Taskforce 6 Accelerating SDGs: Exploring New Pathways to the 2030 Agenda
Abstract
India is a multicultural space founded on an ancient civilisation, cultural heritage, and spirituality and well-being. Ayurveda is a key part of India’s philosophy of lifestyle and well-being. Indeed, the Indian government advocates for a holistic approach to well-being under the AYUSH[a] programme, which promotes scholarship on Indian traditional medicine systems.
This policy brief proposes a G20-wide framework to explore new pathways to adopt Ayurveda principles to encourage a holistic approach to health and well-being, and equitable and sustainable growth.
1. The Challenge
Ayurveda emphasises the use of natural remedies and a holistic approach to health. The modern quest for a healthy lifestyle has led to a wide acceptance of Ayurvedic and herbal products, creating good market conditions for the herbal sector worldwide.[1] The herbal market comprises various sub-sectors, including medicinal and aromatic plants, herbal medicines, herbal extracts, plant derivatives, and supplements. India’s share in the export of herbal products is 2.5 percent of the total global herbal market, while China has a 13-percent share[2] The global herbal medicinal sector expanded at a rate of 7.6 percent between 2014 and 2019.[3] The global market size of the herbal sector was estimated at US$657.5 billion in 2020 and is expected to reach US$746.9 billion by 2022.[4]
The Indian government has undertaken numerous initiatives through its Ministry of Ayush to promote the use of herbal products. The export value of all Ayush products has increased in recent years and was estimated to be around US$470 million in 2020.[5] India’s trade in Ayurveda products has shown a mixed trend over the last decade, with total trade increasing between 2008-09 and 2011-12 before declining and then picking up again in 2015-16.[6] In 2017-18, the total trade in Ayurveda products was US$150.96 million, representing a 10.3 percent increase compared to 2008-09 levels.[7] However, the share of India’s Ayurvedic products in the global herbal products is negligible, totalling a mere 2 percent in 2022.[8] However, as the global Ayurveda market is expected to grow to US$16 billion by 2026 at a compound annual growth rate of 15.5 percent, there is a great opportunity for India’s Ayurveda exports.[9]
The US, European Union (EU), and the United Arab Emirates are the largest markets for Indian Ayush products, accounting for 59.12 percent of all such exports in 2021.[10] However, there are many challenges to overcome for the Ayush industry to realise its full potential.
A primary challenge is regulations regarding the registration of practitioners and institutes as the Ayush fields are not widely acknowledged or accepted in Western countries as alternative medicine. Additionally, there are certain regulatory requirements that must be met for Ayush products to be sold in the global markets. For instance, Ayurveda products are often marketed and distributed as dietary supplements and not as medicines in the US and EU since these are easier regulations to comply with.[11] Both tariff and non-tariff measures are applicable to the international trade of herbal medicines, which can act as barriers to trade based on government import restrictions. Technical measures, such as sanitary and phytosanitary measures (SPS) and technical barriers to trade (TBT), and non-technical measures, such as non-automatic import licensing, quotas, prohibitions, quality control measures, and other restrictions not including SPS and TBT and price control measures, impact the trade of Ayurveda products.[12]
Product patents and issues related to research and development (R&D) are also significant challenges for Ayurveda. Ayurveda products are often not patented because the medical system is viewed as traditional knowledge, making it difficult to have proprietary rights on the drugs. There is limited funding for R&D in this area, and difficulties in registering the product as a drug in foreign countries makes it challenging to conduct clinical trials. Ayurveda products, especially single herb preparations, can be sold as food supplements or dietary supplements in some countries, but cannot be sold as medicines since Ayurveda is not recognised under the healthcare system.
Another significant challenge for Ayurveda is the lack of available data on the sector, making it difficult to estimate its size, contribution to global GDP, employment potential, and socio-economic impact. Without such data, it is difficult to comprehensively assess the size of the sector, project its future growth, and showcase the sector on global platforms.
Addressing these challenges will require collaboration between policymakers, industry, and other stakeholders.
