Ayurveda in India: regulation, registered practitioners, medicines

Ayurveda in India is not an unregulated practice. Medicines, research and practitioner registration are covered by national and State arrangements. This article explains the main rules in plain language, using publications of the Ministry of Ayush and the World Health Organization (WHO). It also gives a practical checklist for choosing a registered practitioner. Please note that rules can change, so always confirm current details with your State authority.

1. Introduction

The Ministry of Ayush was created in 2014 with a mandate to promote and propagate the Indian systems of medicine and Homoeopathy, and to validate them scientifically ^[1]. By 1 January 2024 India recorded 784,962 registered Ayush practitioners, of whom 371,957 were Ayurveda practitioners, as reported by State Boards and Councils. As of 1 April 2024 the Ministry also counted 538 Ayurveda undergraduate colleges ^[1]. So Ayurveda is a large part of the Indian health system.

2. The statutory bodies

The National Commission for Indian System of Medicine (NCISM) is a statutory body constituted under the National Commission for Indian System of Medicine Act, 2020, which was notified on 21 September 2020 ^[1]. The Ministry links this Act with the maintenance of a register of practitioners of the Indian systems of medicine ^[1].

The Ministry's report also names two other bodies. The Central Council for Research in Ayurvedic Sciences (CCRAS) is the apex body in the country for undertaking, coordinating and promoting research, and it is the council responsible for officially sponsored research in Ayurveda ^[1]. The Drug Policy Section of the Ministry handles regulatory and quality control functions for Ayurveda, Siddha, Unani and Homoeopathy medicines and acts as a central drug control framework for them ^[1].

3. Registered practitioners

The practitioner numbers in the Ministry's report are reported by State Boards and Councils of the Indian systems of medicine ^[1]. For patients, the practical point is that a person who calls themselves an Ayurveda doctor should be able to give you a registration number that you can check with the State Board or Council. A registration number is a basic check. It does not guarantee a good outcome from any treatment, and rules about who may practise can change, so confirm the details with your State authority.

4. How Ayurvedic medicines are regulated

Ayurvedic, Siddha and Unani (ASU) medicines are regulated under the Drugs and Cosmetics Act, 1940 and its Rules of 1945 ^{[1, 2]}. The Ministry's own material explains these points.

• Licences: manufacturing units and medicines must meet licensing requirements. Rule 158B sets the proof of safety and effectiveness needed for a manufacturing licence, and State-appointed licensing authorities or drug controllers grant and renew licences and act against violators ^[2]. The Ministry's Drug Policy Section works with State licensing authorities and drug controllers so that the legal provisions are applied in a uniform way ^[1].
• Good Manufacturing Practice (GMP): following GMP is among the licensing requirements, together with the quality standards in the relevant pharmacopoeia ^[2]. GMP means rules for clean, consistent and well-recorded manufacture.
• Standards: the Pharmacopoeia Commission for Indian Medicine and Homoeopathy and its committees develop standards. The Ayurvedic pharmacopoeia lists 645 single drugs and 202 compound formulations, and 985 Ayurvedic formulations have been standardised in formularies ^[2]. Fifty-five laboratories are approved under the Rules to test these medicines ^[2].
• Advisory boards: the Ayurvedic, Siddha and Unani Drugs Technical Advisory Board advises the Central and State Governments on technical matters. Its sub-committees cover topics such as retail sale licences, model laboratory practices for testing ASU drugs, the list of authoritative ASU books and the shelf life of ASU medicines ^[3]. A consultative committee with members from the Centre, States and Union Territories advises the government on how the rules are applied ^[3].
• Advertising: the Ministry's report states that the Drug Policy Section also administers the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 for these medicines ^[1].

The Ministry's page on quality control says that "herbal medicines" are not defined as such in the Drugs and Cosmetics Act. Adulterated, spurious and misbranded medicines are defined in the Act, with penalties for breaking the rules ^[2]. Testing for 2017-18 in 14 laboratories covered 6,947 samples, and about 2.6 percent failed. Actions taken included prosecution, departmental action, show-cause notices, withdrawal of failed batches and bans on sale ^[2]. This shows that testing happens, and also that substandard products exist.

5. International view

WHO has published benchmarks for the training of Ayurveda, dated 11 February 2022, which update an earlier version from 2010. They set out the minimum criteria for establishing Ayurveda training and list the knowledge that everyone involved in practice and training needs, including safety issues in clinical use and in the preparation of medicines. They are meant as a reference for national authorities that set or strengthen standards for qualified Ayurveda training and practice ^[4].

6. How to choose a registered practitioner

• Ask for the practitioner's registration number and check it with the State Board or Council that registered them.
• Ask which qualification they hold, and where they trained.
• Prefer a clinic or hospital that holds recognised licences and is open to working with your other doctors.
• Buy medicines only from licensed sellers and keep the packaging and batch details.
• Be wary of anyone who promises certain results for a disease.

7. When to see a doctor

Whatever the system you choose, see a doctor promptly for any symptom that is severe, new, persistent or worsening. If you use Ayurvedic medicines and develop unexplained stomach pain, vomiting, weakness, numbness or tingling, contact a doctor promptly and take the product and its packaging with you. Tell your doctor about all Ayurvedic treatments, so that your care is coordinated.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

8. Conclusion

India regulates Ayurveda through a national statutory commission, State-level registration and licensing, and the testing of medicines. This is a framework of standards, not a guarantee of benefit or safety. Check that your practitioner is registered, use licensed medicines, and keep your doctor informed of everything you use.