based on International Patent Classification (IPC).
• TKDL breaks the language and format barrier and makes available this information in English, French, Spanish, German and Japanese in patent application format, which is easily understandable by patent examiners. Current status of transcription of the traditional medicine formulation in the Traditional knowledge Digital Library Discipline No. of texts used for transcription Transcribed Ayurveda 75 books 97,337 Unani 10 books 1,75,150 Siddha 50 books 23,016 Yoga 15 books 1,680 Total 150 books 2,92,662 Source: http://www.tkdl.res.in/tkdl/langdefault/common/Abouttkdl.asp?GL=Eng, accessed April 15, 2015
Different Categories of Plants of TKDL Sr. No IPC Codes IPC Categories No of Sub group in IPC 1 Algae A61K 36/02 to 36/0 4 2 Fungi & Lichens A61K 36/06 to 36/09 10 3 Bryophyta A61K 36/10 1 4 Pteridophytes A61K 36/11 to 36/126 3 5 Gymnosperms A61K 36/13 to 36/17 5 6 Angiosperms A61K 36/18 1 7 Dicotyledons A61K 36/185 to 36/87 148 8 Monocotyledons A61K 36/88 to 36/9068 35 Total number of Sub-groups 207 Source: http://www.tkdl.res.in/tkdl/langdefault/common/Abouttkdl.asp?GL=Eng, accessed April 15, 2015.
State wise number of licensed Pharmacies under AYUSH as on April 2012 S N State Total S N State Total 1 Uttar Pradesh 2254 14 Uttarakhand 188 2 Kerala 968 15 Orissa 161 3 Maharashtra 834 16 Himanchal Pradesh 154 4 Andhra Pradesh 693 17 Delhi 64 5 Tamil Nadu 685 18 Assam 63 6 Madhya Pradesh 560 19 Pondicherry 41 7 Gujarat 490 20 Chhattisgarh 31 8 Rajasthan 312 21 J & k 18 9 Punjab 290 22 Daman & Diu 9 10 Bihar 287 23 Goa 7 11 Haryana 257 24 Sikkim 1 12 West Bengal 221 25 Chandigarh 1 13 Karnataka 196 26 other 10 state 0 Source: Press Information Bureau 2013
Chapter 6: Conclusion • India can take advantage of the strength while focusing on specialty on an overall basis, establishing traditional medicine industrial bases for the organic collaboration and coordinated development of medicinal herb growing, research, development and production. • In last few decades, traditional knowledge on primary healthcare has been widely acknowledged across the world. • The role played by the actors to bring about the innovations. In order to use NIS framework, nation needs to decide which observations can be located. • The technological innovation in India is improving the quality and quantity of TM. If government has focus on TM, there is hope of maintaining public health, especially in rural areas because most of the population of India live in villages. • Traditional knowledge digital library (TKDL) has been playing an important role for many years for the protection of traditional knowledge. India is the only country in the world to set up an institutional mechanism namely, the TKDL, for the protection of traditional knowledge.
Future Prospects • The Hindu at 11 august 2015 has pointed out that in India every year need of 2 lacks kidney, 50 thousand heart, 50 thousand liver, for transplant because people did not take percussion on TM based. • In India are increasing life style related disease like depression, diabetes, indigestion, acidity, obesity, which is cure through TM based percussion. • TM have capacity to increase immunity which protect so many disease. Problems • Lack of institution for covering maximum area • Ratio of patient and doctor is low, unskilled human resources are involved. • Growth of health infrastructure TM is slow as the increasing need of population. • Ratio of fund allocation TM and Allopathic medicine 2:8 according to 11th plane.
