AMAI VISION DOCUMENT

To, The Hon. Chief Minister, Govt. of Kerala.   Respected Sir, The Ayurveda Medical Association of India, Kerala State committee hereby submits a vision document for the development of Kerala through Ayurveda, for your perusal. These are the findings of an intellectual conclave conducted by our organization on 23-06-2012 at Mascot Hotel, Trivandrum. Ayurveda being a major domain of Kerala, this report envisages the development of this system for the next twenty years. Anticipating your favorable action in this regard.   Thanking you, Yours faithfully, Dr.  G. VinodKumar,                                                    Dr. Rejith Anand State President, AMAI.                                                 General Secretary, AMAI   Copy to Hon. Health Minister Vice-Chairman, State Planning Board Sri. Vijayaraghavan, Member, State Planning Board Sri. C.P.John, Member, State Planning Board Sri. Sam Petroda, Special Advisor, Govt. of Kerala Secretary, Ayush Dept, Govt.of India Secretary, H & FWD, Govt. of Kerala Honorable Vice-Chancellor, KUHS PVC, KUHS Dr. V.N. Rajasekharan Pillai Sri.  Darshan Shanker DAME Director, ISM department CEO, State Medicinal Plant Board, Managing Director, Oushadhi   Table of Content

SERIAL NO.	TOPIC	PAGE NO.
1.	Introduction	5.6
2.	Objectives	6
3	Major topics discussed	6
4.	Public Health	7,8
5	Medicinal plants- sources, problems & remedies	9,10
6	Research & clinical validation	10,11,12
7	Ayurvedic clinics for health and development of Kerala	13,14
8	Education	14,15
9	Global Propagation of Ayurveda	15,16
10.	Ayurveda industry for the development of Keral	17,18,19

  11.Proceedings                                                                            20,21,22         Introduction Ayurveda as a science and practice has stood the ramifications of time and test of veracity across centuries . The focus of Ayurveda has been to educate people on how to take care of their health by themselves and increase their span of healthy life. This goal can be easily achieved by monitoring and balancing one’s nutritional diet and life style. , Ayurveda is related to the soul, body & mind simultaneously. It recognizes that emotional disturbance in the mind itself can create problems in the body. With such comprehensive approach to healing, it is also referred to as the ‘mother of healing processes’ While several quarters of the society within India itself question its ability to address the modern day requirements of process, structure and validations, there is seldom debate on the effectiveness of its medicines and practices. The question Ayurvedic practitioners counter is whether the science is outdated, does it have the required contemporary knowledge base to substantiate its formulations and therapy methods. The Wellness industry itself adopted the age old  of principles of therapeutic massage, Kerala special treatment modalities and has burgeoned an industry in itself where in bound tourists seek the massages and allied therapy. This has also led to increased number of tourist inflow in the state. On the other side though, this has also increased several ‘unqualified massage centers’ which offer such services without the required trained staff. These quacks have also besmirched the healing practice and raised suspicions of now wary tourists. But it is also an idea whose time has come. There is an increased support from the state and central governments and this impetus can truly provide the umbrella to effectively moot and debate on the way forward and what could be done to propagate Ayurveda globally and how Kerala can play the centre stage. This report covers the suggestions evolved in the intellectual conclave of “Ayurveda-For Health & Development of Kerala” which was held on 23^rd June, 2012 at Mascot Hotel in Thiruvananthapuram. The event was organized by Ayurveda Medical Association of India in association with Centre for Integrated Health & development. We humbly submit the authorities for due consideration. Objectives of the Program

• To promote Ayurveda as a system of medicine in different parts of the world.
• To explore the market of Ayurvedic medicines in India.
• To promote the Ayurvedic medical practices of Kerala in different parts of the country.
• To create an  awareness among people about the Ayurvedic treatments for different diseases, where there are no effective solution in modern medical practices.
• To exploit the potentials of Kerala with respect to Ayurveda.

