Wednesday, February 11, 2009 08:00 IST Peethaambaran Kunnathoor
Centre for Traditional Medicine & Research (CTMR) is an NGO registered under the Tamil Nadu Societies Registration Act. It is a 'not for profit organisation', operational since 2001. The key objectives of CTMR are mainstreaming traditional medicine in the area of public health, creation of awareness, capacity building by way of training, developing cost effective medicine with natural resources and promoting research in traditional medicine. The NGO works with different government departments, institutions and organisations for the cause.Dr T Thirunarayanan, secretary of CTMR, is a siddha physician with 20 years of experience in Indian Systems of Medicine (ISM). To his credit he has prepared the 'Development of ISM' report for Tamil Nadu state under the Tamil Nadu Equitable growth initiative programme along with members of the health sector subcommittee. He has also served as an expert member in 'mother and child healthcare' programme and subsequently in designing training module and 'Kit for RCH' programme of Tamil Nadu govt. In an interview with Peethaambaran Kunnathoor, Thirunarayanan elaborated the efforts taken by the NGO to improve Indian Systems of Medicine.
Excerpts:Do Indian Systems of Medicine have global acceptance now?
Indian Systems of Medicine (ISM), particularly ayurveda, has transcended the Indian subcontinent and now find a foothold in many countries. The regulations pertaining to traditional medicines and alternative medicines govern ISM. Originally the efforts were to promote products, but the acceptance for services, particularly in the 'wellness sector' is fast catching up. But the problem lies in getting trained manpower and the products that are acceptable by the international community. Even the medicated oils used for physical therapies need to be pleasant and should not create stains on cloths, as use of heavy laundering with surfactants is considered eco-unfriendly. The herbal supplements, apart from the issue of heavy metal that occurs in the plant source itself due to alarming level of soil pollution at herbal collection sites, leads to batch-to-batch inconsistency in biological activity. Very few Indian herbs have positive reviews and monographs compared to other herbs.
What are the efforts taken by various stakeholders to promote ISM?
World Health Organisation (WHO) in all keenness to promote traditional medicine has come out with a good number of protocols including, good sourcing practices, evaluation and clinical trials and testing methods for quality control etc. The Dept of Ayush on its part is insisting GMP upgradation and has taken stringent measures for closure of non-compliant units. The efforts are also on to develop method of analysis, making available marker compounds and support for 'drug testing labs' in various states through central schemes. Many institutes have taken up projects on developing method of analysis and monographs. The ayurvedic cluster scheme is yet another initiative. But certain guidelines are still difficult for this sector.
Where does ISM stand in terms of research and infrastructure development?
Large pharma industrial houses are happy to have just a few products mostly as over the counter (OTC). Unlike resource being spent on developing new drug molecules, very little money is spent on R&D of ISM drugs. The turnover being small, money that is required to develop new products from traditional medicine is definitely not being pumped in. National medicinal plants board initiatives have started paying results in easing raw material supplies and more efforts in the future for good agricultural practices and clean post harvest practices. This will enable overcome the issue of heavy metals, microbial contamination and pesticide residue issues. Excessive cultivation and storage for a longer time also needs to be curtailed by proper demand assessment.
What could be done to enable more Indian products get approval in international markets?
A large number of ISM physicians with interdisciplinary qualification are expected to pass out of institutes, even with PhD qualification. These scientists should be encouraged to establish product development labs and clinical research organisations with an exclusive set of rules for ISM in line with WHO guidelines for evaluating traditional medicines. Dept. of Ayush should have funds like the innovator incubation schemes of DST and DBT for product development. This should not be confused with basic research. Perhaps, these scientists may be requiring training and orientation in drug development and evaluation. I am sure in five years time we can have at least 15-20 internationally acceptable ISM products. Besides, resources should be made available for ISM companies for GMP upgradation for few more years and the Schemes for establishing GLP should be implemented on a faster pace without bottlenecks.
How do we address the increasing global demand for ISM services?
Health tourism for wellness is fine, but for fulfilling larger potential of the market, we need to have exclusive training on the speciality treatment procedures of ISM. The govt. has come out with curriculum for panchakarma training. Similar speciality treatment procedures of siddha, including varma, thokkanam and regimental therapy of unani also need to be encouraged. Tamil Nadu Health Department has taken a lead in training almost its entire ISM physicians on these therapies. Efforts are on to train private physicians also. Physical infrastructure has been provided in major govt. hospitals to provide these treatments. But a separate set of paramedical professionals with soft skills needs to be created both for domestic and global requirement. There was a proposal to have nursing therapist-ISM diploma but it has not taken off.
Do you think ISM can play a key role in public health issues?
Definitely, the greatest challenge now is the anemia in adolescent girls and antenatal mothers. Siddha medicines evaluated in a fairly large population in rural area have proved to be very effective. Similarly antenatal care with siddha methods has proven to help easy labour without caesarean. Management of diarrhoeal diseases and 'upper respiratory infection' in which indiscriminate use of antibiotic has led to resistance is possible with siddha medicine. Popularising these siddha methods needs efforts. Geriatric issues can be very well addressed by kayakalpa therapy.
What role do you think organisations like CTMR should be playing in promoting ISM?
Creating awareness of the advantages of ISM in specific areas and where ever possible taking the healthy practices to the community, popularising simple remedies, promoting community herbal gardens, including road side plantation will make more people use these systems and thereby generate demand. Our NGO is focused on capacity building at all levels by conducting trainings on specialised treatment procedures, drug development and on growing medicinal plants. Developing quality learning materials in siddha in English is another key area.
How does CTMR support the cultivation and conservation of medicinal plants?
We support good number of clinical evaluation of less known siddha plants for which literature support from classical siddha texts and preclinical studies are available. Solving identity of controversial raw materials both from plant source and inorganic source is another area we are currently engaged in. Conservation by means of ex-situ, conservation by promoting community herbal gardens, home herbal gardens and plantation of medicinal tree where ever possible are other areas CTMR is working on.