Dr Harsh Vardhan launched ‘Ayush Sanjivani’ app and interdisciplinary studies involving AYUSH interventions for COVID-19
Dr Harsh Vardhan, Union Health & Family Welfare Minister launched the ‘AYUSH Sanjivani’ App and two AYUSH-based studies related to COVID-19 situation on 7th May, 2020 in the presence of Shri Shripad Yesso Naik, MoS (I/c), AYUSH who participated through Video Conferencing from Goa. Highlighting the importance of harnessing technology for COVID-19 response, the Union Health Minister said “The ‘AYUSH Sanjivani’ mobile app, which has been launched today, will help to generate data on acceptance and usage of AYUSH advocacies and measures among the population and its impact in prevention of COVID 19. It is developed by Ministry of AYUSH and MeitY and shall reach out to a target of 50 lakh people.” Dr Harsh Vardhan stated that COVID-19 management has provided a potent platform for alliance between MoHFW, MoAYUSH and technology organisations such as CSIR, ICMR, and UGC to not only develop AYUSH interventions and solutions but also help in promoting AYUSH knowledge for the larger good of the global community. These organisations are joining hands today and are being supported and guided by ICMR and DCGI in propagating the wholesomeness and holistic health benefits of the age-old traditional medicinal knowledge of Ayurveda, he added. In addition to the App, Dr Harsh Vardhan also launched two more scientific studies. One is the collaborative clinical research study on Ayurveda interventions as prophylaxis and as an add-on to standard care to COVID 19, which shall be a joint initiative of Ministry of AYUSH, MoHFW and the Ministry of Science & Technology through Council of Scientific & Industrial Research (CSIR) with technical support of ICMR. The Interdisciplinary Ayush R&D Task Force headed by Dr Bhushan Patvardhan, Vice Chairman, University Grant Commission (UGC) has formulated and designed clinical research protocols for prophylactic studies and add-on interventions in COVID-19 positive cases Impactful S&T efforts initiated in last quarter 69 through thorough review and consultative process of experts of high repute from different organisations across the country for studying four different interventions, viz., Ashwagandha, Yashtimadhu, Guduchi Pippali and a poly herbal formulation (AYUSH-64). This includes the following two areas: a. Ashwagandha for the Prophylaxis against SARS-COV-2 in subjects with increased risk during the COVID 19 Pandemic: A comparison with Hydroxychloroquine in the healthcare providers and b. Effectiveness of Ayurveda Formulation as an adjunct to ‘Standard of Care’ for the Treatment of Mild to Moderate COVID-19: A Randomized, Open Label, Parallel Efficacy, Active Control, Multi-Centre Exploratory Drug Trial. Dr Harsh Vardhan also launched the population-based interventional studies on impact of AYUSH-based prophylactic interventions for prevention of COVID-19 infection in high risk population. The core objectives comprise of assessment of preventive potential of AYUSH interventions for COVID-19 and to assess the improvement in quality of life in high risk population. The study will be carried out through four Research Councils under Ministry of AYUSH and National Institutes in 25 states across the country and several State Governments covering approximately 5 lakh people. The outcome of the study is expected to pave a new horizon in understanding the preventive potential of AYUSH interventions during pandemics like COVID-19 through scientific evidence. Elaborating on the import of these studies, Dr Harsh Vardhan stated that these studies shall reestablish the importance of AYUSH pathies with the help of rigour of CSIR, ICMR and DCGI. “This is truly a momentous day. The technology alliance provides valuable opportunity for such knowledge-based solutions to continue to benefit us even after the COVID-19 pandemic has passed, by possible integration of AYUSH in the mainstream scientific efforts,” he added. “Let us also understand that the modern pathies of medicine and science are not in competition with those of AYUSH, but they complement and strengthen each other in intrinsic ways,” Dr Harsh Vardhan stated. “Under the leadership of our beloved Prime Minister, AYUSH advisories for enhancing immunity during COVID-19 pandemic have been acknowledged the world over,” he said. Shri Rajesh Bhushan, OSD/Secretary (HFW), Shri Vaidya Rajesh Kotecha, Secretary, AYUSH, Dr Shekhar C. Mande, Director General, CSIR, Dr V. G. Somani, Drugs Controller General of India, and other senior officers of MoHFW and AYUSH were also present at the launch event.