 Major Topics Discussed

• Public Health
• Medicinal plants and its sources
• Global propagation of Ayurveda-
•  Research & Clinical validation
• Ayurveda clinics
• Education
• Ayurveda Industries for the development of Kerala

Public Health India is at the gateway of universal health coverage. Indian patients are demanding more and the government too is interested in providing more facilities to meet the growing demands. There is a paradigm shift in the way healthcare providers are thinking too. However, the ancient systemic medical knowledge and traditional treatment methods are still struggling for existence and equitable identity. This may be partly due to the internal weaknesses and partly due to lack of updation in competencies. The need of the hour is to achieve efficiency and to meet the challenges posed by the emerging scenario. Sarve Bhavantu Sukhina – Health for All is the aim of Ayurveda and hence it is considered as a holistic medical practice. Healthy living practices and Ayurveda go hand in hand. Adoption of traditional healthy living practices will be helpful to live a longer and disease free life. Cardiac diseases are one of the major ailments noticed in Kerala. Diseases such as Diabetes, Hypertension, and Hypercholesteremia are the major risk factors of Cardiac problems and are more prevalent in Kerala even within the young generation due to the unhealthy lifestyle followed. Kerala is known as the capital of Diabetes. Propagation of Ayurvedic lifestyle and Yoga can be useful in reducing these problems. Due to the modern lifestyle, the immunity level in people has also reduced and this increases the chances of getting respiratory and skin diseases. This can be effectively managed by Ayurveda Geriatric care is a major area where Ayurveda can contribute. People after 50 years have some common problems like constipation,vision problems and immunity problems. Maternal care is another area where Ayurveda can do much for a healthy mother and child. Not only can Ayurveda be used for curative treatments but it has a wide application in social life. . Aparajith Dhoopa Chooranam is very effective in mosquito repulsion and disease prevention. There are many other similar traditional practices that can be effectively used in day to day life. But there are major obstacles hindering the propagation of a Ayurvedic lifestyle. The network of ISM institutions are yet not sufficient to cater to the larger section of the population. Allopathy is still the most popular and widely promoted treatment method in most primary and secondary health centers. Though the main aim of National Rural Health Mission is to utilize the primary and secondary health centers to provide AYUSH services, this program is not yet implemented in Kerala. There is also a growing need to develop internal expertise in different areas of Public health.  Some suggestions made to improve awareness on the use of Ayurveda in public health are:

• Re-establish the identity and presence of Ayurveda.
• Mass health education in schools, colleges and establishments on Ayurvedic lifestyle and food.
• Compulsory Yoga and Kalari training in schools.
• Special clinics on life style diseases in all ISM centers. Provide facilities in these centers for detection of cardiac risk factors.
• Ensure district level planning for AYUSH systems and services – ensuring sufficient manpower, infrastructure, etc.
• Setting up in-service training institutes for practicing doctors

Ensure coordination and convergence with other healthcare systems.

• Health Programmes suggested – Balya Raksha (Nutrition care), Raktavrudhi (anaemia management), Prasavananthara Raksha (post-natal care), Jara (Geriatic Care), Koumara Pariraksha (adolescent care), Garbharaksha (Antenatal care), Ayurarogysoukhyam, etc.

Medicinal plants- Sources, problems and remedies Medicinal plants are invaluable treasures and a boon to health. The shortage of some of the essential medicinal plants creates stagnation and dilemma in manufacturing industry. This is also reflected in the efficacy of certain products. There are two major sources of medicinal plants – procurement from natural resources like forest or cultivation by farmers. Though procurement from forests is less expensive source, possibility of adulteration and prohibition on certain herbs imposed by the Forest department makes this option less viable. These days the major problems are shortage of medicinal plants, uncontrolled price hike, unhealthy cultivation, and lack of quality control systems . Measure such as cultivation by different means, hi-breed method of cultivation, herbal cultivation, exploring the knowledge of tribal people about their medical practices etc. can be taken to increase the production of medicinal plants. Suggestions