References  WHO (2000) General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, WHO/EDM/TRM/2000.1 Distr.: General Original: English. http://apps.who.int/medicinedocs/pdf/whozip42e/whozip42e.pdf  Planning Commission of India (2000) Report of the Task Force on Conservation &Sustainable use of Medicinal plants. http://planningcommission.gov.in/aboutus/taskforce/tsk_medi.pdf  Herstatt, C., Tiwari, R. And et al (2008). India’s National Innovation system: Key Elements and corporate Perspectives. Hamburg University of Technology Germany.  AYUSH (2012) Ayurveda: the science of life, Department of AYUSH ministry of health & family welfare government of India, www.indiandicie.nic.in  First Five Year Plan (1951). Planning Commission, Government of India.  Hekkert, B. (2007). Functions of innovation systems: A new approach for analysing technological change. Technological forecasting and social change. 74413-432.  Waldram, J. B. (2000). The Efficacy of Traditional Medicine: Current Theoretical and Methodological Issues. American Anthropological Association. Vol. 14, No. 4, pp. 603-625  Foster, G. M. (1987). On the Origin of Humoral Medicine in Latin America. Medical Anthropology Quarterly. New Series, Vol. 1, No. 4, pp. 355-393
 Jain, S. K. (2000). Human Aspects of Plant Diversity. Economic Botany. Vol. 54, No. 4, pp. 459-470  Gaitonde, R. (2005). Community Medicine: Incorporating Gender Sensitivity. Economic and Political Weekly. Vol. 40, No. 18, pp. 1887-1892  Harilal, M. S. (2009). Commercialising Traditional Medicine': Ayurvedic Manufacturing in Kerala. Economic and Political Weekly. Vol. 44, No. 16, pp. 44- 51  Herstatt, C., Tiwari, R. And et al (2008). India’s National Innovation system: Key Elements and corporate Perspectives. Hamburg University of Technology Germany.  Liso, N. D. (2006). Charles Babbage, Technological Change and the National System of Innovation. Journal of Institutional and Theoretical Economics (JITE) / Zeitschrift für die gesamte Staatswissenschaft. Vol. 162, No. 3, pp. 470-485  Singh, S. H. (2011). Perspectives in innovation in the AYUSH sector. Journal of Ayurveda & Integrative Medicine. Vol 2, Issue 2  Joshi, K. (2008). Indian Herbal Sector. India, Science and Technology: 2008. Available at http://www.nistads.res.in/indiasnt2008/t4industry/t4ind19.htm  Chelliah, B. S. and Muthukumar, A. (2014). The Effect of the Removal of Renal Stone using a Siddha Medicine Protocol. International Journal of Current Biotechnology. Vol. 2; Issue 5
 World Health Organization (2001). Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review. Available at http://apps.who.int/medicinedocs/pdf/h2943e/h2943e.pdf Accessed on date 27/04/2015  Unnikrishnan, P. (2010). Role of Traditional Medicine in Primary Health Care: An Overview of Perspectives and Challenges. Yokohama Journal of Social Sciences. Vol. 14 No. 6  Kamakshi & Subhash Kumar, (2014). Role of Traditional Medicine in Improving the Socio-Economic Status of Rural and Urban India. International Ayurvedic Medical Journal. Volume 2; Issue 4 pp. 591-605  Press Information Bureau (2013). Ministry of Health and Family Welfare, Government of India, New Delhi.
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Dissertation presentation

  • 1.
    CHALLENGES AND PROSPECTSOF INNOVATION IN TRADITIONAL MEDICINE SYSTEM IN INDIA M. Phil Dissertation Presented By Shivmohan Prajapati M. Phil/Ph.D. Research Student Supervisor Dr. Kunal Sinha Centre for Studies in Science, Technology and Innovation Policy, School of Social Sciences, Central University of Gujarat, Gandhinagar- 382029
  • 2.
    Chapter 1 Introduction Overview •The accessibility of modern medicine is less in primary health care. • There are insufficient human resources in modern medicine. • Where is available medicine but out of reach that people. who doesn’t have capacity to buy it. • India 70% population are using traditional medicine. Which are multiple types e.g. Ayurveda, Unani, Homeopathy, Siddha and Yoga. • Innovation in traditional medicine can change the scenario of primary health care. • In term of carrier opportunity in TM opens up a new platform for its popularity and wide scale social acceptance. • Identification, manufacturing, process and diagnosis have had own science and technology of TM which was historically accepted. • New science and technology can increase its quantity and quality.
  • 3.
    Continue.. • Poor servicedelivered has eroded people confidence in local herbal product in favour of the imported that are modern health care (Wario 2013). • Wario et al (2013) point out that rural communities access more TM due to the availability and cost effective in India. • Integration of innovative technology in this sector can improve human health in India. • WHO report (2012) pointed that 50% of people from the poorest countries and 33 % from the developing countries have no regular access of basic essential medicine. • In India the shortage of 52% Nurse, 76% doctor, 88% specialist, 58 % pharmacist only 72 state medical colleges are producing human resources (GOI 2012) • For covering total population and total health there will be need to innovation to integrate multicultural medicine system in India like Ayurveda, Yoga, Unani, Siddha, Homeopathy • In terms of resources for economic development, nothing can be considered of higher importance than the health of the people which is a measure of their energy and capacity as well as of the potential of man hours for productive work in relation to the total number of persons maintained by the nation (GOI, 1951).
