Lok Sabha Question No. 63 (STARRED), answered on 2021-07-23
Subject: BRICS Cooperation in Traditional Medicines
Ministry: AYURVEDA,YOGA & NATUROPATHY,UNANI,SIDDHA AND HOMEOPATHY (AYUSH)
Asked by: Adala Prabhakara Reddy, Chinta Anuradha

## GOVERNMENT OF INDIA MINISTRY OF AYURVEDA, YOGA & NATUROPATHY, UNANI, SIDDHA AND HOMOEOPATHY (AYUSH)

## LOK SABHA STARRED QUESTION NO. 63 TO BE ANSWERED ON 23 RD JULY , 2021 BRICS COOPERATION IN TRADITIONAL MEDICINE S

## *63. SHRI ADALA PRABHAKARA REDDY: SHRIMATI CHINTA ANURADHA:

Will the Minister of AYUSH be pleased to state:

- (a)  whether  the  Government  is  planning  to  sign  an  MoU  on  BRICS  Cooperati Traditional Medicines;
- (b)  if  so,  whether  the  Government  plans  to  constitute  a  BRICS  Forum on  Traditional Medicine (BFTM) and if so, the details thereof;
- (c)  whether  the  Government  has  any  plans  to  harmonize,  regulate  and  st traditional medicinal products amongst BRICS countries and if so, the details
- (d)  the initiatives  taken  by  the  Government  for  the  mitigation  of  COVID - 19  through AYUSH system of medicine and to showcase it globally?

## ANSWER THE MINISTER OF AYURVEDA, YOGA & NATUROPATHY, UNANI, SIDDHA AND HOMOEOPATHY (AYUSH)

(SHRI SARBANANDA SONOWAL)

- (a) to(d )A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 63* FOR 23 RD JULY , 202 1

(a) Government of India has proposed BRICS Members States to develop a cons on  signing  an Memorandum  of  Understanding  (MoU)  for  Cooperation  on  Tradition System of Medicines. The Draft Memorandum of Understanding (MoU) developed Ministry of AYUSH has been shared with BRICS Members for the comments/suggestions.

(b) The Government of India has proposed to BRICS Member States for constitutio a  BRICS  Forum  on  Traditional  Medicine  (BFTM).  Ministry  of  AYUSH  organized virtual meeting of ' BRICS experts in Traditional Medicines ' under India's Chairship of  BRICS  2021  on  25th  March,  2021.  The me ting  was  attended  by  Traditiona Medicines Experts from Brazil, Russia, China, and South Africa. T e p oposed BFTM aims at supporting the BRICS Member States in strengthening their respectiv capacities in the area of Traditional Medicines and implementing a Traditional Medicine Action plan with particular emphasis on the safe and effective use of Traditi and its appropriate integration into respective national healthcare systems. Draft Terms of Reference  (ToR)  on  constitution  of  BF TM  developed  by  the  Ministry  of  AYUSH  has been  shared  with  BRICS  Member  States  for  their  comments/suggestions.  The  c Draft Terms of Reference (ToR) is enclosed at Annexure - 1 .

(c) Government of India has proposed to the BRICS Members for the Harmoniz ation of  the  regulations  pertaining  to  the  Traditional  Medicine  including  the services. In  this regard, Ministry of Ayush has  also  conducted a w ' Harmonization of Regulation of standardization of Traditional Medicinal Prod BRIC S  Countries '  on  28thMay  2021under  India's  BRICS  Chairship  of  2021.  The webinar  was  attended  by  the  eminent  experts  and  stakeholders  from  the Traditional  Medicine  from  India,  China,  South  Africa,  Russia  and  Brazil Country presentations were made b y India, China and Brazil.

(d) Ministry of AYUSH has undertaken various steps for the mitigation of CO - 19 through AYUSH system of medicine and to showcase it globally, which are as fo

## Administrative

1. Ministry  of  Ayush issued  advisories  on  protecting  people  from  COVID staying healthy. In these advisories, in addition to maintaining hygiene li use of mask etc. simple Ayush home remedies were also suggested for peopl advisories  have  been  revised  a s  per  the  need  of  the  current  scenario.  The  AY advisories were translated in French, German, Portuguese, Spanish, Japanese

Arabic and Chinese Language and sent to all Indian Missions in various cou various foreign embassies in New De lhi.