Ministry of AYUSH issued advisory for meeting the challenge arising out of spread of Novel Coronavirus in India
The holistic approach of AYUSH systems of medicine gives focus on prevention through lifestyle modification, dietary management, prophylactic interventions for improving the immunity and simple remedies based on presentations of the symptoms. For instance, emphasis on avoidance of causative factors and enhancing the immunity against host of infections are characteristics of Ayurveda management. The preventive aspect of Homoeopathy is well known, and historically, Homoeopathy has reportedly been used for prevention during the epidemics of Cholera, Spanish Influenza, Yellow fever, Scarlet fever, Diphtheria, Typhoid etc. The Genus Epidemicus (GE) is the remedy found to be most effective for a particular epidemic once data have been gathered from several cases. It was reported that, during recent past GE had been used during various disease outbreak for preventing the spreading of diseases like Chikungunya, Dengue Fever, Japanese Encephalitis and Cholera with good results. 70 The AYUSH approach to manage the outbreak broadly comprise of:
Preventive and prophylactic;
Symptom management of COVID-19 like illnesses; and
Add on interventions to the conventional care.
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Notification issued for undertaking research on COVID-19 through Ayurveda, Unani, Siddha and Homoeopathy systems by Ministry of AYUSH
IIn the wake of COVID-19 caused by SARS CoV-2, there has been surge in proposals received by Ministry of AYUSH claiming possible treatment of COVID-19. At present, there is no approved treatment for COVID-19 infection. Indian Traditional Medicines have wide potential for usage in such conditions owing to their longstanding use in the community, huge number of ancient references and large number of publications in scientific journals on their phytochemical constituents, mode of action, clinical efficacy etc. At the same time, it is also essential to have scientific evidence on use of any Ayurveda, Unani, Siddha or Homeopathy formulation on prevention/ management of COVID-19. Therefore, it is felt necessary to make serious efforts for development of drugs based on any of AYUSH systems recognized under Drugs and Cosmetics Act, 1940. There are no specific regulatory provisions in the Drugs & Cosmetics Rules 1945, for conduct of clinical trials of Ayurveda, Siddha, Unani and Homeopathy drugs. At the same time it is also necessary that the clinical data generated is scientifically valid and credible. In this context the Ministry has undertaken consultation with DCGI, CDSCO as well as other research experts. In the above background and based on the consultation of CDSCO, the Ministry of AYUSH with the approval of Minister of State Independent Charge of AYUSH notifies that the scientists, researchers, clinicians of any of recognized systems of medicine under IMCC Act 1970, HCC Act 1973 and NMC Act 2019 (formerly IMC Act 1956) can undertake research on COVID-19 through Ayurveda, Siddha, Unani and Homeopathy systems including prophylactic measures, intervention during the quarantine, asymptomatic and symptomatic cases of COVID-19, public health research, survey, lab-based research etc. to generate evidence. While undertaking research, it is mandatory for the organizations to comply with the following conditions:
The proposal should be approved by their scientific advisory bodies and Institutional Ethics Committees. If it is clinical trial, the project should be registered with CTRI.
The sample size should be based on statistical justification.
The clinical research should be conducted as per AYUSH guidelines for Clinical Research or ICMR guidelines.
It should comply with relevant regulations for Bio-medical and Health Research.
It should comply with Good Clinical Practice Guidelines.
It should comply with National Ethical Guidelines for Bio-medical and Health Research on Human Participation published by ICMR.
It should comply with any other relevant regulations in force.
AYUSH registered practitioner/expert should be part of the study team at each site.
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Ayurveda’s immunity boosting measures for self-care during COVID-19 crisis
In the wake of the COVID-19 outbreak, entire mankind across the globe is suffering. Enhancing the body’s natural defence system (immunity) plays an important role in maintaining optimum health. We all know that prevention is better than cure. While there is no medicine for COVID-19 as of now, it will be good to take preventive measures which boost our immunity in these times. Ayurveda, being the science of life, propagates the gifts of nature in maintaining healthy and happy living. Ayurveda’s extensive knowledge base on preventive care derives from the concepts of “Dinacharya” - daily regimes and “Ritucharya” - seasonal regimes to maintain healthy life. It is a plant-based science. The simplicity of awareness about oneself and the harmony each individual can achieve by uplifting and maintaining his or her immunity is emphasized across Ayurveda’s classical scriptures. Ministry of AYUSH recommended a series of self-care guidelines for preventive health measures and boosting immunity with special reference to respiratory health. These are supported by Ayurvedic literature and scientific publications.
