HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Thursday, February 19, 1998

• 0909

[English]

The Chair (Ms. Beth Phinney (Hamilton Mountain, Lib.)): I call the meeting to order. This is the 20th meeting of the Standing Committee on Health, and we're doing a study of natural health products.

In our first hour and a half we have two groups: the Ginseng Growers Association of Canada, of which Michael Atkins is the president—he will introduce the rest of the panel with him—and then we have Richter's Herbs, with Conrad Richter.

We'll just go in the order on paper here. So we'll ask Mr. Atkins to start with his group. Could you please introduce who is on the panel with you?

• 0910

Mr. Michael Atkins (President, Ginseng Growers Association of Canada): Thank you, Beth.

I'd like to introduce everybody. First of all, I'm from the Ginseng Growers Association of Canada and I'm here representing the ginseng growers in Ontario, B.C., and other provinces.

I've brought with me today a very distinguished panel to help me along. I have with me Dr. Tom Francis, a nutritional food scientist from the University of Toronto; Dr. Chung-Ja C. Jackson, from the University of Guelph, who is going to be doing a study on the nutraceutical value of ginseng; and Dr. Dennis Awang, from the University of Ottawa.

How would I describe you, Dennis? What would be your specialty?

Dr. Dennis Awang (Ginseng Growers Association of Canada): Herbal science. I'm a spokesperson for Health Canada.

Mr. Michael Atkins: Dr. Gary Kakis is also from the University of Toronto.

Ginseng is very important in the herbal industry at this point. There are a lot of products out there now. Even five years ago there was very little in the way of Canadian ginseng on the market. Most people didn't even know about it.

The history of ginseng in Canada goes back to 1742, when a Jesuit priest from France found ginseng growing around Montreal and recognized it to be very similar to ginseng plants the Jesuits had seen in China. They found that native North Americans had been using it for centuries as a herbal remedy. It gave them increased endurance and helped their strength—all this type of stuff.

The cultivated history of ginseng in Canada actually goes back to the late 1800s. Ginseng in Canada was started by the Hellyer family. I think most of you have heard the name Paul Hellyer, our ex-defence minister. He was born and raised half a mile up the road from where I live. It was his grandfather and his grandfather's brother who actually started what we now call the cultivated ginseng industry in Canada, around the Waterford area in the 1890s.

Historically, back in the early 1900s, before the Depression, there were 300,000 or 400,000 pounds of ginseng being exported. Historically, also, at one time, wild ginseng was second only to fur as an export. Most people have never even heard about ginseng. Everybody has heard about fur, about timber, about our other raw materials, but they have never heard about ginseng. At this point, ginseng in the wild has almost been hunted to extinction, but it is now protected under CITES. In Canada, between B.C. and Ontario, this past year we grew somewhere in the neighbourhood of 3.8 million pounds. Actually, Canada is now the largest producer of North American ginseng in the world. We're probably second only to China as a producer of ginseng. We may have already bypassed Korea.

The dollar value on our exports right now is somewhere around $100 million. If the price could go back up, it would be much higher.

I was just talking to one of the buyers here, Lawrence Cheng, who you will be hearing from in the second part. His family was one of the first families to buy ginseng from Canada and sell it in Hong Kong. At one time, they bought most of the crop in North America. If you go to Hong Kong, you will see that their building has all kinds of the red maple leaf on it, representing their interest in Canada.

Where ginseng and the herbal industry are involved is the product end. When we first started in the industry, we analysed a lot of the ginseng products out there, and a lot of them had no ginseng, they were totally mislabelled, or they were just a total fabrication. That's one thing Dennis can speak to, because he has done a study of 450 ginseng products in North America for the American Botanical Council.

I approached some people at that point and told them there were some problems out there. They said they really didn't want to hear about it.

• 0915

Basically what we're working on in the ginseng industry is an aims proposal with the B.C. growers, ourselves, and Ottawa. One of the main things in the aims proposal—which is quite thick—is standards for ginseng root itself and for the products out there, because we know we have to do some things.

The other problem we run into is the fact that there are different ginsengs. There's North American ginseng, be it from Wisconsin, B.C., or Ontario, and there's Asiatic ginseng, be it Korean, Chinese, red or white—and as an industry we're not allowed to tell people what the differences are. And then they hear about Siberian ginseng. I know that's our problem, along with the rest of the herbal industry; we are being kept from telling consumers appropriate information about what the benefits would be.

People have heard that you don't take Korean ginseng if you have high blood pressure. That's very true. That's why the Chinese say not to give Korean ginseng to children under the age of 12. It will cause nosebleeds.

But what people don't realize is that North American ginseng native to Canada has a totally different effect. It's much more cooling and calming, and I can give you examples of many people who have taken it and have actually had their blood pressure lowered with this help.

Scientific studies have been done at the University of Toronto, the University of Alberta and McMaster University, which Dr. Tom Francis, who's also with the Canadian Ginseng Research Foundation, can fill everybody in on. There's been some very promising stuff found there, with the support of the Ginseng Growers Association of Canada, because we realize how important this is. It's the same with what Dr. Jackson's going to be doing. That's also with the support of the Ginseng Growers Association of Canada, and with money from ESA.

We realize there have to be standards, and we want to be part of that. We want standards that are appropriate for our type of industry. We're not pharmaceutical, and we're not claiming to be food either. What we're looking at—and we know you want to hear solutions, not problems—is that basically the Ginseng Growers Association of Canada is a partner with the Canadian health food coalition. Actually, I'm one of the people on that committee. I'm also a member of the Canadian Health Food Association. I think we all want products that are safe out there and we want products that are properly labelled, that are informative.

But you can't bog us down with what somebody putting out a drug is doing, because that is a very specific thing, and if you take too much of that, you're going to get harmful side effects. With herbal remedies, be it ginseng or other things, you have a calmer or milder effect, which is much easier on the system.

We all need proper, appropriate regulations so we can inform the consumers properly. We need a separate regulatory framework, separate from drugs and food. We also need proper identification. Dr. Awang can talk about that.

And when somebody's putting out a product and it's being tested, everybody has to use the same method. We've seen it on ginsenoside analyses that we've done. We do an HPLC with Dr. Kakuda at the University of Guelph. In fact, we paid for seven standards of ginsenosides to be brought over so we could use them as markers. You see other people out there claiming to be at 20% ginsenoside, but when you test it you find that they're lucky if they're at 2% ginsenoside.

We also need a more streamlined process for product review. Because it's something that can't be trademarked or patented, we don't have millions of dollars to spend on this. That's why we're doing stuff with universities. We also need to make sure that imported products are playing by the same rules we are. If we have to meet certain labelling requirements, which is only fair, let's make sure they have to meet the same standards. If we go to another country with our product we have to meet the standards of that country, so why do they not have to meet the standards when they come in here?

Another thing, too, is that I'm into product manufacturing myself, and, hey, there have to be quality standards for what we're doing. We don't want somebody out there who's a fly-by-nighter or whatever, because it's going to give all of us in the health food community a bad name.

So here's what we're looking for. We want to work with whoever is going to be doing this, and we will do everything in our power to come up with rules—in conjunction with anybody—that have to be followed. We will do our time, and the Ginseng Growers Association will do their part in it also.

• 0920

The main thing is I can show you stuff we've already done and my people here can talk about stuff we're going to do. We can do this in partnership, which will be of benefit to everybody, will be cost-effective, and will be very informative.

Thank you.

The Chair: Is that all from the group?

Dr. Tom Francis (Ginseng Growers Association of Canada): No, I think I'm next, Madam Chairman.

The Chair: Okay. That's the 10 minutes, so if you could keep yours down to a couple of minutes each, if the others are still going to speak—

Dr. Tom Francis: I promise sincerely.

The Chair: Okay. He's already used the 10 minutes.

Dr. Tom Francis: I'm with the University of Toronto. I'm also a founding board member of the Canadian Ginseng Research Foundation, an organization set up about six years ago by a group of professors and growers, basically to promote and conduct good-quality scientific research on Canadian ginseng.

We have completed about four studies to date. We did one at the University of Toronto with Dr. Bob Goode. He was working on the role of ginseng in athletic performance, and he showed that it does enhance athletic performance quite well. It improves the oxygen consumption by the heart. I don't know that the work has been published yet.

We then did a study with a man called Tony Sun, and that was on diabetes and ginseng. He worked with rats and he showed there were compounds in ginseng that are basically hypoglycemic, that do reduce blood glucose. He did this initially by injecting the rats with an extract, but later he showed that if they consume this in water, you get the same effect.

There was a big study to be done at St. Michael's Hospital, not sponsored by the foundation but rather by a commercial company, Chai-Na-Ta. This will be looking at humans and diabetes, using whole ginseng, not extracts. A little study has been done in advance of that, which shows very clearly that Canadian ginseng is effective in reducing blood sugar.

Another study at McMaster, a very small one, showed Canadian ginseng is quite good for suppressing intestinal inflammation. And finally, another one at McMaster, which was done some time ago, showed it may be good for people with cardiovascular disease, because it does contain a number of calcium blockers.

One I almost forgot, a very important one, was done very early by Dr. Larry Wang at the University of Alberta. Again using rats, he showed very clearly that a compound in ginseng, ginsenoside Rb1, actually protects short-term memory. It's very good for short-term memory. Indeed he has a patent on the use of that compound in Alzheimer's disease.

That's my contribution, Madam Chairman.

The Chair: Dr. Jackson.

Dr. Chung-Ja C. Jackson (Ginseng Growers Association of Canada): I'm from the University of Guelph's Centre for Functional Foods. Our function is to analyse the active ingredients in ginseng, not only the active ingredients in ginsenoside. We want to look at the whole nutrient value of ginseng—the vitamins, the proteins, the fibre content, the minerals, and of course the ginsenoside.

The reason is the increased interest in using ginseng medicinally or in prevention. People are showing more interest, so we want to be able to identify what the ingredients are and how much is in each product. Also we want to compare North American ginseng, grown in Ontario and B.C., to the different varieties of ginseng, as to what the active ingredients are, so the customers know what's in there and how much is in there. It will be a collaboration with the government, industry, growers, and consumers.

The Chair: Dr. Awang.

Dr. Dennis Awang: I'll be very brief.

I've been associated with the ginseng community as a member of the board of directors of the Canadian Ginseng Research Foundation, which Professor Francis chairs, and I've also been associated with a number of manufacturers. Also, I was the director of the scientific end of the program of evaluation that was conducted by the American Botanical Council, which was referred to earlier. We looked at between four and five hundred ginseng products. Our analyses, which are going to be published soon in HerbalGram, the official organ of the American Botanical Council, will declare these results.

• 0925

However, we did find, as had been found earlier, that there's a great need for the establishment of programs for assuring the proper identity of ginseng products, as indeed of all herbal products. I've been saying that for many years, all during the time I was at the Health Protection Branch of Health and Welfare Canada.

What is basically needed is a program of certification of botanical identity, so when the consumer buys a product he or she can be assured that the material in that package corresponds to what's declared on the label. That's the greatest need in this whole industry.

Further than that, we do need to have a program for a regular survey of the more important herbal products to make sure that these products are of good quality. I think if that would be instituted, you'd see a greater effort on the part of manufacturers to conform to this.

I won't say anything more, but I'd be pleased to answer any questions about ginseng or the herbal scientific area.

Thank you.

The Chair: Thank you very much.

We'll go to Mr. Richter and then we'll open up to questions.

Mr. Conrad Richter (Vice-President, Richter's Herbs): Thank you for allowing me to address the committee on behalf of commercial herb farmers.

I'm vice-president of Richter's Herbs. We specialize in the sale of herb plants and seeds, especially to the commercial herb growing industry. I sit on the boards of the International Herb Association, the Canadian Herb Society, and the Ontario Herbalists' Association.

Besides speaking on behalf of my company, I'm also representing commercial growers in Canada who have not yet organized formally, nationally. I consider myself qualified to do so because we are a leading supplier of propagated material to the industry and because my company has organized national conferences for commercial growers.

What I'd like to do today is press upon the committee that the regulation of herbal products has a large impact on the commercial herb growers and the industry. Regulatory uncertainty has certainly had an impact on members of our industry.

Just to give you some idea of how we see the industry in Canada, briefly, I'd like to review the industry composition and size. We estimate the annual farm gate sales of herbs and herbal products to be about $150 million to $200 million annually. This is based on a variety of data, including information from our customers, reports from growers at conferences, financial reports, Statistics Canada data, etc. There are at least 1,000 commercial growers who derive the bulk of their revenue from the sale of herbs and herbal products, another 4,000 to 5,000 growers who derive part of their income from herbs, and many who are experimenting with herbs for the first time.

