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   Table of Contents - Current issue
Coverpage
January-March 2023
Volume 7 | Issue 1
One Nation, One Health System - Special Issue
Page Nos. 1-76

Online since Thursday, December 8, 2022

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EDITORIAL  

One Nation, One Health System: A perspective in harmonizing contemporary and traditional medical systems Highly accessed article p. 1
Rabinarayan Acharya
DOI:10.4103/jras.jras_158_22  
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GUEST EDITORIAL Top

Aligning collaboration and integration towards “One Nation, One Health System” for a resilient public health delivery p. 4
Vaidya Rajesh Kotecha
DOI:10.4103/jras.jras_177_22  
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ONE NATION, ONE HEALTH SYSTEM - SPECIAL ISSUE Top

One Nation One Healthcare system: Esoteric idea or essential act? p. 6
Bhushan Patwardhan, Rajeshwari Singh
DOI:10.4103/jras.jras_170_22  
The importance of the pluralistic healthcare approach and evidence-based integration of medical systems is well recognized in various reports and policies. There is a need to bring synergy in the context of public health, medical and health education, research, clinical practice, and health administration. There is a growing consensus in favor of transforming the pathy-centric fragmented healthcare system to a people-centric integrative healthcare system in a stepwise manner near future. One Health concept is more about zoonotic and environmental considerations. We propose a One Nation One Healthcare (ONOH) system concept that tries to build on the idea that One Health prioritizes people’s basic healthcare needs and brings the best from scientific experimental research and traditional experiential practices as consolidated evidence-based medicine. ONOH does not mean mixopathy or monopoly of any one system. Whether this is a utopian esoteric idea or an essential act in the best interest of people and nation for moving toward universal health coverage requires a serious dialog and action.
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Evaluation of drug standards, quality control, and trade in medicinal plants p. 13
Shailaja Chandra, Dasalukuntey Bhimarao Anantha Narayana
DOI:10.4103/jras.jras_151_22  
This article is about the importance of medicinal plants in the manufacture of Ayush formulations or exported as raw drugs. Granting a license to manufacture, conducting quality control tests, and enforcing the legal provisions of the Drugs & Cosmetics (D&C) Act 1940 are the responsibilities of the relevant statutory regulatory bodies. The main stakeholders responsible for ensuring the products' quality, safety, and effectiveness are licensed manufacturers who have to follow the standards prescribed under the statutory regulations. The widespread interest in Ayurvedic drugs and other plant-based products led to this appraisal of the achievements and challenges of the regulatory bodies and those responsible for accelerating the organised cultivation of medicinal plants for domestic use and for export.
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Integrative medicine: A unified approach for the future medicine p. 21
Abhimanyu Kumar
DOI:10.4103/jras.jras_154_22  
In India, various healthcare systems are practiced, and every system is well-received by its citizens. Recently, the Government of India has planned to develop a “One Nation, One Health System” to offer a unified Health Care System with all the possible advantages of every system of medicine. Regarding such a plan, a well-designed Integrative Medicine Protocol for various diseases is the need of the hour. This approach to health care should be implemented after a thorough review of the situation, which may come across as a hurdle. A single healthcare system will allow for better outcomes and potentially improve the country’s quality of health care.
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“One Nation, One Health System”: The need, the challenges, and the way forward p. 26
BS Prasad
DOI:10.4103/jras.jras_149_22  
Change is inevitable with time. When change happens, the needs, attitude, behavior, habits, etc., will also change. The same is the case with medical practices also. The public is well aware of the strengths and limitations of each medical system and is willing to accept multisystem or integrated systems of approach for their health needs. It is our duty to identify the strengths and limitations of each medical system and to complement the weakness of one system with the strengths of the other system. We aim to provide a holistic approach to alleviate suffering. It can be said that an ailing person is ready to seek advice irrespective of “pathy” or qualification and accepts medical pluralism, including advice from folk practitioners or tribal practitioners. In this method, where the patients seek pluralistic medical advice, there is a waste of time and money in consulting different systems. Also, there are chances of overdosage or synergetic or antagonistic actions of medicines. Unified medical practices that provide all types of medical services at one contact point ensure the utilization of the strengths of all medical systems at the same place, which would ultimately benefit patients. The unification or integration of medical practice needs to be done at a multilevel, and the medical systems should also be available as parallel services. The broad avenues of integration are at the practice level, medical education, and research. Integration is the key to having a patient-centric approach. The integration of medical systems has difficulties but is not impossible. Coordinated, collaborative, and accessible health care is inevitable in a patient-centered approach. Medical professionals from different systems must align their vision and values to benefit patients by crossing pathy barriers with openness. With unified medical systems in the “Indian Health Care System,” India can advance to be a global leader in the healthcare sector.
