Role of Ayurveda in integrated health system for sustainable development of global health

INTRODUCTION

Health has been recognized as one of the most important human rights and a pillar of sustainable development. Nevertheless, in the 21st century, the global health systems are faced with new challenges never seen before, such as increasing chronic non-communicable diseases (NCDs), mental health disorders, new infectious diseases, and increased effects of climate change on human health. Modern medical frameworks though technologically well advanced tend to be disease focused, intervention oriented and non-financially sustainable to most groups of people. This has caused policymakers and epidemiologists in all parts of the world to look more holistic, preventive, and integrative, not to mention, comprehensive healthcare solutions that are more inclined towards treatment as well as enhance long term health and balance of ecology.¹

International health situation and integration requirement

The World Health Organization (WHO) has accepted the fact that global health in the future lies in interconnected systems that would integrate the power of conventional medicine with the knowledge of traditional and complementary medicine (T&CM). The WHO Traditional Medicine Strategy (2014) states that almost 80 percent of the world citizens seek primary health care using some form of traditional medicine (20142023). This high trust indicates both accessibility and the rich cultural trust and preventive focus of traditional systems like Ayurveda, Traditional Chinese Medicine (TCM), Unani and so on.²

Health inequities, over-medicalization and environmental degradation also point to the necessity of sustainable models of care. The alternative of marriages between the old systems such as Ayurveda and modern biomedicine is a chance to produce a balanced, pluralistic healthcare model, which is founded on evidence, socially as well as financially acceptable, and also ecologically friendly.³

Ayurveda: an age-time tested system of global health

Ayurveda, or literally, the Science of Life is indeed one of the oldest still practiced healthcare systems in the world, with a recorded history of more than 5,000 years. Based on the classical Sanskrit texts such as the Charaka Samhita and the Sushruta Samhita, the Ayurveda approach to health (Swasthya) is regarded as the dynamic state of equilibrium between body (Sharira), mind (Manas) and spirit (Atma). In contrast with several contemporary paradigms in medicine that determine health as the lack of disease, Ayurveda takes health as a state of balancing the biological humours (Doshas), metabolic fire (Agni), tissues (Dhatus), and waste excretion (Malas) along with mental and spiritual satisfaction.⁴

This broad knowledge makes Ayurveda not only a system of medicine but an entire science of life system, taking into consideration not only diet and behaviour but also ethics and community health, and environmental management. The twofold objective, Swasthasya Swasthya Rakshanam (preservation of health) and Aturasya Vikara Prashamanam (treatment of disease), indicates a balance between prevention and treatment - the basis of sustainable healthcare.⁵

Ayurveda and new century health public problems

The global burden of disease has changed in the past decades in the non-communicable and lifestyle-related diseases - diabetes, hypertension, cardiovascular diseases, obesity, infertility, and mental stress. The associated factors are usually sedentary lifestyles, unhealthy diets, mental pressure, and environmental poisons. The focus of Ayurveda on lifestyle (Dinacharya – daily regimen, Ritucharya -seasonal regimen), diet (Ahara Vidhi) and detoxification (Panchakarma) provides useful systems of preventive and chronic disease care.⁶

More so, Ayurvedics Rasayana treatment boosts immunity (Ojas), vitality and cell renewal -which is in tandem with contemporary ideas of immunomodulation, anti-aging and mental health promotion.

This renders Ayurveda especially pertinent to the treatment of the chronic, multifactorial, and psychosomatic conditions, which prevail the modern health fields.⁷

Integration when we first began at Woodstock and global recognition

India has made significant policy frontiers in institutionalizing Ayurveda by developing the Ministry of AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homoeopathy) as the body that is in charge of Ayurveda education, research and structure of Ayurveda to the integration of Ayurveda with other health fields. WHO has also collaborated with India to establish WHO Global Centre for Traditional Medicine (GCTM) in Jamnagar, Gujarat the first step to global appreciation of the potential that Ayurveda can have in planetary health.⁸

The Ayurvedic wellness, dietary and lifestyle modules are part of the complementary healthcare models introduced in several countries such as Germany, the United States, Japan and the United Kingdom among others. Increasing natural, preventive, and person-centered care requirements have increased the uptake of Ayurveda in wellness tourism, integrative health/male, and lifestyle clinics around the globe.⁹

Rationale for the review

It would be necessary to consider the specific contributions of Ayurveda in the sustainable global health because of the growing popularity of traditional systems of knowledge in the world. The article is a systematic review of the conceptual pillars of Ayurveda, preventive, role in modern healthcare, and its role in the sustainable development goals (SDGs).

