Krishnamurthy is a physician, a public health specialist and a researcher, active in the space of public and global health for two decades. Currently he is Professor of Public Health, Dean of the Faculty of Life and Allied Health Sciences, and Dean of the Office of Research and Innovation at Ramaiah University of Applied Sciences, India. 

He is a certified Heartfulness trainer and part of research team that examines the effects of contemplative and integrative practices on well-being and quality of life. He established the Center for Integrative Health and Wellbeing in Bangalore, India, and has published a book, Science & Practice of Integrative Health and Wellbeing Lifestyle, to inspire people to embrace a healthy lifestyle for holistic well-being.

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Krishnamurthy Jayanna

<h4>
 Dr. KRISHNAMURTHY
 JAYANNA is focused on the big picture: how do we ensure health and well-being for all? Here he writes about
 Sustainable Development Goal 3, the importance of Integrative Health, and the actions we will need to make to
 realize that goal.
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 The third UN Sustainable Development Goal (SDG) is about health and
 well-being. It aims at “ensuring healthy lives and promoting well-being for
 all at all ages.” Before this, the UN’s Millennium Development Goals focused
 on disease, and those conditions that contributed to the most illness-related
 deaths around the world. While that continues to be a priority, the current
 SDG also showcases the UN’s commitment to improving people’s well-being and
 quality of life. This is a huge, progressive leap in terms of how we envision
 the betterment of humanity and the world as a global community.


Is this realizable by 2030?


 While it is good to be ambitious and aspirational when setting goals, unless
 our approach is backed by effective intervention and implementation processes
 that are contextually and culturally relevant, realizing the vision will be a
 challenge.



 It is also important to be creative and innovative as we design ways to solve
 complex challenges, by bringing together the problems and the stakeholders.
 “Integrative approaches” appear to be promising, based on the evidence, and it
 is important that we review them critically for adoption within the public
 health ecosystem.



 The National Center for Complementary and Integrative Health (NCCIH), the lead
 agency of the U.S. Government for scientific research in this space, describes
 Integrative Health as “an approach that brings together conventional and
 complementary healing processes in a coordinated way. It lays emphasis on
 multi-modal interventions for treating the whole person, rather than, for
 example, one organ system.”



 The integrative approach focuses on the “person,” with various disciplines
 collaborating to achieve a common goal. The focus is also on the “whole
 person,” including feelings and emotions, not just the physical symptoms and
 physiological factors.


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 Research points to the gaps in well-being and quality of life due to the rise
 of chronic diseases. Treatment can be lifelong, with a greater demand for
 lifestyle management and treatment compliance, which can be stressful,
 hampering the quality of life. 40% of the U.S. population is engaged in
 complementary and alternative approaches (CAM) such as Tai chi, natural
 products, yoga, and meditation. The CAM approaches are perceived by clients as
 friendly and holistic, while providing more autonomy. Integrative approaches
 like Ayurveda recognize the unique nature of the human body-mind constitution,
 and offer personalized recommendations for treatment and lifestyle change.
 Yoga and meditation have been studied to understand their effects on physical
 and mental well-being, and are explored as complementary approaches to
 mainstream treatments.



 In this context, the adoption of “Integrative approaches to Health and
 Well-being” within national health policies is a welcome change. In India, the
 AYUSH systems of Ayurveda, Yoga, Unani, Siddha, and Homeopathy are integrated
 within the primary health care systems. More recently, “Ayush man Bharat,”
 a flagship program of the Government of India, is giving renewed impetus to
 well-being by setting up 150,000 Health and Wellness Centers across the
 country. The Western nations have also demonstrated openness to researching
 the effects of integrative approaches in specific conditions.


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 Countries across the world
 have to focus on strengthening the
 implementation of integrative approaches through methodologies such
 as Implementation Science and Implementation Research.
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 While these developments are certainly encouraging, they are not enough from a
 public health perspective. Countries across the world have to focus on
 strengthening the implementation of integrative approaches through
 methodologies such as Implementation Science and Implementation Research.
 These methods focus not on a single intervention, but a package of
 interventions, and an intervention model as well as implementation processes
 that influence community health and well-being.



 Research agendas and investments need to align in this direction. The small
 pilot studies, predominantly conducted in hospital settings, can expand into
 large-sample, community-based studies. Disease-centric studies can expand
 their focus to address the entire continuum of health – from disease
 prevention to treatment to rehabilitation.



 Integrative health policies have been framed. The next step is to strengthen
 the science and research for a population-wide impact. Collaboration between
 implementation stakeholders and institutions is going to be critical, as we
 continue our march toward this vital SDG.


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References

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 <li>
 Sustainable Development Goals [Internet].
 https://sdgs.un.org/goals. UN [cited 2022 October 11]. Available from:
 <a href="https://sdgs.un.org">https://sdgs.un.org</a>.
 </li>
 <li>
 Complementary, Alternative, or Integrative Health: What’s in a Name?
 [Internet]. https://www.nccih.nih.gov. [cited 2021 Jul 19]. Available from:
 <a
 href="https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name">https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name</a>.
 </li>
 <li>
 Clarke, T.C., L.I. Black, B.J. Stussman, P.M. Barnes, and R.L. Nahin, 2015.
 “Trends in the use of complementary health approaches among adults: United
 States, 2002-2012.” National Health Statistics Reports.10, 79:1-16.
 </li>
 <li>
 Lobb, R.and G.A. Colditz, 2013. “Implementation science and its application
 to population health.”Annual Review of Public Health.34:235-51.
 </li>
 <li>
 Roy, R, 2010. “Integrative medicine to tackle the problem of chronic
 diseases.” Journal of Ayurveda and Integrative Medicine.1, 1:18-21.
 </li>
 <li>
 Lahariya, C, 2018. “Ayushman Bharat” Program and Universal Health Coverage
 in India. Indian Pediatrics. 55, 6:495-506.
 </li>
</ol>

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