India: A leading destination for wellness tourism

We have been changing our focus from health care to wellness. Wellness is relatively new concept and has been defined as healthy balance of mind, body and spirit that results in overall feeling of well - being. In other words, wellness is a feeling.

India provides enormous possibilities for wellness seekers. India’s traditional wisdom not only offers a remedy of illness but provides complete wellness feeling. India once known for affordable quality healthcare because of quality of medical knowledge and affordable pharmaceuticals, is now going to be a leading wellness destination. India is taking all steps to make it a preferred destination for wellness tourism, wellness being an integral part of the Indian way of life. 

Wellness centres are no longer unregulated but regulated. The quality standards are specified.  The accreditation of such centres is a symbol of quality service. The National Accreditation Board Hospitals & Healthcare Providers (NABH) in consultation with AYUSH has developed the standards for wellness centres. NABH is the constituent of Quality Council of India (QCI). QCI is a non-profit organization mandated to develop mechanism for an independent third-party assessment of products, services and processes.

The Government of India supports the establishment of AYUSH Health Wellness Centres (AHWCs) under national AYUSH Mission. Many AYUSH dispensaries / sub health centres have been upgraded as AHWCs.

The wellness products, including those certified by AYUSH, often incorporate natural ingredients and traditional practices to support various aspects of health, from physical and mental well-being to specific conditions. 

Ayurveda is India’s ancient wisdom which focuses on balancing mind, body and spirit through diet, life style and herbal remedies. The present article concentrates on herbal remedies.

Herbal medicines are part of Ayurveda and even they have been used as home remedies. These include herbs, herbal materials, herbal preparations and finished herbal products: Herbs. Herbs include crude plant material such as leaves, flowers, fruit, seeds, stems, wood, bark, roots, rhizomes or other plant parts, which may be entire, fragmented or powdered. Ayurveda is in practice for almost from the existence of human civilization.

Wellness has several dimensions: physical dimension, intellectual dimension, emotional dimension, social dimension, spiritual dimension, vocational dimension, financial dimension, and environmental dimension. Physical dimension means caring for individual’s body and staying healthy now and future.

The government has established National Ayush Mission to establish a holistic wellness model through Ayush health and wellness centres focusing on preventive and promotive health care based on Ayush principles and practices, to reduce the disease burden and out of pocket expenditure.

The government proposed to operationalise 12,500 health and wellness centres under Ayushman Bharat in a phased manner from year 2019-20 to 2023-24. India has always been known for its rich heritage of ‘Wellness’ traditions and has enormous possibilities to offer to ‘Wellness’ seekers. The Indian ‘Wellness’ industry is one of the fastest growing segments of the travel and leisure industry. India has the potential to become a leading ‘Wellness’ destination for the global travellers.

Medicinal plants are the raw materials for herbal remedies. The government of India has initiated several steps to farming conservation, processing and promotion of medicinal plants. Botanical survey of India (BSI) is the Nodal Agency mandated for survey of plant diversity of the country; its documentation, including traditional knowledge associated with it at National, Regional, State and Ecosystem level and its conservation in different parts of the country has been carrying out survey and documentation of all plant resources of the country including medicinal / aromatic plants and herbs.

The survey is the nodal repository for Reference Plant Collections and at present houses about 3.2 million specimens in its different herbaria, which help in taxonomic characterization and monitoring of species, including medicinal plants. This helps in identification of medicinal plants.

There have been many confusions throughout the world on authentic identification.  BSI conserves medicinal plants in its botanical gardens, located in different Phyto-geographical regions of the country.  Ministry of Ayush had supported 56,305-hectare area for cultivation of medicinal plants throughout the country from the financial year 2015-16 to 2020-21 under National Ayush Mission (NAM) scheme. The government supports cultivation through providing subsidy.

National Medicinal Plants Board (NMPB) established and functioning under Ministry of AYUSH is mandated to promote cultivation of medicinal plants. This integrates cultivation of herbs into farming systems. This has overcome the practice of gathering medicinal plants from wild origin like forests contributing to unreliability and unsustainability.