It also addresses issues, opportunities, and avenues of approach towards developing a globally integrative, sustainable health paradigm that incorporates the traditional wisdom as an overlay to the modern science.

Aim

Aim of the study was to assess the position and the possibilities of Ayurveda to enhance in sustainable development of global health by connecting with modern health systems.

Objectives

The objectives of the study were: to investigate both, the philosophical and practical horizons of Ayurveda when it comes to integrated healthcare, to determine the spheres of Ayurveda help in preventive, promotive, and curative healthcare sustainably, to examine existing Ayurveda integration models of global health policies, and to debate issues, policy implications and future of the development of Ayurveda-based sustainable health systems.

METHODS

Study design

It is a narrative review that relies on secondary sources of data such as published materials, policy reports, WHO reports, AYUSH publications.

Data sources

Sources: PubMed, Scopus, Google scholar, AYUSH Research Portal and WHO Traditional medicine database.

Information mining and processing

Thematic extraction of relevant information was done as broad topics and the following broad themes were utilized: Ayurveda philosophy, integration models, public health relevance, sustainability aspects, and global recognition.

Results were integrated to provide an adequate knowledge about the application of Ayurveda in global health sustainability.

Ayurveda: a unified sight of health

According to Ayurveda, health does not only mean the absence of disease but rather a balance of the dosas (Vata, Pitta, Kapha) in the body, optimum digestive fire (Agni) and adequate excretion (Malas) in the body, a happy mind and wellness.

This is a multidimensional concept of health that relates to the holistic health definition by WHO.¹⁰

Preventive and promotive health

Swasthavritta (life habits control)

Everything that prevents lifestyle disorders includes daily and seasonal diets (Dinacharya, Ritucharya).

Ahara (dietary principles)

Ayurveda tells in favour of personalized nutrition in order to keep the doshic balance.

Rasayana (rejuvenation therapy)

This therapy improves longevity, mental health, and immunity.^11,12

Personalized medicine

The Ayurvedic concept of Prakriti (body constitution) offers the basis of customized preventive and therapeutic interventions, which agrees with contemporary precision medicine methods.¹³

Ayurveda in the modern health systems

Laissez-Faire role in public health

By providing a preventive and cheap intervention targeted at primary non-communicable disease (NCD) prevention, including diabetes, obesity, and hypertension, Ayurveda implementation in primary healthcare would decrease the workload of traditional settings.¹⁴

Policy and institutional integration

The Ayurveda has already been institutionalized in countries such as India via the Ministry of AYUSH where research and practice enhancement by integrating education and clinical practice are encouraged. The Traditional Medicine Strategy (20142023) of WHO promotes traditional medicine systems such as Ayurveda in national health systems as well.¹⁵

Research and evidence-based validation

Aswathas: Ayurvedic formula: Ashwagandha (stress), turmeric (inflammation), and Panchakarma (detoxification) Ayurvedic formula preparations are creating gaps between the traditional knowledge and current evidence-based healthcare programs.¹⁶

Ayurveda and sustainable development goals

Ayurveda has both a positive and negative impact on a few SDGs.^17,18

Acceptance and collaborative models

Global recognition

Since 100 countries now practice ayurveda research is increasingly collaborating in more countries, WHO standards in training and practice, presented in integrative centres of medicine worldwide.¹⁹

The two collaborative health models

Countries such as Germany, USA, and Japan are integrating Ayurvedic wellness to include into the integrative clinics. This can further be developed into such models: interdisciplinary research, cross-system referrals, and standardization of Ayurvedic education and regulation.²⁰

Challenges and future directions

Although Ayurveda has huge potential, there are challenges of incorporation including: lack of standardized global regulations, need for quality assurance of herbal medicines, bridging the gap between traditional knowledge and modern scientific validation, and inadequate global policy frameworks for traditional medicine integration.