  • 4.
    • .Health isnot an absence of disease. It is positive state of wellbeing in which the harmonious development of physical and mental capacities of the individual lead to the enjoyment of a rich and full life. • The World Health Organization (WHO) defines traditional medicine as “the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses” (WHO, 2000). Categorization of Indian System of Medicine Folk stream- It includes mostly the oral traditions practiced by the rural villages, herbal healers, Vaidya’s or the tribal physicians. This stream of inherited traditions is together known as local Health Traditions (LHT). Autonomous community supported health system of rural mass. It is still alive and runs parallel to the state supported modern health care system, but its full potential is still not fully utilized (GOI 2000). Classical Stream- At the second level of traditional health care system is the scientific or classical system of medicine. This comprises of the codified and organized medicinal system. The classical text are Charka Samhita, Sushrutasamitha, Bhelasamhita and hundreds of other including some in the regional language covering treaties of all branches of medicine and surgery (GOI 2000).
  • 5.
    • Innovation ofTM is to increase the quality, standardization, diffusion, skill development, conserve TM resources and ecological environment to supporting sustainable development. Structure of AYUSH • A well-developed infrastructure of AYUSH system exists in India which includes educational institutes, research organization, public and private hospitals, dispensaries and registered private practitioners providing health care. • At administrative level there is Department of AYUSH under Ministry of Health & Family Welfare, Government of India, and there are separate Directorates of AYUSH in 23 states. • Though culturally and socially interwoven network with the community AYUSH system have very deep roots healthcare delivery in India. • About 80-90 percentage of population in India is reported to use Ayurveda and other traditional systems of medicine to meet their primary health care needs.
  • 6.
    Statement of Problems •There are scarcities of skilled human resources and technology to integrate with TM system in India • Traditional medicine (TM) have seen as lack of integration of science and technology, • Health services of modern medicine are limited to the city, town and block level. Doctors give services within limited time not for night or whole day. • Lack of diffusion of medicinal plants is inefficient, informal, secretive and opportunistic. • Several constraints exist due to inadequate awareness, inadequate investments in research and development, manufacturer, exporter dissonance, lack of quality and standardization norms, and lack of adequate marketing and trade information.
  • 7.
    Significance of theresearch • The enhancement of traditional medicine is one of the important factors to improve public health in India. • Its relation with NIS, and impact on health has become very significant. • India seems to be a suitable site for the research given that despite infrastructural growth of traditional medicine, the country has seen a decline continuously since the past few decades. • Most importantly, there is a need to understand the government strategies (or policies) for traditional medicine. For the betterment of traditional medicine, government policies and schemes are being implemented.
  • 8.
    Theoretical framework • Nationalinnovation system has been applied to analyse the traditional medicine system in India. • According to freeman (1987), a national system of innovation has been defined as he network of associations in the public and private sectors whose undertakings and interactions initiate, import, transform and diffuse new technologies. • A national system encompasses elements and relationships, either located within or rooted inside borders of a nation state. • Systems of innovation in the traditional medicine consist of complex networks of universities, research institutes, industries and companies, equipment manufacturers and suppliers, government agencies and controlling bodies • For the purposes of this study and reflecting on the country nature of health, we consider NIS as including activities and organisations within the country. • NSI is appropriate however because it is sovereign governments that make policies and oversee patents, regulatory, institutions, budgets for R&D, the creation and operation of organisations and firms, etc.
  • 9.
    NIS RIS SIS Main Actors industry Government Education ResearchOrganization Universities Industrial enterprises Public research Organization Firms Non-firms Organizations Individuals Institutions National Policies Laws National Finance Support Informal institutions depending of trust and reliability among actors Standards Regulations Main Interactions Joint industry activities R & D Collaboration Technological diffusion Personnel Mobility Inter firms interactions Extent interactions for firms with research organizations R & D collaboration Inter industry interactions Interactions among firms and non-firms organizations Table No. 1.1 Innovation System Source: Hekkert, at. al. 2007
  • 10.
