The WHO Traditional Medicine Summit 2025: Global Theater, Domestic Deficit

The WHO Traditional Medicine Summit 2025: Global Theater, Domestic Deficit

DR AAKASH KEMBHAVI MD, PGDMLS, MS (COUNSELING & PSYCHOTHERAPY)

DISCLAIMER: This article represents a personal analysis and opinion based on observations of the current state of traditional medicine systems in India, particularly Ayurveda. It is not intended to judge, criticize, or question the intentions or efforts of individuals, institutions, or organizations working in this field. Rather, it is offered as an honest appraisal of the realities we face today, born from an intense and passionate desire to see Ayurveda preserved, strengthened, and established as a valid, robust healthcare system that can genuinely serve the health needs of people in India and globally.

The concerns raised here stem from deep care for traditional medicine’s future and a belief that acknowledging gaps is the first step toward addressing them. Only through honest reflection can we build the foundations necessary for Ayurveda to fulfill its true potential as a comprehensive healthcare system grounded in both ancient wisdom and contemporary evidence.

For professional transparency: This article was created with the assistance of artificial intelligence (AI) tools, which helped structure and articulate the analysis based on research and documented information about the WHO Traditional Medicine Summit 2025 and the current state of traditional medicine systems in India.

A Critical Analysis of India’s Grand Gestures and Glaring Gaps

The Second WHO Global Summit on Traditional Medicine, held in New Delhi from December 17-19, 2025, was undoubtedly a spectacular affair. With over 500 in-person delegates, 5,000 virtual participants from more than 100 countries, and the adoption of the Delhi Declaration, the summit projected India as a global leader in traditional medicine. Multiple parallel sessions covered everything from research methodologies to integration frameworks, meditation science to regulatory harmonization. The Ministry of AYUSH released the My Ayush Integrated Services Portal (MAISP), the Ayush Mark quality certification, and inaugurated the WHO South-East Asia Regional Office building and Traditional Medicine Global Library.

On the surface, this appears to be a moment of triumph for Ayurveda and traditional medicine systems. However, beneath the veneer of international diplomacy and carefully crafted declarations lies a troubling disconnect between India’s global posturing and its domestic reality. This summit represents not leadership, but rather an exercise in misdirection—presenting to the world a vision of traditional medicine that remains largely unimplemented, unstandardized, and unvalidated within India itself.

The Missing Foundation: Where Are the Stakeholders?

Perhaps the most glaring irony of this global summit is that India—the birthplace of Ayurveda and host of this grand event—has never conducted comprehensive stakeholder consultations within its own borders before presenting its model to the world.

The Ministry of AYUSH, the National Commission for Indian System of Medicine (NCISM), Ayurveda universities, and regulatory bodies have consistently failed to engage meaningfully with the very practitioners, researchers, and educators who form the backbone of traditional medicine in India. There have been no systematic national consultations with:

  • Practicing Ayurveda physicians across diverse settings (urban clinics, rural practices, hospital settings)
  • Faculty members teaching at Ayurveda colleges nationwide
  • PhD scholars and researchers conducting studies in traditional medicine
  • Patients and communities who use or could benefit from Ayurveda services
  • Traditional knowledge holders and vaidyas practicing in communities

While a 2017 symposium organized by Savitribai Phule Pune University brought together about 100 experts to discuss “AYUSH Research for New India,” this remains an isolated event rather than a systemic practice. The recommendations from that consultation—calling for implementation frameworks, capacity building, and evidence generation—remain largely on paper, gathering dust in policy documents.

Contrast this with India’s eagerness to host global summits and present to the international community. We are reaching out to the world, offering frameworks and declarations, while our own house remains fundamentally disordered. This is not leadership; it is performance.

The Research Methodology Charade

Parallel Session 2.A at the summit focused on “Translating the WHO Traditional Medicine Research Roadmap into Global Action,” while Session 2.B examined “Research Methodologies and Applications,” specifically highlighting methodologies aligned with Traditional Medicine epistemologies, including “whole-systems and multimodal clinical trials, transdisciplinary designs and Indigenous methodologies.”

This sounds impressive—until you ask a simple question: How many Ayurveda colleges, universities, or research institutions in India are actually implementing these WHO-recommended research methodologies?

The WHO has long advocated for specific research designs appropriate for traditional medicine systems, including:

N-of-1 Trials

These individualized, multiple crossover trials are considered Level 1 evidence by the Oxford Centre for Evidence-Based Medicine and are particularly suited for traditional medicine’s personalized approaches. Yet, where is the evidence that any postgraduate or PhD scholar in Ayurveda across India’s 400+ colleges is conducting N-of-1 trials? Where is the training being provided to faculty members on how to design, conduct, and interpret such studies?

Black Box Design

The WHO’s research guidelines explicitly discuss black box designs for evaluating traditional medicine interventions, particularly when studying combinations of traditional and conventional medicine or when dealing with complex multi-component interventions. This methodology respects the holistic nature of traditional treatments while still generating rigorous evidence. How many Indian researchers even know what black box design means, let alone implement it?

Whole Systems Research

Traditional medicine operates as whole systems, not isolated interventions. Research methodologies should reflect this reality. Yet Indian Ayurveda research continues to be dominated by either classical RCT designs that are ill-suited to the system, or poorly designed observational studies that generate weak evidence.

Pragmatic Trials and Expertise-Based Designs

These are specifically recommended for traditional medicine evaluation, yet they remain virtually absent from Indian research portfolios.