• Quality control system should be implemented. This can be entrusted to medicinal Plant Board and Care Keralam
• Explore knowledge of tribal community
• Promote community herbal cultivation ,herbal gardens in schools,  hospitals and other public spaces
• Scientifically explore possibilities of substituting some endangered species of herbs.
• Bulk import of raw drugs like Gulgulu, Draksha, Hingu, Madhusnuhi from countries like Iran, Pakistan and Afghanisatan.
• Manufacturing facility should also have reasonable area for cultivation of herbs. It should be a pre-requisite for licence.
• Forest products (MFP) of various states should be centrally procured
• Encourage cultivation. Priority should be given to plants which having more demand. Insist good agricultural and good storage practice. Proper education should be given to interested farmers and by back arrangements should be done to ensure its sale and reasonable pricing. This can be achieved by creating groups of farmers and medicinal plant buyers. The Medicinal plant Board and Care keralam can play a major role in these processes. Organisation like AMAI can also assist these programmes.

Considering the importance of this area, State Medicinal Plant Board should be strengthened to  control and regulate the above specfied areas. Research and Clinical Validation Introduction The ultimate objective of this sector is to develop an international network with a view to provide a multidisciplinary, multidimensional and multisectorial R&D initiatives. In India several activities directly or indirectly related to Ayurveda are currently being operated at different levels including research organizations (public and private), universities, etc. If we do an in-depth analysis and review of the above scenario, the answer is not highly encouraging and in-fact we could not achieve the targets as envisaged in the respective projects/programmes on many occasions. This may be due to various reasons linked with policies, programmes that so far, we had implemented at state, national and international level. In this context, we badly need rethinking as to how to move this task forward to propagate Ayurveda.  This system of medicine is deep rooted in Kerala since time immemorial. Today Kerala is one among the states in India engaged in conserving, preserving and practising Ayurveda in a befitting and scientific manner. Keeping in view of the current situation, the role of Ayurveda for total healthcare, is highly significant and hence we propose the establishment of an ‘International Research Institute in Ayurveda’ with an integrative approach through public private partnership, linking with a global network to fulfill the aim – Ayurveda for the development of Kerala. Govt. of Kerala should take initiatives to set up this institute The International Research Institute is of crucial importance for the growth of Kerala as well as Ayurveda. No other state in the country has ever embarked on a project of this magnitude. The creation of the International Research Institute will be beneficial for patients, doctors and researchers alike and it will add to the prestige of our state. The expected total outlay of the project is Rs. 500 crore VISION                           

• Validate and revalidate the Ayurvedic system of medicine to make them more scientifically proven.
• To create awareness on the safety and efficacy of Ayurvedic products.
• To Disseminate the benefits of Ayurveda to people across the World

OBJECTIVES

• To provide Primary & community health care.
• To provide fellowship program
• To enrich Ayurvedic Pharmacopea.
• To ensure healthy and economic security of the state/nation through developing and marketing diverse and novel Ayurvedic products.
• To document traditional knowledge.
• Tie up with other R&D Organizations.
• To conduct IPR research
• To establish manuscript library and museum
• Establish nodal centre and satellite centres. Existing

Research units  like colleges ,CCRAS,TBGRI  can be treated as satellite centers Structural components of the proposed Institute: International Research Institute in Ayurveda Government Council Director General Faculties Administration           Policies and programs  Scientific disciplines Nodal Centre- Kerala Satellite Centers State Level      National Level           International Level Establishment Phase i To set up a state level Research Council to monitor research activities Phase ii Strengthening of satellite centres. Advanced research facilities may be provided in the existing PG colleges. Research activities may be started under the Research Council. Phase iii International Research Institute in Ayurveda may be set up in this phase Ayurveda Clinics for health & development of Kerala Ayurveda clinics were part of Kerala health system since time immemorial. Based on basic principles of Ayurveda, eminent scholars have developed many special treatments. These kind of procedures are not available in any part of the country. These are termed as ‘Kerala special treatment’ and are very effective cures for diseases which cannot be cured by modern medical practices. The following are the steps that should be taken to bring these modalities to the global attention:

• Branding of Kerala Ayurveda therapy- Specialties of Ayurveda such as:

Panchakarma, Ophthalmology, Anorectal clinic, Cosmetology clinic, Physical medicine, , Respiratory clinic, sports medicine, Pre and post natal clinics.

• Diseases which have no effective cure in modern medicine can be focused by these clinics. Eg.