    Objectives of Research 1.To analyse the role and activities of various actors for the development of traditional medicine systems in India. 2. To understand the current status of traditional medicine and its socio-economic impacts in India. 3. To study the role of IPR in Indian traditional medicine system. 4. To assess the regulatory policy of traditional medicine in India. Research Question 1. What are the factors affecting the practicability of traditional medicine system in India? 2. What is the role played by innovation in traditional medicine system through networking of institutions, actors and society? 3. What are the policies and strategies relating to making use of traditional medicine in India?
  • 11.
    Research Methods • Theresearch is based on secondary sources. • Secondary sources included government documents, national and international journals, articles, books and national and international reports, and various websites dealing with the innovation system in traditional medicine. • The study has gathered data and information from the annual reports, from the various organisations involved in research and development in the field of traditional medicine. Universe of the Study • The study has been conducted to get information in regard to traditional medicine innovation system in India from two Indian universities, four R&D centre and four Indian firms. There are following universe of studies: Universities • Gujarat Ayurved University, Jamnagar. • Homeopathy University, Jaipur
  • 12.
    R & DCenter 1) Central Council for Research in Ayurveda and Siddha (CCRAS), New Delhi 2) Central Council for Research in Homoeopathy (CCRH), New Delhi 3) Central Council for Research in Unani Medicines (CCRUM), New Delhi 4) Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi Firms in Indian Traditional Medicine 1) Dabur India Ltd., Ghaziabad 2) The Himalaya Drug Company, Bangalore 3) Hamdard Laboratories, Delhi 4) SBL Private Limited, Delhi
  • 13.
    Chapter 2: LiteratureReview The following are mentions literature review on basis of three parts; • Traditional medicine • National innovation system • And Co-related with both above • Traditional medicine • Waldram (2000) Point out that the definition of TM remains problematic. Such medical system is often described under the banner of ethno-medicine. Biomedicines only cures disease and TM only heals illness are culturally constructed. Every medicinal system is a cultural system (Hondes 1996) • Foster (1987) stress that all ethno-medical system has a hot remedy for a cold illness or a cold remedy for a hot illness. Hippocratic Galence of ancient Greece, the Ayurveda of India and the Chinese author has described as naturalistic and they represent special cases of proto-scientific, philosophical, cosmological view of the universe.
  • 14.
    Jain (2000) authordid analysis of inter linkage between biodiversity and society. Different human societies have different biodiversity around them. They have different personal or social needs like in food, medicine, and in faith. Gaitonde (2005) pointed out that after 1970s three major changes has been occurred in perspective of medical education. Fist was the broader conception of human biology, individuals were increasingly recognized as part of complex system. Second change was the recognition of the limits of the curative biomedical model of health. Third change was health care system itself consisted of numerous components and institutions with elaborate sets of roles, beliefs and technologies. Harilal (2009), Author discusses practice in modern India which reflects a prolonged Ayurvedic history of standardisation and professionalization that transformed certain aspects of this medical tradition. This revival is marked by negotiations and compromises within and outside the system. The process started with educational reform in different parts of the country and lobbying with the central and state governments to divert policy attention towards qualified practitioners of the indigenous systems of medicines.
  • 15.
    National Innovation system Herstattet al (2008) authors have propounded that in recent years India has emerged as major destination for corporate research and development. India’s indigenous technology finally seems to have joined the global mainstream of innovation. innovation. Apart from that in India, there are many hurdles for gaining the speed of innovation, like poor infrastructure, red tape and corruption. Fromhold-Eisebith (2007) author has stressed on the conceptual discussion on innovation, emphasizing the importance of interaction between actors, institutions and policy element for supporting technology-based economic development. Liso (2006) suggest the economics of innovation and technological change has become one of the most important fields of economics. Since the 1990s a lot of attention has been dedicated, within this field, to systems of innovation and, more specifically, to national systems of innovation. The concept has maintained its strength even in a context of increasing globalisation.
  • 16.
    Co-related with bothabove Singh (2011) has pointed that number of Sectoral Innovation Councils have been constituted. The latest in the series is the AYUSH Sector Innovation Council constituted by the Govt. of India. It warrants a national dialogue and debate on the perspectives and priorities of innovative activities in traditional knowledge practice in general and AYUSH in particular. Soares and Jose (2013) has discrive The research aimed at contributing to unfold innovation systems that move towards inclusive development, opening up the possibility for policies that may promote development alternatives which normatively aspire towards greater sustainability and social inclusion. Based on the research preliminary results, the paper aims at presenting and discussing empirical evidence and analysis of some experiences in the five countries regarding inclusive development at local level. The analysis comprises different health innovative systems covering the informal economy, micro and small enterprises and other local-scale actors, including ‘living pharmacies’, low-cost medical equipment; traditional Ayurveda medicine, among other
  • 17.