2. The G20’s Role
In recent years, there has been growing recognition within the G20 countries of the importance of promoting sustainable lifestyles and holistic well-being, and its importance in achieving the Sustainable Development Goals (SDGs).[13]
In addition to its focus on sustainable lifestyles and well-being, the G20 has also recognised the importance of traditional medicine and alternate healthcare. In 2016, the G20 Health Ministers’ Meeting in Beijing issued a declaration stating that “traditional medicine and alternate healthcare practices can contribute to achieving the SDGs and enhancing global health security”.[14] The declaration called for increased R&D in traditional medicine and alternate healthcare, and to promote their integration into national health systems. Under India’s presidency, the G20 held the first health working group meeting in in January 2023, which identified the global demand for integrated healthcare through medical travel and the role of Ayurveda hubs in holistic healthcare service delivery system.[15]
The global demand for holistic well-being has increased in recent years, driven by a growing recognition of the importance of mental health, physical fitness, and healthy lifestyles. Ayurveda has the potential to address public health challenges across the world through evidence-based integrated practices. The World Health Organization (WHO) has called for increased promotion of physical activity and healthy diets, as well as the prevention of non-communicable diseases (NCDs) such as diabetes, heart disease, and cancer for the holistic well-being of individuals. Ayurveda’s focus on lifestyle interventions, such as diet and exercise, has been recognised as an important component of holistic health. A study conducted in the US found that Ayurveda was popular among people seeking to improve their health through lifestyle changes and that its focus on individualised treatment was seen positively.[16] Another study in Germany found that Ayurvedic therapies were effective in reducing stress and improving quality of life.[17] The upgraded International Classification of Diseases by the WHO has included Ayush terminologies to improve the efficacy and safety of traditional medicines, and this has played significant role in globalising Ayurveda.[18]
The demand for biodiversity-based goods and services, including phytopharmaceuticals, has increased globally due to COVID-19, with herbal medicines experiencing higher demand than anticipated.[19] India has been steadily increasing its presence in the global trade of the herbal medicinal sector, with exports expanding from US$0.86 billion in 2017 to US$1.26 billion in 2021.[20] The Ayush industry’s focus on NCDs has created a receptive consumer base interested in alternative healthcare solutions. The industry has the potential to tap into the growing wellness trend, which could drive demand for Ayush products and services.
The popularity of yoga and Ayurveda has increased globally, with several countries adopting these practices in their healthcare systems. Ayurveda has gained recognition as an alternative form of medicine in countries such as Germany, Switzerland, and Japan.[21] At present, there are about 2,000 Ayurvedic retreat centres around the world, out of which about 100 are based in the US. These centres offer training and certification courses to individuals interested in pursuing a career in the wellness industry. India’s traditional medicine legacies have also played a significant role in promoting medical tourism in the country. The tourism industry in India has been rapidly growing, and the promotion of these practices has contributed to the growth of the industry.[22]
As Ayurveda focuses on healthy and holistic living, it could play a greater role in global health. As a forum of the world’s largest economies, the G20 can provide a platform for member countries to discuss and collaborate on issues related to international trade, including the export of Ayurvedic products. G20 member countries can work together to create a conducive environment for the export of Ayurvedic products, including developing standards and regulations that ensure the safety and efficacy of these products.
3. Recommendations to the G20
As a platform of the world’s largest economies that work to promote international economic cooperation and foster sustainable growth and development, the G20 has a crucial role in promoting sustainable lifestyles and holistic well-being. It can do so in the following ways:
- The grouping must form a committee to review the global situation and facilitate the development of national and regional strategies, policies, and traditional systems of medicine. The committee could also set a unified professional standard for their member countries to promote the safe and effective practice of Ayurveda. It must also set international standards for the certification of Ayurveda practitioners and standardised accreditation of Ayurveda education programmes and institutions.
- The G20 should coordinate and direct the key global health stakeholders in the member countries to set norms and standards for the promotion of holistic lifestyle through traditional medicine systems such as Ayurveda.
- The G20 could facilitate the efforts of interested member states in formulating national policies and regulations on traditional, complementary, and alternative healthcare, and promote knowledge sharing and collaboration on the regulatory policies among member states. Essentially, the G20 must encourage a streamlining of regulatory processes in its member countries to facilitate the entry of Ayurvedic pharmaceuticals into these markets.