2. Ministry of Ayush developed self - care guidelines for preventive health meas and boosting immunity with special reference to respiratory health.

- o General Measures
- o Ayurvedic/Homeopathy/ Unani and Siddha preventive measures for self - care and Immunity Promoting Measures
- o Simple Ayurvedic Procedures
- o During dry cough/sore throat

3. Ministry of AYUSH has released Home care guidelines for children and Ad for  AYUSH  Practitioners  about  prophylactic  care  in  Children  during  the  C - 19 Pandemic.

4. Gu idelines regarding ethical practices during Covid 19 for R Practitioners of respective system of Ayush have been prepared by Director Research  Councils  and  Directors  of  National  Institutes  with  their  team  of same is vetted by the Inter - disciplinary Ayush Research and Development Task Force Ministry of Ayush. These guidelines are made available in the public domain registered  Ayush  practitioners  including  Homoeopathy  to  help  in  the  manag COVID 19 pandemic uniformly.

5. States/ UTs licensing authorities / Drug Controllers has been informe the  licensed  manufactures  for  AYUSH - 64  under  their  jurisdiction  to  include  a indication  of  AYUSH - 64  for  repurposing  as  an  intervention  for  the  manageme asymptomatic, mild to moderate COVID - 19 in addition to existing indication (s). States/  UTs  Licensing  Authorities  have  been  requested  to  expedite  the  pro licensing/ approval of the application for the manufacturing of AYUSH - 64.

6. The Ministry  of  AYUSH  launched  a  three -month  campaign  on  'Ayush  for Immunity',  through  webinar  and  published  bulletins  on  AYUSH  for  Immunity.  More than 50 thousand people participated in the Webinar.

7. A letter to all Chief Secretaries of States / Union territ ories was sent from the Ministry with more specific suggestions on augmentation of General Immunity and  possible  Ayush  intervention  wherever  required  in  coordination  wit departments of the States / UTs.

8. A letter was sent to the Ministry of Health & Family welfare offering to integ and utilize huge Ayush infrastructure to combat the COVID - 19 pandemic.

9. Ministry of Ayush vide its D.O. letter no. Y - 18020/2/2020 -EP-III has requested all States/UTs to issue appropriate instructions to District Authorities urg District Ayurveda Officers in the management and mitigation of Covid - 19 in the districts and utilize the services of Ayush doctors, Ayush healthcare providers and Ayus care  facilities  extensively  so  that  the  shortage  of  manpower  and  infrastru management of Covid - 19 can be duly addressed.

10. On the suggestions of Ministry of Ayush, all available infrastructure facilitie Hospital (IPD & OPD), pathology laboratory, ICU and manpower including medi Paramedical  Staff  of  various  Ayurveda,  Siddha,  Unani  and  Homoeopathy  (ASU colleges    (approximately  727  colleges)  were  offered  to  lo cal  health  authorities  f utilization.  Accordingly,  the  various  Ayush  institutes  hospital  were  util Governments and designated as quarantine centre, isolation centre, Covid care Covid health centre.

11. Ministry  of  Ayush  issued  Gazett e notification  (No. 107  dated:  21.04.2020)  for undertaking research on COVID - 19 through Ayurveda, Siddha, Unani and Homeopathy Systems including prophylactic measures, intervention during the qu asymptomatic and symptomatic cases of COVID - 19, Publ ic Health Research, Survey, Lab Based Research etc. to generate evidence.

12. Ministry  directed  to  all  State/UT  Licensing  Authorities  to  forwar application of such formulations with details and results of the clinical tri for verific ation by the Central Government in the Ministry of Ayush and also dir all State/UT Licensing Authorities shall grant the approval or license to ma sale of any such formulation only after obtaining clearance from the Central t for  effective  quality  control  of  AYUSH  medicines  underwent  clinical  tria studies for COVID - 19,

13. For continuing with the efforts to augment human resources for the ma of COVID - 19 cases, the Ministry of Ayush has issued an advisory to d eploy the trained Ayush human resources available with them for clinical management of COVID - 19 cases.

