COMPLEMENTARY MEDICINE INDUSTRY AND THE ROLE PLAYED BY THE AN OVERVIEW OF THE COMPLEMENTARY MEDICINE INDUSTRY AND THE ROLE PLAYED BY THE HEALTH PRODUCTS ASSOCIATION OF SOUTHERN AFRICA

INTRODUCTION What is Complementary & Alternative Medicine (CAM) Professionals associated with CAM are controlled by Allied Health Professions Council of SA (AHPCSA) Professionals associated with conventional medicine controlled by the Health Professions Council of SA (HPCSA)

COMPLEMENTARY VS. ALTERNATIVE Important distinctions between complementary and alternative medicine Some health care providers practice what is known as "integrative medicine," There is an invalid perception in some areas, that complementary medicines are based on hearsay or anecdotal evidence and that they are not scientific

CAM CATEGORIES 1. Aromatherapeutic Essential Oils 2. Homoeopathic Medicine 3. Biochemical Medicines & Salts. 4. Anthroposophical Medicines 5. Nutritional Food Substances (including vitamins and minerals) 6.Herbal Medicine 7. Sowa Rigpa Medicine 8. Chinese Medicine 9. Ayurvedic Medicine 10. Uani-Tibb Medicine 11. Energy Substances

ROLE OF COMPLEMENTARY AND TRADITIONAL MEDICINES IN SA Historically many diverse cultures somehow possess a wide traditional wisdom that relates to the well-being of their communities and the individual In modern Western society, emphasis has shifted to immediate solutions and ‘fixes’. Conventional Medicine a recent development All Complementary Medicines have in common the “philosophy” or body of knowledge that has become known as “wellness”

ROLE OF COMPLEMENTARY AND TRADITIONAL MEDICINES IN SA WELLNESS Increased Westernized lifestyle - suffer from “side-effects” Complementary and Traditional Medicines - redress imbalance of body system Challenge for the future - to cross pollinate wide communities with benefits obtained from all medicines, practices and approaches

MARKET SIZE World market for herbals and vitamins - approx US$50 Billion SA Market size approx 2 Billion Rand - representing approx 0.7% of world market (HPA Survey 2003) South African market exceptionally buoyant over last few years Exports from SA are growing

SOUTH AFRICA MARKET SHARE BREAK DOWN Vitamins 36% Herbs 14% Food supplements 16% Health drinks 7% Natural cosmetics 7% Homoeopathy 5% Sport nutrition 4% Other 11%

COMPLEMENTARY AND TRADITIONAL MEDICINES IN THE HEALTHCARE SYSTEM More than 200 000 African Traditional Healers About 450 000 active members in Direct Selling “Therapeutic Foods” market size between 1-10% of the total food industry. (i.e. R2 - R20 billion) The HPA has 108 member companies, indirectly employs approx 30,000 Estimated employment by supply chain - in excess of 50,000 people 5,573 registered practitioners with Allied Health Professions Council of South Africa (AHPCSA). Approximately 350 health shops in SA, each employing 2 – 7 persons

THE HISTORY AND ROLE OF THE HPA Established in 1978 to PROTECT and PROMOTE the health products INDUSTRY Established a full-time HPA office in 1988 Members include homoeopaths, naturopaths, chiropractors and complementary medicine practitioners Members are experts in their fields with a unique understanding of complementary and alternative medicine The HPA represents the majority of manufacturers and distributors in Southern Africa Through HPA efforts - an industry that continuously strives for a credible, organized and scientific environment Good manufacturing procedures (GMP)

HPA OBJECTIVES To ensure high profile visibility of the health products industry as a dynamic, organized and responsible force. To protect the industry and ensure long-term validity. To create a unified industry voice when dealing with external entities such as government bodies and the media. To maintain high ethical standards of production, quality control, marketing and advertising within the industry. To act as a body that protects the consumer against exploitation from unethical practices. .

HPA OBJECTIVES To act as a central information point to promote and co-operate with the government, media and other related stakeholders in representing the interests of the industry To provide a forum for education for both the consumer, industry and professional through seminars, conventions and exhibitions To promote co-operation between other international and local associations, medical bodies and fraternities to encourage mutual understanding To promote and develop opportunities for export and import for its members

HPA INTERNATIONAL MEMBERSHIPS AND ASSOCIATIONS Linked to leading international organisations EHPM (European Health Product Manufacturers) IADSA (International Alliance of Dietary Food Supplements Associations) Objectives to establish, maintain, protect and promote international standards IADSA : founded in 1998 – represents 40 dietary supplement associations worldwide EHPM was created in 1975 - membership includes approx 1800 health-product manufacturers in 20 European countries

THE CAM SELF MONITORING TECHNICAL COMMITTEE (SMTC) HISTORY In 1996 BBRG (Broad Based Reference Group) committees were established to “list safe medicines (substances and indications) In 1998 the lists of substances and indications were approved by the MCC In 2002 call up for audit of complementary medicine well over 12 000 applications received by MRA

THE CAM SELF MONITORING TECHNICAL COMMITTEE (SMTC) HISTORY CONT In response to inappropriate CAM draft regulations in July 2004, HPA spearheaded formation of Complementary Medicines Stakeholder Committee (CMSC) CMSC included industry, practitioners, wholesalers, retailers and academia CMSC produced and submitted to the DOH a 600 page document critically commenting on the Draft giving appropriate alternatives

THE CAM SELF MONITORING TECHNICAL COMMITTEE (SMTC) cont RECOMMENDATIONS Separate and appropriate regulations and guidelines for complementary and traditional medicines A separate marketing code A separate directorate with CAM qualified key personnel and structure – MCC, DOH & MRA And in the interim – appropriate representation within the MCC appropriate representation within the MCC committees mandate & appropriate representation within the Complementary Medicines Committee (CMC) – a statutory body of the MCC CAM task team

CURRENT STATUS ON REGULATION No CAM regulations HPA in continuous interaction with DOH HPA requires APPROPRIATE REGULATION HPA will only support appropriate legislation for CAM “One size-fits-all” regulation and legislation totally unacceptable

HPA REACTION: SELF MONITORING TECHNICAL COMMITTEE (SMTC) SMTC established September 2007 To support the DOH To establish level playing fields To reduce unethical behaviour To retain credibility with the public regarding CAM

FEATURES OF THE SMTC SURVEILLANCE Surveillance of defaulters in the marketplace Close co-operation with the ASA (Advertising Standards Authority) Close co-operation with Law enforcement unit of the DOH on advertising claims and indications

FEATURES OF THE SMTC B. CO-OPERATION Continued dialogue with DOH Co-operation with CMC Interaction on BBRG APPROVED LISTS OF SUBSTANCES

FEATURES OF THE SMTC C. ASSISTANCE Assistance to members with regard to advertising claims & indications The provision of technical expertise for both surveillance and assistance

CONCLUSION SA progressive - freedom of speech, regulations and rights Remains role of HPA to acknowledge, protect and promote traditions and practices of CAM as well as its right to exist within all medical paradigms HPA will continue to work towards availability, accessibility, safety and efficacy of essential CAM to all HPA supports concept of individual responsibility for health, preventative health care and informed decision making HPA will continue to work towards establishment of complementary partnership between Government bodies and private providers

ON BEHALF OF THE HPA, THANK YOU FOR YOUR TIME AND ATTENTION MATHABO KONA Executive Director : Health Products Association of Southern Africa