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Herbal Medicine and Practice Today
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The market for herbal medicines has evolved dynamically in 'western countries'. The EU is estimated to have spent the equivalent of 6 billion US dollars on plant based pharmaceuticals in the year 1995 alone & the figure has increased every year and the number of people using herbs rises daily. Of course around the world this has always been the case and it is estimated that worldwide 75% of the worlds population rely on herbal medicine rather than biomedical medicines for the treatment of disease and ill health In such a burgeoning field where westerners are suddenly demanding herbs, it has become increasingly clear that two distinct but related issues must be addressed in order to ensure the continued safety and high quality of herbal medicines; firstly the regulation of 'over-the-counter' (OTC) herbal products and secondly, the statutory registration of herbal practitioners who will doster the correct use of herbs and its traditions as well as take part in research etc. Let's look at these issues in turn. Over the Counter Herbal Medicines.The legislative framework for the registration of OTC herbal medicines is currently being prepared. It is by and large a welcome move that will enable professionally competent, high standard herb businesses to flourish whilst at the same time protecting the public from unscrupulous vendors who exploit booming sales and lack of regulation. The 'Directive on Traditional Herbal Medicinal Products' (DTHMP) is the name of the new legislation destined to define future OTC sales of herbs across Europe. This regulation is still being defined but as of mid-October 2002 those herbal medicines destined to become true 'medicines' will have had to have been in visible circulation (used by herbal practitioners), for at least 15 years. Some vitamin and mineral supplements will be allowed inclusion in these herbal formulas, but only as 'inert substances'. However the issue of vitamins, minerals and supplements is a separate piece of legislation. Another category of herbs ruled out as not suitable for inclusion into the DTHMP is that of Standardised Extracts. These will need to be dealt with in an alternative manner, but categorically it will not cover isolated active ingredients because these are too far removed from traditional Herbal Medicine, as practiced by British and other European, Indian, Chinese etc. practitioners. So what herbs will be sold over the counter?The first draft of the DTHMP was only published this year and the discussions over which herbs will be available is an ongoing process, however, many hundreds are currently listed. Those not eventually included on the 'over-the-counter' list will be confirmed to practitioner use only. This means that certain herbs can only be prescribed after a one to one consultation with a qualified herbal practitioner. Discussions involve the Medicines Control Agency (MCA) the European Herbal Practitioners Association (EHPA) and the British Herbal Medicine Association (BHMA) It is expected that a return to herbal formulations (containing between three and twelve, or even more herbs, in just one remedy) will become more commonplace because traditionally, this is how herbs have been used for hundreds and thousands of years. Single herbs or 'Simples' were used only on occasion, but are now often favoured by the larger pharmacy, nutriceutical based companies. Formulations echo the 'hunter-gatherer' use of herbs. Anthropologists tell us that our ancestors 'grazed' and collected; plants used in this way were both food and medicine. According to archaeological evidence, approximately 100 to 200 different plants species were consumed in any one year and this diversity of chemistry would have doubtlessly provided many of the phytochemicals scientists are only now discovering & greatly protecting the immune system and stimulating digestion more efficiently than does our modern diet. A formula of 4-10 herbs is simply modern 'grazing' in a bottle. Who are the MCA?The 'Medicines Control Agency' was set up in 1968 as a result of investigations into the Thalidomide disaster. Prior to 1968, drugs could enter the market when very little was known about them. Since then the huge rise in OTC herb purchases has meant that the MCA has been called in to investigate and scrutinise herb sales and prescriptions. There involvement with the Traditional Medicine Directive is to ensure safety and quality of herbal medicines, not efficacy. They negotiate the case for British Herbalists and British Herb Companies concerning European Legislation on herbs. Statutory Self-Regulation of Herbs for Practitioners Only.The DTHMP only applies to those herbs bought and sold over the counter; certain herbs have long been restricted to practitioners alone. This restriction to professional herbalists has historically been quite difficult to work due to the lack of statutory self regulation (SSR) for herbalists. This however may change in the future because SSR could pave the way for herbal medicine to enter the National