The uncomfortable truth is that India stood on a global stage advocating for research methodologies that it neither teaches, nor practices, nor has any infrastructure to implement. Our researchers are not trained in these approaches. Our institutions do not have the capacity to conduct such studies. Our regulatory and ethics committees may not even know how to evaluate protocols using these designs.

We spoke eloquently about translating WHO research roadmaps into global action while having no roadmap—or action—of our own.

The Standards of Care Vacuum

Parallel Sessions throughout the summit discussed integration, quality assurance, patient safety, education, training, ethical standards, and evidence-based clinical practice guidelines. Yet India, despite being home to the world’s largest Ayurveda education system and clinical infrastructure, has virtually no published standards of care for Ayurveda practice.

Consider this stunning gap: An Ayurveda practitioner in Kerala treating depression, and another in Rajasthan treating the same condition, may follow completely different approaches with no standardized protocols, no agreed-upon diagnostic criteria, no consensus on treatment duration or outcomes assessment. This isn’t traditional diversity—it’s professional chaos.

Mental Health: A Case Study in Absence

The summit’s Parallel Session 2.C explored “The Science of Well-Being - Evidence from Traditional Medicine,” examining Traditional Medicine’s contributions to mental health. This is particularly relevant given India’s massive mental health crisis and Ayurveda’s potential role in addressing it.

Yet, where are India’s clinical practice guidelines for using Ayurveda in depression? Where are the standardized protocols for anxiety disorders? Where are the evidence-based treatment algorithms for stress-related conditions? They don’t exist.

Despite Ayurveda’s rich theoretical framework around manas (mind), despite concepts like satva, rajas, and tamas that could inform mental health approaches, despite specific treatments and formulations that have been used traditionally for centuries—we have no systematic documentation, no clinical guidelines, no standards of practice that a practitioner across India can reference.

When an Ayurveda physician encounters a patient with major depressive disorder, they operate in a vacuum. There are no nationally recognized guidelines telling them:

  • How to assess the condition through Ayurvedic parameters
  • Which diagnostic methods to employ
  • What treatment protocols to follow
  • How to assess treatment response
  • When to refer to other specialists
  • How to integrate with conventional mental health care when needed

This absence extends across virtually all health conditions. We have no published Ayurveda standards of care for diabetes management, hypertension treatment, chronic pain, digestive disorders, autoimmune conditions, or any other major health concern.

A recent publication urgently called for developing Clinical Practice Guidelines (CPGs) in Ayurveda, noting that while Korean medicine, Traditional Chinese medicine, and Kampo medicine have established robust CPGs, “the utilization of CPGs in any of the AYUSH systems of medicine remains largely unexplored.”

The paper identified key stakeholders—Ministry of AYUSH, CCRAS (Central Council for Research in Ayurvedic Sciences), and NCISM—who “can play a major role” in developing such guidelines. But the key phrase is “can play”—they haven’t. These guidelines don’t exist. And yet, India hosted a global summit discussing integration of traditional medicine into health systems, as if we have our own house in order.

The Implementation Void: Talking Global While Failing Local

The Delhi Declaration speaks beautifully about:

  • Strengthening evidence, regulation, integration, and collaboration
  • Coherent, risk-based regulatory frameworks
  • Structured, evidence-based inclusion into primary health care
  • Safeguarding Indigenous rights and traditional knowledge

All of this sounds admirable—until you examine India’s actual implementation record.

National Health Policy 2017: Promises Unfulfilled

India’s National Health Policy 2017 explicitly advocated mainstreaming AYUSH in public health through:

  • Service delivery via co-location in Primary Health Centers (PHCs) and Community Health Centers (CHCs)
  • Research and evidence generation for prevention and chronic care
  • Protocol-driven integrative practices

Eight years later, where is the evidence of systematic implementation? Where are the comprehensive protocols that were promised? Where is the research on outcomes of integrated care? The policy exists on paper; implementation remains fragmentary and ad hoc.

The WHO Global Traditional Medicine Strategy 2025-2034

The Delhi Declaration explicitly aligns with this WHO strategy. But does India have a national roadmap for implementing this strategy? Has the Ministry of AYUSH published a detailed implementation plan with:

  • Specific milestones and timelines?
  • Resource allocation frameworks?
  • Capacity building strategies?
  • Monitoring and evaluation mechanisms?
  • Stakeholder engagement processes?

If such a roadmap exists, it certainly wasn’t developed through broad stakeholder consultation, and it isn’t widely known or accessible to the Ayurveda community.

We are advocating global strategies while lacking domestic implementation frameworks.

The MAISP and Ayush Mark Illusion

The summit saw the release of the My Ayush Integrated Services Portal (MAISP) and the Ayush Mark quality certification benchmark. These initiatives were presented as major achievements, symbols of India’s commitment to quality and integration.

But technology and certifications are only as good as the standards they enforce. What standards is MAISP implementing? What quality parameters is Ayush Mark certifying?

Without published clinical practice guidelines, without standardized treatment protocols, without agreed-upon quality metrics, without documented standards of care—these initiatives risk becoming empty branding exercises rather than meaningful quality assurance mechanisms.

An “integrated services portal” integrating what, exactly? Unstandardized practices? Unvalidated approaches? Variable quality services with no consensus benchmarks?

A quality certification mark certifying what standards? If we don’t have published standards for Ayurveda practice, education, or products that reflect both traditional knowledge and contemporary evidence, what is being “certified”?

These initiatives may create the illusion of modernization and quality control, but without the foundational work of developing actual standards, they remain largely cosmetic.