    Research Gap • So,on the basis of literature review it can be said that these researchers and authors had more attention on the conservation of plants, ecological issues, and they have also focused environmental issues, some of them differentiate between modern and traditional medicine. • Very rarely literature found which talk about innovation in traditional medicine. Therefore very big research gap on the basis of science, technology innovation policy on the issue. • In the literature review found that most of the literature are written on the environment perspective. Some of them are defining the hegemonic character of modern medicine • TM have been remain under develop it live through the people support.
  • 18.
    Chapter: 3 TheRole and Activities of NIS Actors in Traditional Medicine System in India The structure of the health system in the country is important for the development of information about traditional medicine. This chapter national innovation system has been applied to analyse the traditional medicine system in India. Role of University in TM I. Gujarat Ayurved University Jamnagar II Homeopathy University in Jaipur a) Training activities a) Education b) Treatment Activities b) Research Research and Development Centres Central Council for Research in Ayurveda and Siddha (CCRAS), New Delhi Central Council for Research in Homoeopathy (CCRH), New Delhi Central Council for Research in Unani Medicines (CCRUM), New Delhi Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi
  • 19.
    Components of traditionalmedicine System in India and their Activities Component/ determinant Names Activities Universities Gujarat Ayurved University, Jamnagar, Gujarat. Homeopathy University Jaipur. These Universities have been doing research & development related to traditional medicine. Industries and Companies Dabur India Limited, Kaushambi, Ghaziabad, Uttar Pradesh. Himalaya, Makali, Bangalore. Hamdard Laboratories. Dr. Willmar Schwabe India Pvt. Ltd. Uttar Pradesh. SBL PVT. LTD. Delhi, INDIA. Traditional medicine related production and R&D
  • 20.
    Continue Institution Ministry ofAYUSH, Government of India Roles and Norms Research and development Central Council for Research in Ayurveda and Siddha (CCRAS). Central Council for Research in Unani Medicines (CCRUM). Central Council for Research in Homoeopathy (CCRH). Central Council for Research in Yoga and Naturopathy (CCRYN) Research and Development funding for clinical research, literary research, Research and Development Collaboration Patanjali Research Foundation, Uttarakhand. KLINTOZ Pharmaceuticals Pvt. Ltd. New Delhi. Research & Development (essential for the development of traditional medicine) Sources: own compilation ,2015
  • 21.
    I. Central Councilfor Research in Ayurveda and Siddha (CCRAS) New Delhi • It has been executing its research programmes with a network of 30 peripheral Institutes/centres/units with the headquarters office responsible for control, monitoring and supervision. • It conducting research in following areas Medicinal Plant Research, Drug standardization Research, Pharmacology Research, Clinical Research, Literary Research & Documentation, • Last five year plan (2011-15) 3 Research Projects completed, 6 are ongoing, 3 being approved for initiation. II. Central Council for Research in Homoeopathy (CCRH), New Delhi • The council has undertaken pharmacognostical studies on 272 drugs, physico-chemical on 265, pharmacological on 125 drugs and 117 drugs have been studies from all the three aspects.
  • 22.
    III. Central Councilfor Research in Unani Medicines (CCRUM), New Delhi • The council is involved in multifaceted research studies through a network of 22 institutes functioning in different parts of the country. • Research programmes include preclinical safety and pharmacology, clinical research, cultivation of raw drugs, preparation of compound formulations and their standardization and historical and literary research. Presently council encourage collaborative research studies in the following areas • IV. Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi • Clinical Research: • Literary Research: The council provides financial assistance for translation, publication of ancient Yoga texts and other useful standard literature based on modern scientific research. The quantum of financial assistance under the scheme is decided by the SFC. • In House Research Cell: The council has started an in-house research cell to conduct in-depth research in Yoga and Naturopathy.
  • 23.
    85% 7% 4% 4% Sales Ayurveda Homeopathy Unani Sidha Proportion ofManufacturing Units of Different Systems Source: Joshi 2008
  • 24.