EYE- Muscular degeneration, Myopia, Allergic eye disease. ENT- Nasal polyps, Allergic disorders, Recurrent tonsillitis. ORTHO- Osteoarthristis, Vertebral disc prolapsed, Spondylosis. RHEUMATOL OGY- Musculoskeletal disorder, Rheumatoid spectrum. ANORECTAL- Fistula. SPORTS AYURVEDA- Managing injuries, Developing endurance, Muscle power development. GYNECOLOGY- PCOD, DUB, Preconception. PAEDIATRIC- Developmental disorder, Autism. GASTRO- IBS, Liver disease. GEN. MEDICINE- Asthma, Diabetes Type 2, Hypertension.

• Areas in which Kerala Ayurveda has an advantage should be focused and promoted through series of programs involving government agencies and promotional bodies.
• More scientific validation of Ayurvedic centers. Focus should be given to functional aspect and ambience of centers.
• Insurance coverage to Ayurvedic procedure should be sought. A standard rate is to be fixed for each procedure.
• An Institution to assist service centers in Marketing, tracing Patient, facilitation, transport, Recruitment of skilled employees, etc.
• Special visa should be issued to patient coming from abroad.
• Ayurvedic clinics should have more coverage within the country.

Education Kerala has been a major contributor in the field of Ayurvedic education. It has 17 colleges,  1500 students, 450 faculties and 20 Gurusishya parampara faculties. Blending the strength of these facilities Ayurveda health care system can be utilized as a powerful weapon for the government in the implementation of health projects. In order to cater to the ever growing requirement for quality services in the healthcare sector, there should be more number of specialty courses aimed at upgrading the existing academy. More number of para medical courses is highly essential to add on to the growing requirement in the sector and there should be regular paramedical courses in Ayurveda colleges. To update the knowledge and efficacy, training should be given to all Ayurveda doctors, para medical staff and other professionals, utilizing the existing facilities of academy and medical University. A paramedical council is very essential for Ayurveda to regulate their standards and proper registration. The proposed  Ayurveda University  should mainly focus on Ayurveda research and should be envisaged as a knowledge hub of Ayurveda. Such a facility will contribute enormously to the development of the sector as well as the state in general. The functioning of the Ayurveda University may be modulated in such a way that it can address and promote the overall progress of Ayurveda and needs of the public. It is proposed to establish a centre for research and higher studies in fundamental principles of Ayurveda with the aim of providing a uniform standard of teaching, which is a pre-requisite for Ayurveda. Ayurveda teaching methodology should be developed and implemented and the Central Council of Indian Medicines (CCIM) should take initiatives in this aspect. Regular structured teachers training program should be conducted and the present Re orientation Training Program is insufficient. There is a need to start post diploma courses in clinical subjects. Short term training programs for practicing Doctors can also be initiated to keep them up-to-date on the recent developments in the sector. Modern diagnostic equipments should also be provided in all clinical departments. Global propagation of Ayurveda- prospects, problems and priorities Ayurveda is not yet recognized as the system of global medicine abroad and requires numerous efforts to propagate Ayurveda in such a way that it can be recognized as a Global system of medicine. In Kerala the presence of Ayurvedic medicines are in abundance which provides an opportunity for Kerala to promote it’s Ayurvedic treatments in the foreign markets. But it requires support both from the state as well as central government. In Europe more than 75% of people have used Complementary and Alternate Medicines during their lifetime. However CAM is now defined as Acupuncture, Homeopathy, Phytotherapy, Naturopathy, TCM, Osteopathy and Chiropractic in Medical practices. Ayurveda is still not recognized as a global system of medicine. To promote Ayurveda globally, certain things need to be done such as participation in International trade fairs, international conferences, shows, publishing effective case studies, sharing of information.,market research to tap market such as US, Japan, France, Canada, organizing buyer/seller meet in India as well as abroad. Though promotion is important, efforts should also be taken to focus on training doctors from Medical colleges in Ayurveda, priority based clinical research, supportive programs (Quality assurance) and legal aspects such as constant watch on amendments, creation of directory of authentic Kerala supplier, authentic data based on medicinal plants as well as value added products hosted on website, etc. for global propagation of Ayurveda. In product marketing, adhere international standard in production (GMP), Herbal cultivation(GAP),packing and handling. Other suggestions included-

