Health Canada’s proposed changes to the regulation of Natural Health Products (NHPs) have provoked controversy because they have clear and troubling potential outcomes. The proposed changes will see many NHPs, which range from supplements and vitamins to herbal products and traditional remedies, regulated in the same manner and according to the same standards as drugs. This will result in many of the products which 77% of Canadians incorporate into their health and wellness practices, losing their licenses and even disappearing from store shelves, and those that remain will likely increase in price. This likely outcome has disturbing implications for the diversity of health and wellness practices in Canada, as well as Canadians’ freedom of choice regarding their own health. Health Canada’s purported reasoning for making changes to how NHPs are regulated is additionally problematic.
Based on a single consumer survey which found that consumers feel uninformed about a variety of self care products, including cosmetics, NHPs, and over the counter medication, Health Canada has decided to revise what it means to make a “health claim”. Under the current system of licensing and oversight, the level of supporting evidence required for licensing is determined based on the particular claims, intended uses, and overall risk of the particular product in question. This approach recognizes the unique and varied characteristics of NHPs, as well as their low risk nature. Health Canada believes that consumers do not understand the nature or scope of the claims made by manufacturers of NHPs, and therefore cannot understand or evaluate the different degrees of evidence required to support different types of claims under the current licensing system. They propose to replace the current, nuanced and inclusive system with a one-size-fits-all approach to health and wellness in which a product either makes “health claims”, which require the same evidence and testing as drugs, or simple “claims” which are considered too insignificant to require any oversight.
This change is based on a redefinition of what it means to make a “health claim”. Under the new system, Health Canada will only assess and license claims for treatment, prevention, and diagnosis of disease or conditions. Non-restorative structure function claims, non-specific health claims, and generalized health claims will be reclassified simply as “claims”. For example, a product that “promotes bone health” will be judged to be simply making a claim, not a health claim, and thus not be eligible for oversight or licensing by Health Canada. Products which are deemed to be making a health claim will be subject to the the same standard of evidence and testing as drugs, which will result in higher costs for manufacturers, increasing prices for consumers. Products which are only recognized as making a claim, which will likely include the vast majority of NHPs, will be forced to include a disclaimer on the label stating that Health Canada has not reviewed the claims or statements made by the manufacturer.
Health Canada’s response to supposed concerns about uninformed consumers and health literacy is not to make information more accessible or visible. Instead they are opting to simplify how the diverse and broad range of NHPs are regulated in a way that reinforces a binary between serious health products that make “health claims” and are “like drugs”, and natural products that merely make “claims” and lack legitimating oversight. Disclaimers on labels will deter consumers from considering NHPs as options, they will not prompt them to do further research. Currently, consumers use a product’s Natural Product Number (NPN) to look up the details of the product’s claims and evidence submitted to Health Canada. The new system will remove that source of information entirely because most products will be unlicensed, and therefore will not have to submit the level of evidence currently considered appropriate to their level of claims.
Improving health literacy and creating informed consumers is a worthy goal, but simplifying existing information is counterproductive. Consumers should be encouraged to access trustworthy information and be trusted to interpret it for themselves. By creating a more rigid standard and understanding of what it means to make a “health claim”, Health Canada is simply attempting to discredit the types of claims made by NHPs and limit consumers’ options. If this really is Health Canada’s response to a lack of health literacy and allegedly uninformed consumers, then it reveals a disturbingly paternalistic attitude towards individuals and their right to make personal choices regarding their own health and wellness.