Important medicinal crops in Canada include, of course, ginseng, echinacea, St. John's wort, goldenseal, valerian, dandelion, burdock, and feverfew.

The worldwide market for medicinal herbs is probably in the range of $15 billion, but Canada's production share is less than 1% of the world market, a share hardly commensurate with the availability of arable land in this country. Canada, in our view, is missing a vast opportunity. Opportunities right now are being lost to Australia, New Zealand, the United States, and other major agricultural nations. We know that because Richter's, my company, is selling increasingly more propagated material to farmers in these countries, where the regulatory climate seems to be more favourable for herbal products.

In 1996 I met with six officials of the drugs and food directorates here at Health Canada and I found that the officials were totally unaware that there is a commercial herb growing industry in Canada. They had assumed that all herbs and herbal products sold in Canada were of foreign origin. There were a number of important concerns that came to light at the meeting, and I'd like to relate these to the committee.

• 0930

The first concern was—and this is specific to growers—that the Food and Drugs Act never expressly refers to and indeed never appears to anticipate the sale of live medicinal plants and seeds for planting purposes. However, Health Canada officials told me that they regard the sale of plants and seeds as subject to regulation under the act, especially if medicinal uses are mentioned. A potted plant sold with a label describing medicinal uses would require a drug identification number, they say. But of course, they also say it's impossible to get a DIN for a live plant, a potted plant.

Our industry is also concerned about the effective costs of getting drug identification numbers. Although the published fee is quite nominal, the actual cost to meet all specifications can reach as much as $60,000. At least one client of mine has had that experience. This is an insurmountable barrier for small growers in our industry who wish to market their own herbal products.

Another concern is about quality control parameters. It seems that parameters appropriate for drugs are being applied to herbal products. These are difficult to meet, almost impossible in many cases. Our own research at Richter's has shown that even genetically uniform plant material can yield very inconsistent active constituent levels from year to year, and growers fear that manufacturers will offload the responsibility for constituent levels of their herbal product material onto commercial growers, thereby putting growers at risk of huge losses should their material not meet unrealistically high standards of constituent analysis.

Another concern is that the potential for development of improved varieties of herbs needed to meet the change in quality standards is much more limited than is generally assumed. For example, breeders do not know which of three classes of compounds in echinacea to target. There are dozens of compounds that are suspected to be active in echinacea. Which one do you target if you are a breeder? Even in the case of feverfew, for which there is a regulatory-defined, single-active constituent, there is evidence that there are other compounds now that contribute to feverfew's action against migraine. We have a moving target in terms of breeding and this makes it very difficult.

Another concern of the industry relates to some of the specifics of standards, such as bacterial count standards. The standards that have been applied to herbal products in Canada make it impossible to sell organically grown herbal products. The marketplace is very interested in organically grown material. It's a significant share of the market right now for commercial growers. To meet a drug standard plate count of 1,000, let's say, would actually require gamma radiation, which is unacceptable to consumers of organically grown products. A food standard would perhaps be more appropriate.

I'll conclude, then, with some recommendations from growers.

First, remove the present ambiguity in the Food and Drugs Act concerning the sale of live plants and seeds. The sale of these products is appropriately the purview of Agriculture Canada, not Health Canada.

Second, relax GMP and DIN standards from what's been proposed, perhaps, from excessively narrow standards that would otherwise be appropriate for manufactured drugs. These should be relaxed for herbal products. And give consideration to eliminating the minimum active constituent standards, thus allowing manufacturers to set their own active standards.

In concert with that, we're recommending that it would be more appropriate for the herb industry to adopt a truth-in-labelling strategy for herbal products. If a manufacturer wishes to sell feverfew products, then he should be compelled to prove that his product is free of contaminants and is botanically identical to the label claim, yes. But if another manufacturer wishes to sell feverfew products with a 0.2% parthenolide analysis, then he should be compelled to prove that it's not only free of contaminants and is botanically correct, but also meets that 0.2% label claim within realistic tolerances.

• 0935

We believe these recommendations will ensure the public's access to safe, efficacious herbal products at an affordable price. They will also ensure that the commercial herb farming industry can continue to develop, and especially reach its vast potential in Canada.

Thank you.

The Chair: Thank you very much.

Members, if you want to speak, could you let me know? I'll follow the slot, but just let me know if you want to speak.

Mr. Hill.

Mr. Grant Hill (Macleod, Ref.): I welcome your presence here.

Dr. Awang, your name has been mentioned a number of times as a sad chapter in the HPB. You're an individual whose name I have heard as having some expertise, and your lab of course was closed down and you're no longer there. Is there any expertise today in the HPB in this broad area?

Dr. Dennis Awang: I don't think there is sufficient expertise. I think that's probably why every so often these so-called expert advisory panels are struck, but to my mind the panels that have been struck so far are not sufficiently expert in scientific matters to do the job.

It's interesting. This is a multi-disciplinary pursuit, this herbal science, and it's very difficult to find people who are expert in all disciplines.

I must compliment Mr. Richter on his presentation, but some of the things he said demonstrate the difficulty of getting a really thorough handle on this matter. He spoke about feverfew and the level of parthenolide. I was involved in the establishment of the criteria for acceptability of feverfew material that would be allowed the therapeutic claim of effectiveness in prevention of migraine. Those criteria were, first of all, authentication of the botanical material—a certificate of botanical authentication would have to be provided—and secondly, a minimum level of 0.2% parthenolide. But almost invariably, that 0.2% parthenolide level is interpreted as a level of activity, which it is not. It was meant as an identity criterion in order to separate the chemo-types of the plant.

That sort of expertise is absolutely not resident in Health Protection Branch.

Mr. Grant Hill: That answers my question.

We hear from many witnesses that these products are relatively problem-free and very low-risk, and yet you have said that Korean ginseng can produce nosebleeds and possibly raise blood pressure. Is ginseng one of those products that has enough chemical activity that it needs to be regulated at a higher level than some of the other products?

Mr. Michael Atkins: No way. If you look at the recommended rates for Korean ginseng, they're very low, actually. And the Chinese were saying do not give it to children under the age of 12, because the blood vessels in their noses are very thin.

That's one thing we should be able to say to people, just as a precaution, because you have people out there who don't know the difference, and that was my point. People do not know or understand the difference, and we're not allowed to suggest or tell them what the difference is. With Canadian ginseng, studies have shown that to a certain extent it will lower blood pressure or it will make it remain the same.

So that's part of the problem we run into. I've never heard of anybody actually having a problem from any herbal product if taken properly. If you look at all the problems people get from prescription drugs versus herbal, there's no comparison. Herbal is safe. I'm not saying that prescription drugs aren't, but we're talking about something that is natural and is in very low dosages. We're talking something that is—how can I put it?—a natural thing. It hasn't been processed, other than being ground up and sterilized, so there's no E. coli bacteria or this type of stuff in it. We're talking about something entirely natural.

• 0940

If you look at a lot of the medicines we have nowadays, their origin is herbal, be it aspirin, which I believe came from willow bark, or one heart medication I know of that comes from another herb. We're talking about natural things here. We're not talking about something that somebody's enhanced or re-engineered or made a different form of or a different molecule of or whatever. We're talking about something natural that people over the centuries have taken.

Mr. Grant Hill: So your wish, then, in a scientific sense, to isolate the active components, to make certain that all the genotypes are available, is to get the best product with the best information for the public? It can become inconsistent. If you say on the one hand that one product is inferior and has problems and on the other hand that it's all safe, that's an inconsistent message to me.

Dr. Tom Francis: But I don't think he's saying that. I don't think he's saying that the Korean ginseng is not a good herbal remedy. They're two entirely different things. There's a large degree of difference in the chemical composition between the two of them.

Mr. Grant Hill: And you want to know what the chemical composition is and you want to know what the action is.

Dr. Tom Francis: To a degree, but when you think there might be 50, 60, 70, 80 or 100 different things in the...for example, there are, I believe, 37 or 39 ginsenosides and 6 or 7 panaxins, which are the things that affect diabetes, so you couldn't possibly do an analysis for all of these things. The price would be just too prohibitive. You couldn't do it.

Mr. Grant Hill: So what's Dr. Jackson doing, then? You've said it's impossible and she's—

Dr. Chung-Ja Jackson: No. We are not trying to analyse every single component in the herbal product. We want to look at the main active ingredients, and for most active ingredients the percentage is higher.

I'll use the example of soybeans and soybean products. Isoflavone is the vital estrogen, the vital chemical that provides the health benefit. We've been testing 13 varieties grown in Ontario, in a two-year study in three locations. We find that from variety to variety of soybeans, the isoflavone levels are 1 milligram per gram weight to 3 milligrams, for all varieties. Also, there are 12 isoflavone in each soybean and the composition of each isoflavone level is different.

We are trying to develop the methodology in order to be able to determine what the active ingredients are in each product, so that we know when anything grows what's in there, and when they make the original into a product, at least industry can be quoted about how much is in there, about what's in there. It's a kind of a safeguard against not knowing what's in there.

For one of the garlic products we've been testing that's on the market—a million-dollar business, but I cannot name it—the one product they are selling so well is supposed to have high allicin levels, allicin being one of the active ingredients in garlic. There were zero allicins. When products claim whatever amount they do, we must make sure there is that amount. As scientists, we are trying to determine what the active ingredients are, how much of it there is in the original product, and how much there is in the processed food.

Mr. Michael Atkins: Maybe further to what Mr. Hill is referring to, and to what I'm trying to get at, there are different types of ginseng. Everybody's heard of Siberian ginseng, but it's not even a ginseng. It's a member of the ivy family, and it's actually the root of that family. A lot of products are being manufactured with the word “ginseng” in big bold letters on the package, and underneath, in small letters, the word “Siberian” or whatever. And people have heard the buzzword “ginseng” and they go get this stuff. I'm not saying this doesn't have some effects, because students take it to help them study for exams; women take it and they feel it helps them. But that's not even ginseng.

• 0945

Then you have Korean ginseng, be it red or white. The only difference is the curing process. The red is steamed while the white is dried the way we dry ours, basically with either sun or heat.

You have Chinese ginseng, be it red or white, the same variety as the Korean.

You have Japanese ginseng. It's basically the same variety as Asiatic ginseng.

Then you have North American ginseng, be it from Ontario, B.C., or Wisconsin. It's grown in Prince Edward Island and Nova Scotia, in New Brunswick, Quebec. There's some in Alberta. Wisconsin is the big state down in the United States, but there is a little bit in Illinois, Indiana, Minnesota, New York.

What we're saying specific to the ginseng industry is to put it with all herbs. There is common knowledge out there of what the supposed benefits are or what the warning...not the warning, but the things you should be able to tell consumers.

I'm not a doctor. I'm not saying I'm a doctor or even hinting I'm a doctor. We talk about Korean ginseng or Chinese ginseng versus North American ginseng. Some people are much better off taking North American ginseng. Some people are much better off taking Chinese or Korean ginseng, based on the way they are, their metabolism or whatever. That's what we can't say to people.

We're not trying to make claims. We want to be able to inform people of what they should know, just as with any other herbal product.

The Chair: Thank you very much.

[Translation]

Mr. Dumas, do you have any questions?

Mr. Maurice Dumas (Argenteuil—Papineau, BQ): I would like to thank you for taking part in this morning's meeting. I was particularly impressed by what Dr. Francis had to say about ginseng. Obviously, it was particularly pertinent to me when he said that ginseng is good for short-term memory. A bit of that is good when you start getting old. Obviously, that's when it gets to you.

I would like to ask Mr. Richter a question about quality standards. When you were talking about herbal products, you said that the quality of everything that grows in the ground depends on the sun and the rain. Now, what is it that guarantees the quality of these products from one year to the next?

Take wine for example. We know that, because of grape quality, wine will be very good one year but perhaps not so good the next. How do we know that the crops will be excellent and that your products will be of high quality?

[English]

Mr. Conrad Richter: Take the case of wine. It would be very difficult to analyse that wine in chemical constituents and come up with a quality mapping between the various chemical constituents and what quality wine tasters say makes one wine better than another.

This really alludes to the whole problem here with the herb industry. It's very difficult to relate any objective, active constituent analysis with quality, in many respects. There are some gross characters, yes, that are important. You certainly don't want to have excessive fungi or certain kinds of rotting in your material. You certainly don't want to have contaminants, weeds, and other materials.