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Tentative proposed list of projects related to COVID-19 to be funded by Ministry of AYUSH
Ministry of AYUSH has shortlisted eight projects to be funded which are related to COVID-19. The research activities would be in concordance with interventional studies, drug trials, efficacy evaluation and impact assessment. Following are the titles of the proposed projects. l Clinical research studies on Ayurveda interventions as prophylaxis and as an add-on to standard care to COVID-19: Collaborative clinical studies as a joint initiative of Ministry of AYUSH, Ministry of Health and Family Welfare (MoHFW) and the Ministry of Science & Technology through Council of Scientific & Industrial Research (CSIR) with technical support of ICMR. l Population-based interventional studies on impact of AYUSH based prophylactic interventions. l Ayush Sanjivani application-based study for impact assessment of acceptance and usage of AYUSH advisories in its role in prevention of COVID-19. l Drug Trial to Evaluate Efficacy and Safety of an Ayurvedic Formulation AYUSH-64 as Adjunct Treatment to Standard in COVID-19. l Evaluation of Efficacy and Safety of Ayurveda Intervention (Ayush-64) add-on therapy for patients with COVID-19 infection (Stage I)-A Randomized controlled clinical trial. l Evaluation of the efficacy of an Ayurvedic intervention (Chyawanprash) in the prevention of COVID-19 among healthcare personnel. l Impact of Ayurvedic Interventions in prevention of COVID-19 infection in identified containment area. l Interventional study on the effect of AYUSH as a prophylactic measure among high risk population (Healthcare workers/containment zone population) exposed to COVID-19.
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National repository of AYUSH COVID-19 clinical and other R&D initiatives
AYUSH Research Portal is aimed at disseminating the knowledge of AYUSH systems and the current research updates purely meant for academic purpose. In this portal, users can search AYUSH terminology, research articles, journals etc. You can also search information the Ayurveda, yoga, naturopathy, Unani, Siddha, Homeopathy etc., and information about the clinical research, pre-clinical research, drug research and fundamental research. This initiative aims to collate the current research and clinical activities and updates related to the COVID-19 pandemic.
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Ministry of AYUSH releases guidelines for AYUSH Clinical Studies related to COVID-19
CoronaVIrus Disease-19 (COVID-19) pandemic is a challenge to public health worldwide. In spite of implementation of prophylactic strategies such as promotion of hygiene, social distancing and global lockdown, the spread of disease remains a challenge. There is no ‘Standard of Care’ available in view of inadequate evidence on existing medicines and their limitations. This is an opportune time when AYUSH concepts and interventions should be evaluated for developing better arsenals to prevent and treat the disease. With this objective, the Ministry of AYUSH has constituted an Interdisciplinary AYUSH Research and Development Task Force for facilitating research on COVID-19. The pandemic has however raised complex issues for health systems, communications, research infrastructure, and research governance frameworks. On the background of rapidly evolving scientific and ethical uncertainties, it is a challenge to design research that can yield scientifically valid results. The other short-term challenges include time available to design a study and lack of resources to conduct the study. Any research which is planned during such period should be based on thorough understanding of the disease and its importance as a public health challenge. The AYUSH Task Force has therefore recommended development of a guidance document for researchers that will discuss methodological components of a protocol for evaluating AYUSH interventions in COVID-19.
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Ministry of AYUSH releases guidelines for naturopathy practitioners for COVID-19
The guideline document released by Ministry of AYUSH is for naturopathy practitioners to impart yoga therapy, naturopathy treatment modalities, nutrition, diet and lifestyle approaches to improve immunity in our population. Research has shown that there is a heterogeneity in susceptibility to infections during a flu epidemic. Psychological stress, fitness and physical activity, nutrition, sleep, comorbid conditions and lifestyle play a vital role in shaping this immune response. Naturopathy is a system of lifestyle medicine that works in modulating these factors and improves the body’s innate healing properties that is immunity. The guidelines may be useful in this current scenario when we are facing a COVID-19 pandemic. Since elderly population, children and those with comorbid conditions are vulnerable to this infection, naturopathy interventions can be used as an adjunct preventive management. The impending anxiety and stress of isolation due to COVID-19 and lockdown can down regulate immune responses and lower defence that can lead them to contract this infection and increase its severity.
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Guidelines for Siddha practitioners released by Ministry of AYUSH to combat COVID-19
In the Siddha system, Epidemics/Pandemics are mentioned as ‘Uzhi Noi’ or ‘Kothari Noi.’ In general, they are classified under “KollaiNoikal” (Communicable Diseases) which most commonly occur at the time of “Ayana Santhi” months (end a month of Uthara Ayanam & Thatchana Ayanam) and fall on Adi and Margazhi month in Tamil Calendar. It is believed that in those days, the immunity of human beings will be low based on Mukkutram Theory. In Siddha System, the diseases are raised based on the derangement of Mukkutram. Usually, Thottru Noigal (communicable diseases), associated with Aiya kutram (Respiratory-related illness), gets affected due to its Sthiram gunam (stability factor). In Guru Naadiquoted, Thottru Noigal is generally caused by Kirumi (Pathogens). The symptoms are due to Noiyinan vanmai (immunity of an individual); if it is good, he/she will not be affected. So, the medicines are used to neutralize the Aiya kutram.