The Global Library Paradox: Curating for the World, Chaos at Home

Among the major initiatives launched at the summit was the Traditional Medicine Global Library—a repository meant to serve as a comprehensive knowledge resource for traditional medicine systems worldwide. On paper, this sounds like a commendable effort to make traditional medicine knowledge accessible to global audiences.

But here’s the bitter irony: while India creates libraries for the world, its own educational knowledge infrastructure is in shambles.

The NCISM Textbook Approval Farce

The National Commission for Indian System of Medicine (NCISM) is responsible for approving textbooks for Bachelor of Ayurvedic Medicine and Surgery (BAMS) and postgraduate programs. This should be a rigorous process involving peer review, quality assessment, accuracy verification, and pedagogical evaluation.

Instead, what we have is blind approval without meaningful quality checks or peer review.

Textbooks are approved based on author credentials and institutional affiliations rather than rigorous content evaluation. There is no transparent peer review process where subject matter experts critically evaluate the material. There is no standardized quality framework against which textbooks are assessed. There are no clear criteria for what constitutes adequate scholarship, appropriate pedagogy, or accurate representation of classical knowledge.

The result? A proliferation of textbooks of wildly varying quality, many containing:

  • Inaccuracies and misinterpretations of classical texts
  • Poor Sanskrit translations and transliterations
  • Inadequate integration of fundamental principles
  • Weak pedagogical structure
  • Outdated or incorrect information
  • Inconsistent terminology and concepts

The Static Textbook Culture: No Editions, No Evolution

Perhaps most damning is this: Ayurveda textbooks in India rarely see revised editions.

In modern scientific and medical education, textbooks are regularly updated as knowledge evolves. You see third editions, fifth editions, tenth editions—each incorporating new research, correcting errors identified in previous versions, updating terminology, and reflecting advances in understanding.

Not so in Ayurveda education. Textbooks are published once and remain unchanged for decades. Authors who published books 20, 30, or 40 years ago are still treated as “pioneers and stalwarts,” their works used without revision, their original formulations treated as definitive despite:

  • Advances in understanding of classical texts
  • New archaeological and historical research
  • Improved translation methodologies
  • Contemporary clinical experience
  • Research findings that might inform understanding
  • Pedagogical improvements in medical education

The absence of revised editions signals something troubling: a lack of critical engagement with the material. Knowledge is treated as static rather than dynamic, as received wisdom rather than evolving understanding.

The Pioneer Problem: Reverence Without Rigor

Faculty authors are lionized as “pioneers and stalwarts” based on having published textbooks, regardless of the quality of those textbooks or their continued relevance. This creates a culture where:

  • Criticism is discouraged: Questioning a senior faculty member’s textbook is seen as disrespectful rather than scholarly
  • Errors persist: Mistakes in original texts are perpetuated through generations of students
  • Innovation is stifled: New approaches to teaching classical material are resisted
  • Authority trumps accuracy: What a recognized author wrote becomes more important than what the classical texts actually say

This sends a devastating message to students: that scholarship means deference to established authorities rather than critical thinking, that knowledge is about memorizing what previous generations wrote rather than engaging directly with primary sources, that questioning is inappropriate rather than essential.

The Samhita Abandonment

Classical Ayurvedic knowledge is preserved in the Brihattrayi (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya) and Laghutrayi texts. These samhitas are the foundation of Ayurvedic knowledge—the primary sources from which all understanding should flow.

Yet Samhita-based learning is increasingly marginalized in contemporary Ayurveda education.

Students study from textbooks that are interpretations of interpretations of the samhitas, often several layers removed from the source material. They may never develop the skills to independently read, interpret, and critically engage with the classical texts themselves.

This is comparable to teaching medicine entirely through review articles without ever having students read primary research papers, or teaching literature through study guides without having students read the actual literary works.

The result is a generation of practitioners who:

  • Cannot directly reference classical texts in their practice
  • Lack the skills to resolve ambiguities by consulting primary sources
  • Are dependent on secondary interpretations that may be flawed
  • Have limited ability to innovate or adapt classical knowledge to contemporary contexts
  • Cannot critically evaluate whether modern formulations or practices actually align with classical principles

The Sanskrit Crisis

Compounding this problem is the systematic neglect of Sanskrit language education in Ayurveda programs. Sanskrit is not merely the language in which Ayurvedic texts were written—it is integral to understanding Ayurvedic concepts, many of which lose meaning in translation.

Contemporary Ayurveda education treats Sanskrit as an obligatory subject to be passed rather than a fundamental skill to be mastered. Students emerge with:

  • Inability to read classical texts in the original
  • Reliance on translations that may be imperfect or contested
  • Lack of nuanced understanding of terminology
  • Difficulty grasping concepts that are linguistically embedded in Sanskrit

This linguistic disconnect means that students are essentially studying Ayurveda through a veil, never quite accessing the knowledge in its original form, always dependent on intermediaries for interpretation.

The Global Library Irony

So we return to the Traditional Medicine Global Library launched at the summit. India is curating traditional medicine knowledge for global audiences while its own educational knowledge infrastructure is characterized by:

  • Textbook approval without rigorous quality control
  • Static books that are never revised or updated
  • Culture of reverence that discourages critical scholarship
  • Marginalization of direct engagement with classical source texts
  • Neglect of the Sanskrit language skills necessary for such engagement
  • Students trained to memorize rather than critically engage

What knowledge, exactly, are we sharing with the world through this Global Library? If our own educational materials lack rigor, if our own students aren’t engaging deeply with primary sources, if our own textbooks perpetuate errors and outdated understandings—what quality of knowledge are we exporting?