14. The  MoA  launched  the  Ayush  COVID - 19  Dashboard  to  furnish  the  details guidelines,  official  communications,  research  on  COVID - 19  and  Ayush  drugs  for prophylaxis and management.

15. MoA also developed National Repository on Ayush to provide information to  Ayush  R&D  initiatives,  and  COVID - 19  related  scientific  publications  and  A Guidelines.

16. The Ministry of Ayush issued the National Clinica l Management Protocol based on Ayurveda and Yoga for the management of COVID - 19 on October 6, 2020 enabling uniform clinical management.

17. Vide Notification No. 40 - 3/2020 - DM - I)A(  dated:  02  April, 2020, Ayush Sect was    included  in  essential  services  during lockdown  and  as  a  result  it  facilitate Manufacturing of Ayush Medicine for public distribution

18. To  strengthen  the  community - wide  effort  to  limit  the  spread  of  COVID - 19, Ministry of Ayush has also operationalized a dedicated community support helpl toll - free  number  14443,  to  provide  AYUSH - based  approaches  and  solutions  for  t challenges raised by Covid - 19.

## Public Health Interventions

19. Considering  the  importance  of  immunity  boost ing  measures  in  the  wake  of COVID - 19  outbreak,  Ministry  of  AYUSH  has  promoted  use  of  ready -made  Ayush formulation i.e. 'Ayush Kwath' or 'Ayush Kudineer' or 'Ayush Joshanda' in the interest of health promotion to the masses.

20. In order to provide maximum ben efit of Ayush systems of medicine, a Nati -wide campaign for distribution of AYUSH - 64 and Kabasura Kudineer through Research Councils and National Institute under Ministry of Ayush across the country.

21. To reduce the burden on the hospital - based healthcare delivery system during the recent 'second wave' outbreak of COVID - 19 in India, the Ministry of Ayush launch nation - wide campaign through its Research Councils and National Institutes for distribution of AYUSH - 64  and  Kabasura  Kudineer  to  asymp tomatic, mild to moderate COVID - 19 patients, at isolation centres/ Covid Care Centre / Covid Health Ce hospitals/ dispensary and patients in home isolation.

22. Ministry  of  Ayush  has  also  approached  Indian  Missions/  Indian  Emba abroad to expl ore the possible scope to make the AYUSH 64 available in the Inter markets. The MoA also sent the scientific and research information regarding AYUSH 64 in combating Covid - 19 for circulating the same to generate publicity.

23. All India Institute of Ayurveda (AIIA)(under Ministry of Ayush) as conducted a large  cohort  study  on  80,000  front line workers of  Delhi  police  who  were given 'Ayu -Raksha'  kit  containing  Samshamani  vati  (Tinospora  cordifolia tablet),  a  poly - herbal powder containing holy basil, ginger, Cinnamon and pepper to prepare fresh concoction and 'Anu taila' an Ayurveda herbal oil for nasal application.

24. Ministry of Ayush distributed of Homoeopathy medicine i.e. Arsenic alb 1,5 0,000 police personnel (Maharashtra Police).

25. Yoga instructors were deputed to COVID/quarantine centres in Delhi to yoga sessions to COVID patients and health care workers during the COVID firs

26. AYUSH Sanjivani mobile app has also been devel oped by Ministry of AYUSH and  has  documented  the  impact  assessment  of  effectiveness,  acceptance  and AYUSH advisories & measures in the prevention of COVID - 19 through Mobile app base population study in around 1.35 crores respondents. 85.1% of the respondents reported use of AYUSH measures for prevention of COVID - 19, among which 89.8% respondents agreed to have benefitted from the practice of AYUSH advisory.

27. Ministry of Ayush and MoHFW have jointly provided training to 33,000 master trainers. Total 66045 AYUSH Personnel had obtained training at igot.in pl on continual basis. Ministry of Ayush has coordinated with MoHFW for utili Ayush manpower as COVID warrior to manage COVID - 19 with identified roles.

