Data on the burden and pattern of rheumatism and arthritis in the Indian community is sparse. There are less than a dozen centers devoted to rheumatology and the large majority are in the Government sector busy performing routine patient care. Rheumatism for several reasons is not a priority with the Health Ministry or with the Indian Medical Council. Specialists in private practice rarely if ever contribute to the national needs of research and measures of disease burden. In 1996, Center for Rheumatic Diseases (CRD), Pune, was set up as a research facility on a 1200 sq ft property by a single rheumatologist in close proximity to his growing practice with a 3 fold aim -: collect community data, measure disease burden and explore Ayurveda-Modern medicine interface for better therapy solutions.

        More than 6000 patients have been evaluated and served in over 45 free of cost arthritis camps. The entire camp methodology has been restructured towards providing service and simultaneously collecting research data. For the first time, CRD has used these camps to enroll volunteer patients into clinical therapeutic trials- a fast track model with immense saving of time and money. Driven by economics and a possible future experimental need, blood and serum of almost every patient from camp, trial and population study, has been preserved in a deep freeze. The latter has been a continuous resource for several laboratory based novel experiments to define diagnostics and related characteristics unique to the Indian scenario for several common rheumatic disorders. The lab projects on the preserved blood samples have been undertaken as and when funds are made available. The latter also includes immunogenetics that has attracted prestigious collaborations with institutions abroad and exposed patterns different from the Western World. CRD has simplified several complex lab methods and further demonstrated that economical conventional techniques continue to be as efficient as the expensive modern techniques.

         In a quest to measure disease burden, CRD launched the WHO maiden COPCORD (Community oriented program for control of rheumatic diseases) for India in a 9000+ population of village Bhigwan (Pune District) (100 kms from Pune enroute to Sholapur). Begun in 1996 and in its tenth operational year, COPCORD Bhigwan has generated robust prevalence and incidence data that has been globally presented and published. Though initiated in several countries, COPCORD Bhigwan is the only ongoing planned program in the World serving the original WHO doctrine. While launching the UN endorsed ‘The Bone and Joint Decade (BJD)’, WHO adopted the COPCORD Bhigwan model to project the rheumatic disease burden for South East Asia. However, the success of this Bhigwan population study has been due to the novel and indigenous fast tract study model that to begin with was largely dictated by the concerns and demands of the Bhigwan villagers- the model is a significant variation of the conventional WHO model for the purpose and the core questionnaires etc are modified to suit the Indian conditions. Modifications include validated questionnaires to measure functional disability in arthritis in Indian patients. The COPCORD Bhigwan has been totally free of cost to the local population. Further, in 2003, BJD India adopted the CRD’s COPCORD Bhigwan model to launch several urban population surveys to collect national data for rheumatic diseases -begun in Jammu, Chennai and Pune. The population and camps’ data is continuously fed into a user friendly statistically worthy secure data base, indigenously created and maintained by CRD personnel. In fact, dedicated personnel write exclusive soft ware programs for every major research project. Along with epidemiology, CRD has also developed feasible and economical drug trial protocols to evaluate the efficacy and safety of standardized Ayurvedic formulations. In conjunction with Ayurvedic faculty, several potential promising antiarthritic formulations have been tested in over 12 World class trials, several of which have been published in top class peer reviewed medical journals.

         CRD is the principle clinical co-ordination center for the CSIR,GOI, NMITLI arthritis project 2002-2006 involving several national research facilities such as Pune Univ, AIIMS (Delhi), RRL (Jammu), NIBR (Lucknow), etc. CRD is recognized as a research institute by the Pune Univ and a ‘SIRO’ by the DSIR, GOI. Since 2002, the activities of CRD are administered by the ‘Arthritis Research Care Foundation’, a registered research Society/Trust set up by senior patrons with a personal interest in alleviating the pain and suffering of rheumatism and arthritis patients. Today, CRD is manned by 18 personnel which includes 4 specialist physicians. Since inception, CRD has been financially managed exclusively by the concurrent private referral practice of its founder and some of the funded research projects, and no donation has been ever accepted from the pharmaceutics or the community for its various research projects. The COPCORD Bhigwan project has been completely sustained by the CRD till date.