Almost three in every four Canadians consume natural health products - vitamins and minerals, homeopathic medicines, Chinese herbal preparations and the like.
Each year, they spend $2.5-billion on these largely unregulated products.
Consumers cannot be sure that what is listed on the ingredient label is what is actually in the bottle.
Manufacturers and distributors of natural health products have broad latitude to make health claims with minimal scientific evidence to back them up. And they can advertise these claims freely.
By contrast, prescription and non-prescription drugs have strict quality standards, must submit rigorous scientific evidence of their safety, and their ability to advertise is quite constrained.
That is why Bill C-51, the proposed legislation to update the Food and Drugs Act, is so welcome.
The new law will, in many ways, treat natural health products in the same way as prescription drugs and non-prescription drugs.
Consumers should expect no less.
When you get right down to it, a drug is a drug is a drug, whether its basic chemical ingredients are synthesized in a lab or derived from plants.
And every drug that has a potential benefit has a potential harm.
What consumers need is the basic assurance that the benefits outweigh the harms and that when there are safety concerns regulators will intervene swiftly.
That is the basis of drug regulation and other consumer protection laws.
Yet Bill C-51 has caused an uproar, fuelled by a slick web-based campaign ( ) that features some vastly overheated rhetoric about the criminalization of camomile and dubious claims that parents will be arrested for giving their children vitamins.
The campaign is not exactly grassroots: It is the brainchild of the folks at Truehope Nutritional Support Ltd., a company that has been engaged in a long legal battle with Health Canada. Truehope sells supplements that purport to treat severe mental illnesses such as bipolar disorder.
Let's be frank here: This is precisely the type of company that needs to be regulated. Their supplements are a complex mixture of various "natural" products and claim to work as well as - if not better than - prescription psychotherapeutics.
This is not your granny's cod liver oil.
The fact that a company such as Truehope can organize an elaborate campaign, fight lengthy legal battles and generate media coverage proves that the natural health products industry has come of age. Some of the players in natural health can now behave exactly like the evil Big Pharma companies they decry.
But the reality remains that most retailers and manufacturers of natural health products and most complementary medicine practitioners are small businesses with pretty basic products. Some of the provisions of Bill C-51 were just too onerous and hard to justify.
After Health Canada held a series of public meetings, the government has put forward some amendments to the legislation, a refreshing example of democracy in action.
Natural health products will now be listed as a distinct category in the legislation, separate from food and drugs (as they have been in regulations since 2004).
The major concern about Bill C-51 was that it considered natural health products as "therapeutic products," just like prescription and non-prescription drugs. That meant licensing requirements could be quite strict, even for products that have been around forever.
The amendments put forward acknowledge that natural health products are generally of lower risk and that their long history of use has some value.
The government has also proposed softening the language around enforcement to assuage fears that Health Canada inspectors will be busting down doors and seizing products to ensure the ginseng is crushed properly and the like.
Finally, the government has proposed establishing external advisory committees to provide guidance on the smooth implementation of the legislation.
This is all welcome news. Bill C-51 is the first substantive change to drug regulation in half a century. It is complex and the government must be on guard against unintended consequences.
At the same time, the government and Health Canada must be careful not to bend too far; they must not water down the law to the point where it becomes meaningless or toothless.
There are approximately 21,240 drugs marketed in Canada, including 5,800 prescription drugs, 9,500 non-prescription drugs, 5,300 natural health products and 640 controlled drugs such as narcotics (the latter covered by different legislation than the Food and Drugs Act).
Consumers need the assurance that all these drugs are relatively safe - that their potential benefits outweigh potential harms.
There can be no exceptions to that basic goal. You should not be able to sell pig swill as medication and you should not be able to make outrageous claims that your concoction cures cancer.
Natural health products are not innocuous and the legislation that governs them should not be either.
André Picard