This is the fundamental dishonesty at the heart of initiatives like the Global Library: we present ourselves as authorities preserving and sharing traditional knowledge while failing to maintain the scholarly standards necessary to actually understand, preserve, and transmit that knowledge with integrity.

A true commitment to traditional medicine knowledge would start at home—with rigorous peer review of educational materials, with regular revision and updating of textbooks, with training students in direct engagement with classical texts, with ensuring Sanskrit proficiency, with building a culture of critical scholarship rather than uncritical reverence.

Instead, we build libraries for the world while our own house of knowledge crumbles from within.

The Crumbling Healthcare Reality

The most painful truth that the summit’s grandeur obscures is this: Ayurveda as a healthcare system is failing to meet the health needs of Indian society at large.

The Elite Niche Problem

Ayurveda in contemporary India has increasingly become an elite niche rather than a people’s healthcare system. High-end wellness resorts, expensive Panchakarma centers, costly herbal formulations marketed to affluent consumers, luxury “Ayurvedic spas”—this is the face of much of contemporary Ayurveda.

Meanwhile, the average Indian facing health challenges—diabetes, hypertension, depression, chronic pain, autoimmune disorders—rarely has meaningful access to quality Ayurveda care. Public sector Ayurveda services remain underfunded and under-resourced. Private sector services are often expensive and variable in quality.

The Industry Dilution

Ayurveda has become a multi-billion dollar industry—but at what cost? The commercialization of Ayurveda has led to:

  • Dilution of classical principles: Products marketed as “Ayurvedic” that bear little resemblance to classical formulations or principles
  • Compromised quality: Cost-cutting in sourcing, preparation, and standardization
  • Misleading claims: Marketing that promises miracles without evidence
  • Loss of context: Treatments extracted from their holistic framework and sold as isolated interventions

The industry growth statistics look impressive, but they often represent a hollowing out of Ayurveda’s core principles rather than their flourishing.

The Healthcare Delivery Gap

When public health crises emerge—mental health epidemics, non-communicable disease burdens, antibiotic resistance, climate-related health impacts—Ayurveda is conspicuously absent from systematic, scaled responses. This isn’t because Ayurveda lacks relevant knowledge or approaches. It’s because we have failed to:

  • Document and standardize that knowledge in forms usable by contemporary practitioners
  • Train practitioners adequately in both traditional knowledge and contemporary health challenges
  • Build infrastructure for delivering Ayurveda services at scale
  • Generate evidence for effectiveness in priority health areas
  • Develop integration protocols that allow Ayurveda to work alongside other health systems

Ayurveda remains largely peripheral to India’s healthcare responses, not because of inherent limitations, but because of governance failures, resource deficits, and lack of systematic development.

The Parallel Sessions: Issue-by-Issue Analysis

Let’s briefly examine each day’s sessions through the lens of domestic implementation:

Day 1: Knowledge, Access, Ecosystems, and Governance

These sessions discussed TM knowledge systems, balancing access and benefits, planetary health, and governance equity. All critical issues—yet India has failed to resolve fundamental knowledge documentation challenges, has massive inequities in access to quality traditional medicine, continues to face biodiversity loss of medicinal plants, and maintains governance structures that are fragmented and ineffective.

Day 2: Research, Evidence, Innovation, and Investment

Session 2.A (Research Roadmap): Discussed operationalizing WHO research roadmaps through addressing research complexity and global capacity building. Yet Indian institutions lack capacity in the very methodologies being discussed.

Session 2.B (Research Methodologies): Explored methodologically appropriate approaches including whole-systems trials, transdisciplinary designs, and Indigenous methodologies. How many Indian researchers are trained in these? How many institutional ethics committees can properly review such protocols?

Session 2.C (Well-Being Evidence): Examined evidence for TM in mental health, pain management, cancer care, self-care, antibiotic resistance, and healthy longevity. India’s contribution to this evidence base remains limited, particularly in mental health despite massive need.

Session 2.D (Innovation to Investment): Discussed governance frameworks, validation criteria, and investment pathways for scaling TM innovations. India has a booming TM products industry but lacks robust validation frameworks and struggles to translate innovation into equitable access.

Session 2.E (Meditation and Health): Reviewed evidence on meditation for individual, social, and ecological well-being. While India has rich meditation traditions, systematic integration into health systems, education, and workplaces remains limited compared to adoption in some Western countries.

Day 3: Integration, Quality, Regulation, and Practice

Session 3.A (Integration Models): Examined WHO frameworks for integration—people-led, practitioner-led, coordinated, and blended models. India’s integration efforts remain ad hoc, lacking systematic frameworks and implementation protocols.

Session 3.B (Quality and Safety): Focused on education, training, ethical standards, accreditation, and safety systems. India’s AYUSH education system faces massive quality challenges, with many colleges producing graduates of questionable competence due to inadequate faculty, infrastructure, and clinical training.

Session 3.C (Regulation): Covered market authorization, post-market surveillance, cross-border trade, digital health, and intellectual property protection. India’s regulatory enforcement remains weak, with quality concerns about many AYUSH products and inadequate post-market surveillance.

Session 3.D (Practitioners and Resilience): Addressed regulating practitioners, education standards, ethical conduct, professional development, and evidence-based clinical guidelines. As discussed extensively, India lacks clinical practice guidelines across virtually all health conditions.

Every session touched on issues where India has substantial domestic deficits yet presented globally as if we have solutions to share.

