New regulations were introduced in July 2000 to improve Indian herbal
medicines by establishing standard manufacturing practices and quality
control. The regulations outline requirements for infrastructure, labour,
quality control and authenticity of raw materials, and absence of contamina-
tion. Of the 9000 licensed manufacturers of traditional medicines, those who
qualify can immediately seek certification for good manufacturing practice.
The remainders have 2 years to comply with the regulations and to obtain
certification.
The government has also established 10 new drug-testing laboratories for
Indian systems of medicine and is upgrading existing laboratories to provide
high-quality evidence to the licensing authorities of the safety and quality of
herbal medicines. This replaces an ad hoc system of testing that was consid-
ered unreliable. Randomised controlled clinical trials of selected prescriptions
for Indian systems of medicine have been initiated. These will document the
safety and efficacy of the prescriptions and provide the basis for their
international licensing as medicines rather than simply as food supplements.^32
A randomised, double-blind, placebo-controlled, parallel-group mono-
centre trial with 182 patients investigated the efficacy and toxicity of an
orally administered ayurvedic formulation for rheumatoid arthritis.^33 It was
concluded that the preparation was not significantly superior to a strong
placebo response except for joint swelling, although improvement in the
group taking active medicine was numerically superior at all evaluation time
points. Other trials have shown some promise in the treatment of bronchial
asthma34,35and angina.^36 It is claimed that ayurveda can be used effectively in
combination with modern medicine to provide better treatment of cancer.^37
Practitioners
There are about 25–30 qualified ayurvedic physicians in the UK who are
registered with the Ayurvedic Medical Association UK, and hold malprac-
tice insurance and maintain a code of ethics. Most of the physicians are
based in London but some of them are in areas that have a large Asian
community such as Leicester, Birmingham and Bradford. In the USA legal
licensure for any healthcare profession, including ayurveda, is under the
jurisdiction of each individual state. Currently, none of the US states licenses
ayurvedic physicians as primary care physicians. However, many ayurvedic
physicians use their education and knowledge in combination with their
other healthcare-related licensed credentials.
Integration with western medicine
The Indian Medicine Central Council was established by a 1970 act to
oversee the development of Indian systems of medicine and to ensure good
214 | Traditional medicine