- The G20 platform could support the capacity building of small manufacturers by promoting business-to-customer sales and distribution channels. These channels will include wholesale distribution companies servicing retail stores, practitioners, mail order companies servicing consumers, online e-commerce platforms, health stores, clinics, daycare centres, and spas.
- The grouping must encourage its member governments to work with industry associations to identify gaps in the data and understand the needs and requirements of the private sector. Data on raw materials and intermediary products will be required to sustain future demand, and will help governments take informed policy decisions.
- The G20 should provide expert and technical support to its member countries to form a monitoring mechanism to ensure product quality and efficacy, an adherence to guidelines and safety standards, and promote information exchange related to Ayurveda practices.
- The grouping could facilitate partnerships among its member countries to promote medical tourism circuits in cooperation with other key stakeholders.
- The G20 must encourage the member countries to invest in technologies, such as artificial intelligence and machine learning, to analyse clinical data and use e-commerce platforms to access more clients and consumers.
Attribution: Anisree Suresh and Dharmarajan Dhanuraj, “Promoting Ayurveda as a Pathway to Holistic Well-being,” T20 Policy Brief, June 2023.
[a] AYUSH is the acronym for Ayurveda, yoga and naturopathy, Unani, Siddha, and homeopathy.
[1] Avvinish Narine, Fatemeh Moazzami Peiro, and Gopesh Mangal, “Globalization of Ayurveda”, International Ayurvedic Medical Journal, 9 (10), 2021.
[2] Narine, Peiro, and Mangal, “Globalization of Ayurveda”
[3] Namrata Pathak and Sanjna Agarwal, Ayush Exports: Regulatory Opportunities and Challenges in Key Markets, (Forum on Indian Traditional Medicine-Research and Information System for Developing Countries, 2023).
[4] Ayush Exports: Regulatory Opportunities and Challenges in Key Markets
[5] Export value of Ayush and herbal products from India from FY 2015 to FY 2023, Statista, 2023.
[6] Confederation of Indian Industry, Ayurveda Industry- Market Size, Strength and Way Forward, 2018, CII.
[7] Ayurveda Industry- Market Size, Strength and Way Forward
[8] Ayurveda Industry- Market Size, Strength and Way Forward
[9] Suhayl Abidi, “Ayurveda: A US$ 10 billion export opportunity,” Trade Promotion Council of India, March 24, 2023.
[10] Ayush Exports: Regulatory Opportunities and Challenges in Key Markets
[11] Ayush Exports: Regulatory Opportunities and Challenges in Key Markets
[12] Mathias Helble and Ben Shepherd, Win-Win: How International Trade Can Help Meet the Sustainable Development Goals (Tokyo: Asian Development Bank Institute, 2017).
[13] G20 2020, G20 Riyadh Summit Leaders’ Declaration.
[14] G20 2017, “G20 Berlin Health Ministers’ Meeting Declaration”, G20, 2017.
[15] G20 2023, “1st G20 Health Working Group Meeting to Commence from 18-20 January at Thiruvananthapuram, Kerala”, G20, January 18, 2023.
[16] Tobias Esch, Gregory L. Fricchione, and George. B. Stefano, “The therapeutic use of the relaxation response in stress-related diseases“, Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 14, no. 2, (March 2003).
[17] Priya Vrat Sharma, Charaka Samhita Chaukhamba Sanskrit Pratishthan Vol I, (Varanasi: Chaukambha Orientalia, 1983).
[18] World Health Organization, “International Classification of Diseases (ICD) 11 For Mortality and Morbidity Statistics”, World Health Organization, 2023.
[19] UNCTAD, “Implications of COVID-19 for Biodiversity-based Products and Services, including BioTrade”, United Nations Conference on Trade and Development, Geneva, 2022.
[20] Ayush Exports: Regulatory Opportunities and Challenges in Key Markets
[21] C. Raja Mohan, “Modi’s Diplomacy: Yoga, Democracy and India’s Soft Power,” Indian Express, December 15, 2014.
[22] “Modi’s Diplomacy: Yoga, Democracy and India’s Soft Power”
