Transforming Ayurveda Via Research

Nepal's Ayurveda sector is facing significant challenges, despite neighbouring countries making substantial investments in traditional medicine. India recently increased its alternative medicine budget by 14.15 per cent, bringing it to $462 million for 2025-26. Similarly, China has allocated $7.28 billion since its 13th Five-Year Plan (2016-20) for traditional Chinese medicine projects. In contrast, Nepal dedicates less than 1 per cent of its health budget to complementary and alternative medicine.

The lack of government support for Ayurveda is glaring – look at how the Singha Durbar Baidya Khana, once a proud institution, is unable to produce even basic medicines. The frequent leadership changes at Nardevi Ayurvedic Hospital with each government show the deep politicisation of the sector. Our ancient traditional knowledge and indigenous healing practices are poorly documented and unpreserved, and many medicinal plant species are on the verge of extinction.

The private sector receives minimal government support, and the lack of postgraduate education opportunities after a bachelor's degree forces aspiring Ayurvedic practitioners to either switch careers or seek education abroad. What's worse, there's no real national commitment to develop this sector – no vision, no concrete plans, nothing. Whether it's ministers, secretaries or politicians, Ayurveda seems to just stay in fancy speeches, grand promises and yearly reports. Evidence-based practice and research activities seem a far-stretched thing in this sector. The list of problems in the Ayurveda sector can be exhaustive, and there is no single pill for these problems. But Nepal’s Ayurveda sector needs a detailed roadmap for the next decade – one that ensures a complete modernisation of the sector.

Ayurveda research

Research is one such tool that can play a vital role in modernising the Ayurveda sector and can elevate Ayurveda from dusty backroom clinics into Nepal's mainstream healthcare system. Nepal's research infrastructure, though existing only on paper, tells a story of missed opportunities. The Nepal Health Research Council (NHRC), the apex body for health research in Nepal, also operates under a mandate to promote Ayurveda within the national health system. However, when the NHRC recently advertised for vacant positions, it offered only one position for Ayurveda researchers, requiring a Ph.D., while providing multiple positions for bachelor's and master's degree holders in other medical fields. Ironically, Tribhuvan University offers only one postgraduate programme in Ayurveda with a single annual intake, let alone a PhD.

Another institution, the National Ayurveda Research and Training Centre (NARTC), established in 2012 with Chinese government funding, was envisioned as a state-of-the-art centre for Ayurveda research in Nepal. Its primary role is to promote health research and training activities within the Ayurveda community. While the centre has made quite some progress by offering short-term training and providing basic health services to the public, it has significantly underperformed in its core mission, with barely double-digit research projects and few completed clinical studies. While a lack of funding and inadequate resources have certainly played a role, the deeper issue lies in its governance. NARTC operates under the Development Committee Act, which means it is not an autonomous body and should perform under the Ministry of Health and Population (MoHP). Ironically, it has its own independent frameworks and guidelines which are not endorsed by the MoHP. For example, NARTC has published its own guidelines for conducting Ayurveda research that is a parallel version of the National Ethical Guidelines for Health Research in Nepal 2001 (Revised 2022 A.D.) published by NHRC. Similarly, research and training programmes conducted by NARTC lack a clear framework and objectives. Despite an O&M survey conducted in 2014 to recommend 180 research officer positions at NARTC, these vacancies remain unfilled to date. As a result, young Ayurveda doctors and research enthusiasts face limited opportunities in the country and are discouraged from pursuing research careers.

Other major research institutions also have a similar outlook towards Ayurveda. Bodies like the Nepal Academy of Science and Technology (NAST), the Department of Plant Resources (DPR), the Nepal Agricultural Research Council (NARC), the University Grants Commission Nepal (UGC Nepal), the Central Department of Botany, and others have been conducting surveys and studies on medical plants, indigenous healing practices and local herbal formulations, among others. However, they often overlook the Ayurvedic perspective and rarely collaborate with Ayurvedic institutions. This lack of multi-sectoral cooperation limits the application of research findings on a large scale. For example, the language barrier with classical Sanskrit texts might affect how effectively we can use reverse pharmacology in Ayurvedic drug development.

Complementary and alternative medicine research has seen significant progress worldwide. India has entered a ‘new era of Ayurveda research’ with the establishment of a WHO Global Traditional Medicine Centre (GTMC) in Gujrat. India has led the forefront in standardising AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy) systems through benchmark practices and international disease codes and has demonstrated how traditional concepts like Prakriti (body constituent) can be studied using modern scientific methods such as genomics and metabolomics. Countries like China, Japan, South Korea, and Thailand host WHO Collaborating Centres for Traditional Medicine. The USA, through NCCIH, and Australia, through various university-based research institutes, conduct rigorous studies in the field of integrative and complementary medicine. In these countries, practices like yoga, tai chi, chiropractic therapy, mindfulness meditation, acupuncture and remedial massage are becoming more widely accepted as part of healthcare. These examples show the untapped potential of Ayurveda in Nepal when it is approached with modern and scientific methods.