But to try to say that a set of active constituents, or any constituent—chemical constituent—translates into a higher-quality or a lower-quality product is very difficult in our industry. Really, this is the nub of the problem for herbs. To some extent, it may be necessary to step back from that whole philosophy, that whole notion, and focus more on the traditional gross characteristics of herbs, such as smell, appearance, and so on, to some degree.

• 0950

This is a question that really is not easy to answer at this point. If you're looking for a simple test, send it to a lab. It comes back assessing the quality. It's not going to be that easy. Even in ginseng, as has been alluded to, there are 100 different components. Which compounds are you going to say you're going to use to measure the quality of any particular lot? I don't know. I don't think they know.

[Translation]

Mr. Maurice Dumas: I'll repeat my question. Since the quality of crops is not the same from one year to another, how do we know that the quality of your product will be the same, given this variability?,

[English]

Mr. Conrad Richter: The high-quality product is going to be assured, we hope, by the parameters, which may turn out to be just gross parameters. They may be parameters such as, as I mentioned, bacterial and fungi counts, or water content, or the content of other contaminants. They may be the only objective parameters for some herbal products.

The Chair: Mr. Myers.

Mr. Lynn Myers (Waterloo—Wellington, Lib.): Thank you, Madam Chair.

Mr. Richter, I noted Mr. Atkins said ginseng was a $100-million industry, and you used $150 million to $200 million overall. Does that account for the $100 million out of that?

Mr. Conrad Richter: Yes, I'm including...

[Editor's Note: Inaudible]

Mr. Lynn Myers: As a farmer I'm a little disturbed when you say we're missing this vast opportunity. I wonder if you could zero in on where this opportunity is. More to the point, what should be done to capitalize on that?

Mr. Conrad Richter: As I mentioned, we think Canada is participating at a production level at such a minuscule percentage worldwide...we estimate it to be less than 1%. First of all, in Canada we are an agriculture nation. We have a tremendous body of expertise out there. Not only that, but we have a tremendous willingness out there to grow herbs. I can't tell you the last day on which I have not been called by a farmer and asked for advice on how to get into the business of growing herbs. There is enormous interest out there.

In the last couple of years, conferences on the question of commercial herb growing have been overwhelmed. We put on two conferences in 1996 and 1997 and each of them have been over-subscribed. Over 300 or 400 people attended these conferences, all either in the business of growing herbs already or interested in getting into the business.

We have an agricultural expertise out there. We have a willingness to try medicinal herbs. We have some fantastic success stories. Let me give you an example. One of my clients has a 10-acre farm in southern Ontario. He grosses over $1 million on that 10-acre farm. We're talking about $100,000 per acre. There is no crop in this country—outside of cannabis—that can produce that kind of revenue on an annual basis. So the opportunities are there.

In this particular example, a lot of the value in that $100,000 per acre is value added; that is, through value-added manufacturing. This grower is very astute. He grows his product, he manufactures his herbal products, and he distributes through health food stores, through food co-ops, and through direct sales.

• 0955

These are the kinds of opportunities out there, and farmers are hearing about it and they want to get into it. But I also have to tell these clients, “Well, hold it. Try it, experiment, but keep in mind that the regulatory climate in Canada is scary. You don't know what's going to happen to your crop.” From one year to the next a crop can be banned. That happened in the case of comfrey. Anyone growing comfrey five or ten years ago is not growing comfrey now because comfrey products cannot be sold in this country.

Mr. Lynn Myers: So what you're really saying is that we need a clear set of consistent rules that farmers and producers can tap into to know exactly where they're going.

Mr. Conrad Richter: Exactly. Regulatory uncertainty is the biggest problem right now.

Mr. Lynn Myers: I think that's an important point.

Dr. Awang, I was curious. You spoke of the program of certification, and you also said that good quality must be ensured. I wonder if you could elaborate on those two points. I think they're very important.

Dr. Dennis Awang: If you permit me, I'd just like to make a comment on the comfrey situation, because it was during my tenure at Health Protection Branch that we banned the use of comfrey internally because of a legitimate health risk associated with liver damage and the consumption of comfrey pyrrolizidine alkaloids. Comfrey can be sold but can only used as an external application for wound healing on unbroken skin.

About the certification program, the WHO has a program of certification for pharmaceuticals. When I was involved with deliberations there, I proposed that a similar program be instituted for certification of botanical raw material. We'd want Mr. Richter to assure us that what he's selling is actually what it is in terms of its official botanical name and all the rest of it—the part of the plant and so forth—and also provide us with voucher specimens so that we could check, should there be a problem with adverse reaction down the road or a lack of quality, the authenticity of the material.

This has happened. Even at the botany department of the University of Texas, a voucher specimen that was supposed to be camomile was found to be dog fennel, Anthemis cotula. So it can happen even there.

If we had such a system, we would put the responsibility on the grower, supplier, fabricator, manufacturer—and an outfit can be all of these—to assure us of the botanical authenticity, identity, of that product.

This would also be helpful in terms of trying to track the reasons for adverse reactions occurring if we have some idea of what the identity of the product is. This is a problem with botanicals that are not accorded DINs. Most ginseng is sold without a drug identification number because no claims are allowed. Oddly enough, in most of the European regulatory constituencies they do allow a claim for ginseng in terms of its potential for aid, particularly in the aged, with mental acuity and physical energy and that sort of thing. I can't see the harm in that. But in Canada, no. It's sold without a drug identification number, without any claim, and if you go through the food directorate you do not have to put the Latin binomial down.

So you can sell ginseng with small-labelled “Siberian”, suggesting to the consumer that this is in fact Asian ginseng grown in Siberia when in fact it's a totally different plant, Eleutherococcus senticosis, as we heard earlier.

So there is a lot to be done, but there are very simple programs that could be instituted that would change and improve the character of this industry enormously. But either nobody is listening or they don't want to hear it.

Mr. Lynn Myers: We're listening.

I wonder if Mr. Atkins could respond quickly to this.

The Chair: Mr. Atkins, did you want this gentleman to sit at the table to be able to respond?

Mr. Michael Atkins: Yes, Gary wants to say a couple of things, and I'll let him do that in a minute.

If you don't mind, I'd like to very quickly talk about the different growing seasons. It may affect quality. It's like wine. Every season is a little bit different, but that wine has a quality.

• 1000

It's what you put into it. That's what we're all saying. We're going to put quality stuff in, and then let us say on the label this is what it is, and everybody has to obey those rules. We want to work with everybody to give everybody a good-quality product.

Gary, you have something to add?

The Chair: Would you ask him to identify himself?

Mr. Michael Atkins: This is Dr. Gary Kakis from the University of Toronto.

Dr. Gary Kakis (Individual Presentation): I want to respond to Mr. Dumas' question, which was an excellent question: how do you know the vintage of the particular herb you are looking at?

You can't look at it in terms of whether you are getting 50 milligrams of an active ingredient or 10 milligrams of an active ingredient, because there's an enormous history to the use of these things that dates back thousands of years, with thousands of publications.

Think of it in terms of something very simple, such as vitamin C. You can take 50 milligrams of vitamin C and prevent scurvy, you can take 30 milligrams and prevent scurvy, you can take 20 milligrams and prevent scurvy, or you can take 200 milligrams and prevent scurvy. So the vintage really doesn't matter that much. These things tend to work because there's more than enough of whatever the active ingredient is.

We don't know, in most cases, what the active ingredient is, and that's where the excitement is, when we think we've discovered the active ingredient in this or that. But basically, for most things we still haven't the foggiest idea, and we have a long way to go. As Dr. Awang was saying, what is more critical at this stage is simply to make sure that if it's stated that there's camomile in this preparation, there is camomile there and not something else.

The Chair: Mr. Vellacott has a question for you.

Mr. Maurice Vellacott (Wanuskewin, Ref.): I question your analogy of the vitamin C here. If you take an excess of vitamin C, as you know, that's excreted or passed out, so no harm is done to the individual because they've taken excess vitamin C. But it's not necessarily the same with some of these other products. If you're saying there's that kind of variance, it could be harmful or, who knows, maybe even lethal; it could have some adverse or negative effect.

Dr. Gary Kakis: You're right, but only to a certain extent, because most of these things, in having their effect, tend to normalize.

Ginseng is an example in terms of the blood glucose. We did an extensive study on normals before we did the small study on diabetics. In normal individuals, where you look at all kinds of parameters that you would measure in a diabetic—and we looked at everything—it does nothing. And this was a relatively high dosage. However, if you have someone who is pre-diabetic or diabetic and you give them the ginseng, you get a very dramatic effect: blood sugar is normalized.

So it's not the same as a drug, except the example of the high blood pressure in children, which I think is a relatively rare occasion, and it will be a detrimental side effect, but it's not recommended for children anyway. I wouldn't imagine a child taking ginseng.

The Chair: I think we'll move to Ms. Bennett. If you have another question, you can get on the list.

Mr. Maurice Vellacott: That's fine.

Ms. Carolyn Bennett (St. Paul's, Lib.): As you know, the committee is struggling with what is the appropriate role for the industry and what's the appropriate role for government. What should be done with specific practitioners? What can be available off the shelf? What should be on the labels? Is what's in the bottle what it says on the bottle?

We've heard from some players that they think the industry could regulate this themselves with the expert panel they would set up. Some of us feel there probably is a role for government in being able to test that if it says melatonin on it, there's actually melatonin in it. Then the whole issue of claims or efficacy and all of that is something I'm not sure we're going to really be able to sort out.

What do you think the role for the industry is and what is the role for government?

First I would love to hear from Dr. Awang about the four or five things he said we could do immediately to get some of this sorted out.

• 1005

Dr. Dennis Awang: First of all, you have the certification-of-identity scheme. Secondly, you have a program of lab testing of materials.

Ms. Carolyn Bennett: Who does that?

Dr. Dennis Awang: Government should do it. I don't believe in this “fox in the hen house” approach. You should do it. In fact, we were doing that at Health Protection and at the Bureau of Drug Research when I was heading the natural products section. It was felt by no less eminent a person than Professor Varro Tyler that we were the best lab of this type on the continent. We had prioritized a list of plants based on market value. We had assessed potential risk and stuff like that. We were doing that, and that should be done. I think that would have the effect of having the manufacturers pay closer attention, especially if you attached to failures a substantial final penalty.

Third, this addresses the point about claims. You should have real experts convened to examine the medical—the clinical—data and decide what claims are appropriate. This could be done in a spirit of harmony with other regulatory agencies, particularly the European Union group, to have international harmony on the establishment of therapeutic claims.

In terms of safety, I don't believe that natural is necessarily safe. I do believe these herbal products are generally milder, cumulative, have long-term action and so on, but there are some poisonous ones and the regulatory agencies should have a hand in regulating them. Prohibit germander. Tell people not to eat pyrrolizidine alkaloids. There are other cases where—

Ms. Carolyn Bennett: The presence of pesticides.... Obviously there have been problems. Hopefully, the government—

Dr. Dennis Awang: That's motherhood. I don't know if that's still politically correct, but all plants—

Ms. Carolyn Bennett: What is happening now, since your lab's been closed?

Dr. Dennis Awang: Nothing. They rely on the industry to provide data that they decide is required. For example, in the case of feverfew, they say provide an assay for parthenolide, which, as I noted, is an identity criterion. But there's no lab certification program. You don't know if the analysts are competent. What does it mean? If you're clever, you can make it up, submit it, just as you can put lawn grass in a capsule, call it valerian, and get a DIN for it. You don't have to prove anything.

Ms. Carolyn Bennett: Right now, if I go to the store and buy valerian, I really have no assurance that this is what—

Dr. Dennis Awang: You have to rely on information provided to you by knowledgeable people, people who know the science, who know the market, the reputation of the manufacturers. That's what you have to do.

Ms. Carolyn Bennett: That's a lot of responsibility for me.

Dr. Dennis Awang: I'll say. I think there's perhaps a greater travesty occurring in the consumer buying useless material. I think a lot of people have the view that Health Protection isn't particularly concerned about whether these materials help you. They're totally risk-oriented, protecting their proverbials and making sure they're not blamed for anybody dying, but I don't think they're particularly committed to ensuring that these products are beneficial to the Canadian consumer. There's a lot of work that needs to to done. It is true that in most cases we don't know precisely what the active constituents are that are responsible for the claimed beneficial effect.

There's progress going on. There are groups of compounds and compounds identified as likely the most active.