    Chapter: 4 Current Statusand Impacts of traditional medicine in India • During the last decade, use of traditional medicine has expanded globally and has gained popularity. It has only continued to be used for primary health of the poor in developing countries; conventional medicine is predominant in the national health care system (Murugesa, 1988; Chelliah, 2014). • In the India context, all six traditional systems of medicine with official recognition (Ayurveda, Yoga, Naturopathy, Unani Medicine, Siddha and Homeopathy) have institutionalised education systems
  • 25.
    Table no. 4.1Educationand Training Institutes in India Facilities Ayurveda Unani Siddha Homeopathy Total Undergraduate College 154 32 2 118 305 Admission Capacity 6117 1239 155 4318 11829 Postgraduate Colleges 33 3 1 10 47 Admission Capacity 462 55 35 69 621 Source: World Health Organization, 2001.
  • 26.
    0 2000 4000 6000 8000 10000 12000 14000 Undergraduate colleges AdmissionCapacity Postgraduate Colleges Admission Capacity Educational and Training Institute in India Ayurveda Unani Siddha Homeopathy Total Source: World Health Organization, 2001
  • 27.
    Table no. 4.2Some well-known Indian medicinal plants and their uses Botanical Name Parts used Therapeutic uses Acorus calamus Linn (Araceae) Rhizome Nervine tonic, anti- spasmodic (Satyavati et al .,976; Bose et al., 1960) Aegle marmelos (L.) Corr. (Rutaceae) Fruit Hypoglycemic; chemopreventive (Vyas et al., 1979; Dixit et al., 2006) Allium sativum Linn (Alliaceae) Bulbs Anti-inflammatory; anti- hyperlipidemic, fibrinolytic (Dixit et al., 2006) Source: Ravishankar and Shukla, 2007.
  • 28.
    Usage of TCAMin Developing and Developed Countries Developing Country Usage of CAM Uganda 60% Tanzania 60% Rwanda 70% India 70% Benin 80% Ethiopia 90% Developed Country Usage of CAM Belgium 31% USA 42% Australia 48% France 49% Canada 70% Source: Unnikrishnan 2010
  • 29.
    0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Usage of TCAMin Developing and Developed Countries Source: Unnikrishnan 2010
  • 30.
    . Annual Budget AllocationTo MOHFS As Department Wise In 2011-12 To 2013-14 Department 2011-12 2012-13 2013-14 Total expenditure Total Percent Total expenditure Total Percent Total expenditure Total Percent Department of health and family welfare 24355.08 89.54 30702.00 89.02 33278.00 89.14 Department of AYUSH 783.18 2.87 1178.00 3.41 1259.00 3.37 Department of health research 746.43 2.744 908.00 2.63 1008.00 2.70 AIDS Control 1313.86 4.83 1700.00 4.92 1785.00 4.78 Total 27198.55 100 34488.00 100 37330.00 100 Source: Kamakshi and Subhash, 2014.
  • 31.
    . 0 20 4060 80 100 120 Dep. Of health and family welfare Dep. Of AYUSH Dep of health research AIDS Control Total Annual Budget Allocation Department Wise 2013-14 2012-13 expenditure percentage 2011-12 Source: Kamakshi and Subhash, 2014
  • 32.
    Registered Medical PracticesUnder AYUSH System Number of Practices Percent Total Ayurveda 453661 62.54 Unani 46558 6.41 Siddha 6381 0.87 Naturopathy 888 0.12 Homeopathy 217850 30.03 Total 725383 100 Source: Kamakshi and Subhash, 2014.
  • 33.
    63% 6% 1% 0% 30% Percentage of registeredpractices Ayurveda Unani Siddha Naturopathy Homeopathy Source: Kamakshi and Subhash, 2014
  • 34.
    Chapter 5: Role ofIPR in Conservation of Traditional Medicine in India • Intellectual property rights are ownership right of creators, which is legally acquired by the owner. It is concern to industrial, scientific, literary and artistic fields. • Generally, IPR described as legally protective rights which established for innovative or inventive ideas. • IPR divided into two group 1) Industrial properties covering IPRs such as, patents, trademarks, geographical indications and industrial designs 2) Copyright and related rights cover artistic and literary works, performances, broadcasts and the like. Protection of TM under IP in India Patent Law Trademark Law Anti-Unfair Competition Law Regulation on Protection of TCM Law on the Administration of Pharmaceuticals
  • 35.