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Scope and implementation strategies to streamline medical pluralism in the contemporary healthcare system p. 30
Sanjay Pattanshetty, Maddur D Venkatesh
DOI:10.4103/jras.jras_144_22  
Medical pluralism in the healthcare system can play a significant role in achieving desired health outcomes. Harnessing the capacity and competency of diverse human resources, effective utilization of available healthcare infrastructure, international cooperation, leveraging partnerships among public and private healthcare sectors in health services, and research and development are key strategies to develop and explore further. Following the guidelines and recommendations of the World Health Organization, traditional medicine strategy can be helpful to translate and contextualize the implementation strategies to streamline medical pluralism in the current healthcare system.
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“Integrative Health System” beyond “Integrative Medicine”: A health system research perspective for “One Nation, One Health System” p. 35
Ritu Priya
DOI:10.4103/jras.jras_146_22  
One Nation, One Health System has many dimensions, and an inclusive Integrative Health System is one of the overarching and cross-cutting approaches to attain it. This paper discusses the imperatives for creating an Integrative Health System that incorporates AYUSH and Allopathic knowledge traditions. Since Integrative Health System is a term diversely understood and used, the need to conceptualize it and come to a shared understanding is highlighted. The paper brings insights and tools from a Health Systems perspective to suggest conceptualizing an Integrative Health System framework. It proposes that the IHS has three components— Integrative Medicine, Integrative Public Health, and an Integrative Health Care System. After discussing these components, the paper moves on to the Health Systems Research required for designing an Integrative Health Care System. The Complex Adaptive Systems approach is considered appropriate and explained. An illustration is provided from a study conducted to study the role and status of Ayush services and Local Health Traditions in the Public health system. Inferring conclusions from the study mentioned above and similar studies undertaken by the author, few illustrative inputs regarding Integrative Health Systems are provided, which would adequately support an ecosystem that allows interaction and dialogue between systems. It is postulated that this requires a shift in thinking from the dominant positivist paradigm to a critical holist paradigm.
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One Nation One Health—Journey of a Nation to equipoise health and disease p. 42
Chhaju R Yadav, BG Resmi, Sanjeev Sharma
DOI:10.4103/jras.jras_142_22  
Being a developing country, India has faced many challenges since freedom concerning the economy, health, and education. Providing healthcare facilities to all strata of society was a monumental task. By formulating National Health Policy in 1983, India took its first initiative in this context. Timely revision of the policy in 2002 and 2017, according to the requirements and implementation of many national healthcare programs, has enabled it to advance in the healthcare system. India now aims at bringing uniformity in the healthcare facilities provided by the government to all the people anywhere in India at minimal expenditure. In this regard, universal health coverage has been introduced as a part of the Ayushman Bharat Yojana to reduce the cost of treatment to patients. Slowly, India is heading toward sustainability in terms of quality health care assessible to all sectors of society. To bring uniformity of health care by integrating different healthcare systems according to the choice and needs of the patients, with minimal financial burden and compromise in quality, the “One Nation, One Health System by 2030” agenda has been introduced. Here, the formulation of the National Health Policy and its timely renewal and the role of Ayurveda in achieving its goals have been discussed.
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One Nation, One Health System integrative policy: Blending wisdom of ancient and contemporary health sciences p. 47
Chandrakant Katiyar, Sunil K Dubey
DOI:10.4103/jras.jras_148_22  
Convergence of Ayush/traditional medicines with modern medicines by bringing into effect integration of the two or more systems is the way forward for developing holistic healthcare systems throughout the country, based on the concept of the One Nation, One Health System. Adopting schemes, programs, and strategies for bringing about changes in the education system and medical practice, along with ensuring their implementation at each stratum, will aid in unifying the healthcare systems. Given the existence of medical pluralism in India, it is the need of the hour to amalgamate our ancient traditional knowledge and contemporary medicine to build a system wherein both work in unison to promote good health and confer protection from various diseases and make provision for their management in the best possible manner. The current article discusses the requirements and probable impact of developing such system.
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Approach to seeking global recognition for Ayurvedic medicines p. 56