In the case of ginseng, I think it is almost universally accepted that the most active constituents are the so-call ginsenosides on which the chemical testing is based. There are eight of them that have been tested. Usually seven are tested for, and some people test for six, but that is the basis for the differentiation between the different ginseng species. So we can tell now—and this is being done in our program—whether a product out there that says it's North American ginseng is North American ginseng or Asian ginseng, because if we see ginsenoside RF we know it's either Asian ginseng or it's contaminated with Asian ginseng.

• 1010

So there's been a lot of good science, and good progress has been made, but I'm afraid the regulatory agency is not supporting that progression and does not have the scientific expertise to even judge it.

Ms. Carolyn Bennett: Is there a document that explains why HPB decided to close your lab?

Dr. Dennis Awang: No. I was told to go to a meeting in an hour and a half and the director said, “You're toast. That's it.”

Interestingly, later, after the international interest was evinced in this area, there was a halting attempt to try to acquire some expertise within the Bureau of Drug Research. In fact, one of the chemists from BDR actually came to our phytochemical lab at the University of Ottawa to talk to the people who were doing phytochemical testing there. But then, of course, the whole BDR has been squashed, so there's absolutely no scientific research or capability there any more.

Ms. Carolyn Bennett: The universities have picked up some of the basic research in this field.

Dr. Chung-Ja Jackson: Yes.

Ms. Carolyn Bennett: But the actual quality testing and all of that is not being done.

Dr. Dennis Awang: No.

Dr. Chung-Ja Jackson: It's quality in the sense that the methodology and testing are being developed for the analysis of the active ingredients, and the next step will be a clinical study on a certain product with a known amount of each ingredient. Depending on the compound, you start with the animal and then go to the human. Based on that, whoever the producers and whatever the products, the constituents are checked on a regular basis, because the air and weather and environmental conditions will change the constituents.

How are consumers guaranteed the quality of the products? Botanical scientists are continually doing research to improve the species, by good breeding and genetic alterations. If I can give you another example, the protein in soybean, regardless of the variety, is about 50%. They are also trying to increase the isoflavone levels at a certain stage. Also, after so many years of cropping, some mutation might come in.

But good scientists are trying to work at the best possible quality, continuously doing the research. Those crops will be planted for next year.

The Chair: I just have Mr. Volpe here. Does anybody else want to get on the list? No? Okay.

Mr. Volpe.

Mr. Joseph Volpe (Eglinton—Lawrence, Lib.): Gee, Madam Chair, I thought for a second there you didn't want to get to me. You were waiting for everybody else to get on.

The Chair: No, I was just wondering if....

Mr. Joseph Volpe: No, that's okay.

Some hon. members: Oh, oh!

Mr. Joseph Volpe: Dr. Awang, I was under the impression you were going to appear before this committee on another occasion, because the committee had expressed a desire some weeks ago to delve into the issues associated with some of the decisions that led to the closure of your bureau and the change in policy that developed as a result at the earlier part of the decade. So I'm wondering whether I can defer some of my questions for when that occasion arises.

You've certainly caused a few issues to surface again, but I would like to, if I could, just refer to three areas. So you know where I'm coming from, I recall a time when, as a young boy, we didn't have pharmaceuticals and we didn't worry about going to buy herbals, but for virtually every malady, every scrape, every injury, somebody went out into the field and picked up the appropriate herbs. I don't know whether they did any good, Dr. Awang, but it appears they didn't do any harm.

That causes me to think of this whole question of education. We've raised the issue of labelling and we've raised the issue of claims. In my archaic, rustic environment, there was no question of labelling and no question of claims. Everybody just kind of “knew”. But there was a certain sense of quality.

• 1015

Monsieur Dumas raised the question just as I was formulating it. It must have been because we rode on the same elevator together, so our biorhythms must have been in synch.

I'm wondering whether one of the problems you're facing as an industry is that you yourselves have not yet given assurances, both to the public and to regulators, that you have a consistency of product. I hesitate to use the word “quality”, although Monsieur Dumas said that when lawn growers started to penetrate the market a few years ago, not that long ago, they decided the only way they could make any headway was to control the growers themselves and to ensure there was a certain consistency of process and product at the end of the line.

From what I've heard so far in the committee, I can go into any store right now and pick up literally grass, and it can be sold to me as virtually anything I want to buy. That's probably an exaggeration, but from your expressions today and yours, Mr. Richter, I have a sense that I can't have security or comfort in what I'm buying, because the people in your business aren't interested in providing that consistency of product and aren't interested in the quality or self-regulation to ensure that's there. I'm not talking about what Dr. Awang is talking about, the active ingredients, but just the quality of the product.

Mr. Michael Atkins: I can answer some of those, and then I'll give Conrad a chance.

The vast majority of us are very conscious of quality, and we want quality out there. We find it's hard to compete against the people who aren't putting out the quality. That's why I did ginsenoside analysis before I started even putting out my own products. The stuff I found out there was scary, but I'm not going to go against some big company that has a whole lot more money than I have, and probably a lot of Conrad's customers aren't going to do the same thing.

As I say, the vast majority of us are out there, trying to put out a quality product, and we're doing it. What we're looking at and what we're saying we're willing to do, if we can get the support from the government, is to set up quality standards through the Canadian Health Food Association, through the manufacturers, or whatever, but with the back-up of the government so it has teeth in it.

But don't try to regulate us to death and say, “Your facilities have to be this” or “You're manufacturing a drug” or whatever. You'll ruin and kill the whole herbal industry if you do that. But if—

Mr. Joseph Volpe: Surely you must accept that the regulator, even if, to paraphrase Dr. Awang's observation, it's usually in the business of covering its own why, must be rigorous, especially in the absence of a willingness in the industry to self-regulate.

Mr. Michael Atkins: There is a willingness. If you talk to the people who are members of the Canadian Health Food Association, you'll find that we want to do it, and we want everybody to have to play by the same rules as we want to play by. So what we're saying is give us help to do it and we'll do it with your support. There will have to be labs to double-check, and if somebody is putting something out there and claiming it is something it's not, go after them, nail them to the wall. I don't care, and the reputable people would be happy to see that.

But for the people who are trying to put out the quality product—and we're doing it—don't bog us down in red tape. Be supportive of us and we will be supportive of what has to be done, because we want to give the consumer the best-quality product we can give him, so he can take it and rest assured that he's getting what he's paying for.

Right now it seems the government or the bureaucracy is worried about us being a drug and they don't know how to handle us. It used to be we were classified as food. We're saying we're not a food and we're not a drug; we're somewhere in between. Please give us a chance, with cooperation, to tell everybody, these are the standards, this is what you're going to do, this is what's on your label, and if your product is found not to be what you say it is, these are the penalties you're going to face.

I can't name companies, but there are companies out there putting out products that are nowhere near....

• 1020

In a lot of cases, it's not the small guys. We're putting out good stuff. We want a level playing field. We want quality for consumers. We want them to know what they're getting. We want standards, and we want to work to get those standards.

Mr. Joseph Volpe: So does the regulator, Mr. Atkins. And I don't mean to sound harsh, but when we can't name companies, then it means all companies are guilty. That's the problem.

You've raised the issue of labelling, which was the second question I wanted to address if I could. Labelling is not only a question of content, I think labelling addresses in part the issue of claims. I have yet to hear of a substantial movement to reform the labelling process either for things that are encased in a bottle and a package or those that are allowed to be sold free-standing.

Precisely as was indicated earlier on by Dr. Francis, supported I think by Dr. Jackson, the labelling issue for foods and non-foods is precisely that our legislation so far is not as rigorous as that in other jurisdictions. You can get away with simply indicating what the contents are. You're encouraged to put only the most dominant ingredient in the contents first, and then the rest fall into place.

You may be able to sell ginseng, with a microscopic “Siberian” below, and that's okay. It's not considered fraud, but I think that would be almost criminal under any ethical standards. I can say that because I have immunity here, and if I knew the name of the company I'd even name it. You have immunity even in committee; it's the same thing.

I'm just wondering whether your organizations are getting to the stage of the game whereby they want to propose a format for different labelling, labelling that might be more reflective of an indication that there's a willingness to educate the public.

Mr. Michael Atkins: I'm just looking at whether the objective—

Mr. Joseph Volpe: Dr. Awang wanted to say something.

Dr. Dennis Awang: About the labelling matter, I think the greatest transgression is committed by the regulatory agency that doesn't police the situation properly. There are all kinds of nice little regulations about how many milligrams you're suppose to take regardless of what's in the bottle. If you go into the health food stores, though—and now more so in the pharmacies—you will find products there that are making claims that are patently illegal.

There was a product that was claiming to be useful for treating prostatitis—in parentheses, an inflammation of the prostate—which is a schedule A disease. It's being sold in a pharmacy by a known company, and the product name obviously relates to treating the prostate. That is an infringement of the labelling regulations.

I have seen products that originally conformed with the regulation in not making a therapeutic claim. Then, presumably in recognition of the lack of effective policing, later on I saw a new label with a green star on it, making the claim, in our pharmacies.

In fact, I'll tell you something further. I told the pharmacist about this. I said these products are making illegal claims, they have no DINs, and they should be taken off the shelf. The pharmacist in attendance at the time took it off and said he'd speak to the agent for the company. I went back a few weeks later—this is across the street from where I live—and they were back on.

Mr. Joseph Volpe: We're probably going a little bit ahead of ourselves because—

Dr. Dennis Awang: But that's about labelling.

Mr. Joseph Volpe: That's okay, but I want to defer some of the questions for another occasion, when we probably have a more vigorous exchange with you and the other committee members.

I'm sure you have some views as to why the regulator is perceived not to be following up on its labelling legislation.

Dr. Dennis Awang: It's not perceived. They say they don't have much influence at the retail level. Well, I say that's the business end. That's where you ought to have the influence, because it's the consumer who is going to buy the stuff and who is getting bad information and bad products from some people.

• 1025

I might also point out, in support of Mr. Atkins' position, that the industry is taking the lead in this. This project—

Mr. Joseph Volpe: The lead? In what? In abusing the regulations and legislation and—

Dr. Dennis Awang: No, in surveying the quality of products.

Mr. Joseph Volpe: Okay.

Dr. Dennis Awang: This program, supported by the American Botanical Council, was financed by industry, not by the regulators, and it's because of those responsible manufacturers who want to show how their products compare with some of the other fly-by-night—or day, whatever—products. That's why they have instituted these programs.

The Chair: Time's up. I think Mr. Atkins wants to answer your question, Mr. Volpe.

Mr. Michael Atkins: Yes. Actually, the Ginseng Growers Association and the Wisconsin ginseng growers both contributed money to the study of products. We did the study in Canada first. We were talking to Mark Blumenthal from the American Botanical Council before they even initiated the study.

But anyway, I'll make this quick, and I appreciate your giving me the time, Madam Chairman. I apologize for calling you by your first name earlier.

The Chair: That's all right. I don't mind.

Mr. Michael Atkins: The Ginseng Growers Association of Canada, through the AIMS thing, has three objectives: to define a set of national quality standards that can be applied to production, manufacture, distribution and retail of ginseng root—all ginsengs—and the value-added products produced and sold in Canada, which could serve as a basis for developing international quality standards for ginseng.

Part of the problem has been that mixing fraud, adulteration and misrepresentation are generally considered to be widespread internationally, including in Canada, and are practised in many forms. Currently, no internationally or nationally recognized quality standards exist for ginseng root or value-added products.

The Chair: Could we have a copy of that? You can give it to the clerk.

Mr. Michael Atkins: Yes, or I can make copies for you.

The Chair: Thank you.

Mr. Michael Atkins: China has introduced some standards.

Then we have objective number seven: to implement a national quality control program or a quality assurance program. If national quality standards were implemented, a structure would have to be put in place to ensure compliance, and compliance is what we're all asking for. We can't do it without government support. But we're saying, hey, we'll do it, we'll set it up, but help us to make sure everybody abides by the rules.

Mr. Joseph Volpe: Madam Chair, Dr. Awang...we'll keep that in mind so when he appears again he'll give us the how-to and tell us how much we would have to spend to do that.

Mr. Michael Atkins: I think you will find most people in the industry...even myself, I want my product to be tested. And as long as the testing is a reasonable price, you will find the responsible people asking to have their stuff tested, because they want the results so they can show the consumer. It's a good sales pitch, basically, that “hey, this has been tested” pitch. It means that this is is what it is, said so by something totally independent, and then the consumer would know. Anyway—

The Chair: Thank you. We'll go on to Mr. Hill. Maybe your answer will come up with the question.