DISCUSSION

Ayurveda being integrated into the global health systems is a transformational opportunity, which can help to tackle the multidimensional challenges of the 21^st century, which encompass the increasing prevalence of NCDs, lifestyle-related disorders, mental health issues, and environmental degradation. Ayurveda presents a centuries-old, preventive, and ecological healthcare model, capable of assisting the virtues of contemporary biomedicine.²¹

Ayurveda and the concept of sustainable health

Sustainability in health can be discussed as not only the ecological protection, but also human well-being in the long-term perspective, communal sustainability, and intergenerational equity. In its very philosophy Ayurveda is in line with these. It focuses on a moderate way of life (Swasthavritta), sensible consumption of natural resources (Yukti Vyapashraya Chikitsa) and the harmony between the individual (Pinda) and the world (Brahmanda).²²

In contrast to the contemporary system which is usually oriented to disease management, Ayurveda is oriented at the maintenance of health - Swasthasya Swasthya Rakshanam - which diminishes the risk of diseases and decreases the medical costs. This preventive orientation is guiding towards sustainable development, as it underpins minimizing the economic and ecological cost of disease, as a whole.²³

Complementary action with modern medicine

Modern medicine is very proficient in acute, emergency, and surgery, but Ayurveda offers a system of wellness, rehabilitation, and chronic disease treatment in the long term. Each system can have integrative approach that can give complete care throughout the health spectrum.²⁴

For example: modern medicine deals with glycaemic control in diabetes of mellitus with the aid of Ayurvedic herbs such as Guduchi (Tinospora cordifolia) and Amalaki (Emblica officinalis) that enable the management of metabolism and oxidative stress; Ayurvedic Medhya Rasayanas (e.g. Brahmi, Shankhapushpi) and yoga-based lifestyle interventions may be given to supplement psychopharmacology in mental health; Panchakarma procedures have also been proven useful in detoxification and metabolic balance to supplement contemporary rehabilitative interventions and lifestyle therapies; and the synergy will not only enhance performance but will also address the patient preferences, as well as the cultural diversity - some of the most important aspects of patient-centered sustainable healthcare.^25-27

Public health and preventive dimensions

The Ayurvedic preventive protocol, which is founded on the concept of regulating textual consumption (Ahara), ritual modification (Vihara), and adapting to the season (Ritucharya), proposes low-priced, expansive patterns of populace health. On a time when the burden of NCDs in the world is on the rise, the principles hold considerable potential to bring down the world burden.²⁸

Community-level intervention

Ayurvedic lifestyle awareness program is feasible to be incorporated in the public health campaigns of obesity, diabetes and stress relief.

Maternal and child health

Garbhini Paricharya (antenatal care) and Kaumarbhritya (childcare) are practices that offer culturally sensitive practices to enhance the maternal and the infant outcomes.

Pandemic preparedness

Immunity-promoting measures (Rasayana therapies) and hygienic treatment (Dinacharya) may be of interest to the prevention of infectious diseases.

The given preventive strategies would contribute to SDG 3 (good health and well-being) and SDG 10 (reduced inequalities) by fostering universal, equitable and affordable health.

Ayurveda and environmental sustainability

Ayurveda as such is ecological. Loka-Purusha Samya (microcosm-macrocosm correspondence) is a concept that asserts that the wellness of the planet and the wellness of human beings interrelies. The medicinal plants, traditional agricultural activities, and local health traditions promote the biodiversity preservation and lower the environmental imprint.²⁹

The industrial pollution and wastes are also reduced by the use of plant-based medicines as an alternative to synthetic drugs. The environmental stewardship is associated with populace health through initiatives such as AYUSH herbal gardens, conservation areas, and sources of medicinal plants and community-based plots have implemented community-based cultivation.³⁰

Moreover, it continues to be evident today (in form of the Ayurvedic doctrine of Desha Pariksha (environmental assessment) prior to administering a treatment) that geographic and ecological background is valued (a forerunner to contemporary environmental health), a perspective on medicine.³¹

Policies and economic impact

Ayurveda is an economical and resource-based healthcare model in terms of economics. As the spending on healthcare increases across the world, and particularly spending on chronic illnesses, the impact of introducing Ayurveda will manage the financial pressures to the health systems.³²

The governments can implement the Ayurveda-based programs on health, models of health at workplace and the preventive-based primary healthcare services. The Government of India has already come up with integrative research and national health programs (such as the National AYUSH mission) that can be used by other countries as prototypes.³³

