As the search for effective treatment for Covid-19 intensifies, traditional medicine systems are receiving increasing attention from researchers as well as the public. While scientific rigour is non-negotiable, there remain fundamental issues to be addressed when bringing evidence from traditional systems. Here we examine some of these issues pertaining to Ayurveda and the underlying philosophical underpinnings, and suggest potential ways to move forward. We find an ability to emerge from the cage of "biomedicalism" and its foundational reductionism essential for appropriate research in Ayurveda. We caution against pursuing research in Ayurveda by just mimicking modern medicine and highlight the need for appropriate use of modern science tools and methods to understand Ayurveda and explore its potential for healthcare. We emphasise the need and potential for transdisciplinary research in Ayurveda. A balance between evidence-based medicine and evidence-informed healthcare is required.

Compelling individuals to be vaccinated with candidate vaccines that have been granted emergency use approval based on limited data, and penalising non-compliance, raises challenging ethics issues. For instance, some individuals may wish to be vaccinated, but may be hesitant to be vaccinated with particular vaccine candidates. On the other hand, some individuals may be averse to vaccination of any sort but may find themselves being forced to submit to vaccination in certain situational contexts to gain access to benefits or services. In all such instances, acquiescence and submission runs counter to the notion of voluntariness, which is a central pillar of the doctrine of informed consent.

While governments have been focusing on the unprecedented disruption to the global economy caused by coronavirus disease 2019 (COVID-19) and the urgent need for COVID-19 research, other health research has become a casualty of the pandemic. Major research operations that are unrelated to COVID-19 have been significantly diminished or suspended entirely because of either COVID-19-related legal restrictions or logistical, staffing or operational concerns. Billions of people globally are currently affected by lockdowns or curfews. Since the timescale of such restrictive measures is unknown and subject to change, many studies are now in limbo and the welfare of tens of thousands of study participants is at risk. These circumstances have introduced complex ethical challenges that merit urgent attention from international sponsors, researchers and regulators. Certain sponsors and regulators have published guidelines on how the COVID-19-related disruptions to clinical research should be managed. Although these guidelines provide a good starting point in navigating the challenges of the evolving pandemic, they only apply to those researchers funded or governed by these bodies. Here, we provide guidelines on managing such disruptions that apply beyond these specific settings. We highlight some of the effects of the COVID-19 pandemic on other ongoing research projects that are unrelated to COVID-19 and provide practical guidance on how the welfare of affected study participants should be managed. We conclude that policy-makers, sponsors, researchers and regulators must adopt a more flexible approach to ensure participant safety, while maintaining data integrity and complying with good clinical practices.

The COVID-19 pandemic has brought unprecedented, major challenges to the ethical conduct of research including challenges for the rapid and robust ethical review of biomedical research. The Indian Council of Medical Research’s “National Guidelines for Ethics Committees Reviewing Biomedical and Health Research during COVID-19 Pandemic” aim to assist ethics committees in this time of crisis, whilst simultaneously protecting researchers and research participants. Whilst ethics committees are encouraged to approve studies rapidly, the Indian guidelines also make clear that no shortcuts will be taken. Informed consent must be obtained innovatively, but cannot be dispensed with. Vulnerable people should only be involved in clinical research that is relevant to their health needs. Approaching communities for research also requires new, trust-building methods, given that healthcare workers and researchers have been assaulted during their COVID-19 research. Importantly, the media must carry their share of responsibility and avoid spreading fake news. From an Indian perspective, the question of whether we are sitting on a volcano that might erupt at any time causing more damage than we ever expected is currently unclear. Only global collaborative efforts will help to tide over in the present crisis.

Hinduism, known initially as Sanatana Dharma (eternal or timeless religion), is more of a “way of life” than an ideology; it is a lived religion, not simply a cognitive one. The Hindu way of life is a science of salvation to liberate the human beings from the cycle of births and rebirths so that the individual soul reunites with the universal soul. Vedanta provides the highest spiritual knowledge and the code of conduct and spiritual values. Vedantic philosophy developed these values to anticipate the socio-economic problems fully. It prescribes the Dharma, the righteous duty of each, and Karma, the line of selfless action to be undertaken without expecting any return towards individuals, family, society, nation and the Universe. The concepts of the four goals and five debts everyone is born with, as per Hindu belief, emphasise our interpersonal duties and social responsibilities in this life. They provide each person with a moral compass to guide one’s life by cultivating family and social values to fulfil the social responsibilities towards the weak and the needy. Thus, Hindu ethics leads eventually to self-realisation or liberation from the cycle of birth and death, moksha, through service to humanity. Hindu philosophers encourage the performance of duties not with a sense of compulsion but through love which springs from the perception of God in all living beings. We examine the concept of UNESCO Declaration as applicable to human rights, fundamental freedom, and human dignity in this paper through the Hindu philosophical approach from time immemorial. They are the individual and societal duties and responsibilities that form the current guiding principles of Constitution of India for protection of the fundamental rights of its citizens. We also elaborate on how the Hindu tenets of Dharma and Karma execute their social responsibility in religious institutions and modern corporate houses in promoting Health for All.

We conducted a qualitative study to determine the range of promotional practices influencing drug usage in Mumbai. Open-ended interviews were conducted with 15 senior executives in drug companies, 25 chemists and 25 doctors; focus group discussions were held with 36 medical representatives. The study provided a picture of what might be described as an unholy alliance: manufacturers, chemists and doctors conspire to make profits at the expense of consumers and the public's health, even as they negotiate with each other on their respective shares of these profits. Misleading information, incentives and unethical trade practices were identified as methods to increase the prescription and sale of drugs. Medical representatives provide incomplete medical information to influence prescribing practices; they also offer incentives including conference sponsorship. Doctors may also demand incentives, as when doctors' associations threaten to boycott companies that do not comply with their demands for sponsorship. Manufacturers, chemists and medical representatives use various unethical trade practices. Of particular interest was the finding that chemists are major players in this system, providing drug information directly to patients. The study also reinforced our impression that medical representatives are the least powerful of the four groups.