Mr. Michael Atkins: Thank you.

Mr. Grant Hill: We're just about done, but I would like to ask each one of you, with your expertise, to say which country has a better regulatory regime than we do. Which country should we look at? Could you just tell me what country you think is best, if you have an opinion on that?

Mr. Conrad Richter: From our perspective, in regard to the development of commercial herb growing and the rate at which the industries are growing in different countries, I'm impressed with what's going on in Australia, for instance.

Dr. Dennis Awang: I'd say Germany, with the potential for improvement.

Dr. Chung-Ja Jackson: Yes, I say Germany. Germany has its Commission E, which controls all the herbal products. It's an excellent organization.

Dr. Tom Francis: It's never really been a concern of mine.

Mr. Joseph Volpe: What was that?

Mr. Grant Hill: No opinion.

Dr. Tom Francis: My concern is more with the research that goes into the—

Mr. Grant Hill: Oh, okay.

Mr. Michael Atkins: I would definitely not say Germany, because everything over there now is controlled by the pharmaceutical industry. If you're talking about no control by the pharmaceutical industry, because what's happened in Germany, they have Codex Alimentarius, and it's a case of—

Mr. Grant Hill: So not Germany. Which?

Mr. Michael Atkins: Okay, I'm going to say Australia or—

The Chair: We're planning a trip.

Some hon. members: Oh, oh!

Mr. Grant Hill: Australia or what?

Mr. Michael Atkins: I'm going to say other countries in Europe, because over 50% of the people are using natural products.

Mr. Grant Hill: And Dr. Kakis, do you have an opinion?

Dr. Gary Kakis: I'm in the research end of it.

Mr. Grant Hill: Okay. Thank you.

The Chair: I know we're finished now, but there are a couple of questions the researchers would like us to catch up on.

• 1030

Dr. Francis, I think, mentioned research studies. Can you tell us who funds this type of research on natural health products? Does the Medical Research Council fund any research? As well, does either Health Canada or Agriculture Canada fund any research on these products?

Dr. Chung-Ja Jackson: Agriculture Canada has been funding this, and some industries. For instance, we got some funding from the Ontario Soybean Growers Marketing Board.

The Chair: Can you name any industries that are doing this funding?

Dr. Chung-Ja Jackson: There has also been some research on ginseng by ginseng industries, through the Ginseng Growers Association.

The Chair: Okay.

I have one other short question. We have heard some people mention adverse or negative effects from these products. Let's say I want to report something. What system is currently in place to report negative incidents?

If the answer is no, do you have any suggestions for collecting and disseminating information that comes back?

Mr. Michael Atkins: I think a lot of it is that when you get negative things, if you track back, it's been something that's been mislabelled by a company, either knowingly or unknowingly—

The Chair: I'm not asking that. I'm asking, how can I, as a consumer, report that I got a stomach-ache when I took something last week? To whom do I report that? Is there a system in place? Have you a suggestion of how we could get reporting back from consumers—the ones who use it?

Mr. Michael Atkins: If anybody has a problem with our products—and we haven't had any to speak of—they can call us.

The Chair: Is your phone number on your products?

Mr. Michael Atkins: Yes.

The Chair: Okay. Thank you.

Dr. Dennis Awang: There is an ADR system for conventional pharmaceuticals. I think now, with the increased involvement of pharmacies and pharmacists, adverse drug reaction reports could perhaps be channelled through them.

The Chair: Back to the industry or...?

Dr. Dennis Awang: Yes, through pharmacists, because quite often people don't tell their doctors that they're doing this alternative thing.

The Chair: Conrad.

Mr. Conrad Richter: I think the medical health care community has to be very much involved in that, because they're going to characterize the—

The Chair: But I'm a consumer, I've just taken something, and I want to complain. Right now, to whom would I complain?

Mr. Conrad Richter: At the moment, as far as I know, there isn't anybody.

The Chair: So what is your suggestion for me as a consumer? What could be set up?

Mr. Conrad Richter: My own feeling is that we should certainly get the health care providers involved. Doctors and so on have to be involved.

The Chair: But they don't prescribe it anyway, so why would they be? I'm playing devil's advocate here. I buy the stuff, but my doctor didn't tell me to take it. Why would I go back to my doctor and complain?

Mr. Conrad Richter: Because an adverse reaction is a medical condition at that point.

The Chair: Okay.

Mr. Michael Atkins: One thing I'd like to state is that there have never been any adverse effects from Canadian ginseng.

The Chair: Well, we don't know. There's no place to report it. You have no idea.

Thank you very much for contributing today.

We'll take a five-minute break.

• 1033

• 1044

The Chair: We're calling the meeting back to order. We have three groups with us for this part of our meeting.

Who is going to be the spokesman for The Chamber of Chinese Herbal Medicine of Canada?

Mr. Andy Shih (Vice-President, Chamber of Chinese Herbal Medicine of Canada): I'll be the spokesperson.

The Chair: Mr. Shih, we'll ask you to introduce your group in just a moment.

Next we have the Kiu Shun Trading Company Limited. Mr. Fok is the spokesman.

For the Canadian Chinese Herbal Professional and Merchants Association, Mr. Yu, are you the spokesman?

Mr. Lin-Hoi Yu (Chairman, Canadian Chinese Herbal Professional and Merchants Association): Yes.

The Chair: We'll have you speak in that order, no more than 10 minutes per group. Then we can have more time for questioning.

We'll start with the Chamber of Chinese Herbal Medicine of Canada. Mr. Shih is first.

• 1045

Mr. Shih, would you introduce the people with you, please.

Mr. Andy Shih: Good morning.

Today we have four reps from our chamber. Mr. Wung is president of our association. I'm the vice-president. Mr. Cheng and Mr. Cheung are also vice-presidents.

As our time is limited, I would like to go straight into our presentation. I believe I've given you a copy of my presentation. I will very quickly go over it. I know it's quite thick, but there are very few words.

First, who are we? We are a national trade organization, with members across Canada. We represent the entire spectrum of the industry. We specialize in Chinese herbs and herbal products. Today we're speaking not only for our chamber. We're also speaking on the issue of Chinese herbs, representing four major community groups.

In terms of regulation and regulatory framework, exactly what size of problem, and what size of population, are we dealing with? Chinese traditional herbal medicine has been in Canada more than 50 years, if not 100, and 90% of the products still consumed by the Chinese community come from Chinatown. The market size is less than $50 million. According to government research, it's about $20 million. So we're not talking about a big business, but in terms of culture and tradition, it is very important to the Chinese community.

In terms of the problems we face today, I will give you just a few highlighted points. First, 40% of our products have already disappeared from the market over the last 10 years. Over the last 10 years, we have been trying to comply with the regulations, but only 4% have been successful in terms of a DIN approval rate.

Some of the herbs that we consider very critical, such as ginseng and dong quai, have been classified as drugs or new drugs, which makes it impossible to receive DIN. We're also facing labelling restrictions.

We have done some root cause analysis of why we have met with such a tremendous problem even though, to our knowledge, there's no track record in terms of problems. We believe the root cause of our problem is that there's a lack of understanding and recognition of traditional Chinese herbal medicine as a whole.

In terms of licensing, there are no standards or references that everybody can go by. There's also a severe lack of knowledge within government regulatory bodies. I have listed other points here.

We have presented our problems, but what can we do? We know we're in Canada. We know there is general interest in the history of our culture and the traditions, but what can we do to create a win-win situation?

I would like to make recommendations in four major areas. In the area of policy and regulation, we recommend very strongly a recognition and acceptance of the concept and approach of traditional Chinese herbal medicine. We consider it to be a totally different approach. It's like different sports, such as soccer versus basketball. You have to look at it from a different angle.

How do we recognize or accept this? We recommend acceptance of the Pharmacopoeia of the People's Republic of China as the first step.

We also recommend removal of our herbs from the new drugs or drug classification. We're facing tremendous problems there.

As well, as a total herbal system, there are other natural ingredients—animal parts, insects, minerals, all natural stuff—that are part of the formulation.

There's a severe lack of understanding about herbal formulation. We're not talking about one ingredient; we're talking about formulation as a uniqueness. It's almost like a corporation versus an individual, entrepreneurial type of business. You have to treat a corporation as a whole.

In terms of the regulatory framework, we would like to propose what we call the Olympic approach. You have the same guiding principles guiding all sports, but each one has its own regulations. With that, we would recommend establishing a regulatory body staffed with experts in traditional Chinese herbal medicine. Because the natural herbal industry and the regulations around it are quite new, there are bound to be misunderstandings and disputes. We therefore highly recommend establishing an appeal process, and also a dispute resolution body. Today, we have no such mechanism to sort out the differences and to clarify the misunderstandings.

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Now we'll talk about enforcement, which I think the previous group has also talked about. We need the government to create a level playing field within the trade in order to protect the investments and interests of law-abiding businesses. Today, there is a lack of clear regulations, and there are many things being abused. What we recommend is that once you establish a regulation, there must strict enforcement with severe penalties. It's hard for a trade organization to recommend that, but it is what we're recommending.

Finally, we talk about cost. Everything costs money. Once we establish the cost, we would recommend that the government consider this as an investment, because we believe the cost savings from the current health system has already paid for whatever a regulatory framework requires. We spend $50 million on herbal remedies, and there is at least a $50 million savings from the health system.

Because we are a small business, we are already face a lot of associated business costs to comply with the regulations and to increase the quality. Those costs are a heavy burden on small businesses, and also on family businesses with a small market size. We estimate the cost to the consumer will be at least doubled if not tripled or quadrupled, depending on the size of the market. That's because we're not talking about one product; we're talking about 1,000 to 2,000 different products, and there are some products with a very small market size.

Finally, in summary, we recommend that the standard not be set too high to start with, because by doing that you would be pushing the industry underground. You would not achieve what you want to achieve in terms of increased consumer protection. You would really increase the risk to consumers once the industry goes underground.

Thank you very much. That's our presentation.

The Chair: Thank you. Congratulations. You did that in almost half-time.

Mr. Fok, would you like to speak for your group?

[Translation]

Mr. Albert Fok (President, Kiu Shun Trading Company Ltd.): Good day, Ladies and Gentlemen. I don't speak French very well so, if I may, I'll make my presentation and answer your questions in English.

[English]

I'm Albert Fok, and along with Mr. Mang Wah Leung, I'm representing Kiu Shun Trading Company Limited.

Kiu Shun has been in Canada for 21 years in the Chinese herbal trade. I'm personally also one of the members of the Advisory Panel on Natural Health Products. In my presentation today, I wish to address the facts, the difficulties and the economic impact of traditional Chinese medicine in Canada. Some recommendations will also be proposed towards the end.

Beginning with the facts of traditional Chinese medicine, or TCM, TCM has a profound history of 5,000 years. It has been practised throughout Asia and in countries like Korea, Japan, Malaysia, and Indonesia for centuries. It has been used in North America as well for at least 100 years. TCM is an integral and inseparable part of the Chinese nation's culture.

TCM bases its philosophy on collective empirical experience and evidence. This means it has numerous case studies that have been going on for 5,000 years. It uses natural ingredients of botanical, animal and mineral origin in combination. That is different from the western approach, which uses isolated, laboratory-formulated chemicals based on experimental laboratory researches.

TCM also treats the entire body as one internal integrated and integral organ, as opposed to the western approach of treating one organ at a time, such as liver disease or stomach disease. When used in its originally intended form, TCM has either very low or no known risks. Its survival over time is alone the best evidence as proof of safety and efficacy.

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Moving on to the difficulties that TCM encounters in Canada, there exists a knowledge void, a language void and a cultural void. Currently only one single system and one single set of guidelines, which are inherently biased towards western pharmaceutical standards, are used to govern a very different paradigm, thereby rendering TCM incapable of passing the current regulations—for example, schedule A, the DIN requirement, and application restrictions. There is a lack of recognition on the documented tax on TCM.

Also, and one of the very important elements, different cultures interpret the definition of food and drugs very differently. For example, hawthorn is considered as a drug by western standards in current regulations. However, to the Asian and Chinese it is a very common food, as hawthorn is abundantly used in food preparation or culinary preparations such as soup, tea, jelly cakes and even candies. Interestingly enough, the reverse can also occur. For example, nutmeg by western standards is considered a conventional food. However, to the Chinese nutmeg is a TCM ingredient. Licorice is another good example.