28. A  unique  and  innovative  example  has  been  set  through  the  Dhanvatri mobile  van)  launched  by Institute  of  Teaching  &  Research  in  Ayurveda  (ITR Jamnagar  for extending the Ayurveda preventive and promotive health servic door step of the p eople. Total 53405 healthy individuals and 3505 patients were t benefit  of  Ayurvedic  medicines  for  their  routine  healthcare  problems  a knowledge of measures for boosting their general immunity through Ayurveda ti

## Research

29. Minist ry  of  Ayush  has  also  constituted  core  group  of  experts  to  ide propose formulations on COVID - 19 which are in line with Classical Ayurveda prin and have substantial leads on COVID - 19 viz. one for prophylaxis as immunomodulator another for ma nagement of COVID- 19 with antiviral properties and one product fo COVID - 19 care.

30. Ministry of Ayush has formed an Interdisciplinary Ayush R&D Task Force representation  from  scientists  including  ICMR,  DBT,  CSIR,  AIIMS  and  AY Institutions. The  Interdisciplinary  Ayush  Research  and  Development  Task  Force formulated and designed clinical research protocols for prophylactic studie - on interventions  in  COVID - 19  positive  cases  through  thorough  review  and  consul process of high repute experts from different organizations across the country fo four different interventions viz. Ashwagandha, Yashtimadhu, Guduchi + Pippa polyherbal formulation (AYUSH - 64).

31. The  Ministry  signed  a  MoU  with  Council  of  Scientific  &  Indu strial  Research (CSIR)  and  Department  of  Biotechnology,  Government  of  India  for  further evidence - based research.

32. Ministry  of  Ayush  has  also  launched  interdisciplinary  studies  involv interventions  for  COVID - 19  based  on  Task  force  recommend ations.  Under  various research organizations and National Institutes under the Ministry of Ayush, studies at approx 152 centres in the country have been initiated on Ayush int

33. The researches includes 42 prophylactic, 40 stand - alon e add - on treatment, 11 observational, 8 survey studies along with two pharmacopoeial standards de and one systematic review, and 22 pre - clinical/experimental studies.

34. Ministry of Ayush has undertaken 02 prophylactic studies conducted at D 19  containment  zones,  to  understand  effect  of  Arsenic  album  30C  in  prev COVID - 19. Arsenic album 30C was administered twice in day for 7 days.

35. Considering  the  strength  of  AYUSH  system  in  mitigation  of  Covid - 19 and outcome  of  the  clinical  trials conducted  on  AYUSH  formulations  for  mitigation Covid19 in India; Ministry of AYUSH with collaboration of foreign institutes/organizations from USA, UK, Germany, Brazil, and South Africa has to undertake clinical trials on mutual ident ified AYUSH formulations for the mitigation Covid19.

36. AYUSH PHFI research  study  entitled  ' Assessment of integration of AYUSH into the public health system for combating COVID - 19 ' is being conducted with the support of WHO

37. COVID  research  studies undertaken  by  Research  Councils/  Institutions  u Ministry of AYUSH are as follows:

##  Number of COVID - 19 related studies -126

- Prophylactic studies -42
- Interventional studies -40
- Observational studies -11
- Pre- clinical/experimental studies -22 (includin g 13 AYUSH - DBT studies)
- Systematic Review -01
- Other studies -10 (08 Survey studies; 02 Monographs preparation)
- Study Sites -Approx. 152 (including pre - clinical study centres)
- Studies Completed -90

##  AYUSH System - wise

| Ayurveda           |   66 |
|--------------------|------|
| Homeopathy         |   26 |
| Siddha             |   13 |
| Unani              |   08 |
| Yoga & Naturopathy |   13 |

##  Manuscripts Drafted -62

- Manuscripts Published -09 (Also Published, 03 Case Reports and 02 Study Pro
- Manuscripts accepted for Publication -06
- Manuscripts submitted to indexed Journals -28
- Manuscripts finalized for submission in Journal -09
- Manuscripts Under review -10
- Manuscripts available as Preprints -19

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## Terms of Reference (ToR) for Constitution of BRICS Forum on Traditional Medicine (BFTM)