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Guidelines for homoeopathic practitioners for COVID-19 released by Ministry of AYUSH
In case of epidemics or pandemics, first approach is to follow preventive measures and educate people about general measures and to provide interventions that will keep their immunity enhanced. Homeopathy therefore recommends issuing of public notice for Genus epidemics identified by the designated experts for immunity enhancement and practitioners may suggest the same to the people and as per the Advisory issued by Ministry of AYUSH. Second approach is to provide homoeopathic symptomatic mitigation to affected persons. Homoeopathic medicines are also useful in the treatment of communicable diseases like influenzalike illness, dengue, acute encephalitis syndrome etc. Several studies are also published which show the immune modulatory potential of homoeopathic medicines in preclinical studies. These medicines can be prescribed in an integrated manner or standalone depending on the severity on a case to case.
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Ministry of AYUSH releases guidelines for Unani practitioners for COVID-19
Unani scholars have prescribed several single drugs as well as compound formulations for the prevention and treatment of infectious diseases in general. They have emphasized more on the use of certain drugs which are known to improve host immunity during the outbreak of epidemics, endemics and pandemics. Ismail Jurjani (1041-1136 CE) mentioned that use of Tiryaqs during epidemics strengthens the heart and keeps the body faculties strong. Single and compound Unani drugs may prove to be beneficial and can be used under the supervision of qualified Unani physicians for possible immune-boosting/symptomatic relief in upper respiratory tract infections. As per Unani classical wisdom, improving immunity with immune boosters is one of the key approaches for prevention of disease and maintenance of health. Therefore, a strategy to enhance immunity and provide symptomatic relief in upper respiratory tract infection is advocated in these guidelines for qualified Unani medicine practitioners.
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Guidelines for Ayurveda practitioners for COVID-19 released by Ministry of AYUSH
The COVID-19 pandemic is defining the global health crisis of our time and it has transpired to be the greatest challenge we have faced since the Second World War. The number of deaths and incidence of infection are rising at an alarming rate throughout the world. The situation has materialized to be much more than a health crisis with a potential to create 23 devastating situations at social, economic and political levels. Till date, no effective management to address this infection has been discerned and attempts are being made to integrate a few traditional interventions along with standard treatment protocols for COVID-19. It has further been observed that there is a paucity of empirical evidence to guide appropriate management of the disease. Collecting data and comparing outcomes are being recommended globally. In view of this, it is very essential to develop guidelines for practitioners to generate evidence-based data at prevention, promotion and therapeutic levels. The medicines recommended in the guidelines are based on Essential Drugs List, Standard Treatment Guidelines, Ayurvedic Pharmacopoeia of India, Ministry of AYUSH (Government of India) along with considerations from other recommendations issued by various health authorities across India. The practicing Vaidya has to have his/her own discretion in selecting medicines based on the stage of the disease, symptom complex and availability of the drugs in their locality. Use of mask, hand sanitization, social/physical distancing to break the chain, healthy nutritious diet and measures of improving immunity and all other general healthcare measures are to be advised as per the guidelines issued by health authorities from time to time.
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Guidelines for Yoga practitioners for COVID-19 released by Ministry of AYUSH
Yoga may play significant role in the psycho-social care and rehabilitation of COVID-19 patients in quarantine and isolation. They are particularly useful in allaying their fears and anxiety. The guidelines are for yoga professionals (Certified Yoga teachers/ instructors and therapists etc.) to teach a safe set of yoga practices based on available scientific evidences, to novices in all walks of society as a service to humanity during this pandemic of COVID-19. This is complimentary to all measures that have been adopted. Yoga-based lifestyle modules which can be used for different sections of the society in the present scenario are presented with the following objectives: 1. To improve general immunity among the population; 2. Rehabilitation of vulnerable populations (children, elderly and those with comorbid conditions such as diabetes and hypertension) and to those patients in isolation/quarantine with or without mild symptoms; and 3. To add-on yoga-based interventions and meditation practices for COVID-19 cases in isolation and hospitalization for psychosocial care.
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