The Faculty Knowledge Gap

A particularly troubling question emerges: How many Ayurveda faculty members across India’s 400+ colleges are even aware of WHO research recommendations and methodologies?

Most Ayurveda faculty have no training in:

  • Contemporary research methodology
  • Evidence-based medicine principles
  • Clinical epidemiology
  • Biostatistics beyond basics
  • Research ethics frameworks
  • Quality assurance systems
  • Implementation science

Many have never read WHO guidelines on traditional medicine research. They may not know what N-of-1 trials, pragmatic trials, or whole-systems research designs are. They certainly have not been trained to teach these to students or supervise research using these methodologies.

Yet India stood at a global summit discussing these very approaches as if they are part of our educational curriculum and research culture. The disconnect between what we present internationally and what we practice domestically is staggering.

The Skills Crisis: Graduating Without Competence

Perhaps the most damning indictment of India’s Ayurveda education system is this: the majority of BAMS graduates lack fundamental clinical competence in Ayurveda.

This is not hyperbole. Walk into any Ayurveda college and ask practicing clinicians, faculty members, or the graduates themselves—most will privately acknowledge what everyone knows but few publicly admit: BAMS graduates emerge from five and a half years of education without adequate skills in:

  • Ayurveda diagnosis: Unable to conduct proper Nadi Pariksha (pulse examination), Jihva Pariksha (tongue examination), or systematic Dashvidha Pariksha (ten-fold examination)
  • Prakriti assessment: Superficial understanding of constitutional analysis that forms the foundation of personalized Ayurveda treatment
  • Ayurveda clinical reasoning: Inability to apply Samprapti (pathogenesis) concepts to understand disease development and progression
  • Treatment protocol planning: Lack of systematic approach to developing comprehensive treatment plans based on Ayurveda principles
  • Panchakarma planning: Inadequate knowledge of how to assess suitability, sequence procedures, determine duration, and plan follow-up for Panchakarma therapies
  • Panchakarma procedures: Most graduates cannot competently perform even basic procedures like Abhyanga (therapeutic massage), Swedana (sudation therapy), or Basti (therapeutic enema) according to classical standards
  • Classical formulation knowledge: Poor understanding of how to select, modify, or compound classical formulations for individual patients
  • Integration of diet and lifestyle: Superficial grasp of how to provide practical, individualized Ahara (diet) and Vihara (lifestyle) recommendations

The Pass-Through System

Despite these glaring deficiencies, virtually all students pass their final examinations. The evaluation system has become a rubber stamp rather than a genuine competency assessment. Students who cannot perform basic Ayurveda diagnostic procedures, who cannot explain fundamental concepts, who have never successfully planned and executed Panchakarma treatments—all receive passing grades and BAMS degrees.

Why? Because the system prioritizes throughput over competence. Failing significant numbers of students would:

  • Reflect poorly on institutional quality metrics
  • Reduce fee revenue for private colleges
  • Create administrative complications
  • Invite scrutiny from regulatory bodies

So the charade continues. Students memorize enough to pass written exams that test theoretical knowledge rather than practical competence. Clinical examinations become perfunctory exercises where students perform for examiners who are often too tired, too rushed, or too complicit to fail anyone.

And nobody is bothered about it. Not the colleges who collect fees. Not NCISM which is supposed to ensure quality. Not the universities which grant degrees. The entire system has normalized incompetence.

The Allopathy Drift

What happens to these inadequately trained graduates? During their mandatory internship year, many seek clinical exposure in modern medicine hospitals rather than Ayurveda institutions. This is revealing—they don’t trust their own training or their own system to provide meaningful clinical learning.

In modern hospitals, these interns witness something their Ayurveda training never provided: clear diagnostic protocols, standardized treatment algorithms, predictable outcomes, and structured clinical decision-making. They see patients getting CT scans that definitively identify pathology. They see antibiotics that rapidly resolve infections. They see surgical interventions that immediately correct problems. They see the systematic approach that their Ayurveda education lacked.

Influenced by these experiences and lacking confidence in their Ayurveda skills, many graduates begin practicing allopathy—prescribing modern medicines, ordering investigations, referring for procedures. They do this mechanically, without truly understanding pharmacology, drug interactions, appropriate prescribing, or the theoretical foundations of modern medicine. They are neither competent Ayurveda practitioners nor qualified modern medicine doctors—they inhabit a dangerous middle ground.

The Referral Economy

Unable to provide comprehensive care themselves, these practitioners develop referral networks—diagnostic centers for investigations, specialists for consultations, hospitals for procedures. At every step, they receive commissions for referrals. The practice of medicine becomes a business of patient trafficking rather than healing.

This referral economy serves multiple purposes:

  • Generates income without requiring clinical competence
  • Provides cover for their own inadequacies (someone else is making the real clinical decisions)
  • Creates the appearance of modern, technology-enabled practice
  • Satisfies patients who have also internalized that “real” medicine involves scans and prescriptions

The Support System Vacuum

Once BAMS graduates complete internships, they are entirely on their own. There is no systematic support structure to help them:

  • Develop clinical competence they should have gained in college
  • Build confidence in Ayurveda diagnosis and treatment
  • Access mentorship from experienced practitioners
  • Receive continuing education relevant to practice needs
  • Connect with communities of practice for peer learning
  • Navigate the challenges of establishing Ayurveda practice

They don’t trust their colleges to provide this support—and they’re right not to. The same institutions that failed to train them adequately have nothing to offer post-graduation. Faculty members who couldn’t impart skills during five years of education aren’t suddenly going to become mentors afterward.