BACKGROUND: Traditional medicine is the sum total of knowledge, skills and practices based on  the  theories,  beliefs  and  experiences  indigenous  to  different  cultures  that  are used to maintain health, as well as to prevent, diagnose, improve or treat physical and  mental illnesses. It  plays  an  important  role  in  meeting  demands  of  primary health  care  in  many  developing  countries  and  thus  occupies  a  key  space  in contemporary community health education. The BRICS region has an abundance of natural  resources  and  has  their  own  Traditional  system  of  medicine.    It  has  been observed  that  there  are  many  similarities  in  principles,  practices  and  therapies among  different  systems  of  traditional  medicine  worldwide including  Ayurveda, Traditional Chinese Medicine (TCM), African Medicine etc. The  traditional  medicine  is  already  exiting  in  most  of  the  member  state  of  BRICS wherein,  it  is  developed  in  some  member  state  and  in  some  country,  it  is  in developing  stage  i.e.  Indian  Traditional  system  of  Medicine - Ayurveda,  Yoga  etc. (AYUSH);  Traditional  Chinese  Medicine;  Folk  Medicine/Traditional  Medicine  (In Russia),  Traditional  Brazilian  medicine  and  African  traditional  medicine.  Herbal products/medicines are being used at large scale in all member states of BRICS to countermine various diseases. All member states manufacture herbal products/medicine in various forms. During  6 th BRICS  Health  Minister's  Meeting  held  on  15 th -16 th December,  2016  at New Delhi, it was decided to constitute BRICS Traditional Medicine Forum to share experience and  collaborate in policies, approaches, strategies, institutional  & regulatory  frameworks  of  Traditional  Medicine  amongst  BRICS  countries.  This Forum  shall  develop  a  plan,  aligned  with  the  working  statement  emanated  from BRICS  Wellness  Workshop  and  High  Level  Meeting  on  Traditional  Medicinal finance; health; science, technology & innovation; security and business. Altogether, these  initiatives  have  resulted  in  a  relevant  set  of  achievements,  which  aim  to provide  concrete  benefits  to  our  societies.  Cooperation  in  the  field  of  Traditional Medicine is being discussed under health dialogue of BRICS. The utility of traditional systems of medicines to protect people from COVID-19 has been  well  experienced  by  many  countries.  The  herbal  medicine  and  formulations containing spices have become popular owing to their immunity boosting properties resulting in multi-fold rise in their demand. Keeping  in  view  the  presence  of  Traditional  Medicine  in  BRICS  Member  States, immense potential of Traditional Medicine in reducing the disease burden including the  epidemics,  wide  scope  for  integration  of  TM  in  primary  health  care  and  their likely  role  in  reducing  health  expenditure  by  promoting  health  and  wellness  it  is proposed to constitute a BRICS Forum  on Traditional Medicine  (BFTM).

01. OBJECTIVE: To strengthen the cooperation on Traditional Medicine for holistic health care and to collaborate in policies, approaches, strategies, institutional and regulatory framework of TM amongst BRICS countries and sharing of knowledge of TM among BRICS Countries.

## 02. MISSION:

- b. To  support  Member  States  in  developing  proactive  policies  &  implementing action  plans  that  will  strengthen  the  role  TM  plays  in  keeping  populations healthy  and  to  enhance  cooperation  in  the  health  sector  on  Traditional
- a. To promote and protect public health in BRICS countries through TM through sharing  of  authentic  information  on  TM,  sharing  on  information  of  relevant legislation, guidelines, and experiences in TM.
- c. To  promote  quality  Traditional  Medicine  services  and  products  and  sharing lessons learned and best practices;

e.

- d. To  explore  the  possibility  of  approximating  the  regulations  of  Traditional Medicine;

Promotion of Trade in Traditional Medicine of BRICS countries

- g. To cooperate in human resource development in Traditional Medicine within BRICS Countries.
- f. To  generate  and  share  evidence-based  information  on  Traditional  Medicine knowledge and practices among BRICS Countries;
03. STRATEGIES: a. Development and implementation of comprehensive work plans and cooperative mechanisms  for  regional  collaboration  on  Traditional  Medicine  by  establishing BRICS Forum for Traditional Medicine (BFTM) and developing BFTM work plan.
- c. Exchange of human resource for capacity building by ways of granting scholarship and organizing workshops/ training/seminars etc.
- b.  Sharing  knowledge,  experience  and  information  regarding  different  Traditional Medicine systems, services, products and raw materials among BRICS Countries.
- d. To promote cooperation among industries and academia by arranging industrial meets in the area of TM for trade promotion.