Health Service and thus provide this form of therapy to a wider participation Certain herbs which should really only be used by those thoroughly familiar with them (purity, species, dosage, preparation etc.) have been widely available to the public. Misuse and Banning of HerbsUnfortunately, the misuse or mistaken use of such herbs can and does lead to an outright ban on herbs that might, used correctly, be perfectly safe. These herbs, which would be most appropriately designated practitioner-only status, frequently fail to get this designation simply because, unlike most other health professionals, herbalists have no registration process in place as yet. Historically, herbalists have lacked overall self regulation because it was asserted that there was no proof of the efficacy of herbs, and were/are categorized as 'foods'. Herbalists have long pointed out that economic forces were the primary cause of this lack. In recent years, particularly since the creation of the EU, extensive research has proven certain herbal medicines to be safe, extremely effective and very well tolerated. Examples include Saw Palmetto (Serenoa repens) for prostate disease & St Johns Wort (Hypericum perfoliatum) for depression & Milk Thistle (Carduus marianus) in liver disease & Echinacea (Echinacea purpurea & Echinacea angustifolia) in upper respiratory infections and many, many others. In many cases in continental Europe these herbal remedies are the first choice treatment amongst doctors. The rigorous testing and mainstream acceptance of certain herbal medicines has paved the way for a wider acceptance of those practitioners trained in herbal medicine. To this end, the Department of Health set up a Herbal Medicines Regulatory Working Group with the aim of working towards Statutory Self - Regulation for Herbal Practitioners. To date 95% of herb usage is over the counter, which leaves only 5% as Practitioner prescribed. This very low percentage of Herbal Practitioner use is due to several reasons; one is that there are only approximately 650-750 Traditional Western Herbal Practitioners. (Figures on Chinese and Ayurvedic Practitioners are difficult to obtain but are thought to be in the region of 3-4000). The British government would like to increase the use of qualified practitioners because it rightly believes that it would be safer and would help preserve the old and safe traditions of herbal medicines, thus making it something worth keeping and more available to the general public. To this end, it would like to see herbalists become more organised professionally and politically, and thus become more effective and more efficient at serving the public. The desperate shortage of health care professionals has also served as a wake up call to ditch arguments around ideologies and work together adopting the best practices in each and every tradition and to form what has become known as Integrated Medicine (a truly holistic vision beyond the orthodox / alternative divide). Much goodwill towards integrated medicine has been forthcoming of late and of course Prince Charles is a loud and prestigious figure, who keenly supports integrated medicine and is the patron of FIH - the Foundation for Integrated Health. Several bodies are working together to assist the above regulation. There is great hope that the legislation will generate public confidence and more widespread use. These bodies are: The Foundation for Integrated Health (FIH) The European Herbal Practitioners Association (E.H.P.A.) The Medicines Control Agency (M.C.A.) NOW Medicines and Healthcare products Regulatory Agency Traditional Herbal Medicine, as carried out by professionals, aims to restore and revive everyday health. This knowledge that has been handed down from generation to generation is a concept and viewpoint badly needed in the quick-fix, 'magic bullet' era of modern medicine, previously so dominant within the NHS. Indeed, the British Medical Association in March 2001 stated that 'Integrated Medicine of today should be the Medicine of the new Millennium?. To this end the NHS has hopes to integrate Herbal Practitioners into the NHS, once they become more regulated. It is hoped that Herbal Medicine departments in hospitals will be a reality as well as having an increased number of Herbal Practitioners within the community. A Positive Future at Last, but lots of hard work and difficulties for small businesses. So all in all, these are very interesting and exciting times for Herbal Medicine. A lot of positive feeling exists that, after years of persecution and unrest, herbal medicines can enjoy renewed confidence and finally be used more widely and safely than ever before in the UK. There will of course be a cost involved and that will certainly hit smaller businesses very hard. Their survival is vital because many such businesses lack the kind of funding seen in high street sales of herbs and yet they often employ knowledgeable, dedicated and trained herbal practitioners, providing high quality care and professionalism Brief Landmarks in the History of Herbal Medicine.
Jill Rosemary Davies - Consultant Herbal Practitioner for Herbs Hands Healing ltd. |