So graduates are left to figure things out themselves, often by abandoning Ayurveda for the apparent certainty of modern medicine prescribing.

The Missing Data

Here’s what’s stunning: there is no comprehensive data on what BAMS graduates actually do after graduation. No pan-India survey. No systematic tracking. No outcomes assessment.

We don’t officially know:

  • What percentage practice primarily Ayurveda vs. modern medicine
  • What clinical approaches they use
  • What their patient outcomes look like
  • What barriers they face in practicing Ayurveda
  • What additional training or support they need
  • How their practice evolves over the first 5-10 years post-graduation

Anecdotal evidence and informal discussions suggest that the percentage of BAMS graduates practicing primarily modern medicine could be as high as 75%. Think about that. Three out of four graduates from Ayurveda colleges may be prescribing allopathy rather than practicing Ayurveda.

This represents a catastrophic failure of the education system. We are investing resources in training Ayurveda practitioners and producing unqualified modern medicine prescribers. We are diluting both systems while strengthening neither.

The Summit Disconnect

Now return to the WHO Summit’s parallel sessions on education, training, quality assurance, and ethical standards. India participated in discussions about:

  • Minimum education standards for practitioners
  • Accreditation frameworks
  • Clinical competency requirements
  • Continuing professional development
  • Evidence-based practice guidelines

We discussed these topics while presiding over an education system that produces graduates who lack basic clinical competence and drift into practicing another medical system entirely.

The gap between what we present globally and what exists domestically could not be more stark.

The Postgraduate and PhD Crisis: Higher Degrees, Lower Standards

If the undergraduate skills crisis is troubling, the postgraduate situation is alarming. The problems don’t end with BAMS—they intensify at higher levels of education that should represent academic excellence and research leadership.

PG Students: Unprepared for Research

Students entering MD/MS programs in Ayurveda are typically very poorly trained in research methodology and statistics. Having spent five years in BAMS programs that emphasize memorization over critical thinking, they arrive at postgraduate studies without:

  • Understanding of research design principles
  • Knowledge of appropriate statistical methods
  • Skills in literature review and evidence synthesis
  • Ability to formulate researchable questions
  • Familiarity with research ethics frameworks
  • Training in data collection and analysis
  • Experience in scientific writing

This deficiency is compounded by the reality that most Ayurveda postgraduate programs provide minimal training in research methods. A few lectures on research methodology and biostatistics—often taught by faculty who themselves lack research training—do not equip students for meaningful scholarly work.

The Purpose Problem

More fundamentally, very few postgraduate students understand the actual purpose of PG studies. They pursue MD/MS degrees for various reasons—better job prospects, higher social status, family expectations, requirement for teaching positions—but rarely because they want to contribute to advancing Ayurveda as a science.

Ask most PG students what new knowledge their dissertation will generate, what gap in understanding it will fill, or how it will advance Ayurveda practice—and you’ll mostly get blank stares. The dissertation is seen as a hurdle to clear for getting the degree, not as an opportunity to contribute to knowledge.

This purpose deficit means that even the limited research training provided often falls on unreceptive soil. Students go through the motions of research without understanding why it matters or how it should be done rigorously.

PhD: The Highest Degree, The Lowest Rigor

If postgraduate standards are problematic, PhD standards in Ayurveda are often virtually non-existent. PhDs—which should represent the pinnacle of scholarly achievement, awarded only to those who make original, significant contributions to knowledge—are handed out with shocking laxity.

PhDs are awarded in Ayurveda:

  • Without rigorous research training requirements
  • Without comprehensive examinations of foundational knowledge
  • Without meaningful review of research proposals
  • Without stringent evaluation of completed work
  • Without requirement for publications in peer-reviewed journals
  • Without public defense against knowledgeable critics

Many PhD holders in Ayurveda have never published a single peer-reviewed paper. Their theses may be based on weak methodologies, poor analysis, and questionable conclusions. Yet they receive doctoral degrees and the title of “Doctor” that should signify scholarly excellence.

Eight Decades, No Standardization

Here’s a fact that should shock everyone: Postgraduate studies in Ayurveda have been conducted for nearly eight decades, yet there is still no standardized format for synopsis submission across different departments.

Each university follows its own requirements. Some are more stringent, others barely cursory. Requirements for:

  • Literature review comprehensiveness
  • Methodology specification
  • Sample size justification
  • Statistical analysis plans
  • Ethical considerations
  • Timeline feasibility

…all vary wildly across institutions. There are no national standards ensuring that a synopsis from one university is comparable in quality and rigor to one from another university.

This lack of standardization means:

  • No quality benchmarking across institutions
  • No ability to compare research standards
  • No pressure for institutions to maintain high standards
  • No consequences for accepting weak proposals

International Standards? Forget It

Remember Parallel Session 2.A at the WHO Summit discussing “Translating the WHO Traditional Medicine Research Roadmap into Global Action”? It examined research methodology, validation frameworks, and global standards for traditional medicine research.

The uncomfortable truth: Most Ayurveda research synopses and dissertations from India would not pass muster at the international level. They would not meet the methodological standards expected in international research communities. They would not survive peer review at reputable international journals.

The research questions are often vague. The methodologies are frequently inappropriate or poorly specified. Sample sizes lack proper justification. Statistical analysis plans are inadequate. Ethical considerations are superficial. Expected outcomes and their significance are unclear.

