Nasal application of sesame oil-based Anu taila as 'biological mask' for respiratory health during COVID-19.

This article narrates the potential role of sesame oil-based Anu taila for respiratory health and the prevention of COVID-19. Ayurveda recommends the use of sesame oil and A. taila as a part of daily routine (dinacharya) for oral gargling and transnasal application (Nasya) for preventing upper respiratory tract infections. Recent studies on COVID-19 have elucidated the activity of certain fatty acids in restricting viral binding. Based on the evidence gathered from in-silico, pre-clinical, and pharmacological studies as well as references from classical textbooks of Ayurveda, this article infers that the transnasal application of sesame oil and/or A. taila could provide resilience/protection to the respiratory system. It can act as a 'biological mask' to prevent respiratory infections like COVID-19. Detailed pharmacological study can give fuller confirmation of our informed "inference" that A. taila offers a cost-effective intervention for the prevention of COVID-19 like infections of the upper respiratory tract.

India and its pluralistic health system - a new philosophy for Universal Health Coverage.

In this article we attempt to put forth insights into using traditional medicine (TM) systems to achieve Universal Health Coverage (UHC). We discuss the need for reimagining India's health system and the importance of an inclusive approach for UHC. We comprehend the challenges with appropriate use of TM systems and the lessons from international experience of integrating TM systems. We highlight the pathways for better utilization of TM systems for UHC in India.

Medicalisation and Ayurveda: the need for pluralism and balance in global health systems.

The current global economic and biomedical perspectives contribute content, strategy, and values to global health systems, like objectification and competition, which encourage the medicalisation of the system. Medicalisation overlooks our interdependence with other beings, the environment and biosphere. In contrast, ancient health traditions like Ayurveda, derived from Asian cultures, provide knowledge of the human being's composition of five basic states of nature that need to remain in constant equilibrium to ensure health (Svasthya). Asian health traditions encourage values like vulnerability and respect to facilitate an inherent relationship with the internal and external environment. The recent pandemic has revealed the fragile vulnerability in this nexus and the consequences to human health and well-being when that equilibrium is disturbed. Serious deliberations and discussions are needed between the modern economic and the Asian frameworks for healthcare which result in two different approaches to health and to health systems. This debate may encourage the creation of a philosophy and structure for a new global pluralistic health system more aligned to nature. These deliberations need to encourage the discussion of Svasthya (health), Soukhya (sustainable happiness), and the inner and outer ecological landscapes experienced by human beings that can be understood through mindful self-awareness. Global health systems need to evolve in the direction of a different, pluralistic philosophy of health that encourages a 'population's self-reliance in health' through an intimate and integrated connection with nature.

Reimagining India's national health system (NHS).

In the light of the poor performance of the National Health System as a whole, the article argues the case for the urgent re-imagination and recalibration of the roles of legally approved, health knowledge systems. The article suggests that the analysis of ten years' retrospective clinical data (around 100 million records) from the most reputed Allopathic and Ayurveda clinical establishments may serve as a reliable source of information on the actual performance of different knowledge systems. This strategy for evidence generation, argues the author, is perhaps more realistic than analysis of fragmented clinical and preclinical data from trials and experiments. The article also reviews the quality of evidence and societal performance of western medicine during the last 70 years. The plural health seeking behaviour of millions of citizens, suggest that in the 21st century, a creative, functional, reliable form of integrative healthcare is imperative.

'Population self-reliance in health' and COVID-19: The need for a 4th tier in the health system.

The COVID-19 pandemic is straining health systems globally. The current international biomedical focus for disease control and policies fails to include the resource of a population's capacity to be self-reliant in its health care practices. The ancient wisdom of Ayurveda ('the knowledge of life') and Local Health Traditions (LHTs) in India understand that health is about Svasthya, 'being rooted within'; a concept that includes the relationship and balance between the individual, their families, communities and the environment in creating and maintaining their own health. This 'population self-reliance in health' is the focus of the 4th tier in the health system which honours and respects an individual's capacity for self-care and their inherent responsibility to the health system and its values. It encourages the inclusion of this knowledge in the creation of health systems and in the policies that direct them. Research and practice into the 4th tier will provide health systems and policy information into how communities are managing the COVID-19 epidemic. These insights will help in the creation of future health systems that are better aligned to the 'self-reliance in health' of individuals and their communities.

Controversial identities of medicinal plants in classical literature of Ayurveda.

India's medical heritage across its two streams of experiential knowledge viz. the classical (codified) and folk (oral) reveals an incredible range and depth of knowledge of medicinal plants. In the classical stream of Ayurveda, across the period from 1500 BCE to 1900 CE, there is information of more than 12,000 distinct Sanskrit plant names with overlaps across texts. This information is captured in more than 200 texts viz. 6 samhitas, 57 nighantus and 140 vyakhyas. The information about plants has three major dimensions in codified literature viz. morphological description (rupa gnana), pharmacology (dravya guna shastra) and pharmacy (bhaishajya kalpana). The morphological information is however sketchy and wholly inadequate for establishing botanical identity. Thus despite the huge corpus of plant names backed by sophisticated understanding of pharmacology and pharmacy there is the fact of controversial identities of medicinal plants. Why is this the case? The author believes that the gap in morphological detailing is due to the 'experiential' pedagogy of India's health tradition. While knowledge transmission of plants included theoretical propositions and sophisticated logic related to pharmacology, it also assumed an oral, practical and experiential system of learning about the identity of plants through field work. The purpose of this research is to understand the range and depth at which we have understood the problem of controversial identities of medicinal plants, to analyze work done in the field and to propose a Trans disciplinary approach to solve the problem of controversial identities of medicinal plants in Ayurveda.

Health sector reforms for 21(st) century healthcare.

The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.