On the policy level, WHO has Traditional Medicine Strategy (20142023) and Global Report on Traditional and Complementary Medicine (2019), which offer the frameworks of regulation, research, and education. The addition of Ayurveda to such strategies is a strong step towards internationalization.³⁴

Integration of education and research

The absence of standardized training and interdisciplinary cooperation is one of the most significant obstacles of the globalization of Ayurveda. This can be closed by the development of integrative curricula, which imparts Ayurvedic philosophy and modern biomedical sciences.³⁵

Research integration is equally vital. The application of modern tools such as: pharmacogenomics (to understand Prakriti-based variations), metabolomics and systems biology (to explore multi-target mechanisms), and clinical trials with adaptive protocols (to evaluate personalized interventions) can enhance the scientific credibility of Ayurveda.

In addition, translational research by connecting lab results with the health interests of the community will enable Ayurveda to play an important role in the national health policies.

Ethical and cultural aspects

Ayurveda encourages ethical healthcare based on compassion (Daya), non-harm (Ahimsa), and admirativeness of nature (Prakriti Pujana). It talks about moral responsibility of the physician (Vaidya Dharma), patient-centered care, and social well-being.³⁶

This moral platform can help to enrich the current health systems which fail to cope with depersonalization and excessive commercialization. The inclusion of Ayurveda therefore brings back the humanistic and spiritual aspects of the health care - which is needed to bring about proper sustainability.³⁷

Global integration challenges

Despite increasing global recognition, several barriers persist: lack of uniform international regulations for Ayurvedic practice and products, insufficient clinical evidence adhering to global biomedical research standards, quality control issues in herbal formulations and pharmaceutical manufacturing, and cultural and epistemological differences between traditional and modern paradigms.³⁸

To solve these issues, there is a need to address them through the multi-stakeholder system that includes policymakers, researchers, educators, and the industry. Single formulations, good manufacturing practices (GMP), and crossover of Ayurveda clinical procedures into other countries will bring global confidence in the Ayurvedic formulations.

Future prospects

Ayurveda has a future in its strategic partnership with the digital technology and the public health systems. Personalized Ayurvedic health monitoring can be done by using artificial intelligence, wearable diagnostics and telemedicine. Exchange Knowledge Exchange of knowledge can be facilitated by global collaborative platforms, such as WHO, UNESCO, and educational consortia. The integration of Ayurveda in the global wellness tourism and preventive health industries can also create sustainable economic developments without destroying the cultural heritage. The principles of Ayurveda such as balance (Samya), mean (Mitaahara), and being environmentally friendly provide a holistic solution that is not only medical but also civilizational in the climate change, mental health crisis, and healthcare inequity scenario.^39,40

CONCLUSION

Ayurveda appears in the process of seeking global health and sustainability not only as a traditional system of medicine, but a unified, integrative and ecologically sound paradigm of life and well-being. Based on the concepts of harmony, prevention, and individualized care, Ayurveda proposes useful answers to some of the most burning questions of contemporary healthcare such as the epidemic of chronic lifestyle diseases, mental health crisis, inequity in healthcare, and natural resources exploitation that cannot be sustained. The philosophy of Ayurveda tends to lead towards the achievement of the United Nations SDGs, in conditions of SDG 3 (good health and well-being), SDG 12 (responsible consumption and production) and SDG 15 (life on land). Setting the balance between humans and their environment (Loka-Purusha Samya), Ayurveda provides a particular model of a planetary health, the individual well-being is regarded as something that cannot be destroyed without the ecological balance. It is directly relevant to decreasing the burden of disease in the world by its emphasis on preventive and basic health (through the regulation of lifestyles (Dinacharya) and regulation of the seasons (Ritucharya) and regulation of diets (Ahara Vidhi) and regulation of the mind and the spirit (Sadvritta). These solutions not only are health-enhancing, but will reduce reliance on resource-intensive medical interventions the result of which is healthcare which is more equitable, more affordable and more sustainable. The role of Ayurveda in the integrated health system is to complement the modern medicine, but it is a paradigm shift - not management of sickness but health production, not consumerism but sustainability, and not a multidimensional generation but in its entirety. The Ayurvedic approach of global health policy, education and clinical practice has the possibility of creating a robust, supportive and sustainable healthcare system.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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