Yet these same synopses—which wouldn’t meet international research standards—are routinely approved by Indian universities. And we stood at a global summit discussing research excellence and international collaboration as if our research meets world-class standards.

The Approval Rubber Stamp

Perhaps most damning: there are hardly any synopses or dissertations that have been rejected across India in all these years.

Think about what this means. In nearly eight decades of postgraduate education, with thousands of synopses submitted and dissertations completed, virtually all have been approved and accepted. The rejection rate is close to zero.

This is statistically impossible if genuine quality standards are being applied. In any field with real standards, some proportion of proposals would be deemed inadequate, some research would be judged insufficient, some dissertations would be found wanting. Standards, by definition, mean that not everyone meets them.

The standard defense offered: “We cannot play with the careers of students.”

This excuse reveals the fundamental misunderstanding of what postgraduate and doctoral education should be. These are not participation trophies. These are advanced degrees that should certify genuine expertise and scholarly accomplishment. They should be difficult to earn. They should require demonstrated excellence.

In most rigorous academic fields:

  • Significant percentages of PhD students don’t complete their degrees
  • Proposals are sent back for major revision or rejected outright
  • Dissertations require substantial revision before acceptance
  • Comprehensive examinations have real failure rates
  • The standards are high precisely because the degrees signify achievement

The notion that we’re “playing with careers” by maintaining standards is backwards. We’re playing with careers—and with the credibility of Ayurveda itself—by awarding advanced degrees to people who haven’t demonstrated the competence those degrees are supposed to certify.

The Credibility Crisis

When PhDs are awarded without rigor, when dissertations are approved without scrutiny, when research standards are non-existent, the degrees themselves become meaningless. They don’t certify expertise—they certify endurance in navigating a system that guarantees everyone passes.

This creates multiple problems:

For graduates: They hold degrees that don’t reflect genuine expertise, leaving them unprepared for research careers, unable to mentor the next generation, and lacking credibility in academic discourse.

For institutions: The proliferation of PhDs and MD/MS degrees without corresponding quality dilutes the value of those degrees and undermines institutional credibility.

For Ayurveda: When research is poor, when dissertations are weak, when PhDs are meaningless—Ayurveda’s credibility as a scholarly discipline suffers. How can we claim Ayurveda is evidence-based when the evidence we produce doesn’t meet basic standards?

For patients: Ultimately, patients suffer when the research that should inform clinical practice is unreliable, when the practitioners holding advanced degrees lack actual advanced competence, when the evidence base for Ayurveda treatments remains weak.

The International Comparison

Consider how Traditional Chinese Medicine (TCM) and Korean Medicine have approached this challenge. They have:

  • Standardized research training requirements across institutions
  • Established clear publication expectations for advanced degrees
  • Created national research standards and protocols
  • Built international collaborations with leading research institutions
  • Required dissertations to contribute meaningfully to the field
  • Maintained quality standards even if that means lower completion rates

The result: Their research appears in top-tier international journals. Their researchers participate as equals in international collaborations. Their traditional medicine systems are taken seriously in global academic discourse.

India, with Ayurveda’s rich heritage and theoretical sophistication, should be leading this conversation. Instead, we’re trying to participate in discussions about research excellence while our own research standards are barely maintained.

The Summit’s Parallel Reality

Return once more to the WHO Summit. Multiple sessions discussed:

  • Research capacity building
  • Evidence generation standards
  • Academic excellence in traditional medicine
  • International research collaboration
  • Quality assurance in education and training

India participated actively in these discussions. We shared our perspectives. We contributed to the Delhi Declaration’s calls for research strengthening.

But we did all this while presiding over a postgraduate and doctoral education system that:

  • Produces graduates unprepared for research
  • Lacks standardized quality criteria
  • Approves virtually all proposals regardless of quality
  • Awards PhDs without genuine scholarly contribution requirements
  • Has never comprehensively assessed its own outcomes
  • Operates with minimal alignment to international research standards

Once again, the disconnect between our global presentation and domestic reality is profound.

The Science Without Evidence Paradox

Perhaps the summit’s greatest irony is this: We are promoting Ayurveda globally as a “great science” while lacking the scientific evidence to substantiate many of its claims and applications.

This creates a profound contradiction:

  • We claim Ayurveda works based on millennia of traditional use
  • We claim it is scientific and evidence-based
  • Yet we haven’t generated the contemporary scientific evidence that would actually demonstrate effectiveness for most conditions

This is gaslighting at a global scale. We are asking the world to accept Ayurveda’s value on faith and tradition while simultaneously claiming scientific validity—without doing the hard work of actually generating that scientific evidence through rigorous research.

Traditional knowledge and empirical observation over centuries have value. But in the 21st century, if we want Ayurveda integrated into modern healthcare systems, accepted by medical communities, covered by insurance, and trusted by informed patients—we need contemporary scientific evidence generated through appropriate research methodologies.

That evidence, for the most part, doesn’t exist. Not because Ayurveda doesn’t work, but because we haven’t prioritized generating it. We’ve been too busy promoting and commercializing to do the hard work of validating.

Dissecting the Delhi Declaration: Well-Worded Emptiness

Let’s examine what the Delhi Declaration actually commits to:

“Reaffirming traditional medicine as shared biocultural heritage” - Beautiful words, but what does this mean in practice? How are we protecting this heritage? What mechanisms ensure that Indigenous communities who hold this knowledge benefit from its commercialization?

“Committing countries to strengthening evidence, regulation, integration, and collaboration” - Strengthening to what standard? By when? With what resources? Using what implementation frameworks?

