Herbalists and traditional medicine practitioners are worrying that a new EU directive will end access to herbal medicines. I investigate this claim and attempt to uncover the actual effects of the new legislation.
Denying the power of plants to cure our ills is pointless. Who has not rubbed a dock leaf on their leg to counter the pain of a stinging nettle or drank ginger and lemon tea to treat a raspy sore throat? Despite the often justifiable claims by scientists and sceptics who question the efficacy of many herbal treatments, it is still a popular option for treating illness in Britain. According to an Ipsos MORI poll in 2009, approximately 12 million British adults have used a herbal remedy in the last two years.
But in April many herbal remedies will no longer be allowed to be sold in the UK when an EU directive comes into force. This directive has left many herbalists concerned over the future of herbal medicine practice. For despite their own calls for government regulation of their industry, they claim the directive will do little to protect the public from untrained individuals who will still be legally able to produce potentially dangerous remedies for the public.
Produced from mixtures of crushed, dried or pulverised plant material, herbal remedies currently do not require licences like conventional medicines. But this is set to change with the implementation of the European Union’s Traditional Herbal Medicinal Products Directive (THMPD). As of April 30th 2011, all manufactured, finished and over the counter herbal remedies sold across Europe will be required to prove their safety and quality in order to be gain licenses to be sold.
It won’t be the end of herbal and traditional medicine, however. Herbalists, who are still not legally required to have any formal training or qualifications, will still be able to make up remedies for their patients after direct consultations. They can simply no longer rely on third parties to make the remedies up for them, as many currently do. Herbalists will therefore be required to invest massively in order to stock and find space for the hundreds of base ingredients themselves.
And therein lies a paradox. If the legislation is designed to protect consumers from conmen and quackery, why are untrained individuals still allowed to make up herbal remedies for people walking in off the street? And if trained practitioners are unable to stock all the ingredients required to make the remedies themselves, why are they no longer able to order the prescription from third parties who specialise in making up these formulations?
Richard Woodfield is Group Manager for Herbal Medicines and New Technologies Policy at the the Medical Health and products Research Agency (MHRA), the government body responsible for the regulation of medicines used in healthcare. Prior to the THMPD, over the counter herbal remedies were exempted under the Medicines Act 1968 from meeting any specific standards of safety and quality. He explains that this led to difficulties in controlling standards.
He said: “Consumers had no way of identifying which herbal medicines were of a sufficient quality and which were not. Problems would range from having no or very weak product information about safe usage, side effects and interactions. At the other extreme there are herbal medicines that are actually adulterated and completely mislabelled.”
Under the THMPD, prepared herbal remedies will need to be approved by the conditional herbal registration scheme run by the MHRA in order to be sold. Despite the fact that only 84 applications to the scheme have so far been approved, he believes that consumers will still be able to buy the majority of popular over the counter herbal remedies.
“Pretty much all the top ten or twenty herbs that you can find are already registered herbal medicines and there are more coming through. What you won’t have is every single person all producing their own version of herb x,” he said.
However, Michael Mackintyre, Chair of the European Herbal and Traditional Medicine Practitioners Association (EHTPA) is concerned that the legislation will have unforeseen consequences on herbalists.
He said: “A lot of practitioners don’t have the room to set up their own dispensaries so they’re using third party dispensaries. Over the course of the last thirty or forty years that process has grown into quite a large business.”
The new legislation, he argues, will have grave financial implications. “Suppliers make quite a lot of money selling finished products to practitioners, not for over the counter, but for specific formulations they use for particular conditions they treat. All that will be swept away.”
The only answer, he believes, is the statutory regulation of herbalists. Authorised health care professionals will still be able to order medical products from third party suppliers for patients on a case-by-case basis. But despite repeated calls for regulation of their industry, there is still no legal basis in which to operate as a herbalist.
A herbal practitioner from Manchester and member of the National Institute of Medical Herbalists (NIMH), a voluntary professional body that represents herbal practitioners, who wishes not to be named, agrees that better regulation of the industry is the right step forward
He said: “As a herbalist I am able to prescribe some very powerful herbs which have safety issues and without having the protection of statutory regulation and being an authorised health care professional, we may well lose the use of some of those herbs in the future.
“I think that the problem is that ultimately there’s the potential that people will lose access to herbs. Whether it’s over the counter or whether it’s because it becomes impossible for herbalists to practice.”
The potential power of plants and herbs to treat illness is indisputable. Many modern pharmaceuticals are even developed from plant extracts. Their positive and negative impact on human health is clear from the way society tightly controls tobacco and marijuana.
If there is a medical case for the use of herbs in treating illness, surely the onus should be on regulating who can prescribe herbal medical products, rather than merely controlling which products can be produced.