“Sharing innovations of Traditional medicine for a Holistic Cure “ Dr Deepika Gunawant Medical Director –Integrative Medicine Max Ventures , New Delhi 10th Knowledge Millennium Summit January 16th 2013 , Vigyan Bhawan I would like to thank you all for participating inthis lively discussion and special thanks to ASSOCHAM for arranging this summit . Being an expert in Ayurveda my talk and presentation will focus on how innovations in traditional care can be sued for an improved model of health care delivery .

Innovation – what it means Being innovative does not always mean Inventing Innovation can mean changing and adapting to changes in the environment to deliver better services ( health services ) Innovation generally refers to renewing , changing or creating more effective processes ,services or ways of doing things Innovation is a better or new novelty that is useful and valuable to people . Innovation is an ongoing process In today’s fast paced and increasingly complex world , medical science and the evolution of unique models for health care are bringing us closer to truly personalised medicines . Medical science has primarily evolved over the years due to revolutionary changes in allied health sciences and diagnostics. And this has acquired as much importance as the treatment itself . The trend is moving towards highly specialized care that doesnot compliment the doctor patient relationship and personalised treatment . So let me start by doing a recap on what is INNOVATION all about .

Innovation – four attributes Must haves from innovation - ( Marshal McCluhen) Enhance something and be simple Destroy or unseat something old Restore something we feel we have lost Reverse into their opposite overtime ( anti innovation

Innovation –4 ways to grow Make something new ( may be a new Integrative model of health care ) Make it in a new way (Traditional medicine as EBM ) Sell it to someone new ( International appeal to our Traditional concepts ) Acquire innovation – buy and learn from others Acquire – learn from other models created around us for a better health care delivery system

Why Innovation ?

Present healthcare system – challenges Aging population , rapidly increasing costs of healthcare and growing burden of chronic diseases are all challenges to the health care systems in both developed and developing countries . Growing interest in both the primary prevention of Chronic illness and in better management of those with existing chronic illnesses To meet these challenges will require new approaches to healthcare delivery and comprehensive population management

Statistics - Chronic illness Some statistics - 60% of all deaths worldwide (25 million people ) are due to chronic illness - Chronic illnesses will have a huge economic impact in the next ten years $ 237 billion of costs as well as loss of productivity in India ,$ 558 billion in China and $ 33 billion in UK Chronic illness in the US accounts for 75% of the $ 2.4 trillion of healthcare expenditure PUBLIC HEALTH REVIEWS JOURNAL - INNOVATIONS IN US PUBLIC HEALTH DELIVERY

Some facts The best selling drugs of today are those that treat Obesity ,Type II Diabetes and high levels of Cholesterol . The model is still based on people responding once they have entered a “DYSFUNCTIONAL STATE “ To get people to transition between less healthy diets and lifestyles to more healthy ones requires more than just pointing out the direction they should move in

WHO recommendations on TM SIXTY-SECOND WORLD HEALTH ASSEMBLY WHA62.13 Agenda item 12.4 22 May 2009 Traditional medicine Recalling the Declaration of Alma-Ata which states, inter alia, that “The people have the right and duty to participate individually and collectively in the planning and implementation of their health care” and “Primary health care relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team and to respond to the expressed health needs of the community”; Noting that the term “traditional medicine” covers a wide variety of therapies and practices, which may vary greatly from country to country and from region to region; Recognizing traditional medicine as one of the resources of primary health care services that could contribute to improved health outcomes, including those in the Millennium Development Goals; Noting the progress that many governments have made to include traditional medicine into their national health systems;

Innovation in health care Practitioners must view people through a wide lens in which multiple factors are assessed including – Physical health ,Home life , Mental health , Emotional well being , social interactions and spiritual contentedness . An imbalance in one or another area of life leads to a breakdown in another area . Practitioners should work as coach or partner - helping the patient to tap into their hidden powers of healing .