In order to promote quality, safety and efficacy, the NMPB has introduced guidelines, India specific guidelines on Good Agriculture Practices (GAPs) on the pattern of Good Agriculture and Field Collection Practices (GACPs) developed by the World Health Organization (WHO) for medicinal plants.

GAP covers cultivation of medicinal plants in sustainable manner and maintaining quality of produce by all stake holders. GACP is a cultivation programme to ensure optimum yield in terms of quality and quantity of any crop intended for health purpose. 

The narrative includes: site selection, soil condition, seeds and propagation materials (seed, stem cutting, root cutting), crop management (field preparation, sowing and transplantation, manures and fertilizers,  irrigation, weeding and intercultural operation, crop protection), harvest and post-harvest management (harvesting, primary processing, packaging, storage and transportation), identification and traceability (identification, and traceability), personnel and equipment, workers health, safety and welfare (risk assessment, training, hazards and first aid, protective clothing and equipment), and record keeping and internal self-assessment / internal inspection. Check list for internal assessment is given in Good Agricultural Practices.

In addition, NMPB has also developed standard for Good Field Collection Practices for Medicinal Plants.  This standard covers Good Field Collection Practices for wild medicinal plants in sustainable manner and maintaining quality of produce used by all stakeholders. 

The standards for collection practices includes: site selection, compliance and regulatory requirements, harvest / collection management, environmental considerations, social considerations, post-harvest management, packaging and storage, machinery and equipment used in different operation, documentation for identification and traceability, training and monitoring, workers health, safety and welfare, training on health and safety, hazards and first aid, record keeping and internal assessment / internal inspection. The check list is also developed with critical, major and minor categories.  

The development of herbal remedies begins with standardization of raw materials. The country has made mandatory Good Manufacturing Practice through schedule T implementation of Drugs Rule. Schedule T specifies the requirements of factory premises and hygienic conditions.

The main aim of introducing Schedule-T is to maintain a uniform standard of hygiene for the manufacturers. Compliance to Good manufacturing Practices is mandatory for all the manufacturers of ASU drugs. This is another testimony of quality herbal medicines.

On line with adverse reaction monitoring of modern medicines, the country has adopted and implemented “Pharmacovigilance programme for Ayurvedic, Unani, Sidha and Homeopathic Medicines”. The safety monitoring of traditional medicines started as early as in 2008.

The current programme is known as Pharmacovigilance of Ayurveda, Siddha, Unani and Homeopathy (ASU&H) medicines. All India Institute of Ayurveda (AIIA), New Delhi, an autonomous institute of Ministry of AYUSH, is the National Pharmacovigilance Coordination Centre (NPvCC). There are 99 peripheral centres across the country.

Wellness being an integral part of the Indian way of life, the country offers a wide range of opportunities for wellness seekers. Wellness tourism is the country’s focus. India has been supporting under marketing development assistance scheme to wellness service providers. Under the scheme, the wellness service providers include wellness centres besides SPAs and others.

The medical tourism combines with wellness tourism to provide better service. The scheme is administered by the Ministry of Tourism.    The Ministry permits the use of Incredible India brand in their promotional activities.  Incredible India is one of the most recognised brands internationally. It provides even the financial support for skill development of people working for medical and wellness tourism.  

There have been quality assurance procedures from cultivation of medicinal plants (herbs) to their use to ensure the safety and efficacy products. Quest for healthy and long life are perhaps as old as human existence.

Ayurveda, ancient medical knowledge, is a science of life. It is a holistic science aims to provide complete wellness, not just healthcare. Herbal remedies have been accepted as most promising wellness products. India has projected itself as destination for wellness tourism.

Re-emphasizing India’s strength, Prime Minister, Narendra Modi, has said “India is a treasure trove of herbal plants, it is, in a way our Green Gold”. People can trust India’s herbal remedies and wellness services.