Traditional, complementary and integrative medicine in public health system: India’s policy experience and strategic insights for BRICS countries

Abstract

Traditional, complementary and integrative medicine (TCIM) is utilized by billions of people worldwide and is increasingly recognized as an important component of people-centred healthcare and universal health coverage. However, many countries continue to face challenges in incorporating TCIM into mainstream health systems through appropriate governance, regulation, research, education, and service delivery. India has progressively developed an institutional ecosystem for integrating traditional medicine into its public health system through Ministry of Ayush, supported by legislation, regulatory mechanisms, research institutions, educational infrastructure, digital health initiatives, and international partnerships. This review aims to identify policy approaches, implementation strategies, and institutional mechanisms used to facilitate the mainstreaming of Ayush and evaluate their potential relevance for strengthening the incorporation of TCIM into health systems in BRICS countries. Drawing upon peer-reviewed literature, government reports, policy documents, and multilateral declarations, the review traces the evolution of Ayush, the institutional and regulatory architecture including the National Ayush Mission, co-location of Ayush services, Ayushman Arogya Mandirs, national programmes, digital health initiatives, research and education reforms, and international cooperation. The review identifies sustained political commitment, dedicated governance, regulation, investment in research and human resource, digital innovation, and international cooperation as potential enablers, while highlighting continuing challenges evidence generation, quality assurance, financing, interoperability, and monitoring and evaluation. Building on these experiences, the review proposes a strategic framework for BRICS cooperation encompassing joint research, regulatory convergence, pharmacovigilance, digital health, academic exchange, and harmonized evidence standards. India’s experience may provide a relevant policy case for implementing the World Health Organization Traditional Medicine Strategy 2025–2034 and advancing evidence-informed, people-centred health systems.