• Make Ayurveda a key proposal as part of all FTA agreements. As most of the Governments require G to G (Government to Government) agreements to recognize Ayurveda as part of their Health care.
•  Identify and promote 10 Kerala star products from Ayurveda classical products for international marketing.
• Create separate protocol for wellness therapies for SPA purpose and have separate protocol for Ayurveda.
• Create Standard Operation Procedures for non invasive therapies and train physiotherapists or Ayurvedic doctors (those with good anatomy knowledge) to work as Ayurvedic health care professionals.
• Encourage fusion of herbal products with proven results from other countries.
• Organise buyer seller meets in India and abroad.
• Lobby with insurance companies for recognition of  Ayurveda treatments .
• Institute an official certification authority for Kerala products. Care Keralam can be entrusted this.
• The proposed global Ayurveda village, which envisaged as a public- private partnership project, should be developed as a centre of global propagation of Ayurveda. Its mission is stated as “To disseminate the treasure trove of ancient Ayurvedic knowledge expounded by the great sages of yore among mankind” It is very important to complete this project time bounded.

Ayurveda Industries for the development of Kerala Ayurveda has been developed and grown into an industry where Kerala has a great scope due to following reasons.

1. Traditional physicians of Ayurveda had developed so many clinically effective combinations which are not available in any part of the country.
2. The flora and fauna are abundant in our state contributed much to the raw material bank of Ayurvedic drugs.
3. Kerala being a water excess state could provide pure water for processing.

Even with all these favorable factors in hand, we could not tap the potential of this heavy market. Our turnover from the 1400 units is just Rs 800 crores as against one single company {Dabur} in North India which has a turnover of Rs.5000 crores. With different campaigns like Gods Own Country, Emerging Kerala during the last decade, Kerala Ayurveda has a credible brand name. So Kerala has a great potential to market Ayurvedic products. As green products have a growing potential in the international market, Ayurveda should plan at tapping this prospect. As we have seen above, though we have a large number of units in Kerala, most of them are having a small turnover. Many problems hinder the growth of Ayurveda companies in Kerala. If these are jointly addressed by the Government of Kerala and promotional bodies, the potential for growth is enormous for these companies. A projected turnover of Rs. 1400 Crores as against the prevailing Rs. 800 crores, is a definite reality. The problems faced and the solutions emerged in the conclave are – l. Availability of raw materials  and its genuineness Though Kerala has a climate which is conducive to the cultivation of raw materials, availability of land is a major problem. Cost of land and labourers make cultivation difficult and expensive. So these are done in a more economic level in states like Andhra Pradesh and Chattisgadh etc … For this we will have a collection agency .The present work of Care Kerala is welcoming. Popularization and easy implementation of schemes through medicinal plants board to motivate farmers and entrepreneurs for cultivation of medicinal plants. Panchayats  can take a lead in this. 2. Tapping outside Kerala market To have Kerala health stations in major places of the country to promote Kerala Ayurveda as joint venture of state and Ayurvedic units.lt should have 2 divisions 1. Sales of drugs 2. Procurement of raw materials Either Care Kerala can be endorsed to do this or a separate company can be formed. 3. Common R and D facility- Small units of Kerala are deprived of R and D units. They cannot afford the cost to installation and maintenance of them. So a common research facility for the state has to be started. This should have 3 regional counters at Kottayam, Calicut and Thiruvathapuram. It can be a company under government initiative with share of all units. This should do

• Standardization studies of formulation
• Ensure the genuineness and quality of Raw Materials
• Clinical studies for PP medicines
• Toxicity and allergy studies
•  Pre launch and marketing studies
• More effective ways of cultivation like tissue culture

4. Modification and revision of Ayurvedic pharmacopoeia of India. An expert committee should be formed under the government initiative for revision of Ayurvedic pharmacopoeia of India. This committee should include professors, researchers, pharmacological & industrial experts, drug control authorities etc. They should suggest

• Books and other information sources that could be added to schedule
• New herbs that can be added for internal and external use with proven efficacy. e.g..

ginseng, Arogya pacha etc .. 5. More efficient utilization and upgrading of Oushadhi- Oushadhi should be upgraded as a premium institution for training research and mentor. For that it should have

• State of art research centre
• Unmatched quality control facilities
• Training institute giving admission to Ayurvedic pharmacy, biochemistry and photochemistry graduates.

