In a Public Interest Litigation (PIL) seeking Indian Holistic Medicinal Approach, the Delhi High Court has allowed the intervention applications of Patanjali Research Institute and the Indian Medical Association (IMA).

A Division Bench of Acting Chief Justice Manmohan and Justice Manmeet PS Arora has directed the Ministry of Health & Family Welfare and Ministry of Ayush to file their replies within four weeks and has listed the matter for the next hearing on May 13.

The PIL filed by Advocate Ashwini Kumar Upadhyay has sought appropriate writ order or direction to the Centre to adopt the Indian Holistic Integrated Medicinal Approach rather than Colonial Segregated way of Allopathy, Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy in order to secure the Right to Health under Articles 21, 39(e), 41, 43, 47, 48(a), and 51A of the Constitution.

In his PIL, the petitioner has submitted, “On 15.9.2020, in Rajya Sabha on question of availability of doctors per capita, the Minister of State, Ministry of Health and Family Welfare (Sh. Ashwini Kumar Choubey) said that as per information provided by Board of Governors in supersession of Medical Council of India (MCI), 12,55,786 Allopathic Doctors are registered in MCI. Assuming 80% availability, it is estimated that around 10 lakh doctors may be actually available for active service. It gives a doctor-population ratio of around 1:1500 as per current population estimate.”

It has been pointed out in the PIL that as per information provided by Board of Governors in supersession of Medical Council of India (MCI), 3,71,870 allopathic doctors have registered their specialist/post-graduate qualification with Medical Council of India/State Medical Council which gives a doctor-population ratio of around 1:4000 as per current population estimate and on the other hand, World Health Organization (WHO) has promulgated desirable doctor-population ratio as 1:1,000.

The petitioner says that there are around 8,92,829 Auxiliary Nurse Midwives (ANM), 21,51,850 Registered Nurses and Registered Midwives (RN&RM) and 56,644 Lady Health Visitors (LHV) in the Country and there is availability of 1.4 bed per 1000 people.

“Petitioner submits that all these estimates are well below the WHO threshold of 44·5 doctor, nurses and midwives per 10,000 populations whereas the current situation is 20.6 health workers per 10,000 populations. A substantial proportion of active health worker were found not adequately qualified and more than 20% of qualified health professionals are not active”, says the PIL.

It has been further pointed out by the petitioner that around half of the population is living below poverty line and around 70% dwelling in rural areas and 52% of these doctors are practicing in just five States - Maharashtra (15%), Tamil Nadu (12%), Karnataka (10%), Andhra Pradesh (8%) and Uttar Pradesh (7%) and thus, rural Indian areas still remain deprived of medicinal benefits.

“Since the majority of Allopathic Doctors reside in 5 States, thereby restricting the medical benefits of other States by just providing them with remaining 480/o population of doctors. As doctors are confined to a few States but patients reside across India, it has led to introduction of several health care mediators and they are ruining the integrity of Indian health care system as they tend to fetch more money from patients in the name of providing better treatment. This situation is highly un-ethical and illegal as it will deprive the diseased individuals from attaining health benefits due to their inability to pay high health expenses”, the PIL reads.

The petitioner also states that globally, there is 123% per capita increase in deaths from prescription drug overdoses between 2006-2014 and despite of the knowledge of the linkage between antibiotic use and resistance, there is significant worldwide misuse and overuse of antibiotics.

“Around 150 million patients are harmed every year by doctors' errors, the WHO warned, just a few days before celebrating World Patient Safety Day, with which it seeks to raise awareness of ongoing tragedy. … In 2014, Tamil Nadu lost around 200 lives to drug overdose, followed Punjab which saw 186 deaths. It often results in a short-lived treatment of symptom rather than removal of disease. It does not boost immunity. In fact, endless usage of medicines reduces body's responsiveness, thereby rendering them ineffective”, says the PIL.

It has been mentioned in the PIL that many so-called revolutionary medical innovations have in long-run proven to be dangerous causing severe and long-term side-effects but the Centre is not introducing Holistic Integrated Healthcare System.

Furthermore, the petitioner has submitted that his petition is to secure Right to Health guaranteed under Article 21 of the Constitution and the same is also for the benefit of poor, disabled, EWS and socially-economically down trodden citizens.

The PIL reads, “… in spite of huge investment, current health care system of India is not able to meet its standards and benefit Indian population to fight against acute and chronic diseases. Healthcare delivery in India is classified under three categories - primary, secondary and tertiary care. All three levels need to work in a cohesive manner to help delivery of healthcare on all the four pillars.”

It has also been pointed out in the PIL that As on March 31, 2020, there are 2517 at the level of SC is functional in the urban areas of the country and total Sub Divisional Hospital and District Hospitals are 1193 and 810 respectively.

“According to Indian Public Health Standards, there was a 20°/o shortfall in the number of SCs, a 22°/o shortage in the number of PHCs and a 300/o shortfall in the case of CHCs. … As per the Rural Health Statistics 2019-20, total shortfall of rural health care workers is 2,65,551 in India”, the petitioner submits.

It has been mentioned in the petition that as per recent Government data country-wide, there are over 20% vacancies of doctors in the PHCs which do not take into account high levels of absenteeism among doctors and supporting staff.

“Despite government's attempt over the years to popularize Ayurveda, Yoga or Naturopathy Unani, Siddha and homoeopathy practices, the people at large are still inclined towards allopathy treatment both in rural and urban India. Major reason for such preferences is negligence of AYUSH practitioner in providing stand to their medicinal protocol. Number of institutes, training centers, appropriate infrastructure is not up to mark to make people believe in this therapeutic solution”, says the petitioner.

The petitioner has pointed out that modern medicine practitioners have remained confined to their own niche which has restricted them to avail knowledge of other medicinal practices and thereby cannot benefit the diseased individuals by using other therapeutic regimens.

“An Integrated Health System is only solution to achieve sustainable health goal of India. Commonly preferred allopathic medicine is chiefly comprised of approximately 40°/o plant derived components (USDA Forest Service 2021). If allopathic medicine is originally made of constituents of AYUSH then why not, we can accept them directly as part of our regular medicinal support system”, the petition states.

“Our Indian students who are seeking medical education in China have to mandatorily go through with TCM because it is a part of their medical education curriculum (which is not practicable in Indian scenario). Then why not our Indian practitioners are legally permitted to practice Indian medicinal system in India itself. To facilitate this, it should mandatorily be a part of our medical education system”, says the petitioner.

He further urges that integrated medicinal system should be introduced in currently ongoing medicinal curriculum at both educational and practice level, otherwise, a separate curriculum should be launched as MBBS integrated medicine in which both modern and traditional medicine will be a part of same curriculum.

“Myths, lack of knowledge/awareness, biasness of many self-concerned Pharma companies and drug industries are making arbitrary statements against integrated medicinal approach using various platforms in India which had previously also damaged our health care system and is continuing the same, ultimately leading to health crisis”, the PIL submits.

The petitioner has, therefore, requested the Court to direct the Centre to constitute an Expert Committee having experts of Allopathy, Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy to examine Integrated Healthcare Approach of the developed countries and particularly China and Japan.

Cause Title- Ashwini Kumar Upadhyay v. Union of India & Ors.