Now let's look at the economic impact of TCM in Canada, which is a very pragmatic issue. According to a recent survey done by Health Canada involving stakeholders of Ontario and B.C., statistical results yielded that the total monetary value of TCM in Canada is about $35 million, in which there are 5,000 directly employed and many more indirect ones such as those in shipping, storage, customs, inspections, regulation and marketing. The net result is substantial sales and tax revenues.

Almost 2 million people, 2 million Canadians in fact—and this is very important—use TCM, and they are all willing and ready to finance this home treatment and medication on their own, without the help of the medical system. Let's just imagine the severe negative impact and repercussions, and the loss of revenues and the strain on the medicare system if TCM were eliminated due to unreasonable regulations.

Finally, here are our recommendations.

We request the regulators to grant full availability and recognition of TCM, including its philosophy and documented texts. For example, as mentioned before, the Pharmacopoeia Commission administered the Pharmacopoeia of the People's Republic of China.

We ask the government to establish a new agency, with staff knowledgeable of TCM, to conduct the dialogue and to draft reasonable guidelines that are acceptable to all parties.

Please also implement an appeal mechanism that is open, transparent, and without unreasonable delays to ensure all personnel handle all matters in an appropriate, unbiased manner.

Finally, we ask for the consideration to establish a TCM expert advisory committee to provide expert opinion to the regulators on matters relating to TCM.

Thank you very much. Merci beaucoup.

The Chair: Mr. Yu, could you introduce who is with you? Mr. Shih, I'll ask you to introduce the people with you afterwards.

Mr. Lin-Hoi Yu: I'm the chairman of the Canadian Chinese Herbal Professional and Merchants Association. Today we have our colleagues here, Mr. Sunny Li and Mr. Chong. We are all from Vancouver, B.C. Our association also represents western Canada from Manitoba to B.C.

Before we came to this meeting I had already submitted all my briefs to Ms. Ellen Savage. I don't think everybody has a copy there yet.

Mr. Joseph Volpe: Yes, we do.

Mr. Lin-Hoi Yu: Good. Here I'm just simplifying what I have written on my brief.

Our position on the traditional Chinese herbal medicine is as follows.

Chinese herbal products and natural food items have been profoundly and copiously used on a global basis by different ethnic groups for hundreds and thousands of years with very positive results. The mere test of time has justified their effectiveness. Placing herbal products and natural food items under drug classification and restricting them on the same basis is inappropriate.

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The proposed federal legislation will certainly have a serious negative impact on the Chinese culture and related businesses. Implementing the regulations is guaranteed to put small to medium-sized businesses out of business. Consequently, the unemployment rate will certainly rise.

If people are deprived of freedom of choice in using herbal products, it will result in their health being impaired. This will force them to leave work and put a further drain on the original health care system, which already has limited resources. We strongly believe that implementing these regulations will ultimately cause more harm to Canadians and will not protect their health.

Chinese herbs and their related food products have been used by many for centuries. Many western countries are beginning to be aware of their effectiveness and are recognizing Chinese herbs. We wish to emphasize that many Chinese herbs and related food products are consumed on a regular basis in a regular diet. They are not taken as drugs and medications.

The Chinese believe that consuming these food products promotes health by strengthening the body and causing the immune system to be more effective against disease. Chinese herbs and related food products are not drugs and medication; they are food items. To some in the western world it may seem bizarre to take herbs to promote health, but this is exactly what many other parts of the world are practising. Perhaps a good analogy is taking vitamins to promote health. Instead of doing that, we consume organic foods to achieve a similar goal.

In every country there are abuses of all kinds of items. For example, common adhesive glue has its obvious usage, but there are cases where glue is abused and used for some incorrect purposes. If an extremely small fraction of people ignore their common sense and abuse certain items it's tragic, yet the Canadian government does not seem to overreact on such matters.

Henceforth, the Canadian government should not overreact by imposing inappropriate regulations to ultimately eliminate the availability of something of which the government lacks complete knowledge. If they do so, there may be unforeseeable severe repercussions on the economy, health care systems and the Charter of Rights. The Canadian government should work with those who have profound knowledge of the subject, and ultimately mutual understanding can be reached. Our association has such qualifications and is ready to work closely with the government.

The following are some key points about Chinese herbal products and their impact on the Canadian society and economy.

Herbs in the Chinese and oriental communities have been in use for thousands of years. The positive results prove the historical use of herbs is an exclusive part of the Chinese culture as a food supplement. Restriction of the use of herbs is against the principles of multiculturalism and the Charter of Rights and Freedoms in Canada.

It is inappropriate to define herbs as drugs and it is pathetic to do so for the sake of only revenue generation for the HPB. Cost recovery from regulating herbs simply jeopardizes the trust of the public in the government.

In Canada there are presently over 550 Chinese distributing businesses that create at least 3,000 jobs. Moreover, there are about 3,000 indirect employees handling the herbs. Furthermore, there are at least 500 natural healing clinics across Canada using Chinese herbs or Chinese herbal products, and these alone employ another couple of thousand people. The Chinese herbal business generates a volume of up to $100 million annually. The three levels of government across Canada have benefited from the herbal business for so many years, especially the medical care system.

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Our association has never tried to oppose government regulations or take any actions against the will of protecting the public safety.

The crucial part is that herbs and drugs are two entirely different concepts and approaches toward health. Herbs are used for regulatory purposes, whereas drugs are used for killing a virus or bacteria.

The controversy about ma huang recently speculated about in public was not true. It was ephedrine claiming seventeen victims in the Unites States, not ma huang, and the accident was caused by abusing the product.

We also found out that the Chinese herbal products are not easy to get except with the issuance of a DIN number, because of the lack of knowledge of the Health Protection Branch. Therefore, we suggest that if a regulation must be applied, the health ministry should establish a separate autonomous administrative unit for herbal remedies, operating within the health ministry and parallel to the food and drug administration's supervision of classical, conventional western drugs.

You would be absolutely wiser to establish a separate and parallel system of administration over herbal remedies that includes significant presentations from the main stakeholders involved in herbal products. After this administrative unit for herbal remedies has been established, give three years to the manufacturers, distributors and importers to apply for the appropriate permits, such as DIN numbers for their particular item, and treat DIN applications as you did before 1996, without charge. Thereafter, in the interest of equality, the application fee should be identical to that applicable to homeopathic medicine, namely, $15 for each application.

Chinese herbal products are mainly imported from China. For the information of everybody, in China they have started implementing the GMP and will be completing all of the procedures by the year 2000.

Thank you very much.

The Chair: Thank you.

I hadn't had any indication for speaking order. Mr. Hill, do you want to speak?

Mr. Grant Hill: Thank you for being here and letting us know what you think.

I am interested in the ma huang issue that Mr. Yu raised. It was one issue that I followed quite carefully, the HPB saying that ma huang was dangerous, that there was an ephedra-like component to it. I believe the regulator went about banning this product from Canada, so I presume this is one of the products we cannot have in Canada now. Yet most of the information that has come to me has been that this is not the same product that caused troubles in the U.S.A. Could you amplify on that?

Mr. Lin-Hoi Yu: Yes. According to my research, ma huang, in Chinese use, is very seldom used, actually. It does not have very popular ingredients for the formulation of Chinese herbal remedies. But what ma huang contains is similar components to ephedrine. But ephedrine in the United States has been singled out from ma huang. Then they use a very high dosage, like 20 milligrams or 50 milligrams, especially for those people who want it for weight loss, body-building, energy-enhancing, those kinds of thing.

In our country, Canada, we can't get ephedrine. Therefore, we apply for a DIN number. Within three months we can get one. That means that now we can buy ephedrine from the health food stores anywhere in Canada, but with a DIN number on it. On the other hand, we cannot import ma huang—this kind of grass—into Canada.

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I consider this like the situation of a mother and son. The son creates a lot of criminal records and kills all kinds of things there, but the government policeman doesn't catch him and put him into jail. Instead, they sound like the mother, “Ma huang is no good”. Then they put ma huang into jail and leave the son—ephedrine—everywhere.

That's why we consider that our Health Protection Branch nowadays doesn't have the kind of expertise it needs on Chinese herbs; especially it doesn't know at all about Chinese herbal philosophy. That's why we really think it's very important, for all sides—for regulating, for business and for the benefit of Canadians—to separate the categories completely from the DIN system.

Mr. Grant Hill: I try to ask this question of most groups here. Do you know of another country that regulates your products better than Canada does, so that there is more availability? If any of you have importing experience in other areas, that helps us to make a decision. Are there any countries better than Canada?

Mr. Andy Shih: I would say China. They use the most—

Mr. Lin-Hoi Yu: That's true.

Mr. Andy Shih: —and have a big population. Although it is a communist country and we don't like the system, the one good thing about it is that everything is owned by the government and is produced by the government. When they produce a product that endangers their population, we don't see the population shrink. We don't hear a lot of uproar. I mean, there are different standards. But it is widely used, most heavily used in China. So if you want a reference, I say look at China.

We may have different standards. We may have a lack of understanding, but it has been used for thousands of years without severe problems. If I drink red wine and I get a headache, does that mean red wine has side effects and the government should protect me? I don't read the labels on red wine that say it can cause headaches. That's why we have to understand the negative effects and to what degree. Does it really endanger my life?

I think we all learn. We know our bodies. We all learn a little bit about our bodies, which ones we should take and which ones we shouldn't. We hear people talking about every time they eat chocolate they get pimples. We hear that. I think that because our bodies are different, we learn about ourselves. We know our own bodies. But it's not something that endangers our life. It's really like a natural vegetable. We eat vegetables. In terms of what I hear, how do I know the vegetable is good, that this batch is of the same good quality as the last batch? If there is a long-term consumption, it has to enhance your body.

Mr. Grant Hill: One of the things we've heard a lot is that these products in general, in the very broadest sense, are preventive and will save the Canadian society money. That's a very difficult thing to prove. It's very attractive to say. Do you have any evidence to show that traditional Chinese medicine, acupuncture and all the preventative things that you use can do something positive? A country that uses it a lot—

Mr. Sunny Li (Secretary, Canadian Chinese Herbal Professional and Merchants Association): I am a Chinese herbal practitioner and also an acupuncturist in British Columbia. I also sit on the board of a recreation body. I am not trying to say that Chinese medicine or acupuncture is absolutely the final resort for everything. There is no such system on earth, unfortunately, that is perfect. Nor is conventional medicine. But I'll tell you the truth. The amount of people, including local Canadians—regardless of the nationality a lot of them had before they came to stay in Canada—do consult traditional Chinese medicine and consume traditional Chinese herbal remedies, including acupuncture treatment.

If you ask me whether there is any proof, I know what is up there. You tell me how to prove it and I can, all right? The light is there. You tell me how you saw the electricity there. When I turn the switch on, you know that light is there. But if I put a finger there, I know it too. So this is the way we have to help.

Actually, we are not against government regulation, but we honestly came here because we want to help our country together. I came over to Canada more than 24 years ago. I consider myself a Canadian citizen. I really hope our country can spend a little more time in looking at the philosophy, the integrity of traditional Chinese medicine in order to put law enforcement on it.

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You say now the HPB or the government has a lot of expertise. How are we going to define expertise?

I came over to Canada over 24 years ago. All of my colleagues and my friends think I'm an expert in English, but once I open my mouth, you know I come from there.

So I didn't say that our government didn't put enough effort, but we have to do it slowly and step by step. We accumulate scientific knowledge step by step.

A lot of the people in HPB or in your department may think Chinese medicine is not scientific, but time tests and trial and error use of Chinese herbal remedies and herbal medicines over the last so many centuries or millennia have proved it is scientific.

Mr. Grant Hill: I hope you don't call it my department, because it's not my department.

I have one other question. These gentlemen talked about forty products that are no longer available in Canada.

Mr. Andy Shih: Forty percent.

Mr. Grant Hill: Sorry, forty percent. Has that restriction in the products had an effect on your ability to practise?

Mr. Sunny Li: I was told by my colleagues that there are more and more products that may be considered harmful to their health.

Mr. Grant Hill: So it has already had an effect on your practice.

Mr. Sunny Li: Yes.

Mr. Grant Hill: So there is an actual effect. These weren't minor products.

Mr. Andy Shih: I'm going to go out of business, because with 40% less product, with the cost increases, there is no viability, no future.

Mr. Albert Fok: On your question earlier, on the proof—

Mr. Grant Hill: Evidence, not proof.

Mr. Albert Fok: On evidence. Let's take a pragmatic approach to this.