04. COMPOSITION: The BFTM will consist of officials from the related offices of each Member Countries, policy makers,  regulators,  technical  experts,  scientists,  researchers,  academician, and  industry  representative  on  Traditional  Medicine  in  Member  Countries  upon nomination  by  respective  government.  The  BFTM  may,  in  consultation  with concerned  office  of  each  Member  State,  invite  additional  resource  persons  for  its identified activities by nominating experts of relevant field for the said period and for the said purpose to expedite the task.

## 05. SCOPE OF WORK: In  line  with  the  above  objective,  mission  and  strategies,  the  work  of  the  BRICS Traditional Medicine Forum (BTMF) will be guided by the following: a. To organize Joint Workshop/Seminars  on  TM for regulators and other stakeholders for better understanding on TM, holistic approach behind manufacturing TM products as well as regulatory framework; b.  To  formulate  a  set  of  procedure  for  cooperation  in  traditional  medicine  within BRICS  Countries  and for  regional  cooperation  in  Traditional  Medicine  sector  for consideration; c. To work towards Mutual recognition of TM in BRICS countries. d. To facilitate the understanding about the requirements prescribed in legislations in  respective  member  states  for  the  registration  of  TM  drugs/products  and  for capacity building. e.  Development  of  Long  term  and  sustainable  guidelines  for  promoting  the  use, practice, research and education of Traditional Medicine in BRICS countries. f.  To  develop  cooperation  in  the  field  of  Collaborative  Research  on  traditional medicine on the issues and health problems common in BRICS member states such as COVID 19, Non-Communicable diseases etc. g.  To  build  up  academic  collaboration  and  cooperation  among  the  academic institutes identified by respective  member  states to work  on strengthening education and training in Traditional Medicine. h. Developing academic standards, courses in the field of Traditional Medicine and

- i.  Encourage  strategic  research  in  Traditional  Medicine  by  providing  support  for clinical research projects on its safety and effectiveness;
- k. Developing evidence-based guidelines for integrating Traditional  Medicine principles and practices with modern medicine.
- j.  Develop cooperation in the field of medicinal plants including their conservation, cultivation, sustainable harvesting etc.
- l. Sharing and recognition of mutual Herbal/Plant Pharmacopeia of for harmonization on common plants.

## 06. MECHANISMS AND RULES OF PROCEDURES:

m. To evaluate and monitor outcome of the work programmes/plan of action. n. To identify specific areas of cooperation that will be updated, as needed.

- a. The BFTM will meet yearly and the BFTM Meeting will be held on rotation among BRICS Countries and additional Meeting may be held whenever necessary;
- c. The Chairperson shall be from the host country and the Vice Chairperson shall be elected from the country hosting the next Meeting; the tenure of both positions shall be held until next BFTM Meeting:
- b. The BFTM Meeting shall be attended by the representatives of all BRICS Countries and international organizations as agreed by BFTM;
- d.  The  Chairperson  of  BFTM  shall  be  the  BFTM  regional  coordinator  and  has  the following duties and responsibilities:

i. Attend relevant BFTM Meetings and present highlights of BFTM Meeting;

particular submission of proposals and funding; e. The host country shall have the following duties and responsibilities; i. To propose the date and venue of a meeting in consultation with BRICS Secretariat, at least six months prior to the Meeting; ii. To provide necessary logistics for hosting the Meeting: and iii.  To  follow-up  and  coordinate  the  inputs  received  from  various  BRICS countries for the Meeting of BFTM with the assistance of BRICS Secretariat. f.  The  BRICS  Secretariat  shall  prepare the  Reports  of  Meetings with  the  assistance from the host country. g. The Report shall be finalized and adopted by the Meeting; h.  The  BFTM  shall,  at  each  meeting  recommend  the  date  and  venue  of  its  next meeting; i. The BFTM Meeting shall be convened on a cost-sharing basis whereby the hosting of the Meeting, accommodation, meals and local transportation shall be borne by the Host  Country  whilst  the  participation  of  the  delegations  shall  be  borne  by  the respective Member Countries. The number of delegates who will be provided local hospitality shall be determined by the host country. 075. GENERAL PROVISION: This Term of Reference will be revised when required on consensus.

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