“Aligned with the WHO Global Traditional Medicine Strategy 2025-2034” - Again, alignment sounds good, but where are the country-specific action plans? Where are the accountability mechanisms?

“Calls for coherent, risk-based regulatory frameworks for products, practices, and practitioners” - India has regulatory frameworks. They are neither coherent, nor consistently risk-based, nor effectively enforced. How does this declaration change that reality?

“While respecting the diversity of traditional medicine systems and safeguarding Indigenous rights” - How, specifically? What mechanisms? What enforcement? Indigenous and traditional knowledge holders in India continue to be marginalized while their knowledge is commercialized.

The Delhi Declaration, like many international declarations, is a masterpiece of diplomatic language that commits to everything while committing to nothing specific. It provides no concrete pathways, no measurable targets, no accountability mechanisms, no resource commitments. It is the perfect document for a global summit—aspirational enough to get everyone to sign, vague enough to require nothing from anyone.

The Way Forward: From Performance to Practice

If India is to genuinely lead in traditional medicine rather than merely perform leadership, fundamental changes are required:

1. Systematic Stakeholder Engagement

  • Conduct comprehensive national consultations with all stakeholder groups
  • Establish standing advisory committees with diverse representation
  • Create mechanisms for ongoing dialogue between policymakers, researchers, educators, practitioners, and communities
  • Ensure Indigenous knowledge holders and traditional practitioners have genuine voice in policy development

2. Capacity Building in Research Methodology

  • Train faculty in WHO-recommended research methodologies for traditional medicine
  • Establish centers of excellence in TM research methodology at key institutions
  • Develop standardized curriculum components on research methods for undergraduate and postgraduate Ayurveda education
  • Provide continuing education for existing researchers on appropriate methodologies
  • Build institutional capacity in ethics review for TM research protocols

3. Development of Clinical Practice Guidelines

  • Establish national taskforces to develop evidence-based clinical practice guidelines for priority health conditions
  • Use systematic methodologies that incorporate both classical texts and contemporary evidence
  • Ensure guidelines are practical, accessible, and widely disseminated
  • Create implementation strategies to support guideline adoption
  • Develop mechanisms for regular updating as new evidence emerges

4. Quality Standardization

  • Develop and publish comprehensive standards of care for Ayurveda practice across health conditions
  • Create quality benchmarks for Ayurveda education that actually ensure graduate competence
  • Strengthen product quality standards and enforcement
  • Build robust post-market surveillance systems
  • Establish independent quality assurance mechanisms

5. Implementation of National Roadmaps

  • Develop detailed implementation plan for WHO Global Traditional Medicine Strategy
  • Create concrete action plans for National Health Policy 2017 AYUSH mainstreaming provisions
  • Set measurable targets with accountability mechanisms
  • Allocate adequate resources for implementation
  • Establish monitoring and evaluation frameworks

6. Evidence Generation Priorities

  • Fund research addressing high-priority health conditions using appropriate methodologies
  • Build practice-based research networks to generate real-world evidence
  • Prioritize comparative effectiveness research and integrative care models
  • Ensure research addresses equity and access questions
  • Create pathways for rapid translation of research findings into practice

7. Healthcare Delivery Transformation

  • Develop models for delivering quality Ayurveda services at scale in public health system
  • Create integration protocols that work in real-world clinical settings
  • Build infrastructure for both standalone and integrated service delivery
  • Train practitioners for contemporary health challenges and collaborative care
  • Ensure services are accessible beyond elite consumers

Conclusion: The Emperor Has No Clothes

The Second WHO Global Summit on Traditional Medicine was a spectacular event—beautiful venue, impressive attendance, comprehensive programming, eloquent declarations. It projected an image of India as a global leader confidently sharing wisdom about traditional medicine with the world.

But this projection is fundamentally dishonest. India is not leading; India is performing. We are presenting frameworks we don’t implement, research methodologies we don’t use, standards we haven’t developed, integration models we haven’t operationalized, and evidence we haven’t generated.

The summit was pomp, splendor, and gaslighting writ large. It was a carefully choreographed performance designed to impress international audiences while the domestic foundations remain fundamentally unsound.

The tragedy is that this performance distracts from the real work that needs doing. Instead of honestly acknowledging our gaps and mobilizing resources to address them, we expend energy on global theater. Instead of consulting stakeholders and building consensus on the way forward, we craft declarations that commit to everything while delivering nothing.

Ayurveda and other traditional medicine systems have immense potential to contribute to health and well-being. They deserve better than this. They deserve honest acknowledgment of current limitations, systematic efforts to build capacity, genuine investment in evidence generation, stakeholder engagement in developing standards, and commitment to implementation rather than performance.

Until we stop fooling ourselves and each other with grand summits and empty declarations, until we do the hard, unglamorous work of building systems, generating evidence, training researchers, developing standards, and implementing programs—we will remain a country rich in traditional knowledge but poor in its systematic application for public benefit.

The question is: Do we have the courage to move from performance to practice, from declarations to implementation, from global theater to domestic transformation? Or will we continue hosting summits and issuing statements while Ayurveda’s potential remains largely unrealized?

The choice is ours. But let’s at least be honest about where we currently stand. The emperor has no clothes, and no amount of international applause changes that reality.

This critical analysis is offered not from a place of cynicism but from deep concern for the future of traditional medicine systems in India. Genuine progress requires honest assessment of current realities, not comfortable illusions. Only by acknowledging gaps can we begin to address them. Only by ending the performance can we begin the real work.

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