As aforementioned, Health Canada itself conducted a survey. It was concluded that there is direct employment of 5,000 in the industry. Judging from that—and then there are almost two million people ready and available to finance us on health—I think efficacy as well as safety, as well as the opportunity to have this industry justify itself...otherwise, why would several thousand people want to get involved in it? If there are no financial or commercial advantages to it, then people will not get onto the bandwagon.

[Translation]

The Chair: Monsieur Dumas.

Mr. Maurice Dumas: My question perhaps has to do with the geography of the country. I notice that in Vancouver there is a very large Chinese community. Mr. Fok, does your company also have a base or a branch in Montreal or in Quebec? Do your associations also have members in Quebec?

[English]

Mr. Albert Fok: I believe there are one or two guests right now who are from Montreal.

The Chair: Ms. Bennett.

Ms. Carolyn Bennett: I was very grateful for your presentation, and I think for all of you to have come is very helpful.

I was interested in two things. One was the Olympic model, which obviously included adopting the pharmacopoeia from the People's Republic of China, and having a peer reference group that would be the arbiter of good practice, bad practice; good product, bad product. I would love for you to help us figure out what that would look like, where you would fit. Would there be an umbrella over that fit, then, and what other groups? How would you set that out?

The second thing was, I think we keep having trouble with the fact that the provinces regulate practitioners in this country, yet product is the responsibility of the federal government. I've been asking many panellists if there are products that should only be given by practitioners. Or could all products eventually be available in the grocery story or the pharmacy or the health food store? Do you see two tiers for some of the stuff in traditional Chinese medicine?

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My point as a family physician is that quite often, after patients have come to me once and I've told them to take Advil or to take plenty of fluids, aspirins and rest in bed, the next time the same thing happens, they know how to do it without actually having to come to me. I wonder if that's a parallel situation in traditional Chinese medicine. Or do you have some advice for the committee on how you would set that up in a safe way?

Mr. Tony Cheung (Vice-president, Chamber of Chinese Herbal Medicine of Canada): You are right. Actually, in China we've been using it for so many years. Especially for, let's say, dong quai, angelica sinensis, I can say probably 90% of Chinese know what they are using it for. It's like ginseng; if you feel fatigued, you just take the ginseng. Sometimes I see medical doctors as well say that when you're so dry in wintertime, just drink more cups of water and you'll be all right.

It seems that as time goes by—and we have so many years of history in Chinese medicine—a lot of Chinese pass along all the uses of Chinese medicine, from generation to generation.

As for some herbal products, you said it has to be regulated by a herbalist. As far as our chamber of commerce's standpoint goes, we don't agree with that, because a lot of Chinese herbal products, once they are on the market, and also especially in the lowest situation...once the doctor has prescribed it once, they just go along when they have a problem, and then they take it as they need it. I believe that's the way we should be.

Ms. Carolyn Bennett: So if I'm hearing you, when you say “doctor” you're talking about a traditional Chinese—

Mr. Tony Cheung: A trained herbalist.

Ms. Carolyn Bennett: Did the reference group or your Olympic group here, the ski federation...we seem to have a little bit of trouble with that model, what with the marijuana last week, so I'm not sure the Olympic model is perfect.

Voices: Oh, oh!

Mr. Andy Shih: Nothing is perfect.

Ms. Carolyn Bennett: But if the upper group is more strict than the lower group or vice versa, it's sometimes tough.

If that reference group includes the practitioners and the business people and all, do you think there would be a consensus on most things being available? Do you think there would still be certain products that would have to be dispensed by practitioners?

Mr. Andy Shih: Let me say that when it comes to the name “Olympic”, I gave it that name because—

Ms. Carolyn Bennett: I liked it!

Mr. Andy Shih: You liked it?

Herbal remedies are really accumulated, empirical wisdom and experience from different cultures. So not every culture is the same in the way they look at this. And because of the climate and the soil difference, the herbs are different. They have their own philosophies, so it's very hard to assemble a committee with expertise in each one and try to get a consensus just like you tried to get—

Ms. Carolyn Bennett: Okay. I just want to say that if the natural product stores, the people who presented yesterday, let's say, developed a role for ginseng that is different from the traditional Chinese one in terms of our having an Olympic model, how would we sort that out? If the traditional Chinese academy or whatever decided on certain rules, but the national health food store people decided on a different rule, would you have this umbrella body as the final arbiter?

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Mr. Andy Shih: I think the guiding principles are the same. There's no question about that. It's just like a snowboard and a ski; they overlap a little bit somewhere. But where are the most consumers? Where is the ginseng exported to? If you really want to talk about it, the majority of it all goes to Asia.

You really have to look back to which philosophy or which culture utilizes those things. There's accumulated wisdom there. It's documented. Sometimes I try to make the point that we have to trust our ancestors' wisdom. The scientific is not everything yet. It's nice to know why, but the facts about why things work are not always evident. We may not understand why. It's nice to know about the research, but we sometimes have to accept that it works.

In terms of whether or not every product should be available in the supermarket, I think there are different categories. In Canada today, because we understand the liability involved if you do something dangerous, the majority of businesses do not carry dangerous products. That category is pretty self-medicated.

If you go to China, there are some things that are more sophisticated, but I think that's of a different scope. As the next step, maybe we would like to expand into the arena of natural herbal health, so I think we need to establish some kind of profession to prescribe it.

Ms. Carolyn Bennett: Thank you.

The Chair: Lawrence, did you want to say something?

Mr. Lawrence Cheng (Vice-President, Chamber of Chinese Herbal Medicine of Canada): Yes, I would like to supplement what Andy said.

I guess what Ms. Bennett was basically asking is whether or not there is a thing called a prescription drug in TCM, and then an OTC. When we're talking about these products, pills, tablets, I would say over 90% would be OTC. Basically they have been used for so many years, and they have come into a more convenient format, either as pills or syrup, okay? Most persons of a Chinese background know quite well how to use them.

How are they usually dispensed? You would go to a Chinese health store. There are counter sales there, and most of the people there would have adequate knowledge of these so-called OTC products. A lot of them are not curative, but would be for tonifying, strengthening, those types of things. The herbalist or the counter person would explain when to use the Korean ginseng tablet and when not to.

Once we go into prescriptions, yes, there are Chinese herbal practitioners. We call them doctors in Chinese—which is allowed in Chinese, isn't it? What they prescribe would be herbal formulations in their original forms. Those would be like custom tailoring. Yes, you have a coat, but what kind of coat? We have many practitioners here today. If you are really interested, you can ask them after this session. Like the different kinds of coats, they would prescribe different types of herbal combinations. These herbal combinations are not pills any more, they are the original herbs. They're combinations of ten herbs, five herbs, or twelve herbs.

A standard tablet for cold-like symptoms in TCM would have a fixed nine, ten or eleven combinations. However, when you see a practitioner, he would feel that he could better that. Therefore, usually it's not always the case that you get a so-called herbal prescription. You give it to the herbalist to prepare it for you, and then you can reuse it every time.

I guess that's what I wanted to cover there.

The Chair: Can we go on to another question now? We doubled the time on that one. Maybe it'll come up again and you can answer that one later.

Mr. Hill.

Mr. Grant Hill: I thought I understood you to say that in some preparations of Chinese traditional medicine, insect parts are normal. I'd like you to explain that, because to most individuals that's something that sounds like a contaminant, something you wouldn't ideally like to have.

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Mr. Andy Shih: We could get very philosophical here. When God created everything on this earth, there was a value to everything. He didn't create something for no reason.

Over thousands of years we've discovered the properties of insects, even stones and rocks. They're part of the formulation. How? Nobody knows. Why? Nobody knows. But there are properties. They are documented, well documented and well used. People find they work.

Now, we don't know why they work, but what I'm trying to point out is that herbs are really natural. There are a lot of things on this earth that are natural—not extracts, not synthetic, but natural. If we look at herbal things, should we be expanding the definition? Because really, “natural” covers anything not through extraction or something else. That's what we're talking about.

Mr. Grant Hill: So adding insect parts is not accidental. There's an actual process of including those insect parts in some preparations.

Mr. Andy Shih: Yes.

Mr. Grant Hill: They would not be just an accident. You would actually add them.

Mr. Andy Shih: Exactly.

Mr. Grant Hill: Okay. That's important.

Mr. Andy Shih: You buy them. You pay for it.

Voices: Oh, oh!

Mr. Lin-Hoi Yu: Actually, in Chinese traditional medicine philosophy we have to consider the whole picture. The Chinese follow their experience gained over thousands of years. The Chinese medical philosophy considers everything on the earth as some kind of help for our body.

About two or three years ago in Canada, it was very popular to use urine to cure certain things. Actually, it originated from China, from a few hundred years ago. They passed it over to Asia Minor. Asia Minor passed it over to Europe. Europe then brought it back to North America.

The same thing goes for ginkgo biloba. A few thousand years ago the Chinese used it. They passed it over to Japan. Japan passed it over to Europe. Eight years ago the German people analysed it and said, yes, it's true, ginkgo biloba works for certain things.

In Chinese herbal medicine we use stones. We use animal parts. We use insects, and so on. So many things they consider, and because they have experience, they try that. Those things have stayed in the Chinese philosophy.

Mr. Grant Hill: You've answered my question very well.

The Chair: A couple of others can answer. Do you want them to or not?

Mr. Grant Hill: I don't think we should go into it. That did answer the question.

The other question I have to ask is, do any of you know of any serious side effects from traditional Chinese medicines, such as death or serious morbidity? We hear generally these are low risk. Any argument there?

Mr. Sunny Li: There are reports of a small percentage of fatal accidents regarding the use of Chinese medicine. In a lot of cases, though, it's not well proven. Just as with the conventional medicine a person uses when their health is failing, the health situation changes every hour, and unfortunately, sometimes they take coincidentally some Chinese herbs. Then they put the blame on us.

If you ask me whether there is any toxicity in some Chinese herbs, I will tell you yes, there is. That is why we use the philosophy of traditional Chinese medicine. We usually don't use one single herb. We usually use a combination of six or fifteen herbs together. Then we brew it by cooking a concoction. In that process, a lot of the toxicity of certain chemical constituents in certain herbs is neutralized.

If you ask me how to prove it, of course, let's say you take this package of herbs and analyse it. There may be certain chemical constituents that would be called toxic. The thing is, we don't just grab the raw herb and consume it.

You ask me whether there are things herbal that are toxic too. My concern is that I hope the Canadian government will emphasize proper education in using all the natural herbal remedies, including vitamins.

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It's not the herbal toxicity per se; it's that our education has to be evaluated. I know I have some patients come to me who are taking their conventional medicine in the morning but don't take breakfast. The just take a pile of pills and whole vitamins too. Then they go to the health food store to grab from the counter anything they hear about: milk thistle is good for the liver, and echinacea is good for the immune system. They just eat it everyday. And people consume ginseng everyday, which is ridiculous to my knowledge, but it's what is happening now.

That's what is bothering the public health. This is why I really think our government should look into considering the regulation of traditional Chinese practitioners in this country, and from that path we can do a better job and also evaluate public awareness of using not only Chinese herbs but anything.

Mr. Grant Hill: Finally, is there anybody in the Health Protection Branch who you consider to be an expert or at least sympathetic to your industry?

Mr. Andy Shih: There are those who are sympathetic, maybe. There are quite a few people.

Mr. Grant Hill: There are some who are sympathetic.

Mr. Andy Shih: Sympathetic. But in terms of expertise and knowledge—

Mr. Grant Hill: There is no one you can draw on.

Mr. Andy Shih: Not on the policy-making side.

Mr. Albert Fok: They're trying. To my knowledge, they have hired at least two Chinese persons in the field, but I would not label them as expert; they are gathering information. But having said that—and I don't mean to be touching a minority issue here—they, being inherently Chinese, have the basic knowledge of how Chinese herbs work. At least they don't have to have a different mindset to look at everything through the western pharmaceutical views. But as far as professionalism and expertise in complete Chinese herbal medicine are concerned, I have to say not entirely.

Mr. Lin-Hoi Yu: I can give you one example on that. Just a few years ago I tried to apply for a DIN number for a Chinese herbal tea. That particular Chinese herbal tea is formulated by traditional Chinese herbs with Chinese tea leaves. It's mainly for digestion, reducing body fat and to improve the metabolism. Eventually the formula was changed by the Health Protection Branch completely. They said this is not supposed to be there, that's not supposed to be there. Eventually it changed to being a diuretic tea.