Proceedings of the Conclave The Conclave started at 9:30 am with a prayer. The meeting was chaired by Dr. G.Vinodkumar (State President, AMAI). Dr. Rejith Anand, General Secretary, AMAI, Kerala State Committee welcomed all to the gathering. The program was inaugurated by Adv. V.S. Shivkumar, Honorable Minister for Health. Sri. V.N. Rajasekharan Pillai, Exec. Vice President, KSCSTE was the Chief Guest . The key speaker for the event were Padmashree Darshan Shankar (Vice Chairman, I-AIM, Bangalore), Sri. Ranjith Purani Former General Secretary of ADMA, Sri. John Samuel (Global Adviser and head of Global Programmme-Democratic Governance, UNDP, New York), Sri. G. Vijayaraghavan (Member, State Planning Board) Dr. C. Ratnakaran (Pro VC, KUHS) Dr. Sivadas. T (Director, Ayurveda Medical Education) Dr. Anitha Jacob (Director, Dept of Indian System) Dr. N. Vimala (Drugs Controller, Ayurveda) Dr. P. K. Mohanlal (Former D.A.M.E) Dr. P. Sankarankutty (Former D.A.M.E). The Theme Paper Presentation was done by Dr. K.G. Vishwanathan (CCIM Member). This was followed by Group Discussions on various key topics. The Moderators for the group discussions were Sri. C.P.John (Member, State Planning Board), Dr.G.Vinodkumar (State President, AMAI), Dr. M. R. Vasudevan Nampoothiri (Former DAME & Member, CCIM). After the lunch, by 2:00 pm, a nutshell of the program was presented. After that the moderators expressed their comment.  Declaration of the conclave was held by 3:00pm. President of AMAI, Trivandrum Zone Dr. K. Gopakumar gave the Vote of Thanks.  Objectives of the Program

• To promote Ayurveda as a system of medicine in different parts of the world.
• To explore the market of Ayurvedic medicines in India.
• To promote the Ayurvedic medical practices of Kerala in different parts of the country.
• To create an  awareness among people about the Ayurvedic treatments of different diseases for which there are no effective solution in modern medical practices.
• To exploit the potentials of Kerala with respect to Ayurveda.

List of speakers

❖     Dr. G. Vinodkumar (State President AMAI)

❖     Padamashree Darshan Shankar (Vice Chairman, I-AIM, Banglore)

❖     Mr. John Samuel (Global Adviser and head of Global Programmme- Democratic Governance, UNDP, New York)

❖     Mr. C P John (Member, Planning Board) ❖     Mr. G. Vijayaraghvan (Member, State Planning Board)

❖     Dr. C. Ratnakaran (Pro VC, KUHS)

❖     Dr. M R Vasudevan Nampoothiri (Former D.A.M.E) ❖     Dr. Sivadas T.(Director, Ayurveda Medical Education)

❖     Dr. Rejith Anand (General Secretary, AMAI) ❖     Dr. Joy (Executive Director, CareKeralam) ❖     Dr. Anitha Jacob (Director, Dept of Indian System)

❖     Dr. N. Vimala (Drugs Controller, Ayurveda)

❖     Dr. P. K. Mohanlal (Former D.A.M.E)

❖     Dr. P. Sankarankutty (Former D.A.M.E)

❖     Dr. K.G. Vishwanathan (CCIM Member)

  Major Topics Discussed

• Public Health
• Medicinal plants and its sources
• Kerala
• Global propagation of Ayurveda- Prospects, Problems Research & Clinical validation
• Ayurveda clinics
• Education
• Ayurveda Industries for the development of