Anil Jauhri, Deepika G Gunawant
DOI:10.4103/jras.jras_150_22  
India is negotiating free trade agreements (FTAs) with several countries like the UK, Canada, European Union, and so on; one of the aims of these FTAs is more and easier access to Indian products. Ayurvedic medicines by themselves and especially given the COVID pandemic, which brought to the fore the importance of traditional medicines, represent one sector that needs to be taken up in these negotiations for access to trading partner markets. This paper is an attempt to present an approach to gain recognition of Ayurvedic medicines under FTAs and how it can facilitate easier access.
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Integration of Ayush within national health care systems: Challenges and the way forward p. 59
SP Thyagarajan
DOI:10.4103/jras.jras_166_22  
The utilization of traditional knowledge is crucial for achieving universal healthcare, according to the World Health Organization (WHO) Traditional Medicine Strategy 2014–23. The Indian systems of Medicine—Ayurveda, Yoga, Unani, Siddha, and homeopathy (Ayush)—have been projected to play a significant role in universal healthcare due to the emphasis placed on preventive and promotive health, their reasonable cost, low level of technological input, and the rising popularity of naturally derived plant-based products. These systems are being recommended for inclusion in national public health policy. Traditional Medicine (TM) is being used more frequently, which has raised questions regarding its safety and toxicity potential, such as hepatotoxicity. Thus, under the Department of Ayush’s vision and mission-2030, it is intended to develop scientific evidence in Ayurvedic principles and drug therapies by integrating ancient wisdom with modern technology and to bring Ayurveda to the people through innovations related to diagnostics, preventive, promotive as well as treatment methods and introduce scientific research for sustained availability of quality natural resources, to translate them into practical applications as modern science solutions for ensuring international acceptance of Ayush systems and their integration into National Health System and Modern Medicine, achieving the goal of One Nation, One Health System. Ayurvedic biology, standardization through chemobiological fingerprinting, chemobiological assays, and Pharmacovigilance studies of herbal medicines are suggested.
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One nation one health—Preview through Ayurveda p. 65
Ravi Dhaliya, Bal Krishan Kaushik Sharma, Gagan Singh Dhakkad
DOI:10.4103/jras.jras_137_22  
For many years, the definition of “health” has remained untouched as a narrow concept, encircling physical well-being from a medical context. Over the past years, different healthcare experts, whether groups or individuals, have developed and defended various definitions of what a proper state of “health” actually means in the present time. Human health cannot be separated from the health of our total planetary biodiversity in today’s world. Human beings live in an interdependent existence with the totality of the living world. We now know how liable our human well-being is to the “health” of the Earth’s energy exchange systems. The sustained good health of populations, along with the holistic approach to health and diseases, also requires a proper management of our social resources, economic relations, and the natural world because today’s public health has its roots in the same socioeconomic variations. India is known for its own traditional medicine, far older than modern medicine, with a state-owned education, practice, and research system. The world has recently recognized science’s efficacy in health and wellness. Ayurveda is not limited to medicine or therapy for a target organ; instead, it implies a holistic approach to life and living in harmony with nature. Ayurveda perceives human beings as the microcosm of the macrocosm and highlights how human life is interconnected and interdependent on nature. In achieving health, it always stresses this connection and uses strategies connecting humans to nature. Ayurveda practices assist individuals in taking control of their health and increasing self-reliance, and re-begin their relationship with the environment. Thus, Ayurveda can play an essential part in the One Nation, One Health System as the whole wellness of a nation and environment rather than individual health.
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The prospect of an integrated approach to One Nation One Health policy—Cancer treatment as a potential case p. 69
Sunil K Joshi, Ashutosh Chauhan, Deepak K Semwal
DOI:10.4103/jras.jras_155_22  
Today, every medical system in India is working unconnectedly without associating with one another. Moreover, many lifesaving procedures and medications are not affordable and easily accessible. Hence, the concept of One Nation One Health is a wonderful idea to improve the healthcare sector in India. The present article highlights selective ideas to make the One Nation One Health policy more effective, with a particular focus on cancer treatment. The relevant articles and books based on this theme were reviewed, and their crucial information was included in the present article. In the current scenario, when healthcare facilities are not easily accessible, mainly in rural areas, the One Nation One Health policy should be implemented strongly. The integration of modern and traditional systems of medicine can be more effective in treating diseases, including cancer, because of own strengths of each medical system.
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