Then I asked on what kind of information they changed my whole formula. They answered that it was according to their feeling, their knowledge. I said, “Your knowledge is that of western medicinal experts, but do you know anything about Chinese medicine or Chinese herbs?” They said they didn't. I said “In that case, you use your way, with a lack of knowledge, to regulate the original formula of at least 200 years and now you've changed the whole concept. What do you want me to do?” They answered that if I wanted a DIN number I had to take that one or none. That's the excuse I got.

The Chair: Mr. Myers.

Mr. Lynn Myers: Madam Chair, I wanted to ask Mr. Shih about his final point with respect to not pushing the trade underground. I wondered if today there's an underground trade for any of these products?

Mr. Andy Shih: I believe it's a starting point, because 40% of the products have disappeared. Some products, in our opinion, are very useful, and HPB has classified them as schedule A or whatever, so to fill that gap, yes.

Mr. Lynn Myers: So the 40% you alluded to earlier on in your testimony is in fact underground now. Is that what you're saying? And that's across Canada?

Mr. Andy Shih: Yes, once it comes in it's across Canada.

Mr. Lynn Myers: Madam Chair, I really wanted to ask about the dispute resolution body. I wonder how that would be developed, who would be on it and how it would work. You alluded to it and I think Mr. Fok did as well.

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Mr. Andy Shih: I think the dispute body should really be in the form of an ombudsman's office, where you would have a representative who is an expert from the consumer groups, one from the trade organizations, and a representative from the government. You would table your argument—and everybody would be an expert on it—you would present your view, and a decision would be made, because everybody could say, yes, this one creates headaches. Korean ginseng can cause nosebleeds, and people get the perception it's such a bad thing, but Korean ginseng is the most highly regarded ginseng on this earth by the Chinese community. There is a superb effect, especially for ladies, if I want to say good things about Korean ginseng. It's incredible.

I think we should listen to all points of view from people with knowledge. That's something that's badly missing today.

The Chair: Mr. Volpe.

Mr. Joseph Volpe: I'm wondering whether the root of the problem is associated with the lack of acceptance of the training of practitioners of traditional Chinese medicine. Is that your sense? Or is it the regulatory process that is making it difficult for you to put certain herbs and products on the market?

Mr. Lawrence Cheng: That's the main reason that in our submission we propose that Canada consider adopting the Pharmacopoeia of the People's Republic of China in schedule B. That would solve a lot of resource problems and give adequate background knowledge. It's in English, it's simple to read, and has very detailed quality control. It also specifies the efficacy and dosage of each product.

Right now we do not have a very definitive system to follow. That is why when we apply for a DIN, try to market a product as a food, or a Canadian consumer tries to assess a product it's very controversial and nobody knows what's right or wrong. The person who's supposed to have the most data on the product—how it's tested and expertly rendered with each ingredient assayed—is not officially recognized.

So those in the Chinese community feel very safe about it as long as we have the product. We know it. But what about our next generation? Now when we sell a product we cannot put claims on it. I can understand that because when I read the name I know the product. It's like Aspirin, you don't have to tell anyone what it's good for. With a lot of classic Chinese formulations, most of our first-generation or even second-generation Chinese know about them.

But what are our children going to do? What about our future generations? Our entire knowledge will be lost, mostly. In the meantime to continue our survival in business here, we are trying very hard to do something about it. At least we have seen what it has done.

It's not complete yet. We can't wait or go underground—we're not underground business persons, we're not adventurous—until a workable system comes out. Before it comes out, we will have to close shops. In fact, quite a few of our committee members, not just association members, are already considering discontinuing their leases because the products are gone. People who won't accept this have gone underground to deal in it. That poses a serious danger when it's underground: why should they go to the regional manufacturers to get the real thing? Why can't they just package something and ship it over?

The Chair: Somebody has to answer that. Do you want him to answer?

Mr. Joseph Volpe: Maybe he can follow up, but just before I lose the thought, in the preparation of some of the herbal remedies, as you've both indicated, there's a mixture that then develops into a concoction. If the ingredients of that mixture, in and of themselves, are in compliance with the regulations as they exist, do you not see that, in the prescription of those five to ten or twelve elements together in a concoction, you're engaging in a prescription and a medical treatment? Hence the question I asked earlier. Is the problem that you're infringing on the delivery of a medical system that is under a different set of regulations?

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Mr. Sunny Li: The different chemical constituents from all these different herbs are basically going into the body. They also act with a single purpose. You can say they are also biochemical; they are not synthetic chemicals. To our point of view, it is not target shooting. The lever is actually restoring and regulating the functions of the body so that the body is strong enough not to be bothered by the....

If you ask me, I think your concern is how are we going to guarantee the safety of these. As I said before, it would be very desirable if the government thought about how to help regulate traditional Chinese medicine, which is a very big step. I understand that in any regulation there is a lot of infighting and a lot of nuisance. Unfortunately, that is human nature. At this moment, how the HPB is to do it, to my point of view....

There are good representatives across Canada, west and east, like the people here. We are responsible for a lot of the herbal...

[Editor's Note: Inaudible] ...from this end. We can be responsible, together with the HPB, for certain herbs, instead of just the HPB sending an inspector into some herbal shop and confiscating their product without even knowing what is going on. But I understand the good intention, that it is to protect the public interest. But there is also a lot of emotion from the Chinese community. All the immigrants come here. Some people put their entire family assets into that business. Unfortunately, that kind of disastrous situation is happening.

So why don't we work together and take one thing at a time? The most urgent thing is that the HPB can work with our different herbal associations, make us wholly responsible for the questionable products they are concerned about at this moment, and then notify us that there are some concerns in this area. Then we will take some action, instead of the HPB charging into a situation.

Mr. Joseph Volpe: I can understand that model, and let's say I have a predisposition to it. But when I go to a Chinese practitioner, he'll give me a prescription to go to a herbalist. The herbalist mixes it up for me. He decides just exactly what the proportions will be, according to the practitioner's guidance.

Mr. Sunny Li: That's true.

Mr. Joseph Volpe: In your model, are we going to include the herbalist and practitioner and the consumer? The consumer is the one who has to develop the concoction. That includes the composition of water, the type of water, and the length of time it takes to actually develop it, because my understanding is that that is an integral part of getting the greatest potency. Have you thought that process through?

Mr. Sunny Li: Yes.

Mr. Joseph Volpe: To my mind, at least listening to pharmacists, this is now a prescription drug. You should show some efficacy.

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Mr. Sunny Li: Okay. I understand your point of view. As I say, unfortunately Chinese medicine looks at it from an angle that is slightly different from the viewpoint of you or your department, because traditionally, for centuries, thousands of years, the Chinese have been fortunate to use this method to promote their health.

Of course there are some quacks. Quacks can be found in every field. There may be some professionals in Chinese medicine who are not up to standards for prescribing that. That's why I really suggest the government look into the source of the problem and try to think about eliminating that. And then at the same time...it may take a little bit of time but then the different herbal associations across the country can work together and work with the HPB and provide more information to the panel and the standing committee. Then things will change.

Mr. Joseph Volpe: Can I ask one last minor question? I know that Albert will want to answer, and Andy as well.

Have you collectively approached the College of Physicians and Surgeons to work collaboratively with them in order to get some kind of designation?

Mr. Sunny Li: We are always open.

Mr. Joseph Volpe: Have you approached them?

Mr. Sunny Li: Yes, we tried. We approached, but then...I'll give you an example.

In British Columbia at Vancouver General Hospital there's a centre called the Tzu Chi Institute, which is sponsored by the Tzu Chi Institute, a Buddhist organization from Taiwan, and it is actually trying to form some western, conventional doctors into establishing a research centre there. Unfortunately at this time it is not doing very well yet, but the thing is that it is going.

I don't really say that we are better than them. Actually, we accept their education or their ways, but then we also hope...we can not use one standard to worry about the other standard. You see, that is the danger there. Do you see my point?

Mr. Joseph Volpe: I understand. Thank you.

The Chair: Mr. Shih and then Mr. Fok.

Mr. Andy Shih: The medical system is a very complicated system because there's conflict of interest, especially when money is involved. It's a big problem. Some say the licensing, some say the practitioners...I think this is where you gentlemen of the standing committee can help, because the problem is so big, we need a balance. There's a track record. It's not something brand new in Canada. It's been here for 100 years. For the kind of problem we're facing I think the first step may be the quality of the product. In terms of safety, documents, formulations, manufactured by a government organization...I think really it's the quality. I think we're all talking about the quality, the label quality and the ingredient quality. We're talking about that.

In terms of venturing one step further, into the prescription side, I think it takes time to establish that, but at the same time it's a case of people learning to understand that Chinese herbal medicine is a very basic step. That's what I think we're here to try to establish.

The Chair: Mr. Fok.

Mr. Albert Fok: To answer your question more specifically, Mr. Volpe, to use the correct terminology, it will not be a “concoction” but rather a “decoction”.

Mr. Joseph Volpe: That's right.

Mr. Albert Fok: There is a different mindset within the Chinese community, that is, we don't necessarily visit the so-called practitioner only when we're ill. We would go there and say, for example, that if there is a change of season and we know the dry air is coming, we therefore wish to make our bodies feel better, not to mitigate them or restore them or promote anything. I know the dry air is coming, so therefore I want to cleanse my system. So I will visit the so-called practitioner. I am not necessarily ill.

So in a finite sense it's not necessarily a prescription of some type. They want an assurance. As I said, that's why TCM has to be integral, inseparable, in this type of culture. For example, if I feel there's a change of season or whatever and I go to see a practitioner, basically I know what I wish to have. In a way, I want assurance from a practitioner so he can so-called diagnose—“diagnose” is a bad word because it infringes, once again, on the therapeutic, on the pharmaceutical—or perhaps look at it. In the context of my report, sometimes the translation is difficult because there's a difference of context, so I have to use the word “diagnose”.

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Therefore, you only diagnose to a certain degree, but that does not necessarily mean that you are ill and he is giving you some kind of a medicinal type of drug or medicine, so to speak. It is more like some kind of soup or tea. Once again, it does not have the same element or the same nature as a prescriptive type of drug.

The Chair: Lawrence.

Mr. Lawrence Cheng: TCM and PCM practitioners basically do not seek to medicate or cure a problem. They try to balance a system.

In the translation, to make it easier to understand, we have to use the word “prescription”. Actually, we do not prescribe in Chinese. We call it formulating soup material. It's like in a soup. It's just a bit of soup; that's all.

But the main idea is that we look at the pharmacological care of China; we talk to all TCM practitioners. Behind all the terms, to be precise, in regard to curing a cold, actually in China we do not cure a cold; we call it lowering the external symptoms. There's a specific purpose to it, but how do we write it down and present it to an MP or explain it to somebody who doesn't speak Chinese? Naturopathic doctors understand that, some of them.

Behind all the terms, they try to balance the system; that is all. I don't think they're trying to cure. It's balancing.

The Chair: Mr. Yu.

Mr. Lin-Hoi Yu: Lawrence mentioned that it's to balance the body. I think most people know the Chinese always talk about “yin” and “yang”. Those are exactly the words we use.

When you have too much yin, your body is different. When you have too much yang, your body is different. The Chinese herbalists always try to balance that.

That's why when the seasons change, we don't say that we are sick now; we just feel that the weather is changing now, and we should take something as a precaution for the changing of our bodies and that kind of thing. That's why we follow the seasons.

Chinese herbs come in two major categories. One is the dry herbs, and one is the over-the-counter tablet form. The over-the-counter tablets are very simple things. Most of them we know, just like they know Aspirin or Tylenol. That's why it's over the counter, and you buy it for a specific purpose.

But with the changing seasons, our bodies really.... Last week I had a serious cold. I went down to the Chinese herb stores and said I had a cold. They didn't give me something to cure my cold. They said I had too much yang and that was why my body was completely imbalanced. They gave me two bags of mixed herbs. I brought them home, boiled them and drank them. In two days, I was okay. I didn't take the Tylenol. I didn't take vitamin C or echinacea.

But that's the way. We don't cure that kind of disease; we just balance our body. That's the main traditional philosophy of Chinese herbs.

The Chair: Our time is up. Can you make it really short? That will be the last thing.

Mr. Sunny Li: I want to confirm what they have said. Chinese medicine, including herbal remedies, is used mainly for preventative purposes.

I would like to say one final thing. In the Chinese traditional medicine document, it says that the best doctor is prevention, not to try to cure sickness.

Thank you.

The Chair: Thank you very much.

Thanks to all of you for coming. If you have any new information for us before we're finished our hearings, please send it in to the clerk.

The meeting is adjourned to the call of the chair.