Currently, NARTC mostly operates as an Ayurveda health service provider. Bodies like NARTC should be restructured into an apex and autonomous body within the Government of Nepal and not limited to functioning under the Ministry of Health and Population. In India, the Central Council for Research in Ayurvedic Sciences (CCRAS) serves as a leading authority that conducts and promotes Ayurveda research. NARTC should be restructured as an independent autonomous entity and be guided by its own act and by-laws. Such an effort will enable NARTC to recruit required human resources, collaborate with national and international institutions, resolve budgeting issues, and conduct research and training activities.

Holistic healthcare

Research activities in medicinal plants and traditional health systems should be streamlined across the country. There is no central registry of the research activities, funds and grants disbursed across any levels under the banner of herbs, medicinal plants and traditional medicinal systems. To address this issue, it is crucial to ensure that a central registry is being maintained for any studies in complementary, alternative and traditional medicine and their fundings, and Ayurveda practitioners are involved in decision-making processes. NAST, NARC, DPR and other research academies should include representation from Ayurveda practitioners to ensure that funding is directed toward meaningful and impactful research in traditional health systems. A common consultative forum should also be developed among NARTC, NHRC, NAST, NARC, DPR and other research activities to prepare key priority areas for research in Ayurveda.

Nepal has also signed several agreements to promote traditional medicine research, but a lack of institutional memory has led to poor follow-up on these commitments. The Memorandum of Understanding (MoU) with India, signed on November 25, 2014, aimed to enhance cooperation in traditional medicine by recognising pharmacopoeia, exchanging experts, and supporting research and training programmes. However, its implementation has been weak, with the Department of Ayurveda and Alternative Medicine (DOAA) failing to fulfil its role. Similarly, in 2019, Nepal signed an MoU with China on traditional medicine cooperation but has taken no meaningful steps since. The government must revisit and revise these commitments, ensuring that Nepal actively engages in international collaborations to strengthen research and development in traditional medicine.

There is always a question regarding the safety and efficacy of Ayurvedic medicines. In Nepal, many non-classical Ayurvedic formulations receive licenses without any accompanying clinical studies. While safety provisions exist, there is no mandatory requirement for Ayurvedic medicines to prove effectiveness, allowing companies to bypass the rules simply by classifying their formulations as Ayurvedic. The Department of Drug Administration (DDA) attempted to tighten regulations in 2018 by requiring compliance with WHO Herbal Good Manufacturing Practices (GMP) and Certificate of Pharmaceutical Product (CPP) guidelines, but the fundamental issue of effectiveness is still unaddressed. Mandatory clinical trial studies for proprietary Ayurvedic formulations will enhance their credibility, ensure patient safety, and drive greater research and development in traditional medicine.

The government should also invest in capacity-building programmes for available manpower and aspiring scholars in Ayurveda. Tribhuvan University's Ayurveda Campus in Kirtipur has made efforts to include research subjects in the Bachelor of Ayurvedic Medicine and Surgery (BAMS) curriculum, but it concentrates more on theoretical aspects. Moreover, the campus and its teaching hospital lack the infrastructure and resources necessary for conducting research activities. The existing BAMS curriculum varies across universities, lacks standardisation, and lacks essential features of medical education, such as problem-based learning and scenario-based learning. To address these issues, the Nepal Ayurveda Medical Council (NAMC) should enforce a common standardised curriculum across universities, ensure adequate infrastructure in Ayurveda colleges, and revise the curriculum to balance modern medicine and Ayurveda components. The curriculum should emphasise developing research and critical analytical skills among graduating Ayurveda practitioners. Research training should be conducted for Ayurvedic practitioners in both the public sector and private practice, encouraging them to document and report not only successful case reports but also any adverse drug reactions. Research requirements for academic promotion in Ayurveda institutions should follow similarly stringent rules as those applied to allopathic medicine. The evaluation criteria must prioritise quality over quantity, explicitly excluding publications in predatory journals. The UGC and universities must provide Ayurvedic colleges with research infrastructure, funding opportunities, training, and mentorship programmes.

Ayurveda can be redefined not just as a legacy of the past but as a vital component of Nepal's future health system. This will require coordinated efforts between the government, medical professionals, researchers, and public health advocates to ensure that Ayurveda is scientifically validated, effectively integrated, and widely accessible. Without modernisation, Nepal's Ayurveda sector may find itself with a chronic disease that cannot be cured.

(Regmi is a consultant Ayurveda doctor and researcher. Acharya is an Ayurveda practitioner based in Australia.)