Integrative Medicine (IM ) For me INNOVATION means integration and bringing together all those modalities that can add value and improve health and quality of life

Integrative Medicine In an ideal non-biased and non political society perhaps “ Integrative medicine “ is the term that can be used for the complete health care system From a users point - integration means healthcare that is seamless ,smooth and easy to navigate Many permutations of integration from users and providers perspective are possible

Why Integration - Core values Every individual has the right to healthcare that: Provides dignity and respect Includes a caring therapeutic relationship Honors the whole person - mind, body, and spirit Recognizes the innate capacity to heal Offers choices for complementary and conventional therapies

Holistic Healing True Holistic healing transforms and improves quality of Life This can be achieved only once it is aligned with the philosophy that the mind ,body and spirit must be well for TOTAL HEALTH The techniques used within the holistic care program are often considered addition to valuable care that the person is already scheduled to receive The treatment augments ,it doesn’t replace

Some examples of integration to show innovation

Integration - Study Clinical and cost outcomes of an integrative medicine - Independent Provider Association (IPA ). Analysis of clinical and cost outcomes on 21,743 member over a 4-year period demonstrated decreases of 43.0% in hospital admissions , 58.4% hospital days ,43.2% outpatient surgeries and procedures - all per 1000, and 51.8% pharmaceutical cost reductions when compared with normative conventional medicine IPA performance In the limited population studied, PCPs utilizing an integrative medical approach emphasizing a variety of CAM therapies had substantially improved clinical outcomes and cost offsets compared with PCPs utilizing conventional medicine alone.

Integration – Diet, Lifestyle and Counselling Archives of Internal Medicine 23,000 people were studied for adherence to 4 simple behaviours – Not smoking ,Exercising 3.5 hours a week , Eating a healthy diet and Maintaining a healthy weight (BMI <30 ). In those adhering to these simple behaviours - 93% of diabetes ,81% of heart attacks , 50% of strokes, and 36% of all cancers were prevented .

Integrated treatment - Alzheimer’s Prescription medicine that increases certain chemicals in the brain Antioxidants - herbal supplements Changes in lifestyle ( such as walking programs and relaxation training ) to reduce anxiety and improve behaviour Music therapy Dietary recommendations

Integrative oncology Recognised Potential of TM to enhance body’s immunity and to promote quality of life and even in some cases tumor suppressing activities Integrative oncology focuses on the complexity of health issues centered around cancer patients and the coming together of multitude of approaches /modalities along with the conventional therapies of surgery ,chemo ,radio to facilitate health

Fibromyalgia- yoga Yoga and fibro myalgia (Oregon Health and Science University ) Standard medication Yoga with gentle poses Meditation Breathing exercise Group discussion Assists in combating serious fibromyalgia symptoms like pain,fatigue ,stiffness, poor sleep, depression ,poor memory ,anxiety and poor balance

Researched Herbs Reservatrol – shows potential for blood sugar control Human study ,India ) Psyllium - bulk fiber laxative ( high fiber content ) Fenugreek - fenugreek dietary fiber on blood and serum glucose Cinnamon -consumption of 3 gms in a day may improve people’s control of blood glucose levels ( Scandinavian study ) Ginger – Increases uptake of glucose into the muscle cells Amla – Diabetes and its complications like cataract ( AR inhibitor ) Curcumin – linked to reduced risk of Type 2 Diabetes Gymnema sylvestra –stimulates insulin secretion (UK study )

Innovation that is WELLNESS The traditional holistic concepts in a new form According to the US National Wellness Institute (NWI), wellness is: “an active process through which people become aware of, and make choices towards, a more successful existence”. All dimensions of Wellness - inextricably woven in the concepts of AYURVEDA ( dinacharya, ritucharya , nidan-parivarjanam , sattvavajaya and rasayana chikitsa ,Ahara ,Agni ,Panchakarma etc )

Challenges to successful integration develop appropriate healthcare teams that function well in a clinical setup developing an understanding of the diverse healing traditions with cultural differences Administrative and regulatory issues Looking for Evidence and enhancing of communication skills.

Innovation model Successful model to be reviewed With the healthcare landscape changing continously there is no shortage of innovation challenges nor opportunities to improve people’s experience of healthcare Finally the role played by the country’s political system and its associated culture ,structural barriers size and resources ,incentive alignment and leadership

Innovation model People focused innovation in health care – patients and care providers Promoting a bold and open attitude to innovation that gives room for each discipline to excel and enjoy the freedom to innovate Carrying out onsite research which supports the belief ,understanding and commitment of multidisciplinary innovation teams .

Innovative methods To cure all chronic and incurable diseases by sharing of innovations in health care using all available modalities like Allopathy ,Ayurveda, Naturopathy , TCM ,Acupuncture ,Kampo etc An opportunity for better health services and education rather than replacement of effective but risky therapy by safe but ineffective therapy A commitment to health-promotion, wellness and disease management.

Innovation From an ignorant skepticism ( reductionist approach ) and uncritical enthusiasm towards a well informed and balanced healthcare systems ( holistic approach )

Thank You