    Traditional Knowledge DigitalLibrary (TKDL) • It is a database with a tool to understand the codified knowledge existing for the Indian traditional medicine system, which include Ayurveda, Siddha, Unani and Yoga as prior art. In other words the project TKDL involves documentation of traditional knowledge available in public domain. • The books on Indian traditional medicine system are the prior art which act as the source of information for TKDL. • Two lakh formulations are in the TKDL which have been taken from Ayurveda, Unani, Siddha and Yoga texts. • It is dynamic database, updated according to the inputs from the users of the database and formulation will be continuing added. The existing medicines in TKDL with following main components: i. Name of the drug ii. Origin of the knowledge iii. Constituents of the drug with their parts used and their quantity iv. Method of preparation of the drug and usage of the drugs. TKDL is making communication between traditional and modern knowledge. India evolved Traditional Knowledge Resource Classification (TKRC) was based on International Patent Classification (IPC).
  • 36.
    • TKDL breaksthe language and format barrier and makes available this information in English, French, Spanish, German and Japanese in patent application format, which is easily understandable by patent examiners. Current status of transcription of the traditional medicine formulation in the Traditional knowledge Digital Library Discipline No. of texts used for transcription Transcribed Ayurveda 75 books 97,337 Unani 10 books 1,75,150 Siddha 50 books 23,016 Yoga 15 books 1,680 Total 150 books 2,92,662 Source: http://www.tkdl.res.in/tkdl/langdefault/common/Abouttkdl.asp?GL=Eng, accessed April 15, 2015
  • 37.
    Different Categories ofPlants of TKDL Sr. No IPC Codes IPC Categories No of Sub group in IPC 1 Algae A61K 36/02 to 36/0 4 2 Fungi & Lichens A61K 36/06 to 36/09 10 3 Bryophyta A61K 36/10 1 4 Pteridophytes A61K 36/11 to 36/126 3 5 Gymnosperms A61K 36/13 to 36/17 5 6 Angiosperms A61K 36/18 1 7 Dicotyledons A61K 36/185 to 36/87 148 8 Monocotyledons A61K 36/88 to 36/9068 35 Total number of Sub-groups 207 Source: http://www.tkdl.res.in/tkdl/langdefault/common/Abouttkdl.asp?GL=Eng, accessed April 15, 2015.
  • 38.
    State wise numberof licensed Pharmacies under AYUSH as on April 2012 S N State Total S N State Total 1 Uttar Pradesh 2254 14 Uttarakhand 188 2 Kerala 968 15 Orissa 161 3 Maharashtra 834 16 Himanchal Pradesh 154 4 Andhra Pradesh 693 17 Delhi 64 5 Tamil Nadu 685 18 Assam 63 6 Madhya Pradesh 560 19 Pondicherry 41 7 Gujarat 490 20 Chhattisgarh 31 8 Rajasthan 312 21 J & k 18 9 Punjab 290 22 Daman & Diu 9 10 Bihar 287 23 Goa 7 11 Haryana 257 24 Sikkim 1 12 West Bengal 221 25 Chandigarh 1 13 Karnataka 196 26 other 10 state 0 Source: Press Information Bureau 2013
  • 39.
    Chapter 6: Conclusion •India can take advantage of the strength while focusing on specialty on an overall basis, establishing traditional medicine industrial bases for the organic collaboration and coordinated development of medicinal herb growing, research, development and production. • In last few decades, traditional knowledge on primary healthcare has been widely acknowledged across the world. • The role played by the actors to bring about the innovations. In order to use NIS framework, nation needs to decide which observations can be located. • The technological innovation in India is improving the quality and quantity of TM. If government has focus on TM, there is hope of maintaining public health, especially in rural areas because most of the population of India live in villages. • Traditional knowledge digital library (TKDL) has been playing an important role for many years for the protection of traditional knowledge. India is the only country in the world to set up an institutional mechanism namely, the TKDL, for the protection of traditional knowledge.
  • 40.
    Future Prospects • TheHindu at 11 august 2015 has pointed out that in India every year need of 2 lacks kidney, 50 thousand heart, 50 thousand liver, for transplant because people did not take percussion on TM based. • In India are increasing life style related disease like depression, diabetes, indigestion, acidity, obesity, which is cure through TM based percussion. • TM have capacity to increase immunity which protect so many disease. Problems • Lack of institution for covering maximum area • Ratio of patient and doctor is low, unskilled human resources are involved. • Growth of health infrastructure TM is slow as the increasing need of population. • Ratio of fund allocation TM and Allopathic medicine 2:8